Presumptive Transfer and SB785

Presumptive Transfer

Assembly Bill (AB) 1299 (Ridley-Thomas, Chapter 603, Statutes 2016) was established to presumptively transfer the responsibility for the provision of, or arranging and payment for, Specialty Mental Health Services (SMHS) in a timely manner, from the county of original jurisdiction to the county where the foster child resides. Presumptive Transfer applies to children, youth, and non-minor dependents (under the age of 21) with Medi-Cal, who are placed in foster care outside of their county of original jurisdiction in California.

The placing agency (Child Welfare Services or Probation) shall notify the county Mental Health Plan (MHP) where the foster child resides within 3-business days of the presumptive transfer decision and ensure that the foster child's residence address is updated in the Medi­-Cal Eligibility Data System (MEDS) within 2-business days of making the determination.

INFORMATION TO INCLUDE ON A NOTIFICATION OF PRESUMPTIVE TRANSFER

The county of original jurisdiction shall send a Notification of Presumptive Transfer to the county of residence that shall include the following:

a. Identifying information about the child: name, date of birth, and address;

b. Name, location, and contact information of the referring placing agency;

c. Name and contact information of who can sign releases of information;

d. Name and contact information of who can sign consents.

e. Send, or arrange to have sent to, the MHP the most recent consent for services, and consent for medication, including the JV-220; and

f. Send, or arrange to have sent to, the MHP the most recent mental health records, including the most recent mental health assessment.

EXCEPTIONS TO PRESUMPTIVE TRANSFER

Waivers from the County of Original Jurisdiction

The placing agency may decide to waive presumptive transfer on an individual, case-by-case basis only if one or more of the four exceptions listed below exists.

• The transfer would negatively impact mental health services being provided to the child or youth or delay access to services provided to the foster child;
• The transfer would interfere with the family reunification efforts documented in the individual case plan;
• The foster child’s placement in a county other than the county of original jurisdiction is expected to last less than six months; or
• The foster child’s residence is within 30 minutes of travel time to his or her established SMHS care provider in the county of original jurisdiction.
  
  A waiver processed based on an exception to presumptive transfer shall be contingent upon the MHP in the county of original jurisdiction demonstrating an existing contract with a SMHS provider, or the ability to enter into a contract with a SMHS provider within 30 days of the waiver decision, and the ability to deliver timely SMHS directly to the foster child.

Waiver Requests from Orange County Placing Agencies to Orange County MHP

• When an Orange County placing agency is requesting a waiver for Presumptive Transfer, Orange County Children and Family Services (CFS) or Orange County Probation will notify Orange County MHP by secure email (OCPresumptiveTransfer@ochca.com). Orange County MHP will determine if it already has a contract with a SMHS provider in the county of residence, or if not, Orange County MHP will then determine if a contract can be established with a SMHS provider in the other county within 30 days.
• If Orange County MHP has an existing mental health contract or if a contract with a SMHS provider in the county of residence can be established within 30 days, then the waiver request may be approved. Orange County MHP will then coordinate with CFS or Probation to ensure access to the contracted SMHS provider for the foster child, youth, or non-minor dependent in their county of residence.
• If there is not an existing contract with the requested out-of-county SMHS provider and a contract cannot be established within 30 days, the Orange County MHP will notify CFS or Probation as soon as possible, and the waiver request will be denied. Orange County CFS or Orange County Probation will then generate a Notification of Presumptive Transfer to link the child to a SMHS provider in the county of residence in a timely manner.

Exceptions to Presumptive Transfer: The Client’s Case IS a Presumptive Transfer

• If a client, who has Adoption Assistance Program Medi-Cal (AAP Medi-Cal aid codes 03, 04, 06, 07, and 4A) or Kinship Guardianship Assistance Program Medi-Cal (Kin-GAP Medi-Cal aid codes 4F, 4G, 4S, 4T, and 4W), is in protective custody (CFS and/or Probation), then the case IS a Presumptive Transfer case.
• If the client 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.

Exceptions to Presumptive Transfer: The Client’s Case IS NOT a Presumptive Transfer

• If the client does NOT have Medi-Cal, it is NOT a Presumptive Transfer case.
• If the client’s case is with Child Welfare Services and is in Family Maintenance OR if the client lives with biological parent(s), it is NOT a Presumptive Transfer case.
• If the client has AAP Medi-Cal aid codes OR Kin-GAP Medi-Cal aid codes, the client will require a Service Authorization Request (SAR) and it is NOT a Presumptive Transfer client.

For more information about SERVICE AUTHORIZATION REQUESTS, please see Orange County’s Health Care Agency website entitled, “About Senate Bill (SB) 785 – Service Authorization Requests” for more information. Here is the hyperlink: https://www.ochealthinfo.com/bhs/about/cys/support/sb785

INFORMATION ON WHAT TO DO WHEN AN ORANGE COUNTY SMHS PROVIDER RECEIVES A PRESUMPTIVE TRANSFER CASE DIRECTLY FROM THE COUNTY OF ORIGINAL JURISDICTION

There are times when an Orange County SMHS provider (County or County contract provider or STRTP) receives a Presumptive Transfer referral NOT sent by the Children Youth and Behavioral Health (CYBH) Administration, but DIRECTLY from the county of original jurisdiction (such as from a Foster Family Agency or an out-of-county mental health agency). In these cases, the Orange County SMHS provider should:

• Notify CYBH Administration as soon as possible of the notification via the AB1299 Presumptive Transfer Fax Cover Sheet by either secure email (OCPresumptiveTransfer@ochca.com) or by fax (714-834-4595).
• Request that the county of original jurisdiction’s social worker or probation officer send the Notification of Presumptive Transfer to the Orange County MHP by secure email at (OCPresumptiveTransfer@ochca.com) or by fax (714-834-4595).
• If a clinic or STRTP is having difficulty obtaining a Notification of Presumptive Transfer from the social worker or probation officer from the county of original jurisdiction, the clinic or STRTP can contact the Presumptive Transfer Point-of-Contact in that county. For an updated list of Presumptive Transfer Point-of-Contacts for Child Welfare, Probation and Mental Health, please go to the California Department of Social Services website at: https://www.cdss.ca.gov/inforesources/foster-care/presumptive-transfer/county-points-of-contact

SB 785

About 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