Annex A2 Initiative Specific - NJSAMS...Fee for Service (FFS) ANNEX A2 DMHAS Initiative Specific...

Division of Mental Health and Addiction Services (DMHAS) Fee for Service (FFS) ANNEX A2

DMHAS Initiative Specific Annex A2 – SFY 2017-2018 Page 1 Department of Human Services Division of Mental Health and Addiction Services Revised: March 2016 Posted: April 6, 2016 Effective: July 1, 2016

INITIATIVE-SPECIFIC ANNEX As

Initial the boxes below to identify the Initiatives for which your agency is renewing its contract.

Agency must meet eligibility and application requirements to qualify for Initiative participation. Only

those services initialed will signify the initiatives to be provided in this contract period.

Fee-for-Service Initiatives

Initial

Drug Court Network

Driving Under The Influence (DUII)

Mutual Agreement Program Department of Corrections (MAP DOC)

Mutual Agreement Program State Parole Board (MAP SPB)

Medication Assisted Treatment Initiative (MATI)

New Jersey Statewide Initiative (NJSI)

Substance Abuse Prevention & Treatment Initiative (SAPTI)

South Jersey Initiative (SJI)

I understand and agree to deliver services under these initiatives according to the contract Document

Annex A2. I have reviewed these contract requirements with our agency staff and affirm that our

agency policies and procedures support adherence to these requirements. I understand that our

agency will be monitored by DMHAS for adherence to these contract requirements.

Agency Name: ______________________________

Federal ID: _________________________________

Signature Date

Print Name

Title



DRUG COURT NETWORK

Drug Court Program Summary

Piloted in 1996 and implemented statewide in 2004, the mission of the Drug Courts (DC) is to stop

the abuse of alcohol and other drugs and related criminal activities. Drug Court programs are

rigorous, requiring intensive supervision based on frequent drug testing and court appearances, along

with tightly structured regimens of treatment and recovery services. This level of supervision permits

the program to actively support the recovery process and react swiftly to impose appropriate

therapeutic sanctions or to reinstate criminal proceedings when participants cannot comply with the

program. Approval to provide services to DC participants is predicated on an agency's ability and

agreement to adhere to the following:

Participating providers agree to cooperate with the monitoring requirements of DMHAS, the

Administrative Office of the Courts (AOC) and the vicinages of the New Jersey Superior Court

Drug Court Personnel, which includes site visits, on-site review of case files, billing/fiscal records

and interviews of staff and consumers to insure compliance with Drug Court procedures.

Contract Specific Requirements

In addition to the General Service Requirements stated in the Division of Mental Health and Addiction

Services (DMHAS) Standard FFS Network Annex A, the Drug Court contractee shall comply with the

following Drug Court specific requirements:

1. No paid or volunteer staff involved in the criminal justice system has authority over or access to

any Drug Court consumer’s confidential information including, but not limited to, clinical reports,

records and information disclosed in individual, group, family sessions or community meetings.

2. DMHAS and the referring Drug Court shall be notified in writing of consumers’ program admission

denials which includes referrals to a more suitable level of care.

3. All Drug Court primary counselors shall adhere to the Division of Consumer Affairs, State Board of

Marriage and Family Therapy Examiners Alcohol and Drug Counselor Committee regulations

regarding the practice of alcohol and drug counseling including the requirements for counselor

interns.

4. All Drug Court primary counselors and any clinical staff assigned to conduct substance use



evaluations shall receive training in ASAM and the completion and clinical justification of the LOCI.

Such training and staff competency in the area shall be evaluated annually and documented in the

staff’s personnel file.

5. All non-clinical staff who has contact with Drug Court consumers shall receive an orientation on

Drug Court mandates.

6. Staff attendance is required at court staffing sessions and consumer court appearances.

7. The contractee shall maintain a Drug Court referral waiting list for those individuals who cannot be

served immediately; the waiting list shall be maintained for all levels of care that the contractee is

approved to provide services.

a. The contractee shall ensure that referrals from Drug Court vicinages and subsequent

admissions shall be based upon the order received.

b. The contractee shall notify drug courts and document circumstances under which the

waiting list order is not adhered to for a particular participant: such general reasons shall

be made part of the waiting list policy.

c. The contractee shall provide to the Drug Courts the status of the waiting list on a

monthly basis.

