This page is intended for Providers of treatment and/or support services. Here Providers will be able to find or link to FYI Fridays, Training Opportunities/Guidance documents, Forms, Resources, Program specific pages and more.
- DBH Programs, Initiatives, & Services
- Crisis Services
- Assertive Community Treatment (ACT) - Information for Providers
- Certification
- Certified Community Behavioral Health Clinics/Organizations (CCBHC/O)
- Children's Services
- Community Behavioral Health Liaisons (CBHL)
- Consumer Operated Service Programs
- Deaf Services
- Dialectical Behavior Therapy (DBT)
- Disease Management Projects (DM)
- Emergency Room Enhancement (ERE)
- Employment Services
- Family Support Provider Program
- Forensic Services
- Gambling Services
- Healthcare Home (HCH)
- Integrated Treatment for Co-Occuring Disorders (ITCD) - Information for Providers
- Prevention Services
- Projects for Assistance in Transition in Homelessness (PATH)
- Peer Support Services
- Recovery Support Services
- SATOP
- State Opioid Response (SOR)
- State Operated Psychiatric Hospitals and Facilities
- Tobacco Cessation
- Trauma Informed Care
- Veteran's Services
- Youth Behavioral Health Liaisons (YBHL)
- Youth, Psychosis, and System of Care
- Provider Forms
Forms
For more information, please phone us at (573) 751-4942 or you may e-mail us.
Allocation Transfer Request Forms
Clinical Utilization Forms
Requests for clinical utilization review of services provided after October 1, 2007, must be completed in CIMOR. These forms are being made available to facilitate intra-agency communication of clinical review information and should not be submitted to the Division for review.
Compulsive Gambling Treatment Forms
CIMOR
CPS Status Report
Organization Change Forms
Form to be used by providers to change their organization's information (site addresses, services provided, director name, etc.)
- DMH Extranet Site (for use by contracted DBH providers; includes access to Organizational Change form)
- Organization Information Change Form (for use by contracted DBH providers; includes access to Organizational Change form)
- Organization Information Change Form (for use by Certified Non-Contracted ADA Providers)
- DBH Personnel Contact Info for Pre-Organization Change Info
- Pre-Organization Change Process for DBH Staff
- Provider Pre-Organization Change Request Required Info
- FQHC Status Process
- DMH Extranet/Organization Change Training Webinar
Women's & Children's CSTAR Program Forms
MO HealthNet Managed Care Protocol for Pregnant Women. The following forms are available for use by the Women & Children’s CSTAR programs that are participating in the Substance Abuse Treatment Referral Protocol for Pregnant Women Under MO HealthNet Managed Care.
- MO HealthNet Managed Care Substance Abuse Screening & Referral Form
- MO HealthNet Managed Care Screening Referral Form Instructions
- MO HealthNet Managed Care Protocol for Pregnant Women
- MO HealthNet Managed Care Multi-Party Consent for Release of Information
- MO HealthNet Managed Care and MBHO Contacts
- CSTAR Transitional Housing Request Worksheet
Other
- Diagnosis Mapping
Posted below are three documents that contain the CPS Adult CPR, CPS Youth CPR, CPS DLA, CPS Youth DLA, ADA CSTAR, ADA CSTAR Detox, and ADA Pre and Post Test Counseling (HIV, TB) diagnosis group mapping. This mapping includes the DSM-5 and ICD-10 codes.
CIMOR requires ICD-10 Diagnoses in Episodes of Care for admissions effective 10/1/2015 and later, and for billing in Medicaid eligible programs for dates of service 10/1/2015 and later. DSM-5 diagnoses may be added to CIMOR, and mapping to ICD-10 will be available if there is a one-to-one relationship.
- Medicaid Eligibility
In order to help DMH Agencies and Providers in assisting consumers with applying and keeping their Medicaid (MO HealthNet) coverage, the DMH Medicaid Unit has created this page to provide easy access to needed documents, answered frequently asked questions, and generally provide information about Missouri’s Medicaid program: Medicaid Eligibility
Contact the Department of Mental Health for questions concerning Medicaid Eligibility, case status, MO HealthNet policy, or other matters relating to DMH consumers and MO HealthNet.
