How to Enter into a Fee for Service (FFS) Contract with

1. How to Enter into a Fee for Service (FFS) Contract with NJ Department of Health Division of Mental Health & Addiction Services (DMHAS) MARCH 29, 2018

2. Enter into a contract • As a Licensed Substance Use Disorder (SUD) provider who successfully completed Open Enrollment (OE), your agency is eligible to enter into a contract with DMHAS Earned a Passing Score/Approved Enter into a FFS contract with DMHAS SUD FFS Open Enrollment (OE) Will be invited to re-apply at a future OE Did not earn passing score/ Denied 2

3. SUD FFS Contract • SUD FFS Contract Orientation • Submit Contract Documents • DMHAS will process Contract • Agency attends “FFS Business Rules/ Secures Prior Authorization and Claims” training • Executed FFS SUD Contract 3

4. Required Prior to a Contract • New Jersey Substance Abuse Monitoring System (NJSAMS) • Medicaid • Clinician Roster Information System (CRIS) • Interim Managing Entity (IME) • Co-Occurring Approval 4

5. Requirements Prior to a Contract - NJSAMS • New Jersey Substance Abuse Monitoring System (NJSAMS) • Web-based reporting system • Addiction Services License (ASL) providers enter information on their consumers engaged in Addictions treatment • DASIE – an income and program eligibility tool within NJSAMS used to determine consumer’s eligibility for specific funding based on family income % of Federal Poverty level and specific program funding eligibility • If your agency staff need training, please contact: KyuKyu.Hlaing@doh.nj.gov 5

6. Requirements Prior to a Contract - Medicaid • Enroll as NJ Family Care Provider for each licensed site • Contact Provider Enrollment for New Jersey Medicaid Managed Information System (NJMMIS) • There are three (3) options to obtain an application: • Download from the NJMMIS website https://www.njmmis.com/onlineEnrollment.aspx • Submit a request to have an enrollment application mailed to you using this website. Click on the ‘Contact Provider Relations' link found on this website’s menu; or • Contact the Molina Provider Enrollment Unit at 800-776-6334 or 609-588-6036 • If your agency needs assistance, please contact: Gwen.Carrick@dhs.state.nj.us 6

7. Requirements Prior to a Contract - CRIS • Clinician Roster Information System (CRIS), Contact Trina Jordan Trina.Jordan@doh.nj.gov • Supports the collection, review, and maintenance of participating fee‐for‐service and contract provider agency clinical and medical staff to ensure that each approved agency site meets licensure requirements for counselor credentialing ratios • Agencies are responsible for entering and maintaining up‐to‐date staff information through an accessible web‐based portal • Facilitates reporting on systems‐wide adherence to licensure requirements • Every facility shall ensure that the ratios of substance abuse counseling staff are maintained so that 50% of the staff are LCADC or CADC or other licensed health professionals doing work of an alcohol or drug counseling nature within their scope of practice at all times • The remaining 50% of substance abuse counseling staff will be considered counselor‐interns who are actively working toward LCADC or CADC status, or toward another health professional license that includes work of an alcohol or drug counseling nature within its scope of practice • The director of substance abuse counseling must maintain an active client caseload if the director of substance abuse counseling is to be counted in the above ratios 7

8. Requirements Prior to a Contract - IME • Contact the Interim Managing Entity (IME) Addictions Access Center provider line to enter into an Affiliation Agreement at 1-844-276-2444 • Interim Managing Entity (IME) is the state-contracted entity managing select substance abuse services for eligible adults • Operates a 24/7 phone service screening for clinical and financial eligibility, and offers utilization management and care coordination • Clinically approves Medicaid Prior Authorizations as well as the managed initiatives for FFS 8

9. Requirements Prior to a Contract – Co-Occurring • Contact the Office of Licensure (OOL) to begin the process to add • co-occurring to your Substance Use Disorder license • Contact Jean.DeVitto@doh.nj.gov • Once approved by OOL, providers must submit a separate application to be approved for FFS co-occurring funded services • Contact Christine Scalise – Christine.Scalise@doh.nj.gov 9

