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FAQ

Page history last edited by josh cornell 10 months, 2 weeks ago

 

Frequently Asked Questions

 

  1. About the Outcomes Application
    1. What is the Outcomes Measurement Application (OMA)?
    2. How do I log on to the Outcomes Measurement Application (OMA)?
    3. How do I get a password if I already have an RSA SecureID?
    4. We are also an ACT or AB2034 provider in addition to being a FSP provider, can we just enter all of our data into the OMA for all three programs?
    5. My agency has a bunch of clients who were AB 2034, but they were converted to FSP on July 1, 2007. Do I have to do assessments on them all the way back to 7/1/07?
    6. What about FCCS? Are we using OMA for Field Capable Clinical Services yet?
    7. Has there been a change in the way Specialized Foster Care collects OMA's? Does SFC Basic still collect Outcomes?
  2. About Outcomes
    1. I got some forms from the State of California's POQI website. Do I use those? Are they different from the DMH ones?
    2. What outcomes do I need to complete and what clients do I need to complete them for?
    3. We now have FSS cases (Family Support Services): is this  or will this become a part of the FSP OMA Program to be collecting data for the state/county?
    4. Can my Case Manager complete these forms, or do I need a Clinician to do all the Outcomes forms?
    5. When do I complete the forms?
    6. When completing the Baseline for children, does the client (child) have to be present or is it ok to just meet with the parent/legal guardian?
    7. If my Child FSP client turns 16 while still in my Child FSP program, do I keep filling out Children's forms?
    8. If there is an existing Baseline completed by a different provider, do I have to do a new one?
    9. Do I have to complete the entire KEC form or just for the change I am reporting?
    10. We have a client who moved from one apartment to another apartment within the same complex. Client still has same living arrangements as before as far as living with parents and siblings, the only thing that changed is the apartment number. Do I need to enter a KEC?
    11. What is the Partnership Date?
    12. We just got a new office and a new Reporting Unit number...and now I can't enter KEC's or 3M's...what do I do?
    13. We have a client we had to close and then re-open because of a lapse in service. Do we do a KEC form for that? Does the Partnership Date change because there would be a different episode number?
    14. How do I change the SFPR in OMA?
  3. Finding Episodes and Baselines in the OMA
    1. I can't see any Episodes when I Find Client. I can see the Client, but no Episodes!
    2. I just opened an IS Episode, but I still can't see the Episdoe in the OMA. Why is that?
    3. I can see my Episode, but the link is grey. When I click on it, nothing happens!
    4. I have already opened and CLOSED the Episode...how do I enter Outcomes?
  4. Administrative
    1. If the Service Area Navigator referred the case to FSP, what do I check under referral source?
  5. Living Arrangements
    1. How far back do I track Living arrangements?
    2. We have some clients who are under the age of 1, and I am not sure how to indicate this on the Living Arrangement section because we must account for 365 days. Our infant clients were born less than 365 days ago, so what do I use?
    3. On the OMA forms every living arrangement is only listed once, what do I do if they had more than one occurrence for the same type of living arrangement?
    4. Under living arrangements, when would you enter an occurrence number other than 1?
    5. On the baseline, if I have a client who was hospitalized, can I just enter their admit and discharge dates as the from/to dates for residential types?
    6. I still don't understand how to check the box for "tonight" in the Living Arrangements section of the OMA. How do you mark where the client resides "tonight," which hasn't happened yet? Is the answer different or the same for clients who return to the exact place they stayed "yesterday" night and clients who move into a new place "tonight"? How do you keep the computer from counting "tonight" as another day, thus reading 366 days instead of 365?
    7. My 12-year-old client has lived with their biological parent every day of the last year, but they have moved from a substance rehab center to a transitional residential program to an independent living program. How do I record their living arrangement?
    8. We have a client whose address changed but whose living situation remained the same (still living with both parents). How to record?
    9. We have many 0-5 clients who live at St. Anne’s residential treatment facility with their biological mother. For the living arrangement section, I am not sure if I should put that they live in a Group Home, or if they live with bio parent.
