HomeMy WebLinkAboutResolutions - 2014.09.18 - 21499MISCELLANEOUS RESOLUTION # 14217 September 18, 2014
BY: GENERAL GOVERNMENT COMMITTEE, CHRISTINE LONG, CHAIRPERSON
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/HEALTH DIVISION - AMENDMENT #5 AND #6
TO THE INTERLOCAL AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND THE OAKLAND
COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
To The Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS Oakland County and the Oakland County Community Mental Health Authority (OCCMHA)
have entered into a contract to provide substance abuse services to Medicaid recipients; and
WHEREAS an Interlocal Agreement between the County of Oakland and the Oakland County Community
Mental Health Authority was approved by the Oakland County Board of Commissioners in 2010 by Miscellaneous
Resolution #10236; and
WHEREAS as of October 1, 2014, Public Act 500 of 2012 amended Public Act 258 of 1974, MCL
330.1287(5), and changed the designated substance abuse coordinating agency from the Oakland County Health
& Human Services Department(DHHS)/Health Division to the Oakland County Community Mental Health
Authority (OCCMHA); and
WHEREAS the OCCMHA now as the designated substance abuse coordinating agency wishes to amend
the Interlocal agreement to remove Medicaid services and include Prior Authorization and Central Evaluation
(PACE) and Substance Abuse Disorder Health Education services; and
WHEREAS pursuant to the Urban Cooperation Act of 1967, 1967 PA 7, MCL
124.501 et seq., and the Intergovernmental Contracts between Municipal Corporations Act, 1951 PA 35, MCL
124.1, et seq., the agreement and subsequent amendments for provision of the assessments and compensation
for the assessments must be an Intergovernmental Agreement, and;
WHEREAS Amendment #5 provides for the change in services to be provided by the County and the
payment to be made by OCCMHA; and
WHEREAS Amendment #6 provides for the changes to the sublease agreement between Oakland
County and OCCMHA; and
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners hereby
approves Amendment #5 and Amendment #6 to the Interlocal Agreement between the County of Oakland and the
Oakland County Community Mental Health Authority.
BE IT FURTHER RESOLVED that the future level of service be contingent upon the level of funding for
this program.
BE IT FURTHER RESOLVED that the Board Chairperson is authorized to execute the Amendments on
behalf of Oakland County and thereby accept and bind Oakland County to the terms and conditions of the
Agreement.
Chairperson, on behalf of the General Government Committee, I move the adoption of the foregoing
resolution.
GENERAL GOVERNMENT COMMITTEE
Motion to directly refer the resolution to the Finance Committee carried on a voice vote.
GENERAL GOVERNMENT COMMITTEE
Motion carried unanimously on a roll call vote with Crawford absent.
OAKLAND COUNTY INTERLOCAL AGREEMENT
BETWEEN
OAKLAND COUNTY
AND
THE OAKLAND COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
ATTACHMENT A
PACE Services
Monthly Annual NTE
FY15 $70,986.25 $851,835
CMH Authority agrees to pay to the County, on a monthly basis, and amount equal to
1/12 of the Annual NTE for the County's allowable costs and expenses incurred in
connection with the performance by the County for the Services set for in this Contract.
Health Education Services
Monthly Annual NTE
FY15 As invoiced $204,463
The County shall submit an invoice to the CMH Authority on a monthly basis, which
shall itemize all amounts due and or owing by CMH Authority. The monthly invoice
must reflect total actual program expenditures by category. The invoices shall be
submitted in a form and format agreed upon by the Parties.
Substance Abuse Prevention Coordinator
C.M1-1 Authority agrees to pay to the County the funds, including direct and indirect costs,
required to pay for one Substance Abuse Prevention Coordinator for the period of
October 1,2014 to February 28, 2015.
Monthly Annual NTE
FY15 $9,992 $49,960
OAKLAND COUNTY INTERLOCAL AGREEMENT
BETWEEN
OAKLAND COUNTY
AND
THE OAKLAND COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
ATTACHMENT B
SCOPE OF SERVICES
I. SUPPORTS AND SERVICES:
A. The County shall assure for the provision of services for eligible individuals
pursuant to the Contract and this Scope of Services.
B. The County agrees to provide Prior Authorization and Central Evaluation (PACE)
services for adults and children with substance use disorders, and co-occurring
substance use disorders, and will comply with those terms and conditions in
Attachment E.
C. The County agrees to provide Health Education services and will comply those
terms and conditions in Attachment D.
IL ADMINISTRATIVE RESPONSIBILITIES:
A. The County when practicable, and only when authorization has been obtained
from the Consumer, shall ensure that coordination of care occurs between the
consumer's Primary Care Physician and Medicaid Health Plan.
B. Required Staff Training(s): The County understands that various federal and state
rules and regulations impose specific training requirements on the Parties. The
County agrees that its entire staff will receive all required training(s) as
applicable. The County also agrees to document the completion of applicable
training in the personnel file of each staff.
Page! 015
C. Cultural Competency: The County must assure meaningful service for persons
with diverse cultural backgrounds (including, but not limited to religious,
ethnical, geographical, geriatric, socioeconomic, and/or disability). The County
shall assess the population(s) it serves, collaborating with other community
agencies (e.g., Council on Aging) and training staff on any identified cultural
issues.
D. Relationship with Other Providers (Contractors): The County when practicable
shall collaborate with agencies in the community to the benefit of the consumer.
Such agencies include but are not limited to hospitals, intermediate school district,
local schools, faith based organizations, courts, law enforcement, community
corrections, substance abuse, Indian Health Services and Tribal Health Centers,
Early On and other early intervention programs that are essential to positive
outcomes to our community.
E. Advance Directives. The County agrees to comply with federal and state law
regarding Advance Directives.
F. Customer Services:
1. Orientation: The County will provide orientation to newly enrolled
Consumers. Orientation will include information about benefits and services
provided by Oakland County's Office of Substance Abuse Services.
2. The County will acknowledge receipt of support and for Federal and State
funds from the Michigan Department of Community Health and/or Oakland
County Community Mental Health CMH Authority in any articles or
publications that are produced utilizing any such funding.
3. Grievance: The County will have a policy, procedures and a process to
document the number and nature of grievances and complaints brought to the
County.
G. Due Process: The County shall take reasonable steps to inform new Consumers
of its Due Process procedures. The County will provide Adequate or Advance
Notice whenever there is a proposed or actual denial, termination, suspension or
reduction in services requested by or provided to a Consumer.
1. All such notices will be provided in accordance with State and Federal
regulations.
Page 2 of 5
2. The County will use notice formats approved by both Parties, and will submit
required data elements according to the schedule adapted as set forth in this
Contract and/or any applicable State or Federal statute or rule.
H. Recipient Rights:
1. The County will, and will require its subcontractors to, at every service site,
make readily available to all employees and staff, and if applicable, will post
in a conspicuous place and/or make available, the following:
a. A summary of all recipient rights guaranteed by the Public Health Code;
b. Provide unrestricted access to Rights Complaint forms, Your Rights
booklets, and MDCH Request for Administrative Hearing form to
recipients and others;
c. Post the MDCH/Office of Recipient Rights (ORR) Reporting
Requirements poster for staff;
d. Have available for review by any recipient or others, the Medicaid
Services Administration (MSA) Manual and Bulletins;
Service Cost Tables Reporting: The County agrees to cooperate with and
participate in CMH Authority's cost integrity process. The County agrees to
develop and submit to CMH Authority Service Cost Tables upon request by the
CMH Authority. The County agrees that the rates it establishes for all procedures
listed in the Service Cost Table are based on actual costs and are representative of
current costs incurred and paid by the County.
J. Quality Management:
I. Quality Improvement (QI) Plan and Status Reports Requirements: The
County will submit to the CMH Authority's Quality Management Team (QM)
an annual Provider QI Plan which describes the County's ongoing and
planned QI activities. The County will submit to the QM Team an annual
Status Report for the prior year's Q1 Plan. The status report will describe the
outcomes that were achieved by the County in regards to the QI plan.
Page 3 ors
2. Satisfaction Surveys: The County will also participate in the administration of
the satisfaction surveys as mandated by the Michigan Department of
Community Health.
4. Sentinel Events: The County will comply with state laws and regulations
regarding Sentinel Events and Other Reportable Critical Incidents which
specify actions that the County must take if an incident is identified as a
Sentinel Event. The County if required by state law will report events to the
CMH Authority and it will adhere to reporting timeframes for Root Cause
Analysis and Action Plans.
5. Credentialing: The County will utilize a credentialing process to validate the
qualifications of its direct staff. The process will include evaluating and
verifying the appropriate education, licensing, malpractice history, insurance,
and service site as applicable. The County must complete primary source
verification of staff education and licensure. The County may utilize the
National Practitioners Data Bank for this purpose. The American Medical
Association or American Osteopathic Association (as applicable) may be
utilized to complete primary source verification for physicians. The County
will utilize a privileging process which includes a review of specific
education, training, and experience to determine the consumer populations
and/or service the practitioner will be approved to provide.
III. DATA MANAGEMENT:
A. As to the extent provided for by law the CMH Authority is the owner of all data
related to consumers pursuant to this agreement including all data entered into the
County's management information system(s), such as, all eligibility and
demographic data, utilization data, claims data, and any other service,
administrative or financial information that has passed through the CMH
Authority's or the County's operation that resides with the County.
Notwithstanding the foregoing, the County is not precluded from maintaining and
utilizing the data identified in this section in support of the services provided to
the consumer and internal County operations.
13. The County shall implement tools to prevent unauthorized access and virus
protection to its internal transaction and office system using planning,
management, and system monitoring tools.
Page 4 of 5
C. The Parties agree that when transmitting information electronically the national
ANSI and HIPAA compliant standards shall be utilized
D. If the County is transferring data to the CMH Authority electronically, it shall
transmit data by the close of the next business month following the month of
service for direct care services and within 60 days of the close of the month for
subcontracted services. All data for the fiscal year must be received by the 5th
working day of December in the format reasonably requested by the CMH
Authority. In the event of termination of this Contract and the data is being
transferred electronically, the County shall download for and provide to the CMH
Authority, at no cost to the CMH Authority, all such CMH Authority data in an
electronically accessible format within twenty (20) days following the termination
of this Contract.
