Release Communication

Transcription

1 APRIL 2011 Release Communication View Enhancements by: Program Office P.2 Release Highlights System Module P.3 View All Preschool Enhancements Enterprise Incident Management HCSIS Release Overview HCSIS Release goes live on April 16, The enhancements and changes in this release are a direct result of requests and recommendations from the field. These enhancements will allow HCSIS to support your business processes more effectively. Thank you for your valuable input! This communication describes the enhancements that have been implemented in Release The enhancements discussed in this document are organized by application area and contain information on additional training resources when available. To help you identify types of changes, one or more of these icons classify each enhancement. Important: Action may be required. Look: Updated labels on screens and/or fields. Cheer: You have been waiting for this enhancement! Additional Resources ONLINE HELP Remember that HCSIS Online Help is updated with each release and is a valuable tool. The help link is located in the upper, right corner of each screen. LEARNING MANAGEMENT SYSTEM (LMS) Training resources that provide additional detail about these system enhancements are located on the HCSIS Learning Management System (LMS) and can be accessed by clicking the Learning Management System button on the HCSIS Home Page. 1

2 View enhancements by: Program Office System Module Program Office Enhancements System enhancements are organized by Program Office below. Multiple Programs Enterprise Incident Management... 4 Program Diagnosis on Service Authorization Notice Bureau of Autism Services (BAS) Match ACAP Plan Effective Date to Waiver/Program Enrollment Date... 9 Bureau of Early Intervention Services (BEIS) Security Enhancements for EI Clearance... 6 Preschool Program Enhancements New and Enhanced Dashboards, Dashboard Reports and Ad Hoc Reports in the Data Warehouse Office of Children Youth and Families (OCYF) Changes to Transfer History page... 8 Office of Developmental Programs (ODP) Diagnosis Code Required for Enrollment... 6 Eliminating Cost of SC Services (W7210) from the Plan Budget Total for P/FDS ISPs Diagnosis Code Required for Billable Services Notes ODP AE Monitoring Dashboards Office Mental Health Services and Substance Abuse (OMHSAS) Online Report Enhancements to Support Provider EnrollmentError! Bookmark not defined. Enhancements to M4Q and Consumer Clearance Reports

3 View enhancements by: Program Office System Module Enhancements by System Module Enhancements are organized by system module below. HCSIS Release Overview... 1 Program Office Enhancements... 2 Enhancements by System Module... 3 M4Q... 4 Enterprise Incident Management... 4 Individual... 6 Security Enhancements for EI Clearance... 6 Diagnosis Code Required for Enrollment... 6 Registration... 8 Changes to Transfer History page... 8 Plan... 9 Match ACAP Plan Effective Date to Waiver/Program Enrollment Date... 9 Eliminating Cost of SC Services (W7210) from the Plan Budget Total for P/FDS ISPs SC Diagnosis Code Required for Billable Services Notes Tools Program Diagnosis on Service Authorization Notice Online Report Enhancements to Support Provider Enrollment Enhancements to M4Q and Consumer Clearance Reports Miscellaneous Preschool Program Enhancements Data Warehouse New and Enhanced Dashboards, Dashboard Reports and Ad Hoc Reports in the Data Warehouse ODP AE Monitoring Dashboards Additional Resources Appendix: View All HCSIS Enhancements