    10. How do I get information on time clients spend in jail?
    11. Do I file a 3M if my client is in jail? They're supposed to be in for just a couple of weeks...
    12. Under "Why did client change residential status?" What number do we use for psychiatric hospitalization (entering hosp. and leaving hosp.)? How would you code it if someone is 5150'ed?
    13. I have a client who went into the hospital on Monday, and came out again two days later. Do I really have to fill out two complete KEC forms for that?
    14. In the event a client cannot recall where they lived all 365 days of the previous year, or chooses not to disclose to us where they were living all of the 365 days what does the clinician put on the OMA?
    15. 2008 and 2012 are Leap Years -- What do I need to do about that?
  6. Social Support
  7. Financial
    1. If a client has emergency Medi-Cal do we check the Medi-cal box?
    2. Is HMO Medi-Cal considered full scope Medi-Cal?
    3. If a client gets emergency medi-cal when they are in our program do I complete a KEC for benefits establishment?
    4. If a client refuses to give financial information for her Outcome Measures, what do we do?
    5. How do we categorize foster care payments? As caregiver's wages, child's wages, or as other?
    6. For children, do we mark Yes for question “Is client unemployed at this time?” Unemployed would suggest that they are eligible to work but aren’t.
    7. If client’s rent is supplemented by our program’s flex funds, do we count it as an income (maybe under other)?
  8. Daily Activities / Vocational / Education Level
    1. We have quite a few clients who are not enrolled in school because they are too young, yet they attend daycare. I see that daycare is one of the choices under grade level information, so I am considering this the educational setting. What would I do about grades if no grades are assigned in daycare?
    2. Why there is no "N/A" option for items like School Attendance or Grades if the person is not in school at all. Maybe we should simply skip that section?
    3. What does "highest grade level attained" mean? Is this the same as my client's current grade level?
    4. What should I do when Children or TAY go on summer vacation?
    5. What about the 3M? If they have recently gone on vacation at the end of June, is it asking for when they were in school or currently while they are on vacation? Would you put "never attends school" because they are on vacation?
    6. Why don't we document ADL's (Activities of Daily Living) for Adult and TAY?
  9. Physical Health
    1. Under Physical Health, "client has needed medical services..." ALL clients need medical services and dental services every 12 months...shouldn't this default to YES?
  10. Crisis Stabilization/PMRT
    1. What is the definition of "crisis stabilization" (psychiatric vs. substance abuse). What would you include? PMRT? Urgent Care? Call to home? SMART? It seems PMRT is calculated in the next question.
    2. What’s the difference between emergency room and crisis stabilization? 
    3. If client went to hospital voluntarily, which box I should check? 
    4. For PMRT, does that only happen when client is hospitalized involuntarily?
  11. Legal
    1. Under custody information...should there be a distinction between minor and adult children? Also, there should be another box for "other."
    2. On the 3M assessment, if the client is currently not using but he did previously and has dual d/x, do I check Yes on "Client uses Substances"?
    3. My client has 3 children who all live with family members aside from the client, but there's been no legal change to their custody status. What should the boxes at the end of the Legal section read?
  12. The "Is Complete" Button
    1. What is this button? Can I edit my Assessment after I click this button?
  13. Transfer and Disenrollment
    1. How do I disenroll a client?
    2. I just got a transfer client, but I can't enter their KEC or 3M, and I can't edit the Baseline. What to do?
    3. When a client discontinues service, is the Date of Partnership Status Change the same date as the date that discontinuation is authorized by the County, or is it the discharge date in the Integrated System? 
    4. What about a client who's put in a long term skilled nursing facility because of physical (not mental) illness? What do I put for a reason?
    5. When a provider reestablishes a client and they are also going to then transfer the client to a new provider can the reestablishment and transfer be completed on the same KEC?  Or do they need to create two separate KEC one reestablish and then a second one to transfer?

