Information for Providers
The Division of Child Mental Health Services (CMH) values the partnership with providers in serving the children of Delaware. Providers are expected to share Systems-of-Care philosophy and to work with Department case managers and each other in supporting children and their families within these principles:
- Services are individualized and include strength-based solutions.
- Services are appropriate in type and duration.
- Services are child-centered and family focused.
- Services are, as much as possible, community-based.
- Services are culturally competent.
- Services are provided within and across a seamless system.
- Services are planned and managed within a team-framework that includes the child, the family and whatever natural and systems supports are available to them.
Becoming a Provider
CMH, as part of a state organization, must follow laws, policies, and procedures that are created to assure fair business practices. To this end, the Division solicits bids on regular schedules for most of its services. Providers must respond to a Request for Proposal (RFP). To find RFP’s currently available, return to kids.delaware.gov and click on “Contracts.” Once the RFP process is completed, contracts are awarded.
Providers must have a contract in order to do business with CMH. To obtain information about becoming a CMH provider, or if you have any question regarding the CMH service system or its components, contact one of the following CMH system administrators:
Vanessa Bennifield, Program Administrator I, routine outpatient and wrap-around services connected to these programs, psychiatric services for YRS residential facilities.
John A. Carver, Program Administrator II, hospital, residential treatment and day programs connected to these types of facilities. Budget for hospital and residential services.
Jeanne A. Dunn, Program Administrator II, intensive outpatient and free standing day treatment programs, free-standing wrap-around programs, Provider Forum, Provider Manual and DSCYF Operating Guidelines, budget for nonresidential services.
Mary Moor, Program Administrator II, individualized client services, outpatient and wrap around services
Christine Pritchard, Program Administrator I, out-of-state programs, substance abuse education program in YRS facility, transportation and interpreter services.
Marla S. Selber, Program Administrator I, intensive outpatient services, free standing day hospital programs, DFS foster child screening and , CMH Credentialing Committee Chair.
Use of Out-of-Network Providers
Under some circumstances, CMH may use an out-of network provider. Using Out-of-Network Providers
Once CMH has agreed to develop a contract with a provider, specific business information is required. Business Application
CMH is a public, accredited managed care organization. All licensed practitioners who are contracted independently or who are employed by a CMH contractor must present credentials to the appropriate credentialing committee.
If a licensed practitioner works for a JCAHO, COA, CHAP or CARF accredited agency, credentialing usually takes place at that agency. If a licensed practitioner is in private practice or is employed by an agency not accredited by one of the above, the clinician must have credentials approved by the CMH Credentialing Committee.
DCMHS Credentialing Committee Process
The CMH Credentialing Committee is comprised of licensed practitioners from provider agencies and from CMH. It meets on a regular basis to review applicant materials. Questions can be addressed to the system administrator who chairs this committee (Listed earlier on this website).
- Credentialing Committee Schedule The credentialing committee meets quarterly to review applications and re-applications. Credentials are received and reviewed between scheduled meetings but applicants are credentialed by the committee only on the dates indicated.
- Credentialing Committee Members
- Staff Accountability Policy
- Staff Accountability Procedures
- Initial Application Form PDF Format Word Format
- Directions for Completing Initial Application Form
- Re-Appointment Application PDF Format Word Format
- Directions for Completing Re-Appointment Application
Once a therapist is credentialed under the CMH Credentialing Committee, the credentials are transferable to other CMH agencies who must submit to this committee. If a therapist moves to another CMH agency, their departure date must be sent from the former agency and their start-date must be sent from the new agency. This is done through the submission of the Human Resources Form (see below).
Requirements for Providers
Once providers are under contract with CMH, they are expected to meet standards of professional practice as outlined in the CMH Provider Manual. This manual is incorporated by reference in the contracts signed by providers.
CMH contractors are also expected to follow the minimum DSCYF standards set forth by the Department in the a DSCYF Operating Guidelines incorporated by reference in contracts.
Contracts require providers to abide by CMH and DSCYF policies and procedures as they apply to services being provided. CMH and DSCYF Policies
Forms for Providers
- Mental Health and Substance Abuse Screen (EPSDT) PDF Format Word Format This is to be used by outpatient substance abuse and mental health providers to establish clinical eligibility for clients referred from sources other than CMH.
