Core Services Taxonomy and CCS 3

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Core Services Taxonomy and CCS 3

• Orientation and Training Session
• January 29, 2007

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Agenda

• Welcome, Purpose and Overview of Process
• New Admission and Discharge Paradigm
• Core Service Taxonomy 7.1
• Box Lunch - Discussion
• Questions and Discussion
• Community Consumer Submission Version 3
• Wrap-up
• Adjourn

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New Admission and Discharge Paradigm
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New Paradigm

• The new CCS paradigm will promote enhanced
  accessibility of services for consumers,
  significantly greater efficiency for CSBs and the
  Department, and increased data accuracy, by not
  collecting data before it is needed and by
  generating less data clutter, for CSBs and the
  Department.

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New Paradigm

• In response to the CSAT review of CCS2, the new
  paradigm was conceived as a way to eliminate
  Enrollment and Release in the current (CCS2)
  admission paradigm
• Was created by the VACSB Data Management
  Committee (DMC) and the Consumer Service Record
  Work Group (Work Group) as a framework.
• Was seen as a way to improve service access,
  improve data quality, and streamline
  documentation.

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2 Key Concepts of the New Paradigm

• A more flexible admission process for the
  consumer - case opening, triage, and admission to
  a program.
• A more flexible assessment and information
  collection process relevant to clinical
  necessity.

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Paradigm Significant Changes

• Establishes Case Opening activities and
  services that are offered prior to admission to
  Program Areas (MH, SA and MR).
• Persons needing these services may access them
  without being admitted to a program area as well
  as after admitted to a program area.
• The data elements required at case opening are
  limited.

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Paradigm Significant Changes

• Case opening services
• Emergency Services, including Critical Incident
  Stress Debriefing (CISD) services (formerly
  counted as Prevention Services). CISD consumers
  and service units are collected through the
  z-consumer function in CCS.
• Limited Services Motivational Treatment Services
  (318), Consumer Monitoring Services (390),
  Assessment and Evaluation Services (720) and
  Early Intervention Services (620).
• Consumer-Run Services (730)

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Paradigm Significant Changes

• Replaces enrollments and releases to every
  service with admission to and discharge from each
  of the three program areas (all MH, SA, or MR
  services).
• Eliminates enrollments in and releases from every
  category or subcategory of core services.
• Eliminates reporting enrollments and releases and
  the associated data for these events.

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Paradigm Significant Changes

• The episode of care begins with Admission to a
  Program Area (all MH, SA, or MR services) and
  ends with discharge from that program area.
• There could be up to three separate but
  concurrent episodes of care if a consumer were
  admitted to all three program areas.

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Paradigm Significant Changes

• Admission to a Program Area also admits a
  consumer to any of the services (e.g., various
  inpatient, outpatient, day support, residential
  services and case management) in that program
  area.

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CCS2 vs CCS3

• CCS2
• PERSON - seeks services
• DETERMINATION - CSB determines if it can serve
  person
• ADMISSION TO CSB based on face to face
  assessment and Enrollment in a service.
  Completion of DB/documentation. Licensed and
  limited services.
• ENROLLMENTS RELEASES - multiple
• DISCHARGE FROM CSB Upon completion of all
  service enrollments.

• CCS3
• PERSON - seeks services
• DETERMINATION - CSB determines if it can serve
  person
• CASE OPENING - CSB opens case, as distinct from
  an admission. Emergency and Limited Services may
  be provided. Limited DB/documentation.
• ADMISSION TO PROGRAM AREA Completion of
  DB/documentation. Licensed services. No
  enrollments.
• DISCHARGE FROM PROGRAM AREA Upon completion of
  all services within the Program Area. No
  Releases.
• CASE CLOSING As determined by CSB business
  practice.

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Core Services Taxonomy 7.1
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Core Services Taxonomy 7.1

• Replaces Core Services Taxonomy 7.
• Effective on July 1, 2007 for FY 2008 and
  subsequent fiscal years.
• While much remains the same, there some
  significant changes in Taxonomy 7.1.

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Core Services Taxonomy 7.1

• Reflects the New Admission and Discharge
  Paradigm.
• Includes new System Transformation Initiative
  services.
• Incorporates changes in the CCS 3.

