division of mental health and addiction services fee for service open enrollment technical...
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Division of Mental Health and Addiction ServicesFee For Service Open EnrollmentTechnical Assistance
Division of Mental Health and Addiction ServicesSeptember 2012
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AgendaAgenda
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• FFS Open Enrollment Process
• DMHAS Fee for Service Contract Enrollment Application Components SFY 2013-2014• Initiative Specific Information
• Drug Court• SPB
• DMHAS Co-occurring Network
• Quality of Care Components for Participation in the DMHAS Fee for Service Network
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FFS OPEN ENROLLMENT
Is an opportunity for new or currently contracted agencies to apply for participation in the DMHAS FFS Network•Newly licensed agencies may apply to become a network provider•Add new service sites •Add new services at an existing site•Add new initiatives at existing service site already participating in the FFS Network
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PROCESS FOR OPEN ENROLLMENT
• DMHAS reviewed Initiative specific Utilization data to determine priorities for open enrollment
• DMHAS discussed with system partners (i.e. AOC, SPB) to identify gaps in services and priorities for those services for open enrollment
• The DMHAS merger has emphasized the need for co-occurring capable services
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Current DMHAS FFS Network Initiatives
• Drug Court
• Driving Under Influence Initiative
• Medication Assisted Treatment Initiative
• Mutual Agreement Program –State Parole
• Mutual Agreement Program- Department of Corrections
• South Jersey Initiative
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Current DMHAS FFS Network
• 137 FFS Contracted Agencies Statewide
• 233 Licensed Substance Abuse sites are included in the DMHAS Fee for Service Networks
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Summary of Level of Care (LOC)Services Provided through DMHAS Fee for Service (FFS) Contracts
• Ambulatory Substance Abuse Services • Outpatient• Intensive Outpatient• Partial Care
• Residential Substance Abuse Services• Long Term Residential• Short Term Residential• Halfway House • Detoxification• Medically Enhanced Detoxification 7
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FFS Initiatives Open for Enrollment- Fall 2012• Drug Court Initiative (DCI) • Open for all levels of care statewide
• Driving under the Influence Initiative (DUII) • Open for all levels of care statewide• Agency sites must be an approved IDRC/IDP affiliate for FY 2013
to qualify• Agencies must be accepted into the co-occurring network no
later than December 31, 2012 to qualify • Agencies are encouraged to apply to participate in the Vivitrol
sub-network of the DUII
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Medication Assisted Treatment Initiative (MATI) – •Open for Halfway House and Long-Term Residential treatment services statewide •Open for ambulatory services in Mercer and Camden Counties•Agencies must be accepted into the co-occurring network no later than December 31, 2012 to qualify
South Jersey Initiative (SJI) – •Open for ambulatory services in sites located in the following counties Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester, Ocean and Salem Counties•Agencies must be accepted into the co-occurring network no later than December 31, 2012 to qualify
State Parole Board (SPB) - Open for all levels of care statewide
FFS Initiatives Open for Enrollment- Fall 2012
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FFS CONTRACT ENROLLMENT APPLICATION
Part I-Contract Application Signature Page-(page 1)
Part II-Agency Specific Information (pages 2-3 of FFS Enrollment Application)
Part III- CRIS: Credential Site Specific Information (page 4)
Part IV-Initiative Specific Information (page 5 - 6)
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DMHAS Open Enrollment Checklist-New Provider
ItemsDocuments
submitted with Enrollment Application
Submitted via web-based application during contract
period
Part I: Agency Administrative Information
Contract Application Signature Page - (Page 1) X
Part II: Agency-Specific Information-submit separate attachments for each item below ( 5 copies)
Attachments I - Evidence-Based Practices - Max score 20 X Attachments II - Policy and Procedure Regarding Availability of Public Funds – Max score 10 X Attachments III - Policy & Procedure Regarding Clients Taking Prescribed Medications – Max score 20 X
Attachments IV - Sample Treatment Plan - Max score 25 X
Attachments V - Utilization Rate Performance Criterion - Max score 25 X
Attachments VI - Client Sliding Fee Scale - not scored X
Attachments VII - Affiliation Agreement - not scored X
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Part III: Site-Specific Information
