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BH-TEDS GUIDE, CMHPSM Updated 9/21/15, 1:38 PM

Contents What is BH-TEDS? .................................................................................................................................................................................................................................... 2 Important things to know about BH-TEDS ............................................................................................................................................................................................. 2 BH-TEDS GRID .......................................................................................................................................................................................................................................... 3 BH-TEDS FOR CMH CONSUMERS ............................................................................................................................................................................................................ 4 CHANGING INTEGRATED TX STATUS: DISCHARGE AND READMIT ................................................................................................................................................ 6 BH-TEDS FOR ASSESSMENT ONLY CONSUMERS .................................................................................................................................................................................... 8 BH-TEDS FOR CRISIS ONLY CONSUMERS ................................................................................................................................................................................................ 9 BH-TEDS FOR STATE INPATIENT CONSUMERS ..................................................................................................................................................................................... 10 BH-TEDS FOR CO-LOCATED CONSUMERS ............................................................................................................................................................................................. 11

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What is BH-TEDS? Before 10/1/15, the state collected demographics on our consumers with the info in the “demographics” tab.  The entire demographics tab was sent to the state with every single service we reported  The state required would run audits if too many of these were left blank Starting 10/1/15, the state is going to collect demographic (and other) info with BH-TEDS submissions  Rather than sending the entire tab with every single service, we only send a record at admission, at least once a year, and at discharge  If just one thing is missing in a TEDS submission, that TEDS submission won’t be accepted by the state

Important things to know about BH-TEDS ORDER. The submissions have to be in this order: Admission, Update, Discharge.   

You can’t submit an update or discharge unless the state has a valid admission for that consumer. DOES NOT COMPUTE. For CMH consumers who are already open on 10/1/15, we send in an ADMISSION at their first annual BPS. Even if they’ve been open for years, we can’t send the update first! The state asks us to fill in all the info with what’s true on the date you fill it out. There is an expectation that there will be a face-to-face, billable service on the same day as the admission, and that each admission will be followed (eventually) by a discharge.

CONSUMER TYPES. There are five types of consumers, and there’s a different BH-TEDS process for each (see grid on next page) 

   

CMH Consumers. These are consumers who are eligible for CMH services. Staff need to submit BH-TEDS admissions and updates during the initial and annual bio/psycho/social assessments. i. Integrated MH/SUD treatment. If the consumer’s substance abuse disorder is being active treated at the CMH, and they have an SUD goal in their IPOS beyond “will attend AA/NA”. ii. NON-Integrated MH/SUD treatment. If a substance abuse disorder isn’t actively treated at the CMH, then the consumer is not receiving integrated treatment. Assessment Only Consumers. These are consumers who come in for intake, but will not go on to receive services. Generally speaking, these consumers will have a BPS disposition or "Not Eligible", "GF wait list", "pending", or "refused service". Staff need to submit both their BH-TEDS admission and discharge on the same day, at intake. Crisis only Consumers. These consumers have one service for a crisis or community hospitalization, but are not (or not yet) eligible for CMH services. Staff need to submit the BH-TEDS admission and discharge on the same day, in the BH-TEDS module. State Inpatient Consumers. These are consumers who are in state psychiatric inpatient facilities. BH-TEDS admission and discharge submissions can be done in the BH-TEDS module. Co-located Consumers. These are the consumers that are seen by our staff a limited number of times at an integrated health facility. BHTEDS admission and discharge submissions can be done in the BH-TEDS module.

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BH-TEDS GRID

BH-TEDS admission DEFINITION

BH-TEDS TREATMENT SETTING

State Mental Health Agency

WHEN

WHERE

BH-TEDS update WHEN

*If opened after 10/1/15, then do at initial intake * If already open or had their initial intake completed by 10/1/15, then do at next annual bio/psycho/social assessment

bio/psycho/social assessment

face to face screening or Initial bio/psycho/social assessment

NA

CMH Consumers

Eligible for CMH services

Assessment only consumers

Consumers who had an FTF screening or intake but they will not go on to receive CMH services.

MH assessment only

When it’s clear at face to face screening or intake that consumer will not receive CMH services.

