Welcome Milwaukee WIser Choice

1

• Welcome Milwaukee WIser Choice
• Clinical Providers
• Wednesday December 12, 2007

2
WIsconsin Supports
Everyones Recovery
Choice
3
Why are we here today?

• Learn the differences between ATR 1 and ATR 2
• Review requirements of ATR 2
• Review of provider obligations
• Changes in 2008 agreements

4
ATR 1 vs. ATR 2

• ATR 1 ATR 2
• -22.8 million -14.4 million
• -7,344(duplicated) - 7,626(unduplicated)
• -3 years -3 years
• -GPRA-intervals -GPRA-intervals
• Intake, 30 days, status Intake, discharge,
  follow up
• and discharge 80
• -Quarterly data upload -7 day data upload
• -No client incentives -Client incentives

5
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 coordination insurance TANF,
insurance, etc. -Methamphetamine
client focus -IDP
Methadone -Negative screens
6
Entry into WIser Choice

• CIU staff screen client using ASI and ASAM
• Recommended level of care
• Chosen 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

7
When a DCS is Assigned

• DCS 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

8
On Date of 1st Appointment

• Client 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 treatment
• Provider Feedback form faxed to CIU and RSC/DCS
  agency (keep them in the loop)
• RSC attempts to re-engage client

9
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 services
• GPRA 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

10
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 completed
• Providers, RSCs, DCSs are all responsible for
  the tracking and locating of clients
• All GPRA interviews must be entered into CMHC
  system within 72 hours of being conducted

11
RSCs versus DCSs

• RSC Episode
• Primary responsibility is care coordination
• Paid at daily rate
• Attends Team Meetings
• Maintains SCCP
• Submits SARs to BHD
• Clinical services
• Ancillary services

• DCS Episode
• Primary responsibility is GPRA collection
• Paid for completed face-to-face interviews
• No Team Meetings
• No SCCP
• Does NOT do SARs
• NO ancillary services

12
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.

13
Clinical Provider should call the RSC or DCS
(within 1 business day)

• 1. If RSC/DCS calls provider
• 2. If client misses and/or reschedules first
  appointment date
• 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

14
RSC or DCS should call the Clinical Provider
(within 1 business day)

• When a specific RSC or DCS is first assigned the
  case
• If clinical provider calls RSC/DCS
• 3. If client is switched from one RSC or DCS to
  another
• 4. If client is transferred to a different
  RSC/DCS agency
• 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
• Prior to discharging client from RSC services

15
Discharge Guidelines

• In general, discharge is guided by LOC
• Residential Discharge if client missing 2 days
• Day Treatment Discharge if client misses 5 days
• Outpatient Discharge if missing for 14 days
• Regardless, keep RSC/DCS informed about plans to
  discharge and date discharge will occur.

16
Other ways Clinical Providerscan assist RSC/DCS
agencies

• Make sure all staff (including clerical,
  reception)
• Know what an RSC and DCS are
• Understand 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).

17
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 meetings
• Alumni events
• Agency events
• Activities and celebrations

18
Whats new in 2008 Agreements?

• Agency automobile insurance rider is required
• Professional Liability is required for all
  clinical providers- either agency or personal
  coverage
• Billing
• 60 days vs. weekly
• Discharge
• Submit within 1 business day of discharge
•  Payor of last resort

19
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)

20
Episodes Completed Treatment Per Month, July
2004-Sept 2007
21
Questions
22
Contact Information

• Janet Fleege
• MCBHD SAIL (Service Access to Independent
  Living)
• Milwaukee WIser Choice Project Director
• Office 414-257-6925
• E-mail jfleege_at_milwcnty.com