Health Alliance (HA) Referral Procedures
Referrals to the HA service providers may be generated by any Social Services Agency staff member. HA referrals may also be made by any education and training site, community based organization, or other agency working with CalWORKs clients. Clients can also self-refer. The referrals are made directly to the HA providers.
When the Cal-Learn provider, PPMM, identifies a mental health or substance abuse service need for Cal-Learn participants, the provider contacts the SSA Cal-Learn EC who initiates the referral as per existing business process.
Completing the Referral
All HA referrals must be made by completing the "CalWORKs Community health Alliance Support Service Referral” (SCD 1686). The SCD 1686 is processed as follows:
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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 telephone for the referral. |
||
|
PART B |
Referring Party |
Complete all the information on this section:
Check the box for services requested Enter a brief description of the client’s issues, risks, and/or needs. |
|
Email the SCD 1686 to the appropriate HA service. The SCD 1686 is NOT emailed to the Social Worker Note: If the SCD 1686 has not been received from the provider, referring party should send a follow-up email to provider. |
||
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PART C |
Service Provider |
Complete the “outcome” of the referral |
|
Email the SCD 1686 to the referring party with referral outcome information. |
Selecting a Health Alliance Service Provider
Clients may be referred to any service provider listed below. Consideration to the client’s language needs, ethnicity, and/or service provider location must be given when choosing a service provider. The only HA provider that accepts referrals for CalWORKs children is MHST.
|
HA Provider |
Client Ethnicity or |
Service Offered |
|
Asian Americans for Community Involvement (AACI) 2400 Moorpark Avenue, Suite 300 San Jose, CA 95128 Phone: (408) 975-2730 |
Chinese/Mandarin Spanish Vietnamese English Cambodian |
Substance abuse and mental health treatment Psychiatric services |
|
Catholic Charities Santa Clara County (CCSCC) 195 East San Fernando St. San Jose, CA 95112 Phone: (408) 460-2170 Email Address: calworks-referrals@catholiccharitiesscc.org |
English Bosnian Spanish |
Substance abuse and mental health treatment Psychiatric services |
|
Gardner Family Care (GFCC) 160 E. Virginia St., Suite 280 San Jose, CA 95112 Phone: (408) 287-6200 Email Address: CalWOrks@gfhn.org |
English Spanish Cambodian |
Substance abuse and mental health treatment Psychiatric services |
|
CalWORKs Mental Health Service Team (MHST) Narvaez Mental Health 1887 Monterey Road, Suite 205 San Jose, CA 95112 Phone: (408) 272-6733 Email Address: CalWORKs@hhs.sccgov.org |
English Cambodian Spanish Vietnamese |
Intensive mental health services Psychiatric services Children’s Mental Health Services |
| If the client needs RESIDENTIAL TREATMENT SERVICES and/or DETOXIFICATION from drugs or alcohol, refer the client to Gateway at 1-800-488-9919. | ||
Referral Results and Attendance Tracking
When the client chooses to incorporate their HA services into their WTW plan and/or FS Plan, the HA provider must complete the FRONT of the “CalWORKs Referral Results” (SCD 29) and emails it to the EC.
Throughout the client’s participation in a HA activity, the HA provider must complete the BACK of the SCD 29 on a monthly basis to verify the client’s actual attendance. The SCD 29 must be emailed to the EC by the 5th working day following the report month.
Related Topics
Health Alliance (HA) Services Program Eligibility
Health Alliance (HA) Informing Requirements
Health Alliance (HA) Behavioral Health Screening
Health Alliance (HA) Behavioral Health Screening Results
Health Alliance (HA) Confidentiality and Disclosure
Health Alliance (HA) Temporary Absence
Health Alliance (HA) Welfare-to-Work (WTW) Plan
Health Alliance (HA) Participation Requirements
Health Alliance (HA) Support Services
Health Alliance (HA) Termination of Services
Health Alliance (HA) Time on Aid (TOA)