Page 5 of 5
ATTACHMENT C-1
OAKLAND COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Management by Objective
FY 2014- 2015
Program Name:
Agency/Organization:
Prepared By:
Program Goal:
General Sub Abuse Prevention Date Prepared: 8/5/2014
OCHD/ Health Ed
Angie Gullekson/Jennifer Kirby
To delay onset/ prevent the abuse of ATOD in the Oakland County Community especially
among youth
Specific Activity and Objective (s)
(Number consecutively and use separate page for each
Prevention Activity)
Estimated
Total
Recipients
(12 months)
Number of Direct Service Hours (outputs)
P = Planned / A = Delivered
1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. TOTAL
P A P A P A P A P A
*4 PRESCRIPTION AND OVER-THE COUNTER DRUG ABUSE: (a) Act
as a resource offering technical assistance to OCHD staff, the senior and
general community on Rx and OTC misuse and other emerging trends in
OC especially opiates and stimulants like ritilan (study drugs); (b)
provide support and technical assistance in the implementation of any
local and State-wide (OROSC developed) strategies to prevent the misuse
of Rx and OTC medicines; (c) implement an awareness campaign on the
prevention of the nonmedical use of Rx drugs- "Be The Solution' or
related campaign (d) Pilot a Photovoice Project on the prevention of the
nonmedical use of Rx drugs with several school/youth groups. Outcomes'
(a) report on audiences, types of TA delivered, surveys if administered
emerging trends described; (b) describle local or state-wide strategies
implemented, estimate reach; (c) describe implementation- press releases
diseminated, newsletter articles, podcast implemented, media interviews, .-...-. .i......-4.-....1 .,-..-._,J. • (Al .-, ...,-.1,.....e...r
(a) 100 10 10 10 10 40
(b) 500
(c) 1000
(d) 1000
Strategy: (list) C, N, E, V Sub Total
Total
10 0 10 0 10 0 10 0 40 A = Alternative 222 C = Community-Based
E = Education
N = Information dissemination
P = Problem ID & Referral
V = Environmental
Contract 14/15/Attach B MBO frm
ATTACHMENT C-1
OAKLAND COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Management by Objective
FY 2014 - 2015
Program Name:
Agency/Organization:
Prepared By:
Program Goal:
General Sub Abuse Prevention Date Prepared: 8/5/2014
OCHD/ Health Ed
Angie Gullekson/Jennifer Kirby
To delay onset/ prevent the abuse of ATOD in the Oakland County Community especially among
youth
Specific Activity and Objective (s)
(Number consecutively and use separate page for each
Prevention Activity)
Estimated
Total
Recipients
(12 months)
Number of Direct Service Hours (outputs)
P = Planned I A = Delivered
let Qtr. 2nd Qtr, 3rd Qtr. 4th Qtr. TOTAL
P AP AP A P A P A
#3 UNDERAGE DRINKING (UD) & BINGE DRINKING (BD) BY YOUTH Si
ADULTS: (a) act as a resource and provide technical assistance to OCHD
staff and the general community in support of community campaigns to
prevent UD and BD; (b) collect and provide to OCCMHA, relevant data on
these priority problems by surveying courts, law enforcement and MI
Liquor Control Commission(MLCC), MSP information/data- to assess
what is presently occurring in terms of retailer alcohol enforcement
checks, tracking community location, number and results of checks
accomplished by LE and and the MLCC and data on Minors in Possession
by community; (c) target non-coalition community alcohol vendors and
MLCC violators. Outcomes: (1) list details of services/TA delivered; (2)
report summary of data research at 6 month and year-end intervals; (3)
complete a year to year comparison (FY12, FY13, FY4) of violations
occurring in non-coalition communities who receive vendor education.
10 10 10 20 50 (a) 50
,
(b) na
(c) na
Strategy: (list) N, V, E Sub Total
Total
10 10 10 20 50
A = Alternative
C = Community-Based
E = Education
N = Information dissemination
P = Problem ID & Referral
V = Environmental
Contract 14/15/Attach B MBO frm
ATTACHMENT C-1
OAKLAND COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Management by Objective
FY 2014- 2015
Program Name:
Agency/Organization:
Prepared By:
Program Goal:
General Sub Abuse Prevention Date Prepared: 8/5/2014
OCHD/ Health Ed
Angie Gullekson/Jennifer Kirby
To delay onset/ prevent the abuse of ATOD in the Oakland County community especially among
youth
Specific Activity and Objective (s)
(Number consecutively and use separate page for each
Prevention Activity)
Estimated
Total
Recipients
(12 months)
Number of Direct Service Hours (outputs)
P = Planned / A = Delivered
1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. TOTAL
P AP A P AP AP A
#2 LIFE SKILLS TRAINING (LST) : (a) coordinate recruitment of high risk
student populations from schools and other child activity centers for LST
classes; provide a minimum of 3 series of LST to elementary and/or
middle school age children In high risk school districts as recruited.
Outcomes: number of classes recruited and results of pre/post test
evaluation for each series of classes and by school/ agency.
100 0 20 20 20 60
IN MIMI 111.111011.111111111
MIMI MI= MEM
Il MEI
IIIIIIIIIIIMI
EMI.
NM
III II
MOM
Elll
NM
al
MI
III III
III MI MI
IIIII I= 0. MIMII
01 201 201 201 601 Strategy: (list) E Sub Total
Total A = Alternative MI MI 1111111111.1111.11 = Community-Base
E = Education
N = information dissemination
P = Problem ID & Referral
V = Environmental
Contract 14/15 /Attach B 11/180 frm
ATTACHMENT C-1
OAKLAND COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Management by Objective
FY 2014- 2015
Program Name:
Agency/Organization:
Prepared By:
Program Goal:
General Sub Abuse Prevention Date Prepared: 8/5/2014
OCHD/ Health Ed
Angie Gullekson/Jennifer Kirby
To delay onset/prevent the abuse of ATOD in the Oakland County community, especially among
youth
Specific Activity and Objective (s)
(Number consecutively and use separate page for each
Prevention Activity)
Estimated
Total
Recipients
(l2 months)
Number of Direct Service Hours (outputs)
P = Planned / A = Delivered
1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr, TOTAL
P A P A P A P A l' A
GENERAL SUBSTANCE ABUSE PREVENTION #1 Act as a resource on
the general topic of substance abuse prevention by providing information
and research to OCHD staff and the community at large including (a)
provide display materials, edcational presentations and materials and staff
training; (b) provide technical assistance (TA) to SA related groups and
agencies including but not limited to BASICS, 11/ICHUD, Recovery
Celebration, SOAR; (c) provide a minimum of 30 prevention messages to
OCHD for use in social media; Outcomes: List number and nature of
services delivered, number of recipients and estimated reach.
(a) 100 18 18 18 18 72 0
(b) 150
(c) 2500
Strategy: (list) C, E, N Sub Total
Total
18 0 18 0 18 0 18 0 72
A = Alternative
= uommunity-basea
E = Education
N = Information dissemination
P = Problem ID & Referral
V = Environmental
Contract 14/15/Attach 8 MB° foe
ATTACHMENT C-2
OAKLAND COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Management by Objective
FY 2014- 2015
Program Name:
Agency/Organization;
Prepared By:
Program Goal:
Youth Tobacco Use Prevention Date Prepared: 8/5/2014
OCHD/ Health Ed
Melanie Stone/Jennifer Kirby
To delay/ prevent the onset of youth use of tobacco products in the region and coordinate efforts
to ensure Oakland County's compliance with the federal Synar Amendment
Specific Activity and Objective (s)
(Number consecutively and use separate page for each
Prevention Activity)
Estimated
Total
Recipients
(12 months)
Number of Direct Service Hours (outputs)
P = Planned / A = Delivered
1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. TOTAL
p A P A P A P A P A
TEEN TOBACCO USE PREVENTION: #1 Provide education and
technical assistance on youth tobacco use and secondhand smoke (a) act
as a resource to OCHD staff and general community by providing:
information on tobacco use prevention and emerging trends like snus, e
cigs, hookah, updates on cessation resources, and providing a minimum
of 30 tobacco prevention messages to °CND for use on social media sites
(b) provide display materials, educational presentations and materials as
requested on youth tobacco use/prevention; (c) Promote awareness of
Kick Butts Day, World No Tobacco Day, the ALA's Great American
SmokeOut in the schools and communities in OC; (d) act as staff to TFOC
and provide technical assistance to other local, regional and state
planning groups (TEM, SE Michigan Tobacco Coalition, to promote youth
tobacco use prevention efforts and support for smoke free
environments/policies; Outcomes: (a) and (b) report on populations
nnek y"..4 nntnnrn1 4I,...nn ni 'T-11 nr rl nin .4 rlii nnr.nri n mei runnewninn +nan.4 n • f ..,1
1,000 14 15 12 15 56
Strategy: (list) E, N, V Sub Total
Total
14 0 15 0 12 0 15 0 56 A = Alternative
C = Community-Based
E = Education
N = Information dissemination
P = Problem ID & Referral
V = Environmental
Contract 14-15/Attach B MI30 frm
ATTACHMENT C-2
OAKLAND COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Management by Objective
FY 2014- 2015
Program Name:
Agency/Organization;
Prepared By:
Program Goal:
Youth Tobacco Use Prevention Date Prepared: 8/5/2014
OCHD/ Health Ed
Melanie Stone/Jennifer Kirby
To delay/ prevent the onset of youth use of tobacco products in the region and coordinate efforts
to ensure Oakland County's compliance with the federal Synar Amendment
Specific Activity and Objective (s)
(Number consecutively and use separate page for each
Prevention Activity)
Estimated
Total
Recipients
(12 months)
Number of Direct Service Hours (outputs)
P = Planned / A = Delivered
1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr, TOTAL
P A P A P A P A P A
#2 Synar-Related Activities: (a) train, monitor, collect and assess the
results of groups conducting Synar and law enforcement (LE) inspections;
(b) maintain a current list of O.C. tobacco retailers for delivery to OROSC
as required; (c) provide an educational or incentive program and follow up
to 2 Synar-related target audiences as determined by needs assessment'
(d) coordinate the completion of (d)[1] State required number of Synar
Inspections, (d)12] a minimum of 400 tobacco retailer ed visits, (d)[3] the
mailing of a educational letter to all DC tobacco retailers in cooperation
with the OC Sheriff Department; (e) collect data on youth tobacco use and
provide the following to OSAS at the indicated times (e)[1] on-going non-
Synar LE inspection results, (e)[2] Synar Inspection Report as required by
OROSC, (e)[3] Youth Access to Tobacco Activity Report as required, (e)141
the Annual Action Plan for Synar Implementation. Outcomes: Timely
submission of deliverables as outlined.
