COVID-19: DHS Partners

The information on this page is for DHS partners who provide behavioral health services.

Community Support Programs

The Division of Care and Treatment Services is hosting virtual meetings for professionals involved in Community Support Programs to discuss challenges and solutions related to the COVID-19 pandemic. 

Second and fourth Fridays of each month from 9:30 to 10:30 a.m.

Join the Zoom meeting

To access the downloads discussed during the meeting, join the meeting through Adobe Connect.

Comprehensive Community Services

Virtual meetings

The Division of Care and Treatment Services is hosting virtual meetings for administrators and directors involved in the Comprehensive Community Services program to discuss challenges and solutions related to the COVID-19 pandemic.

Every other Wednesday from 1:00 to 2:30 p.m.
(The next meeting is scheduled for October 28, 2020.)

Join the Zoom meeting

Audio recordings of previous meetings
Use Internet Explorer to access these recordings.

FAQs/guidance

Below are answers to frequently asked questions from counties and tribes offering Comprehensive Community Services related to providing services during the COVID-19 pandemic. This information is subject to change. This information was last updated June 9, 2020. 

Provision of services

How should services be provided during this time? 
The Division of Care and Treatment Services recommends programs determine the safest way to meet the needs of consumers. This may include providing services face-to-face, through telehealth, or through a combination of these approaches (face-to-face and telehealth). Telehealth may be used to provide services that can be delivered with functional equivalency to face-to-face services.  

What does synchronous communication mean in a telehealth setting?
Synchronous refers to the delivery of health information in real time. This allows for a live discussion with the patient or provider to deliver services. Telehealth services delivered through video or phone communication are considered synchronous communications.  

Are texts and emails considered telehealth?
No. Texts and emails are not considered equivalent to face-to-face services.

What documentation is needed to use telehealth in CCS?
Providers must keep accurate and complete documentation according to existing telehealth benefit policy requirements. Providers must also document the type of technology utilized and the reason for remote provision of services for each telehealth encounter. Providers are expected to exercise professional judgment and use telehealth only for services that can be delivered appropriately and effectively via remote communication. Providers must let patients know that these third-party applications can introduce privacy risks. Providers should also enable all available encryption and privacy modes when using such applications.

Who is able to provide telehealth in CCS?
All CCS provider types may deliver allowable services using telehealth. All providers are required to act within their scope of practice.

Is group therapy allowable under telehealth?
Group therapy is allowable under the temporary telehealth policy. See ForwardHealth Update 2020-15: Additional services to be provided via telehealth. (PDF)

Can supervision be provided through telehealth?
Supervision may be provided through telehealth, including phone communications. Providers must keep accurate and complete documentation according to existing telehealth benefit policy requirements. Agencies must adhere to Wis. Admin. Code ch. DHS 36 requirements.

Is there guidance for residential facilities?
Yes. See the following resources:

Agencies must adhere to Wis. Admin. Code ch. DHS 36 requirements.


Program admissions

Have deadlines been extended to support the completion of initial enrollment documentation?
CCS programs should complete the required enrollment documentation in a timely manner. Programs should clearly document reasons for any delays to obtain information in order to complete the required documentation. The CCS program should consider the use of the abbreviated assessment during the COVID-19 pandemic for the enrollment process. The assessment may be abbreviated if the consumer has signed an admission agreement and one of the following circumstances apply:  

  1. The consumer’s health or symptoms are such that only limited information can be obtained immediately. 
  2. The consumer chooses not to provide information necessary to complete a comprehensive assessment at the time of application. 
  3. The consumer is immediately interested in receiving only specified services that require limited information. 

The abbreviated assessment shall be valid for up to three months from the date of application and should include documentation identifying the reason for the abbreviated assessment.  

Can the functional screen be conducted through synchronous technology? 
Yes. 


Signatures

What is the guidance related to obtaining signatures?
Certified CCS counties and tribes should develop policies and procedures to obtain signatures. CCS programs should consider the following when obtaining signatures.