8. The contractee shall complete monthly Drug Court reports for residential programs and weekly

Drug Court reports for non-residential programs in accordance with vicinage specific

requirements.

9. The contractee shall notify the referring Drug Court and DMHAS regarding consumer non-

adherence to treatment and Drug Court program requirements within 2 hours of any relevant

incident. If a consumer absconds, it must be reported immediately.

10. Discharge planning shall begin at admission and include consumer’s probation officer so that

housing and continued care needs can be addressed throughout the course of treatment.

11. The Contractee shall include agency name, contact number and e-mail on all correspondence

sent to the referring Drug Court and to DMHAS.



12. The contractee shall maintain in the consumer file documentation of case management efforts

in the acquisition of prescription insurance for individuals utilizing the reimbursable provision of

physical and psychotropic medication. Agencies are permitted to reimburse for 60 days of

psychotropic and physical medication per episode of treatment at the actual cost of

medication. This provision may be altered or revoked at the discretion of the Administrative

Office of the Courts (AOC) and the vicinages of the New Jersey Superior Court Drug Court

Personnel or the Division of Mental Health and Addiction Services. Requests for prescription

reimbursement are submitted to the Drug Court Initiative program manager.



DRIVING UNDER THE INFLUENCE INITIATIVE (DUII)

Driving Under the Influence Initiative (DUII) Program Summary

Implemented in November 2005, the Driving Under the Influence Initiative (DUII) supports treatment

services for individuals convicted of Driving Under the Influence who meet financial and program

eligibility as set by the Division of Mental Health and Addiction Services (DMHAS).


In addition to the General Service Requirements stated in the DMHAS FFS Standard Network

Agreement Annex A, the DUII contractee shall comply with the following DUII requirements:

1. Affiliation and network requirements:

a. All contractees shall be affiliated through the Affiliation Agreement Process as defined in

New Jersey Administrative Code 10:162 and New Jersey Statute 39:4-50 (NJ Statutes

annotated version as per State Law Library).

i. Outpatient Contractees shall be affiliated with the referring County Intoxicated

Driver Resource Center (IDRC).

ii. All DHS licensed residential programs will be affiliated with the DMHAS

Intoxicated Driving Program (IDP).

b. All affiliated contractees must be approved for EACH level of care and abide by 10:162.

2. Initiative eligibility guidelines:

a. Consumers shall have a DUI conviction on or after October 17, 2005.

b. Consumers shall be a resident of New Jersey.

c. Consumers shall have proof of income less than 350% of the Federal Poverty Level (FPL).



3. The contractee agrees to schedule the consumer for an intake/assessment within 30 days of

referral from the IDRC. If the consumer cannot be scheduled within 30 days, he/she will be

directed back to the referring IDRC in order that another assessment referral may be obtained.

DUII consumers should not be placed on a waiting list before an assessment can commence. All

documentation shall be reported in NJSAMS and connected via the IDRC reporting module.

4. The contractee shall ensure that all consumers will be randomly screened for alcohol and other

drug use. Results are to be documented in NJSAMS IDRC reporting module on a monthly basis.

5. The contractee shall utilize the NJSAMS, DSM-5 and LOCI and all other reporting requirements

of the NJSAMS IDRC reporting module in accordance with N.J.A.C. 10:162.

6. All DUII funded consumers must be connected to an IDRC/IDP for monitoring purposes. All DUII

funded consumers must have monthly reports completed in NJSAMS IDRC reporting module in

order to ensure IDRC/IDP monitoring.

7. The contractee shall meet agency criteria to participate in the co-occurring network and have

demonstrated readiness to provide integrated care for dually diagnosed consumer. New

contractees must submit a co-occurring application no later than 60 days following the execution

of their new FFS contract.

