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Letter re nursing schedule - Dane County

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					                                               COUNTY OF DANE
                                        DEPARTMENT OF ADMINISTRATION
                                             PURCHASING DIVISION
                                               Room 425 City-County Building
                                               210 Martin Luther King Jr. Blvd.
                                                     Madison, WI 53703
                                                        608/266-4131
                                            FAX 608/266-4425    TDD 608/266-4941
        JUNE BUCHANAN, CPPB                                                                 BONNIE HAMMERSLEY
          Purchasing Coordinator                                                         Acting Director of Administration




             Date:                 January 18, 2002

             To:                   All prospective proposers

             Subject:              Request for Proposal #5284
                                   Addendum #1
                                   Pre-Proposal Conference

             The following addendum is to become a part of RFP #5284

             Pre-Proposal Conference
             January 9, 2002 @ 1:30 p.m.
             Room 421 Conference Room
             210 Martin Luther King Jr. Blvd.
             Madison WI 53703

             A pre-proposal meeting was held for the purpose of giving prospective proposers an
             opportunity to ask county staff for clarification of the proposal document and other
             additional information. The meeting was attended by the following vendor representatives
             and county staff:

             Dan Millin, Stratagem                             Jon Hatley, Dane County Information Management
             Jim Maastricht, Stratagem                         Larry Singer, Dane County Information Management
             Lori Bastean, Dane County Human Services          June Buchanan, Purchasing


             Attendees were welcomed to the meeting by June Buchanan. Introductions of county staff
             and vendor attendees followed.

             Vendors were given a handout detailing questions they had submitted for clarification prior
             to the meeting. Discussion followed with Lori Bastean, Jon Hatley, and Larry Singer
             responding to additional questions and comments. Responses to questions that were
             submitted prior to the meeting, and questions discussed during the meeting, are included as
             part of this addendum.




#5284
        Addendum #1 RFP #5284
        Page 2


        Ms. Bastean distributed and discussed additional information about State of Wisconsin
        guidelines for the Mental Health Module (see Attachments).
                Attachment 1 2002 HSRS Mental Health Module Deskcard
                Attachment 2 HSRS Mental Health Module
                Attachment 3 Memo-Human Services Reporting System: Mental Health
                               Consumer Status Data Set
                Attachment 4 Mental Health Module-Wisconsin Mental Health Data Project
                Attachment 5 Mental Health Module Business Area Analysis

        June Buchanan gave an overview of the submittal, selection, and final contract negotiation
        processes. Proposals are due at 2:00 p.m., January 30, 2002 @2:00 p.m., and late proposals
        will be rejected. Dane County has a Vendor Registration Program. Only proposals
        submitted by paid, registered vendors will be accepted. Vendors may register online at
        www.co.dane.wi.us/purch/purch.htm.

        This addendum becomes a part of RFP #5284, All other components of RFP #5284 remain
        the same, unchanged. If you have questions regarding this addendum, please contact me at
        608.266.4133, or buchanan@co.dane.wi.us.




        June Buchanan
        Purchasing Coordinator




#5284
                                                                                   Attachment 1
                                                       2002 HSRS Mental Health Module Desk Card
                                                                                         Page 1

        Questions Discussed
        RFP #5284 Develop a Mental Health Module
        for Dane County Department of Human Services
        Pre-Proposal Conference January 9, 2002


        Question   How can we get a better understanding of the data elements that will be entered
                   into the new/modified system?

        Answer     The Mental Health Business Area Analysis (BAA) referenced as part of RFP
                   #5284 includes a preliminary listing of data elements and their codes related to
                   the state reporting requirements. A copy of the BAA will be distributed at the
                   vendor conference.

                   Specific definitions of other data elements related to Managed Care and other
                   domains have not been identified at this time, and would need to be established
                   as part of the project.

                   HSRS Mental Health Module Reporting

                   Information on the Mental Health Module of the Human Services Reporting
                   System (HSRS) data elements is available from the State’s SOS Desk :

                   Phone (608) 266-9198

                   HSRS SOS Desk
                   1 W. Wilson Street
                   P.O. Box 7851, Room 518
                   Madison, WI 53707-7851

                   Website – although this may not yet specify 2002 requirements:
                   http://www.dhfs.state.wi.us/dsl_info/HSRS/handbook/Acrobat/mh_tot.pdf

                   Please also see DSL Memo Series 2001-08 Human Services Reporting System:
                   Mental Health Consumer Status Data Set available at:
                   http://www.dhfs.state.wi.us/dsl_info/NumberedMemos/NMemo01-08.htm

                   Both of these documents will be made available at the vendor conference.




#5284
                                                                                    Attachment 1
                                                        2002 HSRS Mental Health Module Desk Card
                                                                                          Page 1


                   Children Come First

                   The current requirements are listed in the BAA. However, these are being
                   revised by the State. Changes would make such fields as race consistent with
                   the State HSRS reporting requirements, change the timeframes for the
                   collection of data on the restrictiveness of living scale scores, eliminate
                   collection of dates for juvenile justice charges, etc. Cathy Duster, Medicaid
                   Managed Care Systems Specialist with the State Division of Health Care
                   Financing plans to have these finalized in the next week. She is available to
                   respond to questions at (608) 266-0760.

        Question   What are the state reporting requirements that are not being met (in detail)? Is
                   here some available document or Web site that can furnish this information?

        Answer     The issue is the process which is currently necessary to meeting State reporting
                   requirements rather than the requirements. Currently, the process is labor
                   intensive requiring staff reporting manually, capturing separate data from
                   systems and staff electronically integrating this data and submitting it to the
                   State. (see 1.2.3 of the RFP).

                   For the State HSRS Mental Health Module, the County collects but does not
                   have a repository for: BRC target population, presenting problem, number of
                   children, number of children living with client, psychosocial and environmental
                   stressors, global assessment of functioning, health status, health care
                   appointments, suicide risk, residential arrangement, daily activity, employment,
                   employment level, commitment status update, criminal justice system, financial
                   support, and episode key.

                   The reporting requirements and applicable websites and contacts are cited
                   previously.

        Question   What are the security requirements for the new system?

        Answer     The system would have to employ the Cisco VPN client and the end user’s ISP
                   to create a Virtual Private Network.

                   Direct access to the system’s MH module and components thereof by DCDHS
                   staff should be defined by employee job classification consistent with the rest
                   of the DCDHS Information System.




#5284
                                                                                   Attachment 1
                                                       2002 HSRS Mental Health Module Desk Card
                                                                                         Page 1

                   Our most recently developed application, the Payment Processing System
                   developed in Powerbuilder 6.5 using the PFC, uses menu level security. This is
                   the application level security we anticipate being utilized in the Mental Health
                   system. Other security concerns and access limitations are discussed below.

        Question   What providers can access what information?

        Answer     Providers would only be able to access the system via the VPN client. Only
                   designated providers would be able to access the system and they should only
                   have access to the pertinent records of clients they have been authorized to
                   serve. Access to specific components of the module should be limited by the
                   role or roles of the provider. While some providers should be able to read data
                   created by others, they should only be able to edit or delete data that they’ve
                   created.

        Question   Who has access to read/update what data?

        Answer     General restrictions to provider access via the VPN client and DCDHS staff
                   direct access are described above. For the new module, the specifics of what
                   staff or provider roles will or won’t have access to what functions have yet to
                   be determined. They will be determined during the development and
                   implementation of the project.

        Question   Which elements of the system must be web accessible?

        Answer     (Please refer to Appendix F for the following)
                   Web enabled or VPN client components (Actual status will be determined as
                   part of the confirm business requirements):
                    1.0 Referral for Service
                    2.0 Case Assignment
                    3.0 Case Assessment
                    4.0 Enrollment: Managed Care
                    5.0 Client Registration: Contracted Services
                    6.0 Individualized Service Plan
                    7.0 Manage Waiting Lists
                    8.0 Crisis Plan
                    9.0 Service Provider – very limited access to select providers
                    10.0 Payment Authorization: Managed Care – very limited access to select
                       providers




#5284
                                                                                   Attachment 1
                                                       2002 HSRS Mental Health Module Desk Card
                                                                                         Page 1

                      15.0 Generate Payment for Reimbursable Operating Expenses – very
                       limited access, primarily to one (1) provider
                    18.0 Record Client Services: Contracted Programs
                    19.0 Record Client Outcomes: Contracted Services
                    22.0 Grievances
                    23.0 Discharge and transition plans
                    24.0 Disenrollment: Managed Care
                    25.0 Service Termination
                   26.0 Physical Files
                   Direct access only (not Web enabled) components:
                    12.0 Medical Assistance Claiming
                    13.0 Managed Care Capitated Rate Payments
                    14.0 Billing for Out-of-Home placements
                    16.0 Client Discretionary Account
                    17.0 Institutional Prevention
                    20.0 State HSRS Mental Health Module Reporting
                    21.0 State Children Come First Reporting
                    27.0 System Maintenance

        Question   Is each provider responsible for updating case information, e.g. drug
                   treatment? Is updating of the data a requirement for payment?

        Answer     This will depend in part on whether a provider is a managed care entity, a fee-
                   for-service agency, or a contracted provider. In general managed care providers
                   will be responsible for updating their case information. Typically contracted
                   service providers have fewer reporting requirements and submit data manually
                   or, in the case of the Mental Health Center of Dane County, electronically.
                   Fee-for-service agencies have reporting requirements similar to contracted
                   providers, but here the payment is based on the number of units provided times
                   the unit rate; thus payment is dependent upon receipt of data.




#5284
                                                                                    Attachment 1
                                                        2002 HSRS Mental Health Module Desk Card
                                                                                          Page 1

                   The business process issues regarding who will be responsible for what and the
                   minimal requirements for payment have yet to be determined. They will be
                   determined during the development and implementation of the project.

        Question   What’s the difference between a managed care entity, a fee-for-service agency,
                   and a contracted provider?

        Answer     The most basic differences are that a managed care entity requires a pre-
                   authorization of services and billing is based on the number of units of service
                   provided up to the authorized amount times the unit rate. A fee-for-service
                   provider is paid based on the number of units of service times the unit rate. A
                   contracted provider is typically paid 1/12th of the total contract each month.

        Question   Are there any other interfaces needed besides HSRS – Human Services
                   Reporting System?

        Answer     The system will be expected to interface with the DCDHS Information System
                   and its corresponding Payment Processing System. Additionally, data will
                   need to be reported to the State in two pre-defined ASCII flat files for the
                   Children Come First program.

        Question   What are the County’s current IT standards?

        Answer     These are evolving, but essentially the standards include PowerBuilder, VB and
                   the Microsoft Office Suite of products and NT. The County plans to move from
                   Sybase to SQL server but this most likely will not occur during the life of this
                   project. Also, there is currently an initiative to move to Citrix and to a lesser
                   degree Windows 2000.

        Question   The RFP notes that the “vendor may suggest a phased approach for
                   development with consideration given to the current needs of DCDHS.” How
                   are the phases envisioned?

        Answer     The County does not want to inhibit provider creativity by defining phases. We
                   are looking for the experience and expertise of providers to assist us in
                   designing a successful approach and solution.
                   We perceive three hypthetical approaches that could be taken to address this
                   question. (1) look at the Start Up Phase and the Confirm Analysis Phase as one
                   piece with the vendor then providing suggestions as to how the County should
                   proceed with the development of the project given any time and other resource
                   constraints. (2) look at the immediate needs of the Department first, address
                   those, and then look at the implementation of the remaining portions of the
                   project. The immediate needs are to comply with the reporting requirements of
                   the State HSRS Mental Health Module and the State Children Come First
                   reporting of encounter and outcome data. This will require at a minimum the




#5284
                                                                                          Attachment 1
                                                        2002 HSRS Mental Health Module Desk Card
                                                                                                  Page 1
                   development of the (19.0) record client outcomes: contracted services, (1.0)
                   referral for service, (3.0) case assessment, and (5.0) client registration:
                   contracted services components, and most likely, the (9.0) service provider. (3)
                   look at a proposed software product, compare the functionality to County
                   requirements, implement the software product with critical County
                   functionality, design and develop subsequent components.


        Question   Will County Information Management staff be available during the life of this
                   project?

        Answer     The contract signing date is expected to be March 4, 2002. In March, County
                   Information Management staff will be heavily involved with the
                   implementation of the Wisconsin Statewide Automated Child Welfare
                   Information System (WiSACWIS) scheduled to go live in Dane County June
                   24, 2002. It is hoped during this time, that the selected vendor will be able to
                   work with DCDHS staff and partners on the confirm analysis requirements
                   phase of this project.