 

 

 

About the Outcomes Application

 

What is the Outcomes Measurement Application (OMA)?

The OMA is the method by which LA County is collecting data for Full Service Partnerships, Specialized Foster Care Intensive, Field Capable Clinical Services, and Wraparound FSP Services. The OMA is a web-based application that can be accessed by a secure ID card and IS logon or by DMH workers inside the DMH network. Full Service Partnership providers must submit their Outcomes data electronically to LA county by either using our OMA or by using thier own data collection system and submitting the information to DMH via XML. At the moment, only providers using Caminar are NOT using OMA, and very soon Caminar will no longer be used to collect Outcomes. All LA County FSP providers must collect LA County data elements in addition to the state FSP data requirements.

 

How do I log on to the Outcomes Measurement Application (OMA)?

Once you have had the hands-on (computer/data entry) training you can start entering your outcomes into the LA County OMA. You can follow the Step By Step Guide for accessing the application, or click on the links in the SideBar (on the right side of this page).

 

How do I get a password if I already have an RSA SecureID?

This is a question most Contract providers will encounter because you might have a SecurID to get on the IS, but have never needed another password to get in. DMH users have a user name and password to get the IS since they access it through the intranet.

 

To get that OMA password, you need to call the Help Desk and tell them you need that password...they will set you up... 213-351-1335

 

We are also an ACT or AB2034 provider in addition to being a FSP provider, can we just enter all of our data into the OMA for all three programs?

No, currently the OMA is only being used to collect data for Full Service Partnerships (FSP) including Wraparound FSP, Field Capable Clinical Services (FCCS) and Specialized Foster Care intensive mental health services, not ACT and AB2034. Please see this page for further information on the conversion of AB2034 clients to FSP: AB 2034 Transition.

 

My agency has a bunch of clients who were AB 2034, but they were converted to FSP on July 1, 2007. Do I have to do assessments on them all the way back to 7/1/07?

If they are former AB2034 clients, you don’t need to file 3M’s or KEC's on them until April 1 2008 or later. This is because DMH was still trying to figure out how to handle those clients: we’re not requiring 3M’s from 7/1/07 to 4/1/08 because DMH didn’t have a policy about them until then.

 

What about FCCS? Are we using OMA for Field Capable Clinical Services yet?

There is a set of forms for FCCS Outcomes data collection, and electronic Data collection began in June 2009. More details can be found here: FCCS.

 

Has there been a change in the way Specialized Foster Care collects OMA's? Does SFC Basic still collect Outcomes?

Currently, DMH is requiring the collection of Outcomes information for SFC Intensive In-Home clients in order to provide details of our services to the panel supervising the Katie A settlement. DMH was collecting Outcomes for SFC Basic, but discontinued that practice in 2009. Completion of Outcomes is required for all SFC Intensive cases opened after August 1, 2007. 

 

About Outcomes

 

I got some forms from the State of California's POQI website. Do I use those? Are they different from the DMH ones?

The County of Los Angeles uses modified forms that collect both data that the County deems necessary AND collects all of the State-mandated outcomes information. The State forms are different, and they will not allow you to collect all the data you will need. Please do not use the State forms! Only use the DMH forms! Those forms are located here... Forms

 

What outcomes do I need to complete and what clients do I need to complete them for?

For every client that is enrolled in a full service partnership program, a baseline assessment must be completed upon enrollment. The baseline covers the activities of the client during the 12 months prior to enrollment and the day of partnership, and includes a few questions covering the client's life before the past year. If information reported in the baseline changes in certain areas, (i.e. residential status, hospitalizations, emergency room contacts, starting and stopping school or work, etc.), you will need to report each change on a Key Event Change form. A three month assessment is due every three months on every enrollee in full service partnership programs.

 

The requirement for Specialized Foster Care is the same, but FCCS providers use a different form and a different schedule. Please see this page for information for FCCS providers: FCCS

 

We now have FSS cases (Family Support Services): is this  or will this become a part of the FSP OMA Program to be collecting data for the state/county?

We do not collect any FSP data on FSS cases.    Clients in FSS are the family members of enrolled FSP clients. We collect outcome data on the actual FSP client(s), but not the family member(s).

 

Can my Case Manager complete these forms, or do I need a Clinician to do all the Outcomes forms?

It is recommended that Baselines be completed by clinicians, since many questions require clinical judgment and knowledge.  As with any initial assessment with a client, clinicians needs to gather client’s background information and make informed clinical decision. Since KEC’s and 3M’s are more focused on fact finding/changes with the client, case managers can gather that information and seek consultation with the clinician if they need to answer questions that are clinical in nature or if they are unsure of how to answer them.

 

When do I complete the forms?

For Full Service Partnership and Specialized Foster care, a Baseline assessment should be completed within the first 30 days after enrolling in services. The sooner the baseline is completed the faster your program can start to show outcomes. The three month assessment is due on every 3 month anniversary of your start date. You have a window of 15 days prior to the 3 month anniversary and 30 days after to complete it. A Key Event Change (KEC) needs to be completed as soon as a change is known. You only need to complete the section of the KEC for which you are reporting a change.  You may report more than one change on a single KEC assessment as long as the changes are in different domains.  If you are disenrolling a client, transferring a client, or receiving a transferred client, you should ensure all outcomes are updated at the time of transfer or disenrollment.

 

When completing the Baseline for children, does the client (child) have to be present or is it ok to just meet with the parent/legal guardian?

The baseline is completed from information you have about the client from the client and/or information you have received from supplemental documentation or input from family members. Use your clinical judgment about whether you just need the parent in the room or whether you also need some information from the client. There are some questions that pertain to the client’s preferences like “is the client satisfied with their current living arrangement”, that you might have to ask the question directly to the client. It might be necessary to collect the information over a couple of sessions. DMH does expect that the Baseline will be completed within 30 days of the Partnership Date.