  • Programs can utilize verbal consent for up to 10 days for treatment via telehealth, treatment plans, assessments, and informed consents. Documentation should include what the consent addressed and the associated risks discussed. 
  • Programs must obtain a signature within 10 days after receiving verbal consent. An electronic signature is allowed and encouraged. If an individual is not able to complete an electronic signature, the program must obtain a written signature through mail or email. Text messaging does not satisfy this requirement.
  • Programs should document all attempts to obtain a written signature. If the signature is not received, document the follow-up to obtain the signature.

Agencies must adhere to Wis. Admin. Code ch. DHS 36 and Wis. Admin. Code ch. DHS 94 requirements. 


Recovery team meetings

Can recovery team meetings be held through telehealth?
Yes.


Discharge

What should a program do if a consumer is found not functionally eligible or no longer needs psychosocial rehabilitation services?
If an adult is found not functionally eligible on an annual functional screen, CCS programs do not have to automatically discharge the individual during the COVID-19 pandemic. The CCS program should clearly document reasons why discharge has not occurred. Document if the functional screen indicates not functionally eligible or if psychosocial rehabilitation services are no longer needed. CCS services can continue, if needed, during the COVID-19 pandemic even with a not functionally eligible finding on the functional screen. 

If a child/youth is found not functionally eligible, the CCS program should review the child/youth’s Medicaid source to determine if the child/youth is enrolled in CLTS, the Katie Beckett Program, or on the CLTS Wait List. It is important that eligibility be maintained. If the child is enrolled in a waiver program, the CCS program should work with the waiver staff to ensure waiver services are not impacted.

Medicaid requires a service be medically necessary for the individual. If the individual does not need a service, it is not medically necessary, which means it is a service Medicaid doesn’t cover. Agencies should adhere to the requirements list in Wis. Admin Code ch. DHS 101.03(96m).

 


Correcting files

Is there guidance for correcting files?
Yes. See the CCS: Providers webpage for suggestions regarding how to correct CCS documentation when a discrepancy has occurred or when a document has not been completed within the timeframes specified by CCS rules and regulations.

 

Coordinated Services Teams Initiatives

Thank you for working on the front lines with children, youth, and their families who struggle with mental health during COVID-19. We appreciate your commitment to serving your community. It is a stressful time for all of us and those we wrap around need regular connection and encouragement to make it through the pandemic. We are in this together. Ask for what you need, we are here to support you and the families you work with. Visit the CST: Providers webpage for contact information for DHS staff.

We understand that you may be uncertain as to how to meet new and emerging needs of the families you work with and may be looking for guidance and support. We have researched best practices and resources to support you and the families you work with during this time.

Guiding principles of wraparound during COVID-19
  • The family team is the foundation of wraparound. Be curious about what they need to meet their roles, goals, and responsibilities during the pandemic.
  • Natural supports are the key to keeping the child and youth in the community. It is an opportune time to acknowledge creativity and innovation in the new ways we are connecting. The Search Institute offers many resources you may find valuable.
  • Coordination can be more of a challenge with social distancing. The plan of care, wellness plan, and crisis plan may need to be revised due to new needs or a change in resources.
  • Be curious about new individual, team, and community strengths that have emerged. Many of us have skills that lie dormant until the need arises. Support and encourage your emerging leaders.
  • Developmental needs are impacted by stress. Be sensitive to a lapse in developmental growth. Social and emotional safety is most important at this time; nutrition is also important to developmental growth. 
  • Family and community cultural values and beliefs shift in the midst of emergencies. Provide a supportive listening ear and build on strengths.
  • Unconditional care is even more important when families are under additional stress. Unconditional care requires our own self-care. The DHS COVID-19: Resilient Wisconsin webpage offers many ideas on how to take care of yourself.
  • Outcome measurements may need to be adjusted due to the pandemic. Meet with the family teams to reevaluate goals and objectives.

Following the guiding principles ensures that we give the best wraparound experience even in times of uncertainty and change.