- Outpatient Mental Health (MH) Admission Form PDF Format Word Format This form is submitted by outpatient providers of mental health treatment in order to obtain authorization for those clients with referral sources other than CMH. See provider manual for authorization and submission instructions.
- Outpatient Substance Abuse (SA) Admission Form PDF Format Word Format This form is submitted by outpatient providers of substance abuse treatment in order to obtain authorization for those clients with referral sources other than CMH. See provider manual for authorization and submission instructions.
- Request for Re-Authorization of Outpatient Treatment PDF Format Word Format CMH initial authorization for outpatient clients who have referral sources other than CMH is for 20 sessions in the first year of treatment. This form is submitted to obtain further authorization.
- Outpatient Mental Health (MH) Discharge Form PDF Format Word Format This form is submitted by outpatient providers of mental health treatment within 30 days of discharge from outpatient treatment or when CMH is no longer the funding source.
- Outpatient Substance Abuse (SA) Discharge Form PDF Format Word Format This form is submitted by outpatient providers of substance abuse treatment within 30 days of discharge in order to obtain authorization for those clients with referral sources other than CMH.
- Human Resources Data Form PDF Format Word Format This form is referenced in the provider manual. All staff seeing children in crisis, intensive outpatient, routine outpatient, wrap-around, urgent response and free-standing day and part-day programs and all licensed clinicians who are seeing CMH clients or supervising staff who see clients in residential treatment, hospital or day hospital must submit this form to the CMH system administrator.
- Billing Summary PDF Format Word Format This face sheet must accompany all monthly bills from routine outpatient and wrap-around services. The billing total on this form must agree with the aggregate total on the individual client billing/activity forms.
- Client Billing-Activity Form PDF Format Word Format This form is referenced in the provider manual. It must be used by all unit-cost or cost-reimbursable crisis, intensive outpatient, routine outpatient, wrap-around and urgent response programs.
- DSCYF Reportable Event (Incident) Form Submission of this form is required for all incidents as described in the DSCYF Operating Guidelines. For cases involving CMH clients, the form should be faxed to the Quality Services Administrator at 1-302-661-7270.
- DSCYF Reportable Event Quick Directions This is a synopsis of the incident reporting guidelines listed in the DSCYF Operating Guidelines.
- DSCYF Transfer Instruction Sheet This form is for use for any program that provides residential or hospital services or that may be transferring a client to a residential facility form a community based program. The purpose of this form is to assure that the receiving facility is fully informed as to current and critical information about the client, such as medical conditions, medical or psychiatric appointments, medication, etc. The full process for the use of this form can be found in the DSCYF Operating Guidelines.
Other Useful Information for Providers
Provider Forums
CMH meets regularly with providers at many levels in order to collaborate on regular operational issues. System-wide meetings are held Quarterly. These are generally held at the Delaware Youth and Family Center, 1825 Faulkland Road, Wilmington, Delaware 19805 in Room 199.
Provider Forum Schedule 2007 - 2008
Obtaining Extended Outpatient Medicaid Benefits
The Diamond State Health Care Plan (Medicaid) assures that children are able to get behavioral health services that are clinically necessary. CMH provides all Medicaid behavioral health services with the exception of routine outpatient services.
Each Delaware Medicaid eligible child has an annual (July 1 through June 30) outpatient benefit of 30-units. This benefit is usually provided by one of the three Managed Care Organizations (MCO) contracted by the State
- Delaware Physicians Care, Inc.
- Diamond State Partners
- Unison Health Plan of Delaware, Inc.
To assure continuity of care, CMH provides supplementary funding for additional units per year if they are deemed clinically necessary.
Any outpatient MCO provider who wishes to apply for extended benefits beyond the 30-unit annual outpatient benefit before the end of the benefit year (June 30) should contact the CMH system administrator responsible for routine outpatient services. (See listing earlier on this website). The CMH administrator will need specific business information and an estimate of how many units are being requested through the end of the benefit year. Retroactive requests will not be processed. Providers must accept current CMH outpatient rates.
Making Referrals for a Higher Level of Care
Any provider who believes a higher level of care is needed for their client should call CMH Intake at (302) 633-2571.
Other Useful Information
Other Contract Information
To find other contract information pertinent to becoming a provider, preparing budgets, etc., go to the DSCYF Home Page kids.delaware.gov and click on “Contracts”
