Mental Health/AODA Functional Screen
FAQs
May 19, 2005
What is the MH/AODA Functional Screen (FS) going to be used for?
The MH/AODA FS is a screening tool for individuals with mental illness
and/or AODA issues which will automatically determine a level of need for
the following: Community Support Programs (CSP), Comprehensive Community
Services (CCS), Community Options Program (COP) for people with serious
and persistent mental illness, and for the HSRS, Blue Ribbon Commission (BRC)
target populations, High and Low. The screen will also automatically refer
individuals who have co-morbid substance abuse issues to a level one
screen for UPC (uniform placement criteria). It will also refer
individuals with physical health problems and related ADL (activities of
daily living) deficits to a Long Term Care (LTC) Functional Screen to
determine eligibility for funding through a home and community-based
waiver.
The Department also plans on using the screen for local and state
quality improvement initiatives and the development of quality indicators.
The data provided can be used to measure progress of individuals over
time, identify the success of services and supports delivered and help
determine the effectiveness of various programs such as CSP and CCS.
Why was the MH/AODA FS created?
Initially, the MH/AODA FS was created to provide a consistent and
objective tool to determine need for Medicaid benefits such as CSP and
CCS. The Department conducted statewide listening sessions with consumers
and stakeholders, which identified the eligibility inconsistencies across
counties as a barrier to obtaining services and determined the need for a
neutral tool to assess need for services. The screen will provide very
useful data to counties on the populations they serve, unmet consumer
needs and wants, improved functioning over time and whether the services
and supports provided are meeting consumer outcomes.
Is this a separate screen or is it just an addition to the adult LTC
screen?
The MH/AODA screen is a totally separate screen that has detailed
questions surrounding the issues of MH and AODA. It has its own training
course, clinical backup and set of specific instructions to ensure
validity and reliability. However, since both screens are web-based some
information can be shared across screens. For example, if a consumer has a
LTC screen completed and stored in the system, all of their demographic
information is shared and automatically populates the MH/AODA screen when
run. Information will not have to be re-entered.
Is the MH/AODA Functional Screen required?
The MH/AODA screen is totally voluntary for consumers. They must give
their permission to have a screen completed. A screener can not complete a
screen without the knowledge of and agreement from the consumer. However,
where the screen is the tool for determining need for services, the
consumer needs to know that refusal to participate in the screening
process could affect the determination of the need for services.
The Department has chosen to make this screen the approved screen for
CCS admissions for adults (the new children's screen will be used to
determine CCS for children). It will also be the approved screen for COP
eligibility for COP level 3 individuals with serious and persistent mental
illness, beginning March 1, 2005. It will remain voluntary for CSP at this
time, however many counties may want to begin using the screen for CSP as
it will give each program access to valuable data on the CSP population
locally. For the first time, local agencies will have a mechanism to be
able to sort caseloads by living situation, diagnosis, risk factors and
ADL functional levels.
Is the MH/AODA Functional Screen a comprehensive assessment?
No, the screen is not a comprehensive assessment. The MH/AODA FS is
based on the person's diagnoses, symptoms, and need for help from others
(i.e., functional impairments) because program eligibility (particularly
under federal Medicaid guidelines) is based on the need for program
services. A functional eligibility screen by definition must focus on
functional impairments, i.e., needs for assistance. A full assessment
would be a more holistic approach where one's strengths, weaknesses,
interests, hobbies, support system, etc. are all discussed and a
recovery-based plan is the outcome.
With that said, the functional screen is thorough enough to use in lieu
of the required initial CSP assessment in order to complete the
initial care plan required during the assessment period. For counties who
want to participate in use of the screen for CSP, BQA will accept the
screen in place of the initial assessment, in conjunction with the
BQA required initial care plan. The agency will still be required to
complete the in-depth, strength-based assessment within one month of
admission as required in HFS 63 administrative rules.
Does the MH/AODA FS replace the CSP admission note?
Counties can print out the screen and use it in place of the narrative
part of the CSP admission note ALTHOUGH the psychiatric medical necessity
and the CSP start date must still be documented.
When should the MH/AODA FS be completed and how often?
It should be completed when a person is initially interested in CSP,
COP or CCS services. Once a person is enrolled into CCS or CSP, a screen
must be updated when there is a major change in condition that is likely
to last beyond 6 months and/or annually.