 

If my Child FSP client turns 16 while still in my Child FSP program, do I keep filling out Children's forms?

You will need to switch to the TAY forms even though the child remains in the Child FSP program. When your staff go to enter the data in the OMA system, they will be shown the TAY forms for assessments done on or after the client’s 16th birthday.

 

If there is an existing Baseline completed by a different provider, do I have to do a new one?

No, a new baseline is not necessary if the clients is continuing in the same type of program. If there is an existing baseline, the new provider needs to ensure the previous provider has completed a KEC for the provider site transfer with date. Once that is completed, the new provider can generate KECs and 3Ms off of the other provider's baseline. You should be able to view the client's baseline that was completed by the other provider, you just won't be able to edit it. You only complete baselines for clients newly authorized for FSP or Specialized Foster Care Intensive programs, not all those new to your agency (i.e. transferred clients). The only instance in which you would create a new baseline for a client that already has a baseline is if the client was previously enrolled in the same type of program and has had a lapse of service for more than 1 year. If the existing baseline in the system is for a different type of program then you need to do a new baseline.  For example, if the baseline in the system is for Full Service Partnership, but the client is now in your SFC intensive program, a new baseline is required. If a client is moving between FSP age group programs or Wraparound FSP there is no need for a new baseline. If you are working off of a previous baseline, you adopt the previous partnership date and assume what was their 3M schedule.  

 

Do I have to complete the entire KEC form or just for the change I am reporting?

You only need to complete the section of the KEC for which you are reporting a change. You can report multiple changes in a single KEC as long as the changes are in different domains. You must ensure outcomes are current at the time of disenrollment and transfer.   

 

We have a client who moved from one apartment to another apartment within the same complex. Client still has same living arrangements as before as far as living with parents and siblings, the only thing that changed is the apartment number. Do I need to enter a KEC?

No. As long as they're just moving spaces and not actual living arrangements, you don't need a KEC.

 

What is the Partnership Date?

The Partnership Date is the first date that you provide FSP services, not outreach and engagment. This date cannot precede the authorization date from countywide programs (in the case of FSP programs). The partnership date likely coincides with the first billable service to the FSP IS plan. For Specialized Foster Care the partnership date is the date you would consider to be the start of SFC intensive services.  

 

We just got a new office and a new Reporting Unit number...and now I can't enter KEC's or 3M's...what do I do?

There's a whole page on what to do when you get a new Reporting Unit...right here.

 

We have a client we had to close and then re-open because of a lapse in service. Do we do a KEC form for that? Does the Partnership Date change because there would be a different episode number?

If it has been less than a year, you should do a KEC to represent changes since the client left: basically, use the KEC to bring things up to day. The Partnership Date remains the same as long as it's been less than a year. Check the re-establishing partnership box. When entering the KEC, you will find the client and then select the client baseline click on new KEC and then a drop down episode field should appear allowing you to select your current episode.

 

How do I change the SFPR in OMA?

SFPR is changed in the Integrated System, not in OMA. Change it in the IS, and the change will be reflected in the OMA…although it will take at least 2 hours for the change to show up in OMA (since that’s how often IS updates OMA). Some changes (such as SFPR) might not load until the weekend since there are some database updates that DMH will only do on weekends.

 

 

Finding Episodes and Baselines in the OMA

 

I can't see any Episodes when I Find Client. I can see the Client, but no Episodes!

All clients must have an open episode in the Integrated System in order for you to see an Episode in the OMA. You will not be able to make or open a Baseline unless they have an open Episode in the IS. If you do have an open episode in the IS but can't see it in the OMA, please contact Help Desk at 213-351-1335. If you CLOSED that episode before you entered the Baseline, please see this page:  http://dmhoma.pbworks.com/Remove+Discharge+Date

 

I just opened an IS Episode, but I still can't see the Episdoe in the OMA. Why is that?

The IS and OMA are not directly connected: every two hours, the OMA loads up new data from the IS. In other words, there's a lag time between your opening an Episode in the IS, and it showing up in OMA. Wait for an hour or two and try again.

 

I can see my Episode, but the link is grey. When I click on it, nothing happens!

There are a couple of possibilities here.

 

The first is that there is a problem with your logon: the OMA doesn't recognize you as someone who is authorized to work on this Episode. Double check to make sure that Episode belongs to your clinic (the first four digits of the Episode number should be your Reporting Unit number), and if they are you need to check your logon. It's possible that you did not logon correctly. If you are a DMH employee: make sure you are using your IS logon name and password, NOT your DMH logon and password (that's the one you use first thing to get on the DMH network). If you are a Contract provider, you need to get an IS password. Scroll up and look at this question: "How do I get a password if I already have an RSA SecureID?"

