TERM Providers

This page is utilized by TERM providers to obtain documents and related materials needed for continued work with Child Welfare Services and Probation clients.

Applications

Communications

Name Description Date
* Vol1. 1 - Provider Newsletter.pdf
2018-05-25
* TRES III Provider Tip Sheet.pdf
2018-05-25
* TERM Newsletter 17 - Summer Quarter 7-30-2013.pdf
2018-05-25
* TERM Newsletter 16 - Spring Quarter 2013.pdf
2018-05-25
* TERM Newsletter 15 - Winter Quarter 2013.pdf
2018-05-25
* TERM Newsletter 14 - Fall Quarter 2012.pdf
2018-05-25
* TERM Newsletter 13 - Summer 2012.pdf
2018-05-25
* TERM Newsletter 12 - Spring 2012.pdf
2018-05-25
* TERM Newsletter 11 - Winter 2012.pdf
2018-05-25
* TERM Newsletter 10 - Fall 2011.pdf
2018-05-25
* TERM Newsletter 09 - July 2011.pdf
2018-05-25
* TERM Newsletter 08 - March 2011.pdf
2018-05-25
* TERM Newsletter 07 - January 2011.pdf
2018-05-25
* TERM Newsletter 06 - October 2010.pdf
2018-05-25
* TERM Newsletter 05 - June 2010.pdf
2018-05-25
* Recovery and Resiliency Toolkit.pdf
2018-05-25
* Important Update on Child Sexual Abuse Referrals.pdf
2018-05-25
* Important TERM Historical Document-Original CAO Reponse to Board of Supervisors on Development of TERM Program.pdf
2018-05-25
* Clarification of Authorization for Medi-Cal Funded Psychological Evaluation.pdf
2018-05-25
* Child Welfare Services Billing Codes.pdf
2018-06-15
* Change in CWS Process of Authorizing Treatment or Release of Protected Health Information 2 5 14.pdf
2018-06-15
* 2013 APA Specialty Guidelines for Forensic Psychology.pdf
* TERM Phone Line.doc
2015-10-09
* Standards for use of Therapy Interns.doc
2015-10-09
* Evaluator Interns Standards.doc
2015-10-09
* 1500 Claim Form Changes.pdf
2015-10-26
* CORRECTION - NO DECIMAL POINT REQUIRED ON CMS 1500 CLAIM FORM.pdf
2015-10-26
* Optum TERM Expanded to Include Oversight of Child Sexual Abuse Non-Offending Non-Protecting Parent Treatment 2 1 16.pdf
2018-06-15
* False Claims Act HHSA.PDF
2016-05-11
* 2013 APA Guidelines for Psychological Evaluations in Child Protection Matters.pdf
* Behavioral Health/Justice Services Forum - Tuesday April 17, 2018 (pdf)
2018-04-06
* EFFECTIVE SEPTEMBER 1, 2016 - URGENT Information on the Changes to the Authorization Process (Medi-Cal and TERM) (pdf)
2016-07-06
* May TERM Training Flyer (pdf)
2018-04-06
* Medi-Cal CWS Auth Process FAQ 10 28 16.pdf
2016-10-28
* Microsoft Word - December 2009 TERM Newsletter.doc
2015-10-09
* Microsoft Word - ICD 10 claim insert and email blast
2015-10-09
* Microsoft Word - June 2009 TERM Newsletter.doc
2015-10-09
* Microsoft Word - March 2010 TERM Newsletter.doc
2015-10-09
* Microsoft Word - November 2009 TERM Newsletter.doc
2015-10-09
* Microsoft Word - Optum Letterhead PO Box
2015-10-09
* NEW REQUIREMENTS FOR ADDING AND MAINTAINING OPTUM TERM PANEL CLINICAL SPECIALTIES (pdf)
EFFECTIVE JULY 1, 2018 2018-06-22
* OPTUMIST Newsletter Fall 2017 (pdf)
2018-06-15
* OPTUMIST Newsletter Summer 2018 (pdf)
2018-08-13
* OPTUMIST Newsletter Winter 2018 (pdf)
2018-02-01
* STANDARDS AND AGREEMENT FOR THE USE OF EVALUATOR
2015-10-09
* TERM Panel Speciality Criteria (pdf)
2018-06-22
* TERM Therapy Referral Process - Supporting Timely Access to Care (pdf)
2018-06-25
* Workflow for CWS Therapy Referrals (pdf)
2018-04-30