Crisis only Consumers

Consumers who are not (or not yet) eligible for the CMH, but are admitted to psych inpatient or are treated for crisis

If the location of the service isn't on the list, CMH staff can just pick State Mental Health Agency

first face to face service for the crisis/inpatient stay

Emergency note, Prescreening form, or BHTEDS module

State Inpatient Consumers

Consumers who are in a State mental health facility

State Psychiatric Hospital

first face to face hospital liaison contact

BH-TEDS module

Co-located Consumers

Consumers who are seen only at an integrated clinic

State Mental Health Agency

first encounter with consumer

BH-TEDS module

annual bio/psycho/social assessment or significant change

WHERE

bio/psycho/social assessment

BH-TEDS discharge WHEN

WHERE

discharge

discharge summary

NA

same time as TEDS admission date

Same place as BH-TEDS admission

NA

NA

last face to face service for the crisis inpatient stay

Same place as BH-TEDS admission

NA

NA

hospital discharge

BH-TEDS module

NA

no co-located services for 1 year or last allowable co-located service

BH-TEDS module

NA

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BH-TEDS FOR CMH CONSUMERS BH-TEDS Treatment Setting

State Mental Health Agency

WHEN

WHERE

WHEN

WHERE

*If opened after 10/1/15, then do at initial intake * If already open or had their initial intake completed by 10/1/15, then do at next annual bio/psycho/social assessment

bio/psycho/social assessment

annual bio/psycho/social assessment or significant change

bio/psycho/social assessment

WHEN

discharge

WHERE

discharge summary

These are consumers who are eligible for CMH services. Staff need to submit BH-TEDS admissions and updates during the initial and annual bio/psycho/social assessments, and the discharge can be done in the discharge summary. Every time you do a BPS, whether initial or annual, you will need to submit a BH-TEDS record as outlined here

1. Demographics Tab. Even though the name doesn’t say it, this is part of BH-TEDS. This means the entire tab has to be completed for the BH-TEDS to be accepted.  Integrated Substance use and Mental Health Tx Selecting “yes” implies that the consumer is in an INTEGRATED episode of care. This means that the CMH is actively treating their SUD as well as their MI/DD. Only select yes if the consumer has a substance abuse treatment goal in their IPOS beyond “will attend AA/NA.” See CHANGING INTEGRATED TX STATUS for details.

2. BH-TEDS Tab. This is new to CMH. Like the demographics, the entire BH-TEDS tab has to be completed for the submission to be accepted. Unlike the demographics tab, most things on this form will not prefill.  Start of Service Information This information only applies to BH-TEDS admissions. If you are doing an update or discharge, don’t fill these in.  SUD information The information here is used for before/after comparison. For instance, if there is a substance abuse issue at admission, we will look at the frequency of use for that substance at discharge to see if there was improvement. Don’t forget to reselect the same substances at discharge so we can make this comparison! Also note, these should prefill from whatever is entered in the SUD chart.

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3. Signature tab. Once you’ve filled out the demographics and BH-TEDS tabs in full, this is where you select the event type (admission, update, or discharge) and the treatment setting.  Adding a BH-TEDS record To submit an admission, update, or discharge, click the green plus symbol on the right side of the screen  Event Type Specify whether you are submitting an admission, update, or discharge. REMEMBER – you can’t submit an update or discharge unless there’s already an admission in there. If there are no BH-TEDS submissions listed, then you’re submitting an admission. If there’s already an admission, then you’re submitting an update or discharge.  Type of Treatment Service Setting. The treatment setting tells where the consumer is primary treated at the time of the submission. It’s not obvious, but CMH is “State Mental Health Agency.” Don’t select “Residential Treatment Center” even if they’re at our Specialized Residential Group homes, since the state considers these community based.

When they are ready for discharge from CMH, submit their last BH-TEDS in the discharge summary form.

IMPORTANT NOTES Consumers already open on 10/1/15. Because the state won’t accept an update for anyone who doesn’t already have an admission, there’s a slightly strange process for CMH consumers who are already open on 10/1/15. For these consumers, we send in an ADMISSION at their first annual BPS. Even if they’ve been open for years, we can’t send the update first. The state asks us to fill in all the info with what’s true on the date you fill it out. There is no

need to try to remember what was going on when they were truly first admitted to CMH! Integrated MH/SUD episodes. A CMH consumer is considered to be receiving integrated MH/SUD services if their substance abuse disorder is actively treated at the CMH, and they have an SUD goal (at the time of the BPS) in their IPOS beyond “will attend AA/NA”. The state takes this designation very seriously! In fact, they ask us to define the entire BH-TEDS episode (admission to discharge) by it. In other words,  If at the time of a BPS you find out that the consumer is now receiving integrated treatment (but wasn’t before), then change the designation from non-integrated to integrated and discharge them out of the previous non-integrated episode and start a brand new integrated episode.  The same holds true for the reverse situation. If this designation is changed from integrated to nonintegrated, discharge them out of the previous integrated episode and start a brand new non-integrated episode.  To discharge out of the current episode and open a new one, see the next page.

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CHANGING INTEGRATED TX STATUS: DISCHARGE AND READMIT Integrated Substance use and Mental Health Treatment. Selecting “yes” means the consumer has a substance abuse treatment goal in their IPOS beyond “will attend AA/NA.” If you change the value when doing a BPS (either no to yes or yes to no), be ready; you will need to discharge them out of the current episode of care and start a new one. To do this, follow these steps:

1.