Clinician Roster Information System (CRIS) : credentialing information for clinical & medical staff entered into web-based system for each licensed site
Must be completed by 10/1/12
Part IV: Initiative Specific Information
Drug Court X
Submit copy of DUII-IDRC Affiliation Agreement X
Mutual Agreement Program-State Parole Board X
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DMHAS Open Enrollment Checklist-New Providers
ItemsDocuments
submitted with Enrollment Application
Submitted via web-based
application during contract period
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DMHAS Open Enrollment Checklist-Existing Provider
ItemsDocuments
submitted with Enrollment Application
Submitted via web-based application during contract
period
Part I: Agency Administrative Information
Contract Application Signature Page - (Page 1) X
Part III: Site-Specific Information
Clinician Roster Information System (CRIS) : credentialing information for clinical & medical staff entered into web-based system for each licensed site
Must be completed by 10/1/12
Part IV: Initiative Specific Information –if not currently approved for Initiative
Drug Court X
Mutual Agreement Program-State Parole Board X
Submit copy of DUII-IDRC Affiliation Agreement – for each new site requesting DUII participation
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Annex A’s
Annex A: Signed if adding level of care not currently included in agency FFS ContractX
Annex A2: Signed if adding initiative not currently included in agency FFS Contract X
If your agency has multiple sites please specify site requesting additional Level of Care and/or initiative on Annex A’s
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DMHAS Open Enrollment Checklist-Existing Provider-continued
ItemsDocuments
submitted with Enrollment Application
Submitted via web-based
application during contract period
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Part II: Attachment I-V Scoring Criteria
Attachment I - Evidence-Based Practices - Max score 20
Attachment II - Policy and Procedure Regarding Availability of Public Funds – Max score 10
Attachment III - Policy & Procedure Regarding Clients Taking Prescribed Medications - Max score 20
Attachment IV - Sample Treatment Plan - Max score 25
Attachment V - Utilization Rate Performance Criterion - Max score 25
15Reference: Reference: Division of Mental Health & Addiction Services (DMHAS) FY 2013 2014 FFS Enrollment Scoring Criteria
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Submission Requirements for Contract Enrollment Application:
• 5 copies of Part I and Part II must be received by 5 pm on October 1, 2012
• CRIS information must be entered for licensed sites applying for participation. If providers do not meet licensing requirements for individual sites, the site will not be eligible to participate in network
• 3 copies of Part IV Initiative documents must be submitted if agency is interested in applying to participate in Drug Court or MAP-SPB 16
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All documents should be mailed to address below:
Overnight:New Jersey Division of Mental Health & Addiction Services222 South Warren Street- 3rd floorTrenton, NJ 08611Attention: Geralyn Molinari
Postal delivery: New Jersey Division of Mental Health & Addiction ServicesP.O. Box 362Trenton, NJ 08625-0362Attention: Geralyn Molinari
Submission Requirements for Contract Enrollment Application:
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FFS Open Enrollment link on NJSAMS
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https://njsams.rutgers.edu/samsmain/mainhome.htm
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FFS Open Enrollment documents
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Initiative Specific Initiative Specific Information Information
Drug Court
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Overview
• The Division of Mental Health and Addiction Services (DMHAS) memorandum of agreement with the Administrative Office of the Courts
• DMHAS Drug Court Annex A2
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Drug Court Initiative Specific Agency Requirements
Agencies applying for enrollment in the DCI are required to notify DMHAS and the referring Drug Court in writing of clients’ program admission denials which includes referrals to a more suitable level of care. A copy of the agency’s Board-approved policy and procedure regarding admission denials labeled “Drug Court Admission Denials Policy” must be submitted.
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Drug Court Initiative SpecificAgency Requirements (cont.)
Agencies must provide an orientation on Drug Court mandates to all non-clinical staff that have contact with Drug Court clients. Please attach a copy of the agency’s board-approved policy and procedure regarding non-clinical staff orientation to the Drug Court program and mandates labeled “ Drug Court Non-Clinical Staff Orientation Policy. “
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Drug Court Initiative SpecificAgency Requirements (cont.)