#5284
                                    Attachment 1
        2002 HSRS Mental Health Module Desk Card
                                       Page 1 of 2




#5284
                                    Attachment 1
        2002 HSRS Mental Health Module Desk Card
                                       Page 2 of 2




#5284
                     Attachment 2
        HSRS Mental Health Module
                       Page 1 of 1




#5284
                                                                                      Attachment 3
                      Memo- Human Services Reporting System: Mental health Consumer Status Data Set
                                                                                        Page 1 of 1




This attachment is available on the State web site at:

http://www.dhfs.state.wi.us/dsl_info/NumberedMemos/NMemo01-08.htm




#5284
                                                                                           Attachment 4
                                             Mental Health Module – Wisconsin Mental Health Data Project
                                                                                             Page 1 of 1




This attachment is available on the State web site at:

http://www.dhfs.state.wi.us/dsl_info/HSRS/handbook/Acrobat/mh_tot.pdf




#5284
                                                                                         Attachment 5
                                           Mental Health Module – Wisconsin Mental Health Data Project
Dane County Department of Human Services                     Mental Health Module


Attachment 5 is available on www.co.dane.wi.us/purch/purch.htm as RFP #5284 Addendum #1 Attachment 5




October 16-29, 2001                                                         1
                                                                                         Attachment 5
                                           Mental Health Module – Wisconsin Mental Health Data Project
Dane County Department of Human Services                     Mental Health Module




Mental Health Module
Business Area Analysis




October 16-29, 2001                                                         1
Dane County Department of Human Services                                                                     Mental Health Module




                                                                          Table of Contents

Table of Contents ............................................................................................................................ 1
Introduction ...................................................................................................................................... 2
Mental Health System Background .................................................................................................8
Project Participants........................................................................................................................11
Mission Statements .......................................................................................................................12
Business Purpose Statement ........................................................................................................13
Business Goals.............................................................................................................................. 14
Information System Goals .............................................................................................................15
Business Events and Processes ...................................................................................................16
1.0 Referral for Service.................................................................................................................18
2.0 Case Assignment....................................................................................................................19
3.0 Case Assessment...................................................................................................................20
4.0 Enrollment: Managed Care....................................................................................................24
5.0 Client Registration: Contracted Services ...............................................................................25
6.0 Individualized Service Plan/Plan of Care.................................................................................27
7.0 Manage Waiting Lists .............................................................................................................29
8.0 Crisis Plan............................................................................................................................... 30
9.0 Service Provider .....................................................................................................................31
10.0 Payment Authorization: Managed Care...............................................................................32
11.0 Payment Authorization: AFH and ILA ..................................................................................33
12.0 Medical Assistance Claiming ................................................................................................34
13.0 Managed Care Capitated Rate Payments ............................................................................35
14.0 Generate Billing for Out-of-Home Placements: ....................................................................36
15.0 Generate Payment for Reimbursable Operating Expenses:.................................................37
16.0 Client Discretionary Account (Wrap Around Funds) .............................................................38
17.0 Institutional Prevention .........................................................................................................40
18.0 Record Client Services: Contracted Programs ....................................................................41
19.0 Record Client Outcomes: Contracted Services ...................................................................42
20.0 State HSRS Mental Health Module Reporting......................................................................44
21.0 State Children Come First Reporting....................................................................................47
22.0 Grievances............................................................................................................................ 50
23.0 Discharge and Transition Plan (Disenrollment Plan) ...........................................................51
24.0 Disenrollment: Managed Care .............................................................................................52
25.0 Service Termination..............................................................................................................53
26.0 Track Physical Files..............................................................................................................54
27.0 System Maintenance ............................................................................................................55
Preliminary Data Models................................................................................................................56
Preliminary Data Elements ..............................................................Error! Bookmark not defined.




October 16-29, 2001                                                                                                              1
Dane County Department of Human Services                                        Mental Health Module




                                                          Introduction
In October, 2001 the Dane County Department of Human Services initiated a business area analysis to define
the high-level requirements for capturing data vital to the publicly funded mental health system in Dane County.
This document includes the high-level business and functional requirements for such a system.

Department of Human Services

The Dane County Department of Human Services (DCDHS) provides a comprehensive array of services and
programs to over 30,000 consumers in Dane County each year. The Department includes four Divisions:

              Adult Community Services
              Children, Youth, and Families
              Economic Assistance and Work Services
              Public Health

Mental health services for youth fall under the direction of the Children, Youth, and Families Division while
those for persons age 18 and older are under the Adult Community Services Division. In the Adult System,
mental health services are provided through contracts with eighteen different private non-profit agencies.
Through these contracts forty different programs provide an array of mental health services to around 4,000
people annually. Most of the services are for persons who have a serious and persistent mental illness. However,
anyone who is indigent and in need of ongoing or situational mental health services, is eligible to receive
services. Services are based on the ability to pay and insurance and third party payers are billed. However, if
there is no ability to pay, the service is provided at no cost to the consumer.

The purpose of the mental health system for children, youth and their families is to help children and youth
participate successfully in the community. Services are provided to meet the needs of consumers in the least
intrusive, most effective (cost and treatment) manner. Dane County Department of Human Services (DCDHS)
is the provider/payer of last resort. The Department may pay for a service not offered or available from an
HMO if the consumer meets the criteria to receive Department services. Department funded services are
provided both by the social workers in the CYF Division and by a wide and diverse variety of community-based
organizations with which DCDHS contracts. The current continuum of mental health services in the CYF
Division ranges from some targeted prevention to institutional care.

The Children, Youth, and Families Division, under contract with the State, subcontracts with Community
Partnerships to provide mental health services for severely emotionally disturbed children enrolled in the
County’s managed care program known as Children Come First. Community Partnerships is co-located with
the Department’s Achieving Reintegration Through Teamwork (ARTT) Unit and provides the case
management data system for both programs.
Dane County is also one of four pilot counties selected for implementation of the State’s mental health managed care initiative initially
targeted at adults. This initiative will also fold-in the Children Come First and other mental health programs targeting youth.

Preliminary data from 2000 indicated that 5,670 unduplicated persons received mental health services funded
by the Department of Human Services.




October 16-29, 2001                                                                            2
Dane County Department of Human Services                                     Mental Health Module



Current Information Systems

The Dane County publicly funded mental health system has 64 different agencies, including adult family
homes, providing over 120 programs. Each agency runs it’s own version of a system designed to capture data
critical to its service delivery. There are varying degrees of sophistication and complexity; some systems are
electronic while others are manual. All county-funded agencies are required to report monthly on demographics
of new consumers and the units of services provided to all consumers. Additional data is required for selected
target groups of consumers, such as those with a mental illness or with an alcohol or other drug abuse issue, on
current status and outcomes related to the service. The majority of contracted providers report the data to the
Department of Human Services manually. The Mental Health Center of Dane County provides monthly data in
a County specified flat file format.

Community Partnerships uses the proprietary software, The Clinical Manager™ by Clinical Data Solutions, Inc.
This software at Community Partnerships operates in a client/server environment with a Sybase back end.
License fees in July, 2001 were $85,000 for a 100-user license with an additional $15,000 for The Clinical
Manager Billing Component. The annual maintenance contract is 16% of the total annual license fee. This
system captures most of the data necessary for the provision of managed care services to severely emotionally
disturbed youth and some, but not all, of the utilization data required for reporting to the State Division of
Supportive Living and Division of Health Care Financing.

Additional outcome encounter data required to be collected on the managed care programs for severely
emotionally disturbed youth is maintained in a number of Excel spreadsheets by a Program Analyst with the
Department of Human Services while additional utilization data is captured by the DCDHS Information System
described shortly.

DCDHS in 2001 provided one-time, six-figure funding to the Mental Health Center of Dane County to make modifications to The
Clinical Manager™ software in order to meet the management information system capabilities specified in the Request for
Consideration Mental Health/Alcohol and Other Drug Abuse Managed Care, (also known as the managed care initiative), of the State
of Wisconsin.

Dane County Department of Human Services uses the DCDHS Information System. This is a client/server based application
developed in PowerBuilder 5.0.4 and 6.5, running on Windows NT with a Sybase 12.0.1 back end. It is deployed via WAN to 10
Humans Services sites with up to 600 end users and via a Citrix system to another 16 sites.

The information system has been developed internally by the Division of Information Management.
Information Management staff provide on-going application development, technical support, and database
administration. Database Coordinators within the Department of Human Services are responsible for
maintaining code tables and performing other administrative functions such as deleting clients.
The Dane County Department of Human Services Information System collects information about clients and the services they receive,
whether provided by Department staff or purchased through a provider agency under contract with the Department. Contracted
agencies are required to report monthly on the clients served and the units of service provided. The system is used to generate
payments to service providers and to individuals and is used to transmit service and payment information to the State of Wisconsin.

The information system is organized into six different modules:

     Client Module - The Client Module represents the “front door” to the system. It contains information on the
     client and/or case members who are receiving services. Basic demographic information, such as client




October 16-29, 2001                                                                         3
Dane County Department of Human Services                                       Mental Health Module


     name, date of birth, gender, race, address, etc. are gathered, as is information to track physical files
     associated with a client/case. This information is commonly used in all programs within the Department.

     Personnel Module – This module captures information about employees who work for the Department of
     Human Services. Basic information such as the employee name, position number, start date, end date,
     services authorized to provide, location, supervisor, and phone number are captured.

     Provider Module - This module is used to track information on purchase of service and other contracted vendors. Data is
     captured on the contract, provider, and programs.

     Administrative Module - This part of the system is used by Database Coordinators to perform administrative tasks
     integral to maintaining data integrity, such as maintaining code tables, correcting client addresses entered in error,
     and restoring discontinued members to a case.

     Service Modules –

          Adult Community Services – captures information on client services for developmental disabilities, aging, and
          mental health programs. The Individual Service Plan related to Long Term Support programs is also a part of this
          service module. This part of the system captures client specific service information such as the diagnosis codes,
          target groups, client characteristics, service start date, service end date, units of service provided, and closing
          reasons.

          Alcohol and Other Drug Abuse – this part of the system is used to collect data on clients receiving alcohol and other drug
          abuse services, their characteristics, substance problem and pattern of usage, the services they receive, and the quality and
          quantity of their participation in services. Basic information on frequency of drug use, family/marital relationships, and
          employment status are captured at the completion of services.

          Children, Youth, and Families – captures information on client services for child welfare, juvenile delinquency,
          child protective services, and juvenile mental health programs. This part of the system captures client specific
          service information such as target groups, client characteristics, service start date, service end date, units of
          service provided, and closing reasons.

          Substitute Care – collects State required information on children who live in a foster home, group home, or child
          caring institution funded by the Department of Human Services plus provides front-line staff with a history of all
          placements for each child since the program came on line in 1999.

     MasterFile - This past of the system provides a linkage to tables containing data from the old mainframe MasterFile
     system. This contains basic service and financial information on cases/clients open to the Department ‘s CYF and
     EAWS Divisions prior to the inception of the DCDHS Information System.

     Payment Processing –

          Day Care – this is a financial transaction system that generates payments on behalf of eligible clients to
          daycare providers.

          Interim Assistance – this is a case management and financial transaction system that generates payments
          to clients eligible for temporary financial and medical assistance under the Interim Assistance program.
          This part of the system also captures medical, employment, military, shelter, legal history, and
          determination decisions data.




October 16-29, 2001                                                                           4
Dane County Department of Human Services                             Mental Health Module


          Protective Payee – this is a financial transaction system that manages client accounts and generates
          payments on behalf of clients for whom the Department is the protective payee.

          Special Needs – this is a financial transaction system that generate payments on behalf of clients for
          items and services that fall outside the typical contracting process.

          Subcare - this is a financial transaction system that generates payments to foster homes, group homes,
          and residential care centers on behalf of children placed outside of their natural home. The system also
          collects required data for reporting into the State’s Human Services Reporting System (HSRS) Children
          in Substitute Care (CSC) module.

InfoMaker is used to generate queries and reports against a mirror copy of the production system that is updated
weekly.

Current Needs

Three key issues currently facing the Department include:

         More efficiently meet the obligatory reporting requirements for the State of Wisconsin.
         Replace purchased data with internal reports wherever possible.
         Improve the ability to use and analyze the Department’s own data across Divisions.

These are described in more detail as:

State Mental Health Module Reporting

One of the most pressing demands is to the meet the need for reporting into the State of Wisconsin's Human
Services Reporting System (HSRS) Mental Health Module. The module implemented in 1996 requires
quarterly reporting on client demographic and service data for persons served through the publicly funded
mental health system. In July 2001 this module was enhanced to collect data on 12 consumer status outcome
indicators which are to be updated every six months. For several years, DCDHS has been non-compliant with
reporting primarily due to a lack of a repository for the required mental health module data elements and more
pressing information management needs. Under financial threats for non-compliance, data was first reported
into this module at year-end 2000. This cumbersome process involved considerable hours/weeks of manual
data entry on over 52,000 rows of data.

