Release
Notes (7.52) - 06.22.2018
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Texas Health and
Human Services (HHSC) Clinical Management
for Behavioral Health Services (CMBHS) Release Information Date 06/22/2018 |
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Page or Function |
Description of Change
and/or User Instructions |
Business Entity/User
Type Impacted |
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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. |
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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 |
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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 |
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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 |
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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 |
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If you have problems
using CMBHS please contact the |
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