Notices and Letters



AOD & MH Provider Deadline August 1, 2014 InSyst Data Input Deadline 080414 Out-of-County Provider Deadline July 11, 2014 (Providers who do not enter their own InSyst Data) InSyst Data Input Deadline OOC 071114 BHCS ANNUAL ASSESSMENT: HOUSING/LIVING SITUATION AND CO-OCCURRING INFORMED PRACTICE The BHCS Annual Assessment: Housing/Living Situation and Co-Occurring Informed Practice is due no later than July 10th of each fiscal year. Below you will find the documents that explain which housing and co-occurring practices meet this contract requirement. FAQs about BHCS Annual Assessment Preview Copy: BHCS Annual Assessment FY (survey monkey) Housing/Living Situation Contract Expectations (one page) Co-Occurring Informed Practice Contract Expectations (one page) FY 13/14 Information Sessions Network Office Spring Provider Meetings FY14/15 FY14/15 Contract Renewal Season! These informational meetings will address the FY14/15 contracting process as well as upcoming changes to contracts. We strongly recommend that a program and fiscal representative from your organization attend. A flyer for each contracting unit (AOD & MH) is below. AOD FY14-15 Network Office Spring Provider Meeting Flyer_AOD AOD Agenda BHCS Network Spring Provider Mtg 2014 AOD Presentation Exhibit A Language Changes Summary-AOD MH FY14-15 Network Office Spring Provider Meeting Flyer_MH MH Agenda BHCS Network Spring Provider Mtg 2014 MH Presentation Exhibit A Language Changes Summary-MH Newsletter Network Office Newsletter 2014 Network Office Newsletter 2014 Insert FY 2014-15 CONTRACT RENEWAL DOCUMENTS FY 2014-15 Contract Renewal Packages will be emailed to Executive Directors and Chief Financial Officers of contracted community-based organizations in spring 2014. The Contract Renewal Packages contain specific instructions for completing FY 2014-15 Contract Renewal and customized documents that are specific to organizations/procurement contracts. For your information, BHCS is including a listing of standard documents and forms below. Please note that all provider input related to FY 2014-15 Contract Renewal is due as stated in the contract renewal email sent to you and must be returned to contracts@acbhcs.org, cc’ing both your Program and Fiscal Contract Manager. Standard Exhibit A Attachments MH General Provisions MH QA Addendum for Treatment Programs AOD General Provisions AOD Additional Provisions for Perinatal Programs HealthPAC Grievance and Appeal Process for primary care programs HealthPAC Quality Improvement Plan primary care programs Standard Exhibit B: Payment Terms and Conditions MH – Please check back soon for FY 14/15 updates MH Settlement Methodology Form AOD – PAYMENT PROVISIONS Standard Exhibit C: Insurance Requirements Exhibit C-2C: Insurance Requirements for For-Profit Health Care Services Exhibit C-4: Insurance Requirements for Non-Profit Health Care Services Exhibit C-13A: Insurance Requirements for Medical Services Providers Other Standard Forms and Exhibits Exhibit D: Audit Requirements Exhibit E: Business Associate Provisions (HIPAA) - Revised June 28, 2013 Exhibit F: Debarment and Suspension Certification Cash Advance Policy Cash Advance Form MH Provider Claim/Service Report Instructions CBO Signature Authorization Form FY 2013-14 COST REPORT DOCUMENTS FY 2012-13 Year-End Cost Reports for Master and S.A.N. Contracts Letter InSyst Data Input Deadlines for FY12/13: Providers with InSyst Access InSyst Data Input Deadlines for FY12/13: Providers without InSyst Access Spring Provider Meetings MH Network Office Spring Provider Meeting AOD Network Office Spring Provider Meeting Fall Provider Meeting BHCS Network Office Fall Provider Meeting Updating Contractor Contact Information The Network Office is pleased to announce that for FY 13-14, provider contact information will be collected electronically. We have established a secure online form that takes only a few minutes to complete. The content of this form is almost identical to the Contact Update Sheet previously used for FY 12-13; the additional item we are requesting is the required information about your organization’s Board of Directors. We ask that one person from each organization complete this form by visiting https://networkoffice.wufoo.com/forms/alameda-county-bhcs-annual-contact-update. A confirmation and a copy of the completed information will be sent your organization’s Executive Director’s email. If your organization’s Executive Director does not receive the confirmation email, please make sure to remove no-reply@wufoo.com from your junk/spam inbox. Moving forward, we hope to use more tools