 

The other possibility is that you ALREADY have a Baseline for this client. Click on "Baselines" and see if there is one started. Click on the pencil next to the Baseline to Edit the Baseline.

 

I have already opened and CLOSED the Episode...how do I enter Outcomes?

You will need to ask DMH to remove the Discharge Date. Thereby re-opening the episode so that you can enter Outcomes. The form for doing that, including instructions and contact information, is at this address:

 

http://dmhoma.pbworks.com/Remove+Discharge+Date 

 

Administrative

 

If the Service Area Navigator referred the case to FSP, what do I check under referral source?

Try and find the original source of the referral if possible, for example. if the family contacted the navigator to request services, you should check family member. If you are unable to find out who the original referral source is, and you only have the navigator, please check "mental health facility/community agency" to indicate "service Area Navigators" as the source.

 

 

Living Arrangements

 

How far back do I track Living arrangements?

Start with 12 months prior to the partnership date. For example if your partnership date is 12/1/2006, you are tracking living arrangements from 12/1/2005-11/30/2006, and checking the tonight column where the client slept on the first night of the partnership (12/1/06). This is the way your total days will equal 365. Living arrangements for baseline data collection should end on the day before partnership. It's always the 365 days immediately prior to starting in FSP or SFC. You can get tips on how to fill out Living Arrangements right here:

 

http://dmhoma.pbworks.com/f/Living+Arrangements+Example+2.0.pdf

 

We have some clients who are under the age of 1, and I am not sure how to indicate this on the Living Arrangement section because we must account for 365 days. Our infant clients were born less than 365 days ago, so what do I use?

Since the system requires 365 days to be accounted for "during the past 12 months," please default the time in utero under "Other." These anomalies will have to be accounted for when the data are analyzed.

 

On the OMA forms every living arrangement is only listed once, what do I do if they had more than one occurrence for the same type of living arrangement?

List one occurrence on the form with the residential types listed in the left hand column, fill in the dates, check the appropriate columns, enter an occurence of 1 and number of days for that occurrence. List additional occurrences on the blank page of living arrangements. You can get tips on how to fill out Living Arrangements right here:

 

http://dmhoma.pbworks.com/f/Living+Arrangements+Example+2.0.pdf

 

Under living arrangements, when would you enter an occurrence number other than 1?

Never: the occurrance column should always be one for any living arrangement you report the client has slept in the past 365 days. The electronic application will automatically default to one and will total the occurrences when we report it out to the state. If the client did not reside in a particular living arrangement over the last 365 days, leave that entire line blank, and only check the box at the end of the row if the client has ever resided in that type of setting anytime prior to the last 12 months, or check the tonight box if the client will sleep there on the first night of the partnership.

 

On the baseline, if I have a client who was hospitalized, can I just enter their admit and discharge dates as the from/to dates for residential types?

No, you put their admission date as the "From" date, and the "To" date needs to reflect the last night they slept in the hospital. This is usually the day before the discharge date reflected in the IS or reported by the client. For example if the IS screen shows a hospitalization from 1/1/06-1/05/06, the client was released on 1/5/06, thus did not spend the night there that night. The "To" date should be reflected as 1/4/06 as the last night the client spent the night.

 

I still don't understand how to check the box for "tonight" in the Living Arrangements section of the OMA. How do you mark where the client resides "tonight," which hasn't happened yet? Is the answer different or the same for clients who return to the exact place they stayed "yesterday" night and clients who move into a new place "tonight"? How do you keep the computer from counting "tonight" as another day, thus reading 366 days instead of 365?

The "Tonight" box is not counted because, as you point out, it hasn't happened yet. The best way to think about it is that "Tonight" is what we expect will be happening.

 

Tonight refers to what is happening the evening of the Partnership Date. Often you will check "Yesterday" and "Tonight" on the same living arrangement, but not always. A good example would be this: you establish a new client on January 2, 2008. That means you're going to record the Living Arrangements for this client from Jan 2, 2007 through Jan 1, 2008. That client was Homeless last night, so you will mark the "Yesterday" box under Homeless for Jan 1, 2008. However, for tonight (Jan 2, 2008) you managed to get housing in a shelter. You would then check "Tonight" under Emergency Shelter, although you would not enter any dates. Your next Living Arrangement KEC will tell us when that person moves out of the shelter.

 

Take a look at this sheet if you haven't already:

 

http://dmhoma.pbwiki.com/f/Tips+on+Living+Arrangements.pdf

 

...if you fill it out according to those directions, it will add up to 365.

