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Department of Health Services

Behavioral Health Division

Medi-Cal Informing Materials

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These documents are given to clients receiving specialty mental health services that are covered by Medi-Cal.

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Beneficiary Handbook UPDATED DECEMBER 27TH, 2023
English | Spanish (PDF: 1.19 and 1.29 MB)
Large type: English | Spanish (PDF: 1.23 and 1.36 MB)
(Print on 8.5" x 14" white paper)

Mental Health Provider Manual August 2021
English (PDF: 2.38 MB)

Client Rights Flyer

Client Rights Poster
English | Spanish (PDF: 102 and 27 kB)
(Print on 8.5" x 14" paper)

Clients Rights and Grievance appeal Process Form

Client Rights & Grievance/Appeal Process and Form
English | Spanish (PDF: 786 and 789 kB)
Large type: English | Spanish (PDF: 785 and 591 kB)
(Print on 8.5" x 14" white paper)

Consumer Notification of Licensing Boards

Consumer Notification of Licensing Boards
English/Spanish (PDF: 80 kB)
(Print on 8.5" x 11" paper)

Early and Periodic Screening Form

Early & Periodic Screening & Diagnosis Including Therapeutic Behavioral Services
English | Spanish (PDF: 670 and 608 kB)
(Print on 8.5" x 11" white paper)

Family Feedback Flyer

Family Feedback Flyer
English | Spanish (PDF: 93 and 118 kB)
(Print on 8.5" x 11" paper)

Adult Family Feedback Form

Family Feedback Form - Adult Services
English | Spanish (PDF: 126 kB)
(Print on 8.5" x 11" paper)

Children Family Feedback Form

Family Feedback Form- Children's Services
English | Spanish (PDF: 142 kB)
(Print on 8.5" x 11" paper)

Free Language Assistance flyer

Free Language Assistance Services
English/Spanish (PDF: 48 kB)
(Print on 8.5" x 11" paper)

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Minors' Rights Handbook
English/Spanish (PDF: 246 kB)

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Point to Your Language Poster
English/Spanish  (PDF: 116 kB)
(Print on 11" x 17" paper)

Provider Directory for Specialty Mental Health Services

Provider Directory for Specialty Mental Health Services - February 2024 (Updated Monthly)
English - February 2024 | Spanish - Febrero 2024 (PDF: 514 kB & 486 kB)

Provider Directory for Specialty Mental Health Services

Provider Directory for Substance Use Treatment Services - February 2024 (Updated Monthly)
English - February 2024 | Spanish -  Febrero 2024 (PDF: 1.7 MB & 1.7 MB)

Your Right to Make Decisions About Medical Treatment

Your Right to Make Decisions About Medical and Mental Health Treatment
English | Spanish (PDF: 459 and 573 kB)
(Print on 14" x 8.5" paper)

MHS 158 (04-19) Beneficiary Non-Discrimination Notice-1

Beneficiary Non-Discrimination Notice
English | Spanish (PDF: 141 and 130 kB)
(Print on 8.5" x 11" paper)

Privacy Practices

Attention contractors: You are required by law to provide clients with your own HIPAA Notice of Privacy Practices statement.

Attention clients: these are the County Mental Health Services Notice of Privacy Practices statements.

Notice of Privacy Practices for Health Care Clients
Print version: English | Spanish (PDF: 193 and 122 kB)

Form: Acknowledgement of Receipt of Notice of Privacy Practices
English | Spanish (PDF: 34.8 kB)