State Encounter Data File Reporting

In October 2001 the State Division of Supportive Living and Division of Health Care Financing established an
ACSII flat file format for the reporting of encounter and outcome data for the Children Come First managed
care initiative. The major issues for the Department in complying with this requirement is that the data is
maintained in separate databases. Encounter data which captures basic client demographics and services is
maintained by Community Partnerships in The Clinical Manager™ software. Additional encounter data for
youth in out-of-home placements is maintained in the DCDHS Information System, however, the system does
not incorporate the procedure codes and procedure code modifiers required for reporting. Some of the outcome
data – school and CAFAS scores - is captured in The Clinical Manager™ software and the data is reported out




October 16-29, 2001                                                                 5
Dane County Department of Human Services                          Mental Health Module


to a Program Analyst with the Department of Human Services. This is then verified and appended to the
remaining required outcome data – restrictiveness of living scores and juvenile justice contacts. Again, this
cumbersome approach across multiple data systems impedes the Department’s ability to comply in a timely
fashion with the new requirement.

Support for Multiple Service Delivery System Approaches

With the Children Come First managed care program for youth already in place and having been selected as a
pilot county for the State’s Mental Health/Alcohol and Other Drug Abuse Managed Care initiative, the ability to
track clients and services in a managed care environment is critical. However, the information system must
also continue to support the existing contracted service delivery system, as well as, a fee for service system.

Decision Support
In order to provide for quality, effective, and the continuous improvement of services to persons with a mental
illness in Dane County, the Department needs to have real-time data collection, tracking, and reporting of
consumers, services, costs, outcomes, and benefits.




October 16-29, 2001                                                              6
Dane County Department of Human Services                            Mental Health Module




                                           Mental Health System Background

The publicly-funded mental health system in Dane County has evolved over the past 27 years in response to
legislation, funding opportunities, and experience with what does and does not work.

The Wisconsin State Statute dealing with disabilities, Chapter 51, was revised in the early 1970s to reflect the
change from hospital to community as the focal point of treatment. This comprehensive legislation mandated
that counties be responsible for the planning, development, budgeting, delivery, monitoring, and evaluation of
mental health services relegated to the public sector. Chapter 51 included a patient bill of rights section,
specified that treatment occur in the least restrictive environment, and provided for a dangerousness standard
and due process for involuntary treatment. All court ordered services then became a mandated responsibility
for the counties to implement and it required counties to pay for all services including adult inpatient services in
state mental health institutes. Chapter 51 further specified that all services be authorized and statistically
reported, tracked, and evaluated. These services in Dane County were provided by the 51.42 Board.

Prior to 1989 the Dane County Department of Social Services developed many mental health services for
children and youth and their families that related to Chapter 48 and 938 mandates; these are the mandates to
protect children and youth from abuse and neglect and to protect the community from illegal/delinquent
activity.. Outpatient treatment services and some in-home services were the primary mental health responses.

The 51.42 Board and the Department of Social Services merged in 1989 to create the Human Services
Department. Responsibility for Chapter 48, 938 and 51 mandates for children and youth and their families was
placed in the Children, Youth & Families (CYF) Division. Responsibility for Chapter 51 mandates for adults
was placed in the Adult Community Services Division.

During this same time period, Dane County was awarded a planning grant from the Robert Wood Johnson
Foundation. Over the course of a five-year period, Dane County received $2.4 million to develop a community-
based care system for children and youth with serious emotional disturbance and their families. This grant
increased the range of service options to include youth crisis services, intensive case management,
individualized treatment planning and flexible, wrap-around funds, and parent advocacy. The Robert Wood
Johnson grant evolved into the Children Come First (CCF) initiative on April 1, 1993. Funding for the program
is a combination of Federal Medicaid funds and county levy. CCF is a managed care program serving a target
population of children and youth with serious emotional disturbance at imminent risk of institutionalization and
their families. While the vast majority of services provided by CCF are administered by Community
Partnerships under contract to the Department, in 1995 the Achieving Reintegration Through Teamwork
(ARTT) Unit was created. The purpose of this Unit is to intensively serve the residential care center (RCC)
population utilizing the CCF concept. ARTT’s goal is to reduce the length of residential stay by formulating a
community-based treatment plan and intensely serving youth and their families through the residential care
center stay and during reintegration and stabilization in a less restrictive setting.

In May of 1996, the Governor’s Blue Ribbon Commission on Mental Health Care was created and charged with
reviewing Wisconsin’s mental health care delivery system at all levels, including the needs of children,
adolescents, adults, and the elderly and making recommendations for the development of a service system
targeted at prevention, early intervention, treatment, recovery, and positive outcomes. The concept of recovery,




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Dane County Department of Human Services                            Mental Health Module


defined as “the successful integration of a mental disorder into a consumer’s life, was adopted by the
Commission as a key tenet of a redesigned system. “In a recovery oriented system, mental health consumers
rebuild meaningful lives while decreasing their dependence on the system. They participate in services that
enable them to recover rather than become long-term users of the mental health system.” (p. iii). The
Commission identified five target populations for which to plan mental health services:

Groups in Need of Treatment and Recovery Services
Persons in need of ongoing, high intensity, comprehensive services;
Persons in need of ongoing, low intensity, comprehensive services;
Persons needing short-term situational services;

Groups in Need of Prevention and Early Intervention Services
Persons at risk;
Persons at an acceptable level of mental health.

The Commission also identified fifteen desired outcomes grouped into three categories:

Energizing Outcomes
Consumer Satisfaction
Empowerment and Self-Esteem
Access
Personal Safety
Awareness
Equal Opportunity

Clinical Outcomes
Symptom Relief
Psychological Well-Being
Physical Health

Community Living Outcomes
Social Relations and Supports
Meaningful Activities and Occupations
Goal Attainment
Basic Survival and Housing
Freedom from Substance Abuse
Daily Living Skills

Redesign of the service delivery system was also recommended. The Commission identified four broad
categories of services:

1.   “Core” mental health services, that is, assessment, crisis intervention, case management, etc.
2.   Self-help, peer support, and natural supports;
3.   Community supportive services;
4.   In-residence services.




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Dane County Department of Human Services                         Mental Health Module


It was recommended “that all consumers participate in comprehensive assessment; receive highly individualized
services based on that assessment and the consumer’s chosen way of life; have a plan of services designed to
achieve positive consumer outcomes, including self-sufficiency; be served with dignity, respect, and the least
restrictive interventions necessary to achieve consumer outcomes; and receive services that meet any applicable
standards of care” (p. ix).




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Dane County Department of Human Services                                      Mental Health Module




                                                    Project Participants


The individuals who participated in the business area analysis include:


    Participant                         Agency                              Division/Department
John Bauman              Community Partnerships                     Administration
Ken Baun                 DCDHS                                      Administration – Info Management
Lynn Brady               Mental Health Center of Dane County
Marlene Finger           DCDHS                                      Administration – Data Entry
Fran Genter              DCDHS                                      ACS Division
Lynn Green               DCDHS                                      CYF Division
Jon Hatley               Dane County                                Information Management
David LeCount            DCDHS                                      ACS Division – Mental Health
Patty Severson           DCDHS                                      Administration - Accounting
Scott Strong             Community Partnerships                     Fiscal
Joan Turk                DCDHS                                      Administration - Accounting
Marykay Wills            DCDHS                                      CYF Division – Kids Mental Health

Julie Cousin with DCDHS provided additional insight on the payroll systems.


The project was facilitated by Lori Bastean, DCDHS.




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Dane County Department of Human Services                                          Mental Health Module




                                                       Mission Statements
The following mission statements set the tenor for the mental health system in Dane County.


                                           A. Blue Ribbon Commission on Mental Health

The Vision Statement adopted by the Blue Ribbon Commission is:

          All persons in need of mental health services across Wisconsin have equal access to resources to strengthen
          self-determination and self-sufficiency by promoting health and wellness, improvement and recovery, quality of life
          and dignity.




                                     B.        Vision of Mental Health Recovery      (Draft)
The Recovery Committee of the Dane County Mental Health Service System drafted the following vision statement in
February, 2001:

          It is our belief that recovery from mental illness is an individual and continuing process of healing mind, body and spirit.

          Recovery entails having hope, resources, support and positive connections so that each person discovers
          purpose and direction in their personal life, the strength to build a satisfying present, the courage to pursue a
          rewarding future, and their inherent value as a citizen of our community.

          The role of the mental health service system is to collaborate with each individual
                    To help them to identify their personal recovery goals, and
                    To provide services and supports that assist each person to reach these goals and to enhance his/her unique
                        strengths, resources, and abilities to sustain ongoing growth and recovery.




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Dane County Department of Human Services                                       Mental Health Module




                                              Business Purpose Statement

The purpose statement for a business area is a succinct statement of what the area is to accomplish. This helps
to define the scope of the system and it’s corresponding development.
The purpose of the Dane County Department of Human Services, Mental Health Module is:


          To provide for quality, effective, and the continuous improvement of services to persons with a mental illness in Dane
          County through the real-time collection, tracking, and reporting of information on consumers, the services they receive, the
          outcomes and benefits of those services, and associated costs while meeting the demands for internal and external reporting.




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Dane County Department of Human Services                                          Mental Health Module




                                                          Business Goals

With the development of the Mental Health Module, it is hoped to achieve the following:




                                 1. Decision Support
Identify and quantify the services provided to consumers.
Track outcomes, such as work and symptom management, of services provided to consumers.



     2. Enhanced Coordination/Service
               Integration
Increase service coordination/service integration on a service provision level – specific to families and
individuals.


                                3. Financial Support
Track contract compliance.
Provide data for budget development.
Provide for service authorization, claims adjudication, billing, and reconciliation.
Provide for integration with the Payment Processing System.

                                            4. Improve Quality of Services to Consumers

Identify areas of strength and areas needing improvement in the service delivery system.


                                       5. Increase Productivity
Less staff time spent manipulating data.


                          6. Meet Reporting Requirements
Meet State, Federal, and grant reporting requirements
Provide for information sharing.
Be responsive and timely to outside requests for information.




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Dane County Department of Human Services                                     Mental Health Module




                                                Information System Goals

The following features are considered an integral part of the development of the Mental Health Module:



                                                 1. Accessible
With the appropriate levels of security, the system should be deployed on a community-wide basis to agencies and
divisions within and outside the Department of Human Services involved with the mental health system.

2. Cost-Effective

The offered solution should be cost effective to implement, modify, and maintain.

3. Flexible

    The system should be flexible and adaptable.
    The system should offer ease in updating and modifying.


                                                   4. Integrated
    The system should be integrated with the Dane County Department of Human Services DCDHS Information System and it’s
     corresponding Payment Processing System.
    The offered solution should have an open architecture that will promote integration with other existing systems.




                                                       5. Timely
System must support real time data entry, retrieval, and reporting.


                                              6. User-Friendly
    The system must be simple, easy to use.
    Form should follow function.
    System should not tax the time of the service delivery agent.




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Dane County Department of Human Services                                      Mental Health Module




                                              Business Events and Processes

Business processes are functions performed within the business area. A business event is a significant
happening that requires the business area to take action. Some events occur due to the passage of time or they
may be triggered by an outside organization making a request. Each of the business events then triggers a
response by the system.