1500 5 19 30 20 74
Strategy: (list) C, E, V Sub Total
Total
5 19 30 20 74
A = Alternative
- . _ = community-basee
E = Education
N = Information dissemination
P Problem ID & Referral
V = Environmental
Contract 14-15/Attach 6 MBO frm
ATTACHMENT C-2
OAKLAND COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Management by Objective
FY 2014- 2015
Program Name:
Agency/Organization;
Prepared By:
Program Goal:
Youth Tobacco Usr Prevention Date Prepared: 8/5/2014
OCHD/ Health Ed
Melanie Stone/Jennifer Kirby
To delay/ prevent the onset of youth use of tobacco products and coordinate efforts to ensure
Oakland County's compliance with the federal Synar Amendment
Specific Activity and Objective (s)
(Number consecutively and use separate page for each
Prevention Activity)
Estimated
Total
Recipients
(l2 months)
Number of Direct Service Hours (outputs)
P = Planned / A = Delivered
1st Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. TOTAL
A P A P A P A P A
Activity #3 Promote the effectiveness of Tobacco Free Oakland Coalition
(TFOC) by assisting & participating in the achievement of the following
TFOC Goals using earned media, promoting policy change, and other
appropriate environmental strategies:
a) Eliminating exposure to secondhand smoke in public places
b) Preventing youth initiation and access to tobacco products (school and
retailer policy changes)
c) Increasing and promoting accessible and affordable cessation services
especially targeting pregnant women, individuals with mental health and
addiction disorders.
d) Identifying disparities specific to race/ethnicity, socioeconomic status
occupation, geography, gender and sexual orientation for targeted
services. Outcomes: Report on policy change attempts and success in
resourcing disparate populations.
470 6 8 8 6 28 0
i
Strategy: (list) E,N,V Sub Total
Total
6 0 8 0 8 0 6 0 28 A = Alternative
C = Community-Based
E = Education
N = Information dissemination
P = Problem ID & Referral
V = Environmental
Contract 14-15/ Attach B MBO frm
ATTACHMENT C-2
OAKLAND COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Management by Objective
FY 2014- 2015
Program Name: Youth Tobacco Use Prevention Date Prepared: 8/5/2014
Agency/Organization: OCHD/ Health Ed
Prepared By: Melanie Stone/Jennifer Kirby
Program Goal: To delay/ revent the onset of youth substance use through the implementation of activities that
reduce/prevent the occurrence of bullying /violent behavior in children and teens
Specific Activity and Objective (s)
(Number consecutively and use separate page for each
Prevention Activity)
Estimated
Total
Recipients
(12 months)
Number of Direct Service Hours (outputs)
P = Planned / A = Delivered
1st Qtr. 2nd Qtr. 3rd Qtr, 4th Qtr. TOTAL
P AP AP A P AP A
Activity #4 Act as a resource and provide technical
assistance for anti-bullying efforts in OC: (a)
Develop/initiate a bullying awarenes plan/campaign for
Oakland County; (b) promote the use and distribute toolkit
for parents, youth groups, schools, and communities to
utilize; (c) provide technical assistance to anti-bullying
groups as requested including but not limited to the OC
Youth Suicide Prevention Task Force, Beaumont Health
System's NoBLE Anti-Bullying Collective, and the
Farmington/Farmington Hills Community Target; (d) utilize
media outlets to further anti-bully efforts.
100 18 18 18 18 72
Strategy: (list) E, N, V Sub Total
Total
18 0 18 0 18 0 18 0 72
A = Alternative 230
= uommunity-baseo
E = Education
N Information dissemination
P = Problem ID & Referral
V = Environmental
Contract 14-15/ Attach B MBO frm
ATTACHMENT D
OAKLAND COUNTY
COMMUNITY MENTAL HEALTH AUTHORITY
HEALTH EDUCATION SERVICES
For
P_REVENTION PROVIDERS
FY 2014/2015
CONTENTS
Budgets
Billing and Payment
Amendments and Adjustment to Allocations
IV. Data and Reporting
V. Staff Credentials and Requirements
VI. Cultural Competency and Trauma-Informed Approach to Prevention
VII. Charitable Choice Policy and Procedure
VIII. Confidentiality
IX. Required Statement of Funding Sources and Recipient Rights
X. Programmatic and Financial Review
ATTACHMENTS
C-1 OCHD GEN MBO Final FY 2014-2015
C-2 OCHD TUB MBO Final FY 2014-2015
D-1 Request for Amendment Form
D-2 Mid and End-of-Year Prevention Program Report
D-3 Tobacco Activity Report
FY 2014/2015
OCCMHA Prevention Program Policies and Procedures
I. Budget
A. Prevention programs will submit an annual budget for OCCMHA-administered funds that
include revenue sources for total substance use disorder prevention programming using
the following forms: Prevention Budget/ Billing Summary and Budget/Billing Pages
(Attachment A).
B. Programs will provide a 10% local match for all OCCMHA funding and submit as part of
budget.
IL Billing and Payment
A. The Prevention Billing Summary Form along with the Prevention Budget Billing Pages
are the source document for billing the OCCMHA for actual expenditures related to
prevention services provided each month.
B. Payment for services will be based on actual expenses incurred for service delivery. The
Billing Summary page must include the total amount expended for each category
(Supplies & Materials, Travel, Contractual, etc.) for the month, as well as a breakout by
funding source (i.e., OCCMHA funds and/or Local Match) The Billing pages must
contain the monthly charges by line item in each category as identified in the original
budget.
C. Bills are due to OCCMHA no later than 10 days after the close of each service month;
those received after the 10th will not be processed for payment until the following month.
D. Reimbursements will be based on the understanding that a certain level of performance as
defined by the Prevention Management by Objective (MBO — Attachment C-1, 2),
measured by outputs (face-to-face or direct service hours engaged with the service
population) must be met in order to receive full reimbursement of costs up to the
contracted amount at the end of the contract year.
E. For this agreement, the performance requirement is defined as 100% of the OCCMHA-
funded share of total direct service hours.
III. Amendments and Adjustments to Allocations
A. A program can request an amendment at any time up to the OCCMHA
amendment deadline of August 15, 2015,
B. A budget amendment with revised budget pages is required when there is a
change in a budget category over $2,000 or 15% of the category whichever constitutes the
greater amount. The deviation allowance does not authorize new categories or line items
within the category.
C. Request for Amendment Form (Attachment D-1) must be completed and approved by
OCCMHA before requested changes can be implemented.
1
1. In order to move 15% or $2,000 (whichever is greater) from one budget category to
another, it is necessary to complete the Request for Amendment Form, including a
detailed explanation of the changes, updated billing summary and billing pages —
(fax or email to Cyndi King at 248.975.9768, lcingc@occmha.org or by mail to her
attention at 2011 Executive Hills Blvd., Auburn Hills, MI 48326. For questions call
248.758.1977.
You will receive a determination of approval, disapproval or pending status along
with comments if further direction is required within 10 business days.
IV. Data and Reporting
A. Prevention contractors must provide evidence-based prevention services (as defined in the
Research-based Prevention Protocol of their proposal.)
B. A Prevention Management by Objectives (Attachment C-1, 2) describing specific
measurable objectives and number of outputs for each is submitted as part of the contract
and will be reviewed for compliance during the contract year.
C. All OCCMHA-funded program grantees are required to participate in the collection of
state-required prevention data elements by utilizing the Michigan Prevention Data System
(MPDS) (http://mocis.sminds.com ), a web-based system- including but not limited to:
• the number of direct hours (defined as face to face or output hours);
• the collection of strategies employed (Information Dissemination, Education,
Community-Based, Environmental, or Alternative);
• population code
9 service population, type and domain
• service population demographics
• evidence-based practice
9 funding source.
Outputs delivered during the invoiced month must be entered_ into the Michigan Data
Prevention System (MPDS) by the 10 th of the month following the service month for on-
time reimbursement.
D. Reimbursements will be based on the understanding that a certain level of performance as
defined by the Prevention Management by Objectives (MBO — Attachment C4, 2),
measured by outputs (face-to-face or direct service hours engaged with the service
population) must be met in order to receive full reimbursement of costs up to the
contracted amount at the end of the contract year.
E. OCCMHA grantees must submit a Mid-Year and End-of-Year Prevention Program Report
(Attachment D-2) that includes a narrative and tables with data and outcome evaluation
results for all programs/services - no later than 10 days following the end of the reporting
period (e-mail to altmank(@occinha.orp,.)
F. OCCMHA grantees must incorporate tobacco prevention activities into their
programming. A report of tobacco prevention activities is to be submitted biannually,
using the Tobacco Activity Report Form (Attachment D-3) no later than 10 days following
the end of Mid and End-of-Year reporting periods (e-mail to aitmank@occmha.org
2
G. All forms and reports must be submitted in electronic form. Failure to submit required
reports in a timely manner to OCCMFIA will result in withholding of payment for
services.
V. Staff Credentials and Requirements
A. During the period covered by this contract, the provider agency that directly employs or
contracts with the OCCMHA to provide prevention services is responsible for verifying
the on going certification status of the employee. This includes verification of the
credential(s), monitoring staff development plans, and compliance with continuing
education requirements.
B. As a condition of the contract, Prevention Professionals (commonly described as Program
or Prevention Coordinators, Prevention Specialist, or Consultants i.e., those responsible
for the planning, coordination and or oversight of program implementation) must be
certified by the Michigan Certification Board for Addiction Professional (MCBAP) as one
of the following:
• Certified Prevention Specialist M (CPS-M)
• Certified Prevention Specialist R (CPS-R)
• Certified Prevention Consultant M (CPC-M)
• Certified Prevention Consultant R (CPC-R)
• Certified Health Educator Specialist (CHES)
OR
• Must file a certification "Development Plan" with Michigan Certification Board
for Addiction Professionals (MCBAP) within 60 days of the contract start date.
Information on filing a Plan may be found at www.mcbap.com
• Failure to comply with credentialing requirement may result in termination of
contract.
