Substance Abuse Prevention and Control
Manuals, Bulletins, and Forms
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Manuals & Guides
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Subject Date - SBAT User Registration Form03/07/23
- Companion Guide HIPAA 837P02/01/24
- Companion Guide HIPAA 837I03/06/23
- Provider Manual for Substance Use Disorder Treatment Services Version 10.008/13/25
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SBAT Training Video: Availability Dashboard 10/26/21
- SBAT Training Slides: Availability Dashboard10/26/21
- SBAT Training: Availability Dashboard Q&A10/26/21
- CENS Standards and Practice
- CENS Standards and Practice08/03/21
- CENS Screening Referral Treatment Follow-up Form08/03/21
- CENS Flyer08/03/21
- CENS Spanish Flyer08/03/21
- CENS ASAM Triage Tool08/03/21
- CENS Youth Screener08/03/21
- CENS Staffing Plan08/03/21
- CENS Monthly Invoice08/03/21
- CENS Performance Measures and Outcomes Report08/03/21
- CENS PCNX Documentation Guide11/06/23
- CENS Standards and Practice
- DUI user manual 12/13/20
- DUI Quick Reference Guide 12/13/20
- TCPX Quick Reference Guide 12/13/20
- DUI & TCPX User Registration Form 12/13/20
- Service and Bed Availability Tool (SBAT) User Manual07/06/23
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SBAT Training Video: New Intake Availability Functions11/18/19
- SBAT Survey Webinar 2018/1905/29/18
- Sage Sample LACPRS/CalOMS Data File(Right-click and select "Save target as..." to download the file) 12/06/17
- ASAM Levels of Care and Dimensions: Youth and Adults08/13/15
Contract Bulletins
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Bulletins 2025
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Subject Date - SAPC IN 25-17 RYSE Initiative - Pillar II: Update the Program12/15/25
- Attachment I: Project Approval Form12/15/25
- Attachement II: Start-up Funds Invoice12/15/25
- Attachment I: Project Approval Form
- SAPC IN 25-16 Housing Navigation Services11/26/25
- 25-15 Grocery One-Time Support Initiative11/05/25
- 25-14 Child-Friendly Environments in the Pregnant and Parenting Women Treatment Network10/03/25
- 25-13 Emergency Preparedness Plan09/10/25
- 25-12 Provider Manual 10.008/13/25
- 25-11 Requirements for Appointment and Referral Dispositions08/13/25
- 25-10 R95 Enhancement Activities07/01/25
- 25-09 FY 2025-26 SAPC Rates06/12/25
- 25-08 Fiscal Reporting06/10/25
- 25-07 Fiscal Compliance Reviews06/05/25
- 25-06 RYSE Initiative Pillar I RESET05/19/25
- 25-05 CalAIM Post-Release Linkage Process05/07/25
- 25-04 Recovery Housing04/16/25
- Attachment I: RH Intake Form04/16/25
- Attachment II: RH Discharge Form04/16/25
- Attachment III: RH Bed Claim Submission Form04/16/25
- Attachment IV: RH Billing Procedure04/16/25
- Attachment I: RH Intake Form
- 25-03 Budget Format for Substance Use Services Agreements and Contract01/31/25
- Attachment I: Budget Instructions01/31/25
- Attachment II: Budget Narrative02/26/25
- Attachment III: Budget Revision Worksheet 03/11/25
- Attachment I: Budget Instructions
- 25-02 FY 24-25 Rates and Payment Policy Updates01/31/25
- 25-01 RBH Services Home Improvement Funds01/31/25
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Bulletins 2024
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Subject Date - 24-10 - Pregnant and Parenting Women Expanded Recovery Bridge Housing Benefit 12/18/24
- 24-09 - COVID-19 and Influenza Vaccination Requirements, Masking Guidance, And Reporting Responsibilities10/18/24
- 24-08 - Revised: Substance Use Disorder Treatment Services Provider Manual Version 9.010/07/24
- 24-07 Recovery Bridge Housing - Home improvement Funds (Discontinued)02/10/25
- 24-06 - Bridge Family Supportive Services Program09/23/24
- 24-05 Budget Format For Substance Use Services Agreements and Contracts (Discontinued)02/10/25
- 24-04 Fiscal year 2024-2025 Rates and Payment Policy Updates (Discontinued)02/10/25
- 24-03 - Withdrawal Management Standards in the SAPC Treatment Network07/02/24
- 24-02 - Requirements for Ensuring Culturally and Linguistically Appropriate Service05/16/24
- 24-01 - Addiction Medication Access in the SAPC Treatment Network01/05/24
- Attachment A - Patient Information About Addiction Medications01/05/24
- Attachment B - Required Addiction Medications07/16/24