10. Access NJSAMS documentshttps://njsams.rutgers.edu/njsams/Documents.aspx 10

11. FFS Contract RequirementsMust be Submitted to DMHAS • Signed & Dated Standard Language Document (two copies required with original blue ink signature) • Signed & Dated Business Associate Agreement (with original blue ink signature) • Board Resolution Form w/Authorized Signatures (with original blue ink signature) • Signed & Dated Public Law 2005, Chapter 271* (with original blue ink signature) • Signed and Dated Public Law 2005, Chapter 51* (Formerly Executive Order 117) (with original blue ink signature) * Note: Non-profit organizations are exempt from Chapter 271 and Chapter 51 11

12. FFS Contract Requirements –Must be Submitted to DMHAS • Signed & Dated N.J.S.A. 52:34-13.2 Source Disclosure Certification (formerly EO 129) (original blue ink signature) • Signed & Dated Certification Regarding Disbarment & Suspension- Schedule G (original blue ink signature) • Initial, Signed, and Dated Certification Sheet for Application for Contract Funds- Schedule I (original blue ink signature) • Business Registration Certificate • AA 302 Certification of Employee Information Report (Affirmative Action Profile) • Must be submitted to Treasury with $150 check • Submit a copy with your contract documents or copy of the yellow Certificate of Employee Information returned from Treasury 12

13. FFS Contract Requirements –Must be Submitted to DMHAS • Insurance Declaration Page (Certificate of Liability Insurance – must name the state of NJ as additionally insured) • Certificate of Incorporation • Charitable Registration Status (copy of 501c Letter from the IRS or copy of letter from the State Attorney General’s Office) • Subcontract/Consultant Agreements (if applicable) • Dated Current Board Members List • Latest Audit Financial Statements or Latest Financial Statements 13

14. FFS Contract Requirements –Must be Submitted to DMHAS • Agency Administrative Information and Contract Application Signature Page Addictions FFS SFY 2017-2018 • Standard Fee for Service Annex A (Standard Boilerplate cover and signature page) • ASAM Service Descriptions [Annex A1] • Initiative Specific Annex As [Annex A2] • Enhancement Packages Service Descriptions [AnnexA3] • Submit the signature ONLY page for Annex A, A1, A2 and A3 • Please DO NOT submit a copy of all the pages of the Annexes 14

15. FFS Contract Fiscal Requirements –Must be on File at Provider Site, to be verified by DOH/DMHAS program monitoring staff • Resumes for all Professional Staff Members • Organization Chart • Organizational Structure Chart • Salary Ranges & Policy • Annex B-2 • All Applicable Licenses • Tax Exempt Form 990 (if applicable) • U.S Corporation Income Tax Return, Form 1120 • Annual Report to the Secretary of State (website): http://www.state.nj.us/treasury/revenue/dcr/programs/annrpt.shtml 15

16. FFS Contract Fiscal Requirements –Must be on File at Provider Site, to be verified by DOH/DMHAS program monitoring staff (continued) • Affirmative Action Policy • Conflict of Interest Policy • Board of Director Meeting Minutes • Procurement Policy • Current Equipment Inventory • Cost Allocation Plan • Provider Agency's By-Laws • Personnel Manual • Copy of Lease or Mortgage • All Certificates of Occupancy • State of New Jersey Business Registration website: • http://www.state.nj.us/treasury/revenue/busregcert.shtml 16

17. Contract or FFS Questions • Contracting specific questions: • Lynn Soto - Lynn.Soto@doh.nj.gov ; • 609-438-4287 • FFS specific questions: • Cathy Spencer - Catherine.Spencer@doh.nj.gov ; • 609-438-4265 17

18. American Society of Addiction Medicine (ASAM) Levels of Care - (Annex A1) Provider must be licensed for specific LOC in order to enroll in FFS: • Assessment (Pre-Admission) • Outpatient Service Packages • Intensive Outpatient • Partial Care • Ambulatory Withdrawal Management • Halfway House • Long-Term Residential • Short-Term Residential • Inpatient Withdrawal Management (formerly Residential Detox) 18

