10-011 D. Mental Health Services

Table of Contents

TheMental Health Services section includes the following information:




Mental Health Services

MHS Referral Procedure

Contracted Mental Health Services Provider Duties

Mental Health Treatment Services

WTW Plan

WTW Participation Documentation

WTW Participation Ends

Referral to Social Security Administration



State regulations require counties to make mental health treatment services available, when necessary to enable participants to make the transition from welfare to work.

Mental Health Services

Welfare to Work (WTW) participants can be referred to Mental Health Services (MHS) any time there is a concern that a mental disability exists that impairs the participantís ability to obtain employment.The county contracts with site specific mental health service providers as indicated below:






North Central

StepForward CRF CalWORKs*

2772 4th Avenue

San Diego, CA 92103

Office (619) 295-6067 Fax (619) 295-6067


CalWORKs Multiservices Center

330 S. Magnolia Avenue, Ste. 302

El Cajon, CA 92020

Office (619) 442-5434

Fax (619) 442-5466

North Coastal

CalWORKs Multiservices Center

1919 Apple Street, Ste. A

Oceanside, CA 92054

Office (760) 439-4577

Fax (760) 439-2130

North Inland

CalWORKs Multiservices Center

474 W. Vermont Avenue, Ste. 103

Escondido, CA 92025

Office (760) 745-0281

Fax (760) 745-0778


CalWORKs Multiservices Center

1105 Broadway, Ste. 207

Chula Vista, CA 91911

Office (619) 425-5609

Fax (619) 425-8349


*Note:Provides special mental health services for Cambodian, Laotian, and Vietnamese immigrants and refugees.Participants with these ethnic backgrounds must be referred to StepForward.

MHS Referral Procedure

The Employment Case Manager (ECM) will take the following steps to complete a mental health referral:





Complete the Welfare-to-Work Referral (27-114) and obtain clientís signature in the ďAuthorization for Release of InformationĒ box.


Hand deliver form 27-114 to the on-site contracted mental health services provider


Fax the 27-114 to the appropriate provider listed above, if the service provider is not available on site.


File a copy of the 27-114 in the WTW case folder.


Narrate in CalWIN Case Comments the symptoms/reasons for the referral.


Follow-up on the referral with the contracted mental health services provider within 7 working days.


Upon receipt of referral the contracted mental health service provider will take the following steps.





Review form 27-114 to ensure that the participant signed in the ďAuthorization for the Release of InformationĒ box.


Contact the participant to set up an appointment for an assessment evaluation interview.


Note:In some Regions, through mutual agreement, the ECM may be responsible for scheduling the initial evaluation appointment based on a pre-set schedule of appointment openings provided by the contracted mental health services provider.

Contracted Mental Health Services Provider Duties

The contracted mental health services provider has the following duties:

       Perform a mental health assessment;

       Provide ECM with outcome of assessment referral; and

       Monitor monthly attendance for participants in mental health treatment.



Perform mental health assessment to determine treatment needs and provide written evaluation that includes:

1.    Assessment of participantís barrier(s) to employment;

2.    Recommended treatment to reduce/ eliminate barriers to employment; and

3.    Prior diagnoses, assessments, or evaluations provided by participant.

Referral Response

Send ECM a completed Welfare-to-Work Mental Health Services Referral Response (27-323) when:

1.    Participant fails to keep evaluation appointment;

2.    A mental or emotional disorder does not exist and no further action is required;

3.    A mental or emotional disorder does exist and participant declines treatment; or

4.    A mental or emotional disorder does exist and participant agrees to participate in treatment.


When participant agrees to treatment, the 27-323 must include:

1.    Identified barrier(s) to employment;

2.    Recommended treatment;

3.    Appropriate employment accommodations or restrictions; and

4.    A schedule of weekly participation hours required for treatment.

Attendance Monitoring

After initial response that a mental or emotional disorder does exist and that the participant will be participating in treatment, the mental health services provider will:

1.    Mail or fax to the ECM the Welfare-To-Work Mental Health Services Monthly Attendance Reporting (27-322) for all participants enrolled in treatment in the previous month; and

2.    Ensure that ECM receives the 27-322 by the fifth workday of the month following the report month.

Mental Health Treatment Services

Mental health treatment services include:


       Case management, as appropriate;

       Treatment ;

       Rehabilitation services;

       Counseling to overcome mental health barrier to obtaining or retaining employment; and

       Attendance monitoring and documentation (includes notification to ECM of non-participation).

WTW Plan

Individuals participating in mental health services activities as part of a WTW Plan are eligible to all supportive services, to include transportation and child care.

1.    ECM must consider the following information when developing or modifying an existing WTW Plan in order to avoid placing the participant in situations that may exacerbate a mental condition:

        Any prior diagnosis;

        Evaluation; and

        Assessments provided by the participant.

2. ECM must include substance abuse treatment in WTW Plan if contracted mental health provider identifies a secondary diagnosis of substance abuse.


WTW Participation Documentation

ECMs are required to document and record in CalWIN a participantís WTW activity hours on a monthly basis.Upon receipt of the 27-322 provided by the mental health services provider, the ECM is to complete the following actions:





Review the 27-322 and determine if participantís treatment progress and monthly attendance hours are satisfactory.


If participantís progress/hours are satisfactory, proceed to step 3.


If participantís hours do not meet 32/35 requirement, Good Cause evaluation can be made by the ECM.


Reference: CPG Section 10-020-B Good Cause for Not Participating.


Contact to the mental health provider can be made to follow up on participantís treatment progress and/or monthly attendance hours.


Complete a narrative in CalWIN Case Comments to record the MHS participation hours verified by the MHS provider, as documented on the top portion of the 27-322.


Refer to CalWORKs Program Guide Section 10-300-E WTW Activity Documentation and Reporting Requirements for Case Comment requirements.


Note: At self-disclosure from the WTW participant, the MHS provider will document other activity(ies) and participation hours on the bottom of the 27-322.These reported activity(ies) and participation hours are listed for informational purposes and have not been verified by the MHS provider.


The ECM is required to verify and document participation hours for any self-disclosed activity(ies) by the participant and notify MHS Program staff if a discrepancy is found.


File/Image the 27-322 in the WTW case folder.


Note: Mental health providers offer activities in participantís treatment plans that may include supervised job search, work experience, job skills training, etc.ECMs are not required to add these as additional activities in CalWIN, but must document all activities reported on the 27-322 under the MHS component.

WTW Participation Ends

The ECM must notify the contracted mental health services provider in writing (e-mail, fax or gram) when participant becomes:

       Ineligible for CalWORKs cash aid;

       Closure of WTW case; or

       Exempt from WTW participation, and declines to participate as a volunteer.

Referral to Social Security Administration

Participants must be referred to Social Security Administration (SSA) if the ECM identifies:

    A mental or emotional disorder expected to last for 12 months or more; or

    Prior medical documentation of a disorder that has lasted or is expected to last over 12 months.


ECM must follow the following steps to refer participant to SSA for either SSA or State Supplemental Income (SSI):





Send a CalWIN case alert that a referral to SSA for SSA/SSI is needed.


File (or image) the assessment documentation in the WTW case.


MHS Provider Accommodation

In order for the MHS providers to complete on-site appointments that ensure confidentiality with participants, the WTW sites will make available a private space for MHS counselors to meet with participants.