8. DUII FFS funding is considered payment in full for services rendered.



MUTUAL AGREEMENT PROGRAM – DEPARTMENT OF CORRECTIONS (MAP DOC)

Mutual Agreement Program Department of Corrections Program Summary

The Mutual Agreement Program (MAP) was implemented in 1984 as a cooperative effort between the

New Jersey State Parole Board (SPB), Department of Corrections (DOC) and the Department of

Human Services, Division of Mental Health and Addiction Services (DHS DMHAS). The goal of the

MAP program is to afford the opportunity of community based substance use treatment as a special

condition of parole for the NJDOC inmates who otherwise might not achieve parole status.

MAP DOC agencies are licensed residential fee-for-service substance use treatment programs

located throughout the state of New Jersey. These facilities provide a highly structured environment,

which introduces intensive therapy for behavioral and psychological problems related to addiction.



Services (DMHAS) Standard FFS Network Annex A, the Mutual Agreement Program Department of

Corrections (MAP DOC) network contractee shall comply with the following MAP DOC requirements:

1. No paid or volunteer staff actively involved in the criminal justice system can have authority

over or access to any MAP DOC consumer’s confidential information including but not limited

to, clinical reports, records and information disclosed in individual, group and family sessions

or community meetings.

2. Contractee shall identify and maintain at least one staff person to coordinate MAP DOC

services. This staff person shall act as a liaison with the DOC and DMHAS’ MAP Coordinator

regarding all MAP DOC issues and concerns.

3. In addition to DMHAS Licensure Standards regarding Reportable Events, MAP DOC network

contractee shall ensure that their facility’s policy and procedures manual include and adhere to

the following:



a. The manner by which immediate notification is made to DOC of any incidents which

require a parolee be discharged from the program and returned to the jurisdiction of the

Department of Corrections. Such incidents might include any disciplinary action that

requires the inmate be removed from the program, and should include how written

notification will be provided to the DOC as well as including a copy of the incident report

and discharge summary, as applicable.

b. Written notification will be provided to the DOC including a copy of the incident report

regarding problematic consumer behaviors in any instance where a DOC consumer is

found to be in possession of illegal substances or items (e.g., drugs, paraphernalia,

weapons, etc.).

c. Internal agency policy regarding inmate walkaways or escapes.

4. The contractee shall provide weekly MAP DOC consumer rosters electronically to DMHAS’

Criminal Justice Unit MAP Coordinator and DOC evaluator by close of business each Friday.

The agency must also submit a daily roster to the DOC evaluator by 7am following each

business day.

5. Contractee shall ensure bed availability for DOC referrals once admission confirmation is given

to DOC. Within 7 days of receiving a referral from DOC, contractee will provide written

confirmation to the Department of Corrections with a determination if a referral will be

accepted.

6. DMHAS MAP DOC network contractee shall assist consumers in obtaining prescribed

medications that are required beyond the two week supply provided by prisons at time of

release.

7. Contractee shall participate in meetings/trainings as requested by DMHAS.



MUTUAL AGREEMENT PROGRAM – STATE PAROLE BOARD (MAP SPB)

Mutual Agreement Program State Parole Board Program Summary

The Mutual Agreement Program (MAP) was implemented in 1984 as a cooperative effort between the

New Jersey State Parole Board (SPB), Department of Corrections (DOC) and the Department of

Human Services, Division of Mental Health and Addiction Services (DHS DMHAS). The goal of the

MAP program is to provide the opportunity for substance use disorder treatment to SPB parolees as

required under special conditions of parole, for the purpose of reducing the likelihood of returning

back to criminal behavior.

MAP SPB agencies are licensed substance use treatment programs located throughout the state of

New Jersey. These facilities provide a highly structured environment that provides intensive therapy

for behavioral and psychological problems related to addiction.



Services (DMHAS) Standard FFS Network Annex A, the Mutual Agreement Program State Parole

Board (MAP SPB) contractee shall comply with the following MAP SPB requirements:

1. No paid or volunteer staff involved in the criminal justice system can have authority over or

access to any SPB consumer’s confidential information but not limited to, clinical reports,

records and information disclosed in individual, group and family sessions or community

meetings.

