CCBHC Initial Eval and Comprehensive Plan(s) Workflow (2) (1).docx

CCBHC Initial Eval and Comprehensive Plan ADULTS-Initial Evaluation and 21 CDC: Schedule appointment for 2 hours. All staff can complete Complete Client Data Center (i.e. build the client-name, SSN, DOB, address) ☐ Please utilize https://www.ohcaprovider.com/hcp/Default.aspx?alias=www.ohcaprovider.com/hcp/provider to validate that Medicaid number is correct or to enroll the client in DMH if they are not already enrolled. Print out from OHCA their number, if you click “print preview” it will print out what is needed. In checking eligibility on the eligibility page (screenshot above) scroll down and see if the client is enrolled in a CCBHC. If client is enrolled in CCBHC, assist client in calling the other agency and canceling their services if they want to or inform them that the agency they are enrolled in will provide all services. ☐ If they want to cancel their services at other agency, schedule the initial appointment in a week to allow the other agency to discharge them. Confirm discharge on OHCA (eligibility page will not have a category of CCBHC.) If the client is still enrolled, contact your supervisor. ☐ As a reminder, clients cannot be enrolled in two CCBHCs If they have Private Insurance make a copy of the insurance card! ☐ Make copy of the client’s state I.D. ☐ Set up Client Guarantors (In Go Health, Intake Tab) to set up insurance ☐ Medicaid 01AA-Adult Basic (please note this guarantor is for Adults and Children) 02AA-SA Basic 45AA- MHC 01HC-Helping Connections 02BP-Suboxone 70AA-Gambling *Please see item 32 for directions Go Into PICIS Eligibility and click button Check Now for Go Health to pull over DMH/Medicaid Information ☐ Go Into Manual Eligibility and choose DMH and Medicaid (if client has Medicaid) put in pin and click save. ☐ Set PIN for client (In Go Health, Client Signatories) Age 14 and up ☐ Set PIN for guardian (In Go Health, Client Signatories) If a child/if applicable ☐ Set PIN for treatment advocate (In Go Health, Client Signatories) if Age 18 and up/if applicable ☐ Put Program Name -201 Intake and Engagement ☐ *If client is in hospital discharge, put that program’s name *If client is in suboxone program, put that program’s name Communicable Disease Form (In Go Health, Intake Tab) ☐ Intake Packet (In Go Health, Intake Tab) ☐ Income Verification Form (In Go Health, Intake Tab) ☐ Business Packet (paper forms) which include: Appendix D ☐ Fee Worksheet (Paper form) -In Business Packet ☐ Turn into Medical Records Folder in Mail Room Fee Agreement (Paper Form) -In Business Packet ☐ Turn into Medical Records Folder in Mail Room Pharmacy App (Paper Form)- In Business Packet ☐ Turn into PAP Coordinator’s Folder in Mail Room Medication and Allergies (Paper Form)-In Business Packet ☐ Turn into Medical Records Folder in Mail Room ROI’s for benefit (Paper Form)- In Business Packet ☐ Turn into Medical Records Folder in Mail Room ROI (PCP) (Paper Form)- In Business Packet ☐ Turn into Medical Records Folder in Mail Room ROI (Standard) (Paper Form)- In Business Packet ☐ Complete ROI Standard for clients who need Coordination Agreement because they are also receiving services at another agency. Telehealth Authorization Form Turn into Medical Records Folder in Mail Room Complete following screeners (all in Go Health, Screening Tab) ☐ TB Screen ☐ GAINS ☐ PHQ-9 ☐ GAD-7 ☐ PCL-5 Screener ☐ ACE Questionnaire ☐ Columbia ☐ Safety Plan on crisis tab in Go Health (if client expressed SI in past 30 days) Appendix B ☐ Under Care Coordination Tab Complete Health Risk Appraisal (this must be done for all clients) ☐ Ages 18-25 do Health Risk Appraisal Young Adult Age 25-Up do Adult Health Risk Appraisal Give Client Handbook which should also include the following handouts: Appendix C ☐ H.O.P.E STD/HIV Testing My Health Explanation