C. All providers must conduct yearly criminal background checks on all employees (and
potential employees) employed in programs funded by the OCCMHA as a condition of
employment.
VI. Cultural Competency and a Trauma Informed Approach to Prevention
A. Providers must submit a cultural competency plan to the OCCMHA addressing the
following elements and be able to document same at their annual program review.
1. The program must identify and assess the cultural needs of potential and active
clients based on population served.
2. The program must identify how access to services is facilitated for persons with
diverse cultural backgrounds and Limited English Proficiency (LEP).
3. The program must identify standards for the recruitment and hiring of culturally
competent staff members.
4. The program must document cultural competency training for provider staff upon
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hire and bi-annually (every two years) thereafter for all staff.
5. The program must document staff training in a trauma-informed approach to
prevention. The training must include: an understanding of the critical nature of
trauma in the development of SUD, an understanding of the dimensions of
resiliency, building community capacity, and learning strategies to change
community conditions to support individuals, families and communities affected by
trauma/adverse experiences.
VII. Confidentiality
The provider will comply with all Federal requirements contained in 42 CFR, Part 2,
Confidentiality of Alcohol and Drug Abuse Patient Records, Final Rule, June 9, 1987, as well as
any information about alcohol and other drug use obtained by a "program" (42 CFR2.11),
(42CFR2.12b). Information may be disclosed in summary, statistical, or other form which does not
directly identify particular individuals.
VIII. Charitable Choice Policy and Procedure
A. The Federal Register (45 CFR part 96) contains federal Charitable Choice SAPT block
grant regulations that apply to prevention and treatment providers/programs. The
regulations require: (1) that the designation of religious (faith-based) organizations as such
be based on the organization's self-identification as religious (or faith-based) and (2) that a
program beneficiary receiving services from such an organization who objects to the
religious character of a program has a right to notice, referral and alternative services
which meet standards of timeliness, capacity, accessibility and equivalency — and ensuring
contact to this alternative provider.
B. The program is required to comply with all applicable requirements of the Charitable
Choice regulations. If the program identifies itself as a religious or faith based
organization it must provide the federally mandated model notice to all clients. Providers
who are Faith-based must notify participants of their right by providing the following
model notice:
"No provider of substance abuse services receiving Federal funds from
the U.S. Substance Abuse and Mental Health Services Administration,
including this organization, may discriminate against you on the basis of
religion, a religious belief, a refusal to hold a religious belief, or a refusal
to actively participate in a religious practice.
If you object to the religious character of this organization, Federal law
gives you the right to a referral to another provider of substance abuse
services. The referral, and your receipt of alternative services, must occur
within a reasonable period of time after you request them. The alternative
provider must be accessible to you and have the capacity to provide
substance abuse services. The services provided to you by the alternative
provider must be of a value not less than the value of the services you
would have received from this organization"
4
IX. Required Statement of Funding Sources and Statement of Recipient Rights
Prevention programs that maintain records that include both the recipient's name and information
regarding his or her substance use or abuse, shall provide the recipient with a summary of recipient
rights protected by state or federal laws and promulgated rules. Any program announcement,
brochure, or other written communication that describes the program's substance abuse prevention
services shall state the following:
"Recipients of substance abuse prevention services have rights protected by state and federal
laws and promulgated rules". For information contact the OCCMHA Substance Use Disorder
Services, Recipient Rights Coordinator, Sherrie Kilpatrick, 2011 Executive Hills Blvd.,
Auburn Hills, MI 48326 or call 248.858.1210
Providers must assure that any program reports, articles and publications that result from
information gathered through the use of state, federal or county funds acknowledge receipt of
that support from the OCCMHA and/or the appropriate federal agencies by use of the
following statement:
"Federal, State, and/or County funding has been provided through the Oakland County
Community Mental Health Authority- Substance Use Disorder Services to support the
project costs".
X. Programmatic and Financial Review
OCCMHA grantees are subject to an annual site review as well as annual scheduled program
review by the OCCMHA Clinical Analyst. The site review affords OCCMHA an opportunity to
experience the staff and program in action. The prouain review looks at compliance with
contractual requirements: progress toward meeting output and outcome goals, process and
outcome evaluation, certification and background cheeks on employees, timeliness and accuracy
of billing and reporting, etc.
Grantees are also subject to a complete financial review on a hi-annual basis by the OCCMHA
Fiscal Analyst. The objectives of the financial review are:
O To verify the reported expenditures have supporting documentation and were allowable
expenses;
6 To determine whether agency's internal controls are adequate to provide reasonable
assurance that funds are managed in compliance with applicable laws and regulations
and/or provisions of the contract;
• Confirm the budget was consistent with the contract budget;
O Review the agency's financial audit to determine if there were any significant audit
findings.
5
ATTACHMENT D-1
REQUEST FOR AMENDMENT
OAKLAND COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Substance Use Disorder Services
Agency:
Amending Budget: Date Requested: Requested by:
Purpose of Amendment:
Expenditures Current Budget Proposed Budget Increase/Decrease
Travel
Supplies/Materials
Contractual
Other
TOTAL EXPENDITURES
Source of Funds
Local Match
OCCMHA Funding
TOTAL FUNDING
El Approved
El Not Approved Pended:
Date
Comments:
Signature Date
ATTACHMENT D-2
Agency Name
OAKLAND COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Substance Use Disorder Services
Prevention Program Report
(Mid-Year/End of Year)
1::1 Mid-Year Due April 10, 2015
End of Year Due October 12, 2015
Note: the mid-year report should reflect activity from October thru March. The end-of-year report
should contain a summation of activity for the entire year. Simply type your responses beneath
each question.
1) Describe your service population for the reporting period. Indicate how successful you were
in recruiting your target population. It is not necessary to provide exact numbers...however,
please describe what risk categories you intended to target and if different from your original
plan- describe the actual population served. What impact did this change have on
program/service delivery or outcomes?
2) Refer to your MBO (Management By Objective) form and comment on any services
that were not provided as planned (explain either why you were not able to complete
the activity and/or why you did something different from the original plan.)
3) Describe your program's overall process evaluation method(s) and the results of
your evaluation. (In a process evaluation items commonly include recruitment
procedures and retention rate; number of participants; participants' risk for
substance use; staff processing of program activity; participant comments or results
of satisfaction surveys.) Describe any ways in which your process evaluation results
will be used to improve the program in the future,
4) Outcome Evaluation: Complete the Attached Outcome Tables for each
service/activity listed on your MBO Form, State your measurable indicator(s) and
provide supporting data to show if the outcome was achieved. Use as many tables
as you need to present results in an organized and logical manner (please number if
using multiple tables.) For activities/services that are implemented as series at
multiple locations - you may choose to state outcomes by grade, school, city, etc.
but you must include a table with an overall result for a particular program.
For Alliance of Coalition for Healthy Communities (AC HG) ONLY: In replacement of
the Outcome Tables the ACHC is required to submit an MPDS summary of activities
report at Mid-Year. The Final Report however, must also include a narrative
submission in addition to the MPDS Report in the form of an Annual Report.
5) Provide supporting documentation.
• Actual data used to calculate outcome results and a description of how the
results were determined
• Program flyers or letters used to recruit participants
• Outline or brief description of the program or curriculum
• A copy of evaluation instruments
• Letters of support or news articles generated by the program
Call or email Kathleen Altman at altmankOoccinha.om for assistance in
collecting, calculating, analyzing and reporting data.
OAKLAND COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Substance Use Disorder Services
Prevention Activities FY 2014/2015
Outcomes Table #Example
Program Name:— Group Designation
MBO
Activity # Target Population Indicator Statement Outcome Results
Sat/Unsat
CMH Use
Only (Example) (Example) (Example)
# Econ Hispanic parents who participate in the Love Auburn Hill Elem Group #1 (a) 15% A
Disadvantaged
middle school
students
or Arab-Chaldean
youth or
Hispanic parents
& Logic Program (3 hours per week fora
weeks) will experience (a) 7% increase in
positive parenting attitudes and interaction
with their children and (b) a 10% increase in
knowledge of positive parenting techniques
as measured by the Love & Logic Pre Post
(b) 12% A
Test that accompanies this model program.
Comments:
Please Note: for activities/services that are implemented in series at multiple locations — you may choose to state outcomes by grade,
school location, city, etc., but please also include a table with an overall result. Use as many tables as you deem necessary to report
results. Attach supporting data/spreadsheets to table or at end of report.
OAKLAND COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Substance Use Disorder Services
Prevention Activities FY 201412015
Outcomes Table #1
Program Name: Group Designation
MBO
Activity # Population Served Indicator Statement Outcome Results
Sat/Unsat
CMH Use
Only
Comments:
Please Note: for activities/services that are implemented in series at multiple locations — you may choose to state outcomes by grade,
school location, city, etc., but please also include a table with an overall result. Use as many tables as you deem necessary to report
results. Attach supporting data/spreadsheets to table or at end of report
OAKLAND COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Substance Use Disorder Services
Prevention Activities FY 201412015
Outcomes Table # 2
Program Name; Group Designation
MBO
Activity # Population Served Indicator Statement Outcome Results
Sat/Unsat
CMH Use
Only
Comments:
Please Note: for activities/services that are implemented in series at multiple locations — you may choose to state outcomes by grade, school location,
city, etc., but please also include a table with an overall result. Use as many tables as you deem necessary to report results. Attach supporting
data/spreadsheets to table or at end of report
ATTACHMENT D-3
OAKLAND COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Substance Use Disorder Services
PROGRAM
TOBACCO ACTIVITY REPORT FY 2014/2015
LI 6 Month LI Year End
Instructions: Please briefly describe any tobacco use prevention activities your group or organization has
undertaken in the past six-month reporting period in each of the following strategies-
Information Dissemination
Specific topic of information
Description of population distributed to
Estimated Outputs
Education
Type of format (class, series of classes, video, speaker, skills training, etc.)
Description of audience
Estimated outputs
Community-Based Activity (Describe activity: examples may include assessing community needs
regarding tobacco use; accessing services and funding for tobacco use prevention; providing trainings on
tobacco use prevention, etc.)
Estimated outputs
Environmental Strategies (Describe activity: examples include any activity undertaken to change
the physical, legal, economic, and social processes of a community that are associated with tobacco use,
i.e., establishing tobacco free policies, preventing underage sale of tobacco products to minors, vendor
education, changing codes, ordinances, or regulations regarding sale and use.)
