1. No category

ADMH
HSS
STAFFG
GUIIDE
E:
ONT
O THE
EJO
OB
 Calle R
C
Real Caampus Map M
 Freque
F
ently A
Asked Questi
Q
ons  How To
H
o’s  Safety
S
 Refere
R
nces
Prepared for AD
DMHS Staff 5‐15
(This page intentionally left blank.) BACK
KGR
ROU
UND
D
( (This page intentionally left blank.) Calle Real Campus
Building 1 (300 N. San
Antonio Rd.)
1st Floor
Administrative Offices
Auditorium
Conference Rooms
Emergency Medical Services
Human Services
2nd Floor
General Accounting
Patient Accounting
Human Resources
Information Technology
Building 3 (315 Camino del
Remedio)
Ground Floor
Data Services Training Room
Information Technology
Storeroom
Women, Infants & Children
(WIC)
1st Floor
Laboratory
Psychiatric Health Facility (PHF)
Radiology (X-Ray)
2nd Floor
AFLP/TAPP/Cal-Learn
Nutrition Services
Mental Health
Clinic/Administration
Building 4 (345 Camino del
Remedio)
1st Floor
Gift Shop
Cafeteria (Back Door Deli)
2nd Floor
Clinics & Lobby
Medical Records
Pharmacy
Medical Social Services
MIA Eligibility
3rd Floor
Administrative Offices
AIDS Services
Birth & Death Certificates
Disease Control & Prevention
Epidemiology
MCH Field Nursing
Older Adults Program
Utilization Review/Indigent
Health
Building 6
Building 12 (263 Camino del Remedio)
Casa del Mural
Mental Health Facility
Agricultural Commissioner
Building 7 (260 N. San Antonio Rd.)
APCD, SBCAG, DSS
Building 12A (225 Camino del Remedio)
Environmental Health Services
Building 8 (300 N. San Antonio Rd.)
Public Health Administration
-Director
-Deputy Director
-Health Officer
-Contracts Unit
Building 13 - not in use
Building 10
Building 15 (4444 Calle Real)
Architectural Archives
Veterans’ Outpatient Services
Building 11 (267 Camino del Remedio)
Employee’s University
HCS-040 (10/31//07)
Building 14 (4444 Calle Real)
Mental Health Facility
Building 16 (234 Camino del Remedio)
Social Services
Freque
F
ently A
Asked Questtions Re
evised 5/15
B
Basicss
The Santa Barrbara Calle
e Real coun
nty campu
us is somew
what confu
using. Is there a map I could have? Yes. A Calle Real Campus map is include
ed in the “On
n the Job” sttaff guide. How
w do I find the teleph
hone number of a co
ounty stafff person?
A listt of key ADM
MHS contacts is included
d in the “Abo
out ADMHS”” staff guide.. Instruction
ns on how to
o find the
telep
phone numb
ber of any co
ounty emplo
oyee is includ
ded in the “O
On the Job” staff guide. mation abo
out countyy jobs? Wheere may I ffind inform
Open
n this link: http://agencyy.governmentjobs.com//sbcounty/d efault.cfm How
w may I fin
nd a countyy health cllinic near m
me? Inforrmation abo
out employee
e on‐site heaalth clinics iss here: http://cosb.coun
ntyofsb.org//hr/default.aaspx?id=17758 here a simple way to
o explain h
how to obttain ADMH
HS servicess? Is th
Yes. See “How tto Obtain Services” in the “About AD
DMHS” staff f guide. w do I sign up for classes at Em
mployee Un
niversity?
How
With
h your superrvisor’s approval, you maay register fo
or classes heere: http://cosb.coun
ntyofsb.org//eu/dept1.asspx?id=8566
6 How
w do I obta
ain ADMHSS trainingss? Please consult th
he training o
overview pro
ovided in the
e “On the Job” staff guid
de. How
w can I learn about n
new trainin
ngs? Regu
ularly check the ADMHS training cale
endar here: http://cosb .countyofsb.org/admhs//calmonth.aaspx 1 | P
1
age
How do I reserve a county car? County cars may be reserved online here: https://vehiclereservation.co.santa‐barbara.ca.us/cgi‐bin/cocoweb/csb/start.pl Written instructions are included in the “On the Job” staff guide. I’ve come across lot of jargon and acronyms I’m not familiar with. Is there a glossary of terms? Yes. It is included in the “Clinician’s Toolbox” staff guide. It is also online: http://cosb.countyofsb.org/uploadedFiles/admhs_new/Glossary%2012‐14.pdf Where do I find common forms like mileage lots and travel requests? This is explained in the “On the Job” staff guide. How do I initiate a contract? Please see the information in the “On the Job” staff guide. How do I create a signature block in email? Instructions are included in the “On the Job” staff guide. How do I report a workplace injury? Please follow instructions in the “On the Job” staff guide. Are there manuals for ShareCare and Clinician’s Gateway? Instructions on ShareCare are included in the “Clinician’s Toolbox” staff guide. More detailed information on the use of ShareCare and Clinician’s Gateway may be found here: http://cosb.countyofsb.org/admhs/admhs.aspx?id=38296 How do I request a service provider ID? A form is included in the “Clinician’s Toolbox” staff guide. What is “systems change”? Systems change is a process initiated by the Santa Barbara County Executive Office to address issues about ADMHS raised in a report by the TriWest consulting group released in May 2013. A brief overview of systems change is included in the “About ADMHS” staff guide. More details are available at http://cosb.countyofsb.org/admhs/admhs2.aspx?id=43555&id2=43556 The TriWest report is available here: http://cosb.countyofsb.org/uploadedFiles/admhs_new/resources/TriWest%20Final%20Report%20May%2020
13.pdf May I report concerns about the Department anonymously? Yes. You may report general concerns or comments anonymously using the feedback form here: http://cosb.countyofsb.org/admhs/systemchange.aspx For compliance issues, you may leave a message at 884‐6855. 2 | P a g e Benefits and Rights
Where may I find information about my benefits? 



Start here for general information: http://cosb.countyofsb.org/hr/default.aspx?id=11064
For specific information about your account, log in here: https://essplus.co.santa‐
barbara.ca.us/Home.aspx This site contains your payroll history, timesheet coding guidelines, W2
summary, SBCERS Retirement Statement, etc.
Many benefits forms may be found here: http://cosb.countyofsb.org/hr/default.aspx?id=11078
See also the list of benefits links provided in this guide.
Besides medical insurance, does the county offer other benefits, like housing and child care? Yes. Visit http://cosb.countyofsb.org/hr/default.aspx?id=11072 for more information. How do I contact my union? Most permanent clinical and clerical staff in ADMHS are represented by the Service Employees International Union (SEIU) Local 620. There are currently two Shop Stewards in the department: 

Sara Scofield: 805‐681‐5147
Alice Sealund: 805‐266‐8694
SEIU Local 620 has an office in two locations: 

Santa Barbara: 350 South Hope Ave #A103, 805‐963‐0601
Santa Maria: 114 Vine Street.
Is there a web site at which I may find civil service rules? Yes. http://cosb.countyofsb.org/hr/CSRules.aspx?id=11158 How do I find out about my retirement benefits? The Santa Barbara County Employees’ Retirement System (SBCERS) web site is here: http://cosb.countyofsb.org/sbcers/default.aspx?id=19048 To find out your retirement representative, visit this page: http://cosb.countyofsb.org/sbcers/default.aspx?id=19042 Your retirement statement is available in ESS: https://essplus.co.santa‐barbara.ca.us/Home.aspx How do I find my electronic time card? Click on the round Windows logo on your desktop. Then click on Financial Systems Menu. Click on Employee Time. Details about coding time are provided in the “On the Job” staff manual. What is ESS? 3 | P a g e
ESS stands for Employee Self Service Plus. It may be accessed here: https://essplus.co.santa‐
barbara.ca.us/Home.aspx It contains your payroll history, W2 summary, retirement statement, etc. What is the Employee Assistance Program? The Employee Assistance Plan offers free and discounted benefits, including counseling services such as telephonic support, critical incident stress debriefings, legal counseling, financial counseling etc. General information is here: http://cosb.countyofsb.org/hr/healthbene.aspx?id=11090 Log in here: https://members.mhn.com/external/public/default/homepage What is mediation, and is it available to me? Mediation is a completely voluntary process you can request to help address problems in the workplace. A mediator is a highly trained, neutral individual from one of a number of county departments who will help open up communication. A mediator assigned to assist you will not be an ADMHS employee, and nothing about mediation will be included in your personnel file. A mediation brochure and request form are included in the “On the Job” staff guide. 4 | P a g e
BENEFITS LINKS
Employee Benefits Division
http://cosb.countyofsb.org/hr/default.aspx?id=11064 Affordable Care Act (ACA) and Health Insurance Legal
Notices
http://cosb.countyofsb.org/hr/default.aspx?id=44602 Benefit Forms
http://cosb.countyofsb.org/hr/default.aspx?id=11078 Employee Benefits FAQ's
http://cosb.countyofsb.org/hr/default.aspx?id=11084 Employee Guide to Time Card Coding (2012)
http://cosb.countyofsb.org/uploadedFiles/admhs_new/Staff_Guide_2015/On_th
e_Job/HR Time sheet coding guide.pdf Compensation Summaries
http://cosb.countyofsb.org/hr/default.aspx?id=11022 Home Ownership Program, Employee Discounts, EAP and
Childcare Options
http://cosb.countyofsb.org/hr/default.aspx?id=11072 Employee On-site Health Clinics
http://cosb.countyofsb.org/hr/default.aspx?id=17758 Commuter Benefits
http://cosb.countyofsb.org/hr/default.aspx?id=11074 ADMHS Mission and Co
ore Values
s
Mission
n Statemen
nt
The mis
ssion of ADM
MHS is to promote
p
the
e preventio
on of and re
ecovery from
m addiction
n and
mental illness am
mong individ
duals, families, and communitie
es by provviding effe
ective
leadersh
hip and deliivering state
e-of-the-artt, culturally competentt services.
Core Va
alues
ADMHS
S decisions and service
e delivery re
eflect the fo
ollowing core values:
1. Qualitty services for persons
s of all ages
s with addicction and/orr mental illn
ness
2. Integrrity in individ
dual and orrganization actions
3. Dignity, respect, and compa
assion for all
a persons
4. Activ
ve involvem
ment of cllients and families iin treatme
ent, recove
ery, and p
policy
deve
elopment.
5. Divers
sity through
hout our org
ganization and
a culturall competen
nce in servicce delivery
6. A Rec
covery orien
nted Model of Care
7. Emphasis on pre
evention and treatment
8. Integrrated fiscal and clinica
al strategy to deliver ccare in parrtnership w
with Commu
unitybase
ed Organiza
ations
9. Parity across reg
gions of the County
10. Tea
amwork am
mong ADMHS employ
yees in an
n atmosph
here that is creative and
optim
mistic
11. Colla
aboration with
w county partners
p
an
nd other com
mmunity ag
gencies
12. Conttinuous learrning and im
mprovemen
nt in service
e delivery a
and adminisstration
13. Wellness mode
eled for ourr clients at all levels, i.e., staff w
who regularly arrive a
at the
work
kplace healtthy, energe
etic and resilient
14. Safe
ety for everyone to in
nclude train
nings, prom
motion of ssafety practtices, and wellmain
ntained facillities
Intrroduction to Code off Conduct
mployee, co
ontractor, and voluntee
er, acting on behalf of ADMHS, iss expected to
Each em
act in an
n ethical and lawful ma
anner, to fo
ollow the Co
ode of Cond
duct, and to
o read,
understa
and, and fo
ollow applica
able County
y and Depa
artmental policies.
The Dep
partment ha
as designed
d and imple
emented a C
Compliance
e Program to strengthen
the awareness of compliance
c
issues to all
a employee
es, and to p
prevent, de
etect, and
respond
d to complia
ance violatio
ons. Adheriing to licenssure require
ements, Fe
ederal, State,
local law
ws and regu
ulations are
e viable to th
he successs of our misssion. This C
Code of
Conductt is intended to expres
ss our core values rela
ated to:
Page 1 of 1 P
1. Quality of Care and Services
2. Adhering to Laws and Regulations
3. Conflict of Interest
4. Records Maintenance
5. Workplace Conduct
6. Workplace Relationships
7. Protecting County Assets
Violations of Federal and/or State healthcare regulations carry serious consequences to
both the organization and to the individual. In addition to criminal penalties, violations
can result in being excluded from Federal healthcare program participation.
You are encouraged to ask questions if you are not sure about how things should be
done. Review the Code of Conduct, the policies and procedures, and discuss any
questions you have with your supervisor, manager, or other supervisory/management
staff. Employees may also contact the Chief of Compliance at 805.681.5220. This Code
of Conduct and the related policies will be reviewed and updated annually or as
circumstances warrant. Your input and support is welcome. Our success is shared by
everyone’s commitment to adhering to these standards.
Responsibility of Public Service
Agents of the Public
Public officials and employees are agents of the public and serve for the benefit of the
public. We shall uphold the Constitution of the United States, the Constitution of the
State, the ACE values of the County, and the rules, regulations and policies of the
County, as well as those of the Federal and State governments. Moreover, we shall
discharge our duties faithfully and impartially, recognizing that the public interest is
paramount. Public officials and employees must demonstrate the highest standard of
ethics consistent with the requirements of our position and consistent with the law.
Leadership Responsibilities
While all ADMHS employees are obligated to follow our Code, our leaders are expected
to set the example, to be in every respect a model. Each supervisor is expected to
create an environment that encourages staff to bring forth concerns as they arise and to
propose new ideas.
Our leaders must ensure that those they supervise have sufficient information to comply
with laws, regulations, and policies, as well as the resources and guidance necessary to
resolve ethical dilemmas. Leadership must help to create a culture within ADMHS which
promotes the highest standards of ethics and compliance.
Client Care and Rights
Page 2 of 2 Part of our mission is to provide high quality, cost-effective behavioral healthcare to all
of our clients, to the extent resources are available. We treat all clients with warmth,
respect, and dignity and provide care that is necessary, appropriate, and culturally
competent. We make no distinction in the availability of services; the admission, transfer
or discharge of clients; or in the care we provide based on age, gender, disability, race,
color, religion, or national origin.
ADMHS seeks to involve clients in all aspects of their care, including giving consent for
treatment and making healthcare decisions. As applicable, each client or client
representative is provided with a clear explanation of care including, but not limited to,
diagnosis, treatment plan, right to refuse or accept care, explanation of the risks,
benefits, and alternatives associated with available and recommended service options.
Clients have the right to request transfers to other services and/or providers. In the
promotion and protection of each client’s rights, each client and his or her
representatives are accorded appropriate confidentiality, privacy, security and protective
services, as well as opportunity for resolution of complaints.
Clients are treated in a manner that preserves their dignity, autonomy, self-esteem, civil
rights, and involvement in the planning and delivery of services. ADMHS services
maintain processes to support client rights in a collaborative manner. These processes
involve the managers, supervisors, staff and those who provide direct services. Based
on policies and procedures, these processes are the framework for addressing client
care and organizational ethics. Our structures include informing each client or, when
appropriate, the client’s representative, of the client’s rights for input on providing,
changing or discontinuing care.
Clients and, when appropriate, their families are informed about the outcomes of care,
including unanticipated outcomes. Additionally, clients are involved, to the full extent
possible, in resolving dilemmas about care decisions. Additionally, programs maintain
processes for prompt resolution of client grievances, which include informing clients of
the grievance process and informing clients regarding the grievance resolution.
Client Information
To provide quality care, ADMHS collects information about the client’s current
behavioral health condition, and service records to verify personal history. ADMHS
realizes the sensitive nature of this information and is committed to maintaining client
confidentiality to the full extent of the individual’s rights and applicable laws and
regulations. Consistent with HIPAA, employees must not use, disclose or discuss clientspecific information with others unless it is necessary to serve the client or required by
law.
ADMHS employees must never use or disclose confidential information that violates the
privacy rights of our clients. In accordance with our appropriate access and privacy
Page 3 of 3 policies and proce
edures, wh
hich reflect HIPAA re
equirementss, no ADM
MHS emplo
oyee,
affiliated
d physician,, or other healthcare partner
p
has a right to a
any client in
nformation o
other
than tha
at necessary
y to perform
m his or herr job.
Subject only to em
mergency ex
xceptions, clients
c
can expect the
eir privacy tto be protected.
Client- specific
s
info
ormation will be releas
sed only to persons authorized b
by law or byy the
client’s written
w
auth
horization.
Leg
gal and Reg
gulatory Compliance
e
ADMHS
S provides behavioral
b
health
h
serviices in man
ny locationss across Sa
anta Barbarra
County. These serv
vices are prrovided purrsuant to ap
ppropriate F
Federal, State, and loccal
laws and
d regulation
ns, and the conditions of participa
ation for Fe
ederal healtthcare
program
ms. Such law
ws, regulatiions, and co
onditions o
of participatiion may incclude, but a
are
not limite
ed to, subje
ects such as
a certificate
es of need, licenses, p
permits, acccreditation,
access to
t treatmen
nt, consent to treatmen
nt, medical record-kee
eping, accesss to mediccal
records, confidentia
ality, clients
s’ rights, an
nd Medicare
e and Medi--Cal progra
am
requirem
ments. ADM
MHS is subject to nume
erous otherr laws in ad
ddition to th
hese healthccare
laws, reg
gulations, and
a the con
nditions of participation
p
n.
ADMHS
S has developed policies and pro
ocedures to
o address m
many legal and regula
atory
requirem
ments, including the prevention
n of health
hcare fraud
d and falsse claims. The
ADMHS
S Complianc
ce Program
m outlines the Departtment’s com
mmitment a
and proced
dures
for this area. How
wever, it is
i impractical to devvelop policcies and p
procedures that
encompass the full body of all
a applicab
ble laws an
nd regulatio
ons. In addition, there
e is a
range of
o expertise
e within the
e organizattion, includ
ding Countyy Counsel and nume
erous
functional experts, who should be cons
sulted for a
advice conccerning hum
man resources,
ditions of pa
articipation requirements.
legal, regulatory, and the cond
Anyone aware of violations
v
or
o suspected violationss of laws, rregulations, the conditions
of partic
cipation, or ADMHS po
olicies and procedure
es must rep
port them im
mmediatelyy to a
supervis
sor or mem
mber of ma
anagement,, the Huma
an Resourcces, the AD
DMHS Chief of
Complia
ance, or the
e Complianc
ce Hotline 805.884.68
8
855.
Adherin
ng to Laws
s and Regu
ulations
ADMHS
S follows all laws and
d regulatio
ons and co
onducts bu
usiness in an ethical and
MHS
honest manner. The Code
e of Cond
duct does not require you, a
as an ADM
employee, to be a legal exp
pert; howev
ver, you arre expecte
ed to be fa
amiliar with
h the
laws th
hat apply to
t your sp
pecific job
b, licensurre where a
appropriate
e and leve
el of
respons
sibility.
ADMHS
S employee
es must:
Page 4 of 4 P
 Comply with all applicable laws, rules, regulations, standards, and other
requirements of Federal, State and County governments. Comply with all
requirements of Federal healthcare program statutes, regulations, and
guidelines.
 Not engage in any illegal activity or behavior that violates regulations and
standards.
 Take reasonable precaution to ensure that billing and/or coding of claims
are prepared and submitted accurately, timely, and are consistent with
Federal, State and local laws and regulations and ADMHS policies and
procedures and/or agreements.
 Bill only for eligible services actually rendered and fully documented.
 Ensure that no false, fraudulent, inaccurate, or fictitious claims for payment
or reimbursement of any kind are submitted. Federal and State false claims
laws protect government programs from fraud and abuse. False claims
laws also protect employees who cooperate in reporting, investigating and
identifying false claims from retaliation.
 Act promptly to investigate and correct problems if errors in claims or
billings are discovered.
 Voluntarily disclose to third party law enforcement or regulatory agencies
violations of law, regulations or standards where appropriate and legally
required.
 Not intimidate, threaten, coerce, discriminate against, nor take other
retaliatory action against any patient, constituent, client or employee who
exercises the right to file a complaint or who participates in an
investigation or proceeding relative to a complaint.
 Not reveal medical, clinical, or business information unless such release is
supported by a legitimate clinical or business purpose, patient/client
request, or court or agency order and is in compliance with applicable
laws, rules, regulations, as well as our policies and procedures.
 Exercise care to ensure that confidential and proprietary information is
always
maintained and managed to protect its privacy and value.
 Dispose of medical and hazardous wastes properly and lawfully.
Coding and Billing for Services
ADMHS has implemented procedures and systems to facilitate billing to government
payers, commercial insurance payers, and clients. These procedures and systems
conform to pertinent Federal and State laws and regulations.
Page 5 of 5 In support of accurate billing, medical records must provide reliable documentation of
services rendered. It is important that all individuals who contribute to medical records
provide accurate information and do not destroy any information considered part of the
official medical record. Accurate and timely documentation depends on the diligence
and attention of employees who serve clients in our programs. ADMHS expects our
staff to provide complete and accurate information in a timely manner.
Any subcontractors engaged to perform services are expected to have the necessary
skills, quality control processes, systems, and appropriate procedures to ensure all
billings for services are timely and complete. ADMHS expects such entities to have their
own ethics and Compliance Programs and code of ethics or may adopt ADMHS’ code
as their own.
For billing questions subcontractor employees may contact their supervisor, the Fiscal
Division, the Chief of Compliance, or Compliance Hotline 805.884.6855.
Deficit Reduction Act
In order to comply with Section 6032 of the Deficit Reduction Act of 2005 and with the
Federal False Claims Act, ADMHS has established a Compliance Plan, as well as
policies for all employees, detailing our commitment to detect and prevent waste, fraud,
or abuse in Federal, State, and local health care programs.
It is the policy of ADMHS to submit only valid claims for services performed in an
efficient, effective, and professional manner. All ADMHS employees, contractors and
other workforce members have a duty to participate in efforts to prevent waste, fraud,
and abuse, and ensure that public resources are used ethically, prudently, and for
legally designated purposes.
The Federal False Claims Act prohibits any person from submitting a false claim for
payment or approval from the Federal government. False claims can include
overcharges, underpayments, providing inappropriate or unnecessary medical
procedures in order to increase reimbursement, upcoding, unbundling services to
increase revenue, or charging for one service when providing another. Under the False
Claims Act, those who knowingly submit, or cause another person or entity to submit,
false claims for payment of government funds are liable for three times the
government’s damages, plus civil penalties of $5,000 to $11,000 per false claim. In a
civil lawsuit, the government does not have to prove intent to defraud for financial gain,
only that the claims submitted were not valid.
Criminal lawsuits for willful misrepresentation can take many forms, including
deliberately falsifying documentation for payment, deliberately covering up or hiding
information about a false claim, lying to an investigator, or obstructing an ongoing
investigation related to false claims action. If a person is found guilty, there are both
financial penalties and possible imprisonment of up to five years.
Page 6 of 6 Any person who becomes aware of an entity filing false claims with the government may
bring an action in court under this law for up to six years after
the false claim. That person becomes known as a “qui tam” or “whistleblower.”
Employers cannot retaliate or punish an employee who initiates a qui tam lawsuit.
ADMHS employees are required to report any suspected inappropriate activity to their
immediate supervisor or the Chief of Compliance at 805.681.4092 or the Compliance
Hotline 805.884.6855.
Federal Definitions of Abuse and Fraud:
Abuse means provider practices that are inconsistent with sound fiscal, business or
medical/clinical practices, and result in an unnecessary cost to the Medicaid program, or in
reimbursement for services that are not medically necessary or that fail to meet professionally
recognized standards for health care. It also includes recipient practices that result in unnecessary
cost to the Medicaid program.
Fraud means an intentional deception or misrepresentation made by a person with the
knowledge that the deception could result in some unauthorized benefit to himself or some other
person. It includes any act that constitutes fraud under applicable Federal or State law.
Examples of Fraud and Abuse:
Abuse Abuse usually occurs as a result of poor and/or inefficient utilization of
resources. Examples are the overutilization of services (such as the provision of too
many services and insufficient proof that they are having a positive impact or that the
services are the reason for improvements; billing for excessive documentation and
travel time; and claims for services that are not medically necessary to the extent
provided).
Fraud is intentional and examples are “knowingly” billing for services that were not
provided, misrepresenting the services provided/billing for a costlier service (upcoding),
billing for more time than it took to provide the service, misrepresenting the diagnosis to
justify the service, etc. Continuation of abuse or repeated unnecessary care problems
could be deemed fraud.
Page 7 of 7 Diagram
D
1 – Fraud Triiangle