THD Tulsa Department TB Naloxene Initiative Sanctuary Community Welcome to Sanctuary Safety Plan My personal self-care plan Do 21 CDC located on intake tab ☐ Please note the second 21 CDC needs to be filed after 30 days of the first 21 CDC being filed unless the client has done the 23 CDC. The first 21 CDC is only valid for 30 days. Example: Client is seen on 15th of the month, 21 CDC will expire on the 15th of the next month When you file the second 21 CDC, you need to file it on the day you do a PPS service. PPS services are therapy, rehab, RSS, FSP, medication appointments. Initial Evaluation-T1023 (In Go Health Intake Tab) ☐ Bill for 1 hour Add guarantor 70AA for all clients 18 years and up. ☐ Do initial evaluation and choose 70AA guarantor as the guarantor to bill under Expire the 70AA guarantor in Guarantors Box on Intake Tab after 24 hours of having it on the chart Administer NOMs Baseline Adult Appendix E ☐ Turn in NOMs to mailbox folder in mailroom called NOMs-Adults within 1 business day. ☐ Sand Springs: Turn in NOMs to Office Specialist to be Inter-Officed within 1 business day. ☐ If in community or unable to turn NOMs in physically: Email scanned NOMs to NOMs Data Group. ☐ Schedule Assessment/Comprehensive Plan within 29 calendar days of Initial Evaluation and 21 CDC Appt. ☐ Bill Case Management or RSS note for business appointment and NOMs appointment utilizing Template for the total time of the appointment. Appendix F ☐ *Those forms highlighted in yellow must be done at time of appointment with client and finalized or filed by COB. ** It is expected that all needed services are provided from initial contact until the Comprehensive Care Plan is completed. CHILDREN-Initial Evaluation and 21 CDC: Schedule appointment for 2 hours. All staff can complete Complete Client Data Center (i.e. build the client-name, SSN, DOB, address) ☐ Please utilize https://www.ohcaprovider.com/hcp/Default.aspx?alias=www.ohcaprovider.com/hcp/provider to validate that Medicaid number is correct or to enroll the client in DMH if they are not already enrolled. Print out from OHCA their number, if you click “print preview” it will print out what is needed. In checking eligibility on the eligibility page (screenshot above) scroll down and see if the client is enrolled in a CCBHC. If client is enrolled in CCBHC, assist client in calling the other agency and canceling their services if they want to or inform them that the agency they are enrolled in will provide all services. ☐ If they want to cancel their services at other agency, schedule the initial appointment in a week to allow the other agency to discharge them. Confirm discharge on OHCA (eligibility page will not have a category of CCBHC.) If the client is still enrolled, contact your supervisor. ☐ As a reminder, clients cannot be enrolled in two CCBHCs If they have Private Insurance make a copy of the insurance card! ☐ Make copy of the guardian’s state I.D. ☐ Set up Client Guarantors (In Go Health) to set up insurance ☐ Medicaid 01AA-Adult Basic (please note this guarantor is for Adults and Children) 39AA-WRAP 01HC-Helping Connections Go Into PICIS Eligibility and click button Check Now for Go Health to input DMH/Medicaid Information ☐ Go Into Manual Eligibility and choose DMH and Medicaid (if client has Medicaid) put in pin and click save. ☐ Set PIN for client (In Go Health, Client Signatories) Age 14 and up ☐ Set PIN for guardian (In Go Health, Client Signatories) If a child/if applicable ☐ Set PIN for treatment advocate (In Go Health, Client Signatories) if Age 18 and up/if applicable ☐ Put Program Name of your program e.g. School Based, Moderate Intensity Children or High Intensity Children/WRAP ☐ Communicable Disease Form (In Go Health, Intake Tab) ☐ Intake Packet (In Go Health, Intake Tab) ☐ Income Verification Form (In Go Health, Intake