Presumptive Transfer Requirements

Services provided by Merced County Behavioral Health and Recovery Services (BHRS)

BHRS provides Specialty Mental Health Services to youth and non-minor dependents who meet criteria for Severely Mentally Ill or Severely Emotionally Disturbed definitions. Services may include Individual Therapy, Intensive Home-Based Services (IHBS), Intensive Care Coordination (ICC) and Case Management.

Mild to moderate services are provided by a primary care provider (PCP) or the Managed Care Program. Merced County’s Managed Care Program Provider for mild to moderate services is Beacon Health Options. Please click on the Beacon link to access the website.  To log in, please enter Plan Name CCAH. 

AB1299

AB1299 Presumptive Transfer Requirements

The following applies to AB1299 presumptive transfer youth and non-minor dependents when it is assumed that youth will be placed in a long-term placement.

The placing agency/Mental Health Plan (MHP) should send information about the presumptive transfer to Merced County within 3-business days of the decision by fax, mail, or email.

Please ensure that the youth or non-minor dependent's residence address is updated in the Medi-Cal Eligibility Data System (MEDSLITE) reflecting Merced County address within 2-business days of making the determination.

The notification from Placing County shall be sent to Merced County within 3 business days and shall include:

• Identifying information about the child or non-minor dependent including, name, date of birth, address and caregiver contact information;
• Name, location, and contact information of the referring or placing agency;
• Send or arrange to have sent to Merced County the most recent court document to identify the legal holder of privilege such as Order After Hearing or Jurisdiction Disposition Report (Juris-Dispo). 
• Name and contact information of who can sign releases of information;
• Name and contact information of who can consent for mental health services;

Send, or arrange to have sent to Merced County the most recent consent for services, and consent for medication, including the JV-220.   

Send, or arrange to have sent to, the Merced County the most recent mental health records, including the most recent mental health assessment. 

Please note, in order to provide mental health services, Merced County BHRS must have all consents signed by the legal authority.  

The following consents are required to be returned to Merced County BHRS via fax, mail or encrypted email sent to mhab1299@countyofmerced.com:

• Merced County Behavioral Health & Recovery Services Authorization for Release of Information
• Authorization for Treatment of a Minor (This form is written in Spanish/English languages)
• Acknowledgment of Receipt of Notice of Privacy Practices  (Notice of Privacy Practices)
• Merced County Behavioral Health & Recovery Services Assignment of Benefits

Waivered AB1299 Presumptive Transfer

• If a youth does not meet AB1299 presumptive transfer requirements and/or if the youth meets the criteria for exceptions to Presumptive Transfer, please submit a Presumptive Transfer Waiver to Merced County BHRS via fax or encrypted email sent to mhab1299@countyofmerced.com.  Please refer to ACL 17-77 for information on Presumptive Transfer Waiver.

Merced County Social Workers / Merced County Probation

Merced County Social Workers and/or Merced County Probation personnel completing a Presumptive Transfer for Merced County Dependents should complete the following forms:

• Authorization for Release of Information
• Notice of Presumptive Transfer
  • Identify who has legal privilege/consent 
  • Indicate County receiving youth and contact information to send mental health correspondence to

Return forms to Behavioral Health and Recovery Services

Email: mhab1299@countyofmerced.com

Fax: (209) 724-4046  ATTN: BHRS Presumptive Transfer Designee(s)

The following applies to Merced County youth who do not meet the criteria for AB1299 Presumptive Transfer:

• If requesting Mental Health Services for youth placed out of county please submit SAR to Liliana Pulido, LCSW, and Leticia Servin, LMFT.  Ensure the authorized Medi-Cal Codes for Adoption Assistance Program (APP) and/or Kinship Guardian Assistance Program (Kin-GAP) are established.
• A completed SAR request can be faxed to (209) 724-4046 or sent within an encrypted email to mhab1299@countyofmerced.com
•   Please indicate on Subject Header:  SAR Request