Are COP Level 3 annual rescreens required?
No, it is not required to do an annual COP level 3 re-screen although
it is best practice, particularly in times of fiscal constraint. When you
are re-screening a person who is currently receiving COP level 3 funding
it is important to document that ongoing funding on the Risk Factors page.
Note that the waiver mandate only applies for individuals found eligible
for COP using the Long Term Care Functional Screen. People with mental
illness and no other significant physical or developmental disability with
related functional deficits are ineligible for home and community based
waivers.
How much time does it take to complete a screen?
An initial screen on a new consumer takes approximately 1 ½ to 2
hours, this includes the face-to-face interview time, paperwork, and the
time reaching collateral contacts, providing the collateral contacts are
available to the case manager. The change in condition or annual screens
should take approximately 15-20 minutes since the provider will already
know the person.
How does a provider get reimbursed for completing a functional
screen?
Certified CSP's and TCM programs can bill under Assessment for the time
spent completing a MH/AODA FS for those individuals who are Medicaid
eligible.
How are providers supposed to do this along with their other
paperwork?
The MH/AODA FS should be integrated into your county's existing intake
process, and annually, integrated into one of the required six-month
reviews. The screen simply organizes and streamlines the information case
managers are already obtaining. All of the information is needed for an
initial assessment and the screen provides a format for the review of the
care plan and services provided, which has to be completed every six
months. There are discussions underway at the Department about what the
screen could substitute for in the way of routine paperwork already
required. We would welcome any suggestions regarding this, and can use the
screen lead meetings as a forum for these suggestions.
Do providers have to meet any requirements to do a screen or have
any extra training?
Yes. All persons administering the MH/AODA functional screen must meet
the following conditions:
- Meet the following minimum criteria for education and experience:
- Nursing license, OR
- A BA or BS, preferably in a health or human services related
field, and at least one year of experience working with the target
population, OR
- Prior approval from the Department based on a combination of
post-secondary education and experience or on a written plan for
formal and on-the-job training to develop the required expertise; AND
- Meet all training requirements as specified by the
Department. Currently that means:
- Completing the online course, and
- Reading and following screen instructions.
For those screeners who do not meet the minimum education or experience
requirements and need to obtain "Prior approval from the
Department" please send a resume and/or description of the person's
education and experience to Florene Birch, birchfa@dhfs.state.wi.us,
or call (608) 261-8876. The MH/AODA FS Committee will review this
information and contact the Lead Screener with the result.
The online course mentioned above is provided free of charge, takes
approximately ten hours to complete and provides continuing education
hours/credits for those who become certified screeners. The certificate is
automatically issued at the end of the course. In addition, there is also
an optional technical training that teaches screeners how to maneuver the
web-based screening tool. You may contact the DHFS if your county is
interested in participating in this training or your county's LTC unit may
be able to train your screeners locally in web navigation
What if I am already a certified screener for the adult LTC screen
or the children's LTS screen, do I still have to take the MH/AODA screen
training?
Yes, the training course for the MH/AODA screen is very different from
the other two screens and provides specific information on MH and AODA
issues.
Other than the training, are there any further responsibilities that
counties must commit to in order to start using the MH/AODA Functional
Screen?
Yes, each county must identify a minimum of one person as the Screen
Lead for that county. That person will be the local contact for screen
questions or feedback. That person is also asked to attend monthly Screen
Lead Meetings where all screen issues will be discussed, requests for
changes be considered, and where any changes by the Department would be
reviewed by this group. This system is used with great success with the
LTC Functional Screen and many positive changes to that screen have come
about because of the suggestions by screen leads at the local level,
gathering input from their local screeners.
Counties and providers are already overworked how can they make time
to complete a ten-hour training?
You can complete the training at your own pace and it can be done over
a period of days or even weeks. The training can be completed from any
computer that has Internet access.
When will the screen be ready to use?
Counties can begin using the web-based training on January 18, 2005.
The actual MH/AODA Functional Screen will be ready to use on March 1,
2005. The web-based clinical training course should not be taken more than
one month before the county or the screener plans to start completing MH/AODA
Functional Screens.
Back to: Wisconsin's Functional
Screen Home Page
Last Revised: July 19, 2006
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