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North Sound Mental Health Administration

Improving the mental health and well being of individuals and families in our communities
A Regional Support Network for Island, San Juan, Skagit, Snohomish & Whatcom Counties.
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Numbered Memorandums

2010 | 2009 | 2008 | 2007 | 2006 | 2005 | 2004

2010
Memo No.  Description      Issue Date
2010-001 Memo regarding recommendations from October 2009 Quality Management Oversight Committee along with two (2) attachments - Target Symptoms & Decision Tree Policy 1577.00 - Minor revision specifying in header "Providers that must have policy consistent with"   1/7/2010
2010-002 Revised and approved Clinical Guidelines   1/29/2010
2010-003 Expedited Policy 1576.00 - Medicaid Personal Care Policy (MPC)   2/1/2010
2010-004 Revised Policies/Documents 1009.00 - CIRC Reporting & Review Requirements-CIRC Quality Assurance & Improvement Process 1502.00 - Accessibility Engagement Utilization of Services for High Need 1508.00 - Clinical Practice Guidelines 1562.00 - Monitoring of Less Restrictive Orders 1721.00 - Medical Status Criteria for Crisis ITA Assessments NSMHA Critical Incident Reporting Form New Policy 1578.00 - Western State Hospital Admission Screening   2/3/2010
2010-005 Updates regarding Numbered Memorandum 2009-026 CA/LOCUS Numbered Memorandum 2010-001 PIP   2/8/2010
2010-006 NSMHA CIS Data Dictionary Update   2/24/2010
2010-007 Policy 1520.00 - Second Opinion Policy has been through the final approval stages and is ready for implementation   4/7/2010
2010-008 Performance Improvement Project (PIP) Update   4/20/2010
2010-009 Suspension until further notice of contract deliverable regarding Quality Management report integrating all quality management program activities and data...   5/11/2010
2010-010 The following policies have been through the complete review/approval process: Policy 1532.00 - Residential Placement Policy 1542.00 - Evaluation and Treatment Facilities (E&T) Admission Medical Clearance Criteria Policy 1543.00 - Nursing Assessment for Consumers at Evaluation and Treatment Facilities Policy 1550.00 - Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services Policy 1557.00 - Safety Policy Policy 1563.00 - Program of Assertive Community Treatment (PACT) Policy 1567.00 - Early Intensive Outpatient Program (IOP) for Adults Policy 1577.00 - Evaluation and Treatment Facilities Refusal and Review Process Policy 1716.00 - Accessing Developmental Disability (DD)/Mental Health (MH) Crisis Support Services   6/17/2010
2010-011 Revised Policy 1720.00 Administration of the Involuntary Treatment Program   7/1/2010