Tab) ☐ Business Packet (paper forms) which include: Appendix D ☐ Fee Worksheet (Paper form) -In Business Packet ☐ Turn into Medical Records Folder in Mail Room Fee Agreement (Paper Form) -In Business Packet ☐ Turn into Medical Records Folder in Mail Room Medication and Allergies (Paper Form)-In Business Packet ☐ Turn into Medical Records Folder in Mail Room ROI’s for benefit (Paper Form)- In Business Packet ☐ Turn into Medical Records Folder in Mail Room ROI (PCP) (Paper Form)- In Business Packet ☐ Turn into Medical Records Folder in Mail Room ROI’s for School (Paper Form)- In Business Packet ☐ For clients who want services in Tulsa Public Schools (TPS) there are 3 School Forms to be Completed Turn into Medical Records Folder in Mail Room ROI (Standard) (Paper Form)- In Business Packet ☐ Complete ROI Standard for clients who need Coordination Agreement because they are also receiving services at another agency or for someone who is not the biological parent or guardian to be a part of treatment. Turn into Medical Records Folder in Mail Room ROI’s for School (Paper Form)- In Business Packet ☐ For clients who want services in Tulsa Public Schools (TPS) there are 3 School Forms to be Completed Turn into Medical Records Folder in Mail Room Telehealth Authorization Form Turn into Medical Records Folder in Mail Room Complete following screeners (all in Go Health, Screening Tab) ☐ TB Screen ☐ PHQ-A ☐ Ages 10-17 GAD-7 ☐ Ages 10 and up GAINS ☐ Ages 10 and up Suicide Screen for 6-11 Ages 6-11 Columbia ☐ Ages 12 and up Ohio Forms (paper form) ☐ Shared with you on OneDrive. Please always have copies available to you! Safety Plan on paper (if client expressed SI in past 30 days) Appendix B ☐ The Survey of Well-Being of Young Children (SWYC) Appendix A ☐ Children 0-60 months CATS Youth ☐ Youth to be done ages 7 and up only *Only therapist to complete CATS Caregiver ☐ Caregiver to be done ages 0-17 *Only therapist to complete Under Care Coordination Tab Complete Health Risk Appraisal (this must be done for all clients) ☐ Ages 0-17 do Health Risk Appraisal Youth Ages 18-25 do Health Risk Appraisal Young Adult Give Client Handbook which should also include the following handouts: Appendix C ☐ H.O.P.E STD/HIV Testing My Health Explanation THD Tulsa Department TB Naloxene Initiative Sanctuary Community Welcome to Sanctuary Safety Plan My personal self-care plan Do 21 CDC located on intake tab ☐ Please note the second 21 CDC needs to be filed after 30 days of the first 21 CDC being filed unless the client has done the 23 CDC. The first 21 CDC is only valid for 30 days. Example: Client is seen on 15th of the month, 21 CDC will expire on the 15th of the next month When you file the second 21 CDC, you need to file it on the day you do a PPS service. PPS services are therapy, rehab, RSS, FSP, medication appointments. Initial Evaluation-T1023 (In Go Health Intake Tab) ☐ Bill for 1 hour Administer NOMs Baseline Child Appendix E ☐ Turn in NOMs to mailbox folder in mailroom called NOMs-Child within 1 business day. ☐ Sand Springs: Turn in NOMs to Office Specialist to be Inter-Officed within 1 business day. ☐ If in community or unable to turn NOMs in physically: Email scanned NOMs to NOMs Data Group. ☐ Schedule Assessment/Comprehensive Plan within 7 calendar days of Initial Evaluation and 21 CDC Appt. ☐ Bill Case Management or FSP note for business appointment and NOMs appointment utilizing Template for the total time of the appointment. Appendix F ☐ *Those forms highlighted in yellow must be done at time of appointment with client and finalized or filed by COB. ** It is expected that all needed services are provided from initial contact until the Comprehensive Care Plan is completed. CHILDREN-School Based, EFC Referrals, and EON Referrals CHILDREN-Initial Evaluation and 21 CDC: Schedule appointment for 2 hours. All