Field Capable Clinical Services (FCCS) Outcomes Miguel Juarez Kara Taguchi, Psy.D. MHSA Implementation Unit FSP/FCCS Roundtable Meeting October 7, 2010

Reminders: Important Information on FCCS Outcomes Outcomes do not follow the client in FCCS. No Transfers No Re-establishments The FCCS Start date is the first date you provide FCCS Services (first claim to FCCS IS Plan). There is a 45 day window around each 6 month update (15 days before the due date to 30 days after) Must do a termination outcome even if you just finished an update.

Reminders: Important Information on FCCS Outcomes (cont.) Remember to close out FCCS outcomes so that if the client receives services elsewhere that require outcomes, that provider can enter them. No paper data accepted, outcomes must be entered into OMA. You must have an open IS episode at the time you enter a baseline into OMA.

Reminders: Important Information on FCCS Outcomes (cont.) If a client is transferring from Full Service Partnership (FSP) to FCCS, FSP outcomes must be closed out first with a discontinuation Key Event Change (no provider site ID change needed) then FCCS outcomes can be collected. The FSP Partnership date will have no bearing on the FCCS start date.

Deletion Change Request If I make an error that I cannot correct what do I do? Deletion Change Request Form: http://dmhoma.pbworks.com/Data+Change+or+Deletion+Request If the OMA won’t let me enter my outcomes, what do I do? Call the MHSA Implementation Unit Call the DMH Help Desk at (213) 351-1335

FCCS Issues 1) Client has an age group program changes within a single reporting unit single episode. Example: The agency has multiple Age Group programs within a single Reporting Unit, and a client switches from one age group FCCS program to another after it is determined the next age group FCCS is more clinically appropriate. Age Group Agreement: No change to the original OMA program needed if client stays with the same provider site. Provider should continue on with updates and termination according to DMH rules.

FCCS Issues 2) Client goes from FCCS to another program (i.e., FSP or Wellness) and then back to FCCS using the same IS episode Example: Client starts in FCCS, terminates FCCS, then moves to some other program within the provider site, and then goes back to FCCS all in the same IS episode. Age Group Agreement: Delete the termination update and continue with next update due once client returns to FCCS. There should not be overlapping of programs.

FCCS Issues 3) Multiple provider sites within a single Legal Entity providing FCCS at the same time Example provided: Client is receiving therapy at one location, medication at another provider site, and all are doing Outcomes for the same timeframe. Age Group Agreement: One of the provider sites should take responsibility for collecting the outcomes for the FCCS services received as a whole. Will be evaluated case by case; should be the exception not the rule.

FCCS Issues 4) FCCS Services at multiple sites: different provider numbers and different Legal Entities at the same time Example: Client is being claimed to FCCS at multiple sites at different legal entities simultaneously. Age Group Agreement: Only one set of FCCS outcomes should be collected at a time. This example should not happen. Coordination of services between providers needs to occur to ensure no duplication.

FCCS Issues 5) Short Term FCCS Client Example: A client comes into an agency and is seen only a few times. (billing FCCS). Outcomes were not collected. Do I need to go back and do them? Age Group Agreement: Clients receiving a single service do not need to have outcomes. Client’s receiving more than one claim over a span of 30 days require FCCS outcomes. If you have questions, please consult your age group representative or the MHSA Implementation Unit.

FCCS Issues 6) FCCS and FSP services at the same time Example: Client receiving services from two different programs (FCCS and FSP) during the same/overlapping time period. Age Group Agreement: Age group FSP programs and FCCS should not be overlapping. Clients are considered to be in FSP until authorization to disenroll is requested and approved by countywide. Outcomes must be collected for FSP until the client’s authorized signature date for disenrollment. FCCS data collection should start only after all FSP data collection is complete. An Executive discussion needs to take place regarding concurrent Wraparound FSP, FCCS, and/or FSP services.

FCCS OMA Questions from Child Providers Question: “Can WRAP, WRAP FSP, FSP, and FCCS services be provided at the same time?” Answer: An Executive discussion needs to take place regarding concurrent Wraparound FSP and Wraparound and FCCS. The age group leads agreed there should not be concurrent FCCS and Age group FSP services, except in the instance where a client is transitioning out of FSP.

FCCS OMA Questions from Child Providers Question: “If a client is enrolled in WRAP FSP and a Child FCCS agency, would the FCCS OMA need to be terminated? Can FCCS still be provided without OMA data collection?” Answer: The OMA does not allow for data collection in two different programs at the same time. Wrap FSP outcomes need to be sent to the state so the FSP outcomes have priority over FCCS. Outcome data collection for FCCS must stop once a client is enrolled in Wrap FSP so that outcomes can be collected for entire enrollment period of Wrap FSP. How to handle outcomes may be different than what is clinically appropriate. Executive management over these programs are discussing the appropriateness of overlapping services where Wraparound is concerned.

FCCS OMA Questions from Child Providers Question: “If a client is willing to stay beyond the age of 16 in the FCCS-Child program, what ‘program age group’ would be indicated at the top of the FCCS OMA form?  Would this be based on client’s age group at the time of first service/entering the FCCS program? Or the actual chronological age?” Answer: No change to the original OMA program needed if client stays with the same provider site. Provider should continue on with updates and termination according to DMH rules.

FCCS OMA Questions from Child Providers Question: “When a client changes from FCCS-Child to FCCS-TAY, does the agency close the FCCS-Child episode in the IS and open a FCCS-TAY episode? What is the protocol in OMA?” Answer: The IS episode does not need to be closed when changing FCCS age group programs within the same provider site. No change needs to be made with OMA for FCCS. The IS billing plan that is claimed for the service should change when the client switches age group FCCS programs as clinically indicated.

FCCS OMA Questions Question: “Is there a ‘cheat sheet’ of all the various dates associated with disenrollment?” Answer: No, there is no tool that exists like this. There is only one FSP disenrollment date. It is the last date of FSP services delivered on or after the countywide authorized signature date. If no services were rendered after the authorization to disenroll, then use the signature date as the disenrollment date for outcomes. Please refer to the OMA Chat regarding FSP disenrollment/ discontinuation dates vs. IS episode closing dates.

FCCS OMA Questions Question: “My understanding of termination date from IS for FSP is that it has to be the date on or after the disenrollment authorization date signed by the CWs. Is this correct?” Answer: Refer to OMA chat handout (Date: 5/11/2010 Issue/Topic: FSP Disenrollment dates vs. IS episode close dates)

Training for FCCS and Resources FCCS Forms Trainings via WebEx Oct 28, 2010 from 9:00-10:00 am Nov 9, 2010 from 9:00-10:00 am Nov 30, 2010 from 9:00-10:00 am Dec 14, 2010 from 9:00-10:00 am Upcoming FCCS Hands on Trainings Oct 28, 2010 from 10:30 am - noon Nov 9, 2010 from 10:30 am - noon Nov 30, 2010 from 10:30 am - noon Dec 14, 2010 from 10:30 am – noon Project Website: dmhoma.pbworks.com/FCCS Email alert system: FCCS OMA To Subscribe, email your request to FCCSOMA-subscribe@yahoogroups.com

Contact Information What if I really miss talking to one of those cool OMA Team people? Contact us! Kara Taguchi, Program Head, (213) 251-6818, ktaguchi@dmh.lacounty.gov Richard Hoskins, Ph.D., (213) 251-6865, rhoskins@dmh.lacounty.gov Miguel Juarez, (213) 251-6829, mjuarez@dmh.lacounty.gov John Flynn, Ph.D., (213) 251-6404, jflynn@dmh.lacounty.gov