2. Contractee shall identify and maintain at least one staff person to coordinate MAP SPB

services. This staff person shall act as a liaison with SPB and DMHAS’ Criminal Justice Unit’s

MAP Coordinator regarding MAP SPB issues.

3. In addition to DMHAS Licensure Standards regarding Reportable Events, MAP SPB

Network contractee shall ensure that their facility’s policy and procedures manual

include and adhere to the following:



a. The components of the September 26, 2013 New Jersey State Parole Board

memorandum regarding the Abscond Reporting Procedures. Such incidents might

include a parolee absconding or any disciplinary action that requires the parolee to be

removed from the program.

b. How problematic consumer behaviors will be reported to SPB in any instance where an

SPB consumer is found to be in possession of illegal substances or items (e.g., drugs,

paraphernalia, weapons, etc.) or when removal of a parolee from the program is

required.

4. For Residential Programs only: Provide electronic rosters to the

DMHAS’ Criminal Justice Unit MAP Coordinator and SPB Coordinator by close of

business each Friday. Contractee will provide written electronic notification on all parolee

program arrivals as well a program discharges.

5. Within 7 days of receiving a referral from SPB, contractee will provide written confirmation to

the SPB whether the referral will be accepted.

6. Prescription Reimbursement: The contractee shall maintain in the consumer file

documentation of case management efforts in the acquisition of prescription insurance for

individuals utilizing the reimbursable provision of psychotropic medication. Contractee is

permitted to obtain reimbursement for 60 days of psychotropic medication per episode of

treatment at the actual cost of medication. This provision may be altered or revoked at the

discretion of the State Parole Board and the Division of Mental Health and Addiction Services.

Requests for prescription reimbursement are submitted to the MAP SPB program manager.

7. Contractee shall participate in meetings/trainings as requested by DMHAS.



MEDICATION ASSISTED TREATMENT INITIATIVE (MATI)

Medication Assisted Treatment Initiative Program Summary

Through funding legislated through the Bloodborne Disease Harm Reduction Act, the Division of

Mental Health and Addiction Services (DMHAS) has developed the Medication Assisted Treatment

Initiative (MATI). This initiative funds medication assisted treatment for indigent New Jersey residents

with an opiate addiction, while also offering outreach, office-based services and case management,

as well as the opportunity for supportive housing, sub-acute enhanced medically managed

detoxification, authorizations for other treatment services, and an evaluation of the project.

In order for consumers to attain services through the MATI, individuals must meet requirements set-

forth in both the MATI Eligibility Criteria and DMHAS Income Eligibility Policy. If a consumer requires

another level of care or support service not provided via the mobile unit or office-based program, the

consumer may be eligible for an authorization through the MATI FFS Network, which would enable a

consumer to receive services through one of the MATI Network Providers.



Services (DMHAS) Standard FFS Network Annex A, the Medication Assisted Treatment Initiative

(MATI) contractee shall comply with the following MATI specific requirements:

1. The contractee will provide treatment services in accordance with the MATI service

descriptions and comply with all State regulations/mandates.

2. The contractee will accept MATI consumers within 24 hours or provide an appropriate referral.

3. The contractee will appoint appropriate staff to participate in monthly or bi-monthly consortium

meetings, as well as attend any meetings/trainings requested by DMHAS.

4. The contractee agrees to coordinate with case management services provided by the mobile

van/office-based services.

http://www.state.nj.us/humanservices/das/treatment/neti/DAS%20Income%20Eligibility%20Requirements%201-21-09.doc

http://www.state.nj.us/humanservices/das/feefor/forms/index.html



5. The contractee agrees to accept the physical exam completed at the mobile van/office-based

services to fulfill requirement for a physical exam at admission.

6. The contractee shall maintain policies and procedures to ensure non-discrimination towards

consumers who choose to utilize medication-assisted treatment to support their recovery.

7. The contractee shall adhere to all prior authorization procedures established by DMHAS.



contractees must submit a co-occurring application no later than 60 days following the

execution of their new FFS contract.



