BHD Providers

Provider Forms

• AODA Residential Waitlist No Contact Closing Letter (fillable) - New
• BHD Client Rights and the Grievance Procedure - New
  • BHD Client Rights and the Grievance Procedure - New (Spanish)
• BHD Provider Staff Add/Drop Form - Updated 10/2018
• CARS Client Change/Update Form 
• CARS Comprehensive Assessment (Downtime Form)
• CARS Eligibility Decision Appeal 
• CARS Referral Form
• CARS Services Information Packet
• Combined PPS & NOMS Downtime Form
• Data Collection — Brief Psychiatric Rating Scale (BPRS)
• Data Collection — Role Functioning Scale (RFS)
• Harm Reduction — Heat
• Harm Reduction — Winter Weather

• Medical Record Login and Request Agreement - New
• Progress Note (fillable — .docx)
• Privacy Practices
• Residential Client Verification Checklist — New
  • Residential Client Verification Checklist (Fillable)
• RSC/CM Discretionary Funds - New 3/2018

• SAM Funds Loan Program Policy and Procedure
  • Loan Request Form
  • Repayment Agreement

• STR and MAT Checklist — New
  • STR and MAT Checklist (Fillable)
• Computer Agreement Form

Service Authorization Request (SAR) Forms & ASAMs

• ASAM Placement Summary with MH/AODA Functioning (.docx) 
• Service Authorization Request Justification Form (.docx) 

• Service Authorization Request Justification Training (.pptx)

• 2015 MKE ASAM PowerPoint  

Satisfaction Survey

• TANF Satisfaction Survey

WIser Choice Provider Information

• 2019 CARS AODA Provider Directory
• WCFF Network Requirements (rev. 4/5/13)

Other News & Resources

• 2018-19 Fee For Service Agreement for BHD Contractors Presentation, October 27, 2017
• Addiction Policy Forum
• Addiction Resource Center
• Client Rights and the Grievance Procedure for Community Services
• Client Rights and the Grievance Procedure for Community Services (Spanish)
• Comprehensive Assessment Companion Guide (.docx)
• Crisis Services Brochure
• Drug Rehab Advice Center
• WIser Choice Brochure (Spanish)
• MCTS "Go Pass" Information / Application
  • Milwaukee County residents with documentation of certain disabilities may qualify for a free transit pass.
• MHOP Brochure (.pdf) or (.doc)
• Naloxone Training
• Peer Pipeline (via MHA) — Resources for peer support providers
• Pregnant Women & Substance Abuse #1 (Hmong / Spanish)
• Pregnant Women & Substance Abuse #2 (Hmong / Spanish)
• Pregnant Women & Alcohol Abuse (Hmong / Spanish)
• Start Your Recovery: Relatable, Reliable Information 
• Wisconsin Society of Addiction Medicine

2020 CARS NIATx Collaborative Meetings

3/23/2020: Until further notice, all NIATx Collaborative Meetings are postponed. The plan is to regroup when we have more information regarding our current state with COVID-19.

• January 15
• February 19
• March 18
• April 15
• May 20
• June 17
• July 15
• August 19
• September 16
• October 21

All CARS NIATx Collaborative Meetings are held on the third Wednesday of the month, from 9 to 10 a.m. at BHD CARS, 44B Training Room.

2020 All-Provider Meetings

• Thursday, Feb. 13
• Thursday, May 14
• Thursday, Aug. 13
• Thursday, Nov. 12

All Provider Meetings are held from 9 to 11 a.m. in Room 104 at the Coggs Human Services Center, 1220 W. Vliet Street.

Save the Date

12th Annual Walk for Recovery

Saturday, Sept. 19, 2020

Learn More

CARS Policies and Procedures

• CARS Administrative Discharge Policy
• CARS Billing Policy
• CARS Bridge Housing/OUD Discharge Policy
• CARS Children in AODA Residential Treatment Placements Policy
  • Addendum: Children in AODA Residential Treatment 
• CARS Community Provider Transfer Policy for same level of care
• CARS Complaint & Grievance Resolution
• CARS Consumer Participation Reimbursment
• CARS Crisis Care Management
• CARS Crisis Care Management: Authorization, Service Delivery, Documentation and Reporting
• CARS Crisis Care Management Billing Policy
• CARS Death Reporting Process
• CARS Documentation
• CARS Eligibility, Enrollment, and Coordination of Benefits 
• CARS Family Care Referral
• CARS Fraudulent Activity
• CARS Heat Advisory Policy and Procedure
• CARS Housing Guidelines for Case Management Providers
• CARS Inpatient/Outpatient Collaboration
• CARS Internal Death Reporting Procedures
• CARS Management Information System Progress Notes/Documentation for Mental Health CBRF/Group Home Providers