4 M4Q Enterprise Incident Management Program Office: OLTL and BAS Users Impacted: Users will have new roles for the Enterprise Incident Management (EIM) system Menu Path: M4Q > EIM; Note: EIM is accessible through HCSIS as well as through a direct URL. EIM fulfills the Center for Medicaid and Medicare Services (CMS) requirement that each state implement a robust incident management process for consumers in the Medicaid waivers. The EIM process includes incident reporting, management review and investigations of reported incidents, entering of complaints (program office staff only), and the development of corrective action plans and remediation plans/strategies. EIM is a comprehensive incident and complaint management system that is designed to be used across program offices. The Office of Long-Term Living (OLTL) and the Bureau of Autism Services (BAS) will be the first program offices to start using the new system. Some elements of the system will be configurable by each program office, allowing them the ability to customize the system to meet their office s needs. For BAS, the existing HCSIS incident management functionality will be migrated to the enhanced EIM platform. Program office users, direct service providers and Service Coordination (SC) entities will have the capability to record and review incidents, and perform incident investigations for consumers. (Certified investigators will continue to perform investigations as applicable to the program office.) Program offices will also have the ability to record, review and investigate complaints and link them to incidents as necessary. In addition, direct service providers, Service Coordination entities and program office staff will have access to reports, which can be used in tracking and trending incident and complaint data for quality improvement activities. OLTL and BAS will continue to use HCSIS, as they do today, for their consumer, provider, plan, and case management activities. EIM integrates with HCSIS to gather individual and provider information for use in incident reports. For OLTL, integration with SAMS for Aging Waiver consumers will occur at a later date. Please refer to the following materials posted on the Learning Management System (LMS) under the appropriate program office according to your user role: EIM Administrator Screens Job Aid: provides instructions to create and modify configurable screens EIM Role Mapping PowerPoint: reviews role mapping processes and EIM roles for providers EIM Identity Manager PowerPoint: prepares users to assign EIM roles to user IDs EIM Recording a Complaint Captivate and Job Aid: provides detailed instructions for the Complaint Reporter and Complaint Reporter/Investigator BAS and OLTL BAS and OLTL BAS and OLTL BAS and OLTL RETURN TO TABLE OF CONTENTS 4

5 EIM Incident and Complaint Management Review Captivate and Job Aid: explains the review process EIM Incident and Complaint Management Reports Captivate and Job Aid: explains how to view and use pre-developed and ad hoc reports EIM Administration Manual: provides instructions for EIM Administrators of OLTL and BAS EIM Systems Overview Captivate and Job Aid: provides an overview of the system functionality EIM Recording an Incident Captivate and Job Aid: provides detailed instructions for the Incident Reporter and Incident Point Person EIM Incident Management for Providers: explains the incident process from record creation to investigation to reporting for Providers BAS EIM User Manual: describes all EIM features and functionalities and includes sample screenshots of all incident and complaint management screens EIM System Overview: provides an overview of the system functionality EIM Incident Management for BAS: provides step-by-step instructions for program office staff and providers on how to create and review an incident in EIM BAS and OLTL BAS and OLTL BAS and OLTL OLTL OLTL OLTL BAS BAS BAS RETURN TO TABLE OF CONTENTS 5

6 Individual Security Enhancements for EI Clearance Program Office: BEIS: Infant/Toddler & Preschool Users Impacted: Preschool: Intake & Referral Infant/Toddler: SC Intake & Referral, County Intake & Referral Menu Path: Individual > Clearance > New Individual > Clearance > Individual Inquiry To increase data security and further protect children's information in PELICAN EI, several changes were made to the Clearance and Individual Inquiry screens. The Clearance and Individual Inquiry search results have been modified to show records in the following manner: Only children under the age of eight (8) will display (except in the case of an exact SSN match). If a user enters a birth date in the Clearance search for a child over 8 years old, an error message will display instructing the user to search with a birth date under eight years old. SSN will be masked to display the last four digits of the SSN only The System column information will not display unless the record's source is a system associated to OCDEL. The systems associated to OCDEL are Master Client Index (MCI), Home and Community Services Information System (HCSIS), Child Care Management Information System (CCMIS) and Pre- K Counts (PKC). Diagnosis Code Required for Enrollment Program Office: ODP-MR Users Impacted: Supports Coordinators, SC Supervisors Menu Path: Individual > Eligibility > Elig. Determination > Waiver/Program Enrollment In order to meet HIPAA 5010 diagnosis code requirements, ODP has requested a validation of the program diagnosis before the waiver/program enrollment information can be completed in HCSIS for Consolidated, P/FDS, Base and SC Services Only. The Waiver/Program Enrollment screen will validate the existence of an ICD-9-CM program diagnosis code before enrollment in Consolidated, P/FDS, Base or SC Services Only can be completed successfully. Users RETURN TO TABLE OF CONTENTS 6

