Community Mental Health Center Certification

A provider is required to complete one CMHC application in the DMHA Provider Portal. CMHCs are required to complete an Addiction Service Provider-Regular certification for each location that is providing services under the CMHC umbrella. This is a requirement for providing the continuum of care. If SUD services are being contracted out to another entity, the CMHC should provide that contract in their application. Please note that the contract should be specific in identifying what locations and services this entity is covering. Those entities will be required to have an Addiction Service Provider certification to be in compliance.

A provider who has an area with services for the following six (6) areas of treatment and prevention of mental disorders:

Inpatient services
Residential services
Partial hospitalization services
Outpatient services
Consultation-education services
Community support services

A provider must be compliant with the following Indiana Administrative Code:

440 IAC 4
440 IAC 4.1
440 IAC 9

Completing the application in the DMHA Provider Portal, you will be asked to provide the following information via rich text:

Policies and Procedures for application in DMHA Provider Portal (Note: these are required to be entered as rich text.)
- IC 12-27
- IC 16-39

Copy of each MOU or contract that the agency has with entities that are providing continuum of care services
Copy of accreditation letter, copy of full accreditation report, the accrediting body’s survey recommendations and your response to the recommendations from a Division approved accrediting body. OR if your program is not yet accredited, provide proof that an application for accreditation has been submitted and accepted by a Division approved accrediting body.
Medical Director License
Most recent financial audit
Proof of liability insurance
List of governing board(at least 5 members, 1 should be licensed)
- County the member represents
- Full address of member
- Telephone number(s) of members
- Email address of members
- A written, signed and dated statement verifying consumer representation as required by 440 IAC 4.1-2-2 (c) (2).
  - Consumer representative name should not be included