Estimated outputs
ATTACHMENT E
OAKLAND COUNTY
COMMUNITY MENTAL HEALTH AUTHORITY
PACE SERVICE POLICIES
For
Access Management System
FY 2014 / 2015
OAKLAND COUNTY
COMMUNITY MENTAL HEALTH AUTHORITY
PACE SERVICE POLICIES
Table of Contents
Attachments
I. Policy statement
IL Eligibility Program
Requirements Program
IV. Service Eeligibility: Block Grant
V. Service Eligibility: Medicaid and Healthy Michigan Plan
VI. Clinical Eligibility: Block Grant, Medicaid and Healthy Michigan Plan
VII. Priorities for Admission into Treatment
VIII. Waitlist
IX, Interim Services
X. Access to Care: Medicaid
XI. Covered Services: Block Grant, Medicaid, Healthy Michigan Plan and MIChild
XII. Authorization: Block Grant, Medicaid and Healthy Michigan Plan
XIII. Length of Stay: Block Grant, Medicaid and Healthy Michigan Plan
XIV. Utilization Management
XV. Client Documentation and Record
XVI. Financial Requirements
XVII. Program Reviews
XVIII. Complaint/Grievance/Appeals Process
XIX. Persons Associated with the Corrections System
XX. Sanctions
ATTACHMENTS
E-1 DSM-V Diagnosis Codes
E-2 Medical Necessity Criteria
E-3 CareNet Initial Authorization Request
E-4 CareNet Reauthorization Request
E-5 Billing Codes / Modifiers
E-6 Rights and Confidentiality
E-7 Plan of Action Reauthorization Request
E-8 Interagency Consent & Authorization to Release Protected Health Information
E-9 Client Responsibility Notice
E-10 Client Sliding Fee Schedule
E-11 Communicable Disease and Interim Services
E-12 CareNet SARF Form
E-13 Client Complaint/Grievance Procedure
E-14 Medicaid Fair Hearing Requirements
E-15 Trauma Informed System of Care Overview
Substance Use Disorder Treatment Services
I. POLICY STATEMENT
Oakland County through its Prior Authorization Central Evaluation (PACE) Unit is the provider
of access services for the purpose of this policy.
II. ELIGIBILITY: PROGRAM
A. The access services provider must be a legal entity with the ability to contract and must
follow all state/federal laws and regulations.
B. Services will be available Monday-Friday 8:30 am — 5:00 pm. An after-hours message
will direct callers to Common Ground Crisis Center or a medical emergency center if
immediate service is needed when the agency is closed. The Crisis Center will contact the
on-call PACE Treatment Service Supervisor based on the 24/7 Substance Use Access
Plan. The PACE will make available a toll free telephone number and will accept collect
calls for the purpose of this contract.
C. Screenings
PACE will perform specific services for clients eligible for OCCMHA funding. These
services shall include:
I. Determining funding eligibility based on finances, residency and insurance
coverage;
2. Identifying additional type(s) of funding individuals qualify for and Informing
clients of any copays associated with treatment services;
3. Performing clinical screening to determine service needs, level of treatment
needed based on American Society of Addiction Medicine (ASAM) Patient
Placement Criteria and medical necessity for services;
4. Providing linkage and referrals to the appropriate provider;
5. Conducting care management to ensure successful engagement with referrals and
follow up services;
6. Authorizing services as in accordance to OCCMHA policies.
III. REQUIREMENTS: PROGRAM
A. Cultural Competency Plan
PACE must have a written Cultural Competency Plan implemented in practice which
includes the following:
1. PACE must identify and assess the cultural needs of potential and active clients
based on population served.
1
2. PACE must identify how access to services is facilitated for persons with diverse
cultural backgrounds and Lirriited English Proficiency (LEP).
3. PACE must identify standards for the recruitment and hiring of culturally
competent staff members.
4. PACE must identify how ongoing staff training needs in cultural competency
will be assessed and met and the evidence that staff members receive training.
B. Charitable Choice Policy and Procedure
1. PACE is responsible for processing request for alternative services.
2. The Federal Register (45 CFR part 96) contains Federal Charitable Choice SAPT
block grant regulations that apply to prevention and treatment
providers/programs. The regulations require: (1) that the designation of religious
(faith-based) organizations as such be based on the organization's self-
identification as religious (or faith-based) and (2) that a program beneficiary
receiving services from such an organization who objects to the religious
character of a program has a right to notice, referral and alternative services
which meet standards of timeliness, capacity, accessibility and equivalency — and
ensuring contact to this alternative provider.
3. The Program identified by PACE is required to comply with all applicable
requirements of the Charitable Choice regulations. If the Program identifies itself
as a religious or faith based organization it must provide the federally mandated
model notice to all clients,
4. The model notice is:
"No provider of substance abuse services receiving Federal funds from
the U.S. Substance Abuse and Mental Health Services Administration,
including this organization, may discriminate against you on the basis of
religion, a religious belief, a refusal to hold a religious belief, or a refusal
to actively participate in a religious practice.
If you object to the religious character of this organization, Federal law
gives you the right to a referral to another provider for substance abuse
services. The referral, and your receipt of alternative services, must occur
within a reasonable period of time after you request them. The alternative
provider must be accessible to you and have the capacity to provide
substance abuse services. The services provided to you by the alternative
provider must be of a value not less than the value of the services you
would have received from this organization."
C. Limited English Proficiency Policy and Procedure
PACE must have a written Limited English Proficiency (LEP) policy and procedure that
is in compliance with related Federal and State requirements. The policies and procedures
must contain the following:
2
PACE must have a procedure for identifying and assessing the language needs of
the clients served.
PACE must have a range of oral language assistance options.
3. PACE must provide appropriate staff training and program monitoring related to
LEP policies and procedures.
4. PACE must have provisions for written materials in language other than English,
where a significant number of percentages of the affected population need
services or information in a language other than English to communicate
effectively.
5. PACE must have provisions for language interpreters who are trained and
competent.
6. PACE must provide documentation of timely assistance and explanation of "no
charge" to the LEP recipient for these services.
7. Provisions regarding the use of family members and/or friends as a language
interpreter must not be required. Should the client choose to use family or friends
as an interpreter, both the offering of other resources and the client's choice must
be documented in writing. Availability of client's family and friends as
translator/interpreter will not waive other LEP requirements herein described.
D. Communicable Diseases
OCCMHA is not involved with and does not financially support any needle exchange
programs in Oakland County.
1. PACE must screen all substance use clients entering treatment for HIV/AIDS,
Sexually Transmitted Disease (STD), TB, Hepatitis (Attachment E-J1).
2. PACE must refer all persons receiving substance use disorder services who are
infected with TB for medical evaluation using the OCCMHA/OCHD developed
resource list.
3. The Public Health Nurse will facilitate services with PACE staff.
4. PACE must provide information about resources, health education, risk reduction
activities and referrals for testing and treatment (with follow-up) to clients with
high-risk behaviors.
E. Welcoming/Engagement
1. PACE must have a written policy that describes how the agency will address
client engagement, no-shows, cancellations and Against Medical Advice (AMA).
2. PACE must have a written policy regarding welcoming.
3
3. The Treatment Program will notify the PACE Care Manager immediately of
clients who do not show for admission.
F. Recipient Rights
1. PACE agrees to strictly comply with all recipient rights provisions of the
Michigan Department of Public Health Center for Substance Abuse Service
Programs in Michigan Part 3, Recipient Rights (Rules 301-307).
2. PACE agrees to take all necessary steps to ensure that clients will be protected
from rights violations while they are receiving services under this contract and
will fully cooperate with any Prepaid Inpatient Health Plan (PHIP), State or
Federal agency's investigation into any alleged violation or suspected violation
of any client's Recipient Rights.
3. PACE will make readily available to all employees and clients, the following
information:
a. Recipient Rights shall be displayed in a public area of all licensed
programs that also indicates the names and phone numbers of the PIHP
Recipient Rights Consultant and the State Recipient Rights Coordinator.
b. Instructions on how to contact and/or access the OCCMHA Recipient
Rights Consultant.
c. Provide for unrestricted access to rights complaint forms and rights
booklets.
d. Provide a written or oral description of recipient rights for clients
receiving substance use services in a language that is understood by the
recipient.
e. Have readily available, all applicable State Policies including those set
forth in the Michigan Department of Public Health/Center for Substance
Abuse Services Administrative Rules for Substance Abuse Service
Programs in Michigan; Part 3, Recipient Rights (Rules 301-307).
f. Direct complaints to OCCMHA SLID Service Network Team
4. PACE will notify the Department of Human Services Protective Services
Division, as required by law, regarding any alleged or suspected abuse or neglect
of any client receiving services.
IV. SERVICE ELIGIBILITY: BLOCK GRANT
A. An individual with a substance use disorder as defined in P.A. 368, Public Acts of 1978,
and Section 6107(3) as amended.
Members of a person with a substance use disorder immediate family.
C. Significant others, which include those involved in a continuing primary relationship with
a person who has a substance use disorder whether or not they are legally related to that
4
D. Individuals who meet the criteria established in A, B, or C above must also meet the
income criteria established in the OCCMHA Reimbursement/Sliding Fee Schedule
(Attachment E-10).
E. Preference must be given to individuals who live in Oakland County. Should service
requests exceed the monthly prorated treatment slots, two wait lists should be maintained
to ensure provision of services to Oakland County residents prior to offering services to
residents from other jurisdictions.
V. SERVICE ELIGIBILITY: MEDICAID AND HEALTHY MICHIGAN PLAN
A. Medicaid, Healthy Michigan Plan and MIChild recipients who are eligible for OCCM_HA
Medicaid Prepaid Substance Use Services Plan are those Medicaid recipients who reside
within Oakland County.
B. Current Medicaid, Medicaid spend down, Healthy Michigan Plan and SDA eligibility and
residency must be confirmed using the 270/271 system on CareNet.
C. The following process must be followed for clients with Medicaid spend-down:
Outpatient Referrals (methadone, suboxone, 1OP, OP)
I. Clients are responsible for meeting their deductible each month.
2. Remind the client to submit their receipts to DYIS so their Medicaid will activate
once the deductible is met. All medical bills including prescriptions can be
counted towards the monthly deductible.
