Welcome Milwaukee WIser Choice Clinical Providers

Wednesday December 12, 2007

WIsconsin Supports Everyones Recovery Choice

Why are we here today?Learn the differences between ATR 1 and ATR 2Review requirements of ATR 2Review of provider obligationsChanges in 2008 agreements

ATR 1 vs. ATR 2ATR 1ATR 2-22.8 million-14.4 million-7,344(duplicated)- 7,626(unduplicated)-3 years-3 years-GPRA-intervals-GPRA-intervalsIntake, 30 days, statusIntake, discharge, follow upand discharge80%-Quarterly data upload -7 day data upload-No client incentives-Client incentives

ATR 1 vs. ATR 2, cont.

ATR 1ATR 2-RSC-RSC & DCS (Data Collection Specialist)-Multiple screens -Limited screens-Screen w/o regard to-Benefits coordinationinsuranceTANF, insurance, etc. -Methamphetamine client focus-IDP & Methadone-Negative screens

Entry into WIser ChoiceCIU staff screen client using ASI and ASAMRecommended level of careChosen level of careChooses clinical treatment providerChooses RSC/DCS agencySt. Charles, UCC, MHYH, ATTIC & WCSA percentage of consumers will only receive a DCS (Outpatient)CIU assigns RSC or DCS providerRSC starts contact with client within 24 hours of assignmentDCS begins contact with client at first clinical appointment

When a DCS is AssignedDCS will contact the provider to introduce themselvesIf appointment date changes, it is the responsibility of the provider to inform the DCS that the appt. has changed and the new appointment date and timeDCS will also contact client to introduce themselves and schedule the GPRA intake interview which corresponds with the initial clinical appointmentDCS informs client to contact them should anything change

On Date of 1st AppointmentClient presents for treatmentCall is made to RSC/DCS agency to state that client showed for treatment Provider Feedback form faxed back to referring CIU and RSC/DCS agency

Client does not present for treatmentProvider Feedback form faxed to CIU and RSC/DCS agency (keep them in the loop)RSC attempts to re-engage client

GPRA (Government Performance Results Act)

GPRA Intake interview must be collected within 4 days of the start of clinical treatment services (Outpatient or Day treatment) or w/in 3 days of residential treatment servicesGPRA Discharge GuidelinesMust inform RSC/DCS when discharge is being planned or when the client has not shown for treatment:Inform RSC/DCSDischarge Client-1st day gone from Res.-2 days for residential-Missed 3 days-5 days for day treatment-Missed 2 appointments-14 days for outpatient

GPRA, cont.GPRA Follow up, 6 months post intake (completed within 30 days before or 60 days after)80% of all follow up GPRAs must be collected for all GPRA intakes completedProviders, RSCs, DCSs are all responsible for the tracking and locating of clientsAll GPRA interviews must be entered into CMHC system within 72 hours of being conducted

RSCs versus DCSsRSC EpisodePrimary responsibility is care coordinationPaid at daily rate

Attends Team MeetingsMaintains SCCPSubmits SARs to BHDClinical servicesAncillary servicesDCS EpisodePrimary responsibility is GPRA collectionPaid for completed face-to-face interviewsNo Team MeetingsNo SCCPDoes NOT do SARsNO ancillary services

If your client has a DCSThe clinical provider:Submits the SAR for continuation of service, if needed.Submits the SAR for change in Level of Care, if needed.Submits the SAR for RSC services if the client needs ancillary support services that cannot be met with natural supports.Cooperates with the DCS in GPRA collection.

Clinical Provider should call the RSC or DCS (within 1 business day)1.If RSC/DCS calls provider2.If client misses and/or reschedules first appointment dateIf client status changes in a way that affects RSC/DCS:- Client is incarcerated- Client is hospitalized- Client leaves the county- Client changes residence or has new contact information- Client dies4.If clinical provider intends to discharge client from clinical services

RSC or DCS should call the Clinical Provider (within 1 business day)When a specific RSC or DCS is first assigned the caseIf clinical provider calls RSC/DCS 3.If client is switched from one RSC or DCS to another4.If client is transferred to a different RSC/DCS agencyIf client status changes in a way that affects treatment:- Client is incarcerated- Client is hospitalized- Client leaves the county- Client changes residence or has new contact information- Client diesPrior to discharging client from RSC services

Discharge Guidelines

In general, discharge is guided by LOC:Residential: Discharge if client missing 2 daysDay Treatment: Discharge if client misses 5 daysOutpatient: Discharge if missing for 14 days

Regardless, keep RSC/DCS informed about plans to discharge and date discharge will occur.

