Release Notes (7.52) - 06.22.2018

 

 

 

 

Texas Health and Human Services (HHSC)

Clinical Management for Behavioral Health Services (CMBHS)

Release Information

Date 06/22/2018

Page or Function

Description of Change and/or

User Instructions

Business Entity/User Type Impacted

The DSM 5 Project impacts all CMBHS pages where a diagnosis is entered and/or displayed.

Changes are being made to CMBHS to be consistent with the current national standard for psychiatric diagnostic criteria and codes, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

These changes impact CMBHS mental health and substance use disorder functionality, and online and data exchange users. All CMBHS pages where a diagnosis is entered and/or displayed are impacted.

A second part of this release are new assessments for substance use treatment and intervention services. All assessment types are replaced with new versions that incorporate items from the Adverse Childhood Experience (ACE) and Dan Dubovsky’s Fetal Alcohol Syndrome screening questions and other evidence based measures.  See the section below for more information specific to the new substance use disorder assessments.

 

What will change in CMBHS:

·         The multi-axial system has been eliminated and replaced with a non-axial list ordered according to clinical priority;

·         The Global Assessment of Functioning (GAF) has been eliminated;

·         Up to 18 diagnostic descriptor/codes may be entered for a client including diagnoses for physical health problems and environmental and social factors impacting the client;

·         The diagnosis for which the client is being treated by the contractor is the principal diagnosis and must be the first diagnosis in the list, labeled #1.

 

What will not change in CMBHS:

·         Diagnoses will still be documented on the same pages in CMBHS: for SUD services on the SUD Screening (SCR014), SUD Assessment (AST022), Begin/End Service (SER030) and the Admission and Discharge (ADM029) pages; for MH services on the MH Diagnosis (DIA113). For YES Waiver services the diagnosis is still part of the YES Clinical Eligibility, YES IPC Authorization and the YES Claim process;

·         Diagnoses for physical health disorders are still available in CMBHS and are entered in the non-axial list according to clinical priority;

·         The diagnosis descriptors and codes are not changed because of this project. NOTE: The WHO ICD and APA DSM changes are made on an annual basis, usually in late summer or fall;

·         CMBHS user roles needed to document a diagnosis or assessment in CMBHS have not changed.

 

Resources

CMBHS Online Help – Detailed information about the changes to CMBHS are in the CMBHS Online Help. They can be accessed by logging into CMBHS, select Help from the top menu and then either DSM-5 Release Screens MH or DSM-5 Release Screens SUD.

CMBHS Banner Messages – During the next few weeks, please watch for banner messages for possible updates and alerts related to this deployment.

Development Documentation and Supporting Materials - The updated use case and other technical documentation for the MH Diagnosis and MH Assessment are available in CMBHS.

·         To access this location, you must have the CMBHS Security Administrator or User Administrator role.

·         Log in, go to the top menu select Provider Tools>Development Documentation and Supporting Materials >DSM-5 folder. This information is for LMHAs/LBHAs with the MH calculator built into their electronic health records. Those using the CMBHS Web Calculator require no system adjustments.

 

Contacts

CMBHS Questions: If you have questions regarding DSM-5 training or if you have problems using CMBHS, call the HHSC CMBHS Helpline at 1-866-806-7806.

CMBHS Data Exchange Questions: Call the CMBHD Data Exchange Help Line at 512-206-5825 or send an email to Data Exchange email at CMBHS.DataExchange@hhsc.state.tx.us.

Substance Use Disorder Programmatic Questions: email Tina Hosaka at Tina.Hosaka@hhsc.state.tx.us or call her at 512-838-4307

Mental Health Programmatic Questions: email Kenneth Placke at Kenneth.Placke@hhsc.state.tx.us or call him at 512-838-4340

 

All CMBHS User Organizations are impacted.

DSM 5 Project Changes

For Substance Use Disorder Providers Only

The following DSM 5 project changes are specific to substance abuse services and do not impact mental health services.

The CMBHS Substance Use Disorder (SUD) Assessments have been updated to reflect best clinical practices and more precisely identify our client’s needs. Data fields and the level of care calculator have been revised.

Changes

·         The name of assessments has changed, but the basic concept has not. CMBHS continues to have Initial, Update, Discharge and End Service Assessment types for SUD treatment, detoxification services and case management services.

·         The volume of questions has been reduced and the narrative function removed;

·         The assessment questions include elements from DSM-5 diagnostic criteria for substance disorders, items from the Adverse Childhood Experience (ACE) and Dan Dubovsky’s Fetal Alcohol Syndrome screening questions. 

·         Many of the required fields provide input to the four calculations in the assessment: Severity Score calculation, Priority Population, ASAM-Recommended Course of Treatment, and recommendations for modifications to treatment.

·         A change has been made to the frequency with which Tobacco Cessation Referrals (TCR) may be automatically generated by CMBHS: one TCR can be generated during the course of an EOC and per case management open case. If the client receives more than one case management types, then more than one TCR may be generated. Reminder: TCRs can be made at any time by counselors and case managers using the usual CMBHS referral process.

