Utilization Review

​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​The Utilization Review (UR) Committee is a subcommittee of the Sacramento County Quality Improvement Committee. This UR committee is comprised of representatives from Behavioral Health Services, Mental Health County and Contracted Providers and Division Advocate Liaisons representing clients, families and youth. The UR Committee is responsible for Sacramento County’s mental health quality improvement process and ensuring that the mental health plan is on track to reach quality benchmarks described in the Quality Assessment and Performance Improvement (QAPI) Work Plan. This includes reviewing and planning for compliance to regulations and the Department of Health Care Services (DHCS) Protocol items; following through with the DHCS triennial plan of correction; preparing for audits; discussing quality improvement trends found in audits; updating utilization review tools, internal utilization review minutes and documentation policies and procedures; discussing updates to documentation trainings; creating helpful quality improvement resource documents and overseeing the adequacy and appropriateness of chart documentation.

Mental Health Services​

• Utilization Review Tools for Adult and Child Mental Health Charts
  • Electronic Utilization Review General Tool​​
  • Therapeutic Behavioral Services (TBS) EUR Tool​​​​​​​​​
    
    
• Utilization Review for Crisis/Outreach Services Charts
  • EUR Crisis/Outreach Services Tool
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• ​Utilization Review Addendum Tools
  • Utilization Tool Addendum - Day Treatment Intensive (DTI) & Day Rehabilitation (DR)​​
  • MHSA Programs Addendum Tool​ (This Addendum Tool may also be used by Providers who utilize support service codes and flexible funding codes) 
     
• Utilization Review Documents and Resources​
  • Internal Utilization Review Minutes Template (Right click and Save As)​​​​​​
  • External Utilization Improvement Tool​​
  • MHSA External Utilization Improvement Tool​
  • EUR Supplemental Worksheet (Recoupment shall be focused on fraud, waste, and abuse).​
  • EUR Supplemental Worksheet (ADA)​ (Recoupment shall be focused on fraud, waste, and abuse).​​
  • Helpful Lists and Screens in SmartCare
    
    

Mental Health Utilization Review Committee Meeting

Occurrence: ​Third Friday of the Month from 9:00 a.m. to 10:30 a.m.
Platform: Microsoft Teams
Contact to be added: QMInformation@saccounty.gov

Mental Health Office Hours

Occurrence: ​Fourth Thursday of the Month from 9:00 a.m. to 10:30 a.m.
Platform: Microsoft Teams
Contact to be added: QMInformation@saccounty.gov
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Substance Use Prevention and Treatment (SUPT)​

• Utilization Review Tools for Adult and Child SUPT Charts
  • SUPT Electronic Utilization Review​ Tool​​​​​​​​​
  • SUPT Internal Utilization Review Minutes Template ​(Right click and Save As)​​​​​​
  • SUPT External Utilization Improvement Tool​​
  • SUPT Supplemental Worksheet (Recoupment shall be focused on fraud, waste, and abuse).​​
  • SUPT Supplemental​ Worksheet (Fillable)
  • Helpful Lists and Screens in SmartCare​

Training Videos​​

• Video 1: Continuum of Care
• Video 2: Consents & Forms
• Video 3: Access Criteria & Medical Necessity
• Video 4: Diagnosis Document & Problem List
• Video 5: Cultural Competency
• Video 6: CSI Required Forms/Screens in SmartCare​
• Video 7: Transition of Care/Discharge Plan​

For Policies & Procedures (P & P) related to Utilization Review, please see our P & P webpage or send an email to QMInformation@saccounty.gov. ​