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Community Mental Health for Central Michigan
Provider Network Manual
Table of Contents
INTRODUCTION
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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
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CHAPTER 1 – BOARD STRUCTURE AND ORGANIZATION
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SECTION 100 – GENERAL STRUCTURE AND ORGANIZATION
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001 Mission, Vision, and Values
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SECTION 200 – GENERAL MANAGEMENT STRUCTURE AND ORGANIZATION
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001 Agency Management Structure - Guideline
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CHAPTER 2 – SERVICES ADMINISTRATION
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SECTION 100 – CONCERNS, COMPLAINTS, DISPUTES, GRIEVANCES, AND APPEALS
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001 Overview
002 Recipient Dispute Resolution and Grievance Systems
003 Requests for Second Opinions
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SECTION 200 – BEHAVIOR SERVICES
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001 Behavior Treatment
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SECTION 300 – DIRECT SERVICES
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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 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
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SECTION 400 – UTILIZATION MANAGEMENT
001A Service Authorization Process - Guideline
001 Services Administration
SECTION 500 – PHARMACEUTICAL PRACTICES
001 Pharmaceutical Practices
001C Look Alike - Sound Alike Drugs - Guideline
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CHAPTER 3 – PROVIDER NETWORK MANAGEMENT
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SECTION 100 – PROVIDER NETWORK DEVELOPMENT
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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
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SECTION 200 – PROCUREMENT OF SERVICES
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001 Application
Provider Network Application
002 Requests for Proposals/Quotes
004 Residential Provider Enrollments - Guideline
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SECTION 300 – CONTRACTOR QUALIFICATIONS
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001 Clinical Credentialing and Privileging
Clinical Privileges Application
002 Credentialing of Organizations
003 Training Reciprocity Guideline
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SECTION 400 – CONTRACT MANAGEMENT
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001 Negotiation and Execution of Contracts
003 Claims Processing
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SECTION 500 – MONITORING AND PROFILING
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001 General Guidelines
002 Provider Site Review
003 Event Verification
004 Ad Hoc Investigations Guideline
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2018 Site Review Tool
Safety - Health - Environment Annual Site Report
HCBS Residential Site Review
HCBS Non-Residential Site Review
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CHAPTER 4 – HUMAN RESOURCES
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Human Resource Practices
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CHAPTER 5 – GENERAL ADMINISTRATION/QUALITY MANAGEMENT/SAFETY, HEALTH & ENVIRONMENT
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SECTION 100 – GENERAL ADMINISTRATION
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005 Acronym/Abbreviation List - Guideline
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SECTION 300 – QUALITY MANAGEMENT
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002 Customer Services
004 Quality Assessment and Performance Improvement
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SECTION 600 – SAFETY, HEALTH & ENVIRONMENT
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001 Infection Control & Risk Reduction
001A Infection Control Plan
003 Tobacco-Free Environment
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CHAPTER 6 – This Chapter intentionally left blank
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CHAPTER 7 – RECIPIENT RIGHTS
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SECTION 100 – GENERAL ADMINISTRATION
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001 Establishment of Recipient Rights Office
002 Service Animals
003 Recipient Rights Advisory Committee
006 Recipient Rights, General Administration, General Rights
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SECTION 200 – REPORTING, REVIEWING AND INVESTIGATING
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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
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SECTION 300 – SAFEGUARDING THE RIGHTS OF RECIPIENTS
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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
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