Division of Mental Health & Addiction Services
advertisement
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 2 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 3 • 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 4 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 5 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 6 • 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 7 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) 8 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 9 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) 10 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) 11 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 12 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 13 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 14 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 15 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 16 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 17 FFS Open Enrollment link on NJSAMS September 2012 https://njsams.rutgers.edu/samsmain/mainhome.htm 18 September 2012 FFS Open Enrollment documents 19 September 2012 Initiative Specific Information Drug Court 20 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 21 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 22 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.) 23 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.) 24 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 25 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 26 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.) 27 September 2012 Co-Occurring Services Network Division of Mental Health and Addiction Services 28 • 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 29 • 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 30 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 31 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 32 • 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 33 • • • • • • • • 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 34 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 35