7 should confirm the program diagnosis code has been entered on the Individual Demographics Diagnosis screen before attempting to complete the Waiver/Program Enrollment screen. If the program diagnosis code is not entered prior to clicking [Save] on Waiver/Program Enrollment screen, the error message A Valid ICD9 Program Diagnosis Code is required before the Waiver/Program Enrollment can be completed will be displayed if a user selects Consolidated, P/FDS, Base or SC Services Only from the Waiver/Program Type drop-down list. If a user selects ICF/MR or Other from the Waiver/Program Type drop-down list, the validation for diagnosis code is skipped. RETURN TO TABLE OF CONTENTS 7

8 Registration Changes to Transfer History page Program Office: OCYF Users Impacted: County Data Clearance and Addition, IM Point Person, Provider IM Representative, Incident Manager Menu Path: Temporary Consumers: Registration > Clearance > Temp Record > Additional Info Cleared Consumers: Registration > Demographics > Primary Demographics Field descriptions on the Transfer History screen did not provide clear transfer history information. The following field descriptions were updated to clarify when and where a consumer was transferred to/from an organization: Rename Organization Name column as Transferred From Rename End Date column as Transfer Date Remove Start Date column Add new Transferred To column Before: After: RETURN TO TABLE OF CONTENTS 8

9 Plan Match ACAP Plan Effective Date to Waiver/Program Enrollment Date Program Office: BAS Users Impacted: ACAP Administrators, ACAP Reviewers, ACAP Region Administrators, ACAP Region Reviewers, Supports Coordinators (SCs), and SC Supervisors Menu Path: Waiver/Program Enrollment: Individual > Eligibility > Elig. Determination > Waiver/Program Enrollment Plan Creation: Plan > Manage Plan > Create Initial Plan Annual Plan Review: Plan >Manage Plan > Perform Annual Review BAS s policy for the ACAP program is to coordinate the individual s plan dates with the program enrollment date. This change will align the dates in HCSIS to accurately reflect the program office policy for ACAP. For ACAP individuals, the Waiver/Program Enrollment screen s Effective Begin Date should be the first day of the month and the Plan Effective Date should be the same as the program/waiver enrollment (first of the same month). In addition, the Projected Annual Review Date should be one year from the Plan Effective Date. Following are the validations and checks added on various screens to incorporate this change: Waiver/Program Enrollment Date: The Effective Begin Date for the waiver/program enrollment must be the first of a month. Plan Dates: Plan Effective Date should be same as the waiver/program enrollment date. This means, the initial plan cannot be approved until the individual is enrolled in the waiver (Waiver/Program Status is Enrolled) and the Plan Effective Date is same as the waiver/program enrollment date. When the initial plan is submitted, the Projected Annual Review Date is automatically set to Plan Effective Date plus one year. At the time of annual review, the Actual Annual Review Date must be the first of a month. Note: All current ACAP plans will be automatically updated on April 16 th to comply with this change. Tip: When entering the Actual Annual Review Date, enter the same date as the Projected Annual Review Date for the previous plan year. For example, if the current Projected Annual Review Date is 05/01/2011, when performing the annual review, enter the Actual Annual Review Date as 05/01/2011. As a result, the new Plan Effective Date will be 05/01/2011 and the new Projected Annual Review Date will be 05/01/2012. RETURN TO TABLE OF CONTENTS 9