- Attachment C - Patient Eligibility for Addiction Medications01/05/24
- Attachment D - Administration, Storage, and Disposal of Addiction Medications01/05/24
- Attachment E - Addiction Medication Training Requirements for Staff01/05/24
- Attachment F - Accessing Addiction Medications in Los Angeles County01/05/24
- Attachment G - Incidental Medical Services01/05/24
- Optional Policy Template A for Non-Residential Non-OTP Treatment Sites01/05/24
- Optional Policy Template B for Residential and Inpatient Treatment Sites01/05/24
- Optional Policy Template C for Opioid Treatment Program Sites01/05/24
- Attachment A - Patient Information About Addiction Medications
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Bulletins 2023
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Subject Date - 23-15 - Revised: Substance Use Disorder Treatment Services Provider Manual Version 8.012/28/23
- 23-14 - Revised: Field-Based Services in Non-Clinical Settings12/20/23
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23-13 - Client Engagement and Navigation Services (CENS) Providers to Add Recovery Services Benefit11/30/23
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23-12 - California Advancing and Innovating Medi-Cal Provisions11/03/23
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23-11- COVID-19 and Influenza Vaccination Requirements ,Masking Guidance, and Reporting Responsibilities (Discontinued)10/13/23
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23-10 - Implementation of Fiscal Reporting Process for All Substance Abuse Prevention and Control
Bureau Services Providers10/12/23 - 23-09 - Driving Under the Influence Participant Fees and Financial Assessments09/15/23
- 23-08 - Effective Communications with SAPC Network09/01/23
- SAPC Listserv Update Form09/01/23
- Corporate Information Form09/01/23
- SAPC Listserv Update Form
- 23-07 Fiscal Year 2023-2024 Rates and Payment Policy Updates (Discontinued)06/22/23
- SAPC FY 23-24 Capacity Building Package (Discontinued)04/16/24
- SAPC FY 23-24 Incentives Package (Discontinued)04/16/24
- Invoice 1 SAPC FY 23-24 Capacity Building Start-Up Funds Attestation (Discontinued)03/29/24
- Invoice 2 SAPC FY 23-24 Capacity Building Deliverable-Based Efforts (Discontinued)05/09/24
- Invoice 3 SAPC FY 23-24 Incentives Verification (Discontinued)05/09/24
- Rates Standards Matrix FY 23-24 (Discontinued)03/26/24
- SAPC FY 23-24 Capacity Building Package (Discontinued)
- 23-06 Recovery Incentives Program Pilot: Contingency Management Benefit05/26/23
- Contingency Management Invoice09/13/23
- Contingency Management Invoice
- 23-05 Provider Staffing Guidelines05/04/23
- Provider Staffing Guidelines Grid05/04/23
- Provider Staffing Guidelines Grid
- 23-04 Certified Peer Support Specialist Program 05/01/23
- 23-03 COVID-19 Vaccination Requirements and Responsibilities (Discontinued)04/06/23
- 23-02 Information System Requirements03/23/23
- 23-01 30-Day Pending Medi-Cal Enrollment01/30/23
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Bulletins 2022
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Subject Date - 22-19 California Advancing Innovations in Medi-Cal (CalAIM) Documentation Standards and Requirements12/23/22
- 22-18 COVID-19 Vaccination Requirements and Responsibilities (Discontinued)11/27/22
- 22-17 Early Intervention Services for Youth and Young Adults: Updates on Required ASAM Screener and Training Requirements10/20/22
- 22-16 Revised: Substance Use Disorder Treatment Services Provider Manual Version 7.0 (Discontinued)09/29/22
- 22-15 Compliance with Economic Sanctions Imposed in Response to Russia’s Actions in Ukraine08/08/22
- 22-14 Requesting Amendments to Existing Service Contracts and Agreements08/03/22
- Contract Amendment Form08/03/22
- Contract Amendment Form
- 22-13 Fiscal Year 2022-2023 Rates and Payment Policy Updates (Revised - October 2022)08/03/22
- 22-12 Integrating Sexual and Reproductive Health Specialists in Substance Use Disorder Treatment Settings Project 06/30/22
- 22-11 COVID-19 Federal Public Health Emergency - Residential Outbreak Payments (Discontinued)06/16/22
- CROP Request Form (Discontinued)06/07/22
- CROP Request Form (Discontinued)
- 22-10 Commitment to Identify, Prevent and Respond to Fraud, Waste and Abuse 05/26/22
