Providers are required to submit a criminal background check report for their clinical supervising staff. The report must be dated within the past year.
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MOU Process & Documents
Thank you for supporting the Middlesex County Care Management Organization (CMO) in providing quality care and services to children and families.
To establish a partnership with Coordinated Family Care, your organization must complete a Memorandum of Understanding (MOU) and submit the required supporting documents. This process ensures mutual understanding of the partnership terms and alignment with the expectations set by Coordinated Family Care and the local Children's System of Care.
Outlined below are the steps to complete the agreement. All documents must be submitted electronically for review. Upon approval, you will receive a finalized copy of the MOU for your records. Please ensure all forms are completed accurately, as incomplete submissions may delay processing. MOUs are valid for three years and must be renewed upon expiration.
We look forward to a successful partnership. If you have any questions, please contact Salma Harris at sharris@coordinatedfamilycare.org or Lisa Murray-Williams at lmurray-williams@coordinatedfamilycare.org.
Submit MOU documents here
Criminal background check reports of clinical supervisors should be dated within 1 year of submission. Clinical Supervisor's name on background check should match credentials.
Note: BA/IIC agencies may no longer complete background checks independently using private companies. All background checks will be processed by the Employment Controls and Compliance Unit (ECCU) within the Office of Program Integrity & Accountability (OPIA) at the Department of Human Services. Find more information here.
Credentials of clinical supervisory staff should match the names on the submitted background check report. Licensed professionals performing specific services such as psychiatrist, nurse practitioners, etc credentials should also be submitted in addition to supervising staff's credentials.
Ensure that credentials are not expired. Submitted credentials should have a minimum of 2 months left before expiration.
General liability and Professional Liability Insurance are required. Your required insurance coverage minimum is $1,000,000 for each claim & $3,000,000 for general aggregate.Coordinated family Care MUST be listed as a Certificate Holder on both insurances.
Medicaid approval letters must detail the specific services for which you have been approved. If your organization provides both IIC and IIH services, approval letters for each service line must be submitted.
This Memorandum of Understanding (MOU) outlines the roles and responsibilities of each agency as we work in partnership to provide services to children and families served through the New Jersey Children’s System of Care (CSOC).
Kindly complete this form with your company’s current contact information. If there are any future updates to your contact details, please notify us promptly.
The Services and Rates sheet should outline the services you currently offer and their corresponding fees, formatted on your company’s official letterhead. Only include services that can be currently provided.
For services requiring a licensed professional (e.g evaluations), ensure that the professional is listed on your Staff Listing and include a copy of their license when submitting the MOU.
Include clinical supervisors on the staff listing. For services that require a licensed professional, ensure the individual is included in your Staff Listing, and provide a copy of their valid license as part of the MOU submission.
For example, if your company offers psychiatric evaluations, a licensed psychiatrist must be listed on your Staff Listing, and their psychiatric license must be submitted to complete the MOU process.