NEW JERSEY STATEWIDE INITIATIVE (NJSI)

New Jersey Statewide Initiative Program Summary

The NJSI, a new FFS initiative as of July 1, 2016, has been developed to convert slot-based

contracts to FFS. This initiative funds ambulatory and residential levels of care including Outpatient,

Intensive Outpatient, Short Term Residential, Halfway House, and Long Term Residential and

enhancement services. Eligible consumers are New Jersey Residents who are up to 350% of the FPL

and have been determined to be in need of SUD treatment in the levels of care offered in this

initiative, Upon implementation of the NJSI , the Provider network is comprised of those providers that

held a slot based contract through DMHAS for ambulatory or residential substance use disorder

treatment prior to June 30 2016.



Services (DMHAS) Standard FFS Network Annex A, the New Jersey Statewide Initiative (NJSI)

contractee shall comply with the following specific requirements:

1. The contractee shall provide SUD treatment services to adult consumers residing in New

Jersey who meet program and fiscal eligibility criteria as follows:

a. 18 years of age or older;

b. resident of New Jersey;

c. at 350% or below the Federal Poverty Level (FPL) as determined by the NJSAMS DASIE;

d. assessed to be in need of substance use disorder treatment in the LOCs offered in this

initiative;

e. No other third-party commercial or public insurance/payer for available services;

2. The contractee shall ensure all services provided shall be documented in the consumer’s file

including, but not limited to:

a. Referral(s) for other services;

b. Case management and related activities.

3. The contractee must comply with; develop policy and procedures relevant to; and ensure new

and existing staff receive up-to-date training regarding the Federal confidentiality regulations

as detailed in 42 CFR Part 2 and Federal HIPAA requirements as detailed in 45 CFR Part 160;



4. The contractee must provide priority admission to pregnant women who seek or are referred to

treatment contingent upon the identified needs of the consumer;

5. For contractees that serve a population that includes injecting drug users, the program must

give preference to treatment as follows:

a. Pregnant, injecting;

b. Pregnant;

c. Injecting;

d. Other.

6. The contractee shall participate in meetings, trainings, community events, and other activities

as requested by DMHAS, to support adherence to program accountability and integrity, to

promote awareness of services available under this and other resources, and to improve

coordination of efforts among other service providers.

7. Contractee agrees to cooperate with all monitoring activities conducted by DMHAS, including

site visits, on-site review of case files, review of billing/fiscal records, interview of staff and

consumers, and data collection and reporting activities as necessary to ensure compliance

with program accountability requirements.

8. Contractees who have voluntarily forfeited their license for the level of care identified for slot-

funding prior to July 1, 2016, or have been subject to enforcement in the form of: reduction of

license, issuance of provisional license, suspension of license, or revocation of license, shall

no longer be eligible for participation in this initiative.

9. The contractee is required to participate in the co-occurring network and provide integrated care

for dually diagnosed consumers. New contractees must submit a co-occurring application no

later than 60 days following the execution of their SFY 2017-2018 FFS contract.

10. Substance use disorder services funded through NJSI must be prior authorized by the Interim

Management Entity.



SUBSTANCE ABUSE PREVENTION AND TREATMENT INITIATIVE (SAPTI)

OPIOID REPLACEMENT THERAPY – METHADONE TREATMENT

Substance Abuse Prevention and Treatment Initiative Program Summary As of July 1, 2016 the contracted methadone outpatient, intensive outpatient and residential services reimbursed by Substance Abuse Prevention and Treatment (SAPT) Block Grant (BG) funds transition to Fee for Service. Methadone is a synthetic opioid used medically as an analgesic, and as an anti-addictive medication for use in consumers who meet criteria for opioid dependence. Methadone, used for maintenance and/or detoxification is a medication that is provided in combination with substance abuse counseling in a licensed substance abuse treatment facility that is; accredited by a recognized accreditation body, approved by SAMHSA, complies with all rules enforced by the Drug Enforcement Administration (DEA) and is licensed by the New Jersey Department of Human Services, Office of Licensing.