- 22-09 Harm Reduction Syringe Services Program Certification 05/09/22
- 22-08 COVID-19 Vaccination Requirements and Responsibilities (Discontinued)04/30/22
- 22-07 Revised: Substance Use Disoder Treatment Services Provider Manual Version 6.0 (Discontinued)03/31/22
- 22-06 County of Residence Model10/03/24
- Courtesy Dosing Claim Form10/03/24
- Courtesy Dosing Claim Form
- 22-05 Youth Enhancement Services Project03/31/22
- 22-04 Medications for Addiction Treatment Access in the SAPC Treatment Network (Discontinued)01/27/22
- 22-03 Requesting Amendments to Existing Service Contracts and Agreements (Discontinued)01/27/22
- 22-02 COVID-19 Vaccination Requirements and Responsibilities (Discontinued)01/04/22
- 22-01 Novel Coronavirus (COVID-19) Response (Discontinued)01/04/22
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Bulletins 2021
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Subject Date - 21-09 Fiscal Year 2021-2022 Rates and Payment Policy Updates (revised September 2022)09/26/22
- Perinatal Rates Matrix Fiscal Year 2021-2022 (revised September 2022) 09/26/22
- Standard Rates Matrix Fiscal Year 2021-2022 (revised September 2022) 09/26/22
- Youth Rates Matrix Fiscal Year 2021-2022 (revised September 2022) 09/26/22
- Perinatal Rates Matrix Fiscal Year 2021-2022 (revised September 2022)
- 21-08 Novel Coronavirus (COVID-19) Response (Discontinued)10/07/21
- 21-07 COVID-19 Vaccination Requirements and Responsibilities (Discontinued)09/30/21
- 21-06 Novel Coronavirus (COVID-19) Response (Discontinued)07/01/21
- 21-05 Fiscal Year 2021-2022 Rates and Payment Policy Updates (Discontinued)08/04/21
- 21-04 Effective Communications with SAPC Network (Discontinued)04/19/21
- 21-03 Credentialing Staff03/25/21
- 21-02 Medi-Cal Enrollment Transfer (30-Day) Policy (Discontinued)01/21/21
- 21-01 Novel Coronavirus (COVID-19) Response (Discontinued)01/12/21
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Bulletins 2020
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Subject Date - 20-13 Charitable Choice Referral and Reporting Process12/29/20
- 20-12 Staff Code of Conduct and Description of Duties12/21/20
- 20-11 Member Authorization Submission09/30/20
- 20-10 Fiscal Year 2020-2021 Rates and Payment Policy Updates 07/08/20
- 20-09 Revised: Substance Use Disorder Treatment Services Provider Manual Version 5.0 (Discontinued)07/02/20
- 20-08 Novel Coronavirus (COVID-19) Response (Discontinued)07/01/20
- 20-07 Claim Denials and Cost Reporting Processes 06/18/20
- 20-06 Novel Coronavirus (COVID-19) Response (Discontinued)01/12/21
- 20-05 Novel Coronavirus (COVID-19) Response (Discontinued)04/20/20
- 20-04 Novel Coronavirus (COVID-19) Response (Discontinued)04/01/20
- 20-03 Novel Coronavirus (COVID-19) Response (Discontinued)03/19/20
- 20-02 Youth Enhancement Services Pilot (Discontinued)03/05/20
- 20-01 Mandatory Medicare Enrollment for Opioid Treatment Programs01/10/20
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Bulletins 2019
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Subject Date - 19-08 Transitional Payment Information Notice11/20/19
- Transitional Payment Invoice11/20/19
- Transitional Payment Request Form11/20/19
- Transitional Payment Invoice
- 19-07 Provider Staffing Guidelines (Discontinued)11/12/19
- 19-06 Field Based Services (Discontinued)11/01/19
- 19-05 Notice of Adverse Benefit Determination11/01/19
- 19-04 Naloxone Administration and Availability11/01/19
- 19-03 Fiscal Year 2019-2020 Rates (Discontinued)08/08/19
- 19-02 Provider Staffing Guidelines (Discontinued)04/01/19
- 19-01 Hepatitis A, B, and C Virus Program11/17/19
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Bulletins 2018
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Subject Date - 18-13 Residential Treatment Programs12/20/18
- 18-12 Revised START-ODS Service Reimbursement Rates12/20/18
- 18-11 Pregnant and Parenting Women Services09/20/18
- 18-10 New Contract Requirements08/15/18
- 18-09 Fiscal Audits08/15/18
- 18-08 Electronic Payments for All County Contractors07/30/18
- 18-07 Member Authorizations07/05/18
- 18-06 Provider Incentive Pilot Program06/05/18
- 18-05 Residential Programs05/29/18
- 18-04 Out-of-County Facilities05/29/18
- 18-03 Culturally and Linguistically Appropriate Service Requirements (Discontinued)06/19/18