Pe
erceived pre
essure or mo
otivation ma
ay include
fin
nancial prob lems, addicctions like ga
ambling,
shopping or d
drugs, presssure to show
w good
pe
erformance o
or results (p
productivity
y quotas), orr just
the thrill of be
eing able to get away w
with something.
Ra
ationalizatio n is when in
ndividuals th
hink they arre
jus
stified becau
use they are
e underpaid
d, others are
e
do
oing it, it's fo
or their fam
mily, or they need it now
w but
they'll pay it b
back before anyone nottices.
Op
pportunity iss created when there are weaknes
sses
in controls. I ndividuals tthink they w
won't get cau
ught
be
ecause nobo
ody is lookin
ng, or review
wing, or
pe
erforming re
econciliations and review
ws. Antitrus
st
Antitrustt laws are designed to
t create a level playying field in
n the markketplace an
nd to
promote
e fair compe
etition. The
ese laws co
ould be viola
ated by disscussing AD
DMHS business
with a competitor,
c
such as disclosing
d
th
he terms o
of supplier relationship
ps, or agre
eeing
with a competitor
c
to refuse to
t deal with
h a supplie
er. Our com
mpetitors a
are other health
systems
s and facilitiies in marke
ets where we
w operate .
ADMHS
S must ma
anage our subcontrac
ctor and ssupplier relationships in a fair and
reasona
able manner, free from
m conflicts of
o interest a
and consiste
ent with all applicable laws
and goo
od busines
ss practice
es. ADMHS promote
es competitive procu
urement to
o the
maximum extent practicable.
p
ction of sub
bcontractorrs, supplierrs, and ven
ndors
Our selec
will be made
m
on th
he basis off objective criteria inccluding qua
ality, technical excelle
ence,
price, and delivery
y, adherenc
ce to sche
edules, servvice, and m
maintenancce of adeq
quate
sources of supply.
Our purc
chasing de
ecisions willl be made on
o the sup plier’s ability to meet our needs,, and
not on personal relationship
r
s and frien
ndships. A
ADMHS em
mploys the highest etthical
standard
ds in busin
ness practices in supplies sele
ection, neg
gotiation, determinatio
on of
contractt awards, an
nd the adm
ministration of
o all purchasing activvities.
Stark Regulations
s
To com
mply with Federal Stark
S
regulations, AD
DMHS prohibits physsician refe
errals
considerred a desig
gnated hea
alth service (i.e. labora
atory) to an
n entity in w
which they hold
Page 8 of 8 P
financial interest. Financial interest also includes physician’s family members. This
regulation applies to physicians only. Any questions regarding the parameters of the
Stark law may be directed to the Chief of Compliance or Compliance Hotline
805.884.6855.
Health Insurance Portability and Accountability Act (HIPAA)
"HIPAA" is an acronym for the Health Insurance Portability & Accountability Act of 1996
(August 21), Public Law 104-191, which amended the Internal Revenue Service Code
of 1986. Also known as the Kennedy-Kassebaum Act, the Act includes a section, Title
II, entitled Administrative Simplification, requiring:
1. Improved efficiency in healthcare delivery by standardizing electronic data
interchange, and
2. Protection of confidentiality and security of health data through setting and
enforcing standards.
More specifically, HIPAA called upon the Department of Health and Human Services
(HHS) to publish new rules to ensure:
1. Standardization of electronic patient health, administrative and financial data
2. Unique health identifiers for individuals, employers, health plans and health care
providers
3. Security standards protecting the confidentiality and integrity of "individually
identifiable health information," past, present or future.
HIPAA is designed to standardize the way all healthcare organizations electronically
exchange client data and to protect clients from unauthorized disclosure of their medical
records. HIPAA regulations require healthcare organizations to formalize a plan that
complies with auditability, security, privacy, and transaction exchange standards.
ADMHS has implemented policy and procedures for electronic data and the protection
of health information of our clients. Training has occurred with all employees and
continuing education will occur as new guidelines come from the Federal government.
Business and Financial Information
Accuracy, Retention, and Disposal of Documents and Records
Page 9 of 9 Each ADMHS employee is responsible for the completeness and accuracy of the
organization’s documents and records, not only to comply with legal and regulatory
reporting and disclosure requirements but also to document compliance with our
business standards and guidelines. No one may alter or falsify information on any
record or document. No one may destroy a record in an effort to deny governmental
authorities that which may be relevant to a government investigation.
“Medical and business documents and records” must be retained in accordance with the
law and with ADMHS’ record retention policy, which includes comprehensive retention
schedules. “Medical and business documents and records” include paper documents
such as letters and memos, computer-based information such as e-mail or computer
files on disk or tape, and all other media that contain information about ADMHS, its
clients or business activities.
Business and Financial Information
Accuracy, Retention, and Disposal of Documents and Records
Each ADMHS employee is responsible for the completeness and accuracy of the
organization’s documents and records, not only to comply with legal and regulatory
reporting and disclosure requirements but also to document compliance with our
business standards and guidelines. No one may alter or falsify information on any
record or document. No one may destroy a record in an effort to deny governmental
authorities that which may be relevant to a government investigation.
“Medical and business documents and records” must be retained in accordance with the
law and with ADMHS’ record retention policy, which includes comprehensive retention
schedules. “Medical and business documents and records” include paper documents
such as letters and memos, computer-based information such as e-mail or computer
files on disk or tape, and all other media that contain information about ADMHS, its
clients or business activities.
Confidential Information
ADMHS employees may use “confidential information” only to perform their job
responsibilities and shall not share such information with others unless the individuals
and/or entities have a legitimate need to know the information in order to perform their
specific job duties or to carry out a contractual business relationship, provided
disclosure is not prohibited by law or regulation.
“Confidential information” includes but is not limited to payroll, personnel files, and
information on disciplinary matters.
Page 10 of 10 If an individual’s employment or contractual relationship with ADMHS ends for any
reason, the individual is still bound to maintain the confidentiality of information viewed,
received, or used during the employment or contractual business relationship with
ADMHS. This provision does not restrict the right of an employee to disclose, if he or
she wishes, information about his or her own compensation, benefits, or terms and
conditions of employment. Copies of confidential information in an employee’s or
contractor’s possession shall be left with ADMHS at the end of the employment or
contractual relationship.
Electronic Media and Security Requirements
Each ADMHS employee must protect our computer systems and the information
contained in them by not sharing passwords and by reviewing and adhering to our
information security policies and guidance.
All communications systems, including but not limited to computers, electronic mail,
Intranet, Internet access, telephones, and voice mail, are the property of the County and
are to be used for business purposes in accordance with the following electronic
communications policies and standards:
No user should assume these electronic communications are private, nor expect privacy
in anything they create, store, send, or receive on the computer systems. The
Department reserves the right to monitor and/or access the use and content of
communications.
Employees may not use internal communication channels or access to the Internet at
work to post, store, transmit, download, or distribute any threatening materials;
knowingly, recklessly, or maliciously false materials; obscene materials; or anything
constituting or encouraging a criminal offense, giving rise to civil liability, or otherwise
violating any laws. Also, these channels of communication may not be used to send
chain letters, personal broadcast messages, or copyrighted documents that are not
authorized for reproduction.
Employees who abuse our communications systems or use them excessively for nonbusiness purposes may lose these privileges and be subject to disciplinary action.
Employees shall comply with ADMHS’ security policies governing use of information
systems. Passwords shall never be shared or disclosed. Employees shall not use tools
or techniques to break or exploit ADMHS information security measures, or those used
by other companies or individuals. ADMHS information systems shall not be used to
access inappropriate or prohibited websites.
Workplace Conduct and Employment Practices
Ethics
Page 11 of 11 Ethics are relevant to all aspects of service delivery. ADMHS clients and the public
depend upon the decisions we make and the actions we take each day. Our values
define how we will evaluate our decisions and actions and how we will conduct our
operations. As ADMHS employees, working in a demanding, ever-changing service
environment, the Department recognizes that all employees encounter ethical
challenges in their work. All the activities of our Department’s employees rest on the
foundation of integrity, innovation, and commitment. Together we must move our
Department forward, one good decision at a time. A workplace culture of trust,
openness, and strong values is vital. Each of us shares a personal responsibility to
protect, preserve and enhance their workplace culture.
Fair Treatment of Employees
ADMHS employees provide a wide complement of talents, which contribute greatly to
our ability to carry out our mission and preserve the public trust. ADMHS is committed
to providing an equal opportunity work environment where everyone is treated with
fairness, dignity, and respect. ADMHS complies with all laws, regulations, MOU’s, and
policies related to non-discrimination in all of our personnel actions. Such actions
include hiring, staff reductions, transfers, terminations, evaluations, recruiting,
compensation, corrective action, discipline, and promotions.
No one shall discriminate against any individual with regard to race, color, religion, sex,
national origin, age, disability, or sexual orientation. ADMHS makes reasonable
accommodations to the known physical and mental limitations of otherwise qualified
individuals with disabilities.
Protect Assets
ADMHS protects the County’s property and assets. As employees, we:
• Are responsible and accountable for the proper expenditure of County funds and
for the proper use of County assets and property which include time, material,
supplies and information. We recognize that the County’s assets and property are
to be used for business-related purposes only.
 Have a duty to participate in efforts to prevent fraud, waste, and abuse and ensure
that public resources are used ethically, prudently and for legally designated
purposes.
• Obtain appropriate authorization prior to accessing restricted or secure work
areas.
• Dispose of surplus, obsolete, or inoperable property in accordance with the
County’s procedures. We acknowledge that unauthorized disposal, including
scrapping, selling or transferring of property without appropriate approval, is a
misuse of assets.
Page 12 of 12 • Safely store, secure, document, transport, relocate the inventory controlled and
fixed assets and report missing assets promptly to the assigned asset control
officer in accordance with County policy.
• Use computer systems, networks, and software consistent with ADMHS
license(s) and/or rights, and store equipment, data files and software in a secure
manner in accordance with County policies and procedures.
• Report any observed misuse of ADMHS property or funds to an appropriate
supervisor or manager, Human Resources, the Chief of Compliance, or the
confidential Compliance Hotline 805.884.6855.
Individual Conduct
Our greatest strength lies in the talent of our staff who foster our success and
reputation. We treat our colleagues with respect, dignity, and courtesy.
We must:
• Maintain a working environment free from all forms of harassment or intimidation,
sexual or otherwise, showing respect and consideration for each other.
Discriminatory treatment, abuse, violence or intimidation is not tolerated.
• Provide equal employment and advancement opportunities to all applicants and
employees pursuant to ADMHS and County policies.
• Conform to the codes of ethics and standards of our respective professions and
exercise sound judgment in the performance of duties.
• Comply with work and safety policies in accordance with County and ADMHS
policies and procedures, including but not limited to the County of Santa Barbara
drug and alcohol policy prohibiting the use of alcohol or drugs in the workplace.
• Not bring dangerous weapons to the workplace, out to the work location or onto
any County operated worksite, including parking lots. A dangerous weapon is a
firearm or any other instrument capable of causing bodily harm when used in a
manner and under circumstances that manifest intent to harm, or to intimidate
another person, or that would cause a reasonable person to have concern for
their safety or the safety of another.
• Respect the privacy of our patients, constituents, clients, and colleagues
recognizing that we have access to the information of others on a “need to know”
basis only.
• Refrain from discussing sensitive or confidential information in any public area,
including elevators, hallways, restrooms, lobbies or break rooms.
• Use work hours to perform County duties and assignments in a productive and
professional manner.
Work Relationships
Page 13 of 13 ADMHS is committed to establishing and maintaining ethical and supportive work
relationships. As employees, we:
 Seek positive and cooperative relationships within ADMHS, as well as other
County agencies/departments, government programs, vendors, contractors,
community groups, and industry to enhance services and resources available to
the public.
 Practice integrity in our dealings with customers, vendors, payors, other employees
or agents, and the community.
 Report any observed non-compliance with ADMHS policies and procedures, laws
or regulations to an appropriate supervisor or manager, Human Resources, the
Office of Compliance, or the confidential Compliance Hotline.
 Disclose to the supervisor or manager involvement in any relationships that
compromise objectivity, accountability, or judgment, or give the appearance
thereof.
 Maintain a work culture that promotes the prevention, detection, and correction of
instances of conduct that do not conform to ethical standards and our Code of
Conduct.
 Ensure that no employee is required to compromise appropriate professional
integrity, standards, judgment or objectivity in the performance of his or her
duties.
 Ensure that all reports or other information provided to any internal or external
entities including Federal, State, or local government agencies are accurate and
submitted in a timely manner.
 Perform duties in a way that promotes the public trust and encourages participation
and access to County programs and resources.
Dual/Personal Relationships with Clients
The Department prohibits staff from engaging in dual relationships with clients. Dual
Relationships occur when provider staff exceeds professional boundaries with clients
allowing a personal connection with a client to develop outside of the scope of providing
services. For example, providing services to a client and/or engaging in socialization
activities that are beyond the therapeutic/case management relationship.
Page 14 of 14 Provider staff has an influential position with clients and it is expected that provider staff
establish and maintain appropriate professional boundaries with clients in order to avoid
the exploitation of a client’s trust and dependency. Further, failing to set appropriate
boundaries with clients may impair the professional judgment of provider staff.
Staff is advised that engaging in the following activities with clients, clients’ relatives, or
other individuals with whom clients maintain a close personal relationship are
considered “boundary” issues and may result in disciplinary action up to and including
termination:






Accepting gifts (regardless of value),
Accepting favors,
Renting rooms to/from clients,
Hiring a client to work for you personally,
Discussing personal issues not related directly to a client’s recovery, and
Purchasing gifts for clients that are beyond the therapeutic/case management
relationship and that are not approved by a supervisor.
Staff is expected to report and discuss any and all concerns/questions or potential
issues regarding professional boundaries or client interactions with their supervisor
immediately.
Sexual Relationships
Under no circumstance will ADMHS Workforce members engage in any sexual activities
or sexual contact with current clients, clients’ relatives, or other individuals with whom
clients maintain a close personal relationship. Providers assume the full burden of
setting clear, appropriate, and culturally sensitive boundaries.
Under no circumstance will ADMHS Workforce members engage in physical contact
with clients when there is a possibility of physical or psychological harm to the client as
a result of the contact.
Conflict of Interest
A conflict of interest may occur if an ADMHS employee’s outside activities, personal
financial interests, or other personal interests influence or appear to influence his or her
ability to make objective decisions in the course of the employee’s job responsibilities. A
conflict of interest may also exist if the demands of any outside activities hinder or
distract an employee from the performance of his or her job or cause the individual to
use ADMHS resources for other than ADMHS purposes.
ADMHS employees are obligated to ensure they remain free of conflicts of interest in
the performance of their responsibilities at ADMHS. If employees have any question
about whether an outside activity or personal interest might constitute a conflict of
interest, they must obtain the approval of their supervisor before pursuing the activity or
obtaining or retaining the interest.
Page 15 of 15 Business Courtesies
General
This part of the Code of Conduct should not be considered in any way as an
encouragement to make, solicit, or receive any type of entertainment or gift. For clarity
purposes, please note that these limitations govern activities with those outside of
ADMHS. This section does not pertain to actions between ADMHS and its employees or
actions among ADMHS employees themselves.
Receiving Business Courtesies
Policy
County Counsel sets forth office policy with regards to gifts from persons or entities to a
County employee. “Gift” means any item of value, of whatever nature, and includes
meals, refreshment, transportation, or entertainment.
All decisions must be made and actions taken with complete impartiality and without
favoritism and the appearance of partiality or favoritism must be avoided. To this end,
the following standards shall be observed.
1. No person in ADMHS shall accept from any person or entity with whom the
recipient is dealing as a County employee any gift the cash value of which
exceeds $10.00, or gifts the aggregate value of which exceeds $50.00 in any
twelve-month period.
2. The provisions of paragraph 1 shall also apply where the recipient reasonable
anticipates dealing with the donor in an official capacity in the near future, or
has done so within the past six months.
3. In the event a gift (or gifts) are received in excess of the amounts set out in
paragraph 1, from a person or entity with whom official dealings are not
anticipated, but such dealings in fact arise within six months of the receipt of the
gift(s), the recipient shall inform County Counsel in writing of the nature and
value of the gift, and the time and circumstances of its receipt.
4. In applying the above provisions, the following shall apply:
a. Gifts from other employees of Santa Barbara County are exempt.
b. Gifts for which the recipient would otherwise be entitled to reimbursement
from the County, e.g., transportation on County
business, are exempt.
c. Gifts to members of the employee’s immediate family shall be
Page 16 of 16 considered gifts to the employee.
d. Meals provided to an employee in a setting where the price is not
set forth (non-restaurant dinner or buffet) shall be valued at $10.00.
INCOMPATIBLE OUTSIDE EMPLOYMENT
Purpose
The County's policy is to control the practice of outside employment by employees,
particularly when a conflict of interest exists or when such employment would impair an
employee's effectiveness or ability to perform County duties.
Prohibiting Conditions
County employees are prohibited from holding employment outside the County service
when one or more of the following conditions exist:
a. The employment interferes with satisfactory service because of time away
from the job or causes physical or mental fatigue which impairs regular County
service.
b. Such employment is incompatible with the proper discharge of official duties,
or would tend to impair the employee's judgment or action in the performance of
those duties.
c. A conflict of interest would exist which is prohibited by law or which would be
detrimental to the County.
Notification
A written notification must be given to the Department head for all regular outside
employment and for all occasional outside employment. Failure to provide such
information may be cause for disciplinary action. An outside work statement must
contain the name of the employer (or statement of self-employment), the hours worked,
the nature and the duration of employment.
Order to Cease Working
A Department head shall disapprove outside employment if the employment is in
violation of the provisions of this Rule.
Harassment and Workplace Violence
Page 17 of 17 Each ADMHS employee has the right to work in an environment free of harassment and
disruptive behavior. ADMHS does not tolerate harassment by anyone based on the
diverse characteristics or cultural backgrounds of those with whom we work. Degrading
or humiliating jokes, slurs, intimidation, or other harassing conduct is not acceptable in
our workplace.
Sexual harassment is prohibited. This prohibition includes unwelcome sexual
advances or requests for sexual favors in conjunction with employment decisions.
Moreover, verbal or physical conduct of a sexual nature that interferes with an
individual’s work performance or creates an intimidating, hostile, or offensive work
environment has no place at ADMHS.
Harassment also includes incidents of workplace violence. Employees who observe or
experience any form of harassment or violence should report the incident to their
supervisor, the Human Resources Department, a member of management, County
EEO Manager, the Chief of Compliance or the Compliance Hotline 805.884.6855. For
forms and information refer to the County’s Anti-harassment policy.
Substance Abuse
The Department is committed to providing a safe work environment. This commitment is
placed in jeopardy when any employee participates in the illegal use or abuse of drugs
or alcohol on or off the job. Substance abuse is a serious problem that can endanger
County operations and the safety of employees and those who seek services from the
County. Employees who abuse drugs and/or alcohol, on or off duty, tend to be less
productive and have substandard performance, are less reliable, and prove to have
greater absenteeism, accidents, injury to themselves and others, resulting in the
potential for increased loss, delay, risk, and liability.
The Department strictly prohibits the possession, consumption, sale, purchase,
distribution, manufacture, or being under the influence of, alcohol and/or illegal drugs (or
prescription drugs, if use adversely affects the employee’s ability to perform County
employment safely and effectively) during employee’s work hours, in County vehicles,
personal vehicles used for County business, while in County uniform as applicable, or
on County property.
Diversity and Equal Employment Opportunity
Page 18 of 18 ADMHS
S actively prromotes div
versity in its
s workforce
e at all leve
els of the orrganization.. Our
Departm
ment is com
mmitted to providing
p
an
n inclusive w
work enviro
onment where everyone is
treated with
w fairnes
ss, dignity, and respect. We will make oursselves acco
ountable to
o one
another for the ma
anner in which
w
we trreat one an
nother and for the m
manner in w
which
people around
a
us are treated
d. ADMHS is an equa
al opportunity workforcce, and no
o one
gard to ag
shall dis
scriminate against an
ny individu
ual with reg
ge, ancestry, race, ccolor,
religion, sex, natio
onal origin,, marital status, physsical or mental disab
bility, economic
status, appearance
a
e, medical condition,
c
or
o sexual orrientation w
with respectt to any offe
er, or
term or condition, of employm
ment. ADM
MHS makess reasonablle accomm
modations to
o the
individua
al needs off qualified in
ndividuals with
w disabili ties.
Ineligible Persons
s
ADMHS
S does not contract
c
witth, employ, or bill for sservices ren
ndered by, an individu
ual or
entity ex
xcluded or ineligible
i
to
o participate
e in Federa
al healthcare
e programss; suspende
ed or
debarred
d from Fed
deral govern
nment conttracts; or co
onvicted off a criminal offense related
to the provision
p
of
o healthcarre items or services, and has not been reinstated in a
Federal healthcare
e program after a pe
eriod of exxclusion, su
uspension, debarmen
nt, or
ineligibility, provide
ed that we
e are awarre of such criminal o
offense. AD
DMHS routtinely
searches the Depa
artment of Health and
d Human S
Services’ O
Office of Insspector Gen
neral
and General Services Admin
nistration’s lists of such exclude
ed and ineligible perssons.
Employe
ees, vendorrs and conttract agenc
cy employee
es are requ
uired to repo
ort to ADMHS if
they be
ecome exclluded, deb
barred, or ineligible tto participa
ate in Federal health
hcare
program
ms, or have
e been con
nvicted of a criminal offense re
elated to th
he provisio
on of
healthca
are items orr services.
o the syste
em or re-en
nters the syystem, ADMHS assig
gns a
When a new staff comes into
staff ide
entification number. Before
B
ass
signment o f the number, ADMH
HS conduccts a
number of fraud ch
hecks on the
e new staff.
ADMHS
S Ethics an
nd Complia
ance Program
m Structure
Program
It is the policy of ADMHS to comply
c
with Federal an
nd State law
ws and reg
gulations, an
nd to
promote
e and enforrce adherence to this policy. On
ne of the m
means ADM
MHS will usse to
promote
e and gain adherence
e to this po
olicy is the developme
ent and ma
aintenance of a
Complia
ance Progra
am.
This policy establis
shes a Com
mpliance Pro
ogram, stan
ndards, and
d policies a
and procedu
ures,
which prromote adh
herence to Federal
F
and
d State law
ws and regulations.
mpliance Prrogram is designed,
d
and will be implemente
ed and enfo
orced in ord
der to
The Com
promote
e ADMHS’ understand
u
ding of, and
d adherenc e to, State and Federral statutess and
regulatio
ons that are applicablle to ADMH
HS businesss, as well as to dete
ect, respond to,
and prevent violatiions of tho
ose requirem
ments. The
e Program’s design in
ncorporatess the
seven elements tha
at represen
nt industry standards
s
fo
or scope off a Complia
ance progra
am:
Page 19 of 19 1.
2.
3.
4.
5.
6.
7.
Standards and procedures
High level of oversight and delegation of authority
Employee training
Communication
Auditing & monitoring
Enforcement & discipline
Corrective actions & prevention
ADMHS Chief Compliance Officer
The ADMHS Chief of Compliance is responsible for the daily oversight of the
Compliance Program. The primary responsibilities of the Chief of Compliance include:
• Receiving, investigating, and following-up on concerns, questions, and issues
raised by employees or others related to the Compliance program, including
potential violations of the Code of Conduct, policies and procedures, laws and
regulations.
• Maintaining auditing and monitoring mechanisms to promote compliance.
• Ensuring an ongoing compliance education program for all employees and other
designated individuals.
• Monitoring the operation of the Compliance Hotline.
• Maintaining the Code of Conduct and compliance policies and procedures.
Compliance Committee
Providing direction, guidance and oversight are functions of the ADMHS Compliance
Committee. The Compliance Committee provides organizational support, creates
Department-wide awareness of the ethics and Compliance Program, and advises the
Chief of Compliance, ADMHS Director, and the ADMHS Executive Team on the
development and implementation of the Compliance Program. The Compliance
Committee meets regularly and is comprised of management representatives from all
divisions throughout the Department.
Setting Standards
The Compliance Program addresses the following goals and objectives:
1. Maintain a working environment that promotes ethical values, exemplary
behavior, and compliance with the letter and spirit of all applicable laws.
2. Encourage employees, affiliated professionals and contractors to demonstrate
the highest ethical standards in performing their daily tasks.
Page 20 of 20 3. Establishes a Code of Conduct.
4. Operates a disclosure system (Hotline) that requires ADMHS to respond to
reports by employees or others of a suspected violation of law or the principles of
the Program.
5. Identifies those situations in which the laws, rules and standards of Federal and
State programs or other applicable laws may not have been followed, and
facilitation of the correction of any such practices.
6. Implements procedures to assure future compliance with all laws and regulations
of the Medicare and Medicaid programs and all other applicable laws.
7. Train and communicate to assure employees, affiliated professionals and
contractors understand and comply with all State and Federal laws and
regulations, and endeavor to reduce the likelihood that violations will occur
through appropriate screening of potential employees and agents of ADMHS.
8. Assure that documents are retained and kept secure, as required by Federal and
State regulation, for the appropriate length of time.
9. Establish disciplinary policies related to compliance issues that are prompt,
effective, and consistent, and will discipline employees based on the severity of
the violation, and not on the basis of their position or tenure with ADMHS.
10. Assure that government inspections proceed in a smooth and professional
manner, and that all requests and concerns are addressed promptly and
appropriately.
Training and Communication
Training and education has been developed to ensure that employees throughout the
organization are aware of the standards that apply to them. Code of Conduct training
shall be conducted annually for all employees.
All training will be tracked for attendance. It will be the responsibility of the employee
and the employee’s supervisor to ensure attendance at mandatory training in a timely
manner.
Initial Hire and Annual Compliance Training Required
Compliance training is required for new staff members on initial hire, and training shall
be conducted annually for all employees.
Confidential Disclosure Program
You have an obligation to report, to the supervisor or manager within your chain of
command, any known or suspected violations to this Code of Conduct, as well as
known or suspected violations of any law, statute, regulation, policy, procedure or
guideline applicable to the Federal healthcare programs.
Questions or Concerns Related to Matters of Compliance
Page 21 of 21 The Department of ADMHS recognizes the critical importance of identifying and
appropriately responding to actions or behaviors that are not consistent with the Code of
Conduct, Department Policies and Procedures, or other codes, rules, regulations, or
laws that relate to or govern business and clinical operations.
Errors or non-compliant actions or behaviors are frequently a result of lack of clarity in
rules, regulations, or procedures. The Department believes that most questions or
concerns related to matters of compliance can be resolved promptly on a division or
organizational level. Employees are encouraged to contact their immediate supervisor
or manager to discuss questions or concerns related to compliance.
In addition to contact with an employee’s immediate supervisor or area manager, an
employee may raise questions regarding compliance or report perceived ethical or legal
violations to the Chief of Compliance or may contact the County Compliance Hotline at
805.884.6855.
If consultation with an employee’s immediate supervisor or manager does not clarify or
address the issue raised by the employee, or if the nature of the question or concern
directly involves actions or behaviors of the supervisor or area manager, the
Department has created an alternate means for employee’s to raise questions, express
concerns or report perceived ethical or legal violations.
Chief ofCompliance: Celeste Andersen
Telephone 805.681.4092
E-mail: [email protected]
Compliance Hotline Telephone 805.884.6855
ADMHS makes every effort to maintain, within the limits of the law, the confidentiality of
the identity of any individual who reports concerns or possible misconduct. There is no
retribution or discipline for anyone who reports a concern in good faith. Any employee
who deliberately makes a false accusation with the purpose of harming or retaliating
against another employee is subject to discipline.
Anonymous Reporting
If you want to report a suspected violation and wish to remain anonymous, you may call
the 24-hour Compliance Hotline or fill-out an electronic report online. The Compliance
Hotline 805.884.6855 provides a confidential means to report compliance related
concerns or violations after hours and/or when you are away from the office/clinic. You
can also report anonymously via the ADMHS website:
http://www.countyofsb.org/admhs/compliance.aspx
Calls will be treated as confidentially as practical or allowed by law.
You are not required to identify yourself when reporting a concern.
Internal Investigations of Reports
Page 22 of 22 ADMHS is committed to investigating all reported concerns promptly and confidentially
to the extent possible. The ADMHS Chief of Compliance coordinates any findings from
Department investigations and immediately recommends corrective action or changes
that need to be made to the Compliance Committee and/or ADMHS Director. All
employees are expected to cooperate with investigation efforts.
How to report improper acts
If after exhausting internal reporting channels, including the Chief of Compliance, an
individual has not been able to satisfactorily resolved concerns about possible violations
of Federal or State statutes, rules, or regulations, or violations of fiduciary responsibility
by a corporation or limited liability company to its shareholders, investors, or employees,
you may call the California State Attorney General’s Whistleblower Hotline at 1-800952-5225. The Attorney General will refer your call to the appropriate government
authority for review and possible investigation.
Statement of Non-retaliation
Committing or condoning retaliation for good faith reporting of a perceived or suspected
Code of Conduct violation, or retaliation for participation in an investigation of an alleged
violation, will not be tolerated. Any employee who commits or condones any form of
retaliation may be subject to discipline up to and including suspension or discharge.
The phrase “in good faith” means that the employee honestly or truthfully believes or
perceives the information reported to be true. Individuals who knowingly and
intentionally report false or misleading information in order to harm or retaliate against
another may be subject to discipline.
Corrective Action
Where an internal investigation substantiates a reported violation, it is the policy of
ADMHS to initiate corrective action, including, as appropriate, making prompt restitution
of any overpayment amounts, notifying the appropriate governmental agency, instituting
whatever disciplinary action is necessary, and implementing systemic changes to
prevent a similar violation from occurring in the future.
WHISTLE BLOWERS
In order to ensure that the conduct of ADMHS is ethical, professional, responsible, and
productive, employees and contractors agree to promptly report
any activity which they believe might violate these policies and procedures or any other
applicable law, regulation, rule or guideline, to their supervisor or to the Compliance
Hotline.
Whistleblower Protections in the Federal False Claim Act:
Page 23 of 23 31 USC Section 3730 (h) protects employees against discharge demotion, suspension,
threats, harassment, or discrimination by the employer because of lawful acts done by
the employee in cooperating with the False Claims Act, including investigation for,
initiation of, testimony for, or assistance in an action field or to be filed under this
section.
WHISTLEBLOWERS ARE PROTECTED
It is the policy of the State of California to encourage employees to notify an appropriate
government or law enforcement agency when they have reason to believe their
employer is violating a Federal or State statute, or violating or not complying with a
State or federal rule or regulation.
Who is protected?
Pursuant to California Labor Code Section 1102.5, employees are the protected class of
individuals. “Employee” means any person employed by an employer, private or public,
including, but not limited to individuals employed by the State or any subdivision thereof,
any County, city, city and County, including any charter city or County, and any school
district, community college district, municipal or public corporation, political subdivision,
or the University of California. [California Labor Code Section 1106]
What is a whistleblower?
A ‘whistleblower’ is an employee who discloses information to a government or law
enforcement agency where the employee has reasonable cause to believe that the
information discloses:
1. A violation of a Federal or State statute.
2. A violation or noncompliance with a Federal or State rule or regulation, with reference
to employee safety or health, unsafe working conditions or work practices in the
employee’s employment or place of employment.
What protections are afforded to whistleblowers?
1. An employer may not make, adopt, or enforce any rule, regulation, or policy
preventing an employee from being a whistleblower.
2. An employer may not retaliate against an employee who is a whistleblower.
Page 24 of 24 3. An employer may not retaliate against an employee for refusing to participate in an
activity that would result in a violation of a Federal or State statute, or a violation or
noncompliance with a Federal or State rule or regulation.
4. An employer may not retaliate against an employee for having exercised his or her
rights as a whistleblower in any former employment.
Under California Labor Code Section 98.6, if an employer retaliates against a
whistleblower, the employer may be required to reinstate the employee’s employment
and work benefits, pay lost wages, and take other steps necessary to comply with the
law.
Summary
The Code of Conduct specifies and clarifies the Department’s commitments, values,
and expectations of employees in conducting Department business. In addition, the
Code of Conduct offers employees reference points upon which to focus in carrying out
the highest quality of service delivery.
The Department, as a public entity, is committed to serving the needs of our community.
The Department believes that the Code of Conduct will assist in meeting its goals with
the highest integrity and in a manner that is responsive to our employees, clients and
their families, and other stakeholders. The Code of Conduct affirms the commitment of
the Department to uphold the highest ethical and legal standards.
Page 25 of 25 HOW
WT
TO…
( (This page intentionally left blank.) How to Retrieve Frequently Used Forms Letterhead 1. Open Microsoft Word. 2. Select File  New. 3. Select My Templates. 4. Select the ADMHS Admin tab. 5. Double click on ADMHS Letterhead. 6. Select the site at which you work. 7. Save the file. Travel Reimbursement Claim It is available from the Auditor‐Controller Intranet here: http://sbchome.co.santa‐
barbara.ca.us/auditor/auditor.aspx?id=350 Travel Request 1. Open Microsoft Word. 2. Select File  New. 3. Select My Templates. 4. Select the ADMHS Admin tab. 5. Double click on Travel Requests. 6. Save the file. Mileage Log It is available here: http://sbchome.co.santa‐ barbara.ca.us/auditor/auditor.aspx?id=350 Credit Card Forms G:\Central Files\Fiscal Information\Credit Card Forms ADMHS Organizational Map (Fund Numbers, Cost Centers, Contacts for Approval) G:\Central Files\Fiscal Information\ADMHS Forms & Information\ADMHS Organizational Map Payroll Calendar Open the County Intranet. Click on “Payroll Calendar.” It appears under “Popular Tools on the left‐hand side of the home page. Establishing YYour
E-Learrning Acccount
Go to http://santaabarbaraadmh
hs.network
ofcare4eleaarning.org/ 1.
2.
M
MEETIN
NG TRA
AINING REQUIREMEN
NTS
FOR YOUR
Y
JO
OB AND
D PROFFESSIO
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Each
h year ADMH
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mbers are required to take several mandatory train
nings. The nu
umber and tyype depend on your jobb classs. However, every staff member, inccluding volunteers, musst complete follow
wing courses:: 


Consume
er and Family Culture Cultural C
Competence
e Elective Code of C
Conduct Option 1: C
Check thee ADMH
HS trainin
ng calendar. Some are listed in the trainin
ng calendar:: http://cosb.coun
ntyofsb.org//admhs/calm
month.aspx Option 2: U
Use E‐Lea
arning http://santabarb
baraadmhs.n
networkofcaare4elearnin
ng.org/ Courrses are also
o available to
o take anytim
me using ourr online learrning systeem. All courrses are free
e for ADMHSS staff, and n
numerous CEEU courrses are avaiilable for liceense renewa
al. To take online classess, you mustt have an E‐Learning acccount. If you
u do not alre
eady have ann acco
ount, follow tthe procedu
ure outlined in the colum
mn to the rigght. Forr more in
nformation: For q
questions ab
bout eLearning, please contact Tawn
ny Kauka, 6881‐5339. For m
more inform
mation aboutt systems traainings (non‐‐clinical), conntact Jenn
nifer Langenh
heim, MS, jlaangenheim@
@co.santa‐barbara.ca.uss; 681‐
5367
7. For inform
mation abou
ut clinical trainings, contaact Elisa Gotttheil, Ph.D
D., egotthe@
@co.santa‐baarbara.ca.us;; 681‐5366.
Click th
he “new user” tab Enter yyour user namee in the following way CAM_FFirstnameLastn
name (all onee word) 3. THEN u
use your last naame as your paassword 4. Alwayss use your coun
nty‐
assigneed email addreess Example: if your nam
me is Clark Kent: User Name: CAM_C
ClarkKent Passwo
ord: Kent (The usser name and p
passwords are casse‐sensitive.) 5. After you have registered for an E‐Learn
ning account, p
please send an emaail to Tawny Kaauka, 681‐
5399, [email protected]
nta‐
barbaraa.ca.us, and include the name o
of your superviisor in the email. We will try ou
ur best to activate your accountt within 24 hours u
upon receivingg your email. If you already have an E‐
Learnin
ng account, it is unneceessary to re‐reggister. CLINICAL TRAININGS focus on clinical to
opics such ass co‐
occurring disorders, w
writing accurate aassessmentss, and working towards reco
overy and wellness. SYSTEMS TRAININGSS include mandatorry classes, documentation, consumer and family culture, ettc. Fro
om: http://ww
ww.fullcupthirstyspirit.com
m/includes/550‐ways‐to‐take‐a‐break‐printable.jpg
Contracts Manual
If ANYONE sends you a contract or agreement requesting your signature, DO NOT SIGN,
forward it immediately to Contracts at [email protected]‐barbara.ca.us.
All requests start with a completed REQUEST FORM submitted via email.
Step1. Gather all important backup documentation such as: quotes, rates, estimates , emails and/or
statements of work that will justify your request
County Purchasing is now requiring that all purchases of goods or services over $3,000 include a quote summary
form. As you are working on requesting goods or services over $3,000, please be sure to get quotes or otherwise
obtain pricing from at least two vendors, and make note of both on the attached form (also available
here: http://sbchome.co.santa-barbara.ca.us/gs/purchasing/forms/documents/QuoteSummaryForm.doc). Please
scan and email this form, along with the completed Contracts Request Form (available in Word Templates on the
Contracts tab), to [email protected] for any new or increasing Purchase Orders.
Step2.Fill out the Request Form
 The Request Form is located inG:/CentralFiles/Contracts/Contracts/RequestForm2014and the
 Instructions to fill out the form are located in G:/CentralFiles/Contracts/Contract/Contracts
RequestFormInstructions
Step3.Submit the Request Form to your manager for approval and signature
You are only responsible for obtaining your Manager’s signature (If you are a manager, please have the person you
report to, sign. If an Executive initiates the request, the Managers’ signature line can be left blank (but it will still
require Fiscal approval, which contracts will do for you)
Once you have the appropriate signature for your request , go to step 4
Step4. Forward to Contracts via email at [email protected]‐barbara.ca.us.(Please
DO NOT Brown Mail) or you can leave it in our mailbox in Admin (Bldg.3). We pick up daily.
Don’t forget to include all back up documentation.
Work cannot start until a signed contract has been received by the supplier or the Minute Order from the
Board of Supervisors (Board Contracts). Departments will not be sent a copy of the contract unless
requested. You can also check with Contracts for the status of a request and/or the signed contract.
Fiscal does NOT accept any requests for payment prior to any services rendered
Page 1 of 1
QUOTE SUMMARY FORM
County Department:_______________________________
Requestors Name:_________________________________
Items or services requested:_____________________________________________________________________
Quote Information
Vendor Name:_______________________________
Total Price: $_________________________
Vendor Name:________________________________
Total Price: $__________________________
Vendor Name:________________________________
Total Price:$____________________________

Per Federal Small Purchase Procedures ($3k - $150k) more than one (1) quote is required
Method of competitive analysis performed (circle one):
Oral Quote
Written Quote
Price List
Internet Search
Employee Printed Name:____________________________________
Signature:__________________________________
Date:________________
N/A - Sole-Source
Contracts Manual
Contracts that Require Purchasing Authority to Issue
Tangible Items
 Tangible Items: (Things you can touch and feel ex. tools, machines, equipment)



If under 1K, you can submit it directly to Fiscal/Accounting for a one-time
payment.
If over 1K and/or will require ongoing purchases- Submit to contracts for
Purchasing authority to issue a contract
If over 25K- it will go to Bid, submit to Contracts and it will be forwarded to
Purchasing with Purchasing authority to issue a contract.
Contracts Based on Services
 Independent Contractors: - Provides a service, can ship and charge for goods, are experts
or recognized professionals and agree to perform the "service" specified in the contract.