2009
Memo No.  Description   Issue Date
2009-001 Revision and final approval of the following policies/attachments: Policy 1001.00 - Complaint, Grievance, Appeal, Fair Hearing and Notice - General Policy Requirements Policy 1002.00 - Complaint and Grievance Policy 1003.00 - Appeal Policy 1004.00 - Fair Hearing Policy 1547.00 - Customer Service Policy 1562.00 - Monitoring of Less Restrictive Orders Policy 1570.00 - Children's Short-Term High Intensity Services (STHIS) and Attachment 1570.01 - STHIS Access Flow Chart Attachment 1570.02 - STHIS Coordination for Family Members of STHIS Attachment 1570.03 - Questions for Coordination for Family Member of STHIS Clients   2/5/2009
2009-002 New/Revised Policies NEW Policy 1545.00 - Voluntary Hospital Certification - Tribal Community Members REVISED Policy 1511.00 - Choice or Change of Mental Health Care Provider (MHCP) Policy 1563.00 - Program of Assertive Community Treatment (PACT)   2/27/2009
2009-002-2 Policy 1563.00 - Program of Assertive Community Treatment (PACT) The attached policy should have been the one sent with Numbered Memorandum 2009-002. We apologize for the error and any inconvenience this may have caused. Please refer to that memorandum for details. Please be advised the new signature/effective date is 3/18/09.   3/18/2009
2009-003 Discontinuing requirement of LKO to call VOA Access line for individuals served in the Children/Youth Short-Term High Intensity Program serving Snohomish County   3/13/2009
2009-004 Policy 6001.00 - NSMHA 7.01 Plan (working document) updated 3/19/09   3/20/2009
2009-005 Contract Expectation/Requirement for services to consumers at all Levels of Care   3/30/2009
2009-006 Change in Contract Requirement for "mental health services in a residential setting" from July 1, 2009 through June 30, 2009   4/3/2009
2009-007 Policy 1009.00 - revised to contain consistent language with DSHS along with updated corresponding forms Policy 1021.00 - Changed from Clinical Policy 1554.00 and re-numbered to an Administrative Policy   4/9/2009
2009-008 Revised Policy 1541.00 - Rationale Use of Seclusion and Restraint at E&T   4/10/2009
2009-009 Amendment to NM 2009-006 - Change in Contract Requirement for "mental health services in a residential setting".   4/13/2009
2009-010 Policy 4504.00 - Functional Independence (Ombuds) has been reviewed and revised   4/29/2009
2009-011 Policy 1546.00 - Reviewed and/or revised 4/22/09 - signed and effective 5/6/09   5/6/2009
2009-012 Reviewed/revised fiscal Policy 3046.00 - Flex Funds   5/15/2009
2009-013 Revised Denial Review Request Form   5/26/2009
2009-014 Revised Policies: Policy 1574.00 - State Only Funding Plan - Mental Health Services Policy 1701.00 - Crisis Stabilization Standards for Adults NEW Policies: Policy 1575.00 - Evaluation & Treatment Facility Authorization Policy 1576.00 - Medicaid Personal Care (MPC)   5/29/2009
2009-015 Revised Policy 1705.00 - Domestic Violence Referral - accompanying attachments   7/1/2009
2009-016 Updated Single Bed Cert Form   7/1/2009
2009-017 Mental Health Professional (MHP) and Mental Health Specialist (MHS) Qualifications form   7/20/2009
2009-018 Revised ICRS Contact Sheet - effective immediately   7/20/2009
2009-019 Revised/Reviewed Policy Policy 1005.00 - Notice Requirements   7/28/2009
2009-020 Updated Single Bed Cert Form   8/4/2009
2009-021 Revised Capitation Payment   8/18/2009
2009-022 Reviewed/Revised Policies Policy 1704.00 - Crisis Services - General Policy Policy 5501 - Utilization Review of Outpatient Services   8/28/2009
2009-023 New Policy Policy 1577.00 - Evaluation & Treatment Facilities Refusal & Review Process   9/15/2009
2009-024 Revised Crisis Contact Sheet   9/29/2009
2009-025 Clarification for Policy 1577.00 Regarding section E in this policy, NSMHA would like to clarify that the E&T staff shall notify NSMHA of any refusals of admission to the E&T for any cases that are considered disputed refusals.   10/1/2009
2009-026 Policy 1009.00 - Critical Incicent Reporting and Review Requirements - Critical Incident Review Committee (CIRC) Quality Assurance and Improvement Process NSMHA Critical Incident Report Form The Policy and Critical Incident Report Form were fast tracked to incorporate new contract language requirements Addendum to CA/LOCUS Traning Plan The addendum should outline the data you plan to provide to NSMHA on a quarterly basis to substantiate inter-rater reliability is being achieved within your agency. Agencies may revise their original training plans beyond the new data submission requirement if needed, but any modifications are subject to approval by NSMHA.   10/19/2009

