Step 1: Submit Application
The provider organization must email DHS Form 7890 with the following attachments:
- Section A: PHP Service Needs Assessment
- Describe how the need for PHP services was determined.
- Section B: Community Resources
- Describe the family and community resources that will be accessed and integrated into the design and delivery of PHP services.
- Section C: Partial Hospitalization Manual
- Include the following:
- Table of contents
- Service philosophy
- Anticipated length of stay
- Admission policies
- Discharge policies
- Services provided, including clinical approaches and group psychotherapy and rehabilitative service curriculum/modules
- Documentation processes, including assessment, service planning, discharge, and evaluation
- Timelines for completion and approval of required documentation
- Weekly PHP service schedule
- Separate schedules for children and adults, if applicable
- Section D: Multidisciplinary Team Organization Chart
- Include an organizational chart and NPI’s for each provider,
- Section E: Mock Client File
- Include one mock client file containing:
- Diagnostic Assessment
- Functional Assessment
- LOCUS
- Individual Treatment Plan
- Progress Notes
- Discharge Plan Submit to dhs.php@state.mn.us
Step 2: Application Completeness Review
The provider organization will be notified by e-mail that the application and attachments were received. BHA will review the application to determine whether all required documentation has been submitted. If the application is complete, BHA will notify the applicant and begin the 90-calendar-day review period. If information is missing or incomplete, BHA will notify the applicant in writing and identify the information that must be submitted. The application review will be placed on hold until the requested information is received. Applicants have 30 calendar days to provide requested information. If the requested information is not received within 30 calendar days, the application will be closed, and the provider must submit a new application to begin the approval process.
Step 3: Administrative and Clinical Review
Once the application is complete, BHA conducts an administrative and clinical review of the application and supporting documentation. During the review, BHA may request additional information or clarification and may provide technical assistance as appropriate. A phone conference will be available for the providers to clarify information and raise or answer questions about the application submission process.
Step 4: Final Determination
After completing the administrative and clinical review, BHA will issue a written determination.
If the application meets applicable PHP requirements:
- BHA will issue a written approval letter.
- The provider will be approved to provide PHP services under MHCP.
- BHA will send a copy of the approval letter to MHCP Provider Eligibility and Compliance.
MHCP requires all enrollment information to be complete prior to starting services Contact Minnesota Health Care Programs (MHCP) Provider Call Center at 651-431-2700 or 1-800-366-5411, to enroll as a new MHCP provider or to add PHP services to your organization’s current provider record, if applicable.
The notification letter is proof of approval as a PHP provider. It should be made available to Minnesota Managed Care Organizations, if requested, as part of their enrollment process.
If the application does not meet applicable PHP requirements:
- BHA will issue a written denial letter.
- The letter will identify the basis for the denial.
Step 5
12-18 months after approving the satellite location the Behavioral Health Administration (BHA) will complete a review of the new location by requesting random member clinical files.
Periodic Reviews
In addition to the above review processes, BHA will conduct periodic reviews of Partial Hospitalization Program (PHP) client files to monitor compliance with Department of Human Services (DHS) requirements and PHP program standards. These reviews are intended to ensure that services are delivered in accordance with applicable regulations and that documentation appropriately supports eligibility, service delivery, and medical necessity.
Providers are expected to maintain accurate, complete, and timely documentation demonstrating compliance with all DHS and PHP requirements.