staff can complete Complete Client Data Center (i.e. build the client-name, SSN, DOB, address) ☐ Please utilize https://www.ohcaprovider.com/hcp/Default.aspx?alias=www.ohcaprovider.com/hcp/provider to validate that Medicaid number is correct or to enroll the client in DMH if they are not already enrolled. Print out from OHCA their number, if you click “print preview” it will print out what is needed. In checking eligibility on the eligibility page (screenshot above) scroll down and see if the client is enrolled in a CCBHC. If client is enrolled in CCBHC, assist client in calling the other agency and canceling their services if they want to or inform them that the agency they are enrolled in will provide all services. ☐ If they want to cancel their services at other agency, schedule the initial appointment in a week to allow the other agency to discharge them. Confirm discharge on OHCA (eligibility page will not have a category of CCBHC.) If the client is still enrolled, contact your supervisor. ☐ As a reminder, clients cannot be enrolled in two CCBHCs If they have Private Insurance make a copy of the insurance card! ☐ Make copy of the guardian’s state I.D. ☐ Set up Client Guarantors (In Go Health) to set up insurance ☐ Medicaid 01AA-Adult Basic (please note this guarantor is for Adults and Children) 39AA-WRAP 01HC-Helping Connections Go Into PICIS Eligibility and click button Check Now for Go Health to input DMH/Medicaid Information ☐ Go Into Manual Eligibility and choose DMH and Medicaid (if client has Medicaid) put in pin and click save. ☐ Set PIN for client (In Go Health, Client Signatories) Age 14 and up ☐ Set PIN for guardian (In Go Health, Client Signatories) If a child/if applicable ☐ Set PIN for treatment advocate (In Go Health, Client Signatories) if Age 18 and up/if applicable ☐ Put Program Name of your program e.g. School Based, Moderate Intensity Children or High Intensity Children/WRAP ☐ Communicable Disease Form (In Go Health, Intake Tab) ☐ SCHOOL BASED THERAPIST DO: Intake Packet (In Go Health, Intake Tab) ☐ SCHOOL BASED THERAPIST DO: Income Verification Form (In Go Health, Intake Tab) ☐ SCHOOL BASED THERAPIST DO: Business Packet (paper forms) which include: Appendix D ☐ SCHOOL BASED THERAPIST DO: Fee Worksheet (Paper form) -In Business Packet ☐ Turn into folder in Children’s Suite SCHOOL BASED THERAPIST DO: Fee Agreement (Paper Form) -In Business Packet ☐ Turn into folder in Children’s Suite SCHOOL BASED THERAPIST DO: Medication and Allergies (Paper Form)-In Business Packet ☐ Turn into folder in Children’s Suite SCHOOL BASED THERAPIST DO: ROI’s for benefit (Paper Form)- In Business Packet ☐ Turn into folder in Children’s Suite SCHOOL BASED THERAPIST DO: ROI (PCP) (Paper Form)- In Business Packet ☐ Turn into folder in Children’s Suite SCHOOL BASED THERAPIST DO: ROI’s for School (Paper Form)- In Business Packet ☐ For clients who want services in Tulsa Public Schools (TPS) there are 3 School Forms to be Completed Turn into folder in Children’s Suite SCHOOL BASED THERAPIST DO: ROI (Standard) (Paper Form)- In Business Packet ☐ Complete ROI Standard for clients who need Coordination Agreement because they are also receiving services at another agency or for someone who is not the biological parent or guardian to be a part of treatment. Turn into folder in Children’s Suite Complete following screeners (all in Go Health, Screening Tab) ☐ TB Screen ☐ PHQ-A ☐ Ages 10-17 GAD-7 ☐ Ages 10 and up GAINS ☐ Ages 10 and up Suicide Screen for 6-11 Ages 6-11 Columbia ☐ Ages 12 and up Ohio Forms (paper form) ☐ Shared with you on OneDrive. Please always have copies available to you! Safety Plan on paper (if client expressed SI in past 30 days) Appendix B ☐ The Survey of Well-Being of Young Children (SWYC) Appendix A ☐ Children 0-60 months CATS Youth ☐ Youth to be done ages 7 and up only Only