Health Alliance Referral Procedures

Referrals to the Health Alliance service providers may be generated by any Social Services Agency Staff member. Health Alliance referrals may also be made by any education and training site, community based organization, or other agency working with CalWORKs clients. Clients may also self-refer. The referrals are made directly to the Health Alliance providers.

Completing the Referral

All Health Alliance referrals must be made by completing the "Community Health Alliance Support Service Referral" (SC 1686). The SC 1686 is processed as follows:

Form Section	Who Completes	Action Required
PART A	Referring Party or Client	Complete or have the client complete this section.
		Have the client sign the form. The client may give verbal consent over the phone for the referral.
PART B	Referring Party	Complete all the information on this section: EW and CWES Worker Name and Worker Number, Telephone and Fax Number, Number of months left in the client’s CalWORKs 60-month clock, CalSAWS WTW status, Check the box for services requested, Enter a brief description of the client’s issues, risks, and/or needs.
		Fax the SC 1686 to the appropriate Health Alliance service provider. NOTE: The SC 1686 is NOT faxed to the CalWORKs Social Worker.
PART C	Service Provider	Complete the 'outcome' of the referral
		Fax the SC 1686 to the referring party IF the client chooses to have their hours and schedule sent to the CWES Worker.

Selecting a Health Alliance Service Provider

Clients may be referred to any service provider. Consideration to the client’s language needs, ethnicity, and/or Health Alliance service provider location must be given when choosing a service provider:

Health Alliance Provider	Specialized Language Capacities	Service Offered
Asian American for Community Involvement (AACI) 2400 Moorpark Avenue, Suite 300 San Jose, CA 95128 Email: AACICalWORKsReferral@aaci.org	Cambodian Chinese/Mandarin English Spanish Vietnamese	Substance abuse, mental health treatment and psychiatric services.
Catholic Charities (CCSJ) 195 East San Fernando St. San Jose, CA 95112 Email: calworks-referrals@catholiccharitiesscc.org	Bosnian English Spanish	Substance abuse, mental health treatment and psychiatric services.
Gardner (GFCC) 160 E. Virginia St., Suite 280 Email: CalWOrks@gfhn.org	Cambodian English Spanish	Substance abuse, mental health treatment and psychiatric services.
CalWORKs MHST Narvaez Mental Health 1887 Monterey Rd., Suite 205 Email: CalWORKs@hhs.sccgov.org	Cambodian English Mandarin Spanish Vietnamese	Intensive mental health and psychiatric services. Note: This is the only provider that accepts referrals involving CalWORKs children.
If the client needs RESIDENTIAL TREATMENT SERVICES and/or DETOXIFICATION from drugs or alcohol, refer the client the Gateway telephone number: 1-800-488-9919.

Time on Aid (TOA)

Some clients may need long-term treatment for mental health and/or substance abuse problems past the 60-month CalWORKs time limit. Health Alliance clinicians should continuously monitor client’s TOA to assure that ongoing treatment needs are addressed appropriately.

At the point the client only has six months left in their 60-month CalWORKs life-time limit, the Health Alliance service provider must begin transitioning the client into mainstream treatment services, this will include counseling the client and if necessary requesting a review for an extender. CWES staff will review and approve the request based on extender guidelines. Refer to Extenders - After the 60-month CalWORKs Time Limit for more information on extenders.

Clients Eligible for SSI

If a client is unable to work and the following criteria are met, Health Alliance staff may refer the client to the SSI Plus Advocacy Program:

• The client meets the seriously and persistently mentally ill (SPMI) criteria.
• The client has significant organic brain disorders.
• The client has developmental disabilities.

Clients with Learning Disabilities

If a client has a learning disability, the Health Alliance clinician will work with the client’s CWES Worker to refer the client to the appropriate program for screening and assessment if necessary.

Related Topics

Health Alliance Services Program

Health Alliance Referral Procedures