Section 1000: Administrative

Policy No.Policy Title
1001.00Grievance, Appeal & Fair (Administrative) Hearing
1002.00Grievance
1003.00Appeal
1004.00Fair Hearing
1005.00Notice Requirements
1006.00Policy Development and Review
1007.00Primary Source Verification Credentialing, Re-Cred
1008.00Provider Network Selection and Management
1009.00Critical Incident Reporting and Review Requirement
1011.00Framework for All NSMHA Activities - Core Values a
1011.01Framework for all NSMHA Activities - Core Values a
1012.00NSMHA Project Work Process
1013.00NSMHA Hazard Communication Policy
1013.01MSDS Identity
1013.02MSDS Table of Contents
1013.03Hazardous Chemicals within NSMHA
1014.00Establishing a Safety Committee
1015.00Assurance of Adequate System Capacity and Services
1016.00Response to Requests from Regulatory Agencies
1017.00Remedial Action
1018.00Delegation of North Sound Behavioral Health Organi
1019.00Notifying Consumers of Provider Termination
1020.00Inpatient Provider Appeal and Dispute
1022.00North Sound Behavioral Health Organization (North
1023.00Individual Rights
1024.00Reasonable Accommodation/Access to Services

Section 1500: Clinical

Policy No.Policy Title
1502.00Engagement of High-Need Individuals at Risk of Pre
1503.00Access to Outpatient Behavioral Health Services
1504.00Intake Evaluations for Ongoing Services
1505.00Authorization for Ongoing Outpatient Services
1506.00Availability of Services
1508.00Clinical Practice Guidelines
1509.00Consent for Treatment
1510.00Intra-Network Consumer Transfers and Coordination
1511.00Choice or Change of Mental Health Care Provider (M
1515.00Interpreter and Translation Services
1516.00Mental Health Professionals (MHP) Requirements and
1516.01Exception Request Form for Mental Health Professio
1516.02Waiver Request Form for Mental Health Professional
1517.00Coordination of Care with Primary Care Physician a
1518.00Mental Health Advance Directives
1519.00Provider-Enrollee Communications
1520.00Second Opinion
1521.00Cultural and Linguistic Competence
1522.00Out of Network Referrals
1523.00Outreach to Homeless Individuals and Families
1524.00Access to Housing and Consumer Choice in Housing
1524.01NSMHA Board of Directors Housing Opportunities Pri
1529.00Children's Long-term Inpatient Program (CLIP) Care
1529.01RSN/CLIP Agreement - Appendix A
1530.00Cross System Coordination
1532.00Residential Placement
1533.00Reintegration of Consumers into the Community
1536.00State Hospital Care and Discharge Coordination
1536.01WSH-RSN Working Agreement
1540.00Discharge from Treatment
1541.00Rationale and Use of Seclusion and Restraints at E
1542.00Evaluation and Treatment Facilities Admission Medi
1543.00Nursing Assessment and Treatment Planning for Resi
1545.00Inpatient Psychiatric Authorization Tribes
1546.00Medication Management Transfers to Primary Care Pr
1547.00Customer Service
1549.00Disaster Preparedness
1550.00Early and Periodic Screening, Diagnostic and Treat
1551.00Individual Service Plans (ISP) (Resiliency/Recover
1553.00Evidenced-based, Research-based, Consensus-based,
1555.00Freestanding Evaluation and Treatment Facilities
1557.00Safety Policy
1558.00Mental Health Specialist
1559.00Co-Occurring Disorder Screening and Assessment (GA
1560.00Care Coordination
1561.00Revocation of Less Restrictive Orders (LRO)/Condit
1562.00Monitoring of Conditional Release/Less Restrictive
1563.00Program of Assertive Community Treatment (PACT)
1563.01Washington State Program of Assertive Community Tr
1565.00Children & Adolescent Level of Care Utilization Sy
1565.01Children & Adolescent Guidelines
1565.02Adult and Older Adult Guidelines
1565.03CALOCUS Grid
1565.04LOCUS Grid
1567.00Intensive Outpatient Program for Adults (IOP)
1568.00High Intensity Treatment - Wraparound
1568.01Wraparound Referral Form
1568.02Wraparound Family Guide
1568.03SNCD Wraparound
1571.00Inpatient Psychiatric Authorization
1572.00Inpatient Continuity of Care
1574.00State and Substance Abuse Block Grant Funding Plan
1575.00Evaluation & Treatment Facility Authorization
1576.00Medicaid Personal Care (MPC)
1577.00Evaluation & Treatment Facilities Refusal & Review
1578.00Western State Hospital Admission Screening and Wai
1580.00Mental Health Intensive Programs Crisis Response
1581.00Roads to Community Living (RCL)
1582.00Voluntary Inpatient Psychiatric Authorization for
1585.00Integrated Dual Disorder Treatment (IDDT)
1586.00Children's High Intensity Treatment - Wraparound w
1587.00Crisis Planning for Individuals Receiving Mental H