                                Business Event                              Business Process
Arrival           Service Referral                             Process Referral
Arrival           Emergency Detention                          Process Emergency Detention
Arrival           Accepted Referral                            Update Referral Status
                                                               Assign Care Coordinator/Case Manager
Arrival           Care Coordinator/Case Manager Assigned       Assess Case
Arrival           Completed Case Assessment                    Consumer Enrollment Decision
Arrival           Enrolled Consumer                            Notify EDS
                                                               Establish Individualized Service Plan
                                                               Establish Crisis Plan
                                                               Establish Discharge and Transition Plan
Arrival           Client Registration Form (600)               Enroll Consumer
                                                               Notify Provider of Client Number
Arrival           Completed Individualized Service Plan        Authorize Services
Condition         Services at Capacity                         Generate Waiting List
Condition         Change in Team Membership                    Modify Treatment Team Membership
Condition         Service Checkpoint Reached (90 days)         Update Case Assessment
                                                               Evaluate Individualized Service Plan
                                                               Modify Individualized Service Plan
Arrival           Monthly Client Services Report (610)         Record Client Services
Arrival           Service Billing                              Pay Bill
                                                               Payment Authorization: Managed Care
Condition         Time to Bill for Services                    Generate Billing for Out-of-Home
                                                               Placements
                                                               Generate Billing for Reimbursable
                                                               Operating Expenses
Condition         Time to Bill for Medical Assistance          Generate Claims for EDS
                  Claiming
Arrival           Bill for Adult Family Home and ILA           Payment Authorization for AFH and ILA
                  Services
Arrival           EDS Payment and Report                       Update Consumer Billing Information
                                                               Distribute Provider Payments
Arrival           Request for Wrap Around Funds                Client Discretionary Account (Wrap
                                                               Around Funds)
Arrival           Request for Institutional Prevention Funds   Institutional Prevention
Arrival           New Provider                                 Add Service Provider
Arrival           Change in Provider Status                    Update Service Provider Information
Arrival           Complaint                                    Grievance process
Condition         Decision to Close Case                       Close Case and Disenroll
                                                               Update Disenrollment Plan
Condition         Successful Outcome                           Close Case and Disenroll
                                                               Update Disenrollment Plan
Condition         Lack of Compliance                           Evaluate Treatment Plan




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Dane County Department of Human Services                                    Mental Health Module


                                 Business Event                            Business Process
                                                             Modify Treatment Plan
Condition         Consumer Status Change                     Update Consumer Information
Condition         Duplicate Client                           Merge Clients and Services
Condition         Client Entered in Error                    Delete Client
Condition         Time to Report into Mental Health Module   State HSRS Mental Health Module
                                                             Reporting
Condition         Time for Children Come First Reporting     State Children Come First Reporting
Arrival           Budget Request                             Generate Budget Information
Temporal          Time to Create Reports                     Generate Reports
Arrival           Federal Policy
Arrival           State Policy Change
Arrival           Lawsuit




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Dane County Department of Human Services                                           Mental Health Module




                                                   1.0 Referral for Service

Receive a referral for service. A referral will result in the consumer being provided with an alternative service to contact or
continuing with the assessment.


1.1    Collect Consumer Demographic Information         Collect information regarding the consumer seeking
                                                        services. Examples of this data include: name, age, date-
                                                        of-birth, race, gender, ethnic status, social security
                                                        number, address, and phone.

1.2    Collect Referral Source information.             Collect information about the person/agency that referred
                                                        the consumer for services. Examples of this data include:
                                                        name, agency, program, contact number, and reason for
                                                        referral.

1.3    Collect Presenting Problem information           Collect information on the reason the consumer is seeking
                                                        services. Examples of this data include: the type of
       (Meets HSRS MH Module reporting                  problem - marital or family problem; depressed mood or
       requirements)                                    anxious; attempt, threat, or danger of suicide, disturbed
                                                        thoughts, alcohol or drugs, etc; - the length of time the
                                                        problem has persisted; how the problem interferes with
                                                        the consumer’s life.

1.4    Collect Past Treatment History                   Collect information on the prior treatment history of the
                                                        consumer. Examples of this data include: primary care
                                                        physician, psychiatrist, psychologist, type of service,
                                                        name of institution/agency/clinic providing service,
                                                        service begin date, service end date, outcome of
                                                        treatment, and diagnoses.

1.5    Collect Financial Resource Information           Collect information on the financial and health insurance
                                                        resources available to the consumer. Examples of this
                                                        data include: income, assets, name of insurance provider,
                                                        subscriber number, type of coverage, and other financial
                                                        resources.

1.6    Determine Risk                                   Determine and record the degree to which the consumer is
                                                        a risk to him/herself or is considered dangerous to others.

1.7    Determine Urgency/Immediacy of Need              Determine and record how quickly the consumer needs
                                                        services and the consequences of not providing those
                                                        services.

1.8    Decide Whether to Accept Referral                Determine and record whether to refer the consumer to
                                                        another service, to continue with case assessment, or have
                                                        no further action on the referral.

1.9    Make Referral to Other Services Based on
       Availability




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Dane County Department of Human Services                                        Mental Health Module




                                                  2.0 Case Assignment

Receive a completed case assessment and assign a system-wide or primary case manager (Adult) or a care coordinator (Juvenile).


2.1    Determine Needs of Consumer                   Receive completed referral and assessment of a consumer.
                                                     Based on the available information, determine and record
                                                     the major needs of the consumer.

2.2    Determine Staff Availability                  Determine and display the availability of Primary Case
                                                     Managers or Care Coordinators. Examples of this data
                                                     include: name, number of active cases, number of cases
                                                     referred, number of cases pending closure.

2.3    Match Needs to Staff                          Match the major needs of the consumer to the available
                                                     staff. Examples of this data include: staff name, staff
                                                     availability, and area of staff expertise.

2.4    Assign a Care Coordinator                     Direct the referral to the appropriate Supervisor for
                                                     Primary or System-wide Case Manager or Care
                                                     Coordinator assignment.

2.5    Notify Care Coordinator of Assignment         Send notification to Care Coordinator of newly assigned
                                                     case. This could take the form of a paper or electronic
                                                     notification.

2.6    Update Referral Status




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Dane County Department of Human Services                                                  Mental Health Module




                                                             3.0 Case Assessment

Collect in-depth information to determine if the request for services is appropriate. Allow for information to be updated at pre-defined
intervals.


3.1      Collect Guardian Information                          Collect information on the guardian for the consumer.
                                                               Examples of this data include: name of guardian, address,
                                                               contact number, court order number, date of court order.

3.2      Collect Primary Care Provider information             Collect information on the primary care provider(s)
                                                               involved with the consumer. Examples of data include:
                                                               name of physician/psychiatrist/ psychologist, name of
                                                               clinic, diagnosis, treatment, treatment begin date, follow-
                                                               up, on-going treatment plan.

3.3      Collect Psychotropic Medication information           Collect information on psychotropic medications the
                                                               consumer is currently taking. Examples of data include:
                                                               name of medication, frequency, dosage, name of
                                                               physician ordering medication, length of time on the
                                                               medication, and any side effects experienced.
3.4      Collect Social History Information:

                      Developmental History                    Collect information on the developmental history of the
                                                               consumer from pre-natal through the maturation process
                                                               with emphasis on significant developmental delays.

                      Family History of Mental Illness and     Collect information on the family history of mental illness
                      AODA                                     and/or substance abuse, diagnoses, and treatment.
                                                               Examples of data include: name of family member,
                                                               relationship to consumer, diagnoses, treatment, and
                                                               outcome of treatment.

                      Educational/Vocational History           Collect information on the education history of the
                                                               consumer. Examples of data include: schools attended;
                                                               years of schooling completed; classroom type – LD, ED,
                                                               CD; suspensions, expulsions, absences: degrees received,
                                                               and other comments.

                      Work-Ability History                     Collect information on the ability to work and work
                                                               history of the consumer. Examples of data include:
                               (Data meets HSRS MH             employer, position held, employment start date,
                               Consumer Data Set               employment end date, hourly wage, hours worked per
                               Requirements)                   week, type of employment – competitive, temporary,
                                                               supported, sheltered, pre-vocational; other comments.
                                                               This data is to be updated every 6 months.

                      Health History                           Collect information on the health history of the consumer.
                                                               Examples of data include: vaccinations; major illnesses
                                                               and dates; major surgeries, dates, and outcomes; chronic
                                                               illnesses.

                      Substance Abuse History                  Collect information on the substance abuse history of the
                                                               consumer. Examples of data include: substance used,
                                                               age at first use, frequency of use, route of administration,
                                                               age use discontinued, treatment received, and outcomes of
                                                               treatment.




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Dane County Department of Human Services                                                 Mental Health Module



                      Criminal/Legal History                 Collect information on the criminal justice history of the
                                                             consumer. Examples of data include: court case number,
                                                             statute, offense, disposition, time spent in jail and/or
                                                             prison.

                      Significant Past Events                Collect information on the past significant events in the
                                                             life of the consumer. Examples of data include: type of
                                                             event, date of occurrence, impact of event on consumer.

                      Cultural/Religious History             Collect information on the cultural and religious history
                                                             of the consumer. Examples of data include: language
                                                             barriers, functional illiteracy, medical beliefs or practices,
                                                             religious affiliation or membership, frequency of
                                                             involvement.

                      Placement History                      Collect information on the consumer’s out-of-home and
                                                             out-of –community placements. Examples of data
                                                             include: type of placement – inpatient psychiatric
                                                             hospitalization, foster home, residential treatment center,
                                                             etc. – start date of placement, end date of placement,
                                                             reason for placement, ending reason for placement,
                                                             number of days in placement.

                      Summary of Prior Assessment            Collect a summary of the results of prior assessments.
                                                             Examples of data include: date of assessment, type of
                                                             assessment, conducted by, and a narrative description of
                                                             the prior assessment(s).

3.5      Collect Neuro-Psych Testing Results                 Collect information on the results of prior neuro/psych
                                                             testing. Examples of data include: type of test, name of
                                                             person conducting the test, date of testing, results of
                                                             testing, reliability and validity of testing results.

3.6      Collect Current Status Information:

                      Current CAFAS Score                    For juveniles under age 18, collect the child and
                                                             adolescent functional assessment scale (CAFAS) score.
                                                             This is to be updated at six month intervals.

                      Current Living Arrangements            Collect information on the consumer’s current residential
                                                             situation. Codes include: 1 = street or shelter, 2= private
                               (Meets HSRS MH Module         residence or household, 3 = supported or semi supervised
                               Consumer Data Set and State   residence, 4 = specialized facility – on site supervision, 5
                               CCF Outcome Reporting         = other institution, 6 = jail or correctional facility. For
                               Requirements )                juveniles under age 18, collect the restrictiveness of
                                                             living (ROLS) scale score for 12 months prior to
                                                             enrollment and 6 months prior to enrollment. This
                                                             information is to be updated every six months.

                      Current Social Supports                Collect information on the current social supports used by
                                                             the consumer. Examples of data include: name of
                                                             person, relationship to consumer, type of support,
                                                             frequency of support, nature of relationship – positive,
                                                             negative, etc.

                      Current ADLs                           Collect information on the current activities of daily
                                                             living of the consumer noting those for which assistance
                               (Meets HSRS MH Module         is needed. Examples of data include: personal hygiene,
                               Consumer Data Set             meal preparation, grocery shopping, transportation,
                               Requirements)                 managing finances, medication management, safety skills,
                                                             etc. Collect information on the current planned activity of




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Dane County Department of Human Services                                                 Mental Health Module

                                                              the consumer. Codes include: 1 = no educational, social,
                                                              or planned activity; 2 = part time educational activity, 3 =
                                                              full time educational activity; 4 = meaningful social
                                                              activity; 5 = volunteer or planned activities; 6 = other
                                                              respected status; 9 = unknown. This information is to be
                                                              updated every six months.

                      Current Suicide Risk                    Collect information on the current suicide status of the
                                                              consumer. Codes include: 1 = no risk factors; 2 =
                               (Meets HSRS MH Module          presence of risk factors; 3 = high potential for suicide; 9 =
                               Consumer Data Set              unknown. This information is to be updated every six
                               Requirements)                  months.

                      Current Financial Supports              Collect information on the consumer’s current sources of
                                                              financial support. Examples of data include: type of
                               (Meets HSRS MH Module          support – paid employment, social security benefits, SSI
                               Consumer Data Set              or SSDI benefits, disability payments, worker’s
                               Requirements)                  compensation, alimony, child support, relatives, etc.; and
                                                              the amount of support. This information is to be updated
                                                              every six months.

                      Current Health Status                   Collect information on the consumer’s current
                                                              physical health status. Examples of codes include:
                               (Meets HSRS MH Module          1 = No health problem; 2 = Stable/Capable – Person
                               Consumer Data Set              is capable of seeking medical attention and is
                               Requirements)                  independent in management of health condition.
                                                              This information is to be updated every six months.
                                                              In addition note use of over the counter items,
                                                              sexuality issues, and physical limitations.

                      Recent Health Care Appointments         Collect information on the consumer’s health care
                                                              appointments in the past six months for each of the
                               (Meets HSRS MH Module          following type of appointments: health care, vision care,
                               Consumer Data Set              and dental care. Codes include: 1 = Kept appointment or
                               Requirements)                  no appointment needed, 2 = unable to access needed
                                                              services, 3 = did not keep or refused appointment, 9 =
                                                              Unknown. This information is to be updated every six
                                                              months.

                      Current Vocational/Educational Status   Collect information on the consumer’s current
                                                              vocational/educational status. Examples of data include:
                               (Meets State CCF reporting     name of school/institution, type of school, classroom type
                               requirements)                  – LD, ED, CD; suspension status, expulsion status;
                                                              frequency of attendance, number of school days
                                                              suspended, number of school days expelled, grade point
                                                              average. This information is to be updated every six
                                                              months.