3. In the event the client is unable to meet their deductible and cannot cover
substance use treatment services, submit a Request for Income Category Fee
Waiver form to OCCMHA requesting block grant assistance for the client. The
client is responsible for all payments for services rendered. The provider cannot
bill block grant without the approval of the waiver form.
4. Authorizations must be submitted for the client in the event the deductible is met,
and Medicaid is billed for part of the month, or in the event a waiver is approved
and block grant dollars are used to assist the client.
5. PACE will explain this expectation to methadone and suboxone referred clients
before authorizing services.
5
Residential, Detox and DIOP Referrals:
1. All residential, detox and D1OP referrals are through the PACE office. If the
PACE refers a spend-down client then block grant funding, when needed, will be
authorized during the referral process.
2. PACE will attempt to verify the client's spend-down amount and place it in the
"Payor" screen under the notes section.
3. If PACE is unable to obtain the spend-down before placing the client in
treatment, the provider is responsible to obtain the amount before billing for
services. Without the spend-down amount OCCMHA cannot determine how
many days to approve under block grant funding. Lack of a documented spend
down amount will result in the billing being denied.
4. The client's first few days (until the deductible is met) should be billed under
block grant. Once the deductible is met and DHS activates the Medicaid, the
remaining services for the month should be billed under Medicaid.
5. Providers must submit a receipt to DHS showing the client met their deductible.
Make sure this process is done each month if the client is in treatment more than
one month.
6. .
Billing for the client's Medicaid cannot be completed until the Medicaid is
activated by DHS. Check the 270/271 system for updates to the client's status.
7. Providers may contact the PACE supervisor, if they are unable to obtain the
client's spend-down activated by DHS, or if the spend down amount cannot be
verified.
VI. CLINICAL ELIGIBILITY: BLOCK GRANT, MEDICAID AND HEALTHY MICHIGAN
PLAN
A. Clients must meet use or dependency criteria for one of the substance-related disorders
found in the DSM V Table (Attachment E-1).
B. All decisions concerning client care are based on clinical eligibility and medical necessity
criteria.
C. Decisions concerning client care include admission, level of care, continuation, discharge
and other decisions regarding scope, intensity, and duration of care. These decisions are
based on Medical Necessity Criteria (Attachment E-2). Medical necessity is defined as a
determination that a specific service is medically (clinically) appropriate, necessary to
meet a person's symptomatology and functional impairments, is the most cost-effective
option in the least restrictive environment and is consistent with clinical standards of
care.
VII. PRIORITIES FOR ADMISSION INTO TREATMENT
A. PACE will give preference for admission into treatment services to clients, regardless of
level of care, in the following order:
6
1. Pregnant Injecting Drug Users (1DUs);
2. Pregnant substance users;
3. 1DUs;
4. A parent or caregiver whose child has been removed from the home under the
Child Protection Laws of this state or is in danger of being removed from the
home under the Child Protection laws of this state because of the parent's
substance use;
5. All others.
B. OCCMHA requires that a screening tool be used to gather sufficient information to
determine if a person is a potential substance use disorder client, to establish the client's
eligibility for public dollars, to verify insurance status and to determine admission
priority status, i.e., injecting drug use (IDU) and pregnancy status.
C. Admission Timelines for Pregnant Women
1. Pregnant women must be admitted to the treatment program within 24-hours. If
the Program has a wait list the client must be referred to PACE. PACE will
attempt to locate a treatment program that can enroll the client immediately.
2. If a pregnant woman cannot be admitted within 24-hours into a program, the
client will be placed on the pregnant women wait list and PACE will provide
Interim Services within 48-hours.
3. No pregnant woman should be put on a wait list at the program level.
D. Admission Timelines for Injecting Drug Users (IDU)
1. Programs serving IDUs must maintain a wait list of each 1DU seeking treatment.
2. Programs must establish a mechanism for notifying clients on the wait list that a
treatment slot is available.
3. If a client cannot be located for admission to treatment after three (3) attempts or
if a person refuses treatment, he/she may be taken off the wait list (The wait list
should indicate the number of attempts and method for tiying to reach the client).
VIII. WAIT LIST
PACE will provide for Wait List Management of clients waiting for funded substance use
disorder treatment services. PACE will facilitate admissions to treatment services based
on federally mandated preferences for treatment Admission.
7
IX. INTERIM SERVICES
A. Programs and/or PACE will provide federally mandated Interim Services within 48-hours
to:
1. IDUs who cannot be admitted into treatment within 14-days.
2. Pregnant women who cannot be admitted into treatment immediately.
B. Interim Services minimally consist of the following:
Counseling and education about HIV and hepatitis
Completion of TB screening history
Risks of needle-sharing
Risks of transmission of H1V and other STDs to sexual partners and
infants
C. Steps that can be taken to ensure that HIV transmission does not occur
f. Referral for HIV and TB services if necessary
2. Pregnant Women
a. Services listed above
b. Counseling on effects of alcohol, tobacco and other drug use on the fetus
c. Referral for prenatal care
C. PACE will provide Interim Services for all eligible clients who are assessed. The
Program must refer all pregnant women and IDU clients who present at the Program and
cannot be admitted per above guidelines to the PACE for interim services.
D. OCCMHA provides funding for Women Specialty Services. PACE will refer clients that
meet Women Specialty Services criteria to providers identified in the OCCMHA
network.
X. ACCESS TO CARE: MEDICAID
A. Urgent: PREGNANT WOMEN (individual is determined to be at risk of experiencing an
emergent situation in the near future if care is not received).
I. Must be assessed within 24-hours of referral 95% of the time.
2. Admission to treatment must be within 24-hours of assessment 95% of the time.
3. Report on number of clients who make intake appointment and do not show.
4. Program must report its performance against these standards quarterly to the
OCCMHA.
B. Non urgent
1. Must be assessed within five calendar days 95% of the time.
8
2. Admission into treatment must be within seven calendar days 95% of the time.
3. Report on number of clients who make intake appointment and do not show.
4. Program must report its performance against these standards quarterly to
OCCMHA.
XI. COVERED SERVICES: BLOCK GRANT, MEDICAID, HEALTHY MICHIGAN PLAN
AND MICHILD
A. Covered Services:
Initial/Intake Assessment;
2. Outpatient (including individual, family and group);
3. Intensive Outpatient PRISM;
4. Intensive Outpatient with Domiciliary (NO M1Child);
5. Domicile Outpatient (NO MIChild);
6. Opiate Replacement Therapy including laboratory for Medicaid/Healthy
Michigan Plan (NO MIChild);
7. Sub-acute Detoxification;
8. Residential Services;
9, Pharmacy, Laboratory and Inpatient (MIChild ONLY).
B. Excluded Services:
. Emergency medical care;
2. Emergency transportation;
3. Routine transportation;
4. Substance use prevention and treatment which occurs routinely in the context of
providing primary health care;
5. Room and board;
6. Pharmacy;
7. Laboratory;
S. Acute Detoxification.
9
XII. AUTHORIZATION: BLOCK GRANT, MEDICAID AND HEALTHY MICHIGAN PLAN
A. Prior Authorization for Intensive Services
Services will be reimbursed according to CPT Codes (Attachment E5). Clients will need
prior authorization from PACE prior to admission to a residential (detox, short or long
term), domiciliary intensive outpatient program (DIOP), and Opiate Specific
programming. Programs must refer clients to PACE for screening. Authorizations are
valid for 30 days.
1. The OCCMHA requires that clients be provided individualized treatment to
include timely movement into varying levels of care. While OCCMHA
encourages the development of diversified treatment packages, it must be
emphasized that predetermined documented client need, will determine the
client's movement through various treatment modalities.
2. Decisions related to authorization for initial and continuing care are based on
medical necessity i.e., the service is clinically appropriate, necessary to meet a
person's symptomatology and functional impairments, is the most cost-effective
option in the least restrictive environment, and is consistent with clinical
standards of care.
3. Providers are required to fax a copy of the two-way release to PACE once the
client admits to treatment. PACE will not release information to the provider
until the two-way release is received.
4. Information from the Bio-psycho-social Assessment must be entered into
CareNet by the provider. An initial authorization must be submitted by the
provider and supported with clinical justification. Authorizations should be
requested based on the client's treatment plans.
5. Reauthorizations will be reviewed for clinical necessity. Approval for
reauthorizations will reviewed within 7 business days.
6. Program Admission
a. When the client is admitted, proof of Oakland County residency must be
presented to the provider. The client's identification and other documents
must be in the record. The following documents are acceptable:
• Picture ID
▪ Medicaid card/Department of Human Services
9 Utility bill
• Voter registration card
• Pay stub
• Letter from a family or friend confirming residency
10
b. The Provider will contact PACE if services are unable to be provided
upon admission. The PACE Care Manager will coordinate a transition
plan with the provider.
c. The provider may also contact the PACE Care Manager to assist with
continued care planning for clients who successfully complete the
program.
B. Authorization for Outpatient Services
I. PACE must complete a SARF form (Attachment E-12) on each client and submit
to OCCMHA via CareNet. The ASAM Patient Placement Criteria must be used
in decisions regarding admission, continued stay and discharge/transfer.
2. An individual session is fifty (50) minutes or more in length and one-half (1/2)
individual session is thirty (30) minutes in length. Frequency of individual
sessions must be determined by documented clinical need. A full session will, at
a minimum, be fifty (50) minutes of direct client contact. The additional ten (10)
minutes will be allocated for paperwork and/or transition between client
appointments for scheduled clients.
Programs must fax a copy of their H1PAA/42 CFR compliant two way Consent
for the Release of Confidential Alcohol and Drug Treatment Information form
for the Program, OCCMI-IA and PACE to communicate before initial
authorization will be released. Release should remain valid for thirty (30) days
post discharge from program.
4, The Program has ten (10) days following the date of admission to enter the
authorization request in CareNet and submit the two-way release to PACE. If the
release of information is received within ten (10) days the initial authorization
will be approved. If the release of information is received on day eleven (11) or
after, the initial authorization will be approved starting on the date that the faxed
release is received, not on the date of admission. The Program will not be able to
bill for services provided prior to the date the faxed release of information was
received at the OCCMHA.
5. All units of service (Medicaid, Healthy Michigan Plan, MIChild and Block
Grant) will require authorization. Each level of care will have its own
authorization number. Clients must be discharged from one level of care before
being admitted to another.