 

 

My 12-year-old client has lived with their biological parent every day of the last year, but they have moved from a substance rehab center to a transitional residential program to an independent living program. How do I record their living arrangement?

If the moves were due to issues in the parent's life, the living arrangement would be "Lives with One or Both Biological Parents" for the entire 365 days. The idea is to capture the living arrangements that are affected by the client's wellness...as long as they are being moved as a result of issues in the parent's life, the living arrangement will stay the same: biological parent.

 

We have a client whose address changed but whose living situation remained the same (still living with both parents). How to record?

You would file a KEC change to the same living arrangment residential type and the effective date of the move. The state requests us to capture a residential change every time there is a change in address.

 

We have many 0-5 clients who live at St. Anne’s residential treatment facility with their biological mother. For the living arrangement section, I am not sure if I should put that they live in a Group Home, or if they live with bio parent.

We want to capture the primary living arrangement, and in this case the mother is what’s important in this situation. As long as a younger client is living with a parent, that should be the way the Living Arrangement is listed: Lives with Biological Parent.

 

How do I get information on time clients spend in jail?

Base this information on client's report and do the best that you can. lasd.org might be a resource to find out previous county jail stays up to three months ago. This will also provide information if your client is currently in jail.

 

Do I file a 3M if my client is in jail? They're supposed to be in for just a couple of weeks...

lf the client is still enrolled in your FSP program, you are maintaining contact while the client is in jail. There should be no reason why you cannot complete the 3M. You would do a disenrollment if the client is going to be incarcerated for an extended amount of time.

 

Under "Why did client change residential status?" What number do we use for psychiatric hospitalization (entering hosp. and leaving hosp.)? How would you code it if someone is 5150'ed?

Either (4) Decrease in Functioning or (11) Improved Functioning

 

I have a client who went into the hospital on Monday, and came out again two days later. Do I really have to fill out two complete KEC forms for that?

You can only report one change per domain in one KEC. Since you are reporting two living arrangement changes, you need to fill out two KECs, but just the living arrangements section. You don't need to fill out the other sections. Also, you don't need to fill them out on paper: you can just enter them directly into the OMA and print out the data you entered to place in the file.

 

In the event a client cannot recall where they lived all 365 days of the previous year, or chooses not to disclose to us where they were living all of the 365 days what does the clinician put on the OMA?

There is an "Unknown" category under living arrangements you can use if you don't have information from clients. You are still expected to put date parameters around the unknown time periods. You can reflect multiple periods of unknown time frames the same way you would for multiple occurances of homelessness, hospitalizations, etc. Sometimes you can gain more information if you talk about landmark dates: try asking the client where they were on Christmas, their birthday, etc. We know that taking these histories can be very difficult, but the more complete they are the more clear the outcomes are.

 

2008 and 2012 are Leap Years -- What do I need to do about that?

2008 and 2012 are both Leap Years. For example: February 29th brought the total number of days in 2008 to 366. The OMA program is set up to take account of this when calculating things such as the window for filing 3M's, but one thing you will need to be mindful of is the calculation of Living Arrangements on any new Baselines for the next year.

 

In the past, our advice concerning Living Arrangements has been to write the date range in the top margin before you start tracking, and to start 365 nights before the Partnership Date. For example, a Baseline for a client with a Partnership Date of February 15, 2008 would mean that you need to collect Living Arrangements data from February 15, 2007 to February 14, 2008.

 

Since the Leap Year puts us off by one day, you will need to start your calculation a day later. In other words, if your client has a Partnership Date of March 4, 2008, 365 days before that date (adding in February 29th) is March 5, 2007. This difference will remain in effect until March 1, 2009

 

 

Social Support

 

Financial

 

If a client has emergency Medi-Cal do we check the Medi-cal box?

No, only check the box if the client has full scope Medi-Cal.

 

Is HMO Medi-Cal considered full scope Medi-Cal?

An HMO Medi-Cal client, a client has turned their Medi-Cal over to an HMO, is considered a full-scope Medi-Cal beneficiary for our purposes. Those client services were part of the carve-out and our providers see the clients and bill Medi-Cal for their services. Therefore, check the Medi-Cal box if your client has HMO Medi-Cal.

 

If a client gets emergency medi-cal when they are in our program do I complete a KEC for benefits establishment?

No, you do not have to report if the client gets emergency medi-cal. However, if the client secures full scope medi-cal when in the FSP, you would report this event in a key event change.

 

If a client refuses to give financial information for her Outcome Measures, what do we do?

Report what you can...if they refuse to give info, that's the best you can do!

