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Becoming a Provider
Contract Providers
Directly
Enrolled Providers
CAP Providers
Contract Providers of State Funded (IPRS) Services
The Guilford Center will select IPRS providers based on the following criteria:
- Quality of care as defined in the Guilford Center's Principles and Indicators of Best Practice tools for each population served;
- Quality of service as defined in the Guilford Center's Principles and Indicators of Best Practice tools for each population served and by the agency's credentialing criteria including staff qualifications, clinical supervision, and ongoing staff training and development;
- Business needs of the Guilford Center based on data and trends from the annual community needs assessment.
Procedure
For Network Providers: The Guilford Center will primarily use a Request for Proposal (RFP) process to solicit proposals from prospective qualified, responsible providers to fulfill a described service need. RFPs will be let based on available funding and identified unmet service needs within the county. Continuing services will typically be re-bid every 3-5 years.
Quality of Care and Quality of Service Criteria are specified in the Request for Proposal (RFP) process. The RFP process is a process used to solicit proposals from prospective responsible providers to fulfill a described service need. The RFP document sets forth the description of the client population to be served, scope and array of services to be provided, quality of care and service standards, cost parameters, goals, program outcomes, reporting requirements, and the evaluation criteria for selecting providers through the RFP process. Although cost is a major consideration, the Guilford Center may choose not to award a contract to the lowest bidder.
Responsible providers are those that:
- Have the experience and resources necessary to provide the services sought by the RFP and to carry out the terms of the contract;
- Provide quality of care and service as demonstrated by the agency's responsiveness to the Guilford Center's Principles and Indicators of Best Practice tools for each population served for the service to be provided;
- Provide quality of care as evidenced by the agency's credentialing criteria including staff qualifications, clinical supervision and ongoing staff training and development;
- Are capable of complying with the required performance schedule, taking into account all other existing commitments;
- Have a satisfactory performance record;
- Are otherwise qualified and eligible to receive a contract award under all applicable laws and regualtions.
Out of Network/Sole Source Contracting is a method of procurement, which may be subject to federal and state funding requirements, that involves negotiation with a single responsible provider to meet an identified unmet service need. Out of Network/Sole Source contracting shall nor be used unless there is evidence that the provider netwrok cannot fulfill the requirement.
Evaluating the Request for Proposal: The Guilford Center will establish an evaluation committee whose members have no conflict of interest with any respondent to the RFP. The committee may be comprised of, among others, Guilford Center employees, parents and other community agencies and representatives with expertise in providing the services sought by the RFP. The committee reviews proposals for responsiveness to the service requirements and expectations as set forth in the RFP. The committee uses the criteria published in the RFP to rank the proposals and evaluate the qualifications of applicant agencies.
CAP Providers
Effective as of October 1, 2007, the policy and procedures for becoming an endorsed CAP provider have changed. The new process is featured on the North Carolina Department of Health and Human Services, Division of Mental Health/Developmental Disabilities/Substance Abuse Services Web site.
Effective as of November 1, 2008, CAP/MR/DD Services have to meet national accreditation within 1 (one) year of said date.
NC MH/DD/SAS: CAP-MR/DD Information
If you have any questions after reviewing the new endorsement policy and procedures, contact Alexis Underwood at the Guilford Center (telephone 336.641.4363 or email aunderwood@guilfordcenter.com) for additional information.
Directly Enrolled Providers Registered with the Guilford
Center
The N.C. Division of Medical Assistance (DMA) has established a program of direct enrollment in which all providers of Medicaid services are required to be directly enrolled. To enroll in the Medicaid program, providers of Enhanced Benefits must complete an endorsement process provided through the Local Management Entity (LME).
Providers enrolled in the Medicaid program or contracting for State-funded services on or after July 1, 2008, and providing services which requires national accreditation shall successfully complete all accreditation requirements and will be awarded national accreditation within 1 (one) year of enrollment in the Medicaid program, or within 2 (two) years following the provider's first contract to deliver a State-funded service requiring national accreditation.
For implementation updates from the State Department of Health and Human Services, Division of Mental Health, Developmental Disabilities and Substance Abuse Services, visit the DHHS Web site at: http://www.dhhs.state.nc.us/mhddsas/servicedefinitions/servdefupdates/index.htm
For Information about Endorsement:
Call Alexis Underwood at 336.641.4363 or email aunderwood@guilfordcenter.com.
For Information about Direct Enrollment
Call 919.855.4050 or visit the DMA website at www.dhhs.state.nc.us/dma/provenroll.htm.
DMA determines eligibility requirements for providers and recipients,
requirements for and limitations on coverage, and documentation
requirements for directly enrolled providers.
Basic Benefit/Outpatient Treatment Providers
Fully licensed therapists are required to enroll directly with the Division of Medical Assistance to be issued a Medicaid provider number. This number will allow the enrolled therapist to bill directly for basic benefit services provided to Medicaid recipients. Contact Linda Earnest at the Guilford Center learnest@guilfordcenter.com if you are interested in obtaining a Memorandum of Agreement (MOA) with the Guilford Center. The MOA establishes the responsibilities of the directly enrolled therapist and the Guilford Center in providing outpatient treatment services to eligible Medicaid clients.
Accreditation for Residential Service Providers
As noted in Implementation Update #60, all Medicaid funded child mental health and substance abuse residential services providers ( Level II-program type III and IV) are required to be nationally accredited within one year of enactment of the S.L. 2009-451 for providers enrolled prior to August 7, 2009 or within one year of enrollment of the Division of Medical Assistance (DMA) for providers enrolled after August 7, 2009. That means that all child residential providers of level II program type, level III and IV services that were enrolled on August 7 must achieve national accreditation by August 7, 2010 (one year from date of enactment of the legislation). Accreditation benchmarks outline in G.S 122C-81 will apply to residential service providers. Information on how to apply the accreditatio benchmarks can be found in Implementation Update #47 at http://www.ncdhhs.gov/mhddsas/servicedefinitions/servdefupdates/dmadmh8-4-08update47.pdf.
Insurance Requirements
To get an executed Memorandum of Agreement with the Guilford Center,
directly enrolled providers must obtain and maintain the following
policy or policies of insurance covering their operations:
| Coverage | Minimum Limits |
| Comprehensive General Liability | $1,000,000/$3,000,000 |
| Professional Liability, if applicable | $1,000,000 |
Comprehensive Automobile Liability covering owned, Workers Compensation (3 employees or more) |
Combined single limit of at least $1,000,000
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The insurance company(ies) should have a Best Rating of a least B+, Class VII and be licensed in North Carolina. In addition, the provider may be required to obtain other insurance as the Guilford Center shall request from time to time.
Any provider who has more than three (3) employees must carry worker's compensation insurance in the amount of $500,000/$500,000/$100,000.