6. The Program must submit an INDIVIDUALIZED initial authorization request
on the CareNet Initial Authorization Request (Attachment E-3) using the
appropriate CPT Code (Attachment E-5).
7. PACE will review and authorize initial outpatient sessions based on clinical
necessity once the Consent for the Release of Confidential Alcohol and Drug
Treatment Information form is received. The initial approval for outpatient
services is for ninety (90) days. Any requests for additional sessions must include
clinical justification and a specific plan for treatment intervention. Initial
authorizations will be reviewed within seven (7) business days,
11
8. Outpatient programs may exchange one (1) authorized CPT unit for another.
Sessions will be entered under "individual" and it is expected that the clinician
will exchange them as needed based on the client's treatment plan.
9. Outpatient psychiatric evaluations and medication review units are not
exchangeable.
C. REAUTHORIZATION REQUIREMENTS
1. When requesting a reauthorization, therapists must use the CareNet
Reauthorization Request form (Attachment E-4) that clearly documents the
reasons continued treatment is necessary (ASAM Patient Placement Criteria),
specific goals and objectives on which the continued treatment will focus,
specific time frames for achievement of the goals, and the criteria to be met for
treatment termination.
2. The treatment plan on the Reauthorization Request form must match the Master
Treatment Plan and/or Treatment Plan Reviews from the client's record.
3. OCCMHA/PACE may request additional documentation, ,clarifications, or may
require a PACE assessment if there are clinical concerns. Requests that are
outside the guidelines without an explanation will not be approved.
4. Clients that demonstrate noncompliance with programming via ongoing positive
drug screens and/or nonparticipation in the treatment process; OR are not
demonstrating reasonable progress may not be authorized for further OCCMHA
funding,
5. Re-authorization requests will not be approved without an updated toxicology
report that includes the primary drug of choice.
6. Re-authorizations must be entered 10 days prior to the expiration of the
authorizations.
XIII. LENGTH OF STAY: BLOCK GRANT, MEDICAID AND HEALTHY MICHIGAN PLAN
A. Sub-acute Detoxification (prior authorization by PACE is required)
Detoxification services are defined as medically supervised care provided in a sub-acute
residential setting for the purpose of managing the effects of withdrawal from alcohol
and/or other drugs. A detoxification program must be staffed 24-hours per day, seven
days per week, by a licensed physician or by the designated representative of a licensed
physician. Detox services typically last three to five days. When detoxification cannot be
completed within that time, the Medical Director must determine if acute detox is needed
in a hospital setting. Medicaid and Healthy Michigan Plan recipients must be admitted
within seven (7) days of PACE referral.
B. Residential - Short Term (prior authorization by PACE is required)
12
Short-term residential care is defined as planned individual and/or group therapeutic and
rehabilitative counseling and didactics provided as an intense, organized, daily treatment
regimen in a residential setting which includes an overnight stay. These programs have a
trained treatment staff supervised by a professional who is responsible for the quality of
clinical care. The provider room and board facility shall maintain a daily census log to
document use of the facility by eligible clients. Medicaid and Healthy Michigan Plan
recipients must be admitted within seven (7) days of PACE referral.
C. Residential Long Term (prior authorization by PACE is required)
Long-term residential care is defined as a professionally supervised program that includes
planned individual and/or group therapeutic and rehabilitative counseling, didactics, peer
therapy, and rehabilitative care. These services are provided in a residential setting and
include an overnight stay. The provider room and board facility shall maintain a daily
census log to document use of the facility by eligible clients.
D. Intensive Outpatient (prior authorization by PACE is required)
Services are provided over a specified time period as determined by program design,
clients' needs and individualized treatment plan. Didactic, group, and individual therapy
in combination with the individualized treatment needs of the client are provided.
Aftercare planning and referral services are provided. A minimum of one (1) individual
session per week must be provided during the intensive outpatient program.
E. Intensive Outpatient with Domiciliary (DIOP) (prior authorization by PACE is required)
1. The initial authorization and subsequent reauthorizations will be based on
medical and clinical necessity. DIOP programming should be a minimum of
three (3) clinical contact hours per day, up to seven (7) days per week and
should include at least one (1) individual contact weekly as part of the
programming.
F. Outpatient (including Opioid Treatment Programs)
Outpatient programming should range from very frequent to infrequent based on medical
and clinical necessity, client need, and client motivation and should be individualized
based on where the client is at during the course of treatment.
1. More than one group session may be offered in a week, but no more than one
session per day unless there has been prior authorization. Group therapy may
be up to ninety (90) minutes in length.
2. An individual session is fifty (50) minutes or more in length and one-half
individual session is thirty (30) minutes in length. Frequency of individual
sessions must be determined by documented clinical need. A full session will, at
a minimum, be fifty (50) minutes of direct client contact. The additional ten (10)
minutes will be allocated for paperwork and/or transition between client
appointments for scheduled clients.
S. The Program can provide and bill for up to two different service codes in one
day. Any additional services will need prior approval from OCCMHA/PACE.
13
G. Methadone (prior authorization by PACE is required)
New admissions will require an appointment at PACE.
1. A client under the age of eighteen (18) is required to have had at least two (2) documented unsuccessful attempts (to be determined by PACE) at drug-free
treatment within a twelve (12) month period to be eligible for maintenance
treatment.
2. Clients must provide current copies of all prescription labels and/or receipts and
they must be included in the client record.
3. The initial authorization for methadone dosing will be up to three (3) months.
4. Re-authorizations for methadone dosing may be up to three (3) months based on
medical necessity, unless the client is on a Plan of Action,
5. Re-authorization requests for methadone dosing will be determined using the
following criteria:
a. The client has a clinical diagnosis of Opiate Dependency.
b. The client is demonstrating progress on the Goals and Objectives
established in the Master Treatment Plan (MTP).
c. The client is actively participating in the treatment programming as
demonstrated by attendance, therapist report and active involvement in
treatment planning.
d. The client is submitting clean drug screens for alcohol and all illicit
substances.
e. The clinic physician is in support of the clients continued treatment with
methadone.
6. Clients not meeting criterion will be placed on a formal Plan of Action by the
provider. (Attachment E-7)
7. The following process for the initial Plan of Action must be utilized:
a. The therapist and or physician are responsible for initiating a plan of
action.
b. The PACE Care Manager may initiate a plan of action.
c. The therapist and client must have a written plan which will be included
in the reauthorization request.
d. The plan will remain in the client's record at the program.
e. The Plan of Action must provide clear and concise objectives related to
the identified problem areas and identify the interventions the client and
therapist will use to address them.
f. A signed release of information to all physicians prescribing medications
should be included with the Plan of Action if the client agrees.
g. The Plan of Action will be valid for a maximum of thirty (30) days.
14
8. The Plan of Action will be reviewed for compliance every thirty (30) days, for a
minimum of sixty (60) days, to ensure compliance with the plan. A client must
demonstrate complete compliance with the plan in order to resume normal re-
authorization procedures.
9. If the client fails to submit a Plan of Action or fails to comply with his/her Plan
of Action, funding for treatment will be discontinued. The OCCMHA will send
the client a forty-five day Notice of Discontinuation of Funding letter that will
formally notify the agency and client of our intent to discontinue funding due to
non-compliance. This will allow for a safe detoxification or alternate treatment
options.
10. Authorization for methadone dosing beyond two years will be based on medical
necessity and client compliance with and completion of clinical treatment plan
goals and objectives.
H. Medical Maintenance Only Criteria
The following criteria will be used for clients who may have reached the maximum
therapeutic benefit from treatment services.
1. Client who has remained in continuous treatment for at least two (2) years.
2. Client has demonstrated abstinence from illicit substances and from use of
prescription drugs for a period of at least six (6) months.
3. No reported or demonstrated use of alcohol (ETOH).
4. Ability to maintain stability in their current living arrangement.
5. Stable and legal source of income.
6. Involvement in productive activities as defined in the client's individual
treatment plan.
7. No criminal or legal involvement in the past year.
8. Adequate social support system.
9. Absence of significant or unstable co-occurring disorders.
Authorization Guidelines:
1. Ninety (90) days dosing.
2. One fifteen (15) minute physician contact every sixty (60) days.
3. One sixty (60) minute individual session every sixty (60) days.
4. Treatment Plan Review must be conducted every sixty (60) days.
15
5. If additional sessions are needed a reauthorization request supporting clinical
necessity must be submitted.
XIV. UTILIZATION MANAGEMENT
Utilization Management (UM) is a set of administrative functions that pertain to the assurance of
appropriate clinical service delivery. Through the application of written policies and procedures, UM is
designed to ensure: 1) that only eligible beneficiaries receive plan benefits; 2) that all eligible
beneficiaries receive all medically necessary plan benefits required to meet their needs; and 3) that
beneficiaries are linked to other services when necessary.
UM consists of the following components:
A. Access and Eligibility Determination - This functional component includes both
screening for clinical eligibility and financial eligibility determination. Activities include:
1) development of access and eligibility policy and procedures; 2) initial contact with
potential consumers (when not reported as an encounter); 3) initial screening (when not
reported as an encounter); 4) collection of consumer-specific information; 5) verification
of funding sources including determination of public funding status and first and third
part liability; and 6) service referral, setting up first appointment if determined eligible.
B. 1LIM Protocols - This component is the development and monitoring of clinical and
authorization protocols to be used for determining level of care (LOC) and service
selection process. This includes protocols for: I) determination of Medical Necessity, 2)
LOC assessments; 3) service intensity or selection criteria; 4) Continuing Stay review;
and 5) services requiring specialist review, best practice guidelines.
C. Utilization Review (TJR) - It should be noted that there may be overlap between UM and
UR. This component provides review/monitoring of individual consumer records,
specific provider practices and system trends. Review of activities of the provider
network is included. It may include: 1) review and monitoring to determine appropriate
application of guidelines and criteria (LOC, service selection, authorization, best
practice); 2) consumer outcomes; 3) over-utilization or under -utilization; 4) review of
outliers; 5) development of procedures for system-level data review; 6) policy and
procedures regarding use of review documents; and 7) documentation and monitoring of
UM/UR activities.
XV. CLIENT DOCUMENTATION AND RECORD
A. A Consent and Authorization to Release of Information form must be signed by the client
(Attachment E-8) with an expiration of no less than thirty (30) days after discharge.
B. Verification of current address must be obtained at admission (i.e., driver's license, state
ID, utility bill, etc.).