19. Fee-for-Service (FFS) Network Initiatives (Annex A2) FFS Initiatives OPEN to new providers • Driving Under the Influence (DUII) - all Levels of Care (LOC) statewide • Drug Court Initiative (DC) - all LOC statewide • Mutual Assistance Program - State Parole Board (MAP-SPB) -all LOC for provider locations in Bergen, Salem, Sussex and/or Warren Counties • Medication Assisted Treatment Initiative (MATI) - all LOC except Outpatient • South Jersey Initiative (SJI) - ambulatory LOC in 8 Southern Counties; residential LOC statewide FFS Initiatives NOT OPEN to new providers at this time • Substance Abuse Prevention & Treatment Initiative (SAPTI) • New Jersey Statewide Initiative (NJSI) • State Hospitals Access to Rehabilitation & Education Initiative (SHARE) • State Targeted Opioid Response Initiative (STORI) 19

20. Driving Under the Influence (DUII) DUIIAgency eligibility: • Providers must have a current IDRC/IDP Affiliation Agreement in place for all agency sites and LOCs • Residential Providers Affiliate with the Intoxicated Driving Program IDP directly; contact 609-815-3093 • Ambulatory Providers MUST Affiliate locally with their County Intoxicated Driver Resource Center (IDRC) • Providers MUST share monthly report/information with IDRCs for all clients receiving DUII funding 20

21. Driving Under the Influence (DUII) • DUII Client Eligibility: • NJ resident with a DUI conviction after October 17, 2005 • Client income 350% FPL (Federal Poverty Level) • Client does not have to be referred by IDRC, but connection with IDRC must be established in the NJSAMS • When NJ Drivers License is entered into the DASIE module, conviction eligibility is shown/determined • Any difficulties regarding convictions should be directed to: idp@dhs.state.nj.us for assistance 21

22. Drug Court Initiative (DCI) Drug Court Provider Eligibility - Providers must submit initiative specific documents to be approved by DMHAS DC Program staff • Required to notify DMHAS and the referring Drug Court in writing of consumer program admission denials that include referrals to a more suitable level of care. Please attach a copy of the agency’s Board-approved policy and procedure regarding admission denials labeled “Drug Court Admission Denials Policy”. • 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”. • 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.” 22

23. Drug Court Initiative (DCI) Drug Court Client Eligibility: • Drug Court clients will be referred directly from Drug Court • All referrals should be preceded by a Drug Court referral form that includes the SBI number • Upon referral, if SBI # is not included, please reach out to the referring Drug Court 23

24. MAP – State Parole Board (SPB) MAP SPB Provider Eligibility--Providers must submit initiative specific documents to be approved by DMHAS Program staff • Approved internal policy ensuring that no paid or volunteer staff actively supervised by the criminal justice system can have authority over or access to any SPB MAP consumer’s confidential clinical information, including but not limited to clinical reports, records and information disclosed in individual, group and family sessions or community meetings. • Contractee shall identify and maintain at least one staff person to coordinate MAP SPB services. This staff person shall act as a liaison with SPB and DMHAS’ Criminal Justice Unit regarding MAP SPB issues. • Approved internal policy that includes components of the September 26, 2013 New Jersey State Parole Board memorandum regarding the Abscond Reporting Procedures. • Approved internal agency policy on how problematic consumer behaviors will be reported to SPB in any instance where an SPB consumer is found to be in possession of illegal substances or items (e.g., drugs, paraphernalia, weapons, etc.) or when removal of a parolee from the program is required. • For Residential Programs only: Provide electronic rosters to the SPB Program Specialist by close of business each Friday. Contractee will provide written electronic notification on all parolee program arrivals as well as program discharges. • 7 day communication turnaround on residential referrals 24

25. MAP – State Parole Board (SPB) MAP SPB Client Eligibility: • MAP State Parole Board will be referred directly from Mutual Agreement Program State Parole Board • All referrals should be preceded by a SPB MAP referral form that includes the SBI number • Upon referral, if SBI # is not included, please reach out to the referring district office 25

26. Medication Assisted Treatment Initiative (MATI) • MATI Provider Eligibility: • MATI funds medication-assisted treatment and other treatment services Ambulatory providers located in the vicinity of MATI-contracted providers • Residential providers are statewide and not limited to MATI-contracted provider areas • The MATI contract funds standard outpatient through a Mobile Medication Unit (not through FFS) • Outpatient enrollment is not available at this time 26

27. Medication Assisted Treatment Initiative (MATI) • MATI Client Eligibility: • Indigent New Jersey adult residents who have an opioid use disorder and a history of injectable drug use • Individual must test positive for opioids or have a documented one year history of opioid dependence • Particular emphasis is placed on providing access to treatment for individuals referred by the Syringe Access Programs (SAP) 27