10 Eliminating Cost of SC Services (W7210) from the Plan Budget Total for P/FDS ISPs Program Office: ODP - MR Users Impacted: County SC Oversight, ISP Approval, ISP Financial Support, Supports Coordinator, SC Supervisor, SC Unit Manager, SC Data Entry Menu Path: Plan > Services and Supports > Service Details Plan > Plan Admin > Print Plan > History > Summary Although the cost of the SC Service, procedure code W7210, is not included in the calculation of the P/FDS cap, it has been included in the Plan Budget Total. Users would like the cost of the SC Services to be excluded from the Plan Budget Total as well, to simplify identifying people who are approaching the P/FDS cap. As is the current process, the W7210 service must be entered on the Service Details screen and authorized when the plan is approved. The Plan Budget Total field on the Service Details, Print Plan and Plan History screens, however, no longer contains the cost of the W7210 service for individuals funded by the P/FDS waiver. RETURN TO TABLE OF CONTENTS 10

11 SC Diagnosis Code Required for Billable Services Notes Program Office: ODP - MR Users Impacted: Supports Coordinators, SC Supervisors Menu Path: SC > Service Notes > New Service Note HIPAA 5010 regulations require a valid ICD-9-CM diagnosis code on 837P claims submitted by SC Entities. To validate that the diagnosis code is captured for billable services, the Service Note/Billable Claims Details screen will require that a program diagnosis code exists for the individual prior to allowing the note to be saved as billable. A valid ICD-9-CM diagnosis code will be required for submission of a billable service note. If a diagnosis code does not exist, the user will only be able to save the service note as non-billable. An error message will display that informs the user to save the note as non-billable and add a valid diagnosis code on the Diagnosis screen (Individual > Demographics > Diagnosis). Once the diagnosis code is saved, the user should return to the Service Note screen to indicate the service note as billable. RETURN TO TABLE OF CONTENTS 11

12 Tools Program Diagnosis on Service Authorization Notice Program Office: ODP-MR, OLTL, BAS, BEIS Users Impacted: Provider Registration Data Entry, Provider Access Read Only, ISP Approval, ISP Financial Supervisor, State EI Reviewer, State EI Financial Manager, Provider Administrator, County EI Financial Manager, County EI SC Oversight, County EI Contract Administrator, County EI Provider Administrator, Evaluator, State BAS Reviewer, State BAS Administrator, State BAS Financial Manager, State BAS Service Authorization Manager, Region Reviewer BAS, Region Administrator BAS, Region Service Authorization Manager BAS, Region Monitor, Region Supervisor Inquiry, Region Supervisor, Waiver Review Team Inquiry, Waiver Review Team Menu Path: Tools > Notices > Service Authorization Notice HIPAA 5010 regulations require a valid ICD-9-CM diagnosis code on 837P claims submitted by providers. Providers need to have access to diagnosis code data on the Service Authorization Notice screen. An additional column was added to the Service Authorization Notice screen to show the program diagnosis code. The system will display the diagnosis code information for BAS, ODP-MR and OLTL. This column will appear blank for BEIS users. Note: The mandatory compliance date for providers filing claims to PROMISe TM is January 1, For additional information, go to the PROMISe TM web site at Online Report Enhancements to Support Provider Enrollment Program Office: OMHSAS Users Impacted: Region Supervisors, Reviewers Menu Path: Tools > Reports > Report Request > Provider Enrollment Report To support provider enrollment reporting, OMHSAS requested additional Provider Type/Specialty codes be included in the Provider Enrollment Report parameters.. The Provider Enrollment Report was updated with additional options for the Provider Type and Provider Specialty fields listed below: Provider Type: 21. Case Manager RETURN TO TABLE OF CONTENTS 12

