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Division of Behavioral Health Services

Policy and Procedures Manual

Clinical Operations (CO)
Section	Title	Last Revision Effective Date
CO 1.1	Inter-RBHA Coordination of Services	01/15/2010
CO 1.2	Cultural Competency	03/01/2009
CO 1.3	Use of Telemedicine	03/01/2010
CO 1.4	Confidentiality	12/01/2010
CO 1.5	Family and Youth Involvement in the Children's Behavioral Health System	11/15/2010

Quality Management/Monitoring (QM)
Section	Title	Last Revision Effective Date
QM 2.1	Medical Care Evaluation Studies	07/15/2010
QM 2.2	Showing Report	07/15/2010
QM 2.3	Behavioral Health Recipient Satisfaction Survey	06/15/2011
QM 2.4	Reporting and Monitoring the Use of Seclusion and Restraint	09/15/2009
QM 2.5	Reporting of Incidents, Accidents and Deaths	01/15/2010
QM 2.6	Peer Review	10/01/2010
QM 2.7	Quality of Care Concerns Attachment 1 - Quality of Care Concern Acknowledgement Letter – T/RBHA to ADHS/DBHS Attachment 2 - Quality of Care Concern Response Letter – T/RBHA to ADHS/DBHS	10/01/2010
QM 2.8	Technology	10/15/2011
QM 2.9	Concurrent Review for Hospitalizations	11/01/2011
QM 3.0	Retrospective Review	11/01/2011

Grievance/Appeals (GA)
Section	Title	Last Revision Effective Date
GA 3.1	Conduct of Investigations Concerning Persons with Serious Mental Illness	05/14/2010
GA 3.2	Contractor and Provider Claims Disputes	09/15/2009
GA 3.3	Title XIX/XXI Notice and Appeal Requirements	04/01/2011
GA 3.4	Special Assistance for Persons Determined to have a Serious Mental Illness	12/01/2010
GA 3.5	Notice and Appeal Requirements (SMI and NON-SMI/NON-TITLE XIX/XXI)	05/14/2010
GA 3.6	Complaint Resolution	01/15/2010
GA 3.7	Reserved
GA 3.8	Disclosure of Confidential Information to Human Rights Committees	08/15/2008

Miscellaneous (MI)
Section	Title	Last Revision Effective Date
MI 5.1	ADHS/DBHS Division Document Development, Maintenance, and Dissemination	06/15/2011
MI 5.2	Community Service Agencies - Title XIX Certification	04/01/2008
	Attachment 1 - Title XIX Certification Initial Application
	Attachment 2 - Title XIX Certification Renewal Application
	Attachment 3 - Title XIX Certification Application Amendment
	Attachment 4 - Direct Service Staff/Contractor Reference Form
	Attachment 5 - Community Service Agency Criminal History Affidavit
	Attachment 6 - Self Declaration of Criminal History
	Attachment 7 - Notice of Deficiency
	Attachment 8 - Community Service Agency Title XIX Certificate
	Attachment 9 - Community Service Agency Daily and Monthly Clinical Record Documentation Form
	Attachment 10 - Intent to Contract Form
MI 5.3	Pre-Admission Screening and Resident Review (PASRR)	09/01/2010
MI 5.4	Reserved
MI 5.5	Arizona State Hospital	07/01/2010

Policy and Procedures Manual Definitions

Change Notices to Policy Manual Holders
2010-2011	2009-2008	2007-2006	2005-2004
November 1, 2011 June 15, 2011 April 1, 2011 December 1, 2010 November 15, 2010 October 1, 2010 September 1, 2010 July 15, 2010 July 1, 2010 March 1, 2010 January 15, 2010	September 15, 2009 July 1, 2009 April 1, 2009 March 1, 2009 December 15, 2008 September 15, 2008 July 15, 2008 May 15, 2008 May 1, 2008 April 1, 2008	October 1, 2007 July 1, 2007 May 15, 2007 January 1, 2007 October 1, 2006 September 1, 2006 July 1, 2006 June 1, 2006	November 1, 2005 October 15, 2005 August 12, 2005 February 16, 2005 July 29, 2004 June 22, 2004 April 6, 2004 February 13, 2004 January 22, 2004

ADHS/DBHS Policy Clarification Memorandums

Note: Information provided in PDF files, unless otherwise indicated.