Community Recovery Services: Provider Resources

Are you a provider for the Community Recovery Services (CRS) program? If so, this page has helpful resources to support you.

Meetings and newsletter

We invite providers involved with CRS to join meetings each quarter with Wisconsin Department of Health Services (DHS) staff. You can access materials from these meetings for one year.

We also email a CRS newsletter twice per year, in the summer and winter. The newsletter helps us stay connected and share important information. You can view past editions of the newsletter:

Join our CRS email list

Documents and forms

Expand a section to learn more about document oversight. See DCTS Action Memo 2019-15 (PDF) for more information.

Consumer materials

Once or twice each year, the Division of Care and Treatment Services (DCTS) requests a random sample of CRS consumer documentation from counties. How much they request depends on the program size:

  • 1–9 clients—30% of consumer materials and CRS consumer list once per year.
  • 10+ clients—15% of consumer materials and CRS consumer list twice per year.

Counties have 15 business days to email the most recent completed materials to DHSDCTSCRS@dhs.wisconsin.gov

Consumer list

A consumer list is a list of the people (or clients) who are part of the CRS program. Counties must send the consumer list to DCTS when they send the requested sample of consumer materials. There’s no required format for the list.

View the CRS Consumer List template (Excel). This is an optional resource.

Medicaid memos and handbooks

Use these resources to learn more about Medicaid CRS requirements:

Medicaid provider registration forms

Getting started

If you’re a new CRS provider, first get access to two state information systems:

Functional Screen Information Access (FSIA)

Wisconsin has an automated functional screen. It’s used to document functional eligibility for many state benefits, including CRS. For access to FSIA, follow these steps:

  1. Get a Wisconsin Web Access Management System Identification (WAMS ID). If you already have a WAMS ID, skip this step.
  2. Go to the Human Services System Gateway.
  3. Select FSIA – Request Access.  
  4. Complete the fillable form.
  5. Submit the form to your agency’s information security officer to process.

Program Participation System (PPS)

After the care manager completes the client’s Individual Service Plan (ISP) packet, they must register the client into PPS. PPS links to the state’s Medicaid system. Through PPS, the care manager can request enrollment in CRS. For access to PPS, follow these steps:

  1. Get a WAMS ID. If you already have a WAMS ID, skip this step.
  2. Go to the Human Services System Gateway.
  3. Select PPS – Request Access.  
  4. Complete the paper request form.
  5. Submit the form to your agency’s information security officer to process.


There also are a few terms and definitions that are helpful for CRS providers to know. You’ll use these terms when you prepare the outcomes form. It defines which services a CRS client will get and who will give them.

Community living supportive services

This service covers activities needed to allow a person to live with the most independence in community integrated housing. Others don’t do tasks for the client. Rather, clients get these services through training, cueing, and supervision. This helps the client be more independent in doing tasks.

The person-centered assessment defines what the client needs. Examples of community living supporting services include:

  • Access to community resources
  • House cleaning
  • Meal planning and cooking
  • Medicine reminders
  • Help with watching medicine side effects 
  • Money management
  • Personal hygiene
  • Shopping
  • Social and fun activities
  • Skill development
    • Crisis coping
    • Emotional regulation
    • Interpersonal
    • Parenting
    • Recovery management
  • Transportation

 

Services are available in different community locations: residential, business, social, and recreational settings. Residential settings include:

  • The client’s own apartment or house.
  • Supported apartment programs.
  • Adult family homes.
  • Residential care apartment complexes.
  • Community-based residential facilities with 5–16 beds—includes those whose health and safety are at risk without 24/7 supervision.

The type of residential setting the client needs is defined in the person-centered assessment. The cost of room and board and building maintenance is not included. Services also shouldn’t repeat other State Plan services, including personal care and transportation.

Peer support services

Providers trained and certified as peer specialists serve as advocates. They also provide information and peer support for clients in outpatient and other community settings. All clients who get peer support services live at home or in a community setting.

Certified peer specialists do many tasks to help clients regain control over their lives and recovery process. They function as role models who show techniques for recovery and ongoing coping skills:

  • They offer effective recovery-based services.
  • They help clients find self-help groups.
  • They help clients get services that suit their recovery needs.
  • They teach problem solving techniques.
  • They teach clients how to find and combat negative self-talk. They also help them overcome fears.
  • They help clients build social skills in the community that will improve integration opportunities.
  • They lend unique insight into mental illness and what makes recovery possible.
  • They attend treatment team and crisis plan development meetings to promote the client using self-directed recovery tools.
  • They inform clients about community and natural supports and how to use these in the recovery process.
  • They help clients develop empowerment skills through activities that promote self-advocacy and removing stigmas.

