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Click ‘Get Form’ to open the state of California application for 72 hour detention 2004 form in our editor.
Begin by entering the applicant's personal information in the designated fields, including name, address, and contact details. Ensure accuracy as this information is crucial for processing.
Next, navigate to the section regarding the reason for detention. Provide a clear and concise explanation that aligns with the criteria outlined in the form.
In the following section, you will need to indicate any relevant medical or psychological history. This information is vital for assessing the applicant's needs during detention.
Finally, review all entered information for completeness and accuracy. Utilize our platform’s editing tools to make any necessary adjustments before saving or submitting your form.
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The California Medical Assistance Program (Medi-Cal or MediCal) is the California implementation of the federal Medicaid program serving low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults with incomes below 138% of federal
What is a DHCS 1801 form?
DHCS 1801 (MH 302): Application for up to 72-Hour Assessment, Evaluation, and Crisis Intervention or Placement for Evaluation and Treatment.
What is a DHCS Medi-Cal?
Certified eligibles are those beneficiaries deemed qualified for Medi-Cal by a valid eligibility determination, and who have enrolled into the program. This classification excludes beneficiaries who have not met a monthly share-of-cost obligation.
Who can authorize an involuntary 72-hour hold in California?
In California, law enforcement officers and mental health professionals can place a patient on an emergency 72-hour hold, or 5150, if, due to a mental illness, they are determined to pose a danger to themselves (DTS), a danger to others (DTO), or they are gravely disabled (GD).
What are certified eligibles for DHCS?
Medi-Cal is Californias version of the Federal Medicaid program. Medi-Cal offers no-cost and low-cost health coverage to eligible people who live in California. The Department of Health Care Services (DHCS) oversees the Medi-Cal program. Your local county office manages most Medi-Cal cases for DHCS.
Related Searches
5150 Form exampleHow to fill out a 5150 formDHCS 1801 INSTRUCTIONSCalifornia 5150 advisement form5250 formInvoluntary Patient Advisement formMental health Assessment form PDFDHCS Forms
Related links
Napa County Department of Health and Human Services
Feb 23, 2010 State of California HHS, Department of Mental Health, Application for 72 hour Detention for Evaluation and Treatment, MH302, May, 1999.
This Provider Manual shall serve as a supplement as referenced thereto and incorporated therein, to your Molina Healthcare of California Services Agreement. The
Gravely Disabled: The Vestigial Prong of 5150 Designations
by DY Byun 2021 Cited by 6 The MH-302 document is often erroneously referred to as a 72-Hour Hold. However, the act of filling out the form does not result in
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