28. South Jersey Initiative (SJI) • SJI Provider Eligibility: • SJI Ambulatory Providers must be located in one of the 8 southern counties: • Atlantic County • Burlington County • Camden County • Cape May County • Cumberland County • Gloucester County • Ocean County • Salem County • SJI Residential Providers are statewide and not limited to the counties above 28

29. South Jersey Initiative (SJI) • SJI Client Eligibility: • The South Jersey Initiative (SJI) provides substance abuse treatment services (ambulatory, residential, methadone maintenance, detoxification, enhanced co-occurring) for consumers ages 18 through 24 who reside in one of the 8 southern counties: • Atlantic County • Burlington County • Camden County • Cape May County • Cumberland County • Gloucester County • Ocean County • Salem County 29

30. Enhancements to Treatment (Annex A3) • Clinical Review • Co-Occurring Clinical Services • Co-Occurring Medication Monitoring Services • Psychiatric Evaluation • Medication Assisted- Induction/Stabilization Methadone* • Medication Assisted - Methadone Maintenance* • Medication Assisted - Induction/Stabilization Buprenorphine* • Medication Assisted – Buprenorphine* • Recovery Support • Medical Services • Vivitrol – Pre-Induction • Vivitrol – On-going Induction • Vivitrol –Liver Function Test NOTE: Co-occurring enhancements require a separate application Vivitrol enhancements require a separate application *Medication Assisted Enhancements - must be licensed as Opioid Treatment Provider (OTP) 30

31. Co-Occurring Fee-For-Service Network • What is the Fee-for-Service Co-occurring network? • Strives to advance the integration of mental health services into client’s substance abuse treatment. • Provides reimbursement for an array of co-occurring services • Is exclusive to agencies that hold a current DMHAS substance use disorder Fee-for-Service contract • Requires a separate application 31

32. Co-Occurring Fee-For-Service Network • Providers participating in the all FFS Initiatives shall meet agency criteria to participate in the co-occurring network and have demonstrated readiness to provide integrated care for dually diagnosed consumers. • New providers must submit a co-occurring application no later than 60 days following the execution of their new FFS contract • Agencies must be co-occurring capable and provide at a minimum: • Assessments and treatment, or • Must be able to screen, refer and provide linkages to a • co-occurring capable agency 32

33. Co-occurring Enhancement Services What array of services can be reimbursed through the co-occurring network? These services are based on: • Psychological evaluation (ambulatory and residential settings) • Comprehensive intake evaluation (ambulatory and residential settings) • Medication monitoring (ambulatory and residential settings) • Clinical consultation in a residential setting • Family therapy in a residential setting • Individual therapy in a residential setting • Crisis intervention in a residential setting • Co-occurring group therapy in a residential setting • Case management (limited ambulatory and residential settings) • Refer to initiative specific Enhancement excels for actual funding limits 33

34. Determine who will attend the Addictions FFS Authorization and Billing training • Begin to plan to market your program to funding referral sources • The information to be covered is geared to those who will be responsible for securing authorizations in NJSAMS, and claiming on nj-das.net fiscal agent site, as well as those who supervise this process: • Billing staff • Contract Manager • Quality Assurance • Clinical Director and/or Executive Director 34

35. Additional Information • All those who attended mandatory conference call today must • e-mail Catherine.Spencer@doh.nj.gov • Please identify provider represented, and include all • e-mail addresses that should receive the following: • PowerPoint file detailing Co-Occurring Fee-for-Service Network (must apply within 60 days of contract) • Invitation to the mandatory FFS Authorization and Billing training 35

36. Submit Required Contract Documents Hand Delivery or Overnight delivery service note: Post Office does not deliver mail to this address) NJ Div. of Mental Health & Addiction Services 5 Commerce Way, Suite 100 Hamilton, NJ 08691 Attention: Lynn Soto Postal mail (DMHAS not responsible for delayed mail): NJ Div. of Mental Health & Addiction Services P. O. Box 362 Trenton, NJ 08625-0362 Attention: Lynn Soto 36

37. DMHAS FFS Initiative Contacts 37

38. DMHAS FFS Initiative Contacts 38

39. Questions