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Each local mental health department must set standards and establish systems to monitor the following: • Timeliness of routine mental health appointments; • Timeliness of services for urgent conditions; • Access to after hours care; and • Responsiveness of the county’s toll free 24 hour telephone. Additionally, at least once each year counties survey for beneficiary and family satisfaction and review the numbers and types of beneficiary grievances. Fair hearings and requests to change persons providing services are evaluated at least annually. The local mental health department also identifies meaningful clinical issues relevant to its beneficiaries for assessment and evaluation. These issues always include a review of the safety and effectiveness of medication practices and may include other important clinical issues such as procedures and interventions used to respond when an individual is potentially suicidal. Quality Improvement Committee: Each county, through their Quality Improvement Committee, also establishes quantitative measures to assess performance. Some of these indicators are monitored for the entire population and could include length of stay in inpatient facilities, recidivism, and total number of acute psychiatric bed days. Examples of measures which are specific to children include number of youth and children involved in the juvenile justice system. Documentation Standards: Clinical documentation required in client records includes physical condition, presenting problem and relevant conditions, medications, mental health treatment history, use of alcohol, tobacco, and other drugs, mental status and five axis diagnoses. A complete developmental history is required for children and youth. Treatment plans must include specific observable or quantifiable goals, proposed type of intervention and estimated duration of intervention as well as documentation of the client’s agreement with and participation in the plan. Regular progress notes must include appropriate signature and timely documentation of relevant aspects of client care, clinical decisions and interventions. Will the state utilize any of the following tools to assure quality? (Check all that apply and describe the activities for any categories utilized.) Effective Date: Approval Date: November 1, 2009 HFP Family Contribution Increase November 1, 2009 HFP Co-Payment Increase November 1, 2009 HFP Limited Dental Plan Choice for New Subscribers

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