December 11, 2025

Following are this week’s updates. If you have questions, please contact [email protected]. 

Subscribe to the EHR Weekly Bulletin Newsletter

Non-Production Server Downtime This Weekend 

All non-production SmartCare instances will be patching on Dec. 12 between 8:30 p.m. and 3 a.m. This will affect the web, database, and other utility servers, loading infrastructure patches (e.g., OS and SQL server updates). Because the web servers are being impacted, they will undergo a warmup process once back online. We expect no impact on production systems due to this activity. If issues arise or you have questions, please create a HubSpot ticket. 

Reminder: Prescriptions, Medication Orders Impacted in Medication Management Rx and Client Orders 

As reported in last week’s Bulletin, recent changes have impacted the creation of prescriptions and medication orders in Medication Management Rx and Client Orders.    

Prescribers will need to pay special attention to how they manage the dose of the prescription, as the “unit” value now defaults to the medication strength under certain criteria and certain medications. For example: 

• A 100 mg tablet will now have the unit value of ‘mg’ instead of ‘Each’ or ‘Unit.’  In this example, the dose value will now need to be considered in terms of ‘mg’ instead of ‘Each’ or ‘Unit.’ 

• The generated sig/instructions may now show a modified version of what was ordered by inserting simplified terminology (e.g.,“Take 1 Capsule (300mg) By Mouth Once A Day”).

 CalMHSA is vetting the new generated order sig for our report builds (CalMHSA 118, 113, 116), psych note medical template, and various other screens that contain Medication Rx/Client Orders’ order sig. We plan to update our builds to match these new terms in February 2026. Our builds will continue to show the order sig that the prescriber ordered prior to auto-generation by Streamline.   

See this full list of changes that have been applied to some of the medications in Medication Rx and Client Orders.  

July MSP Is in Production

Counties may be particularly interested in the following: 
 

• Using the All Client Search feature now allows you to use the Broad Search functionality. The client’s name does not need to be spelled exactly in order to find them in the system. More info.: All Client Search – 2023 CalMHSA; EnableMultiFieldAllClientSearch – 2023 CalMHSA 

Modifications to Rate Methodology for Fee-for-Service Medi-Cal Contract Hospitals 

Behavioral Health Information Notice 25-038 informs mental health plans (MHPs) of modifications to the rate methodology for rates negotiated between MHPs and fee-for-service Medi-Cal contract (FFS/MC) hospitals — as well as new requirements for reporting those rates to DHCS. 

• Call to Action: If your county negotiates a new rate with any FFS/MC hospital for acute psychiatric inpatient services, please notify CalMHSA with the updated rate details to ensure accurate claiming. 

Mobile Crisis Satisfaction Survey 

CalMHSA has been developing a satisfaction survey for client use in mobile crisis encounters. We have opted to use the MTAC survey, which is approved by DHCS, for consistency with the other SmartCare mobile crisis documents. 

The new survey has been available in QA systems since Dec. 9 and is scheduled to be deployed to production systems on Dec. 15. Please note that, because this survey is completed by clients, none of the questions are required in order for the document to be signed. This will allow counties to enter data even if the client skips or refuses to answer a question. 

More information can be found in the knowledge base article at How to Complete the Mobile Crisis Satisfaction Survey and the Mobile Crisis protocol page. 

Updates to Client Medical Facesheet and 113/118 

The 113/118 and Client Medical Facesheet now display the following: 
 

1. Client’s date of birth and calculated age 

1. Number of no-shows in the last six months 

1. 113 Report: Displays Guardian or Legal Guardian under “Conservator/Guardian” section, if in Client Information>>Contacts>>, “Legal Guardian” or “Guardian” is check-marked 
2. Only for SmartCare Rx users: Expired but Active Medications (end date is past, order/prescription not discontinued and still active). Not applicable for CalMHSA Rx users.