SBIRT Specialty Treatment Provider Network

1
SBIRT Specialty Treatment Provider Network

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

2
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.

3
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

4
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 10161 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.

5
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 10161 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.

6
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 agencys policy and procedures for
  accepting a warm handoff from the NJ SBIRT
  project sites.

7
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

8
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.

9
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.

10
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

11
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.

12
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 400 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

13
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 08611
• Attention Nancy Hopkins
• Postal Delivery
• New Jersey Division of Mental Health Addiction
  Services
• P.O. Box 700 (note change in PO Box !!)
• Trenton, NJ 08625-0700
• Attention Nancy Hopkins

14
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.