Supported employment services

This service covers activities needed to help clients get and keep a good job. A supported employment program agency or individual employment specialist may provide this service. Supported employment services follow the Individual Placement and Support model. The Substance Abuse and Mental Health Services Administration recognizes this model as an evidence-based practice. The model has shown to be effective at helping people get and keep a good job.

These are the core features of this service approach:

  • Participation is based on client choice. No one is removed because of prior work history, hospitalization history, substance use, symptoms, or other characteristics.
  • Supported employment is part of mental health treatment. Employment specialists meet with the client’s mental health treatment team to coordinate plans.
  • Competitive employment is the goal. The focus is community jobs anyone can apply for that pay at least minimum wage. This includes full-time and part-time jobs.
  • The job search starts soon after a client says they want to work. There are no required assessments, trainings, or intermediate work experiences (pre-vocational work units, transitional employment, or sheltered workshops).
  • Follow-along supports continue as long as the client wants and needs support.
  • Client preferences are important. Choices and decisions about work and support happen based on the client’s preferences, strengths, and experiences.

The service covers help from an employment specialist:

  • Employment intake.
  • Assessment.
  • Job development.
  • Job placement.
  • Work-related symptom management.
  • Employment crisis support.
  • Follow-along supports.
  • Time spent with the client’s mental health treatment team and vocational rehabilitation counselor.

Processes

Expand each section to learn more about a CRS process. We also have a web page with a list of CRS trainings.

Access CRS provider trainings

Individual service plan quality review process

We ask counties and tribal nations to use the ISP template to create an ISP. Using the template is not required. These resources can help:

Incident reporting process

CMS (Centers for Medicare & Medicaid Services) requires that DHS ensures the health, safety, and welfare of CRS clients. We do this with the help of local Medicaid agencies, service providers, guardians, and family members, plus incident reports.

Incident reports help identify state or regional trends. This then leads to interventions that make it less likely these incidents will happen again. Learn more about incident reporting from the video.


View CRS Incident Reporting Overview slides (PDF).

Incident reporting is always person-specific. If an incident involves more than one CRS client, a separate incident report is completed for each client. The process follows these basic steps: 

  1. A Medicaid agency, service provider, guardian, or family member sees, learns, or finds an event or situation that meets the definition of an incident.
  2. Providers, guardians, or family members let Medicaid agencies know about an incident.
  3. Medicaid agencies notify and report the event and response to the assigned state contact.

View:

Discharge process

Discharging a CRS client is an active process. The discharge must be based on discharge criteria from the ISP unless any of these apply:

  • The client no longer wants psychosocial rehabilitation services.
  • It’s unclear where the client is for at least 90 calendar days despite careful efforts to find the client.
  • The client refuses services from the CRS Program for at least 90 calendar days despite careful outreach efforts to engage the client.
  • The client enters a long-term care facility for medical reasons and is unlikely to return to community living.
  • The client dies.

When a client is discharged from CRS, they must get a written notice of the discharge. The notice must include:

  • A copy of the discharge summary.
  • Written steps on how to re-apply for CRS.
  • The fair hearing process in Wis. Admin. Code § DHS 104.01(5) if the client is removed from CRS not by choice and gets medical assistance. For all other clients, a written request for review of the determination of need for psychosocial rehabilitation services should be addressed to:

Wisconsin Department of Health Services
Bureau of Prevention Treatment and Recovery
1 W. Wilson St., Room 851
PO Box 7851
Madison, WI 53707-7851

The county or tribal nation Medicaid agency must create a written discharge summary for each client discharged from psychosocial rehabilitation services. The discharge summary includes:

  • The reason for discharge.
  • The client’s status and condition at discharge. This includes the client’s progress towards the outcomes in their services plan.
  • Documentation of events, determined by the consumer and recovery team, that would suggest a renewed need for psychosocial rehabilitation services.
  • For a planned discharge, signatures from the client, service facilitator, and mental health or substance abuse professional.

Monitoring process

DCTS staff make in-person visits to ensure CRS programs are in line with program policies and procedures. These visits are called monitoring visits.

Each CRS program and provider has a monitoring visit at least once every two years. Before the visit, DCTS staff requests documentation electronically for one client per provider. If the provider has more than one location, they should send documentation for one client per location.

DCTS does in-person interviews with clients and providers. Interviews help collect information about progress toward recovery goals and any barriers to providing services. Programs can request training and technical help from DCTS staff during the monitoring process.

CRS programs should share this documentation with DCTS during the monitoring process:

CRS Staff Background Check Confirmation, F-02565 (Word) .

Contacts

For technical help and support, contact DHSDCTSCRS@dhs.wisconsin.gov.

Related topics

Last Revised: November 24, 2022