like this to improve the way we do business. Standard Exhibit A Attachments Additional Terms and Conditions of Program and Performance MH Contracts that include treatment programs MH Contracts that do not include treatment programs AOD Contracts MH Quality Assurance Addendum for contracts that include treatment programs that bill to Medi-Cal AOD Additional Provisions for Perinatal Programs HealthPAC Grievance and Appeal Process for primary care programs HealthPAC Quality Improvement Plan primary care programs Standard Exhibit B: Payment Terms and Conditions MH (non-School District) MH https://www.surveymonkey.com/s/ExBTermsComments - After reading the Exhibit B: Terms and Conditions of Payment, use this link to provide one response for your organization on the yellow-highlighted sections by noon on Monday, July 15, 2013. MH Settlement Methodology Form AOD Standard B-1 Budget Requirements and Instructions MH AOD Standard Exhibit C: Insurance Requirements Exhibit C-2C: Insurance Requirements for For-Profit Health Care Services Exhibit C-4: Insurance Requirements for Non-Profit Health Care Services Exhibit C-13A: Insurance Requirements for Medical Services Providers Please contact your Fiscal Contract Manager if you need to request a Waiver for Insurance Requirements Other Standard Forms and Exhibits Exhibit D: Audit Requirements Exhibit E: Business Associate Provisions (HIPAA) - Revised June 28, 2013 Summary of Changes to the Exhibit E – Read about the changes to the Exhibit E Exhibit F: Debarment and Suspension Certification Cash Advance Policy Cash Advance Form MH Provider Claim/Service Report Instructions CBO Signature Authorization Form NETWORK OFFICE CONTACT AND ASSIGNMENT INFORMATION Assigned Program and Fiscal Contract Managers by organization Network Office Organizational Chart Network Office Phone And Email List ORGANIZATIONAL AND/OR PROGRAM CHANGES BHCS is implementing new tools to better facilitate notification and request for program changes. Please see the process and standard forms below. Program and Provider Changes Process Provider/Program Change Notification Form – Use this for the process described as ‘A’ – changes that do not require BHCS approval Program Change Request Form - Use this for the process described as ‘B’ – changes that require prior BHCS approval PROGRAM SITE CERTIFICATION MH Medi-Cal Program Site Certification Protocol Template: This template was created by the State and adapted by BHCS. It is used to certify and re-certify mental health programs that bill to Medi-Cal. BHCS staff will provide you with a pre-filled certification protocol, applicable to your program, when certifying or re-certifying program sites. This protocol should be used to prepare for any certifications or re-certifications. Completing the Protocol: Updated! Use this how-to guide to prepare and successfully complete your program site’s mental health Medi-Cal program site certification MH Medi-Cal FAQs: New! Read this to find answers to your questions about mental health Medi-Cal certification! More information about AOD Site Certification Requirements: http://www.adp.state.ca.us/Licensing/certification.shtml OTHER NOTICES AND LETTERS Proposed New Master Contract Boilerplate – Note: This has not yet been adopted by the Board of Supervisors Network Office Newsletters Spring 2013 Spring 2012 Mental Health Plan Provider Network BHCS is seeking qualified individual practitioners and groups of individual providers/practitioners, such as licensed clinical social workers (LCSW), licensed marriage and family therapists (MFT) and licensed clinical psychologists (Ph.D./Psy.D.) to join Alameda County BHCS’ Mental Health Plan Provider Network. Mental Health Plan Provider Network Recruitment Letter - Updated September 24, 2013! BHCS is looking for bilingual providers in specific geographic areas! Mental Health Plan Provider Network Services to Hearing Impaired Clients Outreach - BHCS is looking for ASL providers to join the MHP Provider Network Mental Health Plan Provider Network FAQ's – Updated September 24, 2013! Mental Health Plan Provider Network Brief Application – Updated September 24, 2013! This is a Word version, which can be completed and emailed or faxed Provider Update Form – Use this form to update the BHCS units that co-manage the MHP Provider Network with your new information Voluntary Disenrollment Form – Use this form to voluntarily dis-enroll from the MHP Provider Network AB 109 Referrals Level One Provider Letter for AB109 Referrals Level Two Provider Letter for AB109 Referrals SUD Provider Letter for AB109 Referrals AB109 Client Intake and Progress Form