therapist to complete CATS Caregiver ☐ Caregiver to be done ages 0-17 *Only therapist to complete Under Care Coordination Tab Complete Health Risk Appraisal (this must be done for all clients) ☐ Ages 0-17 do Health Risk Appraisal Youth Ages 18-25 do Health Risk Appraisal Young Adult Do 21 CDC located on intake tab ☐ Please note the second 21 CDC needs to be filed after 30 days of the first 21 CDC being filed unless the client has done the 23 CDC. The first 21 CDC is only valid for 30 days. Example: Client is seen on 15th of the month, 21 CDC will expire on the 15th of the next month When you file the second 21 CDC, you need to file it on the day you do a PPS service. PPS services are therapy, rehab, RSS, FSP, medication appointments. Initial Evaluation-T1023 (In Go Health Intake Tab) ☐ Bill for 1 hour. Administer NOMs Baseline Child Appendix E ☐ Turn in NOMs to mailbox folder in mailroom called NOMs-Child within 1 business day. ☐ If in community or unable to turn NOMs in physically: Email scanned NOMs to NOMs Data Group. ☐ School Based: Schedule Comprehensive Plan within 7-29 calendar days of Initial Evaluation and 21 CDC Appt. ☐ WRAP YIS and EFC: Schedule Business Appointment with Intake and Engagement Case Manager for 1 hour appointment. ☐ I&E Case Manager: Schedule Comprehensive Plan within 7-29 calendar days ☐ Bill Case Management or FSP note for business appointment and NOMs appointment for the total time of the appointment. Appendix F ☐ *Those forms highlighted in yellow must be done at time of appointment with client and finalized or filed by COB. ** It is expected that all needed services are provided from initial contact until the Comprehensive Care Plan is completed Initial Evaluation Diagnosis Workflow Workflow for Assessment and Comprehensive Care Plan Only licensed or under supervision therapists can complete: Do Mental Health Assessment H0031 located on Intake Tab  ☐ Do CAR Scores and Strengths located on Intake Tab  ☐ Do Comprehensive Care Plan H0032 located on Intake Tab  ☐ Do 23 CDC located on Intake Tab  ☐ Do Treatment Plan Note utilizing Treatment Plan Template. Service to choose is Individual Psychotherapy, face to face, MH. Located in Notes Tab, Psychotherapy Notes ☐ Send Treatment Plan email to Treatment Plan Group ☐ Complete Treatment Team Box within Go Health, once clinician is assigned to client within 48 business hours of assignment ☐ *Those forms highlighted in yellow must be done at time of appointment with client and finalized or filed by COB. Workflow for Care Plan Update All staff can complete: Do Care Plan Update by doing a Comprehensive Care Plan Addendum on update tab ☐ Addendum Note to the Comprehensive Care Plan 90 days after the 23 CDC is completed This can be completed 14 days before or 14 days after the 90 days. After 104 days, codes will not be available until the S0281-care plan update is completed) Additional goals and objectives can be added to the addendum if appropriate OR It can be documented that “no new goals or objectives are identified at this time.” *Those forms highlighted in yellow must be done at time of appointment with client and finalized or filed by COB. Workflow for Comprehensive Care Plan Update Only licensed or under supervision therapists can complete: Schedule appointment for 1 hour and 30 minutes to 2 hours. Do CAR Scores and Strength located on Update Tab ☐ Do Comprehensive Care Plan Update H0032 located on Update Tab  ☐ Do 42 CDC located on Update Tab ☐ Please note if comprehensive care plan update is expired, clinician will need to do CAR Scores and Strength, File 42 CDC, then do Comprehensive Care Plan Update. Adult Updates: Do PHQ-9 Screener located on Screening Tab ☐ Do GAD-7 Screener located on Screening Tab ☐ Do PCL-5 Screener located on Screening Tab *Only if client has a PTSD diagnosis ☐ Child Updates: PHQ-A ☐ Ages 