Provider Portal

• Authorization for Release/Exchange 
• Authorization for Release/Exchange - Spanish
• Authorization for Release - Later Use 
• Authorization for Release - Later Use - Spanish
• Consent Acknowledgement Form 
• Consent Acknowledgement Form - Spanish

• Clinical Supervision Log
• Crisis Orientation Attestation 

• Disenrollment Progress Report
• Guide to Writing a Disenrollment Summary

• Certification Protocol
• Interpretation/Translation/Printed Materials Protocol
• Media Protocol
• Non HMO enrolled youth - Crisis Stabilization Services Protocol 
• Pronouns and Inclusive Language Protocol
• Runaway/Missing Protocol
• Warm Handoff Protocol

• Access to PHI Maintained in Synthesis (revised 3/2025) #046
• Advance Directives (revised 3/2025) #075
• Billing Policy (effective 9/2022) #081
• Care Coordination Supervisor Responsibilities (effective 6/2024) #001
• Care Coordinator After Hours Policy (effective 9/2022) #085
• Care Coordinator Changes (effective 1/2024) #006
• Care Coordinator & Lead Care Coordinator Qualifications & Responsibilities (effective 6/2024) #003
• Caregiver Background Check Policy (effective 4/2024) DHHS-001 
• Certified Peer Specialist & Parent Peer Specialist (revised 3/2025) #072
• Change of Placement Temporary and Legal (effective 9/2022) #005
• Client Chart Format & Record Retention (effective 9/2022) #007
• Client Contact (revised 3/2025) #032
• Client Rights (effective 9/2022) #042
• CCS Transition for Youth and Adults (revised 8/2023)
• Contractor/Provider Obligations (revised 4/2024) DHHS-005
• Confidentiality/Exchange of Information (effective 9/2022) #009
• Consent/Acknowledgement and Authorization Forms (effective 9/2022) #011
• Court Appearances (effective 9/2022) #012
• Crisis Stabilization/Supervision Services (effective 9/2022) #036
• Critical and Serious Incident Reports (revised 3/2025) #014
• Critical Incident Policy (revised 6/2024) DHHS-010
• Cultural Humility (effective 1/2024) #033
• DHHS Staff Roster and Add-Delete Procedure (effective 9/2024) #800-004
• Disenrollments (effective 6/2024) #016
• Electronic Signatures for Record Entries in Synthesis (revised 3/2025) #056
• Emergency Management Plan (effective 1/2024) DHHS-002
• Enrollment Criteria REACH-Crisis (effective 5/2024) #017
• Ethics & Boundaries (effective 9/2022) #053
• Fraudulent Activity (Fraud & Abuse) (revised 3/2025) #066
• Grievance & Appeals Process (effective 1/2024) #008
• Guardianship - Temporary and Signatures Required (revised 3/2025) #020
• High Risk Youth Review - Community Safety and Resource Development (effective 9/2022) #023
• Interpretive Services (revised 3/2025) #071
• Mandatory Reporting (effective 9/2022) #034
• Minimum Necessary Access to Client Protected Health Information (revised 3/2025) #044
• Plan of Care (POC) Documentation (effective 9/2022) #028
• Prevention of Duplication of Services (revised 3/2025) #084
• Privacy Practices (revised 3/2025) #047
• Progress Notes (effective 9/2022) #037
• Provider Agency Responsibilities & Guidelines (effective 9/2022) #054
• Provider Notes (effective 6/2024) #078
• Provider Referral Form (effective 9/2022) #038
• Reporting of Provider Network Providers: Sanctions & Disciplinary Actions to Regulatory Agencies (revised 3/2025) #064
• Service Authorization Request (effective 9/2022) #030
• Shelter Care & Stabilization Centers (effective 9/2022) #043
• System & Provider Conflict Resolution (effective 1/2024) #010
• Team & Plan of Care Meeting Facilitation (revised 3/2025) #076
• Transition to Adulthood (effective 9/2022) #086
• Trauma Response Team (revised 3/2025) #079
• Unearned Monies Recoupment Policy (effective 9/2022) #080
• Use of Restraints or Seclusion (effective 1/2024) #067
• Utilization Review Management (revised 3/2025) #073
• Vendor Paper Claims Processing and Appeal System (effective 9/2022) #065
• Whistleblower Policy (effective 1/2022) DHHS-003

• MPS Special Education
• Adult Disability Referral Form
• WE Energies Energy Assistance
• Community Advocates Rent Assistance
• Milwaukee County Transit System - Go Pass and Reduced Fare
• Veyo Gas Mileage Reimbursement
• Crime Victim - Wisconsin (Compensation Application)

• English P4-10 (SDQ for the parents of 4-10 year olds)
• English P11-17 (SDQ for the parents of 11-17 year olds)
• English S11-17 (SDQ for self-completion by 11-17 year olds)
• English i18+ (SDQ for parent/guardian on those aged 18 and over)
• English s18+ (SDQ for self-report by those aged 18 and over)
• Spanish P4-17 (SDQ for the parents of 4-17 year olds)
• Spanish S11-17 (SDQ for self-completion by 11-17 year olds)
• Spanish s18+ (SDQ for self-report by those aged 18 and over)

• Domain Review Checklist
• Team Attendance/Signature Sheet
• CCS Attendance Roster
• Guide for Virtual Team Meetings
• Life Story - Writer's Guide
• The Needs Guide by Pat Miles
• Passport to POC Facilitation
• Plan of Care Coaching Tool
• POC Rubric - Audit Tool
• Best Practice Guide for Youth Ordered to Corrections

• Runaway Missing Toolkit for Youth and Families
• Runaway/Missing Protocol
• Case Worker Quick Reference Guide - Missing Child Reports to NCMEC
• Plan of Care and Prior Authorization Approval Protocol when Youth are Missing from Care
• Essential Components for Crisis Planning - Runaway Missing
• Wisconsin Child Sex Trafficking Indicators and Response Guide
• Finding your Strengths Worksheet

• Guide to Writing a CCS Discharge Summary
• Annual Continuation Agreement
• BHS Consent, Release & Authorization
• Determination of Need
• EPINET Quality of Life
• EPINET Staying Well
• Functional Screen Release
• Modified Colorado Symptom Index
• Supervision Log
• CCS Attendance Roster
• Uploads Naming Conventions
• CCS Physician Prescription
• DHS 36
• CCS/CLTS Dual Enrollment Guide
• CCS Disenrollment Confirmation Form

Training:

• CCS Orientation and Training Packet
• Annual Training Checklist
• Care Coordination Training Checklist
• Ancillary Training Checklist

Practitioners that are subject to credentialing requirements are defined as licensed individuals who are legally authorized to provide independent care and treatment to patients. The practitioner types included in this definition include physicians, doctoral level psychologists, advanced practice nurses (clinical nurse specialists, certified nurse midwives, certified nurse practitioners) and physician assistants.

• Initial Credentialing Application
• Recredentialing Application
• Provider Network Credentialing Program and Governing Document