Division of Mental Health and Addiction Services Office of Care Management March 14, 2013.

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Presentation transcript:

Division of Mental Health and Addiction Services Office of Care Management March 14, 2013

What is SBIRT? Implemented in February 2013, the NJ Screening, Brief Intervention and Referral to Treatment (SBIRT) Project is a federal SAMHSA-funded initiative to expand the existing addiction services continuum of care by making evidence-based risk identification and early intervention services available to reduce substance use and its associated negative health consequences.

What is SBIRT? The NJ SBIRT Project is a partnership between DMHAS and the Henry J. Austin Federally Qualified Health Center (HJA), serving the greater Trenton area. The HJA will implement SBIRT services in a total of five project sites located throughout the city of Trenton. SBIRT services will be fully integrated into existing primary care services at each of the five project sites, affording universal screening for substance use risk for all adult patients seeking medical care. All five of the HJA NJ SBIRT Project sites will serve as treatment referral sources for those patients identified as needing substance use assessment and/or treatment services

Who can provide specialty treatment to SBIRT consumers? Participating NJ SBIRT Specialty Treatment Network providers must be licensed to provide services in Mercer County by the Department of Human Services, Office of Licensure, under the Standards for Licensure of Outpatient Substance Abuse Treatment Facilities at NJAC 10:161 B, and agree to cooperate with the monitoring requirements of DMHAS, including site visits, on-site review of case files, review of billing/fiscal records, and interviews of staff and consumers to ensure compliance with initiative- specific procedures.

Who can provide specialty treatment to SBIRT consumers? Agencies licensed to provide outpatient and intensive outpatient services in Mercer County by the Department of Human Services, Office of Licensure, under the Standards for Licensure of Outpatient Substance Abuse Treatment Facilities at NJAC 10:161 B that are currently contracted with the DMHAS Fee-For-Service network are eligible to apply for enrollment in the NJ SBIRT Specialty Treatment Network Fee-For-Service Initiative at this time. Licensed agencies that are not currently contracted with the DMHAS Fee-For-Service network will be eligible to apply for enrollment during the next DMHAS open enrollment period in the Spring of 2013.

SBIRT Specialty Treatment Network Provider Requirements In addition to the General Service Requirements stated in the DMHAS Standard FFS Network Annex A, the NJ SBIRT Specialty Treatment Network providers shall comply with the following NJ SBIRT specific requirements: All participating treatment providers shall be affiliated with the Henry J. Austin Health Center (HJA) through which they agree to accept referral of NJ SBIRT consumers from all of the five NJ SBIRT project sites located in the city of Trenton. A signed, dated copy of the written affiliation agreement must be on file at the DMHAS, Office of Care Management. At a minimum, the affiliation agreement must include the specialty treatment provider agency’s policy and procedures for accepting a “warm handoff” from the NJ SBIRT project sites.

SBIRT Specialty Treatment Network Provider Affiliation Agreement Requirements All participating treatment providers must develop policy & procedures for accepting a “warm handoff” from NJ SBIRT project sites, including: call receiving, intake appointment scheduling, completion of NJSAMS DASIE+ and LOCI, and documentation of referral status in NJSAMS Assurance that authorizations for services under the SBIRT Specialty Treatment Network will occur when no other payer is available Guaranteed acceptance that payment for services authorized under the SBIRT Specialty Treatment Network is payment in full Identification of primary contact for liaison with HJA NJ SBIRT project staff Verification of DHS licensure status as a substance abuse treatment facility

SBIRT Specialty Treatment Network Provider Requirements All participating treatment providers shall offer NJ SBIRT referred consumers: income and program eligibility determinations; assessments; appropriate ASAM levels of outpatient care; and enhancement packages to include clinical review services and co-occurring services. It is recommended that participating treatment providers schedule initial appointments within 2 business days of the NJ SBIRT referral.

SBIRT Specialty Treatment Network Provider Requirements The participating treatment provider shall document the disposition of all NJ SBIRT referred consumers in NJSAMs to facilitate follow-up and coordination of care by HJA, including: Consumers who do not attend scheduled assessment appointments; Consumers who are assessed and admitted to treatment at the participating treatment provider agency; and Consumers who are assessed and require a level of care not available at the participating provider agency.

SBIRT Specialty Treatment Network Provider Requirements To be eligible for the NJ SBIRT Initiative, consumers must: Be referred from one of the five NJ SBIRT Project sites in the city of Trenton operated by HJA Be 18 years of age or older Meet ASAM criteria for Level I or Level II.1 outpatient care

SBIRT Specialty Treatment Network Provider Requirements Federal funding for treatment services provided to NJ SBIRT Project consumers may be accessed as the payer of last resort. Participating treatment providers must document the income and program eligibility status of all HJA-referred NJ SBIRT consumers using the NJSAMS DASIE Plus module. Authorization or payment for services should be obtained from other payers when another payer is available. NJ SBIRT Specialty Treatment Network providers may only request authorization for services provided to eligible consumers through the NJ SBIRT FFS Initiative when no other payer is available. Payment for services authorized through the NJ SBIRT Initiative shall be accepted as payment in full. Participating treatment providers shall participate in meetings/trainings as requested by DMHAS.

Applying to enroll in the SBIRT Specialty Treatment Network Currently contracted FFS agencies that wish to apply for enrollment should prepare to submit the following application documents for each site which the agency is seeking to enroll in the SBIRT Initiative by 4:00 pm on Thursday, March 28: Updated Annex A 1, Annex A2 noting application for SBIRT enrollment and available levels of care at each site CRIS report summary for each site Agency NJ SBIRT Specialty Treatment Network Fee For Service Initiative Provider Affiliation Agreement with Henry J. Austin Health Center

Applying to enroll in the SBIRT Specialty Treatment Network send the completed application to: Overnight Delivery New Jersey Division of Mental Health & Addiction Services 222 South Warren Street- 3rd floor Trenton, NJ Attention: Nancy Hopkins Postal Delivery New Jersey Division of Mental Health & Addiction Services P.O. Box 700 (note change in PO Box !!) Trenton, NJ Attention: Nancy Hopkins

Applying to enroll in the SBIRT Specialty Treatment Network Applications received by the application deadline will be reviewed by a committee of DMHAS for completeness and fulfillment of contract application requirements. Agencies will be notified of the status of their application and admission to the SBIRT Specialty Treatment Network upon completion of the review process.