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Policies and Procedures
Title
Link
45.04 Jail Diversion Juvenile
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45.01 Jail Diversion
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44.15 MI CCBHC Demonstration Handbook V1.5 (2.8.23) final
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44.14C POC testing result form
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44.14B New Client MAT Referral
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44.14A Existing Client MAT Referral
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44.14 MAT Policy 1.31.23
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44.10 Clozaril Medication Guidelines 1.31.23
Download
44.08C Sedative Agreement
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44.08B Benzo Agreement
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44.08 Guidelines for Prescribing Controlled Substances 1.31.23
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44.07 Administration of Medications 1.31.23
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44.06B Medication Disposal Record 1.31.23
Download
44.06A Refridgerator Temperature Log 2.17.23
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44.06 Medication Storage_Retention_Disposal 1.31.23
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44.05 Health Screens 1.31.23
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44.04 Psychiatric Nursing Standards of Care 1.31.23
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44.03 Pharmacotherapy 1.31.23
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44.01 Guidelines to Psychiatric Care 1.31.23
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43.10 Substance Abuse Prevention
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43.08 Substance Abuse Treatment for Minors 1.2023
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43.07 Admission Criteria and Intake Procedures SUD
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43.06 Fetal Alcohol Spectrum 1.2023
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43.05 Professional Development Plans
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43.04 MIChild and SA Treatment 1.2023
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43.03 Communicable Disease
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43.02 Woman Specialty Services 12 10 21
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43.01 Substance Abuse Treatment 1.2023
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42.05 Family Driven Youth Guided
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42.04 Autism Services 12 10 21
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42.02 Children and Adolescent Minors 1.2023
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41.02 Emergency Services Follow Up
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41.01 Emergency Services
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40.04 Guardianship Process Persons with IDD 1.2023
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40.02 Coordination of Health Care 1.31.23
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36.07 Customer Records Management 2 6 23
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36.06 Scanned Documents
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36.06 Exhibit A
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36.06 Customer Record Organization
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36.05 Social Security Documentation
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36.02 Clinical Documentation
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36.01 Approved Abbreviations_Symbols for Records
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34.03 Transition Planning 1.2023
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34.02 Integrated Discharge Summary 1.2023
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34.01 Change in Type of Treatment 1.2023
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45.06B Parent Consent Form 12 10 21
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45.06A E Grams Narritive Data 12 10 21
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45.06 Youth Intervention Screening 12 10 21
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45.06 C SCREENER BROCHURE revised copy 2021 12 10 21
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45.05 Adolescent Recovery Court
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31.20 LOCUS and Fidelity Interrater Reliability
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31.19D Behavioral Hierarchy and Case Presentation
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31.19B Behavior Treatment Review Guidelines
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31.19A MDCH MH_SA Technical Requirement for Behavior Treatment Plan Review Committees
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31.19A MDCH MH_SA Technical Requirement for Behavior Treatment Plan Review Committees FY19
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31.19 Behavior Treatment Review Committee
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31.18 Management of Behavioral Emergency.doc
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31.15 Co occurring SA Procedure 1.2023
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31.10 Independent Faciliation
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31.09 Self Determination
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31.08 Wellness & Recovery 1.2023
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31.07 Fostering Recovery 1.2023
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31.05 Consistency and Choice in Coordinating Providers
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31.01 Clinical Practice Guidelines
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30.10D Family Guide to Involuntary Hospitalization
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30.10C Supplemental Petition to Application for Hospitalization and Order for Examination (PCM 208a)
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30.10B Clinical Certificate PCM 208
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30.10A Petition_Application for Hospitalization (PCM 201 3 19)
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30.10 Involuntary Services
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30.09 Enhanced Services Entrance Criteria 12 10 2021
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30.08 Eligibility for Specialized Services and Supports
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30.07 Service Eligibility Determination 2.13.23
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30.06 Plan Coverage Eligibility Determination
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30.05 COFR Access Agreements
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30.03A Vulnerable Adult Protocol for St. Joseph County Revised March 2016
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30.03 Vulnerable Adult Protocol
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30.02A Waiting List Placement Letter Template 2.13.23
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30.02 Waiting List 2.13.23
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30.01 Access to Behavioral Health Services
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33.02 Individualized Tx Planning Substance Abuse 1.2023
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33.01A MDCH Person Centered Planning Policy and Practice Guideline
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33.01 Person Centered Planning Process
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24.02 Complaint Investigation Resolution 12 10 21
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24.01 Abuse and Neglect 5 26 22
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24.21 Comprehensive Examination
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24.20 Services Suited to Condition
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24.19 Treatment by Spiritual Means