• Interim Substance Abuse Services
• IPS Assessment
• IPS Confidentiality and Disclosure
• IPS Eligibility, Education and Outreach
• IPS Follow Along Supports
• IPS Job Development
• IPS Quality Improvement Coordinating Committees
• IPS Referral Process
• IPS Team Integration and Collaboration
• IPS Team Staffing, Roles and Responsibilities
• IPS Work Incentives Planning and Assistance
• RSC/CM Bus Pass and Ticket Policy

• RSC/CM Case Notes/Documentation Policy
• RSC/CM Coordination of Clinical Ancillary Services
• RSC/CM Individual Recovery Plan
• RSC/CM Services
• RSC Single Coordinated Care Plan
• RSC/CM Team Supervisor Responsibilities
• TCM/CSP/Day Treatment/Mental Health CBRF Eligibility Determination
• WCFF Network Requirements

Department of Health and Human Services (DHHS) — NEW

• Caregiver Background Check Policy
• Emergency Management Plan Policy
• Payor of Last Resort Policy
• Whistleblower Policy

Resources for CCS Providers

• CCS Brochure

• CCS Informational Video

• Fiscal Technical Assistance — 10/19 Contractor Forum

CCS Training Videos

• Click here for the link to the CCS training videos
  • Please note - Module 6 has been retired.  Agencies need to train staff individually on the RPOC

The following are the Power Points that accompany the videos:

• Module 01 - What is CCS? for Providers (pptx)
• Module 02 - Positions, Roles, & Responsibilities (pptx)
• Module 03 - Service Array (pptx)
• Module 07 - Recovery Team (ppt)
• Module 08 - Clinical Documentation (pptx)     

Additional CCS training materials from DHS:

Training Materials from DHS

Behavioral Health Webinar Series

SAMHSA Evidence-Based Practices Kits

​Wisconsin Public Psychiatry Network Teleconference Series

Provider Directories:

• • CCS Adult Provider Directory
  • CCS Youth Provider Directory

• Forms
  • BHD Consent 2018 (CRA)
  • CCS Functional Screen ROI

ForwardHealth Update: Changes to CCS as a Result of the Wisconsin 2013-15 Biennial Budget

ForwardHealth Update: New and Clarified Coverage Policy for Psychosocial Rehabilitation Programs. May 2018

CCS Policies & Procedures

• CCS Advocacy
• CCS Application and Screening Process
• CCS Assessment 
• CCS Communication of Information to Consumers 
• CCS Cosnumer Records and Confidentiality
• CCS Consumer Rights
• CCS Cultural Heritage & Primary Language
• CCS Discharge Planning and Facilitation
• CCS Exchange of Information
• CCS Monitoring and Compliance
• CCS Monitoring and Documentation
• CCS Orientation and Training
• CCS Outreach Services
• CCS Quality Improvement
• CCS Receiving and Making Referrals
• CCS Recovery Advisory Committee
• CCS Recovery Team Development and Facilitation
• CCS Revising Plan
• CCS Service Coordination, Referrals, and Collaboration
• CCS Service Planning
• CCS Support and Mentoring for Consumer
• CCS Systematic Interface and Enhancement
• CCS Transition for Youth and Adults

CARS Policies & Procedures Required by CCS

• CARS Administrative Discharge Policy
• CARS Billing Policy
• CARS Caregiver Misconduct: Reporting and Investigation of Caregiver Misconduct and Injuries of Unknown Sources
• CARS Community Provider Transfer Policy for same level of care
• CARS Complaint & Grievance Resolution
• CARS Death Reporting Process
• CARS Documentation
• CARS Family Care Referral
• CARS Heat Advisory Policy and Procedure
• CARS Housing Guidelines for Case Management Providers
• CARS Inpatient/Outpatient Collaboration
• CARS Missed Appointment and Inability to Reach Client 
• CARS Provider Transfers 
• CARS Service Authorization Policy
• CARS Winter Weather Policy
• Nursing/Med Staff - Fall Prevention Policy