If under 100K, Submit to Contracts for Purchasing authority to issue a contract
If over $100k (new or on-going increases) Contracts will prepare and forward it
to the Board of Supervisors for Approval (Board Contract) to complete the
process.
You can use a supplier's estimate, proposal, quote, letter of intent, or other like document.
The Statement of Work (SOW) must contain:


The expected outcome, described well enough to determine at completion
whether it was performed satisfactorily;
The pricing structure (per unit, per hour, per deliverable, etc.).
 A COP: (Contractor On Payroll) –They differ from an Independent Contractor because
COP’s perform work tasks similar to a regular employee, utilizing County work-space,
equipment & supervision.


If under 25K, Submit to Contracts for Purchasing authority to issue a contract
If over 25K, Submit to Contracts and it will be prepared and forwarded to the
Board of Supervisors for Approval (Board Contract)
Must include
A description of duties in sufficient detail to evaluate performance; (including
duty schedule)
All compensation details, including: earnings codes and how they are to be used;
Paid leave accrual rates and pay-out/use-lose arrangements;
Any additional benefits negotiated with Contractor (such as disability, health or
death benefits, vacation, paid time off, professional membership dues, etc.)
Page 2 of 2
Contracts Manual
In addition to the above the following apply


This request is also forwarded to the Auditor and or County Counsel for
additional approval.
All new COP’s are subject to County HR/CEO approval and may not be
approved.
Public Projects

Facilities and Maintenance: (These may require bidding and/or a Board Contract)
These can involve equipment, material and labor for construction, alteration, improvement,
repair or demolition of property.
 Under $45k – Does not require a bid; Submit a request to your
Facilities/Maintenance Manager
 $45k - $175k –The request will go to an Informal Bid required with purchasing
authority to issue a contract. Submit a request to your Facilities/Maintenance
Manager
 Over $175k –The request will go to a Formal Bid required with Board Of
Supervisors with authority to issue a Board Contract. Submit a request to your
Facilities/Maintenance Manager
Facilities/Maintenance manager, Ernest Thomas at [email protected]
Contracts that do not require Purchasing Authority
 Student Support Agreements (SSA) - Any student who desires a work study, internship
or other learning experience at any ADMHS location.

A sample SSA will be sent to the school of interest. If the school does not agree or
alters the terms of the SSA, it will be forwarded to County Counsel for review. In the
event, an agreement cannot be reached; ADMHS will NOT accept the student.
 Memorandum Of Understanding (MOU) - A memorandum of understanding is a
formal agreement between two or more parties. MOUs are not legally binding but they carry
guidelines and mutual respect as the parties work towards an objective goal
 State Funding Revenue- These are considered State Contracts and require Board of
Supervisors approval, regardless of the amount
 Resolutions-Resolutions are prepared when required by Federal or State statute, County
Ordinance or accepted County practice. Please see Clerk of the Board Agenda Procedures
Manual (pgs. 15-20) for types of resolutions and guideline requirement’s.
Page 3 of 3
Contracts Manual
How to identify what type of Contract was issued
 Purchase Orders: This is the most common type of contract issued based on the above
guidelines
 Service Contracts are issued as a “CN” number Ex. CN15236
 CN’s regardless of amount do not go to bidding but have the following
guidelines
- Authority up to $100k via a Purchase Order
- Authority over $100k Via a Board Contract


COP’s are issued using their “EID” number (Employee ID) Ex. EID 2536

Public Projects are issued as “DP” numbers
Ex. DP02536
Blanket Orders: This document allows multiple purchases of like items over a time period
(Contracts FY time period ex. 7/1/2014-6/30/2015)

Blanket Orders are issued as “BL” numbers Ex. BL05236
 Board Contract: A Board Contract is a contract that has been approved by the Board of
Supervisors with items outside the approval authority granted.

Board Contracts are issued using a “BC” number
EX. BC15236
When do you need a Board Contract?- For all Purchase Orders over $100,000 and for
construction or public projects over $125,000, COP’s over $25,000, for legal services, and for
contracts in which a Department does not have the budget in place at the time of the request.
Page 4 of 4
Contracts Manual
Estimated Timelines for Processing
 Simple Purchase Orders and Blanket Orders -On average can take up to 2weeks, once
it’s submitted to Purchasing by Contracts
 Complex Purchase Orders – These can take up to 4 weeks, once it’s submitted to
Purchasing by Contracts
 Board Contracts- These can take up to 6-8 weeks to receive a fully executed contract, if
there are no complications or changes to the contract. In addition, Board Contracts must also
follow Docketing due dates and guidelines, for a complete copy see Clerk of the Board
Agenda Procedures Manual (pgs. 10-14). The agenda can be found on the “BOS Agenda”
tab on our home page.

“WET” Signatures- These contracts require an original signature (not a copy). Due to the
process of this contract, it will be routed downtown and hand delivered to all departments
for signatures (by contracts staff). If any department makes any changes to the contract,
the contract will be returned to the Analyst for corrections. The contract will then be rerouted for signatures as the whole approval process will start over again. The occurrence
of changes can happen at any point during the process and it may happen several times.
Wet Signatures include the following departments







Director of ADMHS
Fiscal/Finance Department (B-1’s or BRR’s)
County Counsel
Auditor Controller
Risk Management
Board of Supervisors
Contractor or Supplier (out of county signatures will need to be overnighted,
copy’s will not be accepted)
 Contractors on Payroll(COP’s)- These can take up to 4-6 weeks once it’s submitted to
Purchasing by Contracts, 6-8 weeks if it goes to the Board of Supervisors
 Student Support Agreements(SSA)- These can take up to 1-3 Weeks
 Memorandum of Understanding(MOU)- These can take up to 10-12 weeks
 State Funding Revenue- These can take up to 6-8 weeks.
 Resolutions- These can take up to 1-2 weeks
Page 5 of 5
Contracts Manual
What Can Cause Delays in Processing?
We do not have a timeline for delays as most of these are out of our control. We do work as quickly as
possible, to push the process as much as possible.
 Certificate(s) of Insurance- Failure to provide evidence of coverage will delay the signing of
a contract and therefore the start of the proposed work.
 All new contracts must provide a current copy of their insurance policy(s), with the
Counties minimum requirements.
 Amendments or Renewals- If there is not a current Certificate of Insurance on file or
if it’s expired at the time of the request, it will cause a delay until received. See
Certificates of Insurance for information and instructions.
 Incomplete signatures on the Request Form
 You are only responsible for obtaining your Manager’s signature (If you are a
manager, please have the person you report to, sign. If an Executive initiates the
request, the Managers’ signature line can be left blank (but it will still require Fiscal
approval)
 Any negotiations regarding statements of work/quotes, earnings, benefits, paid
leave/vacation. (Including any COP negotiations)
 All negations will require additional approval. The following will be forwarded to;
County Counsel, Auditor Controller and ADMHS CFO for review
 Non-acceptance/Alterations to the “County of Santa Barbara’s” Standard Terms and
Conditions, changes to any of the Agreements in the Exhibits including the B-1’s
 All requests for alterations will be forwarded to; County Counsel, Auditor
Controller and ADMHS CFO for review
 Financial Approval (internal ADMHS)
 Fiscal approval (signature approval from ADMHS Fiscal Manager)
 Budget approval (signature approval from ADMHS Interim CFO)
 Auditor Controller Approval (Board Contracts, Grants and COP’s)
 The review process may take up to three business days, once submitted by Contracts
for approval
 If the document packet is not complete upon receipt or requires additional documents
at the time of review, the return time will be longer
Note: All financial/accounting related questions will be directed to the CFO
 County Counsel Approval (Board Contracts ,COP’s and any other contracts regarding
alterations)
 This can take up to several weeks. If County Counsel requires Contracts to make
additional changes/corrections, the whole approval/routing process will start over
again
 Contractor Signature- If the contractor disagrees or refuses to sign, work cannot start
Page 6 of 6
Contracts Manual
Certificates of Insurance
A certificate of insurance is a document that gives evidence of the insured’s financial ability (via
an insurance policy) to respond to a claim.
There can be a variety of different requirements based on the contract type and/or the services
being provided. Once the request form is received by Contracts, the Certificate of Insurance is the
next internal step for processing. Please see below

All new contract requests will not be processed until a current Certificate of
Insurance is received by Contracts

All certificates of renewals for ongoing contracts must be received by Contracts
in either mail or email, no later than 30 days following the expiration date. The
contract can be suspended and payment withheld until the renewal
information is provided

Exceptions (waivers) are approved by Risk Management on a case by case basis
only. All requests for a waiver of insurance must be made in writing. Please
notify Contracts with such requests.

If you receive any Certificates of Insurance, forward to
[email protected]‐barbara.ca.us.
Any certificates received that does not provide the proper requirements and/or made alterations
without permission of Risk Management, will be sent back for corrections. This will create a
delay in processing and/or setting up a new contract.
If you are unsure or are being questioned about what is required, please forward all questions to
[email protected]. and Contracts will provide additional follow-up.
Failure to provide this document of evidence will delay signing of contracts
and therefore the start of the proposed work
Please see the next page for, The County of Santa Barbara’s Standard Requirements, per Risk
Management.
Page 7 of 7
Contracts Manual
1. Insurance Requirements that Each Provider is Required to Procure and Maintain
Certificates of Insurance must to be addressed as follows:
County of Santa Barbara
ATTN: ADMHS
300 North San Antonio Road, Bldg. 3
Santa Barbara, CA 93110
a. Automobile Liability Insurance - a current Certificate of - coverage limits for owned
and non-owned automobiles must meet or exceed $1,000,000 per occurrence; with
limit no less than $1,000,000 per accident for bodily injury and property damage.
b. General Liability - a current Certificate of; with limits no less than $1,000,000 per
occurrence and $2,000,000 in the aggregate.
c. Endorsement for General Liability Additional Insured –must read and name
“County of Santa Barbara, its officers, officials, employees, agents and
volunteers.” In the description of operations portion and in the actual
endorsement.
1. As a reminder, any contract requiring the County to be named as
an Additional Insured requires a copy of the endorsement showing
that the County has been added to the policy. These are reviewed
in the Risk Management division for Board Contracts and
Purchasing for their contracts.
d. Professional Liability Insurance - a current Certificate of; with limit of no less than
$1,000,000 per occurrence or claim, $2,000,000 aggregate.
e. Worker’s Compensation Insurance - a current Certificate; with limit of no less than
$1,000,000 per accident for bodily injury or disease. Please note if you are the sole
contractor and do not have employees we require a letter noting this for our files.
Page 8 of 8




Goods/Services over $1,000 in a Fiscal Year Goods/Services less than $1,000 Countrywide Contract Memberships/Subscriptions/Travel Emergencies Yes, determine which type No contract is needed 

Yes Independent Contractors less than 100K Contractor on Payroll less than 25K Purchase Order No Board Contract Submit Contract Request Form Blanket Purchase Order Goods over $1,000 recurring annually Contract Request Form Department Manager Submits to Contracts Executive Approval Include: 


Contract Amount
Rates
Attachments
Fiscal Approval Certificates o
of Insurance
General Liabilitty 

$1 M peer occurrence $2 M agggregate Endorseme
ent for General Liab
bility Additional In
nsured n portion and endo
orsement certificatte of proof Description
should nam
me:  Co
ounty of Santa Barb
bara  Itss officers, officials, employees, agentts, & vo
olunteers Worker’s Compensation Insuraance
Professiional Liability Inssurance 