Section 1700: Crisis Services

Policy No.Policy Title
1701.00Crisis Stabilization Standards for Adults
1702.00ICRS Outreach Safety Screening, Pre- and Post-Disp
1703.00Duration of Crisis Services
1704.00Crisis Services - General Policy
1706.00Safeguarding of Property
1707.00Crisis System Clinical Dispute Resolution
1717.00Urgent Contacts and Follow-up Services
1719.00Utilization of Crisis Respite for Hospital Dischar
1720.00Administration of the Involuntary Treatment Progra
1721.00Medical Status Criteria for Voluntary and ITA Cris
1723.00Outreach and Involuntary Investigations for Reside
1724.00ICRS-Law Enforcement Coordination
1726.00Involuntary Treatment Program Court Liaison Role a
1727.00Crisis Prevention and Intervention Teams (CPIT)
1728.00Single Bed Certification (SBC)/Inpatient Resource
1729.00Designated Mental Health Professionals (DMHP) Coor

Section 2000: Compliance

Policy No.Policy Title
2001.00Business Ethics and Regulatory Compliance Program
2002.00Prohibition on Certain Physician Relationships
2003.00Utilization Management Compensation
2004.00Management Certifications

Section 2500: Privacy

Policy No.Policy Title
2501.00Uses and Disclosures - Business Associate
2501.01Procedure 2501 A
2501.02Model Business Associate Agreement Form
2502.00Administrative Requirements for the Implementation
2503.00De-identification and Limited Data Sets
2503.01Procedure 2503 A
2504.00Designated Record Set
2504.01Procedure 2504 A
2505.00Disposal of PHI
2505.01Procedure 2504 A
2506.00Documentation
2506.01Procedure 2506 A
2507.00Confidentiality
2507.01Form 2507 A
2508.00Marketing
2508.01Procedure 2508 A
2509.00Minimum Necessary
2509.01Procedure 2509 A
2510.00Notice of Privacy Practices
2510.01Procedure 2510 A
2511.00Opportunity to Agree or Object - Disclosure to Ind
2511.01Procedure 2511 A
2512.00Copying and Printing Protected Health Information
2513.00Uses and Disclosures for Research Purposes
2513.01Procedure2513 A
2514.00Right to Access Protected Health Information
2514.01Procedure 2514 A
2514.02Form 2514 A
2515.00Individual's Right to Amend PHI
2515.01Procedure 2515 A
2515.02Form 2515 A
2516.00Right to an Accounting of Disclosures
2516.01Procedure 2516 A
2516.02Form 2516 A
2517.00Right to Confidential Communication
2517.01Procedure 2517 A
2517.02Form 2517 A
2518.00Right to Restrict Uses and Disclosures of Protecte
2518.01Procedure 2518 A
2518.02Form 2518 A
2519.00Safeguarding PHI
2520.00Training of the Workforce
2520.01Procedure 2520 A
2521.00Uses and Disclosures Authorizations - Revised
2521.01Core Elements, Required Statements, Defective Auth
2521.02Procedures for Completion or for Processing an Aut
2521.03Authorization to Receive and/or Release Informatio
2522.00Uses and Disclosures of PHI from Individuals for T
2522.01Procedure 2522 A