Residential agencies are required to notify the referring Drug Court and DMHAS regarding client non-adherence to treatment and Drug Court program requirements within 2 hours of any relevant incident and report immediately when a client absconds. Please attach a copy of the agency’s Board-approved policy and procedure regarding Drug Court non-adherence to program requirements and client absconding labeled “Drug Court Program Non-Adherence and Client Abscond Reporting Policy.”
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SPB Specific Overview
• The Division of Mental Health and Addiction Services (DMHAS) memorandum of agreement with the State Parole Board
• DMHAS SPB Mutual Agreement Program Annex A2
• State Parole Board Abscond Policy
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State Parole Board Initiative Specific
Agency Requirements
Agencies applying for enrollment in the SPB-MAP Initiative are required to provide the name of the staff person responsible for coordinating the SPB-MAP services and serves as liaison to the State Parole Board and DMHAS regarding all SPB-MAP issues. Please attach a document that includes the SPB-MAP liaison’s name, job title, phone and fax number and email address labeled “SPB-MAP Liaison Contact Information.”
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State Parole Board Initiative Specific
Agency Requirements(cont.)Agencies applying for enrollment are required to notify the State Parole Board of any incidents such as parolee absconding or any disciplinary action that requires a parolee to be removed from the program. Written notification shall be provided by the agency to the State Parole Board including a copy of any incident report. Please attach a copy of your agency’s board-approved policy and procedure regarding SPB-MAP non-adherence to program requirements that may result in discharge labeled “ SPB-MAP Program Non-Adherence Reporting Policy. “
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Co-Occurring Services NetworkDivision of Mental Health and Addiction
Services
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Principles of Effective Treatment
• Employ a recovery perspective – treatment plan that provides for continuity of care of over time. Treatment interventions that are specific to the tasks and challenges at each state of the co-occurring disorder recovery process.
• Adopt a multi-problem viewpoint (mental health, medical, substance abuse, family and social problems.)
• Develop a phased approach to treatment (engagement, stabilization, treatment, aftercare or continuing care)
• Address specific, real life problems in treatment• Plan for the client’s cognitive and functional impairments• Use support systems to maintain and extend treatment effectiveness
Source: TIPS 42
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Seven Essential Elements in Programming for Agencies Treating COD Clients
• Screening, Assessment and Referral• Mental and Physical Health Consultation• Use of a prescribing Psychiatrist• Medication and Medication Monitoring• Psycho-educational Classes• Onsite Double-Trouble Groups• Offsite Dual Recovery Mutual Self-Help Groups
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DMHAS Review and Scoring Process of Co-Occurring Applications
• DMHAS Review Committee: 5 staff• Agencies must score minimum of 70 to be approved
• Review Parameters• Program Description• Treatment Plan and Treatment Planning Policy• List of Education and Supportive Services for Family and
Accompanying Policy• Recovery Support Referral List• Discharge Plans and Discharge Policy
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Co-occurring Application Scoring Criteria page 5 of application
• Program Description Max value 3Indicates IntegrationCoordination of ServicesRecovery ManagementClient Centered
• Treatment Plan and Treatment Planning Policy Max value 3
Indicates planning for co-occurring issues
• Discharge Plan Max value 3
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Co-occurring Application Scoring Criteria page 5 of application
• Education and Supportive Services for Family Max value 2
Include services for co-occurring clients and issues• Recovery Support Referral List
Max value 2Include referrals to types of Self Help other than
AA/NA*Peer Supports Peer supports to co-occurring clients
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Co-Occurring Service Array
• Psychiatric Evaluation• Comprehensive Intake Evaluation• Medication Monitoring/Consultation• Clinical Consultation• Family Therapy (with or w/out client present)• Individual Therapy• Crisis Intervention• Case Management
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DMHAS Co-Occurring 2013 Contract Requirements
• All DUII, MATI and SJI providers must meet agency criteria to participate in the co-occurring network and have demonstrated readiness to provide integrated care for dually diagnosed client by December 31, 2012
• DMHAS Reviews Co-occurring Applications Monthly
• DMHAS will offer quarterly technical assistance for providers
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