Clinical Management for Behavioral Health Services (CMBHS) gives service providers contracting with the Texas Health and Human Services Commission (HHSC) a place within the client’s electronic health record (EHR) to document a treatment plan, a detoxification services treatment plan, or a service plan, as well as reviews and updates to the plans.
A Treatment Plan is a clinical document where the treatment team documents the client problems identified at admission, and the interventions that a client will receive during an episode of care.
The Treatment Plan is developed by the treatment team in collaboration with the client and sometimes family members and/or significant others. The Treatment Plan addresses client problems and needs that are identified in the Assessment. It includes problems, goals, and strategies to be implemented by service providers, and objectives to be achieved by the client.
A detoxification services treatment plan is a type of treatment plan created only for clients receiving detoxification services. In CMBHS there are some unique business rules for this plan type to ensure compliance with applicable Texas laws and HHSC policy.
In CMBHS, a service plan serves a purpose similar to a treatment plan but it addresses client needs and problems that do not require “treatment,” but rather, services such as case management. In CMBHS there are some unique business rules for this plan type to ensure compliance with applicable Texas laws, HHSC policy, and special features to facilitate documentation.
This section includes instructions for development of the Treatment/Service Plan and the Treatment/Service Plan Review. These selections can be made from the Service Planning menu on the Client Services Toolbar at the left of your screen.
For SUD providers of Outpatient and Residential Treatment services only, CMBHS has a function that ensures prior to submission to HHSC for payment, claims meet the Texas Administrative Code (TAC), Section 448, Rule §448.804 Treatment Planning, Implementation and Review.
CMBHS will check to see that a Treatment Plan/Review is documented in CMBHS within five (5) individual client service days of the Begin Service for an included service. (See Definitions Below)
The addition of this function to CMBHS does not reflect a new documentation requirement; it is a new method of enforcing a longstanding requirement of the TAC, Section 448.
Service Days – individual days a client receives services. For residential services, this is every day the client is present in the residence and for outpatient services, this is every day the client receives an outpatient service.
Included Services - the services included in this change are Intensive Residential, Supportive Residential and Outpatient substance use treatment services for adults, youth, and specialized females and only when DSHS Program Funding or BMO is the funding source. Medicaid and other funding sources are not impacted.
BMO – a Behavior Management Organization is the term that has recently replaced LBHA in CMBHS. This name change allows functions that were previously only used by LBHAs to be used by more organization types. The name change has no impact on a BHO’s authority or functions.
1. An SUD Treatment Plan/Revision created in collaboration with and signed by the client, must be entered in CMBHS in Closed Complete status by the end of the fifth (5th) individual service day after the Service Begin date.
2. CMBHS will not permit submission of claims for a client whose Treatment Plan/Revision is not Closed Complete after the fifth (5th) individual day of service has passed.
3. Before the fifth (5th) individual service day, providers may submit claims even if the Treatment Plan/Revision is not in Closed Complete.
4. After the fifth (5th) individual service day, providers may not submit claims unless the Treatment Plan/Revision for the client is in Closed Complete. Services provided on the days where the Treatment Plan/Revision is delinquent can never be billed.
5. After the Treatment Plan/Revision is in Closed Complete, CMBHS will again permit submission of claims for services provided on that day, and thereafter but not for the services provided on days when the Treatment Plan/Revision was delinquent.
6. Whenever a Service Begin for a new included service is added for the client, the Treatment Plan/Revision must be updated and placed in Closed Complete, within five (5) individual service days of the new Service Begin.
7. CMBHS has warning messages in place to let users know when these deadlines are approaching and have passed.
Example: If a Treatment Plan/Revision is not in Closed Complete on service day six (6), CMBHS will only allow submission of claims for service days one (1) through five (5). If a Treatment Plan/Revision is completed on service day seven (7), CMBHS will allow submission of claims for service day seven (7) but not for service day six (6).
CMBHS has an add-on role called “Exclusion” that can be assigned only to a Security Administrator or a Clinical Supervisor. The objective is to give the user ability to exclude a Progress Note record from the count of service days. This function can only be used when the note has been entered into a client record in error.
In the event of an extraordinary circumstances The CMBHS Business Rule Suspension page, available only to HHSC System Administrators, allows this change to be disabled for one (1) or more days for a provider or group of providers when extraordinary circumstances make it impossible to comply with the requirement.
Examples of extraordinary circumstances include natural and man-made disasters, power shortages, or epidemics, and when the CMBHS system is unavailable for maintenance.
All requests due to extraordinary circumstances must be reviewed and approved by HHSC program staff.
