BHCS Providers Website (2024)

Program Description

1. Facilitate placement into the least restrictive and cost-effective alternatives and levels of care
2. Stabilize their living arrangements
3. Protect clients who are frequent victims of fraud, theft and their own poor judgment

As long as a client’s funds are being managed by SPP, the assigned therapist, clinician or contact person at the site servicing the client, is expected to maintain ongoing contact with the client and to notify the appropriate Patient Services Technician (PST) of any changes in a beneficiary’s circ*mstances. It is the PST’s responsibility to maintain communication with the Social Security Administration and/or Social Services Agency to maintain the client’s eligibility for benefits. A continuous flow of information from clinicians in the field to the PST unit is essential in providing timely and accurate service to the client.

Should a client’s treatment needs and service site change while they are active in SPP, the clinician is expected to provide a referral to a new and appropriate case manager. If a client’s case is closed at the service site, the clinician will remain responsible for the client for SSP services until there is a new payee.

Substitute Payee Program Description

1. ADMISSION CRITERIA
   1. Social Security Administration (criteria for requiring a payee)
   1. The claimant has requested and received voluntary conservatorship or recognizes own incapability, or
   2. The claimant has demonstrated: loss of memory and awareness that he/she will be receiving benefit checks in specific amounts, or
   3. The claimant has shown continuing inability to perceive the need for paying his/her bills or to avoid being taken advantage of in ordinary transactions, or
   4. The claimant has shown continuing ineptitude in doing fundamental arithmetical operations correctly as regards to spending his/her benefit payments.
   2. Clinical (Alameda County Sub-Payee Program criteria)
   1. History of two or more psychiatric hospitalizations, and/or
   2. Psychopathology renders client unable to handle and manage funds, and
   3. Mental health diagnosis, and
   4. No responsible private person such as a relative or friend is available to act as a payee, or the current payee is inappropriate, and
   5. The service of a substitute payee will help prevent further hospitalization and/or allow placement into a level of care that will be less restrictive or costly, and
   6. The effects of money management by the substitute payee will stabilize the client’s continuing ability to remain in the community, and
   7. The clinician referring the patient to Sub-Payee agrees to maintain the patient in a therapeutic program and to remain in communication with the Sub-Payee Unit concerning the client’s progress (see section III for reporting procedures); and
   8. Continuation in Sub-Payee is contingent on involvement in a County or County contracted agency treatment program or supervised living placement. Should client’s treatment needs change while in the Sub-Payee Program, the supervising clinician agrees to provide referral/linkage to a new and appropriate supervising clinician.
   
   
2. REFERRAL PROCEDURES
   1. Clinician identifies patient as meeting the admission criteria, and judges that having a substitute payee would enhance the patient’s treatment plan.
   2. Referring agency’s psychiatrist completes the Physician Statement (Form SSA 787)
   3. Sub-Payee Program application forms (313-SP-01, 313-SP-04, SSA-787, SSA-4164) are completed and forwarded with the above forms to Sub-Payee Program Clinical Liaison.
   4. If application is accepted:
   1. Application is processed by the Sub-Payee PST to Social Security for approval of Payeeship (processing may take 3 – 6 months by Social Security Administration).
   2. PST notifies case manager/contact person when 1st check is received.
   3. Case manager/contact person forwards budgeting information via the Transmittal form (313-SP-05) to the Sub-Payee Unit PST.
   4. Sub-Payee Program starts issuing checks to or for client.
3. BASIC PROGRAM PROCEDURES
1. Once Alameda County Sub-Payee is appointed the payee by Social Security, the basic responsibilities of the Case Manager/Contact Person for Sub-Payee clients are to:
1. Determine the client’s current and future needs and to use the benefits in the best interest of the client and to conform to Social Security Administration and Alameda County Sub-Payee regulations, procedures and policies.
2. Authorize and disburse payments only for the client’s use and welfare.
3. Maintain a continuing awareness of the client’s needs and condition. You must maintain contact with the client. If the whereabouts become unknown, you must notify the Sub-Payee PST immediately.
4. Notify the Sub-Payee PST of any change in the client’s circ*mstances or event that would affect the client’s eligibility or amount of benefits.
5. Assist the client to maintain eligibility for benefits by providing the Sub-Payee worker with information, documentation or verification when required or mandated by Social Security Administration, Social Services Agency and/or the Sub-Payee Program.
2. All requests for funds, budget changes, or other changes in client’s circ*mstances must be reported via a transmittal form (SP-05) in order for the PST to properly process the changes. Disbursem*nts of checks are processed every Tuesday and Thursdays and on every 1st, 3rd and the 15th of each month
3. Closing the Sub-Payee episode or terminating the client’s participation in the Sub-Payee Program depends on various factors, see Operational Guidelines for more information.

Links to Other Information

Operational Guidelines for Case Managers/Contact Persons
SSA Publication
Reporting Responsibilities
Transmittals