- 18-02 Provider Staffing Guidelines (Discontinued)04/26/18
- 18-01 Recovery Bridge Housing 03/28/18
- RBH Inquiry Guide05/17/19
- RBH Inquiry Guide
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Bulletins 2017
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Subject Date - 17-14 County of Residence Model10/03/24
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Excel attachment (Discontinued)02/26/18
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Excel attachment (Discontinued)
- 17-12 Billing for Youth Treatment and Prevention Services03/05/18
- 17-11 Sage Outage Procedure11/21/17
- 17-10 START-ODS Perinatal Services11/15/17
- 17-09 Service Cost Reconciliation Settlement 10/10/17
- 17-08 Revised Specific Services to be Provided 07/05/17
- 17-07 Service Reimbursement Rates (Discontinued)03/20/18
- 17-06 Medical Necessity Determination07/05/17
- 17-05 Service and Bed Availability Tool 07/05/17
- 17-04 Substance Use Disorder Treatment Services Provider Manual (Discontinued)03/15/18
- 17-03 Field-Based Services (Discontinued)07/05/17
- 17-02 Sage - Managed Care Information System (Discontinued)06/29/17
- 17-01 DMC Client Transitions Plan - New System of Care05/16/17
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Clinical Forms and Documents - Treatment Services Related
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Subject Date - Updated Paper ASAM-Adult
- Updated Paper ASAM Criteria Adult10/09/25
- OLD LOC Determination Tool Optional01/06/25
- Paper SUD DSM Form10/09/25
- Updated Paper ASAM Criteria Adult
- Progress Note09/11/23
- Checklist of Required Documentation for Utilization Management
- Sage Version 7.305/28/25
- Sage Version 7.3
- ASAM Assessment Requirements10/07/24
- ASAM Screener for Youth and Young Adults01/11/24
- Problem List-Main07/10/23
- Problem List Addendum (Additional Problems)07/26/22
- Eligibility Verification and Member Authorizations12/02/21
- Patient Handbook and Orientation Video Acknowledgment Form07/29/20
For more languages, click here - Release of Information - In SAPC SUD Provider Network07/16/20
- Release of Information - Outside SAPC SUD Provider Network07/16/20
- Assessment Tool - Youth (Paper Version)10/10/19
- ASAM CONTINUUM to SAPC Level of Care Crosswalk09/08/19
- Screening - Adults (Paper Version)11/18/17
- Treatment Plan Addendum09/13/17
- Drug Testing Form09/12/17
- Document Examples within the Specialty Substance Use Disorder (SUD) System09/08/17
- Miscellaneous Note Option09/06/17
- Treatment Plan09/05/17
- Assessment Instructions - Youth08/16/17
- Discharge and Transfer Form - All Levels of Care (Except RBH)08/30/17
- DSM-5 Substance Use Diagnosis07/21/17
- Screening - Parents for Youth (Paper Version)06/29/17
- Special Population forms:
DPSS-CalWORKs:- Supportive Services Enrollment Termination Notice (GN 6007B)07/18/17
- Treatment Services Verification (PA 1923)07/13/17
- Notification of Change from Specialized Supportive Services Provider (GN 6007A)07/06/17
- Treatment Provider Report of Changes07/13/17
- Supportive Services Enrollment Termination Notice (GN 6007B)
Clinical Forms and Documents - Administrative and Quality Improvement Related
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Subject Date - Notice of Adverse Benefit Determination Forms
- NOABD Required Attachment: Your Rights07/16/25
- NOABD Required Attachment: Your Rights Audio
09/23/25
- NOABD Required Attachment: Your Rights- Spanish07/16/25
- NOABD Required Attachment: Beneficiary Non-Discrimination Notice07/16/25
- NOABD Timely Access Template07/16/25
- NOABD Termination Template07/16/25
- Notice of Availability07/16/25
- NOABD Training11/22/19
- NOABD FAQ11/22/19
- NOABD Distribution Log11/12/19
- NOABD Required Attachment: Language Taglines11/05/19
- NOABD Sample Language - Termination Reasons11/04/19
- NOABD Required Attachment: Your Rights
- Notice of Appeal Resolution Forms
- NAR Your Rights07/16/25
- NAR Your Rights Audio
09/23/25
- NAR Your Rights- Spanish (Español)07/16/25
- NAR Your Rights
- Progress Note Template
- BIRP Format09/08/17
- GIRP Format09/08/17
- SIRP Format09/08/17
- SOAP Format09/08/17
- BIRP Format
- Adverse Event Reporting Form09/12/17
- Housing Referral Information
Beneficiary
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Subject Date - Overdose Bag Kit and Instructions Guide Materials
