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Legal Resources | Code of Regulations, Title 17 |  T17  6844  

Subchapter 13. Child Health And Disability Prevention Program. Article 4. Required Services. Referral to Health Assessment.   

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(a) The following shall apply to all persons eligible to receive health assessments under the provisions of this subchapter:

(1) All reasonable steps, including assistance in scheduling and completing appointments if requested, and in following up initial efforts, shall be taken to ensure that persons eligible to receive health assessments, and who request a health assessment, receive it.

(2) Appointments for requested health assessments shall be completed in a reasonable period of time, normally not to exceed 60 days.

(3) The first source of referral for a health assessment shall be the person's usual source of health care. Preference should be given to the comprehensive care provider. If no usual source of health care can be identified, the person shall be given, without prejudice for or against any one provider, the names and locations of at least three providers, when available, who have been approved as providers of health assessments by the community child health and disability prevention program director. The availability of health assessments directly from the clinic operated by the community program may also be made known to the person.

(4) Although a person may choose to receive a health assessment from a provider of the person's choice, to be eligible for state reimbursement, the health assessment shall be provided by providers who have been approved to bill the Department for these services.

(b) Additional to (a), above, the following shall apply to Medi-Cal beneficiaries who request health assessments:

(1) Medi-Cal beneficiaries shall be offered assistance with transportation and scheduling health assessment appointments. The response to this offer shall be recorded, and this assistance shall be provided if requested by the beneficiary.

(2) If a person chooses to receive a health assessment from a provider that does not furnish the full range of services as specified in this subchapter, the community child health and disability prevention program shall, if requested, provide or arrange for provision of all such services that are not offered by that provider. At the time of the request, the person must be offered assistance with transportation and scheduling appointments. The response to this offer shall be recorded, and this assistance shall be provided if requested.

(3) If an initial or a periodic health assessment is not provided to a Medi-Cal beneficiary who requests such services and who also requests assistance with transportation or scheduling appointments for services, documentation must exist showing that the family or person lost eligibility, could not be located despite a good faith effort to do so, or the person's failure to receive the services was due to an action or decision by the family or person, rather than a failure by the community child health and disability prevention program to meet requirements of this subchapter, including the requirement to offer and provide assistance with transportation and scheduling appointments for services.

Authority cited:

Health and Safety Code 208

Health and Safety Code 321

Reference:

Health and Safety Code 321.2 (d)

Health and Safety Code 323.7

(Register 80, No. 13.)