CCS Recovery Advisory Committee (RAC)

RAC Flyer

• RAC Meeting Minutes - 1/11/2018
• RAC Meeting Minutes - 3/8/2018
• RAC Meeting Minutes - 5/10/2018
• RAC Meeting Minutes - 7/12/2018
• RAC Meeting Minutes - 9/13/2018
• RAC Meeting Minutes - 11/8/2018
• RAC Meeting Minutes - 01/10/2019
• RAC Meeting Minutes - 03/14/2019
• RAC Meeting Minutes - 05/09/2019
• RAC Meeting Minutes - 07/11/2019
• RAC Meeting Minutes - 11/14/2019
• RAC Meeting Minutes - 01/09/2020
• The March RAC meeting was cancelled due to COVID-19 Pandemic
• RAC Meeting Minutes - 05/14/2020

• Volume 1 Issue 1
• Volume 1 Issue 2
• Volume 1 Issue 3

• Acronyms, Abbreviations & Symbols
• Add Request Form
• Application on to Add New Service(s) – Existing Providers Only
• Audit Waiver Form
• Bed Hold Memo
• Care Coordinator of the Month
• Consulting Psychologist Form
• Critical Incident Report Form
• Family Support Signature Log
• Fee-for-Service Agreement – 2015 Reference Copy
• Fee-for-Service Agreement -2014 Reference Copy
• Housing Assistance Progress Report Log
• In Home Therapy Daily Billing Grid
• In-Home Signature Log (Att6)
• In-Home Progress Note (Att5)
• FISS In-Home Therapy Log (Att7)
• Independent Contractor Agreement (Attach a copy of the signed agreement to the Add Provider Form)
• Invoice – Agency
• Invoice – Foster Parents/Kinship
• Mentor Log

• Parent Assistant Report Log (Single Contact)
• Parent Assistant Report Log (Multiple Contacts)
• Plan of Care Distribution Memo
• Provider Expertise-Interest Declaration Form (In Process)
•   (Used to identify or update provider areas of expertise, interests & language proficiencies)
• Provider Note Entry for non-Crisis services
• Referral for Services Form
• (Used by Care Coordinators for referrals for recipients other than an enrolled youth)
• Resource Guide – Multi-Location Form
• Service Description List (Includes Rates)
• Service Description List (Grouping Levels)
• Synthesis ID Request Form
• Synthesis Password Reset Instructions
• Training Verification Form (15 Hour) – for  Mentoring, Parent Assistance, Tutoring
• Training Session – 2014 Agreement Renewal – Powerpoint Slides
• Transportation Consent
• Universal Application
• Updating Resource Guide Information on Synthesis
• Uploading Documents to the File Store Tab
• Uploading to Staff Tab-directions for submitting staff add requests

• Acronyms, Abbreviations & Symbols
• DRC Collaborative Form
• DRC Referral Form
• Adult Disability Referral
• Adult Disability Services Form – Supplemental
• Authorization to Release/Exchange Information
• Bed Hold Memo
• CANS Manual
• CANS Scoresheet
• Care Coordinator Add Request Form
• Care Coordinator of the Month
• Coach/Consultant Request Protocol
• Complaint/Suggestion Form (English) (Spanish)
• Consent for Education Meetings Form
• Consent to Release
• Consent for Treatment
• Crime Victim – Wisconsin (Compensation Application)
• Crisis Stabilization Informational Brochure
• Disenrollment Confirmation Form
• Disenrollment Confirmation Form – Spanish
• Disenrollment Progress Report
• Disenrollment Progress Report – Spanish
• Disenrollment Progress Report: O-YEAH
• Domain Review Checklist
• Enrollment Request Form
• Foster/Kinship Care – Initial SAR
• Guide to Writing a Disenrollment Plan of Care
• Medication Informed Consent
• MPS Special Education Referral
• One-on-One Staffing Request process
• The Needs Guide by Pat Miles
• Passport to POC Facilitation
• Plan of Care Coaching Tool
• POC Rubric – Audit Tool
• POC – Spanish [data entry format]
• Positive Recognition Form
• REACH Court Process Protocol
• Resources for Wraparound

