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Appendix 11

Provider Network Requirements

  1. State Requirements:

    1. Maintain a safe facility.
    2. Provide information to verify standards
    3. Store and dispense medications according to State and federal requirements.
    4. Maintain client records that meet state and federal requirements.
    5. Comply with the Quality Management standards of the San Francisco Mental Health Plan.
    6. Are providers in good standing with the Medicaid program.
    7. Shall not refuse an admission solely on the basis of age, sex, sexual orientation, race, physical or mental handicap, national origin, or type of illness or condition, except when that illness or condition can be better treated by another provider.

  2. San Francisco Mental Health Plan Requirements:

    1. Have ability to address the needs of the local population, based on factors including age, language, culture, physical disability, and specified clinical interventions.
    2. Have ability or willingness to serve beneficiaries with severe and persistent mental illness and/or children with serious emotional disturbances.
    3. Offer geographical locations that would maximize beneficiary access.
    4. Have ability to work with beneficiaries and their families in a collaborative and supportive manner.
    5. Provide 24 hour availability for crises.
    6. Assure client callback within 1 business day for routine matters.
    7. Offer an appointment within three (3) business days.
    8. Participate in at least one training/network meeting a year.
    9. Disclose circumstances and outcomes of any current or previous litigation against the provider.
    10. Have ability to demonstrate positive outcomes and cost-effectiveness as defined by the SFMHP.
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