Dear SFHP Members: Congress was unable to reach an agreement on funding for Fiscal Year 2026, and the federal government was shut down on October 1, 2025. While we do not know how long the shutdown will last, SFHP will continue its operations as normal. You can still access the care you need. We are committed to ensuring your access to care is not interrupted. If you encounter any issues, please contact SFHP Customer Service at 1(415) 547 7800 or toll-free 1(800) 288 5555 (TTY users can dial 711). We’re open Monday through Friday, from 8:00am to 5:00pm.

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Clinical Guidelines

San Francisco Health Plan (SFHP) approves, adopts, and distributes evidenced-based clinical practice guidelines from recognized sources and promotes them to providers and members in an effort to improve health care quality and reduce unnecessary variation in care. SFHP’s clinical practice guidelines are also reviewed and approved by SFHP’s Quality Improvement Committee.

 

Clinical Practice Guidelines

Other Useful Guidelines and Resources

 

SB 855 requires programs like Healthy Workers to use certain standards for medical necessity decisions for mental health and substance use disorder care, including those developed by the American Society of Addiction Medicine, American Association of Community Psychiatrists, American Academy of Child and Adolescent Psychiatry, and World Professional Association for Transgender Health. For more information on how to access training, training materials, or clinical criteria associated with SB 855, please contact [email protected].

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