$1 M per occurrrence or claim $2 M aggregate W‐9 orm Vendorlink Fo
Bod
dily Injury or Diseasse $1 M *If ssole contractor, fil l out WC exemptio
on form Statement of Work
Services Goods Submit description of services contractors will provide Submit Electronically Submit complete quote Purchase Order SIMPLE? COMPLEX? 2 Weeks Up to 4 Weeks Board Contract No Complications? 6‐8 Weeks COUNTY OF SANTA BARBARA
REQUEST FOR MEDIATION
Please submit to CEO/HR, attention Bob MacLeod, Chief of Employee Relations or Theresa Duer, Assistant HR Director
EMPLOYEE’S NAME
_____________________________
JOB CLASSIFICATION
_____________________________
DEPARTMENT
DATE __________________
__________________________________
CONTACT INFORMATION:
EMAIL ____________________________________________
PHONE _________________
UNRESOLVED WORKPLACE ISSUE
DATE EMPLOYEE AND OTHER PARTY LAST MET ON THE ISSUE _______________________
EMPLOYEE’S SIGNATURE ___________________________
DATE __________________
March 2009
COUNTY OF SANTA BARBARA
MEDIATION PROGRAM
CONFLICT RESOLUTION THROUGH
MEDIATION
The County of Santa Barbara’s Mediation
Program is a confidential conflict resolution
process. The Program is available to all
employees and supervisors as a means to
potentially resolve a variety of workplace
issues such as working relationships between
co-workers or between employees and their
supervisors. It encourages communication,
enables the parties to see and understand
how the other party defines the problem and
their solution and then explores options that
work for both parties and ideally, at the lowest
level of any conflict resolution process or
before the conflict has been allowed to
negatively impact the parties and other
employees. The process is readily accessible
and promotes collaboration between the
parties.
Additionally, the Mediation Program is a
component of the Office Professional (OP)
Performance Management System and will be
specifically used to resolve OP issues related
to:
•
Individual Development Plan core and
elective advancement course choices;
•
Improvement Plan;
•
Annual Performance Review with an
overall rating of less than satisfactory.
The Mediation Program is voluntary. With the
exception of Office Professionals who wish to
resolve issues identified above, employees
are not required to use the Mediation
Program.
How Does the Mediation Program Work?
What Does a Mediator Do?
Request forms are available from CEO/HR,
applicable labor organizations, departmental
HR managers, and on CEO/HR’s intranet site.
A mediator is a trained, experienced “neutral”
who meets with all parties to facilitate
discussion and open communication channels
to enable the parties to come to agreement on
a mutually-acceptable resolution to their
dispute. The mediator does not impose a
decision on the parties, but rather assists the
parties in communicating and exploring
options for resolution, typically focusing on the
parties’ needs and interests. The parties retain
total control of the outcome. The mediators
for this program are County employees, line,
supervisory and management employees.
What Kinds of Disputes Would be
Appropriate for Mediation?
In the workplace, disputes often occur when
communication breaks down or when
emotions are getting in the way of resolving a
workplace issue. The role of the mediator is
to help all employees participating in
mediation to communicate with each other in
order to resolve their own workplace issues in
an effective and constructive manner.
In general, the program works like this:
An employee files a Request for Mediation
with CEO/Human Resources (CEO/HR).
CEO/HR will contact the parties to gather
some basic information on the issues and then
select mediators from a list of trained County
mediators. (Mediators will not be assigned to
a mediation in their own department.)
Mediations will be scheduled as soon as
practical following receipt of the Request for
Mediation.
The mediator will coordinate
the meeting date and location between the
parties. Once scheduled, the mediator will
provide notice to the parties by delivering each
of them a “Confirmation of Mediation Appointment” form. If the parties resolve the issue(s)
prior to the date of the scheduled mediation,
they must contact the mediator to withdraw
the Request for Mediation.
Both parties attend the mediation and each
party may have one representative present
during the mediation if he/she feels it
necessary to do so.
At the mediation, the role of the mediator is to
facilitate discussion between the parties and
enable them to reach their own agreement as
to any issue in dispute. The role of the parties
is to participate in good faith in an effort to
achieve mutual agreement to any issues in
dispute, listen to each other and provide
realistic options for resolution. The role of the
representative is to facilitate the process. The
mediators do not represent either party, and
have no authority to impose a decision or
resolution on the parties.
No documentation of any kind related to the
process will be placed in an employee’s
personnel file.
One confidential file, containing all documentation related to the mediation is created.
Except as necessary for mediation hearings,
all files are maintained in the CEO/HR with the
Employee Relations Officer.
March 2009
COUNTY OF
SANTA BARBARA
MEDIATION PROGRAM
In the event the parties resolve their issues
through the mediation process, the mediators
will prepare a “Mediation Agreement” for
execution by the parties.
One copy of the Mediation Agreement is given
to each of the following:
•
•
•
The parties
The representatives present at the
mediation
CEO/HR
The mediator and the parties will coordinate
with the department to the extent necessary to
implement the resolution of any issue.
Confidentiality
This process is considered confidential.
Except as otherwise mandated by State or
Federal law, all members shall observe
confidentiality and shall refrain from disclosing
the identities of any parties or the substance
of any issues.
CONFLICT RESOLUTION
THROUGH MEDIATION
PAY
YROLL
( Division of Labor Standards Enforcement
Office of the Labor Commissioner
THIS POSTER MUST BE DISPLAYED WHERE EMPLOYEES CAN EASILY READ IT
(Poster may be printed on 8 ½” x 11” letter size paper)
HEALTHY WORKPLACES/HEALTHY FAMILIES ACT OF 2014
PAID SICK LEAVE
Entitlement:
•
An employee who, on or after July 1, 2015, works in California for 30 or more
days within a year from the beginning of employment is entitled to paid sick
leave.
•
Paid sick leave accrues at the rate of one hour per every 30 hours worked, paid
at the employee’s regular wage rate. Accrual shall begin on the first day of
employment or July 1, 2015, whichever is later.
•
Accrued paid sick leave shall carry over to the following year of employment and
may be capped at 48 hours or 6 days. However, subject to specified conditions,
if an employer has a paid sick leave, paid leave or paid time off policy (PTO) that
provides no less than 24 hours or three days of paid leave or paid time off, no
accrual or carry over is required if the full amount of leave is received at the
beginning of each year in accordance with the policy.
Usage:
•
An employee may use accrued paid sick days beginning on the 90th day of
employment.
•
An employer shall provide paid sick days upon the oral or written request of an
employee for themselves or a family member for the diagnosis, care or treatment
of an existing health condition or preventive care, or specified purposes for an
employee who is a victim of domestic violence, sexual assault, or stalking.
•
An employer may limit the use of paid sick days to 24 hours or three days in each
year of employment.
Retaliation or discrimination against an employee who requests paid sick days or uses
paid sick days or both is prohibited. An employee can file a complaint with the Labor
Commissioner against an employer who retaliates or discriminates against the
employee.
For additional information you may contact your employer or the local office of the Labor Commissioner. Locate
the office by looking at the list of offices on our website http://www.dir.ca.gov/dlse/DistrictOffices.htm using the
alphabetical listing of cities, locations, and communities. Staff is available in person and by telephone.
DLSE Paid Sick Leave Posting
11/2014
SA
AFE
ETY
Y
( (This page intentionally left blank.) First Aid
Emergencies
FOR
To handle an emergency situation, use Emergency Scene Management (ESM).
Identify
yourself
offer
to help.
Note: Protect
yourself and others by wearing vinyl gloves when giving first aid.5 Use
a shield or face
mask with and
a one-way
valve when
giving AR or CPR.
Take
charge.
6 If head or spinal injuries are suspected,
2 Call out for help.
support the head and neck.
3 Assess hazards and make the area safe.
7 Assess responsiveness.
4 Find out what happened.
8 Send or go for medical help.
Note: Protect yourself and others by wearing non-latex gloves when giving first aid. Use a shield or face mask with a one-way valve when giving CPR.
1
Cardiopulmonary Resuscitation (CPR – Adult)
Choking (Adult)
1
Open airway – push back on forehead and lift chin.
2
Check breathing. If the casualty is not breathing...
If a choking person can speak, breathe or cough – STAND BY
and encourage coughing.
3
Pinch nose and make a tight seal over the mouth. Give 2 breaths.
If a conscious person cannot speak, breathe or cough:
4
Make sure casualty is on a firm flat surface.
5
Place hands on centre of chest.
6
Position shoulders directly over hands and keep elbows locked.
7
Compress firmly 30 times then give 2 breaths. Push hard - Push fast
8
Continue cycles of 30 compressions and 2 breaths until help arrives.
1
Stand behind person and find top of the hip bones with
your hands.
2
Place a fist midline against the abdomen.
3
Grasp fist with other hand and press inward and upward
forcefully.
4
Continue until object is expelled or person becomes
unconscious.
FIND TOP OF HIPBONES
OPEN AIRWAY
POSITION YOUR HANDS IN THE
CENTRE OF THE CHEST
CHECK BREATHING
BREATHE INTO CASUALTY TWICE
PLACE FIST MIDLINE ON ABDOMEN
PRESS INWARD AND UPWARD
If the person becomes unconscious ease him or her to the
ground and send for medical help
1
Open the mouth and look for obstruction.
2
Open the airway and check breathing. If not breathing…
3
Give two breaths. If air doesn’t go in the first time,
reposition the head and try again.
4
Begin CPR. Give 30 compressions.
5
Each time you finish 30 compressions, look in mouth
before giving the first breath.
PRESS DOWN FIRMLY 30 TIMES, THEN GIVE 2 BREATHS.
CONTINUE CPR UNTIL HELP ARRIVES
Emergency Numbers
Bleeding
To control severe bleeding
AMBULANCE ________________________________________
Immediately apply direct pressure to the wound
over a pad of dressings
FIRE _______________________________________________
Keep the casualty lying down
POLICE _____________________________________________
CONTROL BLEEDING IMMEDIATELY
FAMILY DOCTOR ______________________________________
POISON INFORMATION CENTRE __________________________
Unconsciousness
NOTE: This poster is a step-by-step guide to what you can do until medical
help arrives. These tips do not take the place of first aid training.
Get medical help. Make certain
person is breathing and then place
the casualty in the recovery position.
If the casualty is not breathing, start CPR
RECOVERY POSITION
9901/10/00
w w w. s j a . c a
First Aid
Emergencies
FOR
INFANTS AND CHILDREN
To handle an emergency situation, use Emergency Scene Management (ESM).
Identify
yourself
offer
to help.
Use
a shield or face
mask with and
a one-way
valve when
giving AR or CPR.
If head or spinal injuries are suspected,
support the head and neck.
7 Assess responsiveness.
4 Find out what happened.
8 Send or go for medical help.
Note: Protect yourself and others by wearing non-latex gloves when giving first aid. Use a shield or face mask with a one-way valve when giving CPR.
Note: Protect
yourself and others by wearing vinyl gloves when giving first aid.5
Take
charge.
6
2 Call out for help.
3 Assess hazards and make the area safe.
1
Cardiopulmonary Resuscitation (CPR)
Choking (Child)
1
Open airway – push back on forehead and lift chin.
2
Check breathing. If the casualty is not breathing...
3
Make a tight seal over mouth and nose of an infant (under 1 year).
Pinch nose of a child (1-8 years) and make a tight seal over the
mouth. Give 2 breaths.
4
Make sure casualty is on a firm flat surface.
5
For a child place hands on centre of chest
6
Position shoulders directly over hands and keep elbows locked.
7
Compress firmly 30 times then give 2 breaths. Continue cycles of
30 compressions and 2 breaths until help arrives.
OPEN AIRWAY
CHECK FOR BREATHING
BREATHE INTO CASUALTY 2X
PLACE HANDS ON CENTRE
OF CHEST
If a choking child can speak, breathe or cough – STAND BY and encourage coughing.
If a conscious child cannot speak, breathe or cough:
1
Stand behind the child and find top of the hip bones with your hands.
2
Place a fist midline against the abdomen.
3
Grasp fist with other hand and press inward and upward forcefully.
4
Continue until object is expelled or child becomes unconscious.
PLACE FIST MIDLINE ON ABDOMEN
If the child becomes unconscious ease him or her to the ground
and send for medical help
1
Open the mouth and look for obstruction.
2
Open the airway and check breathing. If not breathing…
3
Give two breaths. If air doesn’t go in the first time, reposition
the head and try again.
4
Begin CPR. Give 30 compressions.
5
MAKE A FIST
THRUST INWARD AND UPWARD
Each time you finish 30 compressions, look in mouth before giving a breath.
Choking (Infant)
COMPRESS FIRMLY 30 TIMES THEN GIVE 2 BREATHS. CONTINUE CYCLES
OF 30 COMPRESSIONS AND 2 BREATHS UNTIL HELP ARRIVES.
1
For an Infant place 2 fingertips on the infant’s breastbone just
below the nipples.
2
Use 2 fingers to press down firmly on the breastbone.
3
Compress firmly 30 times then give 2 breaths.
4
Continue cycles of 30 compressions and 2 breaths until help arrives.
PLACE 2 FINGERTIPS ON THE INFANT’S
BREASTBONE JUST BELOW THE NIPPLES
Bleeding
PRESS DOWN FIRMLY 30 TIMES THEN GIVE 2 BREATHS..
REPEAT UNTIL HELP ARRIVES
To control severe bleeding
If infant is making high pitched noises or is having trouble breathing:
1
Give 5 forceful blows between the shoulder blades.
2
Turn infant over and give five chest thrusts using two fingers on
the infant’s breastbone just below the nipple line.
3
Repeat 5 back blows and 5 chest thrusts .
4
Continue until object is expelled or child becomes unconscious.
If the infant becomes unconscious place him or her on a firm flat surface
and send for medical help
1
Open the mouth and look for obstruction.
2
Open the airway and check breathing. If not breathing…
3
Give two breaths. If air doesn’t go in the first time, reposition the head
and try again.
4
Begin CPR. Give 30 compressions.
5
Each time you finish 30 compressions, look in mouth before giving a breath.
5 CHEST THRUSTS
Unconsciousness
Immediately apply direct pressure
to the wound over a pad of dressings.
Get medical help. Make certain child is breathing and then
place in the recovery position.
Keep the casualty lying down.
If not breathing begin CPR
RECOVERY POSITION
CONTROL BLEEDING IMMEDIATELY
Emergency Numbers
AMBULANCE ________________________________________
5 BACK BLOWS
NOTE: This poster is a
FIRE _______________________________________________ step-by-step guide to
what you can do until
POLICE _____________________________________________ medical help arrives.
These tips do not take
FAMILY DOCTOR ______________________________________ the place of first aid
training.
POISON INFORMATION CENTRE __________________________
w w w. s j a . c a
CPR At A Glance
CALL
▼ Dial 9-1-1 or local
emergency number
▼ Check the victim for consciousness,
breathing, signs of life, and severe bleeding (see bottom of sheet)
step
step
Infant and Child
When breathing is too fast, slow, noisy, or painful,
CALL 9-1-1 IMMEDIATELY!
step
If no response...
CHILD/INFANT: Give 1 slow breath
about every 3 seconds
If the person is not breathing
or you can’t tell...
Position victim on back
while supporting head
and neck
Tilt head back and lift the chin
Conscious Adult & Child
1
2
3
Look, listen, and feel for
breathing for about 10 seconds
If not breathing...
Give two slow breaths
Pinch the nose and seal
the lips
Check for signs of circulation for no more than 10
seconds (child and infant
only)
Check for severe bleeding
DO NOT MOVE THE VICTIM unless it is absolutely neccessary
Recheck pulse every 2 minutes or
40 breaths
Choking
step
Look, listen, and feel
for breathing for about
10 seconds in the position
you found the victim
step
With head tilted back, pinch nose
shut
step
1
2
3
Use basic precautions to
prevent disease transmission.Tap and shout to see if
the person responds
step
2
3
4
5
6
7
8
Rescue Breathing
step
1
▼ Care for
conditions
you find
Obtain consent
Confirm choking
Position legs
Position hands
Lean victim forward/give 5 back blows
Give 5 quick upward thrusts.
Repeat until object is coughed up
and person breathes on their own
or person becomes unconscious
Choking
Unconscious Adult & Child
1
2
3
4
step
step
step
step
step
step
step
Check
the Victim
If unconscious adult, call 9-1-1 immediately
CARE
step
▼ Check the scene for safety
☎
step
✓
step
CHECK
Attempt to give breaths. Re-tilt
the head and if you can’t get air in,
reattempt breaths
If air does not go in...
position hands on chest
Position shoulders over hands…
Give 30 CPR compressions for an
adult or child
Sweep out the mouth by lifting
lower jaw and tongue if you see
something. Attempt breaths. Repeat
cycle of compressions, sweeps, and
breaths until you can breathe air
into the victim.
SIGNS OF LIFE include normal breathing, coughing or movement in response to rescue breaths and a pulse**********
Choking
Signals of
1
2
3
4
SIGNALS
Conscious & Unconscious Infant
step
If conscious:
Confirm choking
step
Give 5 back blows and 5 chest thrusts
until object comes out or victim is unconscious
step
If unconscious:
CARE
Attempt to give breaths;
If you can’t get air in, reattempt breaths
step
Give 30 chest thrusts. If unconscious, add: Sweep
out object if visible. Repeat breaths, back blows,
and sweeps until you can breathe into the person,
making the chest rise
■
■
■
■
■
■
■
■
■
■
■
■
heart problems and care for a heart attack
Persistent chest pain or discomfort lasting more than
3-5 minutes or that goes away and comes back
Pain in either arm, discomfort or pressure that spreads
to the shoulder, arm, neck, or jaw
Nausea, shortness of breath, or trouble breathing
Sweating, changes in skin appearance
Dizziness or unconsciousness
Have the person stop activity and rest
Send someone to call 9-1-1
Help person rest in a comfortable position
Loosen restrictive clothing
Assist with prescribed medication
Monitor breathing and pulse closely
Be prepared to give CPR if the person loses consciousness and breathing and pulse stop
CPR
step
CHAIN OF SURVIVAL
1. Early recognition
2. Early CPR
3. Early defibrillation
4. Early advanced life support
■
■
■
■
■
■
1
2
3
If no pulse:
Find hand position
Position shoulder
over hands;
compress chest
30 times 11/2 -2”
If no pulse:
Position hand
over fingers;
compress chest
30 times 11/2 -2”
step
step
Give 2 slow breaths
(NEWBORN TO
1 YEAR OF AGE)
step
step
Position shoulders
over hands; compress
chest 30 times 11/2 -2”
If no signs of life, continue sets of 30 compressions and 2 breaths
STOP
CPR
1
2
3
Find hand position
step
1
2
3
Infant CPR
(1 to 12 years old)
step
Child CPR
step
step
Adult CPR
Give 2 slow breaths
Find finger
position
Give 2 slow breaths
If no signs of life, continue sets of 30 compressions and 2 breaths
If no signs of life, continue sets of 30 compressions
and 2 breaths
If an Automated External Defibrillator (AED) is available:
1. Activate the EMS system
2. Begin CPR until device arrives
When the scene becomes unsafe
You detect signs of life *************
An AED becomes available
You are too exhausted to continue
Another trained person takes over CPR
EMS personnel arrive and take over
In cooperation with your local Fire Dept., School Districts, Dept. of Parks and Recreation, and City Governments.
Visit our website to find your local
Red Cross chapter, and enroll in a
CPR or First Aid course today!
www.redcross.org
3. Place device on dry bare chest
4. Follow voice prompts
HOW AND WHEN TO CALL FOR HELP
Call 9-1-1 if the person:
■
■
■
■
■
■
■
■
Is unconscious, unusually confused, or seems to be losing
consciousness
Has trouble breathing or is breathing in a strange way
Has persistent chest pain or pressure
Has pressure or pain in the abdomen that does not go away
Is vomiting, passing blood or coughing up blood
Has seizures, severe headache, or slurred speech
Appears to have been poisoned
Has injuries to the head, neck, or back
Be prepared to give
■
■
■
■
■
■
■
Location (street address, city or town, cross streets, landmarks, etc.)
Phone number from where you are calling
Your name
What happened
How many are injured
Conditions of person(s) requiring aid
Help (CARE) being given
Do not hang up first; let the dispatcher hang up first
Earthquakes Guide
Retrieved from
https://www.osha.gov/SLTC/emergencypreparedness/guides/earthquakes.html
on 10-21-14
NOTE:
The Occupational Safety and Health Act (OSH Act) requires employers to comply with hazard-specific
safety and health standards. In addition, pursuant to Section 5(a)(1) of the OSH Act, employers must
provide their employees with a workplace free from recognized hazards likely to cause death or serious
physical harm. Emergency Preparedness Guides do not and cannot enlarge or diminish an employer's
obligations under the OSH Act.
Emergency Preparedness Guides are based on presently available information, as well as current
occupational safety and health provisions and standards. The procedures and practices discussed in
Emergency Preparedness Guides may need to be modified when additional, relevant information becomes
available or when OSH Act standards are promulgated or modified.
General Information
What is an earthquake?
An earthquake is a sudden, rapid shaking of the ground caused by the breaking and shifting of rock
beneath the Earth's surface. This shaking can cause buildings and bridges to collapse; disrupt gas,
electric, and phone service; and sometimes trigger landslides, avalanches, flash floods, fires, and huge,
destructive ocean waves (tsunamis). Buildings with foundations resting on unconsolidated landfill, old
waterways, or other unstable soil are most at risk. Buildings or trailers and manufactured homes not tied
to a reinforced foundation anchored to the ground are also at risk since they can be shaken off their
mountings during an earthquake. Earthquakes can occur at any time of the year.
What hazards are associated with earthquakes?
When an earthquake occurs in a populated area, it may cause deaths and injuries and extensive property
damage. Ground movement during an earthquake is seldom the direct cause of death or injury. Most
earthquake-related injuries result from collapsing walls, flying glass, and falling objects as a result of the
ground shaking, or people trying to move more than a few feet during the shaking. Much of the damage
in earthquakes is predictable and preventable.
What are aftershocks?
Aftershocks are smaller earthquakes that follow the main shock and can cause further damage to
weakened buildings. After-shocks can occur in the first hours, days, weeks, or even months after the
quake. Be aware that some earthquakes are actually foreshocks, and a larger earthquake might occur.
What can I do to prepare before an earthquake occurs?
1 | P a g e Who enters a collapsed structure?
Following a catastrophic failure of a structure, rescue workers and emergency responders may be
required to enter the collapsed structure. Emergency responders include firefighters, police, emergency
medical technicians, construction workers and government representatives. Emergency responders may
be responsible for assisting survivors, extinguishing fires, shutting off utilities, assessing structural
instabilities, shoring-up safe paths into the structure and assessment of other hazards such as airborne
contaminants. Rescue workers such as Urban Search and Rescue Teams focus on finding survivors and
later removing victims from collapsed structures.
Organizing Rescue Workers and Emergency Responders
What is the organizational structure for the response to these events?
Although these catastrophic events may initially be quite chaotic, eventually site management will be
under a unified command such as the recognized Incident Command Structure. Local responders and
rescuers will obviously respond first with the State requesting Federal Emergency Management Agency
(FEMA) assistance if warranted.
A trained Structures Specialist from Urban Search and Rescue will be responsible for:


Evaluating the immediate structural condition of the area to be entered during rescue operations.
Determining the appropriate type and amount of structural hazard mitigation in order to minimize
risks on site to rescue personnel.
What safety and health resources are available during a collapsed structure response?
Once the Incident Command System is established at a collapsed structure, the Incident Commander
maintains accountability for all response personnel at the scene. A Safety Officer may also be mobilized
and report directly to the Incident Commander. The Safety Officer is responsible for monitoring and
assessing the safety aspects of the responders during the collapsed structure event. The Safety Officer's
responsibilities may include:










Overseeing all safety and health aspects of response personnel
Assuring that optimal safety and injury prevention is practiced
Investigating and documenting all response team injuries and illnesses
Preparing and maintaining entry permits
Ensuring that appropriate personal protective equipment (PPE) is used
Developing and implementing daily health and safety plans which address (1) sanitation, (2) hygiene,
(3) PPE, (4) Decontamination, (5) work/rest cycles, (6) acute medical care, etc.
Interviewing off-going shifts to assess developing hazards
Assessing risk for the identified hazards; and
Training in hazard awareness and use of PPE
Assessing structural instabilities
3 | P a g e What hazards may be encountered when entering a collapsed structure?
The following hazards should be considered in order to protect rescue workers and emergency
responders when preparing to enter a collapsed structure:



