• SAIL Referral Form
• SAIL Brochure/Referral Instructions
• SAR (Service Authorization Request) – for SAR’s over 90 days old
• School Letter – Introduction
• School-MPSWorksheet
• SMV Form (Specialized Motor Vehicle)
• SMV Form Instructions
• Special Ed Referral Letter
• Synthesis ID Request Form
• Team Attendance/Signature Sheet
• Team Facilitator Review Form
• Team Meeting Tasks and Commitments
• Team Support Provider Progress Report
• Teen Parenting Protocol
• Terminology – Family Glossary
• Transition Summary Worksheet

Tools for Youth Missing from Care

• WI Child Sex Trafficking Indicator and Response Guide
• "What You Should Know About Me" Form
• Writers Guide for Developing Crisis Plans
• Checklist for Youth who are Missing/History of Runaway Behaviors
• Checklist for Youth Who Return after being On the Run or Missing
• Information Needed for Youth with a Runaway History
• Ten Questions to Ask Myself Before I Run Away
• What should I do when my child goes missing or runs away?
• What should I do when my child comes back from being missing or on the run?
• Essential Components of Crisis Planning – Youth Missing from Care

Website Links

• Center for Missing and Exploited Children
• National Runaway Safeline
• Wisconsin Clearinghouse for Missing and Exploited Children and Adults

• Care Coordinator of the Month Nomination Form
• Complaint/Suggestion Form     
• Complaint/Suggestion Form (Spanish)
• Family Handbook
• Financial Fact Sheet
• Positive Recognition Form
• Resource Guide Instructions

• Terms & Phrases: Wraparound and REACH
• Terms & Phrases: O-YEAH
• The Needs Guide – A Resource for Families and Team Members
• Wraparound Milwaukee Privacy Practices          
• Wraparound Milwaukee Privacy Practices Spanish

Wraparound Provider Forum

• Monday, November 12, 2018
• 1 p.m. - 2:30 p.m.
• Held at SaintA
• 3939 N. 88th St., Milwaukee
• Capitol Academy Entrance 

2018 Newsletters

• August
• July
• June
• May
• April
• March
• February
• January

Family Intervention Support & Services (FISS) Policies

• FISS #01: Receipt of Referral to the FISS Case Manager
• FISS #02: Required Contact for FISS Case Managers
• FISS #03: FISS Assessment Outcome and Recommendations
• FISS #04: FISS Reassessments
• FISS #05: Determining JIPS versus CHIPS Referrals
• FISS #06: Reporting Suspected Abuse/Neglect
• FISS #07: Case Record Documentation
• FISS #08: Services Re-assessment and Service Plan Modification
• FISS #09: Service Hours/Discretionary Funds
• FISS #10: Ongoing Case Management: Activities- Required Contact with Families and Service Providers
• FISS #11: Case Closure

In-services are held the 1^st Wednesday of the month from 10 a.m. to 12 p.m.

• January 3: Wraparound Administration Panel @ Washington Senior Center
• February 7: Transition Planning – Wrap sups and leads @ Wraparound Admin Building
• March 7: Medication Management @ Sojourner Family Peace Center
• April 4: Supports Across the Lifespan: CCS, Children’s Services, Adult Services @ SaintA
• May 2: Criminogenic Risk, Needs& Response @ Sojourner Family Peace Center
• June 6: Engaging Fathers @ Sojourner Family Peace Center
• July 4: No In-service
• August 1: Special Education: Laws and Advocacy @ SaintA
• September 5: Restorative Justice @ SaintA
• October 3: Suicide Awareness @ SaintA
• November 7: TBD @ SaintA
• December 5: No In-Service

Location Information:

SaintA: 8901 W. Capitol Drive, Milwaukee, WI 53222
(Enter through the side of the building to access the Franciscan Center.  Park north of the yellow chain as close to the building as possible down the entire length of the lot to leave the south side of the lot open for the Capitol West students (near the basketball courts))

Sojourner Family Peace Center: 619 W. Walnut, Milwaukee, WI 53212
(You must wear a name tag while in the building for security purposes.)

Contact Julie Miles at 414-257-6532 with any questions.