Agency Designation

Designated Service Providers are categorized as either treatment providers or Recovery Residence (housing) providers.

Treatment Providers

• DMHA certified as a CMHC, ASO, ASR, PIP, or OTP agency — can include level IV recovery residences.
• Responsible for the clinical comprehensive assessment, ANSA, diagnosis, and treatment plan.
• As of July 1, 2019, all treatment providers are required to be enrolled as a Medicaid/HIP provider, as well as be credentialed by all 4 Managed Care Entities.
• Required to enter necessary information into DARMHA and WITS.
• Able to build vouchers for their agency and housing providers.
• Capable of making internal referrals within WITS to housing providers — allows housing providers to be paid directly.

Recovery Residence

• Alcohol and drug free living environments, including recovery homes and sober living homes.
• DMHA Certifications type: level II, III, or IV recovery residence.
• Able to accept participants prior to connection to treatment for an assessment.
• Required to communicate with treatment providers and CJP regarding participants.
• May only claim for the daily housing rate as well as a daily per diem unless the agency is certified as a level IV.

Residential

• DMHA certified as a provider of residential care.
• Clinically Managed Low Intensity ASAM 3.1
  • 24-hour supportive living environment; at least 5 hours of low intensity treatment per week
  • Ability to arrange for and monitor pharmacotherapy for psychiatric medications.
  • Withdrawal Management services 2 and lower
  • Must offer addiction medications when clinically indicated.
  • 10 - 20 hours of clinical addiction services per week
  • 75% of services are clinical in addition medical.
  • Required to provide protocols for the continuation of addiction medication, including direct operational linkage or access to methadone, buprenorphine, injectable naltrexone providers.
• Clinically Managed High Intensity ASAM 3.5
  • 24-hour living environment, more high-intensity treatment
  • Minimal risk of severe withdrawal
  • Withdrawal Management services 3.2 and lower
  • 75% of services are clinical in addition medical.
  • Required to provide protocols for the continuation of addiction medication, including direct operational linkage or access to methadone, buprenorphine, injectable naltrexone providers.
  • 20 or more hours of clinical addiction services per week
  • Each consumer must be staffed and overseen by a medical director at least twice a month.

All Clinically Managed services will require a Prior Authorization for services.