Crisis Hotline (800) 317-0708

Policies and Procedures/Provider Network Manual

I have become a better person... I am smiling more.
-Osceola County

Community Mental Health for Central Michigan

Provider Network Manual

Table of Contents


INTRODUCTION

CHAPTER 1  BOARD STRUCTURE AND ORGANIZATION
CHAPTER 2  SERVICES ADMINISTRATION
CHAPTER 3  PROVIDER NETWORK MANAGEMENT
CHAPTER 4  HUMAN RESOURCES
CHAPTER 5  GENERAL ADMINISTRATION, QUALITY MANAGEMENT, SAFETY / HEALTH ENVIRONMENT
CHAPTER 7  RECIPIENT RIGHTS


 

CHAPTER 1 – BOARD STRUCTURE AND ORGANIZATION

SECTION 100 – GENERAL STRUCTURE AND ORGANIZATION

001   Mission, Vision, and Values

SECTION 200 – GENERAL MANAGEMENT STRUCTURE AND ORGANIZATION

001   Agency Management Structure - Guideline

 

back to top


 

CHAPTER 2 – SERVICES ADMINISTRATION

SECTION 100 – CONCERNS, COMPLAINTS, DISPUTES, GRIEVANCES, AND APPEALS

001    Overview
002    Recipient Dispute Resolution and Grievance Systems
003    Requests for Second Opinions

SECTION 200 – BEHAVIOR SERVICES

001    Behavior Treatment

SECTION 300 – DIRECT SERVICES

001    Crisis Services
002    Person-Centered Planning Process and Individual Plan of Service
002A Case Coordination/Primary Clinician - Guideline
003    Self-Determination
005    Access to Services
006    Service Delivery
007    Psychiatric Hospitalizations
008    Pharmaceutical Practices
008C Look Alike - Sound Alike Drugs - Guideline
009    Respite Services - Guideline
012    Cultural Competence and Limited English Proficiency
016    Service Planning and Documentation
019    Advance Planning for Urgent and Emergency Situations
023    Licensed Residential Placement Protocol
024    Duty to Warn 
033    Home and Community-Based Service Settings 
034    Competitive Integrated Employment Services

SECTION 400 – UTILIZATION MANAGEMENT

001A Service Authorization Process - Guideline
001    Services Administration

 

back to top


 

CHAPTER 3 – PROVIDER NETWORK MANAGEMENT

SECTION 100 – PROVIDER NETWORK DEVELOPMENT

001    Provider Network General Guidelines
002    Appeals
004    Provider Recognition
005    Corporate Compliance and Ethical Standards
          Contact Information for Suspected Compliance Violations
006    Out of Network Providers

SECTION 200 – PROCUREMENT OF SERVICES

001    Application
           Provider Network Application
002    Requests for Proposals/Quotes
004    Residential Provider Enrollments - Guideline

SECTION 300 – CONTRACTOR QUALIFICATIONS

001    Clinical Credentialing and Privileging
           Clinical Privileges Application
002    Credentialing of Organizations
003    Training Reciprocity Guideline

SECTION 400 – CONTRACT MANAGEMENT

001    Negotiation and Execution of Contracts
003    Claims Processing 

 

 

SECTION 500 – MONITORING AND PROFILING

001    General Guidelines
002    Provider Site Review
003    Event Verification
004    Ad Hoc Investigations Guideline

 

2018 Site Review Tool

Safety - Health - Environment Annual Site Report

HCBS Residential Site Review

HCBS Non-Residential Site Review

 

 

back to top


 

CHAPTER 4 – HUMAN RESOURCES

       Human Resource Practices

 

back to top


 

CHAPTER 5 – GENERAL ADMINISTRATION/QUALITY MANAGEMENT/SAFETY, HEALTH & ENVIRONMENT

SECTION 100 – GENERAL ADMINISTRATION

005    Acronym/Abbreviation List - Guideline

SECTION 300 – QUALITY MANAGEMENT

002    Customer Services
004    Quality Assessment and Performance Improvement

SECTION 600 – SAFETY, HEALTH & ENVIRONMENT

001    Infection Control & Risk Reduction
001A Infection Control Plan
003    Tobacco-Free Environment

SECTION 700 – MANAGEMENT OF INFORMATION SYSTEMS

001    Agency Network, Email, and Internet
002    Data Security & Confidentiality

 

back to top


 

CHAPTER 6 – This Chapter intentionally left blank

 

back to top


 

CHAPTER 7 – RECIPIENT RIGHTS

SECTION 100 – GENERAL ADMINISTRATION

001    Establishment of Recipient Rights Office
002    Service Animals
003    Recipient Rights Advisory Committee
006    Recipient Rights, General Administration, General Rights

SECTION 200 – REPORTING, REVIEWING AND INVESTIGATING

001    Appeals Process
003    Investigation of Complaints
004    Mediation of a Dispute
005    Monitoring Residential Homes and Unusual Incidents
006    Staff Training in Consumer Rights

SECTION 300 – SAFEGUARDING THE RIGHTS OF RECIPIENTS

001    Consent to Treatment
002    Suitable Services, Treatment Environment, Right to Second Opinion
003    Access to Services and Barriers to Treatment
004    Confidentiality and Disclosure
005    Communication, Mail, Telephone, Visits, Access to Media and Entertainment Materials
006    Electroconvulsive Therapy
007    Fingerprinting, Photographing, Audio and/or Video Recording, and Use of One-Way Glass
008    Freedom of Movement
009    Consumer Funds
010    Guardianship and Alternatives to Guardianship
011    Performance of Labor
012    Medical Services and Psychotropics
013    Personal Property
014    Recipient Abuse or Neglect
017    Rights for Minors
018    Restraint, Physical Management and Seclusion
019    Sterilization, Abortion and Contraception
020    Treatment by Spiritual Means

back to top


 

 

 

 

 
I have become a better person... I am smiling more.
-Osceola County
Back to Top ▲