Section 3000: Fiscal

Policy No.Policy Title
3001.00Advance Contracts
3002.00Annual Report
3003.00Audits
3005.00Budget Modification
3006.00Cash Disbursements
3007.00Cash Receipts
3008.00Cellular Phones
3009.00Closeout
3010.00Conflict of Interest
3011.00Consultant Contracts
3012.00Cost Allocation
3013.00Email and Internet
3014.00Employee Reimbursement for Non-Travel expenses
3015.00Fair Labor Standards Act
3016.00Financial Reporting
3017.00Fiscal Monitoring
3018.00Imprest Fund - Petty Cash Funds
3019.00In-Kind Donations and Services
3020.00Inventory
3021.00Investment of Excess Cash
3022.00Laptop Computers
3023.00Leases
3024.00Minority and Women Owned Businesses and Enterprise
3025.00Oversight of Subrecipient Audits
3026.00Payroll
3027.00Public Records
3028.00Purchasing
3029.00Record Retention
3030.00Reimbursement for Travel - Advisory Board Members
3031.00Reimbursement for Travel - NSRSN Staff
3032.00Signature Authority
3033.00Storage of Software and Diskettes
3034.00Tax Reporting
3035.00Timesheets
3037.00Contractor Incident Report
3037.01Contractor Incident Report Form
3038.00Vendor vs. Subrecipient Auditing Guidelines
3040.00Transportation Requests
3041.00Signature Stamp
3042.00Credit Card Account
3044.00Third Party Resources Requirements
3045.00Eligibility Verification
3046.00Flex Funds
3048.00Meeting Light Refreshments and Meal

Section 3500: Human Resources

Policy No.Policy Title
3501.00NSMHA Employee of the Quarter Program
3501.01NSMHA Employee of the Quarter Nomination Instructi
3501.02NSMHA Employee of the Quarter Nomination Form
3502.00NSMHA Personnel Policy & Procedures
3503.00Staff Training

Section 4000: Information Systems

Policy No.Policy Title
4001.00Information Systems Policy & Procedures
4001.01Acknowledgement of Receipt Information System Poli
4002.00Access Codes and Passwords
4003.00Audit Vulnerability Scan
4004.00Automatically Forwarded Email
4005.00Email and Internet Security
4006.00Email Retention
4007.00Malicious Software Prevention
4008.00Modem Connectivity
4009.00Privacy and Security Plan
4010.00Remote Access
4011.00Server Security
4012.00Wireless Network Communication
4013.00Workstation/Laptop Acceptable Use
4014.00Data Backup
4015.00Verification of Accuracy of Data
4016.00Asset Disposal
4016.01Donation Request Form

Section 4200: Consumer Information Systems

Policy No.Policy Title
4201.00Certification of Utilization Information Relating
4202.00Timeliness of Consumer Information Data
4203.00Controls and Oversight of Providers Information Sy
4203.01NSMHA Consumer Information System Committee Charte
4204.00Timeliness of Encounter Data Submission to MHD
4205.00Contractor/CMHA Data to be Submitted to NSMHA-CIS
4206.00Loading of MMIS Data
4207.00Primary and Backup Systems for Electronic Submissi
4208.00Consumer Information System Recoverability
4209.00Use of NSMHA Information System for Utilization Re

Section 4500: Consumer Affairs

Policy No.Policy Title
4501.00Advisory Board Requests for Support Staff Services
4502.00Anti-Retaliation
4503.00Registering and Responding to a Complaint of Retal
4504.00Functional Independence Policy
4506.00Enrollee Rights - Compliance with Federal and Stat
4507.00Advisory Board Member Transportation Requests
4509.00Development of Annual Advisory Board Expense Proje
4510.00Attendance and Participation at Conferences, Semin
4511.00Advisory Board Purchasing and Other Expenses Proce
4514.00Advisory Board Functions
4515.00Advisory Board Representation
4516.00Ombuds Services
4517.00Quality Review Team
4518.00Public Awareness of Mental Health Services

Section 5000: Contract/Audit

Policy No.Policy Title
5001.00Administrative, Fiscal, & Quality Assurance/Improv
5002.00Sub Contractual Relationships and Delegation
5003.00Limitations on Enrollee's Financial Obligations
5004.00Contractor Certification and Licensure
5005.00Complying with MHD Published Directives
5006.00Provider Contract Termination - Notification to MH

Section 5500: Quality Management

Policy No.Policy Title
5501.00Utilization Review of Outpatient Services

Section 6000: Tribal Liaison

Policy No.Policy Title
6001.00Tribal Coordination of Implementation of Service P