13 Provider Specialty: 111. Community Mental Health ACT (Assertive Community Treatment) or CTT (Community Treatment Teams) 126. MH Supported Living 215. MH Case Management Administrative 221. MH TCM (Targeted Case Management) Resource Coordination 222. MH TCM Intensive or Blended 456. CRRS (Community Residential Rehabilitation Services) or EPCH (Enhanced Personal Care Home) this Provider Specialty was renamed from CRR Adult) Enhancements to M4Q and Consumer Clearance Reports Program Office: ODP-MR, OMHSAS Users Impacted: County Incident Managers, County Incident Reviewers, County Administrators, County Point Person, Region Incident Managers, Region Incident Reviewers, Region Supervisors, Reviewers, Supervisors, Provider IM Representatives, SC Supervisors, SC Unit Managers, Clearance, Data Clearance and Addition, Data Maintenance and Validation Menu Path: Tools > Reports > Report Request > Cleared Consumer Report M4Q Reports: M4Q > Reports > Reports Request > [Select appropriate report] The reports listed below are real-time reports, which limited to data requests to a six-month time span. To view data for time spans greater than six months users were previously required to make multiple report requests. This enhancement allows users to request the report for any time period. Users must complete the Begin Date and End Date mandatory fields to request this report. Report requests for less than six months are available immediately for the user's review. Report requests for more than six months are processed overnight and available to the user in their Reports Inbox the following day. The following reports received this enhancement: Aging Incident Report Consumer Clearance Report (Note: This report was also enhanced with the ability to download in CSV format.) Corrective Action Report Multiple Reports During Interval Report RETURN TO TABLE OF CONTENTS 13

14 Miscellaneous Preschool Program Enhancements Program Office: BEIS: Preschool Users Impacted: All Menu Path: Various BEIS has introduced new functionality to support the Bureau and Preschool EI Programs with more detailed information on their program operations. These enhancements are designed to: Give Preschool EI Programs a new, more comprehensive, defined set of standardized services to use across the Commonwealth and be able to document enhanced service details Allow Preschool EI Programs to begin tracking classroom capacity and utilization of classrooms consistently across programs tools to easily manage a funding source change for groups of children at one time contract creation processes EI Programs with enhanced reporting and data warehouse information Provide system Streamline the Support Preschool These enhancements include a number of changes and additions across multiple screens in the system. Specific courses on the Learning Management System (LMS) provide details of the enhanced functionality. Please refer to the following LMS courses based on your user role: PELICAN EI PS Release 6.11 Readiness Meeting: provides an overview of enhancements PELICAN EI: PS Release 6.11 ADMINISTRATIVE / DATA MGMT. Training (4/7 or 4/12): provides detailed instruction for Preschool Administrators, Lead Supervisors, and Data Entry roles PELICAN EI: PS Release 6.11 LEAD Training (4/13/11 or 4/15/11) : provides detailed instruction for Preschool Program Leads and Provider Leads PELICAN EI: PS Release 6.11 CONTRIBUTOR Training (4/8/11 or 4/14/11): provides detailed instruction for Preschool Program Contributors and Provider Contributors RETURN TO TABLE OF CONTENTS 14

15 Data Warehouse New and Enhanced Dashboards, Dashboard Reports and Ad Hoc Reports in the Data Warehouse Program Office: BEIS: Infant/Toddler and Preschool Users Impacted: All Infant/Toddler and Preschool users with Enterprise Data Warehouse access Menu Path: Dashboard Reports: Data Warehouse > HCSIS > Near Real Time Reports > EI Reports Ad Hoc Reports: Data Warehouse > HCSIS > EI Analytics Ad Hoc Package > [Launch] Report Studio BEIS has identified the need to add reporting capabilities for the data currently captured in PELICAN EI (HCSIS). OCDEL users identified the need to view critical business information and the corresponding detailed data in order track and manage key business metrics and exceptions. A Preschool Exception Dashboard has been added with three new child count reports. A 2 nd Preschool Monitoring Dashboard has been added with three new reports to monitor service delivery measures. Additionally, most of the existing Preschool Monitoring Dashboard Reports have been enhanced for increased functionality. An Infant/Toddler Transition Dashboard has been added to track Infant/Toddler to Preschool transition steps including notification to the Preschool program and that status of the transition conference. The dashboard has been added using three existing reports from the Infant/Toddler Monitoring Dashboard and adding three new reports. The remaining existing six Infant/Toddler Monitoring Dashboard Reports have been enhanced. Ad Hoc enhancements have been added to provide users with additional reporting data elements to facilitate analysis needs. Users will be able to run ad hoc queries using either Cognos Report Studio or Cognos Query Studio. Data from PELICAN EI and ELN will be loaded into the Operational Data Store (ODS) and refreshed on a daily basis. Historical data will be available in the ad hoc package for select Infant/Toddler and Preschool PELICAN EI screens. This will allow users to run ad hoc queries on data which is displayed in the Referral and Supplementary Documentation PELICAN EI history screens. ODP AE Monitoring Dashboards Program Office: ODP - MR Users Impacted: ODP State, Region and AE users with access to the Enterprise Data Warehouse (EDW) Menu Path: To comply with provisions of the approved waivers, ODP needs to monitor AEs to determine if they are meeting federal and program office standards related to level of care, authorizations, RETURN TO TABLE OF CONTENTS 15

