Behavioral Health Home Enrollment Documents
To be enrolled and participate in the Behavioral Health Home (BHH) program beneficiaries must meet eligibility requirements, including being enrolled in Medicaid or Healthy Michigan Plan, MiChild and who have a select serious mental illness or serious emotional disturbance (SMI/SED) diagnosis. To enroll an individual in BHH services through the NMRE, a Health Home Partner is required to submit the following information.
1. MDHHS 5515 Consent to Share Behavioral Health Information for Care Coordination Purposes
2. BHH Health Home Enrollment Consent
3. Individualized Care Plan - Follow MDHHS care plan requirements as indicated in the handbook.
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BHH Client Care Plan Template.docx 27 KB |
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BHH Enrollment consent updated 1.4.20.docx 76 KB |
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MDHHS-5515 updated 9.29.20.docx 40 KB |