                      Current Work Status                     Collect information on the current employment status of
                                                              the consumer. Examples of data include: yes/no
                                                              indicator for currently employed, employer, position held,
                                                              employment start date, hourly wage, hours worked per
                                                              week, type of employment – competitive, temporary,
                                                              supported, sheltered, pre-vocational; other comments.

                      Current Criminal Justice System         Collect information on the consumer’s criminal justice
                      Involvement                             system involvement within the past 6 months. Codes
                                                              include: 1 = none, 2 = probation, 3 = arrests, 4 =
                               (Meets HSRS and State          jailed/imprisoned, 5 = parole, 6 = juvenile justice system
                               CCF reporting                  involvement, 9 = do not know. For persons under the age
                               requirements)                  of 18 would need to collect the number of offenses in the
                                                              past six months by the following types: weapons, sex,




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Dane County Department of Human Services                                           Mental Health Module

                                                       assaults, drug, property, other. In addition collect
                                                       information on citizenship status, custody arrangements,
                                                       legal guardianship, power of attorney, protective services,
                                                       pending litigation, restraining orders, commitment status,
                                                       etc. This information is to be updated every six months.

                      Others Involved                  Collect information on other persons currently working
                                                       with the consumer. Examples of data include: name of
                                                       person, name of agency/program, relationship to
                                                       consumer, length of involvement, nature of involvement.

                      Problem-Solving Skills           Collect information on the problem-solving skills of the
                                                       consumer.

                      Personal Strengths               Collect information on the personal strengths of the
                                                       consumer.

3.7      Collect Diagnostic Impression                 Collect information on the current diagnosis of the
                                                       consumer’s condition per DSM IV on Axis I and/or Axis
                      (Meets HSRS MH Module and HSRS   II, and/or Axis III, Axis IV (psychosocial and
                      MH Module Consumer Data Set      environmental stressors), and the Global Assessment of
                      requirements)                    Functioning Scale score on Axis V. This information is
                                                       to be updated every six months. Additional information
                                                       would include the name of the person making the
                                                       diagnosis, credentials – psychologist/psychiatrist, and
                                                       date of diagnosis.

3.8      Collect SED information                       Collect information on the severe emotionally disturbed
                                                       status of a juvenile age 17 or less. Examples of data
                                                       include: yes/no response to significantly impaired
                                                       functioning for 6 months or longer without treatment
                                                       disturbance is likely to persist for a year or longer, mental
                                                       or emotional disturbance listed in DSM-IV, psychotic
                                                       symptoms or danger to self, others, or property.

3.9      Collect Assessor Information                  Collect information on the person conducting the
                                                       assessment. Examples of data include: name of assessor,
                                                       date of assessment, duration of assessment.

3.10     Generate Ticklers                             Generate a notice to the primary case manager/care
                                                       coordinator when selected data elements need to be
                                                       updated. Examples of data to be updated include:
                                                       severity update, psychological and environmental
                                                       stressors, global assessment of functioning, health status,
                                                       health care appointment, suicide risk, residential
                                                       arrangement, daily activity, employment, employment
                                                       level, commitment status, financial supports, and criminal
                                                       justice system involvement. For youth in the Children
                                                       Come First program, data to be updated includes:
                                                       CAFAS scores, restrictiveness of living scores, school
                                                       attendance data, number of school days suspended,
                                                       number of school days expelled, number of school days
                                                       not attended, cumulative grade point average, juvenile
                                                       justice charges.




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Dane County Department of Human Services                                            Mental Health Module




                                             4.0 Enrollment: Managed Care

Receive a completed case assignment, meet with the consumer to discuss services, and complete enrollment
request for those who decide to enroll.

4.1    Establish Meeting with Consumer                   Generate a notice to the consumer (and his/her family if
                                                         under age 18) to establish a meeting date.

4.2    Explain Services

4.3    Log Case Contact                                  Create a record of the contact with the consumer.
                                                         Examples of data include: date of contact, time of
                                                         contact, duration of contact, location of contact, type of
                                                         contact – telephone, e-mail, in-person - persons involved,
                                                         and free-form narrative.

4.4    Update Referral Status                            If consumer elects not to enroll in services, generate
                                                         notice to the Case Assigner. Referral status for case is to
                                                         be updated to “inactive”.

4.5    Complete Enrollment Request and Send to           If consumer decides to enroll, generate the Enrollment
       DCDHS                                             Request Form and submit it to the Department of Human
                                                         Services. Examples of data include: client name, social
                                                         security number, date of birth, enrollment (episode) start
                                                         date, enrollment (episode) end date, target group, Care
                                                         Coordinator, inpatient status at time of enrollment, and
                                                         signatures.

4.6    Fax Enrollment Request to EDS

4.7    Determine Medical Assistance (M.A.) Eligibility   Log onto the State system to determine if the consumer is
                                                         eligible for medical assistance. Record the medical
                                                         assistance eligibility of the consumer.

4.8    Receive Notification From EDS                     Receive notification from EDS the Enrollment Request
                                                         Form and approval statement.

4.9    Record the Enrollment Status                      Record the enrollment status of the consumer.




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Dane County Department of Human Services                                         Mental Health Module




                                     5.0 Client Registration: Contracted Services

Receive a completed case assignment, meet with the consumer to discuss services, notify the Department of
Human Services of the new consumer, and generate a client number.

5.1       Establish Meeting with Consumer            Generate a notice to the consumer (and his/her family if
                                                     under age 18) to establish a meeting date.

5.2       Explain Services

5.3       Log Case Contact                           Create a record of the contact with the consumer.
                                                     Examples of data include: date of contact, time of
                                                     contact, duration of contact, location of contact, type of
                                                     contact – telephone, e-mail, in-person - persons involved,
                                                     and free-form narrative.

5.4       Update Referral Status                     If consumer elects not to enroll in services, generate
                                                     notice to the Case Assigner. Referral status for case is to
                                                     be updated to “inactive”.

5.5       Register Consumer                          If consumer decides to enroll, register the consumer and
                                                     submit the data necessary to the Department of Human
                                                     Services to also register the consumer and generate the
                                                     client number. Examples of data include: provider name,
                                                     program number, client name, social security number,
                                                     date of birth, gender, race (2), ethnic status, marital status,
                                                     veteran status, homeless indicator, target group, address,
                                                     home phone number, and business phone number.

5.6       Assign Client Number and Notify Provider   Data Entry staff at DCDHS determine if the client is
                                                     already known to the DCDHS Information System. If
                                                     not, the Client Registration Form information is entered
                                                     and a client number is generated. If the client already
                                                     exists, then the information is provided back to the
                                                     contracted provider. When adding a consumer, a series of
                                                     checks are to be done to verify that a duplicate consumer
                                                     is not being added:

                                                         If a valid SSN is entered, search for the consumer
                                                          based on the SSN. If a client currently exists with
                                                          that SSN, display the client on the screen and
                                                          highlight the SSN. Do not allow entry of the new
                                                          client.

                                                         Produce a result set of potential clients that may be
                                                          the person who is currently being added to the
                                                          system.

                                                         For clients with a hyphenated name, a search must be
                                                          done using the name and for each variation of the
                                                          name. For example, if a last name of Smith-Peterson
                                                          was entered, a search would be done for the last
                                                          name Smith-Peterson, Smith, and Peterson.

                                                         Allow the search for a client to be done using a
                                                          phonetic search on the last name and first name.




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Dane County Department of Human Services                             Mental Health Module

5.7       Collect Data on Aliases          Collect information on the alias names associated with the
                                           consumer.

5.8       Change Consumer Name             Allow for the consumer name to be changed with the
                                           option to indicate that the name change resulted in an
                                           alias name being created.




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Dane County Department of Human Services                                                Mental Health Module




                                       6.0 Individualized Service Plan/Plan of Care

Establish an individualized service plan/plan of care for each consumer. Allow for the plan to be updated at regular pre-defined
intervals.


6.1      Establish Treatment Team                            Identify the persons who should be a part of the
                                                             Treatment Team. Examples of data include: name of
                                                             Treatment Team member, agency/department, contact
                                                             address, contact telephone number, contact e-mail
                                                             address, contact fax number, contact cell phone number,
                                                             relationship to Consumer, and role.

6.2      Collect Consumer Goals                              Collect information on the consumer’s recovery goals and
                                                             preferences.

6.3      Identify Measurable Goals:                          Identify measurable goals. Examples of data to be
                                                             collected for each of the domain areas includes:
                                                             completion criteria, timeline, and expected outcome for
                                                             each goal.
                     Symptom Relief
                     Housing/Living Arrangement
                     Financial Resources
                     Education
                     Work and Other Meaningful Activities
                     Daily Living Skills
                     Physical Health
                     Social Relations and Supports
                     Substance Abuse
                     Behavioral
                     Legal/Criminal Justice
                     Inpatient Utilization

6.4      Identify Services/Interventions                     Identify services and interventions to achieve each goal.
                                                             Examples of data to be collected for each goal identified
                                                             include: type of service, service code, service provider,
                                                             frequency of service, duration of service, type of support
                                                             – formal, informal - , number of units to be provided,
                                                             cost, payment source, designation if this is a medical
                                                             assistance billable service, and financial liability to the
                                                             consumer.

6.5      Check Service Availability                          For each service to be financed by the Department of
                                                             Human Services or the managed care entity, verify
                                                             whether there is an open slot for the consumer. Alert the
                                                             Care Coordinator/Case Manager when a service is not
                                                             available.

6.6      Identify Client Perspective on Goal Achievement     Identify from the consumer perspective how he/she will
                                                             know the goal is achieved.

6.7      Supervisory Approval                                Generate an electronic notice to the Supervisor of the
                                                             Care Coordinator/Case Manager to authorize payments.

6.8      Worker Notification                                 Generate an electronic notice from the Supervisor to the
                                                             Care Coordinator/Case Manager indicating the payment
                                                             authorization status.




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Dane County Department of Human Services                                        Mental Health Module

6.9      Consumer Evaluation of Goal Achievement       Collect information from the consumer perspective the
                                                       degree to which each goal has been achieved. A basic
                                                       question to ask is, “Are things better?”

6.10     Care Coordinator/Case Manager Evaluation of   Collect information from the Care Coordinator/Case
         Goal Achievement                              Manager perspective the degree to which each goal has
                                                       been achieved.

6.11     Generate Ticklers                             Generate an electronic notice to the Care
                                                       Coordinator/Case Manager 14 days in advance of the
                                                       individualized service plan needing to be updated.




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Dane County Department of Human Services                                     Mental Health Module




                                           7.0 Manage Waiting Lists

Create and manage waiting lists of consumers for services with no open slots.


7.1    Collect Consumer Information              Collect information on the consumer awaiting services.
                                                 Examples of this data include: consumer name, date-of-
                                                 birth, gender, race, ethnic status, mailing address,
                                                 telephone number.

7.2    Collect Service Information               Collect information on the type of services for which a
                                                 consumer is waiting. Examples of the services include:
                                                 case management, crisis intervention, day treatment,
                                                 community support program, medications, psychotherapy,
                                                 supervised living, work related services, and other
                                                 services. Additional data includes: date service
                                                 requested, date added to the waiting list.

7.3    Collect Case Manager Information          Collect information on the primary case manager/ care
                                                 coordinator. Examples of this data include: name,
                                                 agency, address, and telephone number.

7.4    Collect Special Needs Information         Collect information on the special needs of the consumer.
                                                 Examples of this data include: need for interpreter,
                                                 language spoken, physical impairments, etc.

7.5    Collect Narrative Information             Collect free-form narrative related to the consumer’s
                                                 placement on a waiting list.

7.6    Allow Consumers to Be Prioritized         Provide a means for consumers awaiting services to be
                                                 prioritized within each service waiting list. Examples of
                                                 this data include: court orders, jail, institutions, pending
                                                 in-patient discharges, etc.

7.7    Generate Reports                          Generate reports with user-defined parameters regarding
                                                 the unduplicated numbers of persons awaiting services,
                                                 information on persons waiting for a specific service, etc.




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Dane County Department of Human Services                                              Mental Health Module




                                                            8.0 Crisis Plan

Develop a plan with the Consumer for dealing with crises.


8.1    Meet with Consumer

8.2    Collect Historical Marker Information                Collect information on the historical markers or potential
                                                            points and triggers for decompensation for the consumer.
                                                            Examples of data include: stressors, personal appearance,
                                                            precipitating signs and/or events, such as the anniversary
                                                            date of a suicide attempt or death of a significant other.

8.3    Collect Personal Strengths for Dealing with Crises   Collect information on the strengths of the consumer, as
                                                            well as, information on what has worked in the past in
                                                            crisis situations.

8.4    Identify Specific Interventions                      Examples of data include: contact person, provider/
                                                            clinic, relationship to consumer, address, phone,
                                                            availability, and inpatient options.

