Wrap-Around Mental Health and Substance Use Recovery Program Details

Comprehensive Community Services Prospective Vendor Information Last Updated: 10/9/24

A wrap-around mental health and substance use recovery program What is CCS 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

1. Must be a resident of Ashland or Bayfield County 2. Must have Medicaid / BadgerCare Plus Insurance benefits Participant Eligibility Requirements 3. Must have a mental health and/or substance use diagnosis, made by a medical doctor or psychiatrist 4. Impairments related to diagnoses interfere with major life activities or goals 5. Must be found eligible through functional screening / assessment

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. How Supports Are Provided Through CCS Supports and service plans are reassessed every six months *minimum Recovery is not linear as needs change, so do plans & supports Ashland County CCS Staff Bayfield County CCS Staff Teri Ovaska (MHP) Tom Croteau (MHP) Annika Herlevi (SF) *Emilie Schutte (SF) Hannah DeWitt (SF) *J.W. Sutton (SF) Courtney Mihalak (RN / SF) *Chris Beirl (SF) *Stephanie Tutor (SF) *Vanessa Sowl (SF) Molly Randa (SF) * =Licensed Substance Use Counselor (SAC)

Individual therapy Equine Assisted Learning Substance Use Counseling *Internal providers available Peer Specialist Mentoring *Team member with lived experience Parental / Family guidance, education and problem-solving *Must be for participant s benefit Medication Management & Use Support *ACCS - help with packing / understanding side effects. BCCS limited Crisis Prevention & Management *Internal & community-wide safety plans Physical Health Monitoring *Help with tracking appointments, assessing needs & how mental health impacts physical health 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) 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)

Covered Services Noncovered Services Coordination with the participant s other team members Medical Necessity In-person / virtual meetings with a participant when providing authorized services No-show appointments Communication with the participant that is not face-to-face / telehealth. * Reminder calls / texts Travel Time to/from completed appointments Provider s clinical notes must demonstrate this, in order for Medical Assistance to approve (pay) for the service provided Services that are outside of the providers scope of practice *includes those they are not authorized to provide Note-Writing Time Full list of covered services here Services that are not rehabilitative *includes primarily recreation- oriented Full list of noncovered services here

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 Reimbursement of Medically Necessary Services Contact for Billing Nettie Titel, Administrative Professional for Ashland & Bayfield County Community Service Programs

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) Reimbursement of Medically Necessary Services

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. Determining Rates & How Prospective Vendors are Considered

Initial Training Needed Before Working with Participants (within 90 days of hire) 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) 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. Initial CCS Provider Requirements Dictated by DHS 36 *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)

Ongoing Training Requirements 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 At least 8 hours of training per year, relevant to the providers role Ongoing Provider Requirements Dictated by DHS 36 Must provide documentation of completion via master log and/or CEU or other training completion verification on a quarterly basis Accredited & licensed doctoral or masters level practitioners: At least 1 hour of supervision / clinical collaboration for every 120 face-to-face service hours Documentation must reflect: Topic covered Entity that offered training Number of hours / minutes Date completed Additional Documentation Needed: Caregiver Background Checks & Background Information Disclosure forms (every 4 years)

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) Next Steps 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 Ashland County Contact for Contracts Bayfield County Contacts for Contracts Lisa Bradley, Front Desk & Fiscal Support Tom Croteau, CCS Mental Health Professional Nina Bucher, Human Services Clerical Support

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 Questions? Reach out! ashlandcountywi.gov/regionalCCSreferral