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Printable W-4 Form California San Bernardino: What You Should Know
Description, Revised Date. 17-12084-1, Individual with Mental Condition, 08/30/18. (Download) The Individual with Mental Condition Agreement: The County Health and Human Services Agency and an Individual With a Mental Illness San Bernardino County The Individual with Mental Condition Agreement is the contract between the County Health and Human Services Agency and an individual with a mental condition to manage certain medical, mental health and related services. The Individual with Mental Condition Agreement is an enforceable health care agency contract. This contract must be signed by a licensed mental health professional to be effective. Form Number. Description, Revised Date. 17-15202-0, Mental Health, 08/31/18. (Download) The Mental Health and Related Services Agreement is a contract between the County Health and Human Services Agency with the health care provider(s) the County provides a mental health services. This agreement must be signed by a licensed mental health professional to be effective. Form Number. Description, Revised Date. 17-15205-3, Mental Health, 08/31/18. (Download) The Mental Health (Mental Retardation) Agreement between the County Health and Human Services Agency and a mental health provider(s) is a contract between the County Health and Human Services Agency and any professional service provider. The agreement must be signed by a licensed mental health professional to be effective. Form Number. Description, Revised Date. 17-15205-4, Mental Health, 08/31/18. (Download) The Mental Retardation Agreement will help protect our county health and human services from litigation. The County is responsible to provide mental health and substance-abuse treatment services to all residents of the County. County health and human services agencies are currently providing services in an estimated population size. These services cannot be provided to an individual with a mental illness unless the individual is involuntarily admitted to hospital and is treated with medication. The individual is required by state law to get health advice, and that person is not to be involuntarily detained if he/she asks for help with his/her health condition in a nonmedical setting if it is not in the interest of the individual. The individual with a mental illness is subject to certain laws that prohibit denial of medically necessary medical treatment.
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