Policies
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
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
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 Admissions
008 Prevention Services
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
001 Services Administration (Utilization Management Policy)
SECTION 500 – PHARMACEUTICAL PRACTICES
001 Pharmaceutical Practices
001C Look Alike - Sound Alike Drugs - Guideline
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 (RFP)/Quotes (RFQ)
003 Enhanced Staffing and Rate - Guideline
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
002 Disqualified Individuals/Organizations
003 Notification of Contract Termination or Closure - Guideline
004 Claims Processing
SECTION 500 – MONITORING AND PROFILING
001 General Guidelines
002 Provider Site Review
003 Event Verification
004 Ad Hoc Investigations Guideline
Safety - Health - Environment Annual Site Report
HCBS Non-Residential Site Review
CHAPTER 4 – PERSONNEL ADMINISTRATION
SECTION 100 - GENERAL
006 Diversity, Equity, and Inclusion Policy
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
003 Tobacco-Free Environment
SECTION 700 – MANAGEMENT OF INFORMATION SYSTEMS
001 Agency Network, Software, Email, and Internet Form CMHCM-52
002 Data Security & Confidentiality
CHAPTER 6 – This Chapter intentionally left blank
CHAPTER 7 – RECIPIENT RIGHTS
SECTION 100 – GENERAL ADMINISTRATION
001 Establishment of a 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, Disclosure, and Consumer Record Requests
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