Comprehensive Community Services Prospective
Description: Comprehensive Community Services Prospective Vendor Information Last Updated: 10924 What is CCS A wrap-around mental health and substance use recovery program Meant to help address needs that if ignored, could lead to inpatient
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slide1. Comprehensive Community Services Prospective Vendor Information Last Updated: 10/9/24<br>
slide2. What is CCS A wrap-around mental health and substance use recovery program
Meant to help address needs that if ignored, could lead to inpatient hospitalization
CCS is in 69 of 72 Wisconsin Counties & three tribes in Wisconsin
Funded through State Medicaid insurance
Is focused on recovery & rehabilitation *not long-term supports
Is fully voluntary – participants must choose to engage *or not
The Ashland and Bayfield County CCS programs operate using a shared services model. *separate programs, but shared supports<br>
slide3. Participant Eligibility Requirements Must be a resident of Ashland or Bayfield County
Must have Medicaid / BadgerCare Plus Insurance benefits
Must have a mental health and/or substance use diagnosis, made by a medical doctor or psychiatrist
Impairments related to diagnoses interfere with major life activities or goals
Must be found eligible through functional screening / assessment<br>
slide4. How Supports Are Provided Through CCS CCS participants work with a Service Facilitator (SF) to identify necessary supports *based on their goals and needs
The program’s Mental Health Professionals (MHP) are continually reviewing plans and participant progress for medical necessity
Supports are authorized (approved) by listing them on the participant’s service plan.
Supports and service plans are reassessed every six months *minimum
Recovery is not linear – as needs change, so do plans & supports<br>
slide5. Support Examples These all fall under one of the covered service categories from ForwardHealth for reimbursement<br>
slide6. State Definition of CCS Service Example Individual Skill Development
*side by side support for developing skills needed to complete daily living tasks
Finding housing
Finding / maintaining employment
Budgeting
Grocery shopping
Home & appointment organization
Completing paperwork
Making community connections
Learning healthy coping skills (Yoga, Cross Fit, Crafts, Nature Healing)<br>
slide7. Medical Necessity Provider’s clinical notes must demonstrate this, in order for Medical Assistance to approve (pay) for the service provided Covered Services In-person / virtual meetings with a participant when providing authorized services
Travel Time to/from completed appointments
Note-Writing Time
Full list of covered services here Noncovered Services Coordination with the participant’s other team members
No-show appointments
Communication with the participant that is not face-to-face / telehealth.
* Reminder calls / texts
Services that are outside of the providers’ scope of practice
*includes those they are not authorized to provide
Services that are not rehabilitative
*includes primarily recreation-oriented
Full list of noncovered services here<br>
slide8. Reimbursement of Medically Necessary Services CCS vendor / service providers must enter a clinical note every time they meet with CCS participants (ie: deliver a service).
This is their ‘bill of service’, but needs to meet standards identified by Medicaid (ForwardHealth) and WI DHS State Statute 36.18 for the counties to pay them for it.
New providers receive training on writing progress notes to meet requirements
Billing is processed twice monthly (on the 8th and 21st)
The counties then submit claims to Medicaid /ForwardHealth for reimbursement of the services they already paid the provider to deliver.
ForwardHealth’s reimbursement rates for the services are based on the individual provider’s qualification (education) level, informed by WI DHS 36.10(g) Minimum qualifications.
These are standard reimbursement rates across all counties, and often vary from the individual vendor’s costs-based rates billed to the County.
The County has to cover any differences<br>
slide9. Reimbursement of Medically Necessary Services Medicaid has determined a standard reimbursement rate to all Counties for the types of CCS providers who can provide services (left)
These are based on qualification levels, outlined in DHS 36.10 (below)<br>
slide10. Determining Rates & How Prospective Vendors are Considered Because CCS is funded by Wisconsin Medicaid, charges for all services must be costs-based (like a nonprofit)
This means prospective vendors need to identify an hourly ‘rate’ for their services, by budgeting direct and indirect costs to provide the service.
Direct costs = Those that are specific to CCS
Reimbursable time
(meetings with participants, note-writing & travel time)
Necessary, but Not Reimbursable Time
(coordination with other CCS team members, phone calls to participants, no-show appointments, training & supervision time)
Supplies needed for work with CCS participants
Cost of supervision / training required by CCS
General overhead costs = Overall costs to keep a business running
(Insurance costs, Office lease/rental, accounting or legal costs, utilities, software subscriptions, training costs associated with maintaining a professional certification / licensure)
The Counties review your rate, break-out of costs that inform it, the type of potential services to provide, and the level of need for those services in our programs when deciding to move forward with a contract, or decline a prospective vendor.
These details are compared with other currently-contracted vendors and/or non-CCS organizations / services to determine if the rate you’ve proposed is considered “usual and customary” by ForwardHealth standards.<br>
slide11. Initial CCS Provider Requirements Dictated by DHS 36 Initial Training Needed
Before Working with Participants
(within 90 days of hire) 20 hours = new providers with 6 months or more experience
40 hours = new providers with less than 6 months experience
40 hours = all volunteers
13+ of these hours are completed through a UWGB online training.