 

How do we categorize foster care payments? As caregiver's wages, child's wages, or as other?

Monthly foster care rates should not be reflected as client or caregiver wages. You can list them under other and write on your form "foster care payment".

 

For children, do we mark Yes for question “Is client unemployed at this time?” Unemployed would suggest that they are eligible to work but aren’t.

Yes, you should mark “unemployed.” Whether or not they are eligible is not really an issue for the State…just whether or not they are working. I think it’s understood that employment among pre-teens is very unusual.

 

If client’s rent is supplemented by our program’s flex funds, do we count it as an income (maybe under other)?

No, it should not be included as income.

 

 

Daily Activities / Vocational / Education Level

 

We have quite a few clients who are not enrolled in school because they are too young, yet they attend daycare. I see that daycare is one of the choices under grade level information, so I am considering this the educational setting. What would I do about grades if no grades are assigned in daycare?

You can leave the ”grades” section blank. The State should be able to interpret the data correctly given the age of the clients.

 

Why there is no "N/A" option for items like School Attendance or Grades if the person is not in school at all. Maybe we should simply skip that section?

We are checking to see if we can add a "No Response" field here...there are some small items like this that are still in process.

 

What does "highest grade level attained" mean? Is this the same as my client's current grade level?

No, for this question you should report the highest grade level completed. For example if you client is currently in 11th grade, your response to this question should be 10th grade since that is the highest grade level completed.

 

What should I do when Children or TAY go on summer vacation?

Since the client is on vacation, they are not required to be in school. They should report their normal attendance pattern as if school was in session unless there is some reason to report a change.

 

What about the 3M? If they have recently gone on vacation at the end of June, is it asking for when they were in school or currently while they are on vacation? Would you put "never attends school" because they are on vacation?

The same rules apply: Since the client is on vacation, they are not required to be in school. They should report their normal attendance pattern as if school was in session unless there is some reason to report a change.

 

Why don't we document ADL's (Activities of Daily Living) for Adult and TAY?

Our initial planning did not include this. When we establish a users group, if there is a strong interest, the age group leads will have to make that decision based on stakeholder input.

 

 

Physical Health

 

Under Physical Health, "client has needed medical services..." ALL clients need medical services and dental services every 12 months...shouldn't this default to YES?

The question refers to whether the client has access to needed medical services. There are clients that do not have insurance, and are not able to afford any kind of medical care, therefore do not have access. For this reason it cannot default to yes.

 

 

Crisis Stabilization/PMRT

 

What is the definition of "crisis stabilization" (psychiatric vs. substance abuse). What would you include? PMRT? Urgent Care? Call to home? SMART? It seems PMRT is calculated in the next question.

Crisis Stabilization is actually a 23 hour facility where they would go for stabilization to deter hospitalization. An example would be Augustus Hawkins Urgent care center, Olive View, or the mental health urgent care center in Long Beach.

 

What’s the difference between emergency room and crisis stabilization? 

Crisis Stabilization is a facility used to divert psychiatric hospitalization. Clients can stay there up to 23 hours and cannot meet criteria for 5150/5585 involuntary hospitalization. The crisis stabilization facilities we have in LA County that I know of are the MH Urgent Care Center in Long Beach, Augustus Hawkins Urgent Care, and Olive View and Westside Urgent Care Center. I am not sure if any of these facilities currently serve children or TAY.

 

If client went to hospital voluntarily, which box I should check? 

If the client went to a hospital without visiting an emergency room or crisis stabilization you would not need to check any box. It is entirely possible to be admitted to a psychiatric hospital without ever setting foot in an emergency room or crisis stabilization unit for a voluntary or involuntary admission. You would only need to check a box if one applies to your client. If a client went to a hospital voluntarily but in order to access care, had to be seen in the emergency room first, then you would check emergency room.

 

For PMRT, does that only happen when client is hospitalized involuntarily?

Psychiatric mobile response teams might come out to see a client and the call might not result in hospitalization at all. If a psychiatric mobile response team evaluated the client and provided crisis intervention services then you would say yes to the question about client being seen by PMRT or 24/7 response teams. If the call resulted in hospitalization then you would say yes to that question.

 

 

Legal

 

Under custody information...should there be a distinction between minor and adult children? Also, there should be another box for "other."

Only children under the age of 18 should be counted. There should not be a box for other because the state is not asking that all of the client’s children be accounted for, rather how many children they have in foster care, adopted out, etc.

 

On the 3M assessment, if the client is currently not using but he did previously and has dual d/x, do I check Yes on "Client uses Substances"?

