LAC Department of Mental Health Public Portal

	LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH
	Policy 302.14 Responding to Initial Requests for Service PROCEDURES

Responding to Initial Requests
1. If the request is made directly to a provider (e.g., call or walk-in during business hours), the request shall be handled on the same business day.
2. If the request is not made directly to a provider (e.g., after-hours voicemail, Service Request Tracking System [SRTS], or faxed referral), the request shall be handled within the following time frames:
  1. The initial request shall be reviewed within one (1) business day.
  2. An attempt to contact the requesting individual/collateral shall occur as soon as possible and in no case more than three (3) business days.
Recording Initial Requests
1. An initial request in which the potential client/representative declines an offered initial appointment in accordance with the time frames set forth in DMH Policy 302.07 and states that they instead intend to present at the provider without an appointment is considered a request for service and shall be logged with the potential client’s preference.
2. Exceptions for recording an initial request are:
  1. The requesting party does not provide sufficient information to follow up on the request (e.g., no telephone number or address).
  2. The request is for general information about services (e.g., location of provider or types of services offered).
  3. The request is clearly not mental health-related.
3. If the requesting/referring party is not the potential client/representative, the date of client agreement shall be entered in the SRL/SRTS after contacting the potential client/representative and obtaining agreement for services. a. The date of agreement will determine access to care timeframes.
Contact Attempts when Unable to Contact the Potential Client/Representative
1. At least two (2) attempts to contact (if reasonably expected to be successful) shall be made prior to recording a disposition.
2. For requests where it is determined that the client is at a higher risk (e.g., needing urgent or expedited services, hospital discharges, jail releases, DCFS referral), at least three (3) attempts shall be made prior to recording a disposition.
3. If the potential client/representative contacts the provider after the disposition has been recorded, the contact will be treated as a new request and appropriately screened and logged in the SRL/SRTS.
Screening/Triaging Initial Requests
1. All initial requests must minimally be screened via the Universal Screening questions and, if needed, triaged to determine the disposition of the request and, in some cases, whether the need for services is emergent, urgent, expedited, or routine as indicated in DMH Policy 302.07.
Inability to Accept Requests
1. Providers must notify their Service Area Program Manager III and their lead Contract Monitor (if applicable) if they can no longer accept new routine requests and must discuss whether they should continue to accept urgent, jail release, and hospital discharge requests. If the inability to serve routine requests is for an intensive program (e.g., Full Service Partnership or Wraparound), the lead for the intensive program must also be notified. The notification shall be made as soon as it is known that one (1) of the following criteria exists:
  1. Over the past three (3) consecutive months, the typical (median) wait time for a routine appointment is greater than 15 business days AND the percentage of initial appointments offered within 10 business days is less than 60%; OR
  2. Over the past three (3) consecutive months, the typical (median) wait time for a routine appointment is greater than twenty (20) business days.
  3. At any point, the typical (median) wait time for a routine appointment is greater than two (2) months.
2. At the point when it is agreed upon with the Service Area Program Manager III/Contract Monitor that a provider will not accept new requests, the provider must immediately update the Network Adequacy: Provider and Practitioner Administration (NAPPA) application to reflect that they are no longer accepting new clients.
3. Providers shall rarely refuse a client an assessment and/or turn a client away. They may only refuse to provide clients with specific services that they are certified to provide after having completed an assessment of the client and with appropriate clinical justification.
4. Providers shall only impose limitations on services based upon community standards of care including professional ethical standards. Any policies or procedures that may lead to refusal of services shall be discussed with the Service Area Program Manager III, Lead Contract Manager, or the Quality Assurance Unit.
5. If a provider is unable to serve a potential client within the time frames specified in DMH Policy 302.07, the initial request may still be served by the provider if it is the potential client’s preference to stay with the provider and accept the appointment at the extended time frame.
  1. a. If the client wishes to be referred elsewhere, the provider must contact another provider prior to transferring the request via (6)(c)(i) below to ensure they are able to provide an appointment sooner than the appointment by the original provider.
6. If a provider is unable to serve a potential client due to a justifiable reason, the initial request shall be transferred to an appropriate service provider using the DMH Provider Directory or Service Area Navigator within one (1) business day. Examples of justifiable reasons include:
  1. Provider is at capacity as identified in E.1;
  2. Provider does not serve the potential client’s age group; and
  3. Provider is not within the time and distance standards as identified in DMH Policy 302.07 (provided the potential client does not prefer an alternate location).
    1. The provider shall record the request in the SRTS to transfer the request to an appropriate provider/Service Area navigator or, if a provider is able to secure an appointment at another provider and provide the appointment date/time to the potential client, the request shall be logged into the SRL, identifying the referred-to provider as the appointment location.
7. If a provider is unable to serve a potential client, who is a Medi-Cal Beneficiary, timely or denies services, a Notice of Adverse Benefit Determination (NOABD) shall be issued in accordance with DMH Policy 200.04.