TERM is an acronym for Treatment and Evaluation Resources Management, a mental health program developed under the direction of the County of San Diego Board of Supervisors and operated by Optum through a contract with County of San Diego HHSA Behavioral Health Services. The mission of the TERM program is to improve the quality and effectiveness of mental health services provided to clients served by the Dependency and Delinquency systems. Optum is responsible for contracting providers to the TERM network who have competence in evaluating and treating clients referred for child maltreatment or delinquency concerns. Optum also provides quality oversight of treatment plans and evaluation reports prepared for these clients.
This page is utilized by providers on the TERM specialty network to obtain documents and related materials needed for their work with Child and Family Well-Being and Probation clients.
Manuals
TERM Provider Handbook
TERM Provider Handbook Appendices
- Court Testimony in the Juvenile Court System (pdf)
- CFWB Form 04 176A Child Therapy Referral Form (dot)
- CFWB Form 04 176A Parent Therapy Referral Form (dot)
- CFWB Form 04-178 Request for TERM Appointed Evaluator (pdf)
- TERM Treatment Plan Documentation Resources (pdf)
- CFWB Treatment Plan Form for Parents (CFWB Form 04-176-04-177P) (docx)
- CFWB Treatment Plan Form for Youth (CFWB Form 04-176-04-177C) (docx)
- Juvenile Justice System Legal Process (pdf)
- Dependency System Legal Process (pdf)
- Documentation Requirements - Individual Treatment Standards (pdf)
- Documentation Requirements - Group Treatment Standards (pdf)
- Legal Issues Related to Therapy and Evaluations for CFWB Cases (pdf)
- Probation Psychiatric Evaluation Referral Form (pdf)
- Probation Psychological Evaluation Referral Form (pdf)
- Psychological Evaluation Procedures (pdf)
- Records Release Protocol for TERM Juvenile Probation Evaluations (pdf)
- Serious Incident Report (docx)
- Specialized Optum TERM Panel Evaluations (pdf)
- Superior Court of CA Order Authorizing Optum to Disclose Therapy Treatment Plans and Evaluations of Clients Receiving Services From HHSA to HHSA CFWB Representatives (expires 10-21-24) (pdf)
- The Format and Required Elements of a CFWB-Probation Psychiatric Evaluation (pdf)
- The Format and Required Elements of a CFWB Psychological Evaluation (pdf)
- The Format and Required Elements of a Juvenile Mental Competency Evaluation (pdf)
- The Format and Required Elements of a Probation Psychological Evaluation (pdf)
- The Format and Required Elements of a Juvenile Threat Assessment (pdf)
- TERM Therapy Provider Telehealth Best Practices (pdf)
- Superior Court of CA Order Authorizing Release of Health Info of Children in Custody of HHSA (expires 3-21-28) (pdf)
- 04-29 CFT FORM (pdf)
- CFT Information Guide for Providers (pdf)
- Claims Resources for TERM Providers (pdf)
- TERM Psychological Evaluation Handbook (pdf)
CFWB Treatment
CFWB Treatment Plan Forms
Permanent Change of Treatment Authorization for a TERM Group Facilitator
CFWB Temporary Change of Authorization
CFWB Treatment Plan Documentation
Request for Authorization of Additional Units of CFT Meeting Form Through CFWB Funds
Invoice Payment Delegation Form
IPV Victim Group Treatment
IPV Victim Progress Reporting Forms
CSA-NPP Treatment
CSA-NPP Progress Reporting Forms
CFWB/Probation Evaluations
Format and Required Elements
- The Format and Required Elements of a CFWB Psychological Evaluation (pdf)
- The Format and Required Elements of a Probation Psychological Evaluation (pdf)
- The Format and Required Elements of a CFWB-Probation Psychiatric Evaluation (pdf)
- The Format and Required Elements of a Juvenile Mental Competency Evaluation
- The Format and Required Elements of a Juvenile Threat Assessment (pdf)
CFWB Evaluation Referral Form
CFWB Evaluation Referral Questions
- Parent Evaluation Referral Questions - Diagnostic Clarification and Treatment Recommendations (pdf)
- Parent Evaluation Referral Questions - FC7827 (pdf)
- Parent Evaluation Referral Questions - Neuropsychological Evaluation (pdf)
- Parent Evaluation Referral Questions - Prospective Adoptive Parent (pdf)
- Parent Evaluation Referral Questions - Psychiatric Evaluation (pdf)
- Youth Evaluation Referral Questions - Adoption (pdf)
- Youth Evaluation Referral Questions - Diagnostic Clarification and Treatment Recommendations (pdf)
- Youth Evaluation Referral Questions - Emotional Damage (pdf)
- Youth Evaluation Referral Questions - Neuropsychological Evaluation (pdf)
- Youth Evaluation Referral Questions - Psychiatric Evaluation (pdf)
Probation Evaluation Referral Form
Medi-Cal Funded CFWB Evaluations
Request to Modify CPT Code Distribution for CFWB Funded Evaluations
CANS/PSC
- CANS User Guide (pdf)
- Electronic CANS Form (pdf)
- CANS and PSC Instructions and Process Provider Correspondence (pdf)
- Electronic PSC - Parent Form (pdf)
- Electronic CANS Form - Early Childhood Version (pdf)
- Electronic CANS/PSC Resources & CWS Treatment Plan Documentation Update (pdf)
- Electronic PSC - Parent Form - Spanish (pdf)
- Electronic PSC - Youth Form (pdf)
- Electronic PSC - Youth Form - Spanish (pdf)
- CANS-PSC Completion Tip Sheet with link to Tools (pdf)
Newsletters
Contact Lists
TERM Updates
Grievances
TERM Grievance Procedures and Complaint Form for Clients
- TERM Grievance Procedures and Complaint Form Chinese.pdf
- TERM Grievance Procedures and Complaint Form English.pdf
- TERM Grievance Procedures and Complaint Form Spanish.pdf
- TERM Grievance Procedures and Complaint Form Tagalog.pdf
- TERM Grievance Procedures and Complaint Form Korean.pdf
- TERM Grievance Procedures and Complaint Form Dari.pdf
- TERM Grievance Procedures and Complaint Form Arabic.pdf
- TERM Grievance Procedures and Complaint Form Farsi.pdf
- TERM Grievance Procedures and Complaint Form Vietnamese.pdf
- TERM Grievance Procedures and Complaint Form Somali.pdf
Complaint Form for Professional Partners
TERM Partner Points of Contact for Concerns
Provider Services Info
Change of Practice Forms
Telehealth Attestation/Standards
Home Office Standards
Claims
- AMFT/ACSW/APCC Intern CWS Billing Codes (pdf)
- Claims Resources for TERM Providers (pdf)
- LMFT/LCSW/LPCC CWS Billing Codes (pdf)
- LMFT/LCSW/LPCC Medi-Cal Billing Codes (pdf)
- MD/DO CWS Billing Codes (pdf)
- PhD/PsyD CWS Billing Codes (pdf)
- PhD/PsyD Intern CWS Billing Codes (pdf)
- PhD/PsyD Medi-Cal Billing Codes (pdf)