10-17 GAD-7 ☐ Ages 10 and up Do CATS Symptom Monitoring and CATS PTSD Caregiver Monitoring on Screening Tab *Only if client is doing TF-CBT Model ☐ Suicide Screen for 6-11 ☐ Ages 6 and 11 Columbia if client expressed SI in past 30 days ☐ Ages 12 and up To BE DONE EACH YEAR: The Survey of Well-Being of Young Children (SWYC) Appendix A Children 0-60 months ☐ Safety Plan on Go Health or paper (if child client) (if client expressed SI in past 30 days) Appendix B ☐ Administer NOMs Re-Assessment Adult or Child (what’s applicable) Appendix E ☐ Turn in NOMs to mailbox folder in mailroom called NOMs-Adult or Child (what’s applicable) within 1 business day. ☐ Sand Springs: Turn in NOMs to Office Specialist to be Inter-Officed within 1 business day. ☐ If in community or unable to turn NOMs in physically: Email scanned NOMs to NOMs Data Group. ☐ Do Treatment Plan Note utilizing Treatment Plan Template. Service to choose is Individual Psychotherapy, face to face, MH. Located in Notes Tab, Psychotherapy Notes ☐ Bill Case Management note for NOMS appointment utilizing Template up to 1 hour. Appendix F ☐ Send Treatment Plan email to Treatment Plan Group ☐ Complete Treatment Team Box within Go Health within 48 business hours of assignment or continued assignment to client ☐ *Those forms highlighted in yellow must be done at time of appointment with client and finalized or filed by COB. Appendix Appendix A: Link to SWYC Screeners https://www.tuftschildrenshospital.org/The-Survey-of-Wellbeing-of-Young-Children/Age-Specific-Forms Appendix B: Safety Plan on Paper https://crsok.sharepoint.com/sites/allstaff/staff/Manuals/Forms/AllItems.aspx?id=%2Fsites%2Fallstaff%2Fstaff%2FManuals%2FSafety%20Plan%20%28Adult%20%26%20Children%29&viewid=c151a779%2Dcbff%2D42f7%2D8da5%2D2949c3f2bc9f Appendix C: Client Handbook and Handouts https://crsok.sharepoint.com/sites/allstaff/staff/Manuals/Forms/AllItems.aspx?newTargetListUrl=%2Fsites%2Fallstaff%2Fstaff%2FManuals&viewpath=%2Fsites%2Fallstaff%2Fstaff%2FManuals%2FForms%2FAllItems%2Easpx&id=%2Fsites%2Fallstaff%2Fstaff%2FManuals%2F2%20Clinical%20Curriculum%20%26%20How%20To%20Resources%2FGo%20Health%20Business%20Paperwork%20%26%20Assessment%20%26%20Treatment%20Plan%20%26%20Discharge%20Curriculum%2FBusiness%20Paperwork%2FHandbook%20and%20Handouts&viewid=c151a779%2Dcbff%2D42f7%2D8da5%2D2949c3f2bc9f Appendix D: Business Packet https://crsok.sharepoint.com/sites/allstaff/staff/Manuals/Forms/AllItems.aspx?newTargetListUrl=%2Fsites%2Fallstaff%2Fstaff%2FManuals&viewpath=%2Fsites%2Fallstaff%2Fstaff%2FManuals%2FForms%2FAllItems%2Easpx&id=%2Fsites%2Fallstaff%2Fstaff%2FManuals%2F2%20Clinical%20Curriculum%20%26%20How%20To%20Resources%2FGo%20Health%20Business%20Paperwork%20%26%20Assessment%20%26%20Treatment%20Plan%20%26%20Discharge%20Curriculum%2FBusiness%20Paperwork%2FBusiness%20Packet&viewid=c151a779%2Dcbff%2D42f7%2D8da5%2D2949c3f2bc9f Appendix E: NOMs https://crsok.sharepoint.com/sites/allstaff/staff/Manuals/Forms/AllItems.aspx?id=%2Fsites%2Fallstaff%2Fstaff%2FManuals%2F2%20Clinical%20Curriculum%20%26%20How%20To%20Resources%2FGo%20Health%20Business%20Paperwork%20%26%20Assessment%20%26%20Treatment%20Plan%20%26%20Discharge%20Curriculum%2FScreeners%2FNOMS&viewid=c151a779%2Dcbff%2D42f7%2D8da5%2D2949c3f2bc9f Appendix F: Note-Case Management Template and RSS Template https://crsok.sharepoint.com/sites/allstaff/staff/Manuals/Forms/AllItems.aspx?id=%2Fsites%2Fallstaff%2Fstaff%2FManuals%2F2%20Clinical%20Curriculum%20%26%20How%20To%20Resources%2FGo%20Health%20Business%20Paperwork%20%26%20Assessment%20%26%20Treatment%20Plan%20%26%20Discharge%20Curriculum%2FNote%20Templates%20%26%20Examples%2FBusiness%20Appt%20and%20NOMS%20Template&viewid=c151a779%2Dcbff%2D42f7%2D8da5%2D2949c3f2bc9f

CCBHC Initial Eval and Comprehensive Plan(s) Workflow (2) (1).docx

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