16 service utilization, and other critical areas. This data will be used to compare AE performance across the commonwealth and determine if remediation and corrective action plans are necessary. Two EDW dashboards have been created to represent the following business metrics: Annual Review Approval of an ISP within established timeframe Level of Care (LOC) Redeterminations Incident Reporting Timeliness Length of Time for Waiver Enrollment (i.e., going from Intent to Enroll to Enrolled) Percentage of Utilized Units YTD Number and Percent of individuals nearing P/FDS Cap Number of Individuals Enrolling and Dis-enrolling in Waiver/Programs Category of Need for individuals in Enrolled Waiver Enrollment status Category of Need for individuals in Intent to Enroll Waiver Enrollment status Data used to create the graphs for these metrics will be refreshed weekly and be available on Tuesdays of each week. Users will have the option of clicking on each graph to display statewide comparison reports or individual data. Please refer to the ODP AE Monitoring Dashboards targeted communication located under the HCSIS Information link on the Learning Management System (LMS) for additional details. RETURN TO TABLE OF CONTENTS 16

17 Additional Resources HCSIS Help Desk Call: Fax: Hours: Monday Friday: 8:00 AM 5:00 PM Learning Management System (LMS) Training resources that provide additional information about these system enhancements are located on the HCSIS Learning Management System (LMS). Access the trainings by clicking the Learning Management System link on the Welcome to HCSIS screen. Release communications are located under the HCSIS Information link on the LMS Homepage. Click the My Curriculum link to navigate to specific module trainings. Online Help Remember that HCSIS Online Help is updated with each release and is a valuable HCSIS tool. The Help link is located in the upper, right corner of each screen. HCSIS Link Quickly access HCSIS by adding the link below to your favorites/bookmarks in your web browser: RETURN TO TABLE OF CONTENTS 17

18 Release Communication Appendix: View All HCSIS Enhancements View all enhancements discussed in this communication by PCR number below. PCR # Program Office System Module Title ODP Plan Eliminating Cost of SC Services (W7210) of P/FDS ISPs BAS Plan OMHSAS Tools Match ACAP Plan Effective Date to Waiver Program Enrollment Date Online Report Enhancements to Support Provider Enrollment OCDEL Individual Security Enhancements for EI Clearance OCYF Registration Changes to Transfer History page OMHSAS Tools Enhancements to M4Q and Consumer Clearance Reports OCDEL Miscellaneous Preschool Program Enhancements OLTL & BAS M4Q Enterprise Incident Management All Individual SC Tools Diagnosis Code Required for Enrollment Diagnosis Code Required for Billable Service Notes Program Diagnosis on Service Authorization Notice ODP Tools Enhancements to M4Q and Consumer Clearance Reports ODP Tools Enhancements to M4Q and Consumer Clearance Reports ODP Tools Enhancements to M4Q and Consumer Clearance Reports ODP Miscellaneous ODP Reporting Analytics for Provider and SCO Performance Review Reports OCDEL ODP Data Warehouse Data Warehouse New and Enhanced Dashboards, Dashboard Reports and Ad Hoc Reports in the Data Warehouse ODP AE Monitoring Reporting ODP Tools Label Modifications to Monitoring and Performance Review Reports RETURN TO TABLE OF CONTENTS 18