The client would still have to meet DSM criteria for diagnosis as a substance use disorder. If they currently meet criteria for a use or abuse diagnosis then you would circle "Yes."

 

My client has 3 children who all live with family members aside from the client, but there's been no legal change to their custody status. What should the boxes at the end of the Legal section read?

The boxes should all have zeroes in them: the boxes do not need to equal the total number of children the client has. If the children do come to live with the client, that should be recorded and should be a positive outcome. Also, these boxes only relate to minors: children over 18 are not counted here in any case.

 

 

The "Is Complete" Button

 

What is this button? Can I edit my Assessment after I click this button?

The OMA team has added an "Is Complete" button to each assessment screen in the OMA. Assessments are only considered complete (meaning they are ready to be added to the database) when a user clicks this button! We know that you sometimes get to the end of the assessment, but you still need to add information. This button lets you tell us when you are done. Users can edit their assessments AFTER they have checked the "Is Complete" button, however we will be looking into locking assessments after a certain period.

 

 

 

Transfer and Disenrollment

 

How do I disenroll a client?

Please consult the FSP Guidelines and/or your service area liaison on disenrollment procedures. You can also seek guidance from the countywide age group leads if you still have questions after that. As far as OMA goes, we expect that once you have countywide authorization to disenroll, the outcomes will be closed out.   We expect that KECs and 3Ms are entered throughout the course of the partnership, however,  please ensure all relevant changes have been reported in a KEC with the respecitve status change dates prior to closing client out. Once all statuses have been throroughly updated and all 3Ms are collected and entered, then fill out the administrative section on a final KEC for the discontinuation using the Countywide signature date or last date FSP was claimed (whichever is more recent) as the date of disenrollment.   The disenrollment guidelines (and the related forms) are on the wiki and also on the MHSA site right here… http://dmh.lacounty.gov/AboutDMH/mhsa.html 

 

I just got a transfer client, but I can't enter their KEC or 3M, and I can't edit the Baseline. What to do?

First, contact the agency that the client started with: they need to file a KEC listing your agency as the New Provider agency under the Administrative section. Prior to the first agency completing the provider site ID change all statuses should be updated and all 3Ms collected should be entered.   Once the provider site ID change is made, the new provider site should complete a KEC for a partnership service coordinator and the date.   There is no need to indicate a program change on the KEC, unless countywide has authorized the client to be in a new age group FSP.   

 

Please note: you will not be able to edit the Baseline for this client. You must, however, use the Partnership Date on that original Baseline as the anniversary date for all the 3M's you will file. In other words, the 3M schedule is based on the first date of FSP service EVER for the client, not on your acceptance of them in you FSP.

 

When a client discontinues service, is the Date of Partnership Status Change the same date as the date that discontinuation is authorized by the County, or is it the discharge date in the Integrated System? 

It is important to remember that you must have authorization from countywide prior to disenrolling a client from FSP.    The disenrollment date therefore must be on or after (very shortly after) the authorized disenrollment countywide signature date.     We realize at times that clients disappear or are in locations where services were not able to be billed prior to requesting disenrollment.   In those circumstances, when you close your IS episodes, you will likely close the episode back to the last date of service.   In these circumstances, the discharge date on the IS episode will predate the FSP disenrollment date.    It is okay if the FSP disenrollment date does not match your IS episode close/discharge date.    What is important is that we capture outcomes for the entire time the client is considered enrolled in FSP.   Remember clients are considered enrolled in FSP until you have authorization to disenroll from countywide age group admins.    Please ensure your partnership status change dates are either on or shortly after the countywide authorized disenrollment signature date.    If you have questions, feel free to contact your age group representative or a member of the OMA team.  

 

For SFC it would be the date that the SFC services stopped (probably the date the case was closed).

 

 

What about a client who's put in a long term skilled nursing facility because of physical (not mental) illness? What do I put for a reason?

 

There doesn’t seem to be a very good fit here.  Since it is a physical health SNF and there is no option about an interruption of program due to prolonged medical care, I would say that “target population criteria are not met”  would be the next best choice here unless it’s truly because the client will be too far away to serve any longer, in which case I would chose “moved to another county/service area." 

 

When a provider reestablishes a client and they are also going to then transfer the client to a new provider can the reestablishment and transfer be completed on the same KEC?  Or do they need to create two separate KEC one reestablish and then a second one to transfer?

 

The OMA will allow you to do both on one, but we would prefer that you isolate the reestablishment KEC so that you only report the reestablishment and do a second one for Transfer.  It might be ideal to have the first provider do the KEC for transfer and the second prov to do the reestablishment for the same date, in the new site.   

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