*30 additional hours = only applies to Peer Specialists and Rehabilitation-level workers (can count trainings completed within past 2 years. results in a minimum of 50 or 70 total hours) Documentation Needed Before Working with Participants
(within 90 days of hire) Caregiver Background Check
Background Information Disclosure form
A resume or application
Two letters of recommendation
Copy of relevant degrees and/or transcripts
Copy of relevant licenses and/or certifications
CCS Clinical Supervision form
CCS Initial Orientation / Training log
Home Office Address (if applicable)
Short Bio & Photo (to be shared with participants and CCS staff)<br>
slide12. Ongoing Provider Requirements Dictated by DHS 36 Ongoing Training Requirements At least 8 hours of training per year, relevant to the providers’ role
Must provide documentation of completion via master log and/or CEU or other training completion verification on a quarterly basis
Documentation must reflect:
Topic covered
Entity that offered training
Number of hours / minutes
Date completed Ongoing Supervision Requirements Service providers at a bachelors level or below, with or without a license, and doctoral / masters level clinicians without a license:
At least 1 hour of supervision for every 30 face-to-face service hours
Accredited & licensed doctoral or masters level practitioners:
At least 1 hour of supervision / clinical collaboration for every 120 face-to-face service hours Additional Documentation Needed: Caregiver Background Checks & Background Information Disclosure forms (every 4 years)<br>
slide13. Next Steps You develop your rate by using a rate setting tool (Excel document), provided by Julie Winter, Quality Assurance & Improvement Coordinator.
Once ready, Julie submits your final rate to Ashland and Bayfield County administration
They accept (with or without exceptions), decline, or may ask for further clarifications
If accepted, a contract is drafted from one or both counties & you provide:
Business name
Physical address of business & mailing address for invoices
Completed W9 form
Proof of Liability Insurance
Civil Rights Compliance Letter of Assurance
Annual Audit Reporting Package (contract section 16) * required for any provider accepting federal funds if over $100,000 per year (Chapter 46 of WI State Statutes)
You also provide necessary documents & ensure training requirements are met for any staff who will be working with participants (listed on slide 11)
These must be completed prior to meeting face-to-face with participants<br>
slide14. Questions? Reach out! Julie Winter
Quality Control and Improvement Coordinator
Comprehensive Community Services Programs
for Ashland and Bayfield Counties
Julie.winter@ashlandcountywi.gov
715-682-7004 x159 | Fax: 715-682-7924 ashlandcountywi.gov/regionalCCSreferral<br>
slide2. What is CCS A wrap-around mental health and substance use recovery program
Meant to help address needs that if ignored, could lead to inpatient hospitalization
CCS is in 69 of 72 Wisconsin Counties & three tribes in Wisconsin
Funded through State Medicaid insurance
Is focused on recovery & rehabilitation *not long-term supports
Is fully voluntary – participants must choose to engage *or not
The Ashland and Bayfield County CCS programs operate using a shared services model. *separate programs, but shared supports<br>
slide3. Participant Eligibility Requirements Must be a resident of Ashland or Bayfield County
Must have Medicaid / BadgerCare Plus Insurance benefits
Must have a mental health and/or substance use diagnosis, made by a medical doctor or psychiatrist
Impairments related to diagnoses interfere with major life activities or goals
Must be found eligible through functional screening / assessment<br>
slide4. How Supports Are Provided Through CCS CCS participants work with a Service Facilitator (SF) to identify necessary supports *based on their goals and needs
The program’s Mental Health Professionals (MHP) are continually reviewing plans and participant progress for medical necessity
Supports are authorized (approved) by listing them on the participant’s service plan.
Supports and service plans are reassessed every six months *minimum
Recovery is not linear – as needs change, so do plans & supports<br>
slide5. Support Examples These all fall under one of the covered service categories from ForwardHealth for reimbursement<br>
slide6. State Definition of CCS Service Example Individual Skill Development
*side by side support for developing skills needed to complete daily living tasks
Finding housing
Finding / maintaining employment
Budgeting
Grocery shopping
Home & appointment organization
Completing paperwork
Making community connections
Learning healthy coping skills (Yoga, Cross Fit, Crafts, Nature Healing)<br>
slide7. Medical Necessity Provider’s clinical notes must demonstrate this, in order for Medical Assistance to approve (pay) for the service provided Covered Services In-person / virtual meetings with a participant when providing authorized services
Travel Time to/from completed appointments
Note-Writing Time
Full list of covered services here Noncovered Services Coordination with the participant’s other team members
No-show appointments
Communication with the participant that is not face-to-face / telehealth.
* Reminder calls / texts
Services that are outside of the providers’ scope of practice
*includes those they are not authorized to provide
Services that are not rehabilitative
*includes primarily recreation-oriented
Full list of noncovered services here<br>
slide8. Reimbursement of Medically Necessary Services CCS vendor / service providers must enter a clinical note every time they meet with CCS participants (ie: deliver a service).
