Network Adequacy and Timely Access

Santa Clara Valley Health & Hospital  System

Network Adequacy and Timely Access - Integrated MHD and SUTS

This replaces BHSD Service Access policy 412-404 and SUTS P&P 2,3, and 4​

Policy & Procedure Manual (BHSD #7100)

Reference​ 
Policy
Standards​
Definitions

Assessment. A service activity designed to evaluate the current status of mental, emotional, or behavioral health. Assessment includes, but is not limited to, one or more of the following: mental status determination, analysis of the clinical history, analysis of relevant cultural issues and history; diagnosis; and the use of mental health testing procedures.​ 

Beneficiary. A Medi-Cal recipient who is currently receiving services from BHSD or a BHSD contracted provider.

Emergency.  A Condition or situation in which an individual has a need for immediate medical attention, or where the potential for such need is perceived by emergency medical personnel or a public safety agency (Health & Safety Code § 1797.07).

Provider.   A person or entity who is licensed, certified, or otherwise recognized or authorized under state law governing the healing arts to provide specialty mental health services and who meets the standards for participation in the Medi-Cal program as described in California Code of Regulations, title 9, Division 1, Chapters 10 or 11 and in Division 3, Subdivision 1 of Title 22, beginning with Section 50000. Provider includes but is not limited to licensed mental health professionals, clinics, hospital outpatient departments, certified day treatment facilities, certified residential treatment facilities, skilled nursing facilities, psychiatric health facilities, general acute care hospitals, and acute psychiatric hospitals. The MHP is a provider when direct services are provided to beneficiaries by employees of the Mental Health Plan.

Procedure

Attachments:

Network-Certification Checklist​
Network Adequacy Certification Tool(NACT)​
Alternative Access Standards Request Form

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