·         The Recommended Level of Care no longer displays on the Client Workspace with the creation of each SUD Assessment document.

 

The following are unchanged

·         The tab format and most of the tab names are unchanged;

·         Questions required for federal reporting;

·         The link from the assessment to the treatment/service plan remains the same.

 

Substance Use Disorder User Organizations

 

DSM 5 Project Changes

For Mental Health Only

 

The following DSM 5 changes to CMBHS are specific to mental health services and do not impact SUD services.

Changes

·         The Global Assessment of Functioning (GAF) has been eliminated. Because the GAF has been used by adult mental health for calculating of a TRR level of care (LOC), a replacement was needed. The GAF has been replaced by the Identified Needs Threshold (INT). The INT uses symptoms identified by clinicians and documented in the Adult Needs and Services Assessment (ANSA) to obtain a score used for the calculation of a LOC for adult mental health services.  

The INT is not used for the Child and Adolescent Needs Assessment (CANS).

·         Mental health clinicians can now document the basis for their diagnosis, for example By Client Report, By Physician’s Report or By Collateral Report etc.

 

For LMHAs that Batch Data to HHSC

Batch business rules have been re-written to match the DSM-5 changes. The batch layout remains the same and current batch work processes remain the same. Data Dumps and Batch Reports will be impacted due to the requirement changes. 

Mental Health User Organizations

 

The HHSC Long Term Services Terms of Use (TOU)

Improvements have been made to the Long Term Services and Supports (LTSS) application and the LTSS Terms of Use (TOU) document used by LMHAs and LBHAs. A copy of the document and/or link will be provided as soon as it is available.

 

What Changed?

A new version of the LTSS Terms of Use (TOU) document will be published on June 30, 2018. All LTSS application users will be required to use the new TOU document when interacting with persons seeking services. The TOU language has been updated to better explain how HHS will use individual’s information. 

The application’s functionality will also allow screening and referral information to be viewed by certain HHS and contracted vendor staff after the TOU has expired. These changes go into effect on June 30, 2018.

The new TOU version will display in the Your Texas Benefits mobile application, https://yourtexasbenefits.com and the LTSS worker portal. English and Spanish versions are available.

 

Need Help with LTSS TOU?

HHSC IT Consolidated Help Desk

Hours: 7 a.m. to 7 p.m., Central, Monday - Friday

Toll-Free Phone: 855-435-7181

Local Austin Number: 512-438-4720

Email: Help@HHSC.state.tx.us

Mental Health User Organizations

Substance Use Disorder (SUD) Services Data Downloads

 

Improvements continue to the CMBHS data download function and new documents are available for downloading data.

This release includes the following CMBHS pages:

·         Open Case and Close Case

·         Service Begin and Service End

·         Administrative Note

·         SUD Assessments – (All types – Treatment, Detoxification and Case Management)

·         All Discharge Follow-ups

 

Use of Excel Data Download

Pre-Conditions The user must have the CMBHS SUD Data Download role to access the Excel data. This is a role of significant responsibility and supervisors and Security Administrator must ensure proper vetting before granting it to users.

Excel Instructions

·         After logging into CMBHS, select Data from the Administrative Menu at the top of the page and then Downloads.

·         Complete all the required data fields designated with a red asterisk.

·       Document Type: Select one of the documents that has been released.

·       Location: Select the CMBHS location where the client’s record is located.

·       Date Type: Select either the Created Date, Document Date, or Updated Date as the type of date for your search.

·       Date: Enter the date to search for using the mm/dd/yyyy format

·       Output Format: Select your preference for formatting of the data; Excel (Formatted) or Excel (Raw)

·         When you select Download, the data will be downloaded directly onto your computer into the folder designated to receive Downloads.

 

Use of Web Service XML Data Downloads

Users of XML Format Data

·         This function is for use by your organization’s IT staff to download data from CMBHS and uploading into your electronic health record.

·         Data can now be downloaded any time (except between 11:30 PM to 01:30 AM) rather than just a few limited hours nightly.

·         For the XML format download output, only 25 MB worth of data can be requested per download request.

·         When CMBHS receives a Web Service request, it validates for an alphanumeric User Id and Password.

o   If the credentials are not correct, an error message is sent in the response “Check User ID and/or Password”.

·         CMBHS verifies that all the required parameters are submitted in the Web Service request.

o   If one of the required parameter values sent is Null, an error message “<Parameter Name> cannot be a null value” is returned.

·         The previous download process will continue to be available for 6 months from the first deployment in May 2018 and will then be discontinued.

 

For questions regarding the XML data download, please contact the HHSC CMBHS Data Exchange Help Line via email at CMBHS.DataExchange@hhsc.state.tx.us or (512) 206-5825.

For help with the Excel data download function, please contact the HHSC CMBHS Help Line at 1 866 806-7806.

Please provide feedback about the data downloads to CMBHS@dshs.texas.gov so we can improve our products and processes.

Substance Use Disorder Services Users

 

If you have problems using CMBHS please contact the
CMBHS Help Line at 1 866 806-7806
Monday - Friday 8:00 am to 4:30 pm