2008
Memo No.  Description   Issue Date
2008-001 Revised policy 1549.00 & 1565.00 2006-07 Regional Training Plan   1/10/2008
2008-002 Revised QMC/QMOC Policy Subcommittee Charter   1/17/2008
2008-003 Finalized/Reviewed Policies Policy 1508.00 - Clinical Practice Guidelines - Reviewed - no changes made - signed with new signature date Policy 1703.00 - Duration of Crisis Services - Approved through all committees and signed Policy 1707.00 - Crisis System Clinical Dispute Resolution - Approved through all committees and signed   1/28/2008
2008-004 Revised Attachment 1704.01 to include "Marty Law" information   2/13/2008
2008-005 New Policy 1568.00 and accompanying attachments (01-03)   2/14/2008
2008-006 Final for policies and attachments 1509.00 1510.00 & 1510.01 1532.00 1566.00 &1566.01 1572.00 1706.00   3/3/2008
2008-007 Revised 1534.01 - Single Bed Certification Fax Form Capacity Process Regarding Contractual Requirements   3/21/2008
2008-008 Attachments 1572.01 & 1572.02 - Invalid, incorporated in policy Revised Policies 1505.00 - Authorization for Ongoing Outpatient Services 1516.00 - Minimum Requirements and Certification Processes for Requesting Mental Health Professional (MHP) Exceptions and Waivers 1516.01 - Exception Request Form 1516.02 - Waiver Request Form 1520.00 - Second Opinion 1531.00 - Consumer Employment Services   3/31/2008
2008-009 Final Approved Policies, Attachments and Regional Training Plan: 1009.00 - Critical Incident Reporting & Review Requirements 1009.16 - NSMHA Critical Incident Report Form 1522.00 - Out of Network Referrals Regional Training Plan   4/28/2008
2008-010 Fast Tracked - Policy 1570.00 - Children's Short-Term High Intensity Services (STHIS)   4/29/2008
2008-011 Authorization/Re-authorization Requests   4/29/2008
2008-012 2008-2009 NSMHA QM Plan   5/19/2008
2008-013 Final approved policies and attachments. 1529.00 - Children's Long-Term Inpatient Program (CLIP) Care Coordination 1529.01 - Appendix A - RSN/CLIP Agreement 1556.00 - Clinical Eligibility and Care Standards (CECS) 1556.01 - CECS Manual 1557.00 - Safety Policy 1564.00 - Day Support Services   5/21/2008
2008-014 Final approved revised policies and attachments: 1503.00 - Access Standards 1506.00 - Availability of Services 1528.00 - Mental Health Screening Prior to Nursing Home Placement 1528.01 - PASRR Initial Evaluation 1528.02 - PASRR Followup Evaluation 1528.03 - PASRR Invalidation Statement 1528.04 - PASRR Documentation for Interrupted Evaluation 1528.05 - RPIDFORM - Jarvinen   5/29/2008
2008-015 Statewide Performance Improvement Projects for Administrators and Provider Intervention "Improved Deliver of Non-Crisis Outpatient Appointments after a Psychiatric Hospitalization"   6/4/2008
2008-016 The following contract deliverable, if a requirement on your contract deliverables, is no longer required effective July 1, 2008. If you have any questions regarding this, please feel free to contact Margaret Rojas at margaret_rojas@nsmha.org or 360-416-7013. "CONTRACTOR shall report on a monthly basis, on the daily occupancy number and number of admissions and discharges for crisis beds."   6/16/2008
2008-017 The following policies and/or forms have be revised to meet system changes and have been through the final approval process. Policy 1702.00 - ICRS Outreach Safety Screening for Dispatch Policy 1703.00 - Duration of Crisis Services Policy 2001.00 - Business Ethics and Regulatory Compliance Program ICRS Outreach Safety Screening for Dispatch Form   6/17/2008
2008-018 Critical Incident (CI) Reporting   7/8/2008
2008-019 Policies completed through the final approval process. Policy 1515.00 - Interpreter and Translation Services Policy 1517.00 - Coordination of Care with External Health Care Providers Policy 1523.00 - Outreach to Homeless Individuals and Families Policy 1533.00 - Reintegration of Consumers into the Community Policy 1561.00 - Revocation of Less Restrictive Alternative/Conditional Release Orders Policy 1570.00 - Children's Short-Term High Intensity Services (STHIS)   7/8/2008
2008-020 Updated policies that have been through the final approval process. Policy 1009.00 - Critical Incident Reporting and Review Requirements… Policy 1501.00 - Accessibility/Travel to Service Locations for Medicaid Consumers Policy 1518.00 - Mental Health Advance Directives Policy 1521.00 - Cultural and Linguistic Competence Policy 1534.00 - Single Bed Certification Policy 1543.00 - Nursing Assessment for Consumers at Evaluation and Treatment Facilities Policy 1551.00 - Individual Service Plans (ISP) Policy 1555.00 - Freestanding Evaluation and Treatment Facilities   7/31/2008
2008-021 Contract deliverable "Data Certification" for both Medicaid and State contracts is no longer required to be submitted. There is no replacement for this deliverable. This change takes effect immediately.   8/20/2008
2008-022 Revised policies/attachments: 1018.00 (Formerly 1548.00) - Delegation of North Sound Mental Health Administration (NSMHA) Functions and Responsibilities 1018.01 - Sample Delegation Plan 1019.00 (Formerly 1552.00) - Notifying Consumers of Provider Termination 1502.00 - Accessibility, Engagement and Utilization of Services for High Need Individuals and/or Families not Engaging in Treatment 1536.00 - State Hospital Care and Discharge Coordination   9/4/2008
2008-023 New, revised and/or fast tracked policies Policy 1574.00 - State Only Funding Plan Mental Health Services - new and fast tracked for EQRO Policy 1001.00 - Complaint, Grievance, Appeal, Fair Hearing and Notice - General Policy Requirements -Revised to meet system changes Policy 1704.00 - Crisis Services - General Policy Revised to meet system changes Policy 1721.00 - Medical Status Criteria for Crisis and ITA Assessment - New policy created to meet system changes   10/9/2008
2008-024 Crisis Alert Form both manual and electronic   10/17/2008
2008-025 Capacity Template Policy 1524.00 - Access to Housing and Consumer Choice in Housing and 1524.01 - NSMHA Board of Directors Housing Opportunities Principles Clinical Guideline for Anorexia Nervosa, Bulimia Nervosa and Adult Co-Occurring Disorders. Anorexia and Bulimia Nervosa include assessment elements and lab components.   10/27/2008
2008-026 Data Dictionary Changes   11/3/2008
2008-027 Policy 1006.00 - Reviewed/Revised Policy 1019.00 - Reviewed/revised; Moved from Clinical to Administrative and Cancels Policy 1552.00 Policy 1020.00 - Reviewed/revised; Moved from Clinical to Administrative and Cancels Policy 1573.00 Policy 1518.00 - Reviewed/revised Policy 1554.00 - Reviewed/revised; re-numbered and cancels Policy 1530.00 Policy 4015.00 - Reviewed/revised; Moved from Clinical to Information Systems; Cancels Policy 1535.00   11/25/2008
2008-028 Policy 1570.00 - Children's Short-term High Intensity Services (STHIS) fast tracked 12/15/2008 with highlighted change   12/15/2008