- Applying for MO HealthNet (Medicaid)
- DMH Coversheet for MO HealthNet
- Annual Reviews
- Disability Determinations
- Medication Training and Documents
- Spend Down Information
- Ticket to Work Health Assurance
- QMB/SLMB Coverage
- DMH Consumers in a State Mental Hospital
- Frequently Asked Questions
- DMH Medicaid Waiver Services
- Helpful Links
- Guidance for Substance Use Treatment
- Guidance on CIMOR Data Collection and Reporting for Substance Abuse Treatment (ADA CIMOR Guidance)
- CSTAR Matrix Model
- Notice of Priority Admission to Substance Abuse Treatment
- Medication Assisted Treatment
- Priority Populations for Substance Abuse Treatment
- Pregnancy Monitoring Protocol
- Appropriate Use of Community Support for Consumer Employment
- This document is designed to provide guidance on billing appropriate community support interventions for individuals pursuing employment while receiving services in the Comprehensive Substance Treatment and Rehabilitation (CSTAR) program.
ASAM Information
Frequently Asked Questions
- This FAQ is considered a living document, subject to change as more information becomes available. Please review regularly. The date of the last revision is noted at the bottom of the document.
ASAM and TEDS
Provider Readiness Materials
ASAM & Billing
ASAM in CIMOR Training
- Resources for Providers
- Background Screening for Employees and Volunteers
- Background Checks Utilizing the Family Care Safety Registry
- Behavioral Health Resources
- Billing Services and Review Manual
- Block Grant Applications and Reports
- Compassion Fatigue Awareness Project
- CIMOR Provider Information
- Confidentiality
- Contracted Providers Rate Sheets
- Deaf Services - Info for Providers
- Diagnosis Mapping - ICD-10/DSM 5 information and resources
- Division of Behavioral Health Maps
- DRA False Claims Act Policy
- Employee disqualification information
- Evidence Based Practices
- Food Stamps Information for Individuals with Drug Felonies
- Language Matters
- Learning Opportunities - Free Webinars, PowerPoints and Information
- Medicaid Eligibility
- MO HealthNet Division Provider Bulletins
- Person-Centered Planning
- Proven Community-Based Mental Health Practices
- Psychiatric Services Catalog
- Reporting Abuse and Neglect
- Sample Contract/MOU for CMHCs
- Standing Order for Naloxone
- Trauma Informed Care
Protection and Advocacy MOU Information
Protection & Advocacy MOU - The Memorandum of Understanding (MOU) between Missouri Department of Mental Health and Missouri Protection & Advocacy recognizes the legal rights and responsibilities of each agency and formalizes the cooperative relationship. The MOU clarifies that Missouri Protection & Advocacy has authority to access consumers at community agencies for providing information about P & A services; to explain legal rights obtained through applicable State and Federal laws; to complete an application for P & A services; to investigate allegations of abuse, neglect, death, or other violations of rights; to advocate for the legal rights of consumers, and to monitor compliance with respect to the rights and safety of consumers.
DMH Protection & Advocacy MOU presentation
Enhanced Psychosocial Rehabilitation (PSR) Information
We have received a number of questions concerning our recommendation of group size no greater than 8 for the enhanced rate. We have further researched this issue. Our original directive of 8 came from the SAMSHA-IMR fidelity scale. WRAP standards indicate that 5-8 is appropriate for the group portions of the program.
We have, however, recognized that Procovery allows 15. There may be other manualized or curriculum based approaches that have different group size guidelines. Thus, in order to give providers greater flexibility, we suggest that you indicate in your proposal what approach you are planning to adopt, including group sizes recommended for the practice. If you are not using an established program, we will expect a limit of 8 persons per group.
- Supported Community Living
Adult Offender Notification Process for DBH Funded Residential (DBH SCL & SCL Decentralization)
Supported Community Living Decentralization
SCL Referral Packets
Adult SCL Referral Packet - This packet is for adult placements only. Please contact your respective regional office for approval and any additional requirements.
- Application for Supported Community Living Services/Notice of Privacy Practices
- Residential Services Funding Form
- Standard Means
- Standard Means Test (SMT) for Adult Supported Community Living (SCL) Consumers - a guide for applying the SMT for Adult SCL consumers
- Reimbursement of Interim Assistance
Youth SCL Referral Packet - This packet is for youth placement only. Please contact your respective regional office for approval and any additional requirements prior to placement.
- Application for Supported Community Living Services/Notice of Privacy Practices
- Supported Community Living Training
- Community Placement Application Form for Minors - This form is kept in the Administrative Agent Clinical Record and a copy sent to the facility along with the other requirements for the Administrative Agent Referral Packet.
- Consent and Agreement for Supported Community Living Services: Children and Youth (DMH 9716)
- Standard Means Financial Questionnaire (DMH 69)/Notice of Cost (DMH 8004) - This is a combined form
- Notice of Change/Status Form
- JSOR General Notification Letter to the Parent or Guardian