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«STATE OF WISCONSIN 1 West Wilson Street Department of Health Services PO Box 7851 Division of Mental Health and Substance Abuse Services Madison WI ...»

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STATE OF WISCONSIN 1 West Wilson Street

Department of Health Services PO Box 7851

Division of Mental Health and Substance Abuse Services Madison WI 53707-7851

Telephone: 608-266-2717

Fax: 608-266-2579

TTY: 888-241-9432

Date: February 1, 2016 DMHSAS Numbered Memo 2016-01 To: Area Administrators / Human Service Area Coordinators Bureau Directors / Section Chiefs County Departments of Community Programs Directors County Departments of Developmental Disabilities Service Directors County Departments of Human Services Directors County Departments of Social Services Directors County Mental Health Coordinators Tribal Chairpersons / Human Services Facilitators From: Patrick Cork, Administrator Division of Mental Health and Substance Abuse Services Community Mental Health Allocation Document Summary This memo references Profile #516 of the State and County Contract for Social and Community Programs, outlines the reporting requirements for the Community Mental Health Allocation for Calendar Year 2016 (CY 2016), and includes expenditure requirements for the use of CY 2016 funds. Counties must comply with the reporting requirements in the Mental Health Program Participation System (PPS) data system including the reporting of consumer functional outcomes every 6 months through the Consumer Status Data Set in PPS. Return the County Reporting Form (F-01684) no later than March 31, 2017.

The County Reporting Form is an online Select Survey which will be available on the

Department of Health Services (DHS) Website at:

http://4.selectsurvey.net/DHS/TakeSurvey.aspx?SurveyID=SCMHAReport. The survey will be live for data entry in 2017.

Background Wisconsin 2015 Act 55 included a provision to consolidate base funding for several community mental health program funding allocations to a single allocation for community programs under the state's community aids program. The bill combined two mental health institutional relocation programs, one psychosocial rehabilitation program (CSP Waitlist), and one program supporting development and operations of certified CSP, CCS, CRS, and/or Crisis services into a community aids program for community mental health services. In addition, funding will be transferred from the Community Options Program (COP), in an amount that approximates the annual use of COP funding for program participants receiving community-based mental health and substance abuse services.

www.dhs.wisconsin.govDMHSAS Memo 2016-01Community Mental Health AllocationPage 2 of 16

The Department of Health Services (DHS), Division of Mental Health and Substance Abuse Services (DMHSAS) convened an advisory group to review and comment on DMHSAS internal workgroup documents and consolidation plans, and inform DMHSAS on how the consolidation plans may impact counties and constituents. The group consists of various community stakeholders who are interested in the consolidation of contracts and its impact on mental health services.

DMHSAS, as required by State statute 46.40 (7m) annually obligates up to $24,348,700 of the Community Mental Health funding to all counties within the state. This memo describes the county reporting requirements and expenditures for 2016.

Community Mental Health Reporting for 2016 The funding carries reporting requirements on how the allocation is spent. As a result, DMHSAS requires counties to report how much of their formula allocation was spent and for what purposes. Counties’ deadline for reporting expenditures and outcomes for the 2016 Community Mental Health Allocation is March 31, 2017. Use the County Reporting Form Fto record county expenditures in the twenty-two allowable expenditure categories and record the associated outcomes for those expenditures on page two. Mental Health COP reporting requirements are no longer valid due to the consolidation of funds; however counties should carefully review and consider each program priority area and the reporting requirements below. Should counties have additional questions related to Mental Health COP after reviewing the instructions they should contact the Contract Administrator. Counties must use the instructions in this memo to complete the County Reporting Form F-01684 correctly.

Community Mental Health Allocation Expenditures for 2016 DMHSAS will allocate an estimated $24,348,700 in funding for Federal Fiscal Year 2016.

Counties’ allocations for CY 2016 must be spent by December 31, 2016 and the associated expenditure reports are due to the Community Aids Reporting System (CARS) within 90 days of the expenditure deadline. Please check your current expenditure level to ensure your county is on track to spend its formula allocation by December 31, 2016. If you have questions contact Maura Klein at the Department of Health Services.

The federal and state requirements associated with the expenditure of the Community Mental Health funds for CY 2016 are described in detail below.

Some of these requirements include:

Funds must be used for activities associated with community mental health services.

 Funds must be used for services to adults or children with a mental health diagnosis who  have or at risk of having a serious mental illness (SMI) or a serious emotional disorder (SED).

DMHSAS has identified twenty-two program areas to which counties can apply these funds  including Certified Community Support Program (CSP), Certified Comprehensive Community Services (CCS), Community Recovery Services (CRS), Crisis Intervention, Certified Peer Specialists, Case Management, Counseling/Therapeutic Resources, DMHSAS Memo 2016-01 Community Mental Health Allocation Page 3 of 16 Medication Management, Day Treatment-Medical, Outreach, Information and Referral, Intake Assessment, Supported Employment, Day Center Services-non Medical, Work Related Services, Supportive Community Services (excluding Case Management), Adult Family Home, Group Home, Community-Based Residential Facility, Transportation, Assistance for people relocating from an IMD/Medicaid-certified skilled nursing facility to community placement and Coordinated Services Teams Initiatives (CST).





Action Summary This Memo outlines a reporting process with information on allowable services and county allocations. Counties are required to report data.

Submit the completed form F-01684 (01-2016) no later than March 31, 2017 Summarize activities, expenditures, and outcomes related to the Community Mental Health Funding in CY 2016.

Community Mental Health Allocation Requirements for CY 2016 Counties must follow the requirements below for the expenditure of funds and the reporting of their expenditures and activities on form F-01684 (01/2016).

