Opioid Health Home Enrollment Documents

To be enrolled and participate in the Opioid Health Home (OHH) program beneficiaries must meet eligibility requirements, including being enrolled in Medicaid or Healthy Michigan Plan and have a diagnosis of an opioid use disorder. To enroll an individual in OHH services through the NMRE, an OHH provider is required to submit the following information.  

1) MDHHS 5515 - Consent to Share Behavioral Health Information for Care Coordination Purposes 
2) NMRE Opioid Health Home Program Enrollment Consent 
3) Individualized Care Plan derived from an evidence-based assessment of need - The care plans should include all the conditions of the client and specify how the OHH provider will coordinate and support clients in addressing their needs.  
4) Treatment Needs Questionnaire screening tool 
Creation date: 1/3/2019 9:32 AM (hserven@nmre.org)      Updated: 9/29/2020 3:01 PM (hserven@nmre.org)
Files   
C1 OHH Client Care Plan Template.docx
23.2 KB resend
C2 MDHHS 5515 updated 9.29.20.docx
39.2 KB resend
C3 NMRE Opioid Health Home Enrollment Consent updated 9.29.20.docx
75.5 KB resend
Vermont Hub-Spoke Treatment Needs Questionnaire.pdf
202.1 KB resend
This section includes information and resources pertaining to the Opioid Health Home (OHH) program. For specific questions regarding OHH services at your location, please contact Heidi Serven OHH Care Coordinator hserven@nmre.org.