September 2012
Division of Mental Health and Addiction Services
Fee For Service Open Enrollment
Technical Assistance
Division of Mental Health and Addiction Services
September 2012
1
Agenda
• FFS Open Enrollment Process
• DMHAS Fee for Service Contract Enrollment
Application Components SFY 2013-2014
• Drug Court
• SPB
September 2012
• Initiative Specific Information
• DMHAS Co-occurring Network
• Quality of Care Components for Participation in the
DMHAS Fee for Service Network
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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
September 2012
FFS OPEN ENROLLMENT
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•
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 cooccurring capable services
September 2012
PROCESS FOR OPEN ENROLLMENT
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Current DMHAS FFS Network Initiatives
• Drug Court
• Medication Assisted Treatment Initiative
• Mutual Agreement Program –State Parole
September 2012
• Driving Under Influence Initiative
• Mutual Agreement Program- Department of Corrections
• South Jersey Initiative
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Current DMHAS FFS Network
• 233 Licensed Substance Abuse sites are included
in the DMHAS Fee for Service Networks
September 2012
• 137 FFS Contracted Agencies Statewide
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• 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
September 2012
Summary of Level of Care (LOC)Services Provided
through DMHAS Fee for Service (FFS) Contracts
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FFS Initiatives Open for EnrollmentFall 2012
• Drug Court Initiative (DCI)
• Open for all levels of care statewide
• 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
September 2012
• Driving under the Influence Initiative (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
September 2012
FFS Initiatives Open for EnrollmentFall 2012
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FFS CONTRACT ENROLLMENT APPLICATION
Part II-Agency Specific Information
(pages 2-3 of FFS Enrollment Application)
Part III- CRIS: Credential Site Specific Information (page 4)
September 2012
Part I-Contract Application Signature Page-(page 1)
Part IV-Initiative Specific Information (page 5 - 6)
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DMHAS Open Enrollment Checklist-New Provider
Items
Documents Submitted via websubmitted with based application
during contract
Enrollment
period
Application
Part I: Agency Administrative Information
X
Part II: Agency-Specific Information-submit separate attachments for each item below ( 5 copies)
Attachments I - Evidence-Based Practices - Max score 20
Attachments II - Policy and Procedure Regarding Availability of Public Funds –
Max score 10
Attachments III - Policy & Procedure Regarding Clients Taking Prescribed Medications –
Max score 20
X
X
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
September 2012
Contract Application Signature Page - (Page 1)
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DMHAS Open Enrollment Checklist-New Providers
Items
Documents
Submitted via
submitted with
web-based
Enrollment application during
contract period
Application
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
September 2012
Part III: Site-Specific Information
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DMHAS Open Enrollment Checklist-Existing Provider
Items
Documents Submitted via websubmitted with based application
during contract
Enrollment
period
Application
Part I: Agency Administrative Information
X
Part III: Site-Specific Information
Must be
completed by
10/1/12
Clinician Roster Information System (CRIS) : credentialing information for clinical & medical
staff entered into web-based system for each licensed site
Part IV: Initiative Specific Information –if not currently approved for Initiative
Drug Court
X
Mutual Agreement Program-State Parole Board
X
September 2012
Contract Application Signature Page - (Page 1)
Submit copy of DUII-IDRC Affiliation Agreement – for each new site requesting DUII
participation
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DMHAS Open Enrollment Checklist-Existing Provider-continued
Items
Documents
Submitted via
submitted with
web-based
Enrollment application during
contract period
Application
Annex A: Signed if adding level of care not currently included in agency FFS Contract
Annex A2: Signed if adding initiative not currently included in agency FFS Contract
X
X
September 2012
Annex A’s
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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Part II: Attachment I-V Scoring Criteria
Attachment I - Evidence-Based Practices - Max score 20
Attachment III - Policy & Procedure Regarding Clients Taking Prescribed Medications - Max score 20
Attachment IV - Sample Treatment Plan - Max score 25
September 2012
Attachment II - Policy and Procedure Regarding Availability of Public Funds – Max score 10
Attachment V - Utilization Rate Performance Criterion - Max score 25
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:
• 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
September 2012
• 5 copies of Part I and Part II must be received by 5 pm
on October 1, 2012
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Submission Requirements for Contract
Enrollment Application:
Overnight:
New Jersey Division of Mental Health & Addiction Services
222 South Warren Street- 3rd floor
Trenton, NJ 08611
Attention: Geralyn Molinari
September 2012
All documents should be mailed to address below:
Postal delivery:
New Jersey Division of Mental Health & Addiction Services
P.O. Box 362
Trenton, NJ 08625-0362
Attention: Geralyn Molinari
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FFS Open Enrollment link on NJSAMS
September 2012
https://njsams.rutgers.edu/samsmain/mainhome.htm
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September 2012
FFS Open Enrollment documents
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September 2012
Initiative Specific
Information
Drug Court
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Overview
• DMHAS Drug Court Annex A2
September 2012
• The Division of Mental Health and Addiction
Services (DMHAS) memorandum of agreement
with the Administrative Office of the Courts
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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.
September 2012
Drug Court Initiative Specific
Agency Requirements
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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. “
September 2012
Drug Court Initiative Specific
Agency Requirements (cont.)
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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.”
September 2012
Drug Court Initiative Specific
Agency Requirements (cont.)
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SPB Specific Overview
• DMHAS SPB Mutual Agreement Program Annex A2
September 2012
• The Division of Mental Health and Addiction
Services (DMHAS) memorandum of agreement
with the State Parole Board
• State Parole Board Abscond Policy
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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.”
September 2012
State Parole Board Initiative Specific
Agency Requirements
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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. “
September 2012
State Parole Board Initiative Specific
Agency Requirements(cont.)
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September 2012
Co-Occurring Services Network
Division of Mental Health and Addiction
Services
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• 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
September 2012
Principles of Effective Treatment
Source: TIPS 42
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• 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
September 2012
Seven Essential Elements in Programming for
Agencies Treating COD Clients
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DMHAS Review and Scoring Process of
Co-Occurring Applications
• 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
September 2012
• DMHAS Review Committee: 5 staff
• Agencies must score minimum of 70 to be approved
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Co-occurring Application Scoring Criteria
page 5 of application
• Program Description
Max value 3
Coordination of Services
Recovery Management
Client Centered
• Treatment Plan and Treatment Planning Policy
Max value 3
September 2012
Indicates Integration
Indicates planning for co-occurring issues
• Discharge Plan
Max value 3
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• Education and Supportive Services for Family
Max value 2
Include services for co-occurring clients and issues
• Recovery Support Referral List
Max value 2
Include referrals to types of Self Help other than
AA/NA*Peer Supports
Peer supports to co-occurring clients
September 2012
Co-occurring Application Scoring Criteria
page 5 of application
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Psychiatric Evaluation
Comprehensive Intake Evaluation
Medication Monitoring/Consultation
Clinical Consultation
Family Therapy (with or w/out client present)
Individual Therapy
Crisis Intervention
Case Management
September 2012
Co-Occurring Service Array
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DMHAS Co-Occurring 2013 Contract
Requirements
• DMHAS Reviews Co-occurring Applications Monthly
September 2012
• 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 will offer quarterly technical assistance for
providers
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Division of Mental Health & Addiction Services