Dhia mus rau cov ntsiab lus
Tsev Cov tib neeg Cov Kev Pab Kho Mob Tshuaj Yeeb

Cov Kev Kho Mob Narcotic

Kev Thov Kev Pab Cuam Narcotic Treatment Exception Request

The NTP Exception Request form is to facilitate the submission of patient exceptions to state regulations California Code of Regulations (CCR), Title 9, Chapter 4 in accordance with Section 10425This form is intended for exceptions that only require DHCS state approval and do not require SAMSHA’s federal approval.  This does not preclude other forms of notifications.  DHCS may grant a temporary exception request in accordance with CCR, Title 9, Section 10425 for individual licensed NTP locations on a per patient basis.

Patient exception requests to 42 CFR, Part 8, must be submitted through the CSAT portal as these are federal laws which require both DHCS and SAMHSA’S approval.  

All approved exception requests must be documented and maintained in the patient’s file.

DHCS 1834 NTP Exception Request Form to State Regulations Only

Daim Duab Qhia Txog Kev Thov Kev Zam NTP

Daim ntawv thov thiab cov ntawv

Lub Rooj vag rau Kev Tso Cai thiab Daim Ntawv Pov Thawj ntawm DHCS lees txais Daim Ntawv Thov Kev Tso Cai rau Kev Kho Mob Narcotic (NTP)

Lub DHCS Licensing and Certification Portal tam sim no lees txais cov ntawv thov tso cai rau Narcotic Treatment Programs (NTP). Qhov no suav nrog cov ntawv thov thawj zaug thiab cov ntawv thov hloov kho rau NTPs, Mobile NTP (MNTP), Medication Units (MU), thiab Office-Based Narcotic Treatment Networks (OBNTN). Lub portal tam sim no kuj txhawb nqa kev rov ua dua tshiab rau NTPs, MNTPs, MUs, thiab OBNTNs. Cov neeg muab kev pabcuam NTP uas tau txais daim ntawv tso cai thiab cov neeg xav tau raug txhawb kom tsim lawv cov ntaub ntawv koom haum thiab ua tiav cov txheej txheem txheeb xyuas kom pib siv lub portal.

Thov nco ntsoov: DHCS txhawb kom cov kev pab cuam NTP uas tau txais daim ntawv tso cai thiab cov uas xav tau los teeb tsa lawv lub koom haum thiab txheeb xyuas lawv cov ntaub ntawv ntawm DHCS Licensing and Certification Portal ua ntej xa daim ntawv thov. 

Xa txhua daim ntawv thiab cov ntaub ntawv txhawb nqa mus rau:

      Department of Health Care Services
      Counselor & Medication Assisted Treatment Section, MS2603
      PO BOX 997413
      Sacramento, CA 95899-7413

DHCSNTP@dhcs.ca.gov

Mobile Narcotic Treatment Programs

Kev Pabcuam Kev Kho Mob Narcotic Licensure Nqi

Lub Chaw Tso Cai Tso Cai thiab Ntawv Pov Thawj (LCD) tam sim no yuav lees txais kev them nyiaj online siv cov nyiaj hloov hluav taws xob ua tiav los ntawm Automated Clearing House (ACH) network. Cov kws kho mob tab tom nrhiav them cov nqi hluav taws xob tuaj yeem ua raws li cov lus qhia hauv qab no: https://www.govone.com/PAYCAL/DHCS/Account.

Cov lus nug nquag