This is their ‘bill of service’, but needs to meet standards identified by Medicaid (ForwardHealth) and WI DHS State Statute 36.18 for the counties to pay them for it.
New providers receive training on writing progress notes to meet requirements
Billing is processed twice monthly (on the 8th and 21st)
The counties then submit claims to Medicaid /ForwardHealth for reimbursement of the services they already paid the provider to deliver.
ForwardHealth’s reimbursement rates for the services are based on the individual provider’s qualification (education) level, informed by WI DHS 36.10(g) Minimum qualifications.
These are standard reimbursement rates across all counties, and often vary from the individual vendor’s costs-based rates billed to the County.
The County has to cover any differences<br>
slide9. Reimbursement of Medically Necessary Services Medicaid has determined a standard reimbursement rate to all Counties for the types of CCS providers who can provide services (left)
These are based on qualification levels, outlined in DHS 36.10 (below)<br>
slide10. Determining Rates & How Prospective Vendors are Considered Because CCS is funded by Wisconsin Medicaid, charges for all services must be costs-based (like a nonprofit)
This means prospective vendors need to identify an hourly ‘rate’ for their services, by budgeting direct and indirect costs to provide the service.
Direct costs = Those that are specific to CCS
Reimbursable time
(meetings with participants, note-writing & travel time)
Necessary, but Not Reimbursable Time
(coordination with other CCS team members, phone calls to participants, no-show appointments, training & supervision time)
Supplies needed for work with CCS participants
Cost of supervision / training required by CCS
General overhead costs = Overall costs to keep a business running
(Insurance costs, Office lease/rental, accounting or legal costs, utilities, software subscriptions, training costs associated with maintaining a professional certification / licensure)
The Counties review your rate, break-out of costs that inform it, the type of potential services to provide, and the level of need for those services in our programs when deciding to move forward with a contract, or decline a prospective vendor.
These details are compared with other currently-contracted vendors and/or non-CCS organizations / services to determine if the rate you’ve proposed is considered “usual and customary” by ForwardHealth standards.<br>
slide11. Initial CCS Provider Requirements Dictated by DHS 36 Initial Training Needed
Before Working with Participants
(within 90 days of hire) 20 hours = new providers with 6 months or more experience
40 hours = new providers with less than 6 months experience
40 hours = all volunteers
13+ of these hours are completed through a UWGB online training.
*30 additional hours = only applies to Peer Specialists and Rehabilitation-level workers (can count trainings completed within past 2 years. results in a minimum of 50 or 70 total hours) Documentation Needed Before Working with Participants
(within 90 days of hire) Caregiver Background Check
Background Information Disclosure form
A resume or application
Two letters of recommendation
Copy of relevant degrees and/or transcripts
Copy of relevant licenses and/or certifications
CCS Clinical Supervision form
CCS Initial Orientation / Training log
Home Office Address (if applicable)
Short Bio & Photo (to be shared with participants and CCS staff)<br>
slide12. Ongoing Provider Requirements Dictated by DHS 36 Ongoing Training Requirements At least 8 hours of training per year, relevant to the providers’ role
Must provide documentation of completion via master log and/or CEU or other training completion verification on a quarterly basis
Documentation must reflect:
Topic covered
Entity that offered training
Number of hours / minutes
Date completed Ongoing Supervision Requirements Service providers at a bachelors level or below, with or without a license, and doctoral / masters level clinicians without a license:
At least 1 hour of supervision for every 30 face-to-face service hours
Accredited & licensed doctoral or masters level practitioners:
At least 1 hour of supervision / clinical collaboration for every 120 face-to-face service hours Additional Documentation Needed: Caregiver Background Checks & Background Information Disclosure forms (every 4 years)<br>
slide13. Next Steps You develop your rate by using a rate setting tool (Excel document), provided by Julie Winter, Quality Assurance & Improvement Coordinator.
Once ready, Julie submits your final rate to Ashland and Bayfield County administration
They accept (with or without exceptions), decline, or may ask for further clarifications
If accepted, a contract is drafted from one or both counties & you provide:
Business name
Physical address of business & mailing address for invoices
Completed W9 form
Proof of Liability Insurance
Civil Rights Compliance Letter of Assurance
Annual Audit Reporting Package (contract section 16) * required for any provider accepting federal funds if over $100,000 per year (Chapter 46 of WI State Statutes)
You also provide necessary documents & ensure training requirements are met for any staff who will be working with participants (listed on slide 11)
These must be completed prior to meeting face-to-face with participants<br>
slide14. Questions? Reach out! Julie Winter
Quality Control and Improvement Coordinator
Comprehensive Community Services Programs
for Ashland and Bayfield Counties
Julie.winter@ashlandcountywi.gov
715-682-7004 x159 | Fax: 715-682-7924 ashlandcountywi.gov/regionalCCSreferral<br>