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Taxonomy 7.1 Changes

• Reflects New Paradigm
• Reorders core service categories and
  subcategories.
• Some core services moved to Services Available
  Outside of a Program Area (400).
• However, most core services are in Services
  Available at Admission to a Program Area (100,
  200, and 300).

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Taxonomy 7.1 Changes

• Adds New System Transformation Services
• Consumer-Run Services (730).
• Ambulatory Crisis Stabilization Services (420).
• Residential Crisis Stabilization Services (510).

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Taxonomy 7.1 Changes

• Restructures Some Services
• Separates Early Intervention Services (620) and
  Infant and Toddler Intervention Services (625).
• Moves Limited Services to Services Available
  Outside of a Program Area.

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Taxonomy 7.1 Changes

• Service Definition Changes
• Community-Based SA Medical Detoxification
  Inpatient Services (260)
• Substance Abuse (Social) Detoxification Services
  in Highly Intensive Residential Services (501)
• Day Treatment/Partial Hospitalization (410)

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Taxonomy 7.1 Clarifications

• Consumer Designation Codes
• Identify consumers served in specific initiatives
  or projects.
• Not core services service codes.
• Will be entered in the type of care file in CCS
  3.
• May encompass more than special projects or
  initiatives.

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Taxonomy 7.1 Clarifications

• Peer-provided services
• Not Consumer-Run Services (730).
• Included and reported where they are delivered.
• CSBs will report the number of peers they employ
  in each program area to provide core services in
  CARS management reports.

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Taxonomy 7.1 Clarifications

• Provider Service Hours reported for all services
  with a Service Hour unit of service. Include
  direct and consumer-related services (p. 19).
• Consumer Service Hours reported only for those
  services listed on the Matrix (p. 17). Include
  only direct, face-to-face services received by
  individual consumers.

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Taxonomy 7.1 Revised Definitions

• Admission
• Discharge
• Episode of Care
• Program Area

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Taxonomy 7.1 New Definitions

• Case Opening (New Paradigm)
• Case Closing (New Paradigm)
• Co-Occurring Disorders (State Board Policy)

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Taxonomy 7.1 Stricken Definitions

• Enrollment
• Release
• Retired Service Codes (Appendix D)

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COMMUNITY CONSUMER SUBMISSION
Version 3
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CCS 3

• Implements the new paradigm
• Attempts to resolve data reporting limitations
  for Central Office
• Effective July 1, 2007 (i.e. FY08)
• Few changes to design and process

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CCS 3 The Extract Files

• Consumer.txt
• Consumer status and demographics
• TypeOfCare.txt
• Episodes of various types
• Service.txt
• Services provided

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CCS 3 Consumer Extract

• Continues as a snapshot of a consumer information
  at the time of extract
• Department will warehouse data to track changes
  over time.
• Medicaid Number replaces Medicaid Y/N status
• Consumer Name needed to generate a unique
  State-wide ID, but is not exported to Department

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CCS 3 Consumer Extract

• Deleted from the consumer extract
• Transaction Activity Code
• Codependent/Collateral Status
• Medicaid Status
• Date of Last Direct SA Service

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CCS 3 Type of Care Extract

• Replaces Board admission and program enrollment
  extracts
• Facilitates identification of various types of
  episodes, e.g. program areas, 900 series special
  projects
• Not limited to clinical/program area episodes
  of care

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CCS 3 Services Extract

• Monthly submissions for complete fiscal year
• Individual dated services, no longer aggregated
• Begin and end dates for services provided over
  time, e.g. 30 bed days
• SA Prevention not included in extract.

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CCS 3 Services Extract

• Optional local staff ID
• Pseudo Program Area ID 400, identifies services
  provided outside of a program area episode of
  care, i.e. case opening services. Only used in
  services.txt file.

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CCS 3 Submission Notes

• Monthly submissions for the fiscal year
• Type of Care extract includes all records which
  were open and effective at any time during the
  fiscal year
• Submissions due no later than end of the month
  following reported month
• Department will monitor and report on compliance

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Wrap Up

• Questions and Comments?

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Thank you!

• Presenters Fred Mitchell, Chair, VACSB DMC
• Paul Gilding, DMHMRSAS
• Kippy Cassell, Piedmont CSB
• Cathy Pumphrey, Fairfax-Falls Church CSB
• Eddie Roadcap, Harrisonburg-Rockingham CSB
• Dave Clark, DMHMRSAS