A. Definition Of Adults With A Serious Mental Illness (SMI) And Children With Serious Emotional Disorders (SED) "Adults with a serious mental illness" are persons: (1) age 18 and over and (2) who currently have, or at any time during the past year, had a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria specified within DSM-5 or their ICD-10 equivalent (and subsequent revisions) with the exception of DSM-5 codes, substance use disorders, and developmental disorders which are excluded, unless they co-occur with another diagnosable serious mental illness, and (3) that has resulted in functional impairment, which substantially interferes with or limits one or more major life activities. Federal Register Volume 58 No. 96 published Thursday May 20, 1993, pages 29,422 through 29,425. Pursuant to Section 1911(c) of the Public Health Service Act, children with a serious emotional disorder are (1) from birth up to age 18, and (2) currently have, or at any time during the last year, had a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria specified within DSM-5. (Federal Register, Volume 58 No. 96 published Thursday, May 20, 1993, pages 29,422 through 29,425).

B. Allowable Services The purpose of these funds is to expand the county-operated or contracted system of community-based services for adults with SMI and children with SED. These funds must be used to initiate new programs or significantly strengthen existing programs for these population categories.

DMHSAS Memo 2016-01 Community Mental Health Allocation Page 4 of 16 Program Priority Areas These funds shall be used by the County only to pay for the cost of community-based care and services provided to any person who has a mental illness in the following program

priority areas:

1. Certified Community Support Program (CSP)

2. Certified Comprehensive Community Services (CCS)

3. Community Recovery Services (CRS)

4. Crisis Intervention

5. Certified Peer Specialists

6. Case Management

7. Counseling/Therapeutic Resources

8. Medication Management

9. Day Treatment-Medical

10. Outreach

11. Information and Referral

12. Intake Assessment

13. Supported Employment

14. Day Center Services-non Medical

15. Work Related Services

16. Supportive Community Services (excluding Case Management)

17. Adult Family Home

18. Group Home

19. Community-based residential facility

20. Transportation

21. Assistance for people relocating from an IMD/Medicaid-certified skilled nursing facility to community placement

22. Coordinated Services Teams Initiatives (CST) The following section defines allowable uses of the funds for each of the twenty-two priority areas and presents information on how funds may be used. Use of the funds in these priority areas should be reported through the Mental Health PPS data system as a service. Each of the descriptions of the program priority areas below is followed by its associated Standard Program Category (SPC) code which counties should use when recording data in the Mental Health PPS data system.

For further descriptions of each allowable use of funds, refer to the online PPS Mental Health Module Handbook at: https://www.dhs.wisconsin.gov/sites/default/files/legacy/pps/mhaoda/MHHandbook.pdf. Service definitions are listed in ‘Appendix 2’.

1. Certified Community Support Program (CSP) The provision of a network of coordinated care and treatment services to adults with serious and persistent mental illness and chronic alcoholic clients in a natural or supportive service setting by an identified provider and staff to ensure ongoing therapeutic involvement and individualized treatment in the community for the purpose of reducing the disabling effects DMHSAS Memo 2016-01 Community Mental Health Allocation Page 5 of 16 of their mental illness or alcoholism and assisting clients to access and participate in the community.

The service of case planning, monitoring and review as well as the activities involved in case  management/service coordination are a required part of this program for every client.

Funds may be used only by certified CSP for the following activities: assessment/diagnosis,  eligibility determination, advocacy, education/training, counseling/psychotherapy, person locating, medical support, referral and transportation. Includes identifying persons in need of services, assisting with and training clients in all aspects of community functioning, crisis consultation, assistance with learning and performing daily living tasks, supervision of community work or educationally related activities, assistance with obtaining health care, assistance with acquiring and maintaining adequate housing, social/recreational activities, and coordinating services delivered by both CSP and other human service programs such as the Division of Vocational Rehabilitation, General Relief and Supplemental Security Income.

All services delivered as a component of a CSP with these funds should be reported using the

following standard program category code in PPS:

–  –  –

2. Certified Comprehensive Community Services (CCS) Comprehensive Community Services (CCS) are certified per the requirements of DHS 36 and provide a flexible array of individualized community-based psychosocial rehabilitation services authorized by a licensed mental health professional under DHS 36.15 and provided to consumers with mental health or substance use issues across the lifespan who qualify based on level of need through a completed MH/AODA Functional Screen.

Funds may be used only by certified CCS counties for the following activities: assessment,  recovery/service planning, service facilitation, and individually authorized psychosocial rehabilitation services when such services are not covered by MA.

All services delivered as a component of a CCS benefit with these funds should be reported

using the following standard program category code in PPS:

510.10 Comprehensive Community Services – hours (per diem code is no longer available)

3. Community Recovery Services (CRS) CRS is a non-waiver, state Medicaid plan amendment benefit provided by a certified County or Tribe or vendor. The goal of CRS is to provide services which enable mental health consumers to live in the least restrictive community environment available. CRS offers three services: Community Living Supportive Services (activities necessary to allow individuals to live with maximum independence in community integrated housing), Supported Employment (activities necessary to assist individuals to obtain and maintain competitive employment), and Peer Supports (advocacy, information and support provided by certified Peer Specialists).

DMHSAS Memo 2016-01 Community Mental Health Allocation Page 6 of 16 Funds may be used only by certified CRS counties for the following activities: Funds may be  used to cover the county match of the Federal Financial Participation (FFP) for the CRS program.

Funds may be used to cover administrative county overhead to support CRS, to include CRS  Coordinator role, Quality Assurance activities in support of CRS, and Fiscal activities in support of CRS.

Funds may be used to cover costs associated with Targeted Case Management in support of  clients within the CRS Program, or case management activities from CSP case managers in support of CRS.

Funds may be used to cover Room and Board for the CRS program.

 All services delivered as a component of the CRS benefit these funds should be reported

using the following standard program category code in PPS:



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