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Community Services > Mental Health > Policies and Procedures

Policies and Procedures

TABLE OF CONTENTS
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 Document Title

 Eff. Date

 Last Rev.

Table of Contents    01/28/2010
 Administration    
AD01 - Policy and Procedure Review  09/01/2001  07/09/2009
AD03 - Drug Free Workplace  09/01/2001  
AD04 - Payment Process & Fiscal Accountability   09/01/2001  12/15/2009
AD05 - Sliding Fee Scale   09/01/2001  
AD06 - Consumer, Family, Advocate Education & Training Fund  09/01/2002  12/28/2006
AD07 - Disaster Planning  09/01/2004 07/27/2009
AD08 - Mental Health Advisory Board  09/01/2001  06/23/2009
AD09 - Financial Eligibility for RSN Services  11/04/2005  05/03/2006
AD09-A - Statement of Income Eligibility - Form  11/04/2005  04/02/2009
AD10 - Allied Systems Coordination  11/04/2005  
AD11 - Management Report Certification  11/01/2005  
AD12 - PACT Stakeholder Advisory Committee  07/01/2007  08/21/2007
 Care Management    
CM02 - Utilization Management Plan  09/01/2004  11/15/2005
CM02-A - Utilization Management Plan  09/04/2004  11/23/2005
CM03 - Notice of Action  11/01/2004  02/04/2009
CM03-A - Notice of Action Form  09/01/2004  01/30/2009
CM03-B - Notice of Determination  11/01/2004  01/30/2009
CM04 - Authorization for Services  09/01/2001  11/23/2005
CM05 - Single Bed Certification  10/01/2005  
CM05-A - Single Bed Certification Request Form  10/01/2005 04/02/2009
CM06 - Intensive Element of Care Authorizations and Reauthorization/Change in Element of Care  07/01/2002  12/28/2006
CM07 - Eligibility Criteria & Access to Care Standards - Adult  09/01/2001  12/06/2005
CM07-A - Authorization for AC Standards - Adult 11-25-03  09/01/2001  11/15/2005
CM08 - Eligibility Criteria & Access to Care Standards - Child  01/01/2002  12/06/2005
CM08-A - Authorization for AC Standards - Child/Youth 11-25-03  09/01/2001  11/15/2005
CM09 - Involuntary Treatment Services  11/01/2005  
CM10 - Ancillary Crisis Services  11/01/2005  
CM11 - Functional Assessment - Adults  09/01/2001  09/01/2004
CM12 - Functional Assessment - Child  09/01/2001  09/01/2004
CM13 - Intake and Mental Health Assessment  09/01/2001  11/15/2005
CM14 - Referral & Authorization into PACT Programs  07/01/2007  
CM16 - Coordination of Care with Primary Care Physicians & Other Health Care Providers  11/17/2005  
CM17 - Out of Network Referrals  11/01/2004  08/18/2009
CM17-A - Facilitated Referral - Form  09/01/2004  
CM18 - Inpatient Services - Concurrent Review  09/01/2001  02/01/2005
CM19 - Inpatient Services - Authorization  09/01/2001  12/09/2008
CM19-A - Psychiatric In-Patient Covered Diagnosis  09/01/2001  09/01/2004
CM19-B - Authorization Triage - Form  09/01/2001  01/26/2009
CM19-C - Psychiatric Consultation and Expedited Review  09/01/2001  01/26/2009
CM19-D - Inpatient Voluntary Authorization Extension Form   03/24/2009
CM21 - Inpatient Services - Appeal of Denial  09/01/2001  01/01/2005
CM22 - Adult Congregate Care Placement  09/01/2001  06/01/2005
CM23 - Adult Congregate Care Screening & Wait List  09/01/2001  09/01/2004
CM24 - Adult Residential Rehabilitation Center Placement  09/01/2001  06/01/2005
CM25 - Adult Residential Rehab. Center Screening & Wait List  09/01/2001  09/01/2004
CM26 - Authorization for Adult Crisis Beds  09/01/2001  
CM27 - Transfer of Care  02/01/2003  05/02/2003
CM27-A - Clark County Children's Service Providers - Form  05/01/2003  09/01/2004
CM28 - Crisis Plans  01/01/2003  04/27/2003
CM29 - Respite Services  04/01/2004  11/22/2005
CM30 - Mental Health Medicaid Personal Care Funds for Adults  10/01/2003  11/22/2005
CM30-A - Consumer Rights and Responsibilities for Mental Health Funded Medicaid Personal Care Services Reimbursed by the Clark County Regional Support Network - Form  10/01/2003  