C. PACE may require the client to sign Client Responsibility Notice (Attachment E9).
1. If a client has a medical condition that may impact their substance use disorder
treatment and/or treatment plan, there should be evidence of coordination of care with the physician.
16
The Medicaid assigned physician should be identified on the form. The client
may indicate communication is not authorized.
3. If a client does not have a primary care physician PACE must refer to a Federally
Qualified Health Clinic.
D. There must be evidence that PACE checked Medicaid/Healthy Michigan Plan eligibility
via the 270/271 system on CareNet.
E. Medicaid and Healthy Michigan Plan clients have access to the Fair Hearing Process.
(Attachment E-14) Information regarding the Fair Hearing Process must be presented at
time of admission, with signed documentation in the client record.
XVI. FINANCIAL REQUIREMENTS
A. Sliding Fee Scale
1. PACE will at minimum, utilize the sliding fee scale implemented by OCCMHA.
(Attachment E-10)
2. The sliding fee scale must be applied to all persons receiving Block Grant funds,
3. If a person's income falls within the sliding fee scale, clinical need must be
determined through the standard assessment and ASAM criteria.
4. If a financially and clinically eligible person has third party insurance that
insurance must be utilized to its full extent.
5. If those benefits are exhausted or the person needs services not covered by the
third party insurance or if the co-pay or deductible amount is greater than the
person's ability to pay, Block Grant funds may be utilized.
B. Co-Pays
1. PACE will assess and determine the co-pays for detoxification, short-term
residential, DIOP and long-term residential. PACE Care Managers will
communicate the determined co-pay at the time of the referral. Co-pays should
be distributed throughout the duration of their initial authorization. If the client
leaves treatment early, the client will forfeit their entire co-pay to the Provider.
XVII. PROGRAM REVIEWS
A. PACE will be reviewed at least annually to ensure compliance with contact requirements.
XVIII. COMPLAINT/GRIEVANCE/APPEALS PROCESS
A. Clients wishing to express an opinion about care or service provided or to present an
issue with a request for remedy may contact the OCCMHA with either an oral or
written complaint/grievance. The procedure is documented in (Attachment E-13).
17
B. Medicaid, MI Child, and Healthy Michigan Plan clients have access to the Fair Hearing
Process. Information regarding the Fair Hearing Process must be presented at time of the
screening, with signed documentation in the client record. The procedure is documented
in (Attachment E-14).
XIX. PERSONS ASSOCIATED WITH THE CORRECTIONS SYSTEM
A. When the OCCMI-IA or its PACE receives referrals from the Michigan Department of
Corrections (MDOC), PACE shall handle such referrals as per all applicable
requirements in this agreement. This would include determining financial and clinical
eligibility, authorizing care as appropriate, applying admissions preferences, and other
steps. MDOC referrals may come from probation or parole agents, or from MDOC
Central Office staff.
B. In situations where persons have been referred from MDOC and are under their
supervision, state-administered funds should be used as the payment of last resort.
C. When persons who are on parole or probation seek treatment on a voluntary basis from
the OCCMTIA, PACE or from a panel provider, these self-referrals must be handled like
any other self-referral to the MDCH-funded network. PACE or provider staff may seek to
obtain releases to communicate with a person's probation or parole agent but in no
instance may this be demanded as a condition for admission or continued stay.
D. The OCCMHA may collaborate with MDOC, and with the Office of Community
Alternatives (OCA) within MDOC, on the purchase of substance use disorders services
and supports. This may include collaborative purchasing from the same providers, and for
the same clients. In such situations, OCCMTIA must assure that:
1. All collaborative purchasing is supported by written agreements among the
participants.
2. Rates paid to providers, whether by a single purchaser or two or more purchasers,
do not exceed provider costs.
3. Rates paid to providers are documented and are developed consistent with
applicable OMB Circular
4. No duplication of payment occurs.
XX. SANCTIONS
Non-compliance with contract requirements may result in the following sanctions:
A. Additional reviews from OCCMHA.
B. Probation/Corrective Action Plan.
18
FISCAL NOTE (MISC. #14217) September 18, 2014
BY: FINANCE COMMITTEE, TOM MIDDLETON, CHAIRPERSON
IN RE: DEPARTMENT OF HEALTH AND HUMAN SERVICES/HEALTH DIVISION - AMENDMENT #5
AND #6 TO THE INTERLOCAL AGREEMENT BETWEEN THE COUNTY OF OAKLAND AND THE
OAKLAND COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above-referenced
resolution and finds:
1. The resolution approves Amendment #5 and Amendment #6 to the Interlocal Agreement
between the County of Oakland and Oakland County Community Mental Health Authority
(OCCMHA).
2. Public Act 500 of 2012 amended Public Act 258 of 1974, MCL 330.1287(5), and changed
the designated substance abuse coordinating agency from the Oakland County Health &
Human Services Department (DHHS)/Health Division to the OCCMHA.
3. The funding and services amend the initial FY 2010 Inter-Governmental contract
(approved per MR #10236) with an allocation of $851,835 for PACE Services, $204,463
for Health Education Services, and $49,960 to provide a Substance Abuse Prevention
Coordinator for a total of $1,106,258 in funding for this agreement.
4. Future level of services is contingent upon level of funding for this program.
5. The FY 2015, FY 2016 and FY 2017 Special Revenue budgets are amended as follows:
OSAS ADULT BENEFIT WAIVER (Fund 28227)
Budget Reference 2014 / GR0000000272
FY2015 — FY2017
Amendment
Revenues:
1060261-134790-610313 Federal Operating Grants
1060261-134790-615571 State Operating Grants
Total Revenues
Expenditures:
1060261-134800-702010 Salaries
1060261-134800-722740 Fringe Benefits
1060261-134800-730366 Contract Administration
1060261-134800-730926 Indirect Costs
Total Expenditures
($ 61,302)
( 30,193)
($ 91,495)
($ 46,850)
( 29,963)
( 7,659)
( 7,023)
($ 91,495)
CMH OSAS MEDICAID (Fund 28565)
Budget Reference 2014 / GR0000000208
FY2015 — FY2017
Amendment
Revenues:
1060261-134790-610313 Federal Operating Grants
1060261-134790-615571 State Operating Grants
Total Revenues
Expenditures:
1060261-134800-702010 Salaries
1060261-134800-722740 Fringe Benefits
1060261-134800-730366 Contract Administration
1060261-134800-730926 Indirect Costs
Total Expenditures
FINANCE COMMITTEE VOTE:
Motion carried unanimously on a roll call vote with Matis absent.
($551,712)
( 271,738)
($823,450)
($421,646)
( 269,665)
( 68,934)
( 63,205)
($823,450)
($259,612)
( 53,174)
204,463
49,960
851 835
$793,472
($225,034)
( 30,837)
( 1,776)
( 6,057)
( 4,622)
101,980
70,542
15,287
3,673
450
5,000
1,327
300
400
1,500
600
2,500
904
5,203)
10,733
780)
350
400
468,496
299,628
70,228
467
500
100
1,500
1,133
1,200
300
1,850
6,433
$793,472
(
(
HEALTH MDPH OSAS (Fund 28249)
Budget Reference 2014 / GR0000000203
FY2015 — FY2017
Amendment
Revenues:
1060261-134790-610313 Federal Operating Grants
1060261-134790-615571 State Operating Grants
1060261-134795-610313 Federal Operating Grants
1060261-134796-610313 Federal Operating Grants
1060261-134800-610313 Federal Operating Grants
Total Revenues
Expenditures:
1060261-133405-730373 Contracted Services
1060261-133960-702010 Salaries
1060261-133960-722740 Fringe Benefits
1060261-133960-730366 Contract Administration
1060261-133960-730926 Indirect Costs
1060261-134795-702010 Salaries
1060261-134795-722740 Fringe Benefits
1060261-134795-730926 Indirect Costs
1060261-134795-731346 Personal Mileage
1060261-134795-731213 Membership Dues
1060261-134795-731388 Printing
1060261-1 34795-7320 18 Travel and Conference
1060261-134795-750245 Incentives
1060261-134795-750294 Materials and Supplies
1060261-134795-750392 Metered Postage
1060261-134795-750399 Office Supplies
1060261-134795-750567 Training-Educational Supplies
1060261-134795-770631 Bldg Space Cost Allocation
1060261-134796-702010 Salaries
1060261-134796-722740 Fringe Benefits
1060261-134796-730926 Indirect Costs
1060261-134796-732018 Travel and Conference
1060261-134796-731346 Personal Mileage
1060261-134800-702010 Salaries
1060261-134800-722740 Fringe Benefits
1060261-134800-730926 Indirect Costs
1060261-134800-731346 Personal Mileage
1060261-134800-731388 Printing
1060261-134800-731997 Client Transportation
1060261-134800-732018 Travel and Conference
1060261-134800-750392 Metered Postage
1060261-134800-750567 Training-Educational Supplies
1060261-134800-774637 info Tech Managed Print Svcs
1060261-134800-774677 Insurance Fund
1060261-134800-778575 Telephone Communications
Total Expenditures
Resolution #14217 September 18, 2014
Moved by Spisz supported by Woodward the resolutions (with fiscal notes attached) on the amended
Consent Agenda be adopted (with accompanying reports being accepted).
AYES: Dwyer, Gershenson, Gingell, Gosselin, Hoffman, Jackson, Long, Matis, McGillivray,
Middleton, Runestad, Scott, Spisz, Taub, Weipert, Woodward, Zack, Bosnic, Crawford. (19)
NAYS: None. (0)
A sufficient majority having voted in favor, the resolutions (with fiscal notes attached) on the amended
Consent Agenda were adopted (with accompanying reports being accepted).
, HEREBY APPROVE TH1 RESOLUTION
CHIEF DEPUTY COUNTY EXECUTIVE
ACTING PURSUANT TO MCL 45.569A (7)
STATE OF MICHIGAN)
COUNTY OF OAKLAND)
I, Lisa Brown, Clerk of the County of Oakland, do hereby certify that the foregoing resolution is a true and
accurate copy of a resolution adopted by the Oakland County Board of Commissioners on September 18,
2014, with the original record thereof now remaining in my office.
In Testimony Whereof, I have hereunto set my hand and affixed the seal of the County of Oakland at
Pontiac, Michigan this 18th day of September 2014.
4/5414,
Lisa Brown, Oakland County