SB 785

About Senate Bill (SB) 785 – Service Authorization Requests

Senate Bill (SB) 785 is intended to facilitate the receipt of medically necessary Specialty Mental Health Services (SMHS) by a child, youth, or non-minor (under the age of 21), who is placed outside of their county of original jurisdiction with Adoption Assistance Program (AAP) Medi-Cal or Kinship Guardianship Assistance Payment Program (Kin-GAP) Medi-Cal. SB 785 clarifies responsibility for treatment authorizations and transfers the responsibility for the provision of services to the county of residence while keeping the financial responsibility to authorize and pay for services with the county of original jurisdiction.

To request an authorization for SMHS, the county of residence or SMHS clinic submits a Service Authorization Request (SAR) with any applicable paperwork to the county of original jurisdiction (where the child’s Medi-Cal originates).
 

EXCEPTIONS TO A SERVICE AUTHORIZATION REQUEST

The Client’s Case DOES NOT REQUIRE a Service Authorization Request, but a Notification of PRESUMPTIVE TRANSFER for SMHS

• If a client with AAP or Kin-GAP Medi-Cal is in protective custody (Children Family Services and/or Probation), then the case IS a Presumptive Transfer case.
• If the child has been in protective custody, but now has an AAP Medi-Cal aid code and is the process of being adopted, but the adoption has not yet been finalized, the case will CONTINUE being a Presumptive Transfer case until the adoption is finalized.  Once the adoption is finalized, the case will REQUIRE a Service Authorization Request due to the AAP Medi-Cal aid code. 

For more information about PRESUMPTIVE TRANSFER, please see Orange County’s Health Care Agency website entitled, “About Assembly Bill (AB 1299) – Presumptive Transfer” for more information.  Here is the hyperlink: https://www.ochealthinfo.com/bhs/about/cys/support/presumptive_transfer

For further questions regarding SB 785, please email Children and Youth Behavioral Health (CYBH) Administration at OCPresumptiveTransfer@ochca.com or call (714) 834-5015.

ADDITIONAL INFORMATION:

• ORANGE COUNTY HEALTH CARE AGENCY BEHAVIORAL HEALTH SERVICES POLICIES AND PROCEDURES – SERVICE AUTHORIZATION REQUESTS FOR OUT-OF-COUNTY MEDI-CAL BENEFICIARIES (SB785). Signed 11-02-2017.
• ORANGE COUNTY HEALTH CARE AGENCY BEHAVIORAL HEALTH SERVICES POLICIES AND PROCEDURES – ACCESS TO SPECIALTY MENTAL HEALTH SERVICES FOR OUT-OF-COUNTY BENEFICIARIES.  Signed 08/03/2016.
• DMH INFORMATION NOTICE NO.: 09-06. Released May 4, 2009.
  • Subject: DELIVERY OF MEDI-CAL SPECIALTY MENTAL HEALTH SERVICES FOR CHILDREN IN A FOSTER CARE, KIN-GAP, OR AID TO ADOPTIVE PARENTS AID CODE PLACED OUTSIDE THEIR COUNTY OF ORIGIN
  • Website:https://www.dhcs.ca.gov/services/MH/InfoNotices-Ltrs/Documents/InfoNotice09-06.pdf