Kev Thov Kev Pab Cuam Narcotic Treatment Exception Request
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 10425. This 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.
Cov kev thov zam rau tus neeg mob rau 42 CFR, Ntu 8, yuav tsum xa los ntawm CSAT portal vim tias cov no yog cov kev cai lij choj hauv tebchaws uas xav tau kev pom zoo los ntawm DHCS thiab SAMHSA.
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.
Please note: DHCS encourages licensed and prospective NTP programs to set up their organization and verify their profile on the DHCS Licensing and Certification Portal before submitting applications.
- Daim Ntawv Thov Rov Ua Dua Daim Ntawv Tso Cai- DHCS 4029
- Interim Treatment Patient Notification – DHCS 4032
- Daim Ntawv Thov Thawj Zaug Rau Kev Kho Mob Tshuaj Yeeb - DHCS 5014
- Daim ntawv cog lus lav - DHCS 5020
- Facility and Geographical Area – DHCS 5025
- Staff Information – DHCS 5026
- Daim Ntawv Pov Thawj ntawm Lub Nroog - DHCS 5027
- Lub Luag Haujlwm ntawm Lub Koom Haum - DHCS 5031
- Daim Ntawv Qhia Txog Kev Tuag Ntawm Tus Neeg Mob - DHCS 5048
- Kev lees paub txog kev koom tes thiab kev koom tes - DHCS 5134
- Application for Protocol Amendment – DHCS 5135
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
Mobile Narcotic Treatment Programs
- BHIN 24-005 Mobile Narcotic Treatment Programs (MNTP). This BHIN sets forth the requirements that a MNTP shall comply with lawful implementation and operation in California and establishes an application process for Narcotic Treatment Programs (NTPs) to apply for a MNTP component.
- Mobile Narcotic Treatment Programs (MNTP) Toolkit
- Mobile Narcotic Treatment Program Initial Application – DHCS 1830
- Daim Ntawv Thov Rov Ua Dua Daim Ntawv Tso Cai - DHCS 1831
- Daim Ntawv Thov Kev Hloov Kho Protocol - DHCS 1832
- MNTP Daim Ntawv Tso Cai Webinar
Kev Pabcuam Kev Kho Mob Narcotic Licensure Nqi
Lub Chaw Muab Kev Tso Cai thiab Kev Pom Zoo (LCD) tam sim no yuav lees txais cov nyiaj them online siv kev hloov nyiaj hauv hluav taws xob uas ua tiav los ntawm Automated Clearing House (ACH) network. Cov neeg muab kev pabcuam uas xav them nqi hauv hluav taws xob tuaj yeem ua raws li cov lus qhia uas tau muab rau hauv qhov txuas hauv qab no: https://www.govone.com/PAYCAL/DHCS/Account.