Clinical Services Department

• Provides mental health assessment, consultation, and referral services to clients/family members
• Works with residential/day program staff, other service providers, and case management staff
• Actively works with L.A. County Mental Health programs and Substance Abuse programs regarding treatment issues/barriers, and with identifying local and county  resources for clients
• Participates in team conferences/committees and reviews assessments and intervention plans completed by other providers/agencies, making recommendations and coordinating appropriate referrals/plans
• Evaluates the mental health needs of clients residing in or transitioning to specialized residential behavior homes, who are at risk for losing placement or for psychiatric hospitalization
• Provides training to residential/day program staff, other service providers, families, and regional center staff regarding mental health topics
• Participates in the following committees: BBCC, Difficult to Serve, Forensic, and in bi-monthly meetings with CBEM

Our Mental Health Policy Liaison, represents county-wide regional center agencies at the policy level. He works with county departments that have signed the memorandum of understanding (MOU) and their contractors to ensure compliance with agreements to serve individuals served by regional center and county agencies, including Department of Children & Family Services, the Department of Mental Health, the Department of Probation, and the seven LA County regional centers. Additionally, he represents and attends local mental health service area meetings, collaborative agency meetings regarding policy, and chairs the quarterly county-wide Agency MOU liaison meeting.

Our Mental Health Policy Liaison provides in-house consultation on the psychiatric hospitalization, admission, and discharge processes related to county policies.

• Developmental assessments of children under the age of three to determine functional levels of development and/or  determine the need for ongoing occupational/ physical therapy
• Consultation regarding therapy, equipment, or related service needs for clients
• Provision of resources and referral information to clients and/or their representatives related to therapy  equipment  needs
• Prepare written reports of assessments and written interdisciplinary notes documenting consultations within pre-established  guidelines
• Assessment and recommendations for therapy, adaptive devices, equipment, etc. for various Regional Center clients
• Consults with staff, doctors, clients, parents, etc.; provides training for staff, support groups, etc.
• Participates in eligibility team conferences and infant clinic.

Triages dental Referrals for the Following:

• Individuals who are known to be the most difficult to serve, including those that are medically fragile with oral health problems who no one would treat in the community
• Individuals unable to leave their home due to agoraphobia, extreme level of behaviors, have medical equipment like traches, G-tube, oxygen dependent, suction dependent, ventilator dependent or chronically ill or who will need to use a medical or ambulance to transport
• Individuals who are on gurneys, extra wide wheelchairs and with equipment that will impede care in the office, or the community dentist is limited and unable to address treatment needs due to current medical issues or morbid obesity.
• Emergency situations wherein individuals do not have a dentist 
• Insurance issues and lack of care coordination for a dental office or the hospital/surgical centers
• Treatment Plan Reviews from other dental offices

INTAKE and ELIGIBILITY

• Review all records submitted for applicants to SGPRC
• Eligibility assessments:  psychological evaluations, Early Start Clinic,  Early Start Clinic – evaluations for children under age 3.
• Lanterman eligibility – children turning 3, new intake cases
• Fifth Category Consultation – for challenging intake cases
• Review of cases for continued eligibility/ diagnostic clarification
• Eligibility appeals

• Create/review Restricted Health Conditions Care Plans (RHCCP). 
• Provide training related to the RHCCP to facilities/community programs. 
• Provide nursing assessment to determine appropriate placement for clients that have a change in condition.
• Provide nursing assessment for respite level of care.
• Provide dental and medical consents.
• Assist with physician order for life-sustaining treatment. (POLST) form as needed.
• Adult residential Facility for Persons with Special Health Care Needs (ARFPSHN) homes monitoring for compliance.
• Provide support to QAs & SCs through evaluation of cases and medical recommendations.

Under the general direction of the Director of Clinical Services, the Clinical Services Manager is responsible for the management and supervision of the Federal and Risk Management Programs, including Medicaid Waiver, Special Incident Reporting, the Clinical Services Department Clerks, Federal Programs Specialist, Medicaid Waiver Specialist, and the Health Care Support Specialist.

Additionally, the Clinical Services Manager oversees the Eligibility Coordinator and is part of the Eligibility Review Team. This position also ensures compliance with Nursing Home Reform (PASARRs) & Office of Inspector General (OIG) Claims, oversees the transition of Behavioral Health Treatment (BHT) to/from Medi-Cal Managed Care, and submits monthly reports to the Department of Developmental Services (DDS).

• Assists with the coordination, review, certification, and data entry for individuals that are eligible for enrollment in the 1915 (c) waiver programs, 1915 (i) State Plan programs, and 1915 (k) Community First Choice State Plans for HCBS provided through Medicaid (Medi-Cal).
• Supports individuals and their families with the Institutional Deeming process: educating parents on Medi-Cal under Institutional Deeming, supports with the application process, and monitors timelines.
• Assists with Nursing Home Reform programs: PASRR’s (pre-admission screening resident review) summary reports.
• Assists with the coordination of data files for individuals 21 years of age and older that are transitioning their Behavioral Health Services from Managed Care Funding to regional center funding and vice versa for children under age 21.
• Serves as a liaison with the Medi-Cal Managed Care Health Plan and with the Centers for Medicaid and Medicare (CMS).
• Supports case management with the switch of service delivery type from traditional case to SDP case.
• Track and monitor data for the Department of Social Services: dual enrollments under HCBS-DD/HCBA waivers, and 3-day specified consumer reporting and out-of-state placement.

• Maintains centralized information related to generic benefits to which regional center clients may be entitled. 
• Provides consultation and support in accessing Medi-Cal Managed Health Care benefits. This includes enrollments/disenrollments and changes in Manage Care Plans (MCP).
• Assist with questions or concerns about our most utilized generic resources.
• Supports with cases that require a review of benefits or if families are having trouble obtaining services. 
• Acts as an intermediary between SC’s and MCP liaisons.
• Schedule requested appointments by the Service  Coordinators for psychological, nutritional and Neurological  evaluations, Vision and Medical assessments.
• Maintain clinical appointment calendars for all
• Mailing an appointment letter to the parent and copy of the letter to the S/C two weeks in advance 
• Confirm appointments with parents the day before the appointment date via text.

The Intake Services Team is the initial point of contact for individuals seeking assistance, services, and/or supports from our regional center. They are responsible for evaluating eligibility for services, conducting initial assessments, and they manage the entry point into the regional center system