Forms

Name Description Date
* TERM Provider Complaint Form for Professional Partners.pdf
2015-10-09
* Child Physical Abuse Treatment Intake Assessment.docx
* Child Physical Abuse Treatment Quarterly Report.docx
* Sample Psych Testing Request Form 012016.pdf
2018-05-25
* Psych Testing Request Form 012016.pdf
2018-05-25
* Psych Testing Guidelines.pdf
2016-02-24
* TERM Grievance Procedures and Complaint Form Arabic.pdf
2018-05-25
* TERM Grievance Procedures and Complaint Form English.pdf
2018-05-25
* TERM Grievance Procedures and Complaint Form Spanish.pdf
2018-05-25
* TERM Grievance Procedures and Complaint Form Tagolog.pdf
2018-05-25
* TERM Grievance Procedures and Complaint Form Vietnamese.pdf
2016-05-11
* 04-178 Youth Evaluation Questions - Diagnostic Clarification and Treatment Recommendations.pdf
2016-09-30
* 04-178 Youth Evaluation Questions - Adoption Evaluation.pdf
2016-09-30
* 04-178 Parent Evaluation Questions - Prospective Adoptive Parent.pdf
2016-09-30
* 04-178 Parent Evaluation Questions - FC 7827.pdf
2016-09-30
* 04-178 Youth Evaluation Questions - Emotional Damage Evaluation.pdf
2016-09-30
* 04-178 Parent Evaluation Questions - Diagnostic Clarification and Treatment Recommendations.pdf
2016-09-30
* CWS Form 04-182 DV Victim Intake Assessment.dot
2016-09-30
* CWS Form 182A DV Victim Quarterly Progress Report.dot
2016-09-30
* CWS Treatment Plan Form 04-176-177-Parent.dot
2016-10-11
* CWS Treatment Plan Form 04-176-177-Youth.dot
2016-10-11
* CWS Form 04-183A Sexual Abuse Protection NPP Quarterly Progress Report.docx
2017-02-06
* Foster Youth Bill of Rights.pdf
2017-03-29
* CWS Temporary Change of Authorization.pdf
2017-10-16
* CWS Form 04-183 Sexual Abuse Protection NPP Intake Assessment.dot
2017-12-26
* TERM Partner Contacts 11 27 17.pdf
2018-01-04

DV Victims Group Treatment

Manuals

Quick References

CSA NOP/NPP Treatment

Psychological Evaluations

Name Description Date
* 04-178 Youth Evaluation Questions – Emotional Damage Evaluation (pdf)
CWS Psychological Evaluation Resources 2017-03-20
* 04-178 Parent Evaluation Questions - Diagnostic Clarification and Treatment Recommendations.pdf
CWS Psychological Evaluation Resources 2017-03-20
* 04-178 Parent Evaluation Questions - FC 7827.pdf
CWS Psychological Evaluation Resources 2017-03-20
* 04-178 Parent Evaluation Questions - Prospective Adoptive Parent.pdf
CWS Psychological Evaluation Resources 2017-03-20
* 04-178 Youth Evaluation Questions - Adoption Evaluation.pdf
CWS Psychological Evaluation Resources 2017-03-20
* 04-178 Youth Evaluation Questions - Diagnostic Clarification and Treatment Recommendations.pdf
CWS Psychological Evaluation Resources 2017-03-20
* APA Guidelines for Psych Evals In Child Protection Matters.pdf
CWS Psychological Evaluation Resources 2017-03-20
* APA Speciality Guidelines Forensic Psych.pdf
TERM Psychological Evaluation Resources 2017-03-20
* CWS Form 04-178 Request for TERM Appointed Evaluator.pdf
CWS Psychological Evaluation Resources 2017-03-20
* Probation Psychological Evaluation Referral Form.pdf
Juvenile Probation Psychological Evaluation Resources 2017-03-20
* Psych Testing Guidelines.pdf
TERM Psychological Evaluation Resources 2017-03-20
* Psych Testing Request Form 012016.pdf
TERM Psychological Evaluation Resources 2017-03-20
* Psychological Evaluation QA Checklist (docx)
TERM Psychological Evaluation Resources 2017-04-19
* Psychological Evaluation Procedures.pdf
TERM Psychological Evaluation Resources 2017-03-20
* Sample Psych Testing Request Form 012016.pdf
TERM Psychological Evaluation Resources 2017-03-20
* Specialized Optum TERM Panel Evaluations.pdf
Juvenile Probation Psychological Evaluation Resources 2017-03-20
* TERM Psychological Evaluation Handbook (pdf)
2017-09-08
* The Format and Required Elements of a CWS Psychological Evaluation.pdf
CWS Psychological Evaluation Resources 2017-03-20
* The Format and Required Elements of a Juvenile Mental Competency Evaluation.pdf
Juvenile Probation Psychological Evaluation Resources 2017-03-20
* The Format and Required Elements of a Probation Psychological Evaluation.pdf
Juvenile Probation Psychological Evaluation Resources 2017-03-20

CWS Treatment Plans

Name Description Date
* CWS Form 04-176A Therapy Referral Form (pdf)
2017-05-03
* CWS Treatment Plan Form 04-176-177 Youth (dot)
2017-05-03
* CWS Treatment Plan Form 04-176-177-Parent (dot)
2017-05-03
* Documentation Requirements (pdf)
2017-05-03
* Legal Issues Related to Therapy and Evaluations for CWS Cases (pdf)
2017-05-03
* TERM Treatment Plan Documentation Resources (pdf)
2018-01-24