Water system breaks that may flood basement areas
Exposure to pathogens from sanitary sewer system breaks
Exposed and energized electrical wiring
Exposure to airborne smoke and dust (asbestos, silica, etc.)
Exposure to bloodborne pathogens
Exposure to hazardous materials (ammonia, battery acid, leaking fuel, etc.)
Natural gas leaks creating flammable and toxic environment
Structural instability
Insufficient oxygen
Confined spaces
Slip, trip or fall hazards from holes, protruding rebar, etc
Being struck by a falling object
Fire
Proximity to heavy machinery such as cranes
Sharp objects such as glass and debris
Secondary collapse from aftershock, vibration and explosions
Unfamiliar surroundings
Adverse weather conditions
Noise from equipment (generators/heavy machines)
4 | P a g e BOMB THREAT
CALL PROCEDURES
Most bomb threats are received by phone. Bomb threats
are serious until proven otherwise. Act quickly, but
remain calm and obtain information with the checklist on
the reverse of this card.
BOMB THREAT CHECKLIST
Date:
Time:
Time Caller
Hung Up:
Phone Number Where Call Received:
Ask Caller:
If a bomb threat is received by phone:
• Where is the bomb located?
1. Remain calm. Keep the caller on the line for as long as
possible. DO NOT HANG UP, even if the caller does.
•
•
•
•
•
•
•
2. Listen carefully. Be polite and show interest.
3. Try to keep the caller talking to learn more information.
4. If possible, write a note to a colleague to call the
authorities or, as soon as the caller hangs up,
immediately notify them yourself.
5. If your phone has a display, copy the number and/or
letters on the window display.
6. Complete the Bomb Threat Checklist (reverse side)
immediately. Write down as much detail as you can
remember. Try to get exact words.
7. Immediately upon termination of the call, do not hang
up, but from a different phone, contact FPS
immediately with information and await instructions.
If a bomb threat is received by handwritten note:
• Call ______________________
• Handle note as minimally as possible.
If a bomb threat is received by email:
• Call ______________________
• Do not delete the message.
(Building, Floor, Room, etc.)
When will it go off?
What does it look like?
What kind of bomb is it?
What will make it explode?
Did you place the bomb?
Yes
No
Why?
What is your name?
Exact Words of Threat:
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
Information About Caller:
• Where is the caller located? (Background and level of noise)
• Estimated age:
• Is voice familiar? If so, who does it sound like?
• Other points:
Signs of a suspicious package:
•
•
•
•
•
•
No return address
Excessive postage
Stains
Strange odor
Strange sounds
Unexpected delivery
•
•
•
•
•
Poorly handwritten
Misspelled words
Incorrect titles
Foreign postage
Restrictive notes
DO NOT:
• Use two-way radios or cellular phone; radio signals
have the potential to detonate a bomb.
• Evacuate the building until police arrive and evaluate
the threat.
• Activate the fire alarm.
• Touch or move a suspicious package.
WHO TO CONTACT (select one)
•
•
•
Follow your local guidelines
Federal Protective Service (FPS) Police
1-877-4-FPS-411 (1-877-437-7411)
911
Caller’s Voice
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
Accent
Angry
Calm
Clearing throat
Coughing
Cracking voice
Crying
Deep
Deep breathing
Disguised
Distinct
Excited
Female
Laughter
Lisp
Loud
Male
Nasal
Normal
Ragged
Rapid
Raspy
Slow
Slurred
Soft
Stutter
Background Sounds:
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
‰
Animal Noises
House Noises
Kitchen Noises
Street Noises
Booth
PA system
Conversation
Music
Motor
Clear
Static
Office machinery
Factory machinery
Local
Long distance
Threat Language:
‰
‰
‰
‰
‰
‰
Incoherent
Message read
Taped
Irrational
Profane
Well-spoken
Other Information:
_____________________________________
_____________________________________
RE
EFE
ERE
ENC
CES
S
( (This page intentionally left blank.) Mental Health First Aid at a Glance:
Quick Tips: ALGEE
Retrieved from http://www.integration.samhsa.gov/about-us/esolutions-newsletter/may2012 on 10-21-14
The Action Plan: Helping Someone in a Mental Health Crisis
Mental Health First Aid teaches a five-step action plan for individuals to provide help to
someone who may be in crisis. Called ‘ALGEE,’ the Mental Health First Aid action plan
includes:
Assess for risk of suicide or harm Listen nonjudgmentally Give reassurance and
information Encourage appropriate professional help Encourage self-help and other
support strategies Assess for Risk of Suicide or Harm. When helping a person going
through a mental health crisis, it is important look for signs of suicidal thoughts and
behaviors and/or non-suicidal self-injury.
Listening Nonjudgmentally. It may seem simple, but the ability to listen and have a
meaningful conversation with an individual requires skill and patience. It is important to
make an individual feel respected, accepted and understood. Mental Health First Aid
teaches individuals to use a set of verbal and nonverbal skills to engage in appropriate
conversation – such as open body posture, comfortable eye contact and other listening
strategies.
Give Reassurance and Information. Individuals must recognize that mental illnesses
are real, treatable illnesses from which people can and do recover. When having a
conversation with someone whom you believe may be experiencing symptoms of a
mental illness, it is important to approach the conversation with respect and dignity for
that individual and to not blame the individual for his or her symptoms.
Mental Health First Aid teaches you helpful information and resources you can offer to
someone to provide consistent emotional support and practical help.
Encourage Appropriate Professional Help. A variety of health and behavioral health
professionals and interventions can help when someone is in crisis or may be
experiencing the signs or symptoms of a mental illness.
Encourage Self-Help and Other Support Strategies. There are many ways
individuals experiencing mental illness can contribute to their own recovery and
wellness. These strategies may include: exercise, relaxation and meditation;
participating in peer support groups; self-help books based on cognitive behavioral
therapy; and engaging with family, friends, faith, and other social networks.
Mental Illness FACTS AND NUMBERS
Numbers of Americans Affected by Mental
Illness

One in four adults−approximately 61.5 million
Americans−experiences mental illness in a given
year. One in 17−about 13.6 million−live with a serious
mental illness such as schizophrenia, major depression
or bipolar disorder.1
Approximately 20 percent of youth ages 13 to 18
experience severe mental disorders in a given year. For
ages 8 to 15, the estimate is 13 percent.2
Approximately 1.1 percent of American adults—

about 2.4 million people—live with schizophrenia.
Approximately 2.6 percent of American adults−6.1


3,4
4,5



million people−live with bipolar disorder.
Approximately 6.7 percent of American adults−about
14.8 million people−live with major depression.4,6
Approximately 18.1 percent of American adults−about
42 million people−live with anxiety disorders, such as
panic disorder, obsessive-compulsive disorder (OCD),
posttraumatic stress disorder (PTSD), generalized
anxiety disorder and phobias.4,7
About 9.2 million adults have co-occurring mental


15
of 14; three-quarters by age 24. Despite effective
treatment, there are long delays−sometimes
decades−between the first appearance of symptoms
16
and when people get help.
The Impact of Mental Illness in America




19
20



a mental health condition.
Seventy percent of youth in juvenile justice systems
have at least one mental health condition and at least

10
11
20 percent live with a severe mental illness.
Getting Mental Health Treatment in America

Approximately 60 percent of adults12, and almost one-half
treatable medical conditions.
Over 50 percent of students with a mental health
condition age 14 and older who are served by special
education drop out−the highest dropout rate of any
21
9
and/or substance use disorders.
Approximately 20 percent of state prisoners and 21
percent of local jail prisoners have “a recent history” of
Serious mental illness costs America $193.2 billion
in lost earnings per year.17
Mood disorders such as depression are the third most
common cause of hospitalization in the U.S. for both
youth and adults ages 18 to 44.18
Individuals living with serious mental illness face an
increased risk of having chronic medical conditions.
Adults living with serious mental illness die on average
25 years earlier than other Americans, largely due to
8
health and addiction disorders.
Approximately 26 percent of homeless adults staying
in shelters live with serious mental illness and an
estimated 46 percent live with severe mental illness
of youth ages 8 to 15 with a mental illness received no
mental health services in the previous year. 13
African American and Hispanic Americans used
mental health services at about one-half the rate of
whites in the past year and Asian Americans at about
one-third the rate.14.
One-half of all chronic mental illness begins by the age
disability group.
Suicide is the tenth leading cause of death in the U.S.
(more common than homicide) and the third leading
cause of death for ages 15 to 24 years.22 More than 90
percent of those who die by suicide had one or more
23

mental disorders.
Although military members comprise less than 1
percent of the U.S. population24, veterans represent
20 percent of suicides nationally. Each day, about 22
veterans die from suicide.25
NAMI • The National Alliance on Mental Illness • 1 (800) 950-NAMI • www.nami.org
3803 N. Fairfax Drive, Suite 100, Arlington, VA 22203
1
Mental Illness FACTS AND NUMBERS
References
1 National Institutes of Health, National Institute of Mental Health. (n.d.). Statistics: Any Disorder Among Adults. Retrieved March 5, 2013, from
http://www.nimh.nih.gov/statistics/1ANYDIS_ADULT.shtml
2 National Institutes of Health, National Institute of Mental Health. (n.d.). Any Disorder Among Children. Retrieved March 5, 2013, from
http://www.nimh.nih.gov/statistics/1ANYDIS_CHILD.shtml
3 National Institutes of Health, National Institute of Mental Health. (n.d.) The Numbers Count: Mental Disorders in America. Retrieved March 5, 2013,
from http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml
4 Prevalence numbers were calculated using NIMH percentages (cited) and 2010 Census data. Census data is available at: United States Census
Bureau. (revised 2011). “USA [State & County QuickFacts].” Retrieved March 5, 2013, from http://quickfacts.census.gov/qfd/states/00000.html
5 National Institutes of Health, National Institute of Mental Health. (n.d.). The Numbers Count: Mental Disorders in America. Retrieved March 5, 2013,
from http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml
6 Ibid.
7 National Institutes of Health, National Institute of Mental Health. (n.d.). Statistics: Any Anxiety Disorder Among Adults. Retrieved March 5, 2013, from
http://www.nimh.nih.gov/statistics/1anyanx_adult.shtml
8 Substance Abuse and Mental Health Services Administration. (2012). Results from the 2010 National Survey on Drug Use and Health: Mental
Health Findings NSDUH Series H-42, HHS Publication No. (SMA) 11-4667). Rockville, Md.: Substance Abuse and Mental Health Services
Administration, 2012.
9 U.S. Department of Housing and Urban Development, Office of Community Planning and Development. (2011). The 2010 Annual Homeless
Assessment Report to Congress. Retrieved March 5, 2013, from http://www.hudhre.info/documents/2010HomelessAssessmentReport.pdf
10 Glaze, L.E. & James, D.J. (2006, updated December). Mental Health Problems of Prison and Jail Inmates. Bureau of Justice Statistics Special Report.
U.S. Department of Justice, Office of Justice Programs Washington, D.C. Retrieved March 5, 2013, from
http://bjs.ojp.usdoj.gov/content/pub/pdf/mhppji.pdf
11 Skowyra, K.R. & Cocozza, J.J. (2007) Blueprint for Change: A Comprehensive Model for the Identification and Treatment of Youth with Mental
Health Needs in Contact with the Juvenile Justice System. The National Center for Mental Health and Juvenile Justice; Policy Research Associates, Inc.
The Office of Juvenile Justice and Delinquency Prevention. Delmar, N.Y: The National Center for Mental Health and Juvenile Justice; Policy
Research Associates, Inc.
12Substance Abuse and Mental Health Services Administration. (2012). Results from the 2010 National Survey on Drug Use and Health: Mental
Health Findings NSDUH Series H-42, HHS Publication No. (SMA) 11-4667). Rockville, Md.; Substance Abuse and Mental Health Services
Administration, 2012.
13 National Institute of Mental Health. (n.d.). Use of Mental Health Services and Treatment Among Children. Retrieved March 5, 2013, from
http://www.nimh.nih.gov/statistics/1NHANES.shtml
14 Agency for Healthcare Research and Quality. (2010). 2010 National Healthcare Disparities Report. Agency for Healthcare Research and Quality,
Rockville, MD. Retrieved January 2013, from http://www.ahrq.gov/research/findings/nhqrdr/nhdr10/index.html.
15 Kessler, R.C, et al. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey
Replication. Archives of General Psychiatry, 62(6), 593-602.
16 National Institutes of Health, National Institute of Mental Health. (2005). Mental Illness Exacts Heavy Toll, Beginning in Youth. Retrieved March 5,
2013, from http://www.nih.gov/news/pr/jun2005/nimh-06.htm
17 Insel, T.R. (2008). Assessing the Economic Costs of Serious Mental Illness. The American Journal of Psychiatry. 165(6), 663-665.
18 Wier, LM (Thompson Reuters), et al. HCUP facts and figures: statistics on hospital-based care in the United States, 2009. Web.. Rockville, Md.
Agency for Healthcare Research and Quality, 2011. Retrieved March 5, 2013, from http://www.hcup-us.ahrq.gov/reports.jsp.
19 Colton, C.W. & Manderscheid, R.W. (2006). Congruencies in increased mortality rates, years of potential life lost, and causes of death among
public mental health clients in eight states. Preventing Chronic Disease: Public Health Research, Practice and Policy, 3(2), 1-14.
20 Parks, J.,et al. (2006). Morbidity and Mortality in People with Serious Mental Illness. Alexandria, VA: National Association of State Mental
Health Program Directors (NASMHPD) Medical Directors Council.
21 U.S. Department of Education. (2006). Twenty-eighth annual report to Congress on the implementation of the Individuals with Disabilities
Education Act, 2006, Vol. 2. Washington, D.C.: U.S. Department of Education.
22 McIntosh, J.L.. & Drapeau, C.W. (for the American Association of Suicidology). (2012). U.S.A. suicide: 2010
official final data. Washington, D.C: American Association of Suicidology.
23 American Association of Suicidology. (2012). Suicide in the USA Based on 2010 Data. Washington, DC: American Association of Suicidology.
24 Martinez, L. & Bingham, A. (2011). U.S. Veterans: by the Numbers. Retrieved March 5, 2013, from http://abcnews.go.com/Politics/usveterans-numbers/story?id=14928136
25 U.S. Department of Veterans Affairs, Mental Health Services, Suicide Prevention Program. (2013). Suicide Data Report, 2012. Retrieved March 5,
2013, from http://www.va.gov/opa/docs/Suicide-Data-Report-2012-final.pdf
NAMI • The National Alliance on Mental Illness • 1 (800) 950-NAMI • www.nami.org
3803 N. Fairfax Drive, Suite 100, Arlington, VA 22203
2
SANTA B
S
BARBARA
A COUN
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CTICES EEffective:: September 27, 2013 / Reevision: JJanuary 7
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be used an
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on. PLLEASE REVIEW IT CAR
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ADMHS County of San
nta Barbara PRIVACY OFFFICER 500 We
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Maria, CA 93455 Tel: 8
805‐934‐63444 Fax: 8
805‐934‐63333 SSanta Barbarra County Alcohol Drug &
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mental healtth treatmentt and related
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may use and disclose me ntal health information about you.
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WHO WILLL FOLLOW THIS NOTIICE TThis notice d
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

Any h
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professional authorized to enter infoormation intto your med
dical chart; Any m
member of aa volunteer ggroup we allow to help yyou while yo
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mployees, sttaff and othe
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medical information with each other for treatment, paymennt or health care operations purposes d
described in this notice. O
OUR PLEDG
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need this reccord to proviide you withh quality caree and to com
mply with ceertain legal require
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mental healtth informatio
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Alice Gleghorn,, Ph.D., Directo
or of ADMHS Page 1 This notice will tell you about the ways in which we may use and disclose mental health information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of your mental health information. We are required by law to: 