2007
Memo No.  Description   Issue Date
2007-001 New and/or Revised Policies   2/13/2007
2007-002 Policy & Procedure Grid Attachment for Contracts   2/16/2007
2007-003 Updates to NSMHA Policies 1505.00 and 1717.00   3/8/2007
2007-004 Updates to NSMHA Policies 1701.00 and 1704.00   5/29/2007
2007-005 New and/or revised policies 1009.00, 1557.00, 1558.00 and 1702.00   6/26/2007
2007-006 Revised Policy 1004.00 - Fair Hearing   6/29/2007
2007-007 Revised Policy 1550.00 - Early Periodic Screening, Diagnostic and Treatment (EPSDT) Services   7/3/2007
2007-008 New Care Advocacy Policy - 1560.00   7/6/2007
2007-009 A fast tracked version of the policy will be on the web. It will still go through the appropriate approval process.   7/31/2007
2007-010 Revised Policies: 1009.00 - Critical Incidents 1522.00 - Out of Provider Network Referrals 1525.00 - Inpatient Certification and Authorization 1529.00 - Children's Long-Term Inpatient Program (CLIP) Care Coordination 1702.00 - ICRS Outreach Screening, Crisis Line Pre- and Post-Dispatch and 1707.00 - Crisis System Clinical Dispute Resolution New Policies: 1561.00 - Revocation of Less Restrictive Court Orders/Condition Release Court Orders 1562.00 - Monitoring of Less Restrictive Orders 1563.00 - Program of Assertive Community Treatment (PACT) 1564.00 - Day Support Services 1706.00 - Safeguarding of Property 1716.00 - Accessing DD/MH Crisis Support Services 1720.00 Administration of the Involuntary Treatment Program Attachments (New) 1527.01 - Intensive Services Referral Form - Adults 1529.01 - RSN/CLIP Agreement - Appendix A   9/14/2007
2007-011 New Policy 1559.00 - Co-Occurring Disorder Screening and Assessment (GAIN)   10/1/2007
2007-012 New Training Modules American Indian Administrative Policy Module PTSD Module   10/2/2007
2007-013 Reporting Requirement of Per Diem Services   10/18/2007
2007-014 Reporting Requirement of Unbundling Services   10/30/2007
2007-015 Integrated Crisis Response System (ICRS) Training Module and Affidavit Documents   11/15/2007
2007-016 New and Revised Policies 1571.00 (Formerly 1525.00) - Inpatient Certification and Authorization - re-numbered only no content change 1573.00 - Inpatient Provider Appeal and Dispute - NEW 1717.00 - ICRS-Urgent Contacts and Follow-up Services - NEW 1718.00 - Integrated Crisis-Secure Detox (Pilot) - NEW   11/8/2007
2007-017 New Policy 1719.00 - Utilization of Crisis Respite for Hospital Discharge Planning   11/8/2007
2007-018 Revised/New Policies 1549.00 - Disaster Preparedness - Revised 1550.00 - EPSDT - Revised 1559.00 - Co-Occurring Disorder Screening & Assessment - Revised 1565.00 - CALOCUS-LOCUS - Revised 1567.00 - Intensive Outpatient Program for Adults (IOP) - New 3046.00 - Flex Funds - New   12/3/2007
2007-019 Removal of Attachment 1556.01 from website until updated version is available.   12/10/2007
2007-020 Revised Policy 1567.00   12/10/2007
2007-021 Codes Used for Marty Smith legislation   12/18/2007
2007-022 Special Episode Codes   12/18/2007