Contract Specific Requirements:


Services (DMHAS) Standard FFS Network Agreement Annex A, the Substance Abuse Prevention

and Treatment Initiative network contractee shall comply with the following requirements:

I. Providers will maintain capacity information in the IME Service Capacity Management System

(SCMS). Intravenous Drug Users (IVDUs) are a priority population. As required by Federal

Block Grant, providers must supply information that allows the IME and state to effectively

manage capacity and assure access. Providers must alert the State and IME when any

agency is at ninety (90) percent of their overall capacity.

II. Consumer Eligibility

The consumer meets specifications as indicated in 42 CFR 8.12 (e).

The consumer meets specifications as indicated in the NJ Standards for Licensure of Outpatient Substance Abuse Treatment Facilities, Subchapter 11 for Opioid Treatment Services

If admitted for ambulatory detoxification, per subchapter 11, consumer must meets ASAM criteria for levels 2WM

III. Provider Eligibility

A. Participating SAPT initiative Network providers must be licensed by the NJ

Department of Human Services, Office of Licensure, be a registered non-profit

agency, have the ability to provide Opioid Treatment Services under the

Standards for Licensure of Outpatient Substance Abuse Treatment Facilities at



NJAC 10:161 B, and agree to cooperate with all monitoring activities conducted

by DMHAS, including site visits, on-site review of case files, review of billing/fiscal

records, interview of staff and consumers, and data collection and reporting

activities as necessary to ensure compliance with DMHAS and FBG program

accountability requirements.

B. The contractee shall establish and adhere to take-home medication policies

which are consistent with State and the Drug and Enforcement Administration

(DEA) regulations.

C. The contractee providing methadone treatment shall maintain on-site, and make

available upon request, an electronic daily log which permits the identification of

consumers by Phase, length of time in Phase, form of medication and dosing,

and urine drug screen results.

D. Guest Emergency Medication System (GEMS)

1. The contractee shall ensure full participation in the GEMS. The

GEMS forms are available at:

https://njsams.rutgers.edu/gemsmain/Login.aspx

E. Continuity of Operations Plan (COOP)

1. The contractee shall ensure that written policies for disaster

planning, contingency planning and response shall address all

hazards and be communicated to staff in annual trainings with

updates as needed.

2. The agency shall have an Affiliation Agreement with providers to

ensure interim service providers, when needed.

3. Agencies will submit their agency Continuity of Operations Plans (COOP) to the IME COOP email address at [email protected]

4. If COOP activation includes the provision of take-home medication, agency Medical Director is responsible to ensure that a “blanket” emergency request is submitted via the SAMHSA Extranet System (as per Federal and State Regulations)

5. An agency will call the DHS Reportable Events number, (609) 292-5760, ONLY in the event of a reportable event.

IV. Clinical Services:

1. The contractee shall ensure that consumers have been educated about the Phase system

of methadone maintenance and what they must do in order to progress through the

Phases. This shall be documented in the consumer’s file.

2. The contractee shall ensure that their outpatient methadone maintenance program(s)

assign each consumer to one of the following Phases and provide counseling to the

consumer in accordance with the following schedule:

https://njsams.rutgers.edu/gemsmain/Login.aspx

mailto:[email protected]



Phase I. At least one counseling session per week with at least one individual

session per month, for a total of four sessions per month.

Phase II. At least one counseling session every two weeks with at least one individual

session, for a total of two sessions per month.

Phase III. At least one individual counseling session per month.

Phase IV. At least one individual counseling session every three months.

Phase V. Consumers who have had twenty-four consecutive months of negative drug

screens and meet other program criteria for treatment progress shall receive counseling

services at a frequency determined by the multidisciplinary team and program policy.

Phase VI. Consumers who have had thirty-six consecutive months of negative drug

screens and meet other program criteria for treatment progress shall receive counseling

services consistent with their clinical needs and the documented recommendations of

the multidisciplinary team.