Make sure that mental health information that identifies you is kept confidential (with certain
exceptions);
Give you this notice of our legal duties and privacy practices with respect to mental health
information about you; and
Follow the terms of the notice that is currently in effect.
HOW WE MAY USE AND DISCLOSE MENTAL HEALTH INFORMATION ABOUT YOU The following categories describe different ways that we use and disclose mental health information. For each category of uses or disclosures we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories. DISCLOSURE AT YOUR REQUEST We may disclose information when requested by you. This disclosure at your request may require a written authorization by you. FOR TREATMENT We may use mental health information about you to provide you with medical or mental health treatment or services. We may disclose mental health information about you to doctors, nurses, technicians, health care students, or other ADMHS personnel who are involved in taking care of you at ADMHS. For example, a doctor treating you for a mental health condition may need to know what medication you are currently taking, because the medications may affect what other medications may be prescribed for you. In addition, the doctor may need to tell ADMHS’ food service if you are taking certain medications so that we can arrange for appropriate meals that will not interfere or improperly interact with your medication. Different divisions of ADMHS also may share mental health information about you in order to coordinate the different things you need, such as prescriptions, lab work and x‐
rays. We also may disclose mental health information about you to people outside ADMHS who may be involved in your medical or mental health treatment after you leave ADMHS, such as skilled nursing facilities, home health agencies and physicians or other practitioners. For example, we may give your physician access to your health information to assist your physician in treating you. FOR PAYMENT We may use and disclose mental health information about you so that the treatment and services you receive at ADMHS may be billed to and payment may be collected from you, an insurance company or a third party. For example, we may need to give your health plan information about treatment you received at the ADMHS so your health plan will pay us or reimburse you for the treatment. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment. Alice Gleghorn, Ph.D., Director of ADMHS Page 2 FOR HEALTH CARE OPERATIONS We may use and disclose mental health information about you for health care operations. These uses and disclosures are necessary to run ADMHS and make sure that all of our patients receive quality care. For example, we may use mental health information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine mental health information about many ADMHS patients to decide what additional services ADMHS should offer, what services are not needed, and whether certain new treatments are effective. We may also disclose information to doctors, nurses, technicians, health care students, and other ADMHS personnel for review and learning purposes. We may also combine the mental health information we have with mental health information from other healthcare providers to compare how we are doing and see where we can make improvements in the care and services we offer. We may remove information that identifies you from this set of mental health information so others may use it to study health care and health care delivery without learning who the specific patients are. APPOINTMENT REMINDERS We may use and disclose mental health information to contact you as a reminder that you have an appointment for treatment or care at ADMHS. TREATMENT ALTERNATIVES We may use and disclose mental health information to tell you about or recommend possible treatment options or alternatives that may be of interest to you. HEALTH∙RELATED PRODUCTS AND SERVICES We may use and disclose mental health information to tell you about our health‐related products or services that may be of interest to you. FAMILY MEMBERS OR OTHERS YOU DESIGNATE Upon request of a family member and with your consent, we may give the family member notification of your diagnosis, prognosis, medications prescribed and their side effects and progress. If a request for information is made by your spouse, parent, child, or sibling and you are unable to authorize the release of this information, we are required to give the requesting person notification of your presence in an ADMHS inpatient facility, except to the extent prohibited by federal law. Upon your admission to an ADMHS inpatient facility; we must make reasonable attempts to notify your next of kin or any other person designated by you, of your admission, unless you request that this information not be provided. Unless you request that this information not be provided we must make reasonable attempts to notify your next of kin or any other person designated by you, of your release, transfer, serious illness, injury, or death only upon request of the family member. RESEARCH Under certain circumstances, we may use and disclose mental health information about you for research purposes. For example, a research project may involve comparing the health and recovery of all patients who received one medication to those who received another, for the same condition. All research projects, however, are subject to a special approval process. This process evaluates a proposed research project and its use of mental health information, trying to balance the research needs with patients' need for privacy of their mental health information. Before we use or disclose mental health information for research, the project will have been approved through this research Alice Gleghorn, Ph.D., Director of ADMHS Page 3 approval process, but we may, however, disclose mental health information about you to people preparing to conduct a research project, for example, to help them look for patients with specific mental health needs, as long as the mental health information they review does not leave ADMHS. AS REQUIRED BY LAW We will disclose mental health information about you when required to do so by federal, state or local law. TO AVERT A SERIOUS THREAT TO HEALTH OR SAFETY We may use and disclose mental health information about you when necessary to prevent a serious threat to your health and safety, or the health and safety of the public or another person. Any disclosure however would only be to someone able to help prevent the threat. SPECIAL SITUATIONS ORGAN AND TISSUE DONATION We may release mental health information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation. PUBLIC HEALTH ACTIVITIES We may disclose mental health information about you for public health activities. These activities may include, without limitation, the following:  To prevent or control disease, injury or disability;
 To report births and deaths;
 To report regarding the abuse or neglect of children; elders and dependent adults;
 To report reactions to medications or problems with products;
 To notify people of recalls of products they may be using;
 To notify a person who may have been exposed to a disease or may be at risk for contracting or
spreading a disease or condition;
 To notify the appropriate government authority if we believe a patient has been the victim of
abuse, neglect or domestic violence. We will only make this disclosure if you agree or when
required or authorized by law;
 To notify emergency response employees regarding possible exposure to HIV/AIDS, to the
extent necessary to comply with state and federal laws.
HEALTH OVERSIGHT ACTIVITIES We may disclose mental health information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs and compliance with civil rights laws. LAWSUITS AND DISPUTES If you are involved in a lawsuit or a dispute, we may disclose mental health information about you in response to a court or administrative order. We may also disclose mental health information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the Alice Gleghorn, Ph.D., Director of ADMHS Page 4 dispute, but only if efforts have been made to tell you about the request (which may include written notice to you) or to obtain an order protecting the information requested. We may disclose mental health information to courts, attorneys and court employees in the course of conservatorship, and certain other judicial or administrative proceedings. LAW ENFORCEMENT We may release mental health information if asked to do so by a law enforcement official;  In response to a court order, subpoena, warrant, summons;
 To identify or locate a suspect, fugitive, material witness, certain escapes and certain missing
persons;
 About death we believe may be the result of criminal conduct;
 About criminal conduct at ADMHS;
 When requested by an officer who lodges a warrant with the facility; and
 When requested at the time of a patient’s involuntary hospitalization.
CORONERS AND MEDICAL EXAMINERS We may be required by law to report the death of a patient to a coroner or medical examiner. PROTECTION OF ELECTIVE CONSTITUTIONAL OFFICERS We may disclose mental health information about you to government law enforcement agencies as needed for the protection of federal and state elective constitutional officers and their families. INMATES If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release mental health information about you to the correctional institution or law enforcement official. Disclosure may be made when required, as necessary to the administration of justice. ADVOCACY GROUPS We may release mental health information to the statewide protection and advocacy organization if it has a patient or patient representative's authorization, or for the purposes of certain investigations. We may release mental health information to the County Patients' Rights Office if it has a patient or patient representative's authorization, or for investigations resulting from reports required by law to be submitted to the Director of Mental Health. DEPARTMENT OF JUSTICE We may disclose limited information to the California Department of Justice for movement and identification purposes about certain criminal patients, or regarding persons who may not purchase, possess or control a firearm or deadly weapon. MULTIDISCIPLINARY PERSONNEL TEAMS We may disclose mental health information to a multidisciplinary personnel team relevant to the prevention, identification, management, or treatment of an abused child, the child's parents, or an abused elder or dependent adult. Alice Gleghorn, Ph.D., Director of ADMHS Page 5 SENATE AND ASSEMBLY RULES COMMITTEES We may disclose your mental health information to the Senate or Assembly Rules Committee for purpose of legislative investigation. SPECIAL CATEGORIES OF INFORMATION SUBSTANCE ABUSE INFORMATION Although the federal Privacy Rule does not make a distinction between medical and substance abuse information, other federal statutes and California state laws do provide statutory restrictions for the release of information developed or obtained in the course of providing substance abuse treatment in federally funded substance abuse programs. Substance abuse information obtained in the course of general medical treatment is not subject to these provisions. Therefore, substance abuse information may be shared among ADMHS providers and to its contracted providers without authorization of the patient for patient care purposes. For example, substance abuse information may be shared from the General Medical Clinic to ADMHS Mental Health Services or to a substance abuse program. However, the contracted substance abuse treatment program must obtain the patient’s authorization to share information back to the General Medical Clinic or ADMHS Mental Health Services. All other uses and disclosures require specific substance abuse authorization from the patient. Information pertaining to substance abuse patients is subject to special protection under federal statute 42 U.S.C. Section 290dd‐2 and under federal regulations found in the "Confidentiality of Alcohol and Drug Abuse Patient Records," 42 C.F.R. part 2. Additionally, California Health and Safety Code Section 11977 provides special protections to information of certain drug abuse programs. The LPS Act may also apply if the patient receives services such as involuntary evaluation and treatment because the patient is gravely disabled or dangerous to self or others as a result of abuse of alcohol, narcotics, or other dangerous drugs. These federal and state statutes require written authorization for disclosure of substance abuse information in certain circumstances and other special protections for substance abuse information. In these situations, the state law must be followed. Questions regarding the use or disclosure of substance abuse information should be referred to the ADMHS Privacy Officer. OTHER SPECIAL CATEGORIES OF INFORMATION Special legal requirements may apply to the use or disclosure of certain categories of information e.g., tests for the human immunodeficiency virus (HIV) or treatment and services for alcohol and drug abuse. In addition, somewhat different rules may apply to the use and disclosure of medical information related to any general medical (non‐mental health) care you receive. PSYCHOTHERAPY NOTES Psychotherapy notes means notes recorded (in any medium) by a health care provider who is a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session and that are separated from the rest of the individual's medical record. Psychotherapy notes excludes medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and any summary of the following items: diagnosis, functional status, the treatment Alice Gleghorn, Ph.D., Director of ADMHS Page 6 plan, symptoms, prognosis, and progress to date. We may use or disclose your psychotherapy notes, as required by law, or:  For use by the originator of the notes;
 In supervised mental health training programs for students, trainees, or practitioners;
 By the covered entity to defend a legal action or other proceeding brought by the individual;
 To prevent or lessen a serious and imminent threat to the health or safety of a person or the
public;
 For the health oversight of the originator of the psychotherapy notes;
 For use or disclosure to coroner or medical examiner to report a patient’s death;
 For use or disclosure necessary to prevent or lessen a serious and imminent threat to the health
or safety of a person or the public; and
 For use or disclosure to the Secretary of DHHS in the course of an investigation. Unless we
obtain your written permission, we will never use or disclose Psychotherapy Notes for any
other purpose.
YOU’RE RIGHTS REGARDING MENTAL HEALTH INFORMATION ABOUT YOU You have the following rights regarding mental health information we maintain about you: RIGHT TO INSPECT AND COPY You have the right to request access to inspect and copy mental health information that may be used to make decisions about your care. Usually, this includes mental health and billing records, but may not include some mental health information. To inspect and copy mental health information that may be used to make decisions about you, you must submit your request in writing to: ADMHS‐MEDICAL RECORDS 315 Camino Del Remedio Santa Barbara, CA 93110 Tel: 805‐681‐5328 Fax: 805‐681‐5294 lf you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to mental health information, you may request that the denial be reviewed. Another licensed health care professional chosen by ADMHS will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review. RIGHT TO AMEND If you feel that mental health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for ADMHS. To request an amendment, your request must be made in writing and submitted to ADMHS‐MEDICAL RECORDS 315 Camino Del Remedio Santa Barbara, CA 93110 Tel: 805‐681‐5328 Fax: 805‐681‐5294 Alice Gleghorn, Ph.D., Director of ADMHS Page 7 In addition, you must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:  Was not created by us, unless the person or entity that created the information is no longer
available to make the amendment;  Is not part of the mental health information kept by or for ADMHS;
 Is not part of the information which you would be permitted to inspect and copy; or
 Is accurate and complete.
Even if we deny your request for amendment, you have the right to submit a written addendum, not to exceed 250 words, with respect to any item or statement in your record you believe is incomplete or incorrect. If you clearly indicate in writing that you want the addendum to be made part of your mental health record we will attach it to your records and include it whenever we make a disclosure of the item or statement you believe to be incomplete or incorrect. RIGHT TO AN ACCOUNTING OF DISCLOSURES You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of mental health information about you other than our own uses for treatment, payment and health care operations (as those functions are described above) and with other exceptions pursuant to the law. To request this list or accounting of disclosures, you must submit your request in writing to: ADMHS‐MEDICAL RECORDS 315 Camino Del Remedio Santa Barbara, CA 93110 Tel: 805‐681‐5328 Fax: 805‐681‐5294 Your request must state a time period which may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper, electronically). The first list you request within a 12 month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred. In addition, we will notify you as required by law if your health information is unlawfully accessed or disclosed. Once ADMHS has fully converted to maintaining mental health information as an Electronic Health Record (EHR), then it will also give patients, upon written request, an accounting of disclosures made through an EHR for treatment, payment and healthcare operations. This accounting will be made for a period of up to three years prior to the date the accounting is requested, and will include disclosures by business associates, or a list of all business associates with their contact information. RIGHT TO REQUEST RESTRICTIONS You have the right to request a restriction or limitation on the mental health information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the mental health information we disclose about you to someone who is involved in Alice Gleghorn, Ph.D., Director of ADMHS Page 8 your care or the payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about a type of therapy you had. We are not required to agree to your request unless it is for a restriction on disclosures to health plans for services you paid in full. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. To request restrictions, you must make your request in writing to: ADMHS‐MEDICAL RECORDS 315 Camino Del Remedio Santa Barbara, CA 93110 Tel: 805‐681‐5328 Fax: 805‐681‐5294 In your request, you must tell us 1) what information you want to limit; 2) whether you want to limit our use, disclosure or both; and 3) to whom you want the limits to apply, for examp1e, disclosures to your spouse. RIGHT TO REQUEST CONFIDENTIAL COMMUNICATIONS You have the right to request that we communicate with you about mental health matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. To request confidential communications, you must make your request in writing to: ADMHS‐MEDICALRECORDS 315 Camino Del Remedio Santa Barbara, CA 93110 Tel: 805‐681‐5328 Fax: 805‐681‐5294 We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted. RIGHT TO A PAPER COPY OF THIS NOTICE You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. Using Internet Explorer or another web browser, go to this web page: http://www.countyofsb.org/admhs/admhs.aspx?id=40035 Alternatively, go the web page http://www.countyofsb.org/admhs. Then click on "For Individuals and Families," then on "Forms for Clients," and then on "HIPAA." You will need to have Adobe Acrobat Reader installed on your computer in order to view the Notice of Privacy Practices. If your computer does not have Adobe Acrobat Reader installed, you may obtain and install a copy here: http://get.adobe.com/reader/ The Notice is available in both English and Spanish. Click on the version you would like, and the Notice will appear in a new window. If you want, you can save or print a copy of the form using the menus on Adobe Acrobat Reader. Alice Gleghorn, Ph.D., Director of ADMHS Page 9 CHANGES TO THIS NOTICE We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for mental health information we already have about you as well as any information we receive in the future. We will post a copy of the current notice at ADMHS. The notice will contain the effective date on the first page, in the top right‐hand corner. In addition, each time you register at ADMHS or receive treatment or health care services as an inpatient or outpatient, you may request a copy of the current notice in effect. COMPLAINTS If you believe your privacy rights have been violated, you may file a complaint with ADMHS or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with ADMHS, contact: ADMHS ‐ PRIVACY OFFICE HIPAA Privacy Officer Tel: 805‐934‐6344 OR ADMHS Quality Care Management Beneficiary Concerns Tel: 805‐934‐6542 All complaints must be submitted in writing. You will not be penalized for filing a complaint. OTHER USES OF MENTAL HEALTH INFORMATION Unless we obtain your written permission, we will never use or disclose your Mental Health Medical Information for: 

Marketing purposes; or
Sale of your information
Other uses and disclosures of mental health information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose mental health information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, this will stop any further use or disclosure of your mental health information for the purposes covered by your written authorization, except if we have already acted in reliance on your permission. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you. Alice Gleghorn, Ph.D., Director of ADMHS Page 10 CONDA
ADO DE SANTA BARBAR
RA DEPA
ARTAMEENTO DEE ALCOHO
OL, DROGAS Y SERVICIO
OS DE LA
A SALUD MENTA
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AD Vigente
e: 27 de septiembrre de 201
13 / Revisión
n: 7 de en
nero de 20
015 EEn este avisso se descrriben los p
posibles usos y divulggación de ssu informaación médica y lass maneras en que ustted puede obtener aacceso a essta informaación. LEA ESTEE DOCUMEENTO DETEENIDAMEN
NTE. Si tiene pregguntas sobre
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e aviso, comuníquese coon: ADMHSS County of SSanta Barba ra PRIVACY OFFICER 500 We
est Foster Ro
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Fax: 805
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Ell Departame
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de la Salud M
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ompromete a proteger la informació
ón de su trattamiento de salud mentaal y servicioss de atenció
ón m
médica relacionados (info
ormación de salud mental). Este avisso le informaa de qué maaneras el Departamento de Alcohol, Drogas y SServicios de la Salud Menntal del Condado de San
nta Barbara (en ad
delante, “no
osotros” o “A
ADMHS”) puede usar y revelar inform
mación sobrre su salud m
mental. QUIÉNES EESTÁN SUJJETOS A ESSTE AVISO
El presente aviso describe las práctiicas del ADM
MHS y las de:: 



todo
o profesional de atención médica autorizado a inngresar inforrmación en ssu historia clínicca; todo
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den comparttir informaciión médica e
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nciones médicas que se d
describen en
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NUESTRO C
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RESPECTO A LA INFO
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D MENTALL Co
omprendem
mos que su in
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nerada por e
el ADMHS. Alice Gleghorn, Ph.D., Directorr of ADMHS Page 1 Este aviso le informa de qué maneras podemos usar y revelar información sobre su salud mental. También describimos sus derechos y ciertas obligaciones que tenemos con respecto al uso y la revelación de su información de salud mental. Por ley, estamos obligados a: 


asegurarnos de que la información de salud mental que lo identifica a usted se mantenga
confidencial (con ciertas excepciones);
entregarle a usted este aviso que describe nuestras obligaciones legales y prácticas de
privacidad con respecto a su información de salud mental; y
respetar los términos del aviso vigente.
CÓMO PODEMOS USAR Y REVELAR SU INFORMACIÓN DE SALUD MENTAL Las categorías siguientes describen las diferentes maneras en que podemos usar y revelar la información de salud mental. Explicamos el significado que le damos a cada categoría de uso y revelación, y damos algunos ejemplos. No se enumeran todos los tipos de usos y divulgación de cada categoría. Sin embargo, cada forma de uso y revelación de información que se nos permite pertenece a alguna de las categorías. DIVULGACIÓN CUANDO USTED LA SOLICITE Podemos revelar información cuando usted la solicite. Esa divulgación realizada a pedido suyo puede requerir que usted la autorice por escrito. PARA FINES DE TRATAMIENTO Podemos usar su información de salud mental para proveerle tratamiento o servicios médicos o de salud mental. Podemos revelar su información de salud mental a los médicos, enfermeros, técnicos, estudiantes de atención médica o demás personal del ADMHS que participen en su atención en el ADMHS. Por ejemplo, es posible que un médico que lo esté atendiendo por un trastorno de salud mental necesite saber qué medicamentos está tomando, ya que estos pueden influir en qué otros medicamentos se le pueden recetar. También es posible que el médico necesite avisarle al servicio de comidas del ADMHS que usted está tomando ciertos medicamentos para que se puedan organizar comidas apropiadas que no interfieran o interactúen inadecuadamente con su medicación. Las diferentes divisiones del ADMHS también pueden compartir su información de salud mental para coordinar diferentes servicios que usted pueda necesitar, como recetas médicas, análisis de laboratorio y radiografías. También podemos revelar su información de salud mental a personas ajenas al ADMHS que participen en su tratamiento médico o de salud mental una vez que usted deje de atenderse en el ADMHS, tales como centros de enfermería especializada, organismos de salud a domicilio, médicos u otros profesionales. Por ejemplo, podemos darle a su médico acceso a su información de salud para ayudarlo con el tratamiento que él le provee a usted. POR CUESTIONES RELATIVAS A LOS PAGOS Podemos usar y revelar su información de salud mental a usted, una compañía de seguros o un tercero para que se le puedan facturar y cobrar los servicios y el tratamiento que usted reciba del ADMHS. Por ejemplo, podemos necesitar darle información sobre el tratamiento que usted recibió en el ADMHS a su plan de salud para que éste nos pague o le reembolse a usted lo gastado en el tratamiento. También podemos informarle a su plan de salud acerca de algún tratamiento que usted esté por recibir, para obtener la aprobación previa o determinar si su plan cubrirá el tratamiento. Alice Gleghorn, Ph.D., Director of ADMHS Page 2 PARA ATENCIONES MÉDICAS Podemos usar y revelar su información de salud mental para atenciones médicas. Estos usos y revelaciones son necesarios para el funcionamiento del ADMHS y para asegurarnos de que todos nuestros pacientes reciban una atención de calidad. Por ejemplo, podemos usar información de salud mental para revisar nuestros tratamientos y servicios y para evaluar la atención que le brinda a usted nuestro personal. También podemos combinar la información de salud mental de muchos pacientes del ADMHS para decidir qué servicios adicionales debería ofrecer el ADMHS, qué servicios no son necesarios y si ciertos tratamientos nuevos son efectivos. También podemos revelar información a médicos, enfermeros, técnicos, estudiantes de atención médica y otro personal del ADMHS con fines de revisión y aprendizaje. También podemos combinar la información de salud mental que tenemos con información de salud mental de otros proveedores de atención médica para comparar cómo nos desempeñamos y ver qué áreas de la atención y los servicios que ofrecemos podemos mejorar. Podemos eliminar información que lo identifique a usted de este conjunto de información de salud mental para que otras personas puedan usarla para estudiar la atención médica y la prestación de la misma sin saber quiénes son específicamente los pacientes. RECORDATORIOS DE CITAS Podemos usar y revelar información de salud mental para comunicarnos con usted para recordarle que tiene una cita para un tratamiento o atención en el ADMHS. ALTERNATIVAS DE TRATAMIENTO Podemos usar o revelar su información de salud mental para informarle de las posibles opciones o alternativas de tratamiento que podrían interesarle. PRODUCTOS Y SERVICIOS RELACIONADOS CON LA SALUD Podemos usar y revelar su información de salud mental para informarle acerca de productos o servicios relacionados con la salud que podrían interesarle. PARIENTES U OTRAS PERSONAS QUE USTED DESIGNE A solicitud de un pariente, y con el consentimiento suyo, podemos notificarle a ese pariente su diagnóstico, pronóstico, medicamentos recetados y efectos secundarios, y su evolución. Si su cónyuge, o uno de sus padres, hijos o hermanos, presenta una solicitud de información y usted no puede
autorizar que se revele dicha información, se nos exige que le notifiquemos a la persona solicitante que usted se encuentra en un centro de internación del ADMHS, salvo en la medida que lo prohíban las leyes federales. Cuando usted es admitido en un centro de internación del ADMHS, debemos hacer intentos razonables de notificarle tal hecho a su pariente más cercano o a otra persona que usted designe, a menos que usted solicite que no se dé esa información. Debemos hacer intentos razonables, únicamente a solicitud de su pariente más cercano o quien usted designe, de notificarle a dicho pariente si usted ha sido dado de alta, transferido, tiene una enfermedad grave o una lesión, o si fallece, a menos que usted solicite que no se dé esta información. INVESTIGACIÓN En ciertos casos, podemos usar y revelar su información de salud mental para fines de investigación. Por ejemplo, un proyecto de investigación puede incluir una comparación de salud y recuperación de todos los pacientes que recibieron un medicamento con otros que recibieron otro medicamento para el mismo problema de salud. Todos los proyectos de investigación, no obstante, están sujetos a un proceso de aprobación especial. Mediante ese proceso se evalúa un proyecto de investigación Alice Gleghorn, Ph.D., Director of ADMHS Page 3 propuesto y su uso de la información de salud mental, tratando de equilibrar las necesidades de la investigación con la necesidad de los pacientes de mantener la privacidad de su información de salud mental. Antes de que usemos o revelemos información de salud mental para fines de investigación, el proyecto será aprobado mediante ese proceso de aprobación de investigaciones. Sin embargo, podemos revelarles su información de salud mental a personas que se estén preparando para realizar un proyecto de investigación para, por ejemplo, ayudarles a buscar pacientes con necesidades de salud mental específicas, siempre y cuando la información de salud mental que revisen no salga del ADMHS. SEGÚN LO EXIJA LA LEY Revelaremos su información de salud mental cuando así lo exijan las leyes federales, estatales o locales. PARA EVITAR UNA GRAVE AMENAZA PARA LA SALUD O LA SEGURIDAD Podemos usar y revelar su información de salud mental cuando sea necesario para evitar una amenaza grave para su salud y seguridad, o para la salud y seguridad del público o de otra persona. Sin embargo, la información se le revelaría únicamente a alguien capaz de ayudar a evitar la amenaza. SITUACIONES ESPECIALES DONACIÓN DE ÓRGANOS Y TEJIDOS Podemos entregar información de salud mental a organizaciones dedicadas a obtener órganos o a realizar trasplantes de órganos, ojos o tejidos, o a un banco de donaciones de órganos, según sea necesario para facilitar las donaciones y trasplantes de órganos o tejidos. ACTIVIDADES RELACIONADAS CON LA SALUD PÚBLICA Podemos revelar su información de salud mental para actividades relacionadas con la salud pública. Estas actividades pueden incluir, sin limitación, las siguientes: 
Para evitar o controlar enfermedades, lesiones o discapacidades.

Para reportar nacimientos y fallecimientos.

Para denunciar maltrato o abandono de niños, ancianos y adultos dependientes.

Para reportar reacciones a medicamentos o problemas con productos.

Para notificar a las personas que se retiran del mercado productos que ellas puedan estar
usando.

Para notificar a una persona que puede haber estado expuesta a una enfermedad o que
puede estar en riesgo de contraer o contagiar una enfermedad o problema de salud.

Para notificar a la autoridad gubernamental correspondiente si creemos que un paciente fue
víctima de maltrato, abandono o violencia doméstica. Revelaremos esta información
únicamente si usted está de acuerdo o cuando la ley lo exija o autorice.