2006
Memo No.  Description   Issue Date
2006-001 Memo from Wendi Gunther at MHD   4/10/2006
2006-002 New Guidelines   6/12/2006

2005
Memo No.  Description   Issue Date
2005-001 Second Opinion Policy #1520   4/19/2005
2005-002 Limitations on Enrollee's Financial Obligations Policy #5003   4/19/2005
2005-005 MHP Exceptions   5/31/2005
2005-006 Revised NSMHA Training Module   6/14/2005
2005-007 Revised QMOC Charter   6/14/2005
2005-008 New NSMHA Policies   6/14/2005
2005-009 Revised WACs   7/15/2005
2005-010 New NSMHA Policies   9/9/2005
2005-010-A Numbered Memorandum 2005-010   9/9/2005
2005-011 Peer Support Licensure for CMHAs   10/13/2005
2005-012 Updated Clinical Guidelines   10/18/2005
2005-013 New and/or Revised Policies   11/28/2005
2005-014 New and/or Revised Policies   11/29/2005
2005-015 New and/or Revised Policies   12/28/2005

2004
Memo No.  Description   Issue Date
2004-001 New Regional Training Module "Administrative Policy 7.01/American Indian Policy"   12/3/2004
2004-002 Staff Training regarding Clinical Practice Guidelines   12/3/2004
2004-003 Updates to NSMHA Policies #1504 and #4505   11/18/2004
 

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North Sound Mental Health Administration