16-HealthChoices Service Description Addendum Form.docx
DOCX document 30 KB Posted
- Attached to
- Drug & Alcohol Treatment Services
- Solicitation number
- 25-47
- Issued by
- Montgomery County, Pennsylvania
About this file
The document is a Service Description Requirements Addendum from Magellan for the HealthChoices behavioral health program in Pennsylvania, specifically related to a Drug and Alcohol Treatment Services contract for Montgomery County. The request for proposal (RFP) seeks providers to deliver comprehensive substance use disorder (SUD) services across four county regions, targeting adults and adolescents aged 11-21. Applicants must provide three core services: Clinical Outpatient Services (Intensive Outpatient/Outpatient), Case Management, and Recovery Support Services, along with potential region-specific specialty services.
The addendum details extensive requirements for service providers, including mandatory documentation of service descriptions, evidence-based practices, quality management plans, cultural considerations, outcome measurement tools, staff qualifications, supervision protocols, and incident reporting procedures. Providers must demonstrate alignment with Montgomery County's recovery-oriented principles and develop comprehensive treatment plans that address medical necessity, cultural needs, and specific intervention strategies. The document emphasizes a holistic approach to substance use treatment, requiring detailed documentation of service delivery, staff-to-member ratios, and compliance with Magellan's reporting expectations.
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Text version
Service Description Requirements for In-lieu-of (Supplemental) Services- Magellan Addendum (in addition to the state’s Supplemental Service Description Form Template, Magellan requires these additional areas to be added in an Addendum)
Please provide a description of which behavioral HealthChoices in-plan service(s), this proposed supplemental service is in-lieu of.
Describe how agency will target referrals and the Medicaid population to meet this goal.
Specify the mission or purpose of the service, including what the service intends to accomplish and the nature of needs to be addressed. Clearly describe all applicable treatment activities, approaches, interventions and highlight any evidence-based or best practices:
Billable Unit Definition:
Anticipated Units of Service per Person per Month:
Special Populations Served (i.e. pregnant women; transitional age youth; autism):
Describe how cultural and ethnic values including language needs will be considered as part of the development and delivery of services:
Proposed Evidence-Based or Best Practices:
Outcome Measurement Tools Used and Frequency of Measurement:
Description of Quality Management plan including information on internal activities and guidelines to assess quality standards
Internal auditing process for clinical record reviews
Information on supervision provided (individual and group if applicable) and frequency of chart reviews, internal case consultation, staff trainings provided/required, qualifications for supervisor staff (degree and licensure requirements)
Incident management – information on internal process/procedure for incident reporting. Include acknowledgement of intent to follow Magellan’s incident reporting expectations (reporting to Magellan within 24 hours).
Staff to Member Ratio:
Prescription Requirements (i.e. how will medical necessity be established):
Service/ Treatment Plan Requirements (include when initial service plan will be created and at what frequency goals will be reviewed and updated):
Documentation Requirements:
Non-Billable Services (i.e. Travel & Transportation, Provider staff meetings, supervision, recordkeeping activities and other non-direct services):
Description of Compliance Plan:
File details come from the government source that posted it. Updated .