Program Participation System Redesign

Parts of the Program Participation System are being replaced with a new data collection and reporting system built on a cloud-based platform. The current system runs on outdated technology. It is difficult to adapt to changing treatment practices and does not meet federal reporting requirements. The new system will simplify data submissions and provide agencies with the ability to use visual analytics with their data.

The new system does not yet have a name.

What is included in this project?

The project includes the following parts of the existing Program Participation System.

Mental health services and outcomes
Substance use services and outcomes
Mental health program participation
CORE module
Human services revenue report
942 expense report for human services

The mental health services and outcomes, substance use services and outcomes, and mental health program participation parts of the existing Program Participation System will be combined in the replacement system. There will be one module for mental health and substance use data.

The Substance Abuse Prevention Services Information System is moving to the cloud-based platform as part of this project.

What is not included in this project?

The long-term care modules in the existing Program Participation System are not moving to the cloud-based platform at this time. This includes the Birth to 3 and nursing home referrals modules.

What is the current status of the project?

The goal of the Program Participation System redesign project is to develop a cost-effective data system that improves federal data reporting as well as creates efficiencies in data submission by local agencies. Input on new system requirements was gathered in 2022 from county agencies, electronic health record vendor representatives, and advocates for people with mental health and substance use concerns. Throughout 2023, a system was designed that incorporated this feedback while better aligning data collection with current practices and improving federal reporting data quality.

The proposed requirements are described below. Feedback is being requested from local agencies on their processes to implement these changes and input will continue to be solicited from agency and electronic health record representatives during the development phase.

Once development is complete, the final requirements will be communicated to local agencies. Agencies and electronic health record vendors will receive guidance on how to implement these changes in local systems. An estimated date of completion is not known at this time.

Will the new system change options for data submissions?

No. Options for submitting data to the replacement system will be the same as the existing Program Participation System.

Batch file upload from a local electronic health records systems and direct data entry screens available

New combined mental health and substance use module
CORE module

Direct data entry screens only

Human services revenue report
942 expense report for human services

The Substance Abuse Prevention Services Information System will continue to have direct data entry screens only.

What are the proposed changes for data requirements and specifications?

No major changes are planned for the data requirements and specifications for the 924 expense report for human services, and human services revenue report.

Changes planned for mental health and substance use

Many of the current mental health and substance use data requirements and specifications in the existing Program Participation System will remain the same due to federal and state rules. Some changes are planned. The changes will include:

Integrated mental health and substance use data requirements.
Updated data requirements on participant demographics and behavioral health needs.
Improved participant functional status indicators to measure effectiveness.

Various aspects of the proposed mental health/substance use module are described in the sections below. Several details are still to be determined, such as definitions for the SPC codes and specifics on the batch submission process (data entry options will still include direct data entry or electronic submission options). These details will be established during the design process.

Since the system has not yet been designed, these are still draft requirements. They can be used for estimating the amount of time and work needed to align with the requirements, but some of the specifics may evolve throughout the design process.

Key definitions for mental health and substance use

Module: Currently in Program Participation System, a mental health and/or substance use episode can be opened for a participant. Information can also be manually entered in the Mental Health Program Participation module. All of these modules (mental health, substance use, and Mental Health Program Participation) will be integrated into one module in the new system.
Episode: In the current mental health and substance use module, an episode is opened for a participant which includes one or more services. After a period of inactivity, episodes are to be closed. A new episode can be opened if a participant receives additional services. In the new system, the episode structure is being removed.
Service/program: In the current Program Participation System, services are entered using SPC codes to specify the service (for example, SPC code 501.00 for initial crisis intervention). Each of these SPC codes are entered individually. In the new system, some services or programs may have multiple SPC codes nested within them. For example, a crisis service may include the SPC codes of 501 for initial crisis intervention and 501.20 for the crisis intervention follow-up. A Comprehensive Community Services program may include the SPC codes of 510.01 for diagnostic evaluation and 510.08 for psychotherapy. The service or program is the overarching group of services.
SPC (Standard Program Category) code: In the current system, each service has a specific SPC code. In the new system, some services may have multiple SPC codes nested within them. For example, a Comprehensive Community Services program may include the SPC codes of 510.01 for diagnostic evaluation and 510.08 for psychotherapy. The SPC is the specific service code that may nested within an overarching service or program.
Functional status report: The current mental health module includes the entry of consumer status indicators upon the opening of an episode, every six months and upon the close of an episode. Similarly, in the new system, all participants with qualifying services (other than brief or crisis services) will have functional status indicators entered upon the first service opened, every six months, and upon the end of the last open service.