8.5    Advance Directive                                    Collect information on whether the consumer has an
                                                            advance directive.

8.6    Power of Attorney                                    Collect information on who is designated to have the
                                                            power of attorney for the consumer. Examples of data
                                                            include: name, provider/program, address, telephone
                                                            number, and level of decision-making authority.




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Dane County Department of Human Services                                    Mental Health Module




                                              9.0 Service Provider


Establish Service Providers, authorize services, and monitor performance.


9.1    Collect Vendor (Agency) information       Collect information on the vendor (agency). Examples of
                                                 this data include: agency name, address, telephone, fax
                                                 number, e-mail address, contact person.

9.2    Collect Contract Information              Collect information on the contract with the vendor
                                                 (agency). Examples of this data include: contract
                                                 number, contract start date, contract end date.

9.3    Collect Service information               Collect information on the services the vendor
                                                 (agency) is authorized to provide. Examples of this
                                                 data include: name of service, type of service code,
                                                 standard program category (SPC) code, place of
                                                 service code, HCPCS procedure code, Wisconsin
                                                 Medical Assistance Program (WMAP) procedure
                                                 code, HSRS provider type, HSRS license type,
                                                 HSRS provider number, number of consumer slots,
                                                 type of consumers accepted, contracted dollar
                                                 amount, cost per unit of service, narrative
                                                 description of the service.

9.4    Collect Service Provider information      Collect information on the persons authorized to provide
                                                 the services. Examples of this data include: individual
                                                 name, educational degree, type of provider, specialty,
                                                 Medical Assistance (MA) certification number, rate of
                                                 pay.

9.5    Establish Vendor Number                   For vendors new to Dane County, establish a vendor
                                                 number. Examples of data include: vendor name, vendor
                                                 number, address. This is currently done via a phone call
                                                 to the County Controller’s Office.

9.6    Establish HSRS Facility Number            Generate a Human Services Reporting System (HSRS)
                                                 request for a facility number if the provider or provider
                                                 service is new to the system. Examples of this data
                                                 include: facility name, operator, address, county code,
                                                 provider type, license type, requesting agency RU code.

9.7    Collect Monitoring Information            Collect monitoring information on the services provided
                                                 by the vendor. Examples of this data include: results of
                                                 site visits, pending litigation, service usage, consumer
                                                 demographics, consumer outcomes, consumer and other
                                                 feedback.

9.8    Log Vendor Contacts                       Create a record of contacts with the vendor. Examples of
                                                 this data include: date of contact, time of contact,
                                                 duration of contact, location of contact, type of contact,
                                                 persons involved, and a free-form narrative.




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Dane County Department of Human Services                                       Mental Health Module




                                      10.0 Payment Authorization: Managed Care

Authorize payments on behalf of the consumer to vendors.


10.1     Generate Report for Authorized Services     Generate a monthly report (viewable from the Web) for
                                                     each provider/program or service of the clients and
                                                     maximum billable units per month. Examples of data
                                                     include: month of service, vendor, service, service
                                                     provider, consumer name, rate, authorized units of
                                                     service for month.

10.2     Receive Bill from Provider Agency

10.3     Update Client Record with Actual Services   Update the client record to reflect the actual units of
                                                     service delivered for the month. Examples of this data
                                                     include: consumer name, month of service, number of
                                                     units of service.

10.4     Reconcile Bill with Authorized Services     Generate a monthly report detailing by agency/ service by
                                                     consumer where units provided exceeded the units
                                                     authorized.

10.5     Identify Billable Services                  Generate a record of the billable services to be paid on
                                                     behalf of each consumer to each vendor/service by month.

10.6     Generate Payment                            Generate a payment voucher and payment for each
                                                     vendor/service based on the number of units billable times
                                                     the unit rate for the month.

10.7     Maintain Payment Records                    Maintain a record of all payments searchable by user-
                                                     defined parameters by date, month, check number,
                                                     invoice number, agency, service, provider, or consumer.




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Dane County Department of Human Services                                      Mental Health Module




                                     11.0 Payment Authorization: AFH and ILA

Authorize payments to vendors on behalf of consumers with a mental illness in adult family homes and innovative living
arrangements.


11.1     Generate Report for Service Verification   Generate a monthly report by provider of the consumers
                                                    and amounts to be paid. Examples of this data include:
                                                    month of service, vendor, vendor number, voucher
                                                    number, consumer name, name of placement, type of
                                                    placement, address of placement , units of service, and
                                                    amount to be paid on the consumer’s behalf. (Currently,
                                                    this information, maintained in an Excel spreadsheet, is
                                                    sent only to Tellurian U.C.A.N. CRX on the 20th of each
                                                    month. Units of service information is recorded by Data
                                                    Entry staff manually …see 18.0 Record Client Services:
                                                    Contracted Programs.)

11.2     Receive Updated Service Verification       (Currently this is updated with any changes by Tellurian
                                                    U.C.A.N. CRX and submitted to DCDHS by the 15th –
                                                    18th of the month.)

11.3     Generate Recurring Payment Voucher         Generate a Recurring Payment Voucher for supervisory
                                                    signature and submittal to the Controller’s Office.
                                                    Examples of this data include: Payroll Name (Adult
                                                    Family Homes), recurring payment voucher number,
                                                    account number, description, and month payment is for.

11.4     Receive Checks from the Dane County
         Controller’s Office

11.5     Distribute Payments to Providers

11.6     Update Client Record                       Update the client record with the amount of payment and
                                                    month the payment was made. (Currently this
                                                    information is posted in a mental health book maintained
                                                    in Payroll.)

Note: This process should be re-visited for streamlining. Information on the number of days (units of service)
each consumer is in a placement is provided separately and could be used as the basis for payment.
.




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Dane County Department of Human Services                                       Mental Health Module




                                             12.0 Medical Assistance Claiming

Submit claims to Medical Assistance, receive, and distribute revenue on behalf of consumers to the appropriate provider
agencies.



12.1     Collect Information for Billing Medical     Collect information for billing Medical Assistance.
         Assistance                                  Examples of this data include: County MA billing
                                                     number, provider agency, provider number, consumer
                                                     name, medical assistance number, diagnosis, other
                                                     primary insurance, begin date of service, end date of
                                                     service, units of service, HCPCS procedure codes,
                                                     presenting problem codes, place of service codes, type of
                                                     service code, charges.

12.2     Generate and Submit Claims to EDS           Submit claims to EDS for the following services:
                                                     Case management, crisis intervention, personal care,
                                                     community support programs, and in-home. This may be
                                                     done by paper or electronically via magnetic tape or
                                                     telephone transmission. For further information on
                                                     electronic submission contact: EMC Department
                                                     EDS
                                                     6406 Bridge Rd
                                                     Madison, WI 53784-0009
                                                     (608) 221-4746

12.3     Receive Payments from EDS

12.4     Update Consumer Data                        Receive ASCII delimited flat file from EDS on a weekly
                                                     basis. Update the consumer billing information to
                                                     indicate the amount allowed, the amount paid, and the
                                                     reason if the amount was not paid in full.

12.5     Sort Payments by Provider                   Sort payments from EDS by provider agency. Each
                                                     provider agency is to receive a check and a paper report
                                                     indicating the updated consumer billing information. This
                                                     may be the paper report received from EDS or a generated
                                                     report from the system.

12.6     Distribute Payments to Providers            For crisis intervention billing for Community
                                                     Partnerships, the Medical Assistance revenue is currently
                                                     split as follows: first $200 per consumer per month goes
                                                     to the Department and the second $200 per consumer per
                                                     month is split equally between Community Partnerships
                                                     and the Department.




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Dane County Department of Human Services                                              Mental Health Module




                                    13.0 Managed Care Capitated Rate Payments

Generate on a monthly basis the necessary paperwork to make payments to the managed care provider agency for consumers in the
program each day of the prior month.


13.1     Generate a Payment Voucher and Supporting          Generate a payment voucher for the managed care
         Documentation                                      provider agency. 1 Examples of this data include: name
                                                            of provider agency, address, number of clients billed for,
                                                            and signature. Examples of the supporting documentation
                                                            include: client name, number of days in program for the
                                                            month, daily rate, total charge by client, total charge for
                                                            agency.

13.2     Receive Signed Payment Voucher

13.3     Generate Recurring Payment Voucher for on-line     Examples of this data include: provider agency name,
         keying into Controller’s System                    address, contract number, recurring payment voucher
                                                            number, account number, payment amount, description of
                                                            charges, total amount to be paid.




1 This represents a departure from the current system where the voucher is generated by the provider agency two (2) months in advance. Voucher
received by the end of August will be for October.




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Dane County Department of Human Services                                         Mental Health Module




                               14.0 Generate Billing for Out-of-Home Placements:
                                                                                                                   Managed Care

Generate a monthly bill for out-of-home placement services for consumers that are the responsibility of the managed care
entity and reconcile differences.


14.1     Collect refund information                    Collect information on refunds received on behalf of
                                                       children in out-of-home placements. Examples of this
                                                       data include: consumer name, placement, placement start
                                                       date, placement end date, service code, amount of refund.

14.2     Collect correctional placement information    Collect information on youth placed with the Department
                                                       of Corrections. Examples of this data include: consumer
                                                       name, placement, placement start date, placement end
                                                       date, service code, amount charged.

14.3     Generate Bill with Supporting Documentation   Generate a monthly report on the consumers for
                                                       whom the managed care entity should be billed.
                                                       The report should list for each month the consumers
                                                       in an out-of-home placement by managed care
                                                       entity for whom a bill should be generated. This will
                                                       require comparisons of consumers enrolled in the
                                                       managed care entity to those in placements less the
                                                       amount of refunds received on their behalf.
                                                       Examples of this data include: month billing for,
                                                       consumer name, placement, placement start date,
                                                       placement end date, number of days that month in
                                                       placement, daily rate, amount of refund, amount
                                                       billed, and total amount billed.

14.4     Make Adjustments                              Receive the supporting documentation with adjustments
                                                       from the managed care entity. Make adjustments in
                                                       placement information as needed.




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Dane County Department of Human Services                                  Mental Health Module




                      15.0 Generate Payment for Reimbursable Operating Expenses:
                                                                                Managed Care

Receive bills and generate payments for reimbursable operating expenses. This currently only pertains to Community
Partnerships with which the Achieving Reintegration Through Teamwork (ARTT) Unit of the Department of Human
Services is co-located.


15.1     Receive Payment Invoice               Receive an invoice for reimbursable operating expenses,
                                               such as for telephones, for which DCDHS is responsible.

15.2     Submit Invoice for Payment Approval   Generate a notice with the accompanying invoice to the
                                               CYF Division Manager and Program Manager for
                                               approval.

15.3     Receive Approval for Payment

15.4     Generate Payment Voucher              Generate a hard-copy payment voucher for submission to
                                               the Controller’s Office. Examples of this data include:
                                               vendor name, address, fund, agency, org number, object
                                               code, amount, total to be paid, and description of service.




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Dane County Department of Human Services                                         Mental Health Module




                          16.0 Client Discretionary Account (Wrap Around Funds)

Process requests for use of wrap around funds, generate payments, reimburse the appropriate account, and track
balances by office. Each DCDHS CYF Division Office receives an annual allocation of $3,000 - $5,000 for use in meeting
the needs of consumers. Checks from this account are typically issued the same day as the request is received.


16.1      Generate Request for Payment                 Worker generates a written request for funding.
                                                       Examples of this data include: DCDHS worker name,
                                                       consumer name, vendor name, vendor address, amount of
                                                       request, description of service to be provided or basis of
                                                       request.

16.2      Supervisory Approval                         Generate a notice with the accompanying request to the
                                                       worker’s supervisor for approval.

16.3      Worker Notification                          Generate a notice from the supervisor to the worker
                                                       indicating the payment approval status – approved, not
                                                       approved, and reason for non-approval.

16.4      Managerial Approval                          Generate a notice with the accompanying request to the
                                                       CYF Division Manager to authorize payment.

16.5      Worker Notification                          Generate a notice from the CYF Division Manager to the
                                                       supervisor and worker indicating the payment
                                                       authorization status – approved, not approved, and reason
                                                       for non-approval.

16.6      Receive Approval for Payment                 Generate a notice to Payroll of the request approved for
                                                       payment and accompanying documentation.

16.7      Generate Action Sheet                        Generate an Action Sheet. Examples of this data include:
                                                       name of payee, address of payee, consumer or case name,
                                                       approved amount.

16.8      Payroll Supervisory Approval                 Submit the Action Sheet and accompanying request for
                                                       funding to the Payroll Supervisor for approval.