Para notificar a los empleados de emergencias acerca de alguna posible exposición al
VIH/SIDA, en la medida necesaria para cumplir con las leyes estatales y federales.
ACTIVIDADES DE SUPERVISIÓN SANITARIA Podemos revelar su información de salud mental a organismos de supervisión de salud para las actividades autorizadas por la ley. Estas actividades de supervisión incluyen, por ejemplo, auditorías, investigaciones, inspecciones y concesiones de licencias. Estas actividades son necesarias para que el gobierno supervise el sistema de atención médica, los programas gubernamentales y el cumplimiento de las leyes civiles. Alice Gleghorn, Ph.D., Director of ADMHS Page 4 JUICIOS Y CONFLICTOS Si usted está involucrado en un juicio o conflicto, podemos revelar su información de salud mental en respuesta a una orden judicial o administrativa. También podemos revelar su información de salud mental en respuesta a una citación, solicitud de presentación de pruebas u otro proceso legal realizado por otra persona involucrada en el conflicto, pero únicamente si se ha hecho lo posible por informarle a usted acerca de dicha solicitud (que puede incluir una notificación escrita) o por obtener una orden de protección de la información solicitada. Podemos revelar información de salud mental a los tribunales, abogados y empleados judiciales durante el transcurso de una curatela y otros procedimientos judiciales o administrativos determinados. CUMPLIMIENTO DE LA LEY Podemos revelar información de salud mental si lo solicita un funcionario policial; 
en respuesta a una orden o citación judicial;

para identificar o localizar a un sospechoso, fugitivo, testigo esencial, ciertos escapes o
ciertas personas desaparecidas; 
con respecto a un fallecimiento que creemos puede haber sido el resultado de una
conducta delictiva; 
con respecto a conductas delictivas en el ADMHS;

cuando la solicita un policía que emite una orden judicial con el centro; y

cuando la solicita en el momento de la hospitalización involuntaria de un paciente.
FORENSES Y EXAMINADORES MÉDICOS Es posible que la ley nos exija informar acerca de la muerte de los pacientes a un forense o examinador médico. PROTECCIÓN DE FUNCIONARIOS ELECTIVOS CONSTITUCIONALES Podemos revelar su información de salud mental a cuerpos policiales gubernamentales según sea necesario para proteger a funcionarios electivos constitucionales federales y estatales y a sus familias. PRESOS Si usted está preso en una institución correccional o si está bajo la custodia de un funcionario policial, podemos revelar su información de salud mental a los mismos. La información puede revelarse cuando se solicite, según lo necesite la administración de justicia. GRUPOS DE DEFENSA Podemos revelar información de salud mental a la organización de protección y defensa del estado, si ésta tiene la autorización del paciente o del representante del paciente, o en el marco de ciertas investigaciones. Podemos revelar información de salud mental a la Oficina de Derechos de los Pacientes del Condado si ésta tiene la autorización del paciente o del representante del paciente, o en el marco de investigaciones resultantes de informes que por ley deben entregarse al Director de Salud Mental. DEPARTAMENTO DE JUSTICIA Podemos revelar información limitada al Departamento de Justicia de California con fines de traslado e identificación de ciertos pacientes criminales, o con respecto a personas que no deben comprar, tener o controlar armas de fuego o armas mortales. Alice Gleghorn, Ph.D., Director of ADMHS Page 5 EQUIPOS DE PERSONAL MULTIDISCIPLINARIO Podemos revelar información de salud mental a un equipo de personal multidisciplinario pertinente para la prevención, identificación, gestión o tratamiento de un niño maltratado, los padres del niño, o un anciano o adulto dependiente maltratado. COMITÉS NORMATIVOS DEL SENADO Y LA ASAMBLEA Podemos revelar su información de salud mental al Comité Normativo del Senado o de la Asamblea con fines de investigación legislativa. CATEGORÍAS ESPECIALES DE INFORMACIÓN INFORMACIÓN SOBRE EL ABUSO DE SUSTANCIAS A pesar que la regla de privacidad federal no define la diferencia entre la información sobre el abuso de sustancias y abuso médico, otros estatutos federales y leyes del estado de California sí disponen de restricciones legales en cuanto a la revelación de información desarrollada o conseguida en el transcurso de tratamientos contra el abuso de sustancias prestados a través de programas financiados con fondos federales. La información sobre el abuso de sustancias que se obtiene en el transcurso de tratamientos médicos generales no se ve sujeta a éstas provisiones. Por ende, la información sobre el abuso de sustancias se puede compartir entre los proveedores del ADMHS, y con los que contratan, sin tener que conseguir la autorización previa del paciente para efectos de la atención del mismo. Por ejemplo, la información sobre el abuso de sustancias la puede compartir la oficina de la Clínica médica general con el departamento de Servicios de salud mental del ADMHS o, con un programa contra el abuso de sustancias. Sin embargo, un programa contra el abuso de las sustancias contratadas debe conseguir la autorización previa del paciente para poder compartir la información con la oficina de la Clínica médica general o con el departamento de Servicios de salud mental del ADMHS. Todo otro uso o divulgación sobre el abuso de sustancias requiere la autorización previa del paciente.
La información sobre los pacientes que padecen del abuso de sustancias se sujeta a protecciones especiales según el estatuto federal 42 U.S.C. sección 290dd‐2 y según las regulaciones federales contenidas en “Confidencialidad de los records de pacientes que abusan de las drogas y el alcohol”, 42 C.F.R. parte 2. Además, el código de salud y seguridad de California, sección 11977, dispone de protecciones especiales a información sobre ciertos programas contra el abuso de sustancias. Puede que la ley LPS también aplique cuando el paciente recibe servicios tales como evaluaciones y tratamientos involuntarios cuando éste se encuentra gravemente incapacitado o presenta un peligro a si mismo o a los demás como resultado de su abuso de alcohol, narcóticos u otras drogas peligrosas. Estos estatutos federales y estatales requieren autorización por escrito para poder divulgar información sobre el abuso de sustancias en ciertas circunstancias, como también otras protecciones especiales de la información del abuso de sustancias. En dichas situaciones, se deben respetar las leyes estatales. Preguntas sobre el uso o la divulgación de la información sobre el abuso de sustancias se debe dirigir al encargado de privacidad de ADMHS. OTRAS CATEGORÍAS ESPECIALES DE INFORMACIÓN Pueden aplicarse requisitos legales especiales al uso o a la revelación de ciertas categorías de información, como por ejemplo, pruebas del virus de inmunodeficiencia humana (VIH) o tratamientos y servicios contra el abuso de alcohol y drogas. Asimismo, pueden aplicarse normas un tanto diferentes al uso y la revelación de información médica relacionada con la atención médica general (no de salud mental) que usted recibe. Alice Gleghorn, Ph.D., Director of ADMHS Page 6 APUNTES DE PSICOTERAPIA Los apuntes de psicoterapia son los apuntes registrados (por cualquier medio) por un proveedor de atención médica que es un profesional de la salud mental que documenta o analiza el contenido de las conversaciones durante una sesión de asesoramiento privada, grupal, conjunta o familiar y que están separadas del resto de la historia clínica de la persona. Los apuntes de psicoterapia excluyen las recetas y la supervisión de medicamentos, las horas de inicio y finalización de las sesiones de asesoramiento, las modalidades y frecuencias de los tratamientos provistos, los resultados de las pruebas clínicas y los resúmenes de los siguientes elementos: diagnóstico, estado funcional, plan de tratamiento, síntomas, pronósticos, y evolución hasta la fecha. Podemos usar o revelar sus apuntes de psicoterapia cuando así lo exija la ley, o: 
para uso del originador de los apuntes;

en programas de capacitación de salud mental supervisados destinados a estudiantes,
aprendices o profesionales;

por parte del centro asegurado para defenderse en una acción legal u otro procedimiento
iniciado por la persona;

para evitar o reducir una amenaza grave e inminente para la salud o seguridad de una
persona o el público;

para la supervisión médica del originador de los apuntes de psicoterapia;

para uso o revelación al forense o examinador médico al informar el fallecimiento de un
paciente;

para uso o revelación necesarios para evitar o reducir una amenaza grave e inminente
para la salud o seguridad de una persona o el público; y

para uso o revelación al Secretario del DHHS (Departamento de Salud y Servicios
Humanos) durante una investigación. A no ser que consigamos su permiso por escrito.
Nunca usaremos ni divulgaremos los apuntes de psicoterapia para otros efectos.
SUS DERECHOS CON RESPECTO A SU INFORMACIÓN DE SALUD MENTAL Usted tiene los siguientes derechos con respecto a su información de salud mental que se encuentra en nuestro poder: DERECHO A REVISAR Y COPIAR Tiene derecho a revisar y copiar información de salud mental que pueda usarse para tomar decisiones sobre su atención. Esto habitualmente incluye los expedientes de salud mental y de facturación, pero puede no incluir alguna información de salud mental. Para revisar y copiar información de salud mental que pueda usarse para tomar decisiones sobre su atención, debe enviar su solicitud por escrito a: ADMHS‐MEDICAL RECORDS (HISTORIAS CLÍNICAS) 315 Camino Del Remedio Santa Barbara, CA 93110 Tel: 805‐681‐5328 Fax: 805‐681‐5294 Si solicita una copia de la información, podemos cobrarle un honorario por los costos de las copias, el correo u otros suministros asociados con su solicitud. Alice Gleghorn, Ph.D., Director of ADMHS Page 7 Podemos rechazar su solicitud de revisar o copiar en ciertos casos muy limitados. Si se le niega el acceso a la información de salud mental, usted puede solicitar que se revise la denegación. Otro profesional de atención médica habilitado elegido por el ADMHS revisará su solicitud y la denegación. La persona que realice la revisión no será la que denegó su solicitud. Cumpliremos con lo que se determine conforme al resultado de la revisión. DERECHO A SOLICITAR MODIFICACIONES Si usted considera que su información de salud mental que se encuentra en nuestro poder es incorrecta o incompleta, puede solicitar que la corrijamos. Usted tiene derecho a solicitar una modificación durante el tiempo que el ADMHS conserve la información o el tiempo que dicha información se conserve para el ADMHS. Para solicitar una modificación, debe hacerlo por escrito y presentarle la solicitud a: ADMHS‐MEDICAL RECORDS (HISTORIAS CLÍNICAS) 315 Camino Del Remedio Santa Barbara, CA 93110 Tel: 805‐681‐5328 Fax: 805‐681‐5294 Además, deberá indicar el motivo que justifica su solicitud. Podemos rechazar la solicitud de modificación que no se presente por escrito o no incluya un motivo que la justifique. También podemos rechazarla si nos pide que modifiquemos información que: 
no fue creada por nosotros, a menos que la persona o entidad que la haya creado ya no
esté disponible para hacer la modificación;

no forma parte de la información de salud mental que conserva el ADMHS, o que se
conserva para este;

no forma parte de la información que a usted se le permitiría revisar y copiar; o

está exacta y completa.
Aún si rechazamos su solicitud de modificación, usted tiene derecho a presentar una adenda escrita, que no exceda las 250 palabras, con respecto a cualquier elemento o declaración de su registro que usted considere incompleto o incorrecto. Si indica con claridad por escrito que desea que la adenda forme parte de su historia clínica de salud mental, la adjuntaremos a esta y la incluiremos toda vez que revelemos el elemento o declaración que usted considera incompleto o incorrecto. DERECHO A RECIBIR UN REPORTE DE LO DIVULGADO Tiene derecho a solicitar una reporte de los documentos que se hayan divulgado. Se trata de una lista de los documentos de su información de salud mental que hemos divulgado, aparte de los que hemos divulgado para nuestros propios usos, de los tratamientos, pagos y atenciones médicas (según se describen esas funciones anteriormente) y con otras excepciones determinadas conforme a la ley. Para solicitar esta lista de relación de revelaciones, debe presentarle su solicitud por escrito a: ADMHS‐MEDICAL RECORDS (HISTORIAS CLÍNICAS) 315 Camino Del Remedio Santa Barbara, CA 93110 Tel: 805‐681‐5328 Fax: 805‐681‐5294 Alice Gleghorn, Ph.D., Director of ADMHS Page 8 Su solicitud debe establecer un período que no exceda los seis años ni incluya fechas anteriores al 14 de abril de 2003. Debe indicar en su solicitud de qué forma desea recibir la lista (por ejemplo, impresa o por medios electrónicos). La primera lista que solicite en un período de 12 meses no tendrá ningún costo. Si solicita listas adicionales, podremos cobrarle los costos de entrega de las listas. Le notificaremos el costo correspondiente y usted podrá optar por retirar o modificar su solicitud en ese momento, antes de que se incurra en algún gasto. Asimismo, le notificaremos, según lo exige la ley, si alguien accede o revela su información de salud de manera ilegal. Una vez que el ADMHS se haya convertido por completo al sistema para mantener la información de salud mental como un Registro de salud electrónico (EHR son sus siglas en inglés), éste también les dará a los pacientes, previa solicitud escrita, una relación de las revelaciones realizadas a través de los EHR con fines de tratamientos, pagos y atenciones médicas. Este reporte se realizará para un período de hasta tres años anteriores a la fecha en que se solicite el reporte e incluirá revelaciones realizadas por asociados comerciales, o bien una lista de todos los asociados comerciales con la información de contacto de estos. DERECHO A SOLICITAR RESTRICCIONES Tiene derecho a solicitar que se restrinja o limite la información de salud médica suya que usamos o revelamos para fines de tratamientos, pagos o atenciones médicas. También tiene derecho a solicitar que se limite la información de salud mental suya que le revelemos a alguien que se ocupe de su atención o del pago de su atención, tal como un pariente o amigo. Por ejemplo, puede pedirnos que no usemos ni revelemos información sobre algún tipo de terapia que haya recibido. No estamos obligados a aceptar su solicitud, a menos que sea para limitar las revelaciones a los planes de salud por servicios que usted ya pagó por completo. Si aceptamos su solicitud, la cumpliremos a menos que la información sea necesaria para proveerle tratamiento de emergencia. Para solicitar restricciones, debe presentarle su solicitud por escrito a: ADMHS‐MEDICAL RECORDS (HISTORIAS CLÍNICAS) 315 Camino Del Remedio Santa Barbara, CA 93110 Tel: 805‐681‐5328 Fax: 805‐681‐5294 En su solicitud, debe indicarnos 1) qué información quiere limitar; 2) si quiere limitar el uso, la revelación, o ambos; y 3) a quiénes quiere aplicarles los límites; por ejemplo, su cónyuge. DERECHO A SOLICITAR COMUNICACIONES CONFIDENCIALES Tiene derecho a solicitar que nos comuniquemos con usted con respecto a sus asuntos de salud mental de un modo o en un lugar determinados. Por ejemplo, puede solicitar que nos comuniquemos con usted solamente en su horario laboral o por correo. Para solicitar comunicaciones confidenciales, debe presentarle su solicitud por escrito a: ADMHS‐MEDICAL RECORDS (HISTORIAS CLÍNICAS) 315 Camino Del Remedio Santa Barbara, CA 93110 Tel: 805‐681‐5328 Fax: 805‐681‐5294 Alice Gleghorn, Ph.D., Director of ADMHS Page 9 No le preguntaremos cuál es el motivo de su solicitud. Satisfaremos todas las solicitudes que sean razonables. En su solicitud debe especificar cómo o dónde quiere que nos comuniquemos con usted. DERECHO A OBTENER UNA COPIA IMPRESA DE ESTE AVISO Tiene derecho a obtener una copia impresa de este aviso. Puede solicitarnos una copia de este aviso en cualquier momento. Aunque haya aceptado recibir este aviso por medios electrónicos, usted tiene derecho a recibir una copia impresa del mismo. Si usa Internet Explorer u otro navegador de Internet, visite esta página web:
http://www.countyofsb.org/admhs/admhs.aspx?id=40035
Otra opción es visitar la página web http://www.countyofsb.org/admhs, hacer clic en "Para individuos y familias", luego en "Formularios para clientes" y por último en "HIPAA". Para poder ver el Aviso de prácticas de privacidad necesitará tener Adobe Acrobat Reader instalado en la computadora. Si su computadora no tiene instalado Adobe Acrobat Reader, puede obtenerlo e instalarlo desde aquí: http://get.adobe.com/reader/
El Aviso está disponible en inglés y español. Haga clic en la versión que desee ver y el Aviso aparecerá en una nueva ventana. Si lo desea, puede guardar o imprimir una copia del formulario con los menús de Adobe Acrobat Reader. MODIFICACIONES DE ESTE AVISO Nos reservamos el derecho a modificar el presente aviso. Nos reservamos el derecho a poner en vigencia el aviso revisado o modificado para la información de salud mental que ya tenemos de usted y para toda información que recibamos en el futuro. Publicaremos una copia del aviso vigente del ADMHS. El aviso contendrá la fecha de entrada en vigencia en la primera página, en el ángulo superior derecho. Asimismo, cada vez que usted se registre en el ADMHS o reciba tratamiento o servicios de atención médica como paciente internado o ambulatorio, podrá solicitar una copia del aviso que esté vigente en ese momento. QUEJAS Si usted considera que se han violado sus derechos de privacidad, puede presentar una queja al ADMHS o al Secretario del Departamento de Salud y Servicios Humanos de los Estados Unidos. Para presentar una queja ante el ADMHS, comuníquese con: ADMHS ‐ PRIVACY OFFICE HIPAA Privacy Officer Tel: 805‐934‐6344 O ADMHS ‐ Quality Care Management Division (Division de Control de Calidad) Beneficiary Concerns (Inquietudes de los beneficiarios) Tel: 805‐934‐6542 Alice Gleghorn, Ph.D., Director of ADMHS Page 10 Todas las quejas deben presentarse por escrito. Usted no será penalizado por presentar una queja. OTROS USOS DE LA INFORMACIÓN DE SALUD MENTAL Sin permiso en escrito, su información médica de salud mental jamás será usada para: 
Propósitos de promoción; o

Propósito de venta.
Los usos y revelaciones de información de salud mental que no estén cubiertos por el presente aviso o por las leyes aplicables a nosotros se realizarán únicamente con el permiso escrito suyo. Si nos da permiso para usar o revelar su información de salud mental, usted podrá revocar ese permiso, por escrito, en cualquier momento. Si revoca su permiso, la revocación detendrá todo otro uso o revelación de su información de salud mental con los fines cubiertos por su autorización escrita, salvo que ya hayamos actuado en consonancia con su permiso. Usted comprende que no podemos revertir las revelaciones que ya hayamos hecho con su permiso, y que se nos exige que retengamos nuestros registros de la atención que le proveamos a usted. Page | 11
Privacy Support
What does the acronym “HIPAA” stand for?
HIPAA stands for Health Insurance Portability and Accountability Act and is a federally mandated law signed in 1996. The HIPAA Privacy Rule sets standards how protected health information can be disclosed and used, and what rights patients have regarding their health information. Only health plans, health care clearinghouses, health care providers, and other entities that exchange health information are responsible for complying with HIPAA regulations. The Notice of Privacy Practices describes the County's policies regarding use, disclosure, and protection of your information under HIPAA. 
To learn more about the County of Santa Barbara ADMHS Notice of Privacy Practices go the web page
http://www.countyofsb.org/admhs. Then click on "For Individuals and Families," and then on "HIPAA."
Where may I find information about HIPAA?
 Start here for general information: http://www.countyofsb.org/admhs/admhs.aspx?id=40035 .
 For specific information about your online HIPAA training, contact the ADMHS Privacy Officer:
[email protected]‐barbara.ca.us.
How may I report a possible privacy violation?
To report a suspected or known privacy violation, whether for yourself or another, you may contact the Privacy Office by using any of the following options: 



Email the ADMHS Privacy Officer [email protected]‐barbara.ca.us,
Call the Privacy Office at 805‐934‐6344,
Call the Privacy Hot Line at 805‐934‐6330, or
Open the Santa Barbara County Intranet to internally send email to [email protected].
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( (This page intentionally left blank.) Name of exiting staff: Location(s) of Office: Supervisor: Separation Date: CivilService,ExtraHelp,andVolunteers
SeparationfromServiceForm
The following checklist will be facilitated by the assigned Supervisor and then followed up with by HR. Exit Interview on __/___/201_ (Facilitator: HR and Supervisor) Cell/Droid/IPhone Returned and Disabled on __/___/201_ (Facilitator: Pat Kinoshita) Network Acct. Disabled on __/___/201_ (Facilitator: Pat Kinoshita) Clinician Gateway Acct. Disabled on __/___/201_ (Facilitator: Pat Kinoshita) ShareCare Acct. Disabled on __/___/201_ (Facilitator: Pat Kinoshita) Tablet or Laptop Returned on __/___/201_ (Facilitator: Pat Kinoshita) Keys Returned on __/___/201_ (Facilitator: Ernest Thomas) Badge Returned on __/___/201_ (Facilitator: Ernest Thomas) HR action on personnel files and accounts on__/__/201_ (Facilitator: ADMHS HR) Re‐direct incoming e‐mail messages to other staff on __/__/201_ (Facilitator: Supervisor) Name of Community Based Organization: Name of exiting Contracted staff: ContractProviders
SeparationFromServiceForm
Location(s) of Office: Supervisor: Separation Date: Program contact info: Is the staff co‐located at an ADMHS Clinic? Y/N Does the staff use Clinician’s Gateway? Y/N Does the staff use ShareCare? Y/N Does the staff have a County email address? Y/N Name of Replacement Staff (if known) Facilitated by Pat Kinoshita DATE Cell/Droid/IPhone Returned and Disabled: Network Acct. Disabled: Clinician Gateway Acct. Disabled: ShareCare Account Disabled: Tablet or Laptop Returned: ___ /___ /2015
___ /___ /2015
___ /___ /2015
___ /___ /2015
___ /___ /2015
Facilitated by Ernest Thomas Keys Returned: Badge Returned/Deactivated: DATE ___ / ___ / 2015
___ / ___ / 2015