Phase I-A. Consumers in Phase I, for a period of at least twelve (12) months, who have

failed to progress in treatment despite documented efforts by the program to intensify

treatment services and where referral to supplemental treatment services or a

residential program is not available, may be retained in treatment at a lesser level of

service designated as Phase I-A in accordance with the following:

The program can document a multidisciplinary team case conference that

determines a substantial identifiable benefit exists to the consumer and/or the

general public that supports retaining the consumer in treatment despite the

consumer’s continued lack of progress in treatment;

The program’s decision to retain a consumer in Phase I-A shall be based on a

benefit to the consumer and/or general public which is documented in the

consumer record and supported in writing by the counselor, director of

substance abuse counseling, director of nursing services and medical

director; and

Written documentation of alternative treatment (i.e., IOP, residential,

hospitalization, etc.) options explored by the program shall be included, along

with reasons why these options are inappropriate (i.e., not available in area,

etc.).

Consumers designated as Phase I-A shall receive at least two (2)

counseling sessions per month, including one (1) individual counseling



session, and shall receive at least one monthly drug screening; and

The multidisciplinary team shall review and document the status of

consumers designated in Phase I-A on a quarterly basis.

Phase I-A consumer who refuse treatment services:

All Phase I consumers shall be maintained on a therapeutic dose of

methadone for a minimum of one year.

All clinical interventions to engage consumer into treatment shall be

documented in the consumer’s file.

If, after a minimum of one year on a therapeutic dose of methadone, the

consumer does not make any progress in treatment, despite repeated

attempts to engage the consumer into treatment, the multidisciplinary team

may recommend that the consumer be detoxed from methadone.

3. Minimums Billing Requirements

Phase I- Four (4) encounters within an identified week, with evidence of documented outreach, if not meeting ambulatory licensure regulations. A full individual counseling session will count as two (2) encounters. If consumer receives an exception for take home medication during this Phase, it shall not effect payment to agency if clearly documented in consumer chart.

Phase II- Minimum of two (2) encounters within an identified week, with evidence of documented outreach, if not meeting ambulatory licensure regulations. A full individual counseling session will count as two (2) encounters. If consumer receives an exception for take home medication during this Phase, it shall not effect payment to agency if clearly documented in consumer’s chart.

Phase III- Minimum of one (1) encounter within an identified week, with evidence of documented outreach, if not meeting ambulatory licensure regulations. If consumer receives an exception for take home medication during this Phase, it shall not effect payment to agency if clearly documented in consumer’s chart.

Phase IV, V and VI- All monthly requirements as detailed in ambulatory regulations are met.

An encounter includes any of the services included in the bundle (medication monitoring, medication and dispensing, and counseling services) with the exception of case management.

Medication and dispensing includes take home bottles.



4. Co-occurring Disorders.

a. The contractee shall admit and medicate all consumers (classified in Quadrants I ,

II, III and IV by the National Association of State Mental Health Program Directors

and The National Association of State Alcohol and Drug Abuse Directors

(NASMHPD/NASADAD) with co-occurring mental health and substance

abuse/dependence disorders.

b. The contractee shall admit and provide counseling services for methadone

maintenance consumers classified in Quadrants I and III, with co-occurring mental

health and substance abuse/dependence disorders, and/or who meet the agency’s

admissions criteria.

c. The contractee shall ensure the referral of a consumer for psychiatric assessment,

differential diagnosis, and/or assessment/prescription for, and monitoring of

medication, shall be clearly documented in the consumer’s treatment plan.

d. The contractee shall ensure that all methadone maintenance consumers classified in

Quadrants II and IV, with co-occurring mental health and substance

abuse/dependence disorders are referred to and receive at a minimum the following

services: i. Consumers shall be referred to an appropriate mental health agency for

counseling services and medication monitoring other than methadone.

ii. The contractee shall work collectively with the mental health facility to ensure

participation in the consumer’s treatment plan

V. Policies and Procedures:

A. The contractee shall establish and adhere to take-home medication policies which are

consistent with State and the Drug and Enforcement Administration (DEA) regulations.

B. The contractee providing methadone treatment shall maintain on-site, and make available

upon request, an electronic daily log which permits the identification of consumers by Phase,

length of time in Phase, form of medication and dosing, and urine drug screen results.

