2-Exhibit C - Provider Program Description Expectations - Magellan.docx
DOCX document 108 KB Posted
- Attached to
- Drug & Alcohol Treatment Services
- Solicitation number
- 25-47
- Issued by
- Montgomery County, Pennsylvania
About this file
The document is a Provider Program Description Expectations template from Magellan, focused on Drug and Alcohol Treatment Services for Montgomery County, Pennsylvania. The county is issuing a Request for Proposal (RFP) to procure substance use disorder (SUD) services for eligible adults and adolescents, covering four geographic regions: Western (Region 1), North Central (Region 2), Central (Region 3), and Eastern (Region 4). The services include Clinical Outpatient Services (Intensive Outpatient/Outpatient), Case Management, Recovery Support Services, and Specialty Services specific to each region. Providers must demonstrate the ability to offer all three core services in each region they apply for and align with the county's recovery-oriented principles.
The program description expectations outline comprehensive requirements for providers, including detailed specifications for staffing, services, quality management, and compliance. Key areas of focus include staff qualifications, training plans, evidence-based practices, clinical specialties, documentation requirements, population served, and quality management processes. Providers must provide information on staffing patterns, supervision, treatment modalities, cultural competency, outcome monitoring, and internal auditing processes. The target population includes county residents aged 11-21 who require substance use treatment and recovery support, with an emphasis on demonstrating compliance with state regulations, internal controls, and quality improvement mechanisms.
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Text version
Provider Program Description Expectations The list below is provided as a guideline for providers creating/revising program descriptions. Note that not all items will be applicable to all programs. These expectations are for in plan services only. Descriptions for in lieu of services are required to use the Supplemental Service Description template and Magellan Addendum template.
Staffing Staff patterns and qualifications Training plan Staff to member ratio Supervision of clinical staff
Services Provided Program philosophy, goals, and objectives Evidence Based Practices offered Understanding of Medical Necessity Criteria/assessment description Cultural competency Clinical specialties Targeted average length of stay Anticipated units of service/contacts per month Treatment modalities Service/treatment plan requirements Documentation requirements Languages offered Billable unit definition Description of non-billable services (travel and transportation, supervision, recordkeeping, etc.)
Population served (including any specialty populations served) Plans to address special needs/populations
Quality Fidelity Measures (if applicable)- evidenced based practices (EBP) offered; fidelity review (assessment) of adherence to EBPs used Description of Quality Management plan - information on internal activities and guidelines to assess quality standards 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).
Outcomes monitoring, including outcome measurement tools used and frequency, including outcome measurement tools used and frequency- include information on satisfaction surveys; any treatment outcomes measures used; symptom checklists and scales; targeted length of service 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 supervisory staff (degree and licensure requirements) Documentation requirements - information on assessments completed; timeframes for completion of treatment plans; information on crisis planning and discharge planning; list of documentation requirements; information on EHR if applicable
Compliance Acknowledgement of regulatory requirements, as applicable - information on state regulations followed specific to the LOC; state bulletins followed; review of billable and nonbillable services Internal controls, including provider self-monitoring process, including provider self-monitoring process- policies/procedures for monitoring staff and best practices Compliance plan - staff involved in any quality improvement process; information on Compliance Officer and Quality Improvement Committee if applicable; program standards; staff training standards; internal plan for audits
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