The provider organization must submit by email a notice of intent to apply to become an ADT provider organization to dhs.mhadt@state.mn.us. The email subject line must include “Notice of Intent to Apply for ADT Service”.
A link to the ‘New or Expanding ADT Service Application’ will be sent to the provider organization. Provider organization must complete and submit the application as an electronically scanned PDF to dhs.mhadt@state.mn.us. The email subject line must include “New/Expanding Adult Day Treatment Service Application”
Provider organization is notified by e-receipt that the application and attachments were received.
DHS-AMHD will examine the submitted application and attachments. A phone conference will be scheduled with the provider to clarify information, raise or answer questions about the application submission or process. DHS-AMHD will recommend factors that may need to be addressed before a decision is granted, or during the startup or implementation phase of the new program. DHS-AMHD will make recommendations made by AMHD available in writing with targeted timelines to the provider organization.
DHS will make a determination after required documentation is reviewed and scheduled phone conference call has been completed.
A written notification of Approval as an ADT Provider Organization will be mailed to the new or expanding ADT Provider Organization. The County Mental Health Authority Liaison and MHCP Provider Enrollment will be copied in this notification letter. MHCP Provider Enrollment will expect that all enrollment information about the Provider Organization, is complete as part of the enrollment process.
Contact Minnesota Health Care Programs (MHCP) Provider Enrollment at 651-431-2700 or 1-800-366-5411, to add Adult Day Treatment (ADT) services to your organization’s provider record, or to enroll as a new MHCP provider.
The notification letter is proof of approval as an ADT Provider Organization. It should be made available to Minnesota Managed Care Organizations, if requested as part of their enrollment process. The notification letter will include:
Please use form Adult Day Treatment – Contract Cover Sheet DHS-3868 (PDF) to submit the annual county contract.
AMHD will submit a written notification to the Provider Organization Applicant with recommendations identifying the key factors to be addressed before they resubmit a new ADT Application.
If a potential ADT Provider Organization has questions, or is experiencing problems with the electronic submission of the ADT Approval Application, notify AMHD through secured email dhs.mhadt@state.mn.us. The subject line must include
“Assistance Requested for ADT Application.” Identify your question or subject to be addressed and provide your contact name and phone number.
New or expanding ADT Provider Organizations must schedule an on-site review with DHS-AMHD ADT Program Consultant within 6-9 months after being approved. Failure to schedule an on-site review will impact the approval of the ADT Provider organization and the ability to expand future ADT services or service locations.
The on-site review is conducted at the new or expanded service location and includes the following components:
After the on-site review is complete, a follow-up phone conference will be scheduled to discuss the written summary of findings. This summary will identify strengths of the ADT provider organization, as well as recommendations for further implementation of ADT, if necessary.
On-line training for documentation of Diagnostic Assessments, Functional Assessments, and overall MA Documentation is offered through DHS/AMHD DHS TrainLink.
The ADT provider organization is encouraged to develop a Quality Improvement Action Plan which informs the strategic plans of the organization and may be submitted to the AMHD ADT Coordinator as a part of the renewal process