C. In accordance with Federal Block Grant requirements, the contractee shall establish a waiting

list management program providing for the systematic reporting of treatment demand which

ensures that all IVDA consumers who request and are in need of treatment for IVDA are

admitted to a program not later than:



a. 14 days after making the request for admission to such a program; or

b. 120 days after the date of a request when no program has the capacity to admit the

individual on the date of the original request.

c. Consumers shall be provided and/or referred to interim services immediately.

d. Pregnant women shall receive immediate services.

D. The contractee shall provide priority treatment to the following in this order: pregnant injecting

drug users, pregnant drug users, injecting drug users.

E. The contract shall ensure that pregnant injecting drug users and pregnant drug users receive

immediate on demand services.

F. The contractee shall have policies for providing interim services. The policy shall include a list

of available services, the frequency of service availability and any associated consumer fee

schedule. At minimum, interim services shall include:

Counseling

Education about HIV, tuberculosis and Hepatitis C

The risks of needle-sharing

The risks of HIV and Hepatitis C transmission to sexual partners and infants

Steps that can be taken to ensure that HIV and Hepatitis C transmission does not occur

Referral/testing for HIV, tuberculosis and Hepatitis C treatment services.

G. The contractee shall have policies and procedures in place to ensure the provision of

treatment for priority populations.

H. The contractee shall have a policy regarding the assessment, treatment and/or referral of

consumers with co-occurring disorders (classified in Quadrants I thru IV,

(NASMHPD/NASADAD).

I. The contractee shall ensure that written policies for disaster planning, contingency planning

and response shall address all hazards and be communicated to staff in annual trainings with

updates as needed.

J. The contractee shall conduct criminal background checks for all staff, volunteers, interns and

any other personnel routinely scheduled to work in the agency. This shall be in accordance

with the agency policies and procedures, and in accordance with DMHAS Licensure.

Documentation of this should be maintained in the staff’s personnel file. The contractee may

use DMHAS funds for this effort. The contractee shall submit a listing of these costs with the

final expenditure report for this contract.



SOUTH JERSEY INITIATIVE (SJI)

South Jersey Initiative Program Summary

Funded by DMHAS, the SJI began in 2001 to serve residents age 13-24 of Atlantic, Burlington, Cape

May, Camden, Cumberland, Gloucester, Ocean and Salem Counties. The program was initially

created to serve adolescent and young adults in the aforementioned counties until a residential

treatment facility could be built. The project evolved to a full continuum of care for residents of eight

southern counties between the ages of 13-24. On January 1, 2014 the initiative ceased serving the

13-17.99 year old population and is now solely dedicated to serving the 18-24 young adult population

in the eight southern counties.



Services (DMHAS) Standard FFS Network Annex A, the South Jersey Initiative (SJI) contractee shall

comply with the following SJI specific requirements:

1. The contractee shall provide treatment services for young adults aged 18 to 24 years old from

Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester, Ocean and Salem

Counties.

2. The contractee shall complete appropriate assessments on each consumer specific to their

age group:

a. Addiction Severity Index (ASI) for ages 18 to 24

b. All consumers shall have an appropriate Level of Care Index (LOCI).

3. Urine Drug Screens:

a. SJI contractee shall ensure that all consumers will be screened weekly and randomly

for alcohol and other drug use.

b. SJI contractee shall ensure that young adults will be screened upon return from off

grounds visits.

c. SJI contractee shall ensure that young adults with positive urine drug screens shall

receive additional individual counseling, with the focus on addressing the circumstances

behind the positive urine drug screens.



d. SJI contractee shall ensure that the adults treatment plan must be reviewed by the

multidisciplinary team with the treatment plan revised documenting targeted

interventions.

4. Clinical Services:

a. The SJI contractee shall ensure that progress note entries include, but are not limited

to:

i. Referral(s) for other services

ii. case management related activities



contractees must submit a co-occurring application no later than 60 days following the

execution of their new FFS contract.

Date post:	26-Jun-2020
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