16.9      Issue Check and Payment Receipt              Issue check to the payee. Generate a letter to the payee
                                                       for signature that accompanies the check indicating
                                                       receipt of funds. Examples of this data include: name of
                                                       payee, the purpose of the funds, month funds issued, the
                                                       dollar amount, date received.

16.10     Track Allocations and Balance                Update record for payments by CYF Division Office.
                                                       Examples of this data include: Supervisor Name, initial
                                                       allocation, date check issued, amount of check, name of
                                                       payee, balance remaining by Office.

16.11     Generate Payment Voucher to Reimburse 0810   Generate a hard-copy payment voucher for submission to
          Account                                      the Controller’s Office. Examples of this data include:
                                                       vendor name – in this case Dane County Department of
                                                       Human Services, address, account number 260-510-4555-
                                                       2828, date, check number, date check issued, amount of
                                                       check issued, total to be reimbursed, and description of
                                                       service. (Currently this is done when either 10 checks or
                                                       $1,000 are outstanding.) Record the date submitted to the
                                                       County Controller’s Office.




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Dane County Department of Human Services                                   Mental Health Module



16.12     Track the Reimbursement                Receive the check from the Controller’s Office and record
                                                 the date the check was received and the check number.
                                                 (Currently this is recorded on a copy of the Payment
                                                 Voucher.)

16.13     Generate Report on Account Usage and   Generate a user-defined report of the allocations and
          Balances                               remaining balances by office. Examples of this data
                                                 include: Supervisor Name, initial allocation, date check
                                                 issued, amount of check, name of payee, balance
                                                 remaining by Office.




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Dane County Department of Human Services                                         Mental Health Module




                                                 17.0 Institutional Prevention

Process requests for use of institutional prevention funds, generate payments, and track fund usage.


17.1      Receive Approved Invoice for Payment         Receive an invoice approved by the CYF Division
                                                       Manager for payment out of account 260-510-4365-6571.

17.2      Generate Payment Voucher                     Generate a hard-copy payment voucher for submission to
                                                       the Controller’s Office. Examples of this data include:
                                                       vendor name, address, account number, date, total to be
                                                       reimbursed, and description of service. Record the date
                                                       submitted to the County Controller’s Office.

17.3      Distribute Payment to Vendor                 Receive the check from the Controller’s Office and record
                                                       the date the check was received, the check number, and
                                                       the date the check was mailed to the vendor. (Currently
                                                       this is recorded on a copy of the Payment Voucher.)

17.4      Generate Report on Account Usage and         Generate a user-defined report of the allocations and
          Balances                                     remaining balances. Examples of this data include:
                                                       consumer name, vendor, service date, service description,
                                                       date check issued, amount of check, amount expended in
                                                       fund, balance remaining.




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Dane County Department of Human Services                                            Mental Health Module




                               18.0 Record Client Services: Contracted Programs


Record units of service.


18.1      Receive Monthly Client Services Report          The report may be received in electronic or manual
                                                          formats.

18.2      Add Monthly Client Service Information to the   (Manual entry) For each provider by service, display in
          System                                          alphabetical order the open clients each month and allow
                                                          addition of unit of service information. Examples of data
                                                          to be displayed include: provider name, provider number,
                                                          unit type, number of open clients, client name, client
                                                          number, service start date, service end date. Allow for
                                                          entry of units of service and updating of monthly total
                                                          number of units provided, total year-to-date of units
                                                          provided, and total units provided year-to-date by
                                                          consumer.

                                                          (Electronic Entry) Update the service record. Generate
                                                          an edit exception report for fields with invalid data.




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Dane County Department of Human Services                                              Mental Health Module




                               19.0 Record Client Outcomes: Contracted Services


Capture State required Human Services Reporting System (HSRS) Mental Health Module data for consumers with
contracted purchase-of-service (POS) agencies.


19.1      Identify Consumers Needing Data Collected        At the time of client registration, identify consumers for
                                                           whom the mental health supplemental data elements need
                                                           to be collected. Notification needs to be provided to the
                                                           Data Entry staff and Purchase of Service agency.2 Data
                                                           will need to be collected for consumers with a new
                                                           episode of mental health services.

19.2      Collect Initial Mental Health Module             Collect the mental health module supplemental elements
          Supplemental Data                                for each episode of mental health services. Examples of
                                                           this data include: episode start date, primary system case
                                                           manager, client characteristics, medical assistance
                                                           number, commitment status, severity, presenting problem,
                                                           diagnostic impression, number of children, and number of
                                                           children living with the consumer. POS agencies have
                                                           asked that this data be able to be collected on-line and that
                                                           they be able to print a hard-copy of the data submitted to
                                                           DCDHS. Security in this scenario would permit an
                                                           agency to only view those consumers currently open to
                                                           the agency. This information must also be able to be
                                                           entered manually by the DCDHS Data Entry staff.

19.3      Collect Initial Mental Health Module Consumer    Allow for manual data entry by DCDHS Data Entry staff,
          Status Data Set Information                      as well as, electronic data entry by POS agencies of the
                                                           mental health module consumer status data set
                                                           information on consumers with a new episode of mental
                                                           health services. Examples of this data include:
                                                           psychosocial and environmental stressors, global
                                                           assessment of functioning, current health status, health
                                                           care appointments – physical, vision, dental - , current
                                                           suicide risk, current residential arrangement, current
                                                           planned daily activity, current employment activities,
                                                           employment hours, current commitment status, criminal
                                                           justice system involvement, and current financial
                                                           supports. POS agencies have asked that this data be able
                                                           to be collected on-line and that they be able to print a
                                                           hard-copy of the data submitted to DCDHS. Security in
                                                           this scenario would permit an agency to only view those
                                                           consumers currently open to the agency.


19.4      Notify the System Wide Case Manager Of           Generate an electronic and hard-copy notice to the Mental
          Needed Updates                                   Health System-Wide Case Manager that the Consumer
                                                           Status Data Set must be updated. This information should
                                                           be able to be queried and printed by the individual case
                                                           manager, the purchase-of-service agency, and the
                                                           Contract Manager using user-defined parameters, i.e., one
                                                           month in advance, by updates overdue, by agency with


2 Data Entry staff may receive requests for DCDHS client numbers for either one consumer or a group of consumers at one time. One option discussed
was generating a report in both electronic and hard-copy format that could be sent to the POS agency notifying them of the consumers for whom the
additional data elements need to be collected.




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Dane County Department of Human Services                                       Mental Health Module

                                                     updates to be completed, etc. Updates are required on all
                                                     consumers at six month intervals.

19.5      Collect Updated Consumer Status Data Set   Allow for manual data entry by DCDHS Data Entry staff,
          Information                                as well as, electronic data entry by POS agencies of the
                                                     updated mental health module consumer status data set
                                                     information on consumers with a new episode of mental
                                                     health services. Examples of this data include: severity
                                                     update, psychosocial and environmental stressors, global
                                                     assessment of functioning, current health status, health
                                                     care appointments – physical, vision, dental - , current
                                                     suicide risk, current residential arrangement, current
                                                     planned daily activity, current employment activities,
                                                     employment hours, current commitment status, criminal
                                                     justice system involvement, and current financial
                                                     supports. POS agencies have asked that this data be able
                                                     to be collected on-line and that they be able to print a
                                                     hard-copy of the data submitted to DCDHS. Security in
                                                     this scenario would permit an agency to only view those
                                                     consumers currently open to the agency.




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Dane County Department of Human Services                                      Mental Health Module


                                20.0 State HSRS Mental Health Module Reporting


Generate on a quarterly basis a pre-defined ASCII flat file for reporting into the State of Wisconsin Human Services
Reporting System Mental Health Module.


20.1      Edit Exceptions                         Run the mental health data for the quarter through a set of
                                                  edits to determine those errors that need to be rectified
                                                  prior to submittal of the data to the State. Examples of
                                                  edits include: all fields must contain valid data; names
                                                  are not to contain any hyphens or other punctuation; if
                                                  severity code = 1, then number of children and children in
                                                  the home are required fields; diagnostic impression 1
                                                  must be on Axis I; etc. Generate a report of all fields in
                                                  error.

20.2      Develop Flat File                       Allow for the end user to pre-define the reporting period
                                                  for data to be submitted to the State. The current flat file
                                                  format is as follows:

                                                  Field Name                    Length        Start        End
                                                  MH-RU-CODE                         6           1           6
                                                  MH-MODULE-TYPE-                    1           7           7
                                                  CODE
                                                  MH-CLIENT-ID                       14          8          21
                                                  MH-CLT-SSN                          9         30          38
                                                  MH-CLT-MA                          10         39          48
                                                  MH-WORKER-ID                       10         49          58
                                                  MH-CLT-LN                          19         59          77
                                                  MH-CLT-FN                          10         78          87
                                                  MH-CLT-MI                           1         88          88
                                                  MH-CLT-SUFF                         3         89          91
                                                  MH-CLT-DOB                          8         92          99
                                                  MH-CLT-GENDER                       1        100         100
                                                  MH-CLT-HISP-                        1        101         101
                                                  ORIGIN
                                                  MH-CLT-RACE-1                       1        102         102
                                                  MH-CLT-RACE-2                       1        103         103
                                                  MH-CLT-RACE-3                       1        104         104
                                                  MH-CLT-RACE-4                       1        105         105
                                                  MH-CLT-RACE-5                       1        106         106
                                                  MH-CLT-CHAR-1                       2        107         108
                                                  MH-CLT-CHAR-2                       2        109         110
                                                  MH-CLT-CHAR-3                       2        111         112
                                                  MH-CLT-STREET                      30        113         142
                                                  MH-CLT-CITY                        17        143         159
                                                  MH-CLT-STATE                        2        160         161
                                                  MH-CLT-ZIP-5                        5        162         166
                                                  MH-COUNTY                           3        167         169
                                                  MH-CLT-TEL-AREA                     3        170         172
                                                  MH-CLT-TEL-PRE                      3        173         175
                                                  MH-CLT-TEL-SUF                      4        176         179
                                                  MH-DIAGNOSIS                        6        180         185
                                                  MH-FAMILY-ID                        7        186         192
                                                  MH-LOCAL-1                          8        193         200
                                                  MH-LOCAL-2                          6        201         206
                                                  MH-START-DATE                       8        207         214
                                                  MH-REVIEW-DATE                      8        215         218
                                                  MH-END-DATE                         8        223         230




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                                           FILLER                   2        231    232
                                           MH-COM-STA               1        233    233
                                           MH-SEVERITY              1        234    234
                                           MH-PRES-PB1              2        235    236
                                           MH-PRES-PB2              2        237    238
                                           MH-PRES-PB3              2        239    240
                                           MH-DIAGNOSIS-            3        241    243
                                           IMP1
                                           MH-DIAGNOSIS –           2        244    245
                                           IMP2
                                           MH-DIAGNOSIS -           3        246    248
                                           IMP3
                                           MH-DIAGNOSIS –           2        249    250
                                           IMP4
                                           MH-DIAGNOSIS-            3        251    253
                                           IMP5
                                           MH-DIAGNOSIS –           2        254    255
                                           IMP6
                                           MH-DIAGNOSIS –           3        256    258
                                           IMP7
                                           MH-DIAGNOSIS –           2        259    260
                                           IMP8
                                           MH-DIAGNOSIS –           3        261    263
                                           IMP9
                                           MH-DIAGNOSIS –           2        264    265
                                           IMP10
                                           MH-CNTY-RES              2        266    267
                                           MH-SOC-SUPP              2        268    269
                                           MH-NUM-CHILDREN          2        270    271
                                           MH-CHILDREN-             2        272    273
                                           HOME
                                           MH-VETERAN-              1        274    274
                                           STATUS
                                           MH-REFERRAL-             2        275    276
                                           SOURCE
                                           MH-CASE-REV-DT           8        277    284
                                           MH-SPC-CODE              3        285    287
                                           MH-SPC-SUB-CODE          2        288    289
                                           MH-SPC-START-DT          8        290    297
                                           MH-PROVIDER-NUM         10        298    307
                                           MH-UNITS-DAYS            3        308    310
                                           MH-UNITS-OTHERS          5        311    315
                                           MH-SPC-END-DATE          8        316    323
                                           MH-SPC-CLR               2        324    325
                                           MH-DEL-DATE              8        326    333
                                           MH-SPC-REV-DT            8        334    341
                                           MH-STATUS-               8        342    349
                                           REPORT-DATE
                                           MH-SEVERITY-             1        350    350
                                           UPDATE
                                           MH-DSMIV-AXISIV          1        351    351
                                           MH-DSMIV-AXISV           2        352    353
                                           MH-HEALTH-               1        354    354
                                           STATUS
                                           MH-HLTH-CARE-            1        355    355
                                           APPT1
                                           MH-HLTH-CARE-            1        356    356
                                           APPT2
                                           MH-HLTH-CARE-            1        357    357
                                           APPT3
                                           MH-SELF-HARM             1        358    358
                                           MH-RES-ARRANGE           1        359    359




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Dane County Department of Human Services                               Mental Health Module

                                            MH-DAILY-                          3        360            362
                                            ACTIVITY
                                            MH-EMPLOYMENT                      2        363            364
                                            MH-EMPLOY-LEVEL                    1        365            365
                                            MH-COMMIT-STAT-                    1        366            366
                                            UPD
                                            MH-CRIMINAL-                       4        367            370
                                            ACTIV
                                            MH-FIN-SUPP-1                      2        371            372
                                            MH-FIN-SUPP-2                      2        373            374
                                            MH-FIN-SUPP-3                      2        375            376
                                            MH-FIN-SUPP-4                      2        377            378

20.3      Update Records with Episode Key   Receive from the State the flat file with the episode key
                                            added for new episodes. Update the consumer record
                                            with the episode key.

