Community Outreach Services (COS) Workshop for Mental Health Services Act (MHSA)

1. Community Outreach Services (COS) Workshop for Mental Health Services Act (MHSA) Wellness and Client-Run Centers ______________________________________ Presenter: Urmi N. Patel, PsyD (213) 738-3377 UPatel@dmh.lacounty.gov

2. Use of COS forms at Wellness/CRC Centers • In the past, COS forms were typically used to capture outreach in the community or to capture services provided to unopened clients. • How are COS forms used in the Wellness/CRC Centers? • We continue to use COS to capture outreach in the community- services like presentations to community based organizations • We continue to COS to capture services provided to unopened clients- such as referring them to outside services like a primary care doctor or SSI office • So what is different with Wellness Centers? • We now use COS to capture the direct service Peer Advocates and Community Workers provide to OPEN Wellness/Client Run Center clients; including case management, groups, and individual peer support services.

3. Completing the COS Form: Step by Step • Provider Number: Your 4-digit Provider Number (examples: 7769 for Edelman MHC Wellness Center; 7099 for Step up on Second Client Run Center) • Date of Service: Date the service was provided, i.e. 3/8/2010 • Rendering Provider: Name and Staff code of lead person who provided the service (Sara Smith – E123456 or June Lee – ENK1234)

4. Completing the COS Form: Step by Step cont. • Service Recipient Type: Code and description for whom services are delivered or on whose behalf. (ex. 3-Individual) • Number of Persons Contacted: How many people were involved in the delivery of the service? • You can estimate for outreaches in the community.

5. Completing the COS Form: Step by Step cont. • Service Type Description (in grey margin): list the MHSA program with which you are associated. Write in margin one of following: FSP-Child Housing Spec. TAY Drop-In FSP-TAY Safe Haven CW Res. Mgmt. FSP-Adult TAY Housing Serv. Extenders FSP-OA FCCS SA Nav. Family Focused Jail Linkage Wellness Center O & E Staff Client Run Center

6. Completing the COS Form: Step by Step cont. • Agency Name: List name of location (i.e. Clinic’s name) where service was delivered (i.e. if COS is for a group); or if service was to a client, list client identifier or name (can use initials to make it confidential). • Agency Address: Address where service was delivered (i.e. Clinic’s address) or location description (ex. Corner of 6th and Vermont) • Agency Contact: Person who arranged the contact or referred the client (i.e. staff member providing service) • Phone Number: Agency Contact’s phone number (could be n/a – not applicable) • City/State/ZIP: Complete for address listed above.

7. Completing the COS Form: Step by Step cont. • Primary Language: Reflects the code that best describes language of the group or individual for whom services are being provided. • Ethnicity: Choose the code that best describes the majority of the target group/individual to whom the services area directed. If 03-Hispanic is selected must indicate origin. If 04-American Indian or Alaska Native is selected, must indicate tribe. • Age Category: Select Age category that best describes the age range of the target group to whom services will be provided. For example, when talking to group of parents about child full service partnerships, select 0-17 as the age category. • Please note: If many language/ethnicity/age category are represented in the group, select the category with the most representation.

8. Completing the COS Form: Step by Step cont. • Duration: Enter the number of FMI – Fifteen minute increments. 15 minutes= 1 FMI. For example: You spent 45 minutes with a client linking them to services, spent 5 minutes filling out the COS forms, this is 50 minutes/15 minute interval = 4 FMI. • There is NO restriction on how long it took you to write a note. Please account for all the minutes it took to complete your note when calculating your total. • Handicap: Indicate any handicaps/ disabilities client or target group may have. Select ONE only.

9. Completing the COS Form: Step by Step cont. • Program Area: Primary Focus or content of services provided. Ex. Engaging clients so that they choose to receive Wellness or Client-Run Center services: 33 – Engaging Clients and Families • Funding Source: Funding Source/ MHSA plan through which you are billing Community Outreach Services: Wellness / Client-Run Centers choose MHSA Family-Focused Wellness

10. Completing the COS Form: Step by Step cont. • Service Code: Choose either 200- Mental Health Promotion or 231-Community Client Services. • 6000- Case Management Support is not an available choice for WCRCs. • Additional Participating Staff: List names and staff codes for any additional rendering providers at your same provider site that participated in the delivery of the service. Each additional staff member will get credit for full duration of service. • Do not include staff who capture their time on a progress note claimed to MediCal • This is considered “double dipping”.

11. Mental Health Promotion vs. Community Client Services • Mental Health Promotion (Service Code 200): Activities and projects directed towards strengthening individuals and communities skills to cope with stressful situation before onset of problems. This includes mental health education, consultation, information, outreach, and program development. • Examples: presentations in the community or providing information to unopened clients/providers via email, telephone, or mail.

12. Mental Health Promotion vs. Community Client Services • Community Client Services (Service Code 231): Performing outreach and services to identify potential persons with mental health problems and linking them to appropriate community services and resources. • This includes giving tours to potential clients or providing them referrals in the community; facilitating groups at the clinic or in the field; providing opened clients individual rehabilitation support or case management; providing support to clients scheduling appointments or welcoming clients during intake process.

13. Completing the COS Form: Step by Step cont. • Progress Notes: Describe services provided including, presenting problems, goals, content, process, and outcome. Make sure to note any specific information when appropriate for documentation purposes. • Future Plans/ Recommendations: Include major topics or problem areas to be addressed and any special problems or techniques that might be helpful in future consultations.

14. Tips for Completing the COS forms for MHSA Programs • Think about what services you are providing to determine which service code to select. • Who are the services directed toward or on behalf of? • What is the age category/ ethnicity/ language that best describes your target group?

15. Current Practices • Too often, staff clump an entire day of service into 1 COS note. • It is okay to clump small contacts into ONE COS note. • For example, clump greetings and appointment phone calls into 1 COS note.

16. Best Practices: Think about separating the service • ASOC encourages staff to write a separate COS note for the following services: • A community outreach event • An individual case management/linkage/rehab service provided to a client • Each group staff facilitates/co-facilitates • Attach Group sign in sheet to original COS form when submitting for input into IS.

17. Common Errors when Completing COS Forms • Identifying more than one or the incorrect “Service Recipient Type”, “Language”, “Ethnicity”, etc. • Writing down the incorrect Provider Number • Not using specified ranges on codes sheet • Reporting actual minutes instead of in FMI-Fifteen Minute Increments • Billing the wrong Service Code and Program Area based on the service provided • Putting the Supervisor or Clinic’s name under Rendering Provider and Agency name. • Putting client’s personal identification information in the body of the note.

22. Other Examples • Please refer to your handouts

23. “Service Type Desc.” field is currently unused. We use it to identify the MHSA Program, e.g. FSP – Child, FSP - TAY, FSP – Adult, FSP – Older Adult, SA Nav., O&E, Housing, etc.

24. Where to find the COS Forms • DMH Homepage http://dmh.lacounty.gov/default.asp • Provider Tools • Integrated System • Directly Operated or Contract Providers • IS Forms → Clinical Forms • You can find Fillable COS forms on this link as well

25. Where to find the COS Forms • Wellness / Client-Run Center Wiki http://wcrc.pbwiki.com/ • Links • COS Forms and Information This takes you to the OMA website where the fillable COS form is, the non-fillable COS form, COS manual, FAQs and IS movie on COS.

26. Questions about COS? • Download the COS manual and view COS Frequently Asked Questions (FAQ) at www.dmhoma.pbwiki.com (revised versions will be posted soon) • Please forward questions to us to post on the COS-FAQ.