A Service Begin record can now be deleted if it is created in a client record in error AND no records have been created for the new Service Type.
The new delete function only works if a Service Begin is created and the user determines they have made an error before they create any documents for the new service such as a Progress Note, Day Rate Attendance, Treatment Plan/Revision, or a Service End Assessment.
If you have created a new Service Begin and documents for the service, you must complete a Service End and a Service End Assessment and then create a new Service Begin.
A Progress Note with a funding source of DSHS Program Funding or BMO is only billable with the Contact Type of Telephone if it is for the Service Type Outpatient – Youth, Outpatient - Youth (CYT Wrap-around) and it is for one of these services: Adolescent Support, Family Support - Single Family or Family Support w/o Client - Single Family.
If you are submitting a Progress Note for a service other than one of the Outpatient Services for Youth listed above and/or with a different funding source, CMBHS will not prevent you from creating it with the Contact Type of Telephone. When submitted as a claim, it will be paid or denied depending on whether the funding source permits the Contact Type of Telephone for that service.
In CMBHS, the treatment plan and the service plan are combined on the Client Services Toolbar under the Service Planning menu.
To access the CMBHS Treatment Plan, go to the Client Services Toolbar on the left side of your screen. Hover over Service Planning with your mouse. A dropdown menu will appear. Select Treatment/Service Plan by CLICKING on it. The Treatment Plan page will display.
The Treatment Plan Date is pre-filled with today’s date. Under Type of plan, select the appropriate option from Detoxification, SU Treatment Plan, or Service Plan.
After the client has been assessed and admitted, the clinician develops a treatment plan in collaboration with the client. CMBHS carries problems over to the Treatment Plan from the Assessment and provides a template for documentation of the plan as well as the periodic reviews that are conducted.
Select the type of Treatment Plan you want to create from the dropdown list at the top of the page. The page will refresh and the Treatment Plan will be automatically created.
Complete the required data fields for each Problem carried over from the Assessment. After your documentation is complete, set the status as Closed Complete.
The Treatment/Service Plan Review is required based on the service type the client is receiving. For Residential services, a treatment plan review is due no less than every 30 days or whenever anything significant happens. For outpatient services, a treatment plan review is due halfway through projected length of stay, or when anything significant happens.
This page is used to review the problems from the client’s Treatment Plan that are in a status of Treat or Case Manage. Many of the fields in this form are pre-filled with data from previous versions of the treatment plan completed with the client.
From the Client Services Toolbar > Service Planning, select Treatment/Service Plan Review. For each problem, the Goal statement must be reviewed. Progress toward Goal is a required field. The dropdown selections are:
The clinician will determine the progress and select the appropriate choices.
For each Goal, the Objective must be reviewed. Objective Progress is a required field. The dropdown selections are:
The clinician will determine the progress and select the appropriate choices. Any comments regarding the Objective progress can be entered in the Comments section. The maximum length for the Comments field is 500 characters
After all Problems are reviewed and the progress entered, the Summary section must be completed. The fields are:
Review Date – Defaults to today’s date. Enter the date the Treatment Plan was reviewed. You can enter the date by typing eight numbers – two for the month, two for the day, and four for the year (use zeros before one-digit months and dates). The system will format 03012019 as 03/01/2019. Or, you may type in the slash marks yourself if you wish.
Recommendation – Select one of the options from the dropdown. List includes:
Justification for Recommendation – This field is used to justify the recommendation selected. This field has a maximum length of 1,530 characters.
Effective Date – Date defaults to today’s date. Enter the effective date of the Treatment Plan Review. You can enter the date by typing eight numbers – two for the month, two for the day, and four for the year (use zeros before one-digit months and dates). The system will format 03012019 as 03/01/2019. Or, you may type in the slash marks yourself if you choose.
Performed By – Select the name of the individual who performed the Treatment Plan Review.
Document Status – Select the appropriate document status. Click here for more information on Document Status in CMBHS. On documents that are signed by the client, it is recommended that the document is saved in Ready for Review, printed out, and then signed by the client. Once signed by the client, change the status to Closed Complete.
Client Signed – Checkbox to indicate the client has signed. Must be checked to close the document in Closed Complete status.
Comments – Text box for any comments that pertain to the Treatment Plan Review. This is not a required field. The maximum length for this field is not specified.
Buttons for the Treatment Plan Review – Save, Cancel, and Spell Check.
Click here for an explanation of commonly used buttons on CMBHS pages.
NOTE: Hard-copy documents that are printed and require a client’s signature — kept in the client’s hard-copy file — must match exactly the electronic version of the document in CMBHS.