20.4      Flag Sent Records                 Set indicator to identify service records that have been
                                            sent to the State.




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Dane County Department of Human Services                                       Mental Health Module


                                       21.0 State Children Come First Reporting


Generate on a semi-annual basis two pre-defined ASCII flat files for reporting into the State of Wisconsin Children Come
First system.


21.1      Edit Exceptions                          Run the Children Come First data an a semi-annual basis
                                                   through a set of edits to determine those errors that need
                                                   to be rectified prior to submittal of the data to the State.
                                                   Examples of edits include: all fields must contain valid
                                                   data; names are not to contain any hyphens or other
                                                   punctuation; diagnostic impression 1 must be on Axis I;
                                                   etc. Generate a report of all fields in error.

21.2      Develop Flat Files                       Allow for the end user to pre-define the reporting period
                                                   for data to be submitted to the State. The current
                                                   Encounter Data flat file format is as follows:

                                                   Field Name                    Length        Start        End
                                                   CCF Medicaid ID                    8           1           8
                                                   Record Identification             30           9          38
                                                   Number
                                                   Recipient Identification           10         39          48
                                                   Number
                                                   SSN                                 9         49          57
                                                   Last Name                          34         58          91
                                                   First Name                         24        115          24
                                                   Middle Initial                      1        116         116
                                                   Gender                              1        117         117
                                                   Date of Birth                       8        118         125
                                                   Ethnicity                           1        126         126
                                                   Procedure Code                      5        127         131
                                                   Procedure Code                      3        132         134
                                                   Modifier
                                                   Date of Service Begin               8        135         142
                                                   Date
                                                   Date of Service End                 8        143         150
                                                   Date
                                                   Number of Service                   3        151         153
                                                   Units
                                                   Axis I Diagnosis (A1A)              5        154         158
                                                   Axis 1 Diagnosis (A1B)              5        159         163
                                                   Axis 1 Diagnosis (A1C)              5        164         168
                                                   Axis 1 Diagnosis (A1D)              5        168         173
                                                   Axis 2 Diagnosis (A2A)              5        174         178
                                                   Axis 2 Diagnosis (A2B)              5        179         183
                                                   Axis 2 Diagnosis (A2C)              5        184         188
                                                   Axis 2 Diagnosis (A2D)              5        189         193
                                                   Encounter Data                      8        194         201
                                                   Submission Date

                                                   The current Outcome Data File Format is as follows:

                                                   Field Name                    Length        Start        End
                                                   CCF Medicaid ID                    8           1           8
                                                   Record Identification
                                                   Number                             15           9         23
                                                   Recipient Identification
                                                   Number                             10         24          33




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Dane County Department of Human Services                            Mental Health Module

                                           SSN                             9         34     42
                                           Last Name                      34         43     76
                                           First Name                     24         77    100
                                           Middle Initial                  1        101    101
                                           CS 1                            4        102    105
                                           CD 1                            8        106    113
                                           CS 2                            4        114    117
                                           CD 2                            8        118    125
                                           CS 3                            4        126    129
                                           CD 3                            8        130    137
                                           CS 4                            4        138    141
                                           CD 4                            8        142    149
                                           CS 5                            4        150    153
                                           CD 5                            8        154    161
                                           CS 6                            4        162    165
                                           CD 6                            8        166    173
                                           CAFAS Score Point
                                           Indicator                       1        174    174
                                           ROLS 1                          2        175    176
                                           ROLD 1                          8        177    184
                                           ROLS 2                          2        185    186
                                           ROLD 2                          8        187    194
                                           ROLS 3                          2        195    196
                                           ROLD 3                          8        197    204
                                           ROLS 4                          2        205    206
                                           ROLD 4                          8        207    214
                                           ROLS 5                          2        215    216
                                           ROLD 5                          8        217    224
                                           ROLS 6                          2        225    226
                                           ROLD 6                          8        227    234
                                           ROLS 7                          2        235    236
                                           ROLD 7                          8        237    244
                                           ROLS 8                          2        245    246
                                           ROLD 8                          8        247    254
                                           UA 1                            3        255    257
                                           UA 2                            3        258    260
                                           UA 3                            3        261    263
                                           UA 4                            3        264    266
                                           SS 1                            3        267    269
                                           SS 2                            3        270    272
                                           SS 3                            3        273    275
                                           SS 4                            3        276    278
                                           SE 1                            3        279    281
                                           SE 2                            3        282    284
                                           SE 3                            3        285    287
                                           SE 4                            3        288    290
                                           School Attendance Data          3        291    293
                                           Classroom Type                  2        294    295
                                           PO 1                            2        296    297
                                           PO 2                            2        298    299
                                           PO 3                            2        300    301
                                           PO 4                            2        302    303
                                           PO 5                            2        304    305
                                           PO 6                            2        306    307
                                           OO 1                            2        308    309
                                           OO 2                            2        310    311
                                           OO 3                            2        312    313
                                           OO 4                            2        314    315
                                           OO 5                            2        316    317
                                           OO 6                            2        318    319
                                           AO 1                            2        320    321
                                           AO 2                            2        322    323




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                                           AO 3                               2        324            325
                                           AO 4                               2        326            327
                                           AO 5                               2        328            329
                                           AO 6                               2        330            331
                                           WO 1                               2        332            333
                                           WO 2                               2        334            335
                                           WO 3                               2        336            337
                                           WO 4                               2        338            339
                                           WO 5                               2        340            341
                                           WO 6                               2        342            343
                                           SO 1                               2        344            345
                                           SO 2                               2        346            347
                                           SO 3                               2        348            349
                                           SO 4                               2        350            351
                                           SO 5                               2        325            353
                                           SO 6                               2        354            355
                                           DO 1                               2        356            357
                                           DO 2                               2        358            359
                                           DO 3                               2        360            361
                                           DO 4                               2        362            363
                                           DO 5                               2        364            365
                                           DO 6                               2        366            367

21.3      Flag Sent Records                Set indicator to identify service records that have been
                                           sent to the State.




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                                           22.0 Grievances


Record and track grievances.


22.1      Log Grievances                   Record information on consumer grievances. Examples
                                           of this data include: consumer name, whether the
          (Meets State CCF requirements)   consumer is a Medicaid or Badger Care enrollee,
                                           summary of problem, date of complaint, type of grievance
                                           – program administration or services - , formal or
                                           informal, agency response, resolution, action taken, date
                                           resolved, parties involved, consumer satisfaction with
                                           resolution.

22.2      Generate Reports                 Generate user-defined reports on consumer grievances in
                                           both summary and detail forms. Examples of this
                                           summary data include: number of grievances, number
                                           resolved, number denied, number reversed, resolution,
                                           consumer satisfaction with resolution.




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                           23.0 Discharge and Transition Plan (Disenrollment Plan)

Establish discharge and transition from service plans.


23.1      Identify Measurable Goals                Identify measurable goals that indicate that transition
                                                   from services is appropriate. Examples of this data
                                                   include: goal, completion criteria, timeline.

23.2      Identify Services to Be Continued        Identify services that will be provided when this provider
                                                   is no longer involved. Examples of this data include:
                                                   service, service provider, service location, frequency of
                                                   service, duration of service, type of support, cost, method
                                                   of payment, and financial liability to the consumer.

23.3      Identify Consumer Perspective on Goal    Identify from the consumer perspective the progress made
          Achievement                              toward the goals.

23.4      Identify Care Coordinator/Case Manager   Evaluate from the Case Manager/Care Coordinator
          Perspective on Goal Achievement          perspective the progress made toward the goals.

23.5      Discharge Note                           Allow for a free-form discharge note.

23.6      Future Expectation                       Collect information on the future expectations for this
                                                   consumer.




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Dane County Department of Human Services                                        Mental Health Module




                                           24.0 Disenrollment: Managed Care


Make a decision on disenrolling a consumer from managed care services and complete the disenrollment request forms
for those who decide to disenroll.


24.1      Establish Meeting with Consumer and         Generate a notice to the treatment team members and the
          Treatment Team                              consumer (and his/her family if under age 18) to establish
                                                      a meeting date.

24.2      Discuss Disenrollment Decision

24.3      Collect Information on the Disenrollment    Collect information on the reason for disenrollment.
                                                      Examples of this data include: date of disenrollment,
                                                      progress toward goals, reason for disenrollment, parties
                                                      involved in disenrollment decision, whether the parties
                                                      were in agreement with the disenrollment decision.

24.4      Collect Outcome Information                 Collect outcome information. For youth in the Children
                                                      Come First initiative, examples of data include: current
                                                      CAFAS score, current living arrangement. For all
                                                      consumers with a mental illness, examples of data
                                                      include: global assessment of functioning, health status,
                                                      residential arrangement, daily activity, employment, and
                                                      financial supports.

24.5      Complete Disenrollment Request Form and     Generate a hard-copy and paper version of the
          Submit to DCDHS                             Disenrollment Request Form for submittal to DCDHS.

24.6      Submit Disenrollment Documentation to EDS   Fax a copy of the Disenrollment Request Form to EDS.

24.7      Receive Notification from EDS               Receive notification from EDS on the disenrollment
                                                      decision. Update the consumer record.




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Dane County Department of Human Services                                            Mental Health Module




                                                   25.0 Service Termination


Close services.


25.1      Collect Information on the Reason for Closing   Collect information on the reason for termination of
          Services                                        services. Examples of this data include: service end date
                                                          and SPC closing reason. SPC closing reason codes
                      (Data meets HSRS MH Module          include: 01 = Completed treatment, major improvement;
                      reporting requirements)             02 = completed treatment, moderate improvement; 03 =
                                                          completed treatment, no positive change; 04 = transferred
                                                          to another community based resource; 05 =
                                                          administratively discontinued service; 06 = referred; 07 =
                                                          withdrew against staff advice; 08 = funding/authorization
                                                          expired; 09 = incarcerated; 10 = entered nursing home or
                                                          institutional care; 11 = no probable cause; 99 = Death.




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Dane County Department of Human Services                                                Mental Health Module




                                                     26.0 Track Physical Files


Track physical file folders associated with each consumer/case.


26.1      Collect Information on the Physical File Folder   Collect information on the physical file folder associated
                                                            with each consumer. Examples of this data include:
                                                            casehead name, consumer name, date file was established,
                                                            file number, volume number, volume start date, volume
                                                            end date, type of folder, status of folder.

26.2      Track the Location of the File Folder             Track the location of the physical file folder. Examples
                                                            of this data include: file type, file location, date assigned
                                                            to this location.




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Dane County Department of Human Services                                              Mental Health Module




                                                      27.0 System Maintenance


Perform basic system maintenance and data integrity functions.


27.1      Establish Audit Trails                           For each change to any database row, including the
                                                           original insert, the system must record the date/time
                                                           stamp of the create date, the date/time stamp of the update
                                                           date, the user ID of the creator, and the user ID of the last
                                                           person making the update.

27.2      Identification of Required Fields                The system must clearly identify required fields on the
                                                           screen.

27.3      Allow for Deletion of Clients Entered in Error   The system must allow for the deletion of clients entered
                                                           in error. System must allow for the deletion or clearing of
                                                           data prior to the save function. The system must allow for
                                                           the deleting of clients entered in error only after checking
                                                           that no services, assessments, referrals, individualized
                                                           service plans, etc. have been attached to the client.

27.4      Allow for Merging of Clients and Services        The system must allow for the merging of duplicate
                                                           clients and services. This is to allow for a comparison of
                                                           clients, the transferring of all client identifiers and
                                                           attached referrals, assessments, etc. from one client to the
                                                           other, and the transferring of all services from one client
                                                           to the other. Protocols related to financial payments must
                                                           also be followed.




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Dane County Department of Human Services                     Mental Health Module




                                           Preliminary Data Models




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                                           Preliminary Data Elements




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