Information from the National Wraparound Initiative

Wherever possible, wraparound teamwork, process, and quality assurance activities should continue at the same frequency and intensity, even if the methods need to be temporarily modified to protect the health and safety of staff, children, families, and team members. Wraparound is defined by child and family team meetings and the convening of a team of important people in each family’s life. These meetings are essential for development and implementation of the plan of care and should occur no less frequently than 30 to 45 days. The National Wraparound Initiative offers additional resources on working with family teams during the pandemic.

Information on how to talk to children about COVID-19

In this very difficult time, children are receiving information from multiple sources, including the internet, television, friends, teachers, and parents. The information, whether accurate or not, can lead to fear and anxiety with everyone including children. When speaking with children about COVID-19, it is important to consider developmental and emotional differences. Substance Abuse and Mental Health Services Administration, UW-Madison, the UW-Madison Center for Healthy Minds,  and Resilient Wisconsin all have strategies, tips, and ideas for talking with children about COVID-19.

Crisis intervention services

The Division of Care and Treatment Services is hosting meetings for professionals involved in responding to behavioral health crisis situations to discuss challenges and solutions related to the COVID-19 pandemic.

Second and fourth Mondays of each month from 2:00 to 3:00 p.m.

Join the Zoom meeting

To access the downloads discussed during the meeting, join the meeting through Adobe Connect.

DHS 35 and DHS 75 certified providers

All providers certified under Wis. Admin. Code ch. DHS 35 and Wis. Admin. Code ch. DHS 75 are encouraged to participate in monthly virtual meetings for information regarding the COVID-19 pandemic and an opportunity for providers to share questions and concerns with DHS staff from the Division of Care and Treatment Services, the Division of Medicaid Services, and Division of Quality Assurance.

Join the DHS 35 and DHS 75 email list to receive information on future virtual meetings.   

Video recordings

Resources

Client rights

Data

Electronic signatures

Emergency orders

Current (in effect)

Emergency Order #2 (Information from the Department of Safety and Professional Services)

Previous (no longer in effect)


ForwardHealth information

Naloxone information
Relief funding

U.S. Health and Human Services announcement: Phase 3 provider relief funding


SAMHSA updates

Self-care tips

STAR-QI

The Strengthening Treatment Access and Retention-Quality Improvement (STAR-QI) learning collaborative is for DHS 75 programs seeking to receive support implementing change projects for increasing treatment access and retention, including projects related to telehealth and self-care. 


Telehealth information

DQA information

Waivers and variances for behavioral health providers

DHS contacts

Division of Care and Treatment Services

DCTS Information Memo 2020-05: Behavioral Health Administrative Rule Compliance - Technical Assistance (PDF)

Division of Medicaid Services

Division of Quality Assurance

Email staff who work with mental health and substance use providers

Preadmission Screen and Resident Review

The Wisconsin Preadmission Screening and Resident Review (PASRR) process remains in place. Federal law requires that all people requesting admission to a nursing facility must be screened to determine the presence of a mental illness and/or an intellectual disability. A PASRR Level I screen must be completed on every individual entering a Medicaid certified nursing facility. An individual suspected of having a mental illness and/or an intellectual disability should be referred for PASRR Level II screen. To prevent a backlog of screens, review all current or new residents to determine if a PASRR-related condition exists. Residents may be isolated in their rooms due to the COVID-19 pandemic, which may increase symptoms of anxiety and depression. Monitor residents carefully for mental health concerns and refer them for PASRR Level II screening as needed. Contact Donna Wrenn with questions.

The Centers for Medicare and Medicaid Services has implemented a blanket 1135 PASRR Waiver related to the COVID-19 pandemic. It is up to each state to determine if implementation of the waiver would be best for the state. Wisconsin will not be implementing this waiver. This decision was made because the vast majority of PASRR screens in Wisconsin do not require face-to-face contact. There was also a concern that implementing this waiver would result in a large backlog in screens. Therefore, the PASRR process will remain unchanged in Wisconsin during the COVID-19 pandemic.

 

Logo for Resilient Wisconsin: Connected. Stronger. Thriving.Finding healthy ways to cope with challenges is more important than ever. Resilient Wisconsin offers strategies for practicing self-care, maintaining social connections, and reducing stress and anxiety. 

 

Last Revised: October 21, 2020