 Consumer Rights and Responsibilities    
CR01 - Consumer Rights & Responsibilities  09/01/2001  11/17/2005
CR02 - CCRSN Funded Ombuds Service  07/01/2002  05/25/2006
CR03 - Consumer Complaints and Grievances  09/01/2001  08/17/2005
CR03-A - Complaint & Grievance - Form  09/01/2001  07/20/2004
CR03-B - Grievance Acknowledgement - Sample Form Letter  09/01/2004  
CR03-C - Grievance Resolution - Sample Form Letter  09/01/2001  11/21/2005
CR04 - Advance Directives  09/01/2001  02/04/2009
CR05 - Consumer Rights to an Administrative Hearing  09/01/2004  06/05/2007
CR06 - Consumer Rights to Appeal  11/01/2004  06/05/2007
CR07 - Request for Second Opinion  11/01/2004  05/01/2005
CR08 - Long Term Care Rights for Consumers in Resid. Facilities  09/01/2001  06/01/2005
 Quality Management and Improvement    
QM01 - Quality Management Program  09/01/2001  
QM02 - Quality Management Committee  09/01/2001  
QM03 - Quality Review Team  07/01/2002  03/18/2003
QM04 - Fraud and Abuse  07/01/2004  07/01/2005
QM04-A - Fraud and Abuse Compliance Plan  07/01/2004  07/01/2005
QM05 - Element of Care Clinical Guidelines  09/04/2002  08/01/2006
QM05-A - Levels/Elements of Care Clinical Guidelines  09/04/2002  08/01/2006
QM06 - Evidence Based Practices/Practice Guidelines  07/01/2004  11/20/2006
QM07 - Cultural Competence  09/01/2001  
QM07-A - Cultural Competence - Clinical Practice Standards  09/01/2001  
QM08 - Recovery Vision  09/01/2001  11/15/2005
QM09 - Access Standards  09/01/2001  11/17/2005
QM10 - Wait List  09/01/2001  09/01/2004
QM11 - Individualized Tailored Care  09/01/2001  
QM12 Treatment Plans  09/01/2001  03/18/2002
QM13 - Employment Services and Resources  09/01/2001  01/13/2009
QM14 - Vulnerable Adult Abuse and Reporting  09/01/2004  
QM15 - Child Abuse & Reporting  09/01/2001  
QM16 - Consumer Satisfaction  09/01/2001  
QM17 - Case Review  09/01/2001  11/17/2005
QM18 - Sentinel Event Review and Negative Medical Coverage  09/01/2001  11/16/2005
QM18-A - Sentinel Event Report - Form  09/01/2001  11/16/2005
QM18-B - Sentinel Event 30 Day Standard Review - Form  09/01/2001  11/16/2005
QM-18-C - Report to WA MHD Negative Media Event - Form  11/16/2005  
QM19 - Provider Agency Credentialing & Clinician Profiling  09/01/2001  10/28/2004
QM19-A - Credentialing Application - Form 09/01/2001  09/01/2004
QM19-B - Practitioner Credentialing Report  09/01/2004  02/11/2009
QM20 - Washington State Patrol/FBI Background Check  07/01/2002  09/01/2004
QM20-A - Fingerprint Acknowledgement Form  07/01/2002  05/01/2003
QM21 - Clinical & Administrative Record Review  09/01/2001  11/18/2005
QM22 - Provider Complaint and Grievance  09/01/2001  
QM23 - Availability of Services  11/01/2004  02/10/2009
QM24 - Housing Services and Resources  09/01/2001  12/18/2007
QM25 - Practitioner Credentialing  09/01/2001  12/18/2009
QM25-A - Practitioner Credentialing Report Form  09/01/2001  11/10/2009
QM26 - Public Awareness of Mental Health Services  09/01/2001  11/15/2005
QM27 - Involuntary Treatment Services: Less Restrictive Alternative (LRA) and Conditional Release (CR) Monitoring  06/01/2007  
 Glossary of Terms and Acronyms    
Glossary of Terms  09/28/2004  

Clark County Community Services: Vanessa R. Gaston, Director
Street address: 1601 East Fourth Plain Boulevard, Suite C214, Vancouver, WA 98661
Mailing address: P.O. Box 5000, Vancouver, WA 98666-9810
Main phone: (360) 397-2130 | FAX: (360) 397-6028
E-mail: Community.Services@clark.wa.gov
Community Services Fraud and Abuse Hotline
The Fraud and Abuse Hotline number is (360) 397-8030 and is for the reporting of suspected fraud or abuse related to payment for services. Messages may be left anonymously. To speak directly with the Department Compliance Officer, call (360) 397-2075 ext. 7840.
Responsible Elected Official: Board of Clark County Commissioners

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