Other ways Clinical Providerscan assist RSC/DCS agenciesMake sure all staff (including clerical, reception):Know what an RSC and DCS areUnderstand that Milwaukee WIser Choice clients have signed consent forms that permit clinical providers to share client information with RSC/DCS agencies.If possible, allow the RSC/DCS to do interviews in the treatment facilities (in a separate conference room or private office space).

Other ways Clinical Providerscan assist RSC/DCS agenciesDevelop procedures to discover and communicate changes in client status, for example, by updating contact information when clients come in and sharing any changes with RSC/DCS agencies.Organize or sponsor ongoing activities that promote client contact.Support group meetingsAlumni eventsAgency eventsActivities and celebrations

Whats new in 2008 Agreements?Agency automobile insurance rider is requiredProfessional Liability is required for all clinical providers- either agency or personal coverageBilling60 days vs. weeklyDischarge Submit within 1 business day of dischargePayor of last resort

WIser Choice needs to be a System of CooperationCooperation is the common effort of a group for their mutual benefit

Cooperation is teamwork

Cooperation is working together peacefully

When spider webs unite, they can tie up a lion. (Ethiopian proverb)

A single arrow is easily broken, but not ten in a bundle. (Japanese proverb)

Episodes Completed Treatment Per Month, July 2004-Sept 2007

Chart2

8

11

26

24

23

15

45

10

41

34

17

123

102

142

150

146

123

151

155

124

144

167

154

177

149

165

153

147

135

158

173

155

187

213

189

179

197

175

170

Episodes of Care with Clinician's Closing Reason "Completed Treatment"

mrnxq06_Scripts_Completed_to_5_

Milwaukee AODA System

Number of Episodes with the Clinical Provider's Closing Reason "Completed Treatment" by Month and Level of Care

before and after Milwaukee WIser Choice was fully implemented on June 20, 2005

Level of CareJul-04Aug-04Sep-04Oct-04Nov-04Dec-04Jan-05Feb-05Mar-05Apr-05May-05Jun-05Jul-05Aug-05Sep-05Oct-05Nov-05Dec-05Jan-06Feb-06Mar-06Apr-06May-06Jun-06Jul-06Aug-06Sep-06Oct-06Nov-06Dec-06Jan-07Feb-07Mar-07Apr-07May-07Jun-07Jul-07Aug-07Sep-07

Outpatient32788530526668965879998718997739210395109841028697829910392105

Intensive Outpatient0001103743341131022033

Day Treatment2320010000144610107815512111114102223151112182327

Trans Residential25263633283539303236463649443640294043483049

Med Mon. Residential571379101261014841023602473

Residential (Combined)36171615915515281030334940374551364237504453543843354045523752

All Levels of Care811262423154510413417123102142150146123151155124144167154177149165153147135158173155187213189179197175170

Level of CareOct-05Nov-05Dec-05Jan-06Feb-06Mar-06Apr-06May-06Jun-06Jul-06Aug-06Sep-06Oct-06Nov-06Dec-07Jan-07Feb-07Mar-07

Outpatient98718997739210395109841028697829910392105

Intensive Outpatient103743341131022033

Day Treatment107815512111114102223151112182327

Trans Residential283539303236463649443640294043483049

Med Mon. Residential9101261014841023602473

Residential (Combined)374551364237504453543843354045523752

All Levels of Care146123151155124144167154177149165153147135158173155187

&CClients Completing Treament

Page &P

mrnxq06_Scripts_Completed_to_5_

Episodes with Clinician's Reported Closing Reason "Completed Services/Treatment"

Episodes of Care with Clinician's Closing Reason "Completed Treatment"

Questions

Contact Information

Janet FleegeMCBHD SAIL (Service Access to Independent Living)Milwaukee WIser Choice Project DirectorOffice #414-257-6925E-mail: jfleege@milwcnty.com

for all agency vehicles (owned, non-owned, and/or hired). In addition, if any employees of Provider will use its personal vehicles to transport Purchaser participants/service recipients, or for any other purpose related to this Agreement, those employees shall have Automobile Liability Insurance providing the same liability limits as required of the Provider through any combination of employee Automobile Liability and employer Automobile or General Liability Insurance which in the aggregate provides liability coverage, while employee is acting as agent of employer, on the employees vehicle in the same amount as required of the Provider.