LOS ANGELES COUNTY
DEPARTMENT OF MENTAL HEALTH
  Policy 312.01 Clinical Termination of Mental Health Services
 
  PROCEDURES
  1. CLINICAL TERMINATION WITH THE CLIENT PARTICIPATION:
    1. Review the clinical record.
    2. Consult with the supervisor, treatment team, and, if needed, the program manager.
    3. Review criteria for clinical termination.
    4. Meet with the client to discuss termination; the discussion shall include the following:
      1. ​​​​​​​The rationale for a recommendation of termination;
      2. The client's response to the recommendation;
      3. A reasonable timeframe for the termination of services;
      4. Appropriate referrals; and
      5. Complete NOABD electronically through IBHIS.
    5. Complete a Discharge Progress Note in collaboration with the client and enter it in the client's clinical record. The Discharge Progress Note shall include the following elements:
      1. ​​​​​​​A brief treatment summary;
      2. A status update on the client's progress toward treatment objectives;
      3. Referrals provided (if applicable);
      4. Reason for termination of services;
      5. Follow-up plans (if applicable); and
      6. Other pertinent information, such as whether medication was provided upon termination.
    6. Deactivate Primary Program of Service in client's record in IBHIS.
      1. ​​​​​​​NOTE: Primary Program of Service practitioner shall deactivate all current Client Practitioner assignments
  2. UNILATERAL TERMINATION:
    1. ​​​​​​​Service providers shall attempt to re-engage inactive clients via phone, letters, telehealth, and/or field visits. Document all attempts to re-engage client.
      1. ​​​​​​​Issue an Outreach and Engagement letter notifying the client of potential termination due to inactivity. Include linkage materials, Mental Health Urgent Care facilities, local mental health clinics, local hospitals, and other information which is provided in the Welcome Package.
      2. If contact attempts are unsuccessful, the client's record shall be deactivated.
      3. An NOABD shall not be issued since client has terminated treatment by not engaging.
        1. ​​​​​​​NOTE: Client may re-engage in services at any point in the future.
    2. The program manager may consult with the Patients' Rights Office.
    3. If clinical risk issues are identified, the Program Manager shall:
      1. ​​​​​​​Notify Service Area Program Manager III;
      2. Consult with Clinical Risk Management (CLRM);
      3. CLRM may consult with County Counsel if needed.