Health Alliance (HA) Referral Procedures

Referrals to the HA service provider may be generated by any Social Services Agency (SSA) staff member. HA referrals may also be made by any education and training site, community-based organization (CBO), or other agency working with CalWORKs clients. Clients can also self-refer. Referrals are made directly to the HA provider.

All referrals for HA services, including those for CalWORKs children, will be processed by the CalWORKs Mental Health Services Team (MHST).

When the Cal-Learn provider, Planned Parenthood Mar Monte (PPMM), identifies a need for mental health or substance abuse services for Cal-Learn participants, the provider contacts the SSA Cal-Learn Associate Employment Counselor (AEC)/Employment Counselor (EC), who initiates the referral according to the 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:

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.
PART B	Referring Party	Complete all the information on this section: Eligibility Worker (EW) and AEC/EC Name Worker Number Telephone Number Email Address Number of months remaining on the CalWORKs 60-month time clock CalSAWS WTW/Cal-Learn Program status Check the box for the services requested Enter a brief description of the client’s issues, risks, and/or needs.
		Submit the referral via the DEBS Referral Application. Note: If the SCD 1686 has not been received from the provider, referring party should send a follow-up email to the provider.
PART C	Service Provider	Completes all areas listed under Part C, including the “Outcome of Referral" section.
		Emails the SCD 1686 to the referring party, including the referral outcome information.

DEBS Referral Application

When the referring party is an AEC/EC or EW, the DEBS Referral Application must be used to refer clients to HA. The DEBS Referral Application can be assessed through the DEBS Referral Application link or through the SSA's intranet by navigating to Applications > SSA Applications > DEBS > DEBS Referral icon. For additional guidance, refer to the DEBS Referral App User Guide.

The AEC/EC and EW are to follow the guidance below when initiating a HA referral:

In the Program field, select, "WTW." If the client is a Cal-Learn participant, select "CL."
In the Referral Type field, select, "Health Alliance."
In the Provider Name field, select, "Health Alliance Assessment-ESB-MHST."
Enter Referral Comments with any relevant information.
Upload and attach the completed SCD 1686 to the DEBS Referral Application.
Submit a copy of the SCD 1686 to Imaging.
Enter a Journal Entry in CalSAWS.

Note: Referring parties such as education and training sites, CBOs and other agencies working with CalWORKs participants who do not have access to the DEBS Referral Application should email the completed SCD 1686 to the MHST at: CalWORKs@hhs.sccgov.org.

Reminder: The SCD 1686 is NOT emailed to the Social Worker.

Referral Results and Attendance Tracking

When the client chooses to incorporate their HA services into their WTW plan and/or Family Services (FS) Plan, the HA provider must complete the front of the CalWORKs Referral Results (SCD 29) form and email it to the AEC/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 AEC/EC by the 5th working day following the report month.

Health Alliance (HA) Referral Procedures

Completing the Referral

DEBS Referral Application

Referral Results and Attendance Tracking

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