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 - The tool should be given to clients to complete during their initial OHH visit.  It will be used to determine the treatment that is appropriate for the client and to assist the OHH team in developing the care plan. 
Creation date: 1/3/2019 9:32 AM (hserven@nmre.org)      Updated: 5/27/2021 11:49 AM (hserven@nmre.org)
C1 OHH Client Care Plan Template.docx
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C2 MDHHS 5515 updated 9.29.20.docx
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C3 NMRE Opioid Health Home Enrollment Consent updated 1.4.20.docx
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Vermont Hub-Spoke Treatment Needs Questionnaire.pdf
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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.