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24.18 Substance Abuse_Recipient Rights
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24.17 Sterilization_Abortion_Contraception
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24.16A Recipient Rights Complaint Form
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24.16 Staff Recipient Rights Responsibilities
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24.15 Seclusion and Restraint for Recipients 12 10 21
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24.14 Residential_Space Allocations for Customers
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24.13 Residential_Day Program Customer Rights
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24.12 Recipient Rights Advisor
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24.11 Office of Recipient Rights
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24.10 Informed Consent 7 19 2022
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24.08B Consent to Audio and Video
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24.08A Authorization for Release of Information
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24.08 Fingerprints_Photographs_Audio 7 20 22
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24.07 Financial Exploitation Protection
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24.06 Family Rights
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24.05 Dignity_Respect for all Recipients 5 26 22
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24.04 Contraband
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24.03A Consent_to_Share_Behavioral_Health_Information_for_Care_Coordination_Purposes1
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24.03 Confidentiality and Release of Information 1 30 23
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18.21 CCBHC Sliding Fee Scale Program
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10.02 Complaint and Investigation Process
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10.01A Corporate Compliance Program
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10.01 Corporate Compliance
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10.03 Compliance Program Reports to Management and Board
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10.02C Investigation Template
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10.02B Compliance Violation Reporting
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10.02A Compliance Posting
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08.10 Advance Payments and Reimbursements 1 31 2023
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08.02A Claims Denial Letter 2 1 2023
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08.02 Claims Management 2 2 2023
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08.01 ABILITY TO PAY 1 30 2023
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08.11 Model Payment 1 31 2023
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07.04 Record Retention and Disposal
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07.02 Health Information Security
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06.06 Advance Directives
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06.05B Action Notice Non Medicaid
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06.05A Action Notice Medicaid
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06.05 2nd Opinion Greivance and Appeal
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06.04A Accommodation Request
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06.04 Accessibility and Accommodations
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06.03 Limited English Proficiency
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06.02 Cultural and Linguistic Competency
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06.01 Customer Services
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07.14 Information Management
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03.07E CMHSAS SJC Property and Staff Incident Report Form
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03.07D Emergency Use of Physical Management
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03.07C Recipient Death Report
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03.07B DHHS Incident Accident Report
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03.07A Incident Report Recipient
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03.07 Incident Reporting 8 11 22
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03.06A Employee Recommendation for Improvement Form
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03.06 Employee Recommendation for Improvement
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03.04A Stakeholder Input Methods and Sources 1.30.2023
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03.04 Stakeholder Input 1.30.2023
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03.03 Performance Indicators 1.31.23
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03.01 Quality Management 1.31.23
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2.12 Clinical Qualifications
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2.12 A Clinical Qualifications Tree
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2.05A PC Application updated 07 30 2020
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02.12 Notification of Change in Network
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02.11 Subcontracting
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02.10D Stipend Voucher
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02.10C Stipend Rates
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02.10B Application for CAC Membership
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02.10A Committee Participation Interest Form
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02.10 Stipends to Persons Served and Family Members
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02.09A Staff Competency Training
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02.09 Training Requirements
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02.08B Provider Monitoring Review Process
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02.08A Provider Monitoring Matrix
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02.08 Provider Network Monitoring
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02.07 Exclusion from Participation in the Provider Network
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02.06 Credentialing Organizational Providers
Download
02.05A PC Application for CMHSAS SJC
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02.05 Credentialing Individual Providers
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02.04D Form Letter for Sanction Level 3
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02.04C Form Letter for Sanction Level 2
Download
02.04B Form Letter for Sanction Level 1
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02.04A Provider Sanctions Actions Communication and Authority
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02.04 Provider Contract Compliance
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02.03 Addition of Off Panel Providers
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02.02A Provider Appeal Process (non clinical) Flow Chart
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02.02 Provider Grievance and Appeals
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02.01b Purchase Request Form
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02.01A Procurement Documentation
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02.01 Procurement of Services 2 2 2023
Download
4.02 LOCUS SIS CAFAS ASAM Cross Walk 12 10 2021
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04.01 Utilization Management 1.26.2023
Download
03.08 Recipient Death_Sentinel Event Reporting
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03.07F Definitions Related to Incidents and Events
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