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Division of Behavioral Health Services

Policy and Procedures Manual

Clinical Operations (CO)
Section Title Effective Date
CO 1.1 Inter-RBHA Coordination of Services 01/15/10
CO 1.2 Cultural Competency 03/01/09
CO 1.3 Use of Telemedicine 03/01/10
CO 1.4 Confidentiality 12/01/10
CO 1.5 Family and Youth Involvement in the Children's Behavioral Health System 11/15/10

Quality Management/Monitoring (QM)
Section Title Effective Date
QM 2.1 Medical Care Evaluation Studies 10/15/12
QM 2.2 Showing Report 10/15/12
QM 2.3 Behavioral Health Recipient Satisfaction Survey 06/15/11
QM 2.4 Reporting and Monitoring the Use of Seclusion and Restraint
 09/15/09
QM 2.5 Reporting of Incidents, Accidents and Deaths 01/15/10
QM 2.6 Peer Review 07/01/12
QM 2.7 Quality of Care Concerns 07/01/12
QM 2.8 Technology 10/15/11
QM 2.9 Concurrent Review for Hospitalizations 11/01/11
QM 3.0 Retrospective Review 11/01/11

Section Title Effective Date
Grievance/Appeals (GA)
GA 3.1 Conduct of Investigations Concerning Persons with Serious Mental Illness  05/14/10
GA 3.2 Contractor and Provider Claims Disputes 07/01/12
GA 3.3 Title XIX/XXI Notice and Appeal Requirements 07/01/12
GA 3.4 Special Assistance for Persons Determined to have a Serious Mental Illness
 12/01/10
GA 3.5 Notice and Appeal Requirements (SMI and NON-SMI/NON-TITLE XIX/XXI) 05/14/10
GA 3.6 Complaint Resolution 10/15/12
GA 3.7 Reserved
GA 3.8 Disclosure of Confidential Information to Human Rights Committees  08/15/08

Section Title Effective Date
Miscellaneous (MI)
MI 5.1 ADHS/DBHS Division Document Development, Maintenance, and Dissemination 06/15/11
MI 5.2 Community Service Agencies - Title XIX Certification 03/01/13
  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  
  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) 03/01/13
MI 5.4 Reserved  
MI 5.5 Arizona State Hospital 07/01/10

Policy and Procedures Manual Definitions

Change Notices to Policy Manual Holders
2012-2013 2010-2011 2009-2008 2007-2006

ADHS/DBHS Policy Clarification Memorandums


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