Key changes for mental health and substance use

The episode structure will be removed. Services will be started and ended in a person’s records, but there will no longer be episodes to open and close. This is to reduce confusion and errors in the data entry process and to better align with local data systems. There will be data elements on the person-level, the service-level, and the functional-status (currently consumer status) level.
The mental health, substance use, and mental health program participation modules will be combined into one module. All mental health and substance use services will be entered into this module. This is to reduce duplicate data entry and to better align with current practices of integrating treatment. For federal reporting purposes, each service will be indicated as mental health, substance use, or integrated. The data elements will be consistent across all participants in this new module.
The new module will be largely based on the current mental health module, but fields from the current mental health, substance use, and program participation modules will be combined into this module. Approximately 30 fields will be removed, and six new fields will be added. This is to reduce data entry burden and improve federal reporting data quality.
The service data structure will be modified.
- Since some of the fields from the episode-level are moving to the service-level, some SPC codes will be grouped together under a single service or program to reduce the data entry burden. For example, for a Comprehensive Community Services program, the referral source, legal status, service start date, service end date, service end reason, etc. will be entered upon Comprehensive Community Services enrollment and discharge, but not for every SPC code entered. For each individual SPC code under Comprehensive Community Services (for example, medication management), just the provider, SPC code, and delivery month will be entered. For the majority of services, however, each service will be associated with only one SPC code rather than grouped with other SPC codes.
- To reduce data entry burden, service records won’t be submitted as a monthly record. Each service or program will have an initial starting date, provider, SPC code(s), SPC delivery month(s) (each month that the participant received the service), and a final ending date. For ongoing services, after the initial entry of an SPC code, only additional delivery months will need to be submitted until the service ending date. Units such as days and hours will no longer be submitted.
- This also streamlines the date entry process as it fulfills the role of the current mental health program participation module for tracking mental health program enrollments. Since some participants may be enrolled in more than one program (for example, Comprehensive Community Services and Coordinated Services Team Initiatives), and specific SPC codes may be listed under just one of the programs (for example, Comprehensive Community Services), SPC codes are not required for some programs. In this example, the Coordinated Services Teams Initiative enrollment may be entered with the referral source, starting date, ending date, end reason, etc. but no SPC codes are required.
Functional status (currently consumer status) reports for all participants will follow the current mental health timeline. This reduces the entry of these fields and makes them consistent for all participants. Functional status indicators will be submitted upon first service with the local agency, every six months, and then upon the close of the last open service with the local agency. These indicators include substance use information, but there will be a "not applicable" option for participants without a substance use problem.
Crisis services will have reduced demographic data requirements but will have a couple of extra fields specific to crisis services, including law enforcement involvement and crisis assessment outcome. The initial crisis SPC code and the crisis follow-up SPC code will be grouped under one crisis service.
The SPC codes will be integrated into one list and will account for the revised Wis. Admin. Code ch. DHS 75.
CANS scores for Coordinated Services Teams Initiatives participants may be entered manually into the website or sent through a separate batch file.

Changes planned for CORE module

Changes to the CORE module will be similar to those to the mental health and substance use modules. Refer to the proposed fields and XML file document below for more details.

Reference materials

How is this project being funded?

The Department of Health Services is funding the development and maintenance costs of the new system. Local agencies will need to cover costs to adapt to new data requirements such as programming data into their electronic health records system. Tribal nations and counties will be provided with sufficient notice to plan for these expenses.

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If you have questions about this project, email DHSDCTSPPSRedesign@dhs.wisconsin.gov.