Comprehensive Community Services Prospective

Transcript:Comprehensive Community Services Prospective:
Comprehensive Community Services Prospective Vendor Information Last Updated: 10/9/24 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 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 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 Support Examples These all fall under one of the covered service categories from ForwardHealth for reimbursement 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) 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 Reimbursement of Medically Necessary Services CCS vendor / service