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​​​​​​​​​

Mental Health Urgent Care Clinic Utilization Review Tool
Mental Health Urgent Care Clinic E​UR Tool​​​​​​​​​​​​​​​

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).​
Helpful Lists and Screens in SmartCare​​

Substance Use Prevention and Treatment (SUPT)

Utilization Review Tools for Adult and Child SUPT Charts

SUPT Electronic Utilization Review​ Tool​​​​​
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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. ​









 
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