麻醉品治疗计划
麻醉品治疗计划例外请求
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.
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 例外申请表（仅适用于州法规）
申请表和表格
许可证续期申请-DHCS 4029
临时治疗病人通知- DHCS 4032
麻醉品治疗计划初始申请--DHCS 5014
担保人协议--DHCS 5020
设施和地理区域- DHCS 5025
工作人员信息- DHCS 5026
县认证- DHCS 5027
组织责任- DHCS 5031
病人死亡报告- DHCS 5048
附属和关联确认- DHCS 5134
协议修订申请- DHCS 5135
将所有表格和证明文件提交至：
卫生保健服务部
咨询师和药物辅助治疗科，MS2603
PO BOX 997413
萨克拉门托，CA 95899-7413
流动麻醉品治疗计划
- 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.
- 移动麻醉品治疗计划 (MNTP) 工具包
- Mobile Narcotic Treatment Program Initial Application – DHCS 1830
- Application for License Renewal – DHCS 1831
- Application for Protocol Amendment – DHCS 1832
- MNTP 许可网络研讨会
麻醉品治疗计划许可费用
许可和认证部门 (LCD) 现在将接受通过自动清算所 (ACH) 网络处理的电子货币转账的在线支付。希望以电子方式支付费用的提供商可以按照以下链接中的说明进行操作： https://www.govone.com/PAYCAL/DHCS/Account 。