- Patient/Provider Orientation Videos for SUD Treatment System of Care
- Member Handbook (English)01/02/25
- Member Handbook (English - Large Print)01/02/25
- Member Handbook (Spanish)01/02/25
- Patient Handbook - Additional languages
- Beneficiary Notification Letter (English)12/08/25
- Beneficiary Notification Letter - Additional languages12/01/24
- Notice of Availability (Language Taglines)12/08/25
- Non-Discrimination Notice12/01/24
- Non-Discrimination Notice - Spanish07/16/25
- Appeal Form10/31/24
- Complaint and Grievance Form10/31/24
- Patient Rights and Responsibilities08/19/25
- Complaint and Grievance Form - Spanish07/16/25
- Notice of Privacy Practices (English)03/05/19
- Notice of Privacy Practices (Spanish)03/05/19
- Confidentiality and Consent10/16/17
- Patient Handbook (English - Large Print)02/02/18
- Patient Handbooks (other languages)
Contracts & Compliance
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Subject Date - Application for Drug Medi-Cal Contracts 5-1-23 05/01/23
- Application for Opioid Treatment Program License 12-1-1912/06/19
- Reportable Incident Reporting Form09/13/17
- SAPC Contractor Corrective Action Plan Form01/21/12
Finance Related Forms and Documents
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Subject Date - Inter-County Transfer and Other Medi-Cal Eligibility Topics06/26/25
- Inter-County Transfer and Other Medi-Cal Eligibility Topics Recording06/26/25
- Sage Claim Denial Reason and Resolution Crosswalk Version 4.003/08/23
- Sage Guide to Claim Denial Resolution and Crosswalk Version 4.003/08/23
- Documenting Changes in Financial Eligibility Status09/09/22
- Updating Financial Eligibility for Patients Who Obtain Benefits During Treatment
09/09/22
- Updating Financial Eligibility for Patients Whose Benefits Expired During Treatment
09/09/22
- Updating Financial Eligibility Admitted Under Other County Funding or MHLA
09/09/22
- Updating Financial Eligibility for Self-Pay Patients Who Establish Benefits
09/09/22
- Updating Financial Eligibility for Patients Who Obtain Benefits During Treatment
- Reupload File (277, 835, EOB, RA) Request Form11/04/20
- Claiming for SUD Screening Instructions07/28/20
- Quick Guide to Identifying Denials05/08/20
- 17-09 Service Cost Reconciliation Settlement 10/10/17
- ICD-10 & DSM-5 Crosswalk 08/14/17
- ICD-10 & DSM-5 Crosswalk08/14/17
- Contract Financial Handbook 07/30/10
- Audit Assistance Guide 07/30/10
- Provider Reimbursement Manual
- VPN Access Video05/13/25
- Provider Invoice Automation System (PIAS) Training Video01/04/24
- Provider Invoice Automation System (PIAS) Training Manual08/07/24
- Budget Approval System (BAS) Training Video06/27/24
- Budget Approval System (BAS) User Guide 06/27/24
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DMC Fiscal Tool Meeting Recording08/12/25
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DMC Fiscal Reporting Tool Meeting PowerPoint08/12/25
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Fiscal Reporting Tool DUI, Prevention, Harm Reduction, & Other Services Recording08/12/25
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Fiscal Reporting Tool DUI, Prevention, Harm Reduction, & Other Services PowerPoint08/12/25
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FY 21-22 Drug Medi-Cal Cost Report Training Recording05/06/25
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FY 21-22 Drug Medi-Cal Cost Report Training PowerPoint05/06/25
- FY 21-22 Drug Medi-Cal Cost Report Templates
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DMC ODS Cost Report Template05/13/25
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NTP ODS Perinatal Cost Report Template05/06/25
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NTP ODS Non-Perinatal Cost Report Template05/06/25
Cultural Responsiveness and Language Assistance
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Subject Date - Resource List of Language Assistance Vendors10/17/24
- CIBHS ADA Toolkit Course09/05/24
- Ensuring Affirming and Culturally Responsive Care For Transgender Patients Toolkit09/05/24
- How to Work With Interpreters SAPC Information Sheet06/25/24
- Language Assistance Request Process01/12/22
- Language Interpreter Request Form01/12/22
- Verification of Service form01/12/22
