Welcome Milwaukee WIser

Choice Clinical Providers

Wednesday December 12, 2007

WIWIsconsin sconsin SSupports upports EEveryone’s veryone’s RRecovery ecovery ChoiceChoice

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 1 ATR 2-22.8 million -14.4 million-7,344(duplicated) - 7,626(unduplicated)

-3 years -3 years-GPRA-intervals -GPRA-intervalsIntake, 30 days, status Intake, discharge, follow upand discharge 80%

-Quarterly data upload -7 day data upload-No client incentives -Client

incentives

ATR 1 vs. ATR 2, cont.ATR 1 ATR 2-RSC -RSC & DCS (Data Collection

Specialist)

-Multiple screens -Limited screens-Screen w/o regard to -Benefits coordinationinsurance TANF, insurance, etc.

-Methamphetamine client focus-IDP & Methadone-Negative screens

Entry into WIser ChoiceCIU staff screen client using ASI and ASAM

Recommended level of careChosen level of care

• Chooses clinical treatment provider• Chooses RSC/DCS agency

– St. Charles, UCC, MHYH, ATTIC & WCS– A percentage of consumers will only receive a DCS

(Outpatient)

CIU assigns RSC or DCS provider• RSC starts contact with client within 24 hours of

assignment• DCS begins contact with client at first clinical

appointment

When a DCS is AssignedDCS will contact the provider to introduce themselves

If 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 time

DCS will also contact client to introduce themselves and schedule the GPRA intake interview which corresponds with the initial clinical appointment

DCS informs client to contact them should anything change

On Date of 1st AppointmentClient presents for treatment

Call 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 Guidelines

Must inform RSC/DCS when discharge is being planned or when the client has not shown for treatment:

Inform RSC/DCS Discharge 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 GPRA’s must be collected for all GPRA intakes completed

Providers, RSC’s, DCS’s 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 DCSs

RSC EpisodePrimary responsibility is care coordinationPaid at daily rate

Attends Team MeetingsMaintains SCCPSubmits SARs to BHD

• Clinical services• Ancillary services

DCS EpisodePrimary responsibility is GPRA collectionPaid for completed face-to-face interviewsNo Team MeetingsNo SCCPDoes NOT do SARsNO ancillary services

If your client has a DCS…

The 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 date3. If 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 dies

4. If clinical provider intends to discharge client from clinical services

RSC or DCS should call the Clinical Provider (within 1 business day)

1. When a specific RSC or DCS is first assigned the case2. If 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 agency5. If 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 dies

6. Prior 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 agencies

Make 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 agencies

Develop 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

What’s new in 2008 Agreements?

Agency automobile insurance rider is requiredProfessional Liability is required for all clinical providers- either agency or personal coverageBilling

60 days vs. weekly

Discharge Submit within 1 business day of discharge

 Payor of last resort

WIser Choice needs to be a System of Cooperation

Cooperation 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

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

0

50

100

150

200

250

Jul-04

Sep-04

Nov-04

Jan-05

Mar-05

May-05

Jul-05

Sep-05

Nov-05

Jan-06

Mar-06

May-06

Jul-06

Sep-06

Nov-06

Jan-07

Mar-07

May-07

Jul-07

Sep-07

Questions

Contact Information

Janet FleegeMCBHD – SAIL (Service Access to Independent Living)

Milwaukee WIser Choice Project DirectorOffice #414-257-6925

E-mail: jfleege@milwcnty.com