On BH-TEDS tab, the Start of Service Information will end up referring to the start of this new episode. Select Time to Treatment=0 and Referral Source = Individual. Fill in the rest of the tab to reflect the consumer’s status today.

2.

On the signature tab, click the green plus sign to discharge the consumer out of the current non-integrated episode

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Select Event Type=Discharge/Service End, then choose the appropriate treatment service setting. Choose the current episode as the one to discharge (match the ID numbers to be sure - see arrow), and reason = transferring to another pgm/fac.

4.

Click the green plus sign again to admit them to the new integrated episode

5.

Select Event Type=Admission/Service start, then choose the appropriate treatment service setting.

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BH-TEDS FOR ASSESSMENT ONLY CONSUMERS BH-TEDS Treatment Setting

MH assessment only

WHEN

Initial intake

WHERE

bio/psycho/social assessment

WHEN

N/A

WHERE

WHEN

same as BH-TEDS admission date

WHERE

bio/psycho/social assessment

These are consumers who come in for a face to face screening or intake, but will not go on to receive services. Generally speaking, these consumers will have a BPS disposition of "Not Eligible", "GF wait list", "pending", or "refused service". At intake, once it’s determined that they will not be receiving services, you will need to submit both an admission and discharge at the same time. To do this… 1. Once the demographics and BH-TEDS tabs are filled out, go to the signature page and click the green plus sign.

2. Select Event type=Admission/Start Service, and treatment setting = MH Assessment only. Then click the green plus sign to add the discharge.

3. Select Event type=Discharge/ Service End, treatment setting = MH Assessment only , select today’s admission as the one that needs discharge, and Reason for Discharge = Treatment completed

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BH-TEDS FOR CRISIS ONLY CONSUMERS BH-TEDS Treatment Setting If the location of the service isn't on the list, CMH staff can just pick State Mental Health Agency

WHEN

first face to face crisis service

WHERE

WHEN

WHERE

Emergency note, Pre-screening form, or BH-TEDS module

N/A

N/A

WHEN

last face to face crisis service

WHERE

Same place as BHTEDS admission

These consumers are admitted to the community hospital or have service for a crisis but are not (or not yet) eligible for CMH services. Staff need to submit the BH-TEDS admission and discharge at the same time, from an emergency note, hospital pre-screening assessment, or the BH-TEDS module. 1. In the emergency note or pre-screening assessment, go to the demographics tab. Select “Not Collected for this Crisis Service”. Many of the demographics fields will automatically prefill with ‘NA Crisis Only’. Fill out the rest of the info on this tab.

2. Fill out the entire BH-TEDS tab to the best of your ability. 3. Go to the signature page and click the green plus sign to add an admission.

4. Select Event type=Admission/Start Service. Select the appropriate treatment setting; if the right setting is not listed in the dropdown, select State Mental Health Agency. Then click the green plus sign to add the discharge.

5. Choose Event type=Discharge/Service End. Select the same treatment setting as on the admission, the admission that needs a discharge, and Reason for Discharge = Treatment completed.

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BH-TEDS FOR STATE INPATIENT CONSUMERS BH-TEDS Treatment Setting State Psychiatric Hospital

WHEN first hospital liaison contact

WHERE

BH-TEDS module

WHEN

WHERE

N/A

N/A

WHEN at hospital discharge

WHERE

BH-TEDS module

These are consumers who are in state psychiatric inpatient facilities. ADMISSION 1. At (or soon after) the first face-to-face hospital liaison contact, go into the BH-TEDS module. Select Start MH Treatment Episode

2. Under Service Treatment Information, the date/time = the date and time of the first face-to-face hospital liaison encounter with the consumer, treatment setting = State Psychiatric Hospital.

3. As you continue through the form, some fields will automatically prefill with “not applicable.” Fill in everything EXCEPT these “not applicable” fields – you’ll get a confusing error message if you accidentally fill one in. 4. At the end of the form, select Save and Exit.

DISCHARGE 1. At (or soon after) the consumer is discharged from the state facility, go into the BH-TEDS module. Find the State Psychiatric Hospital BH-TEDS episode and click Discharge Episode

2. Under Service Treatment Information, the date/time = the date and time of the hospital discharge.

3. As you continue to update the form, some fields will automatically prefill with “not applicable.” Fill in everything EXCEPT these “not applicable” fields – you’ll get a confusing error message if you accidentally fill one in. 4. At the end of the form, select Save and Exit.

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BH-TEDS FOR CO-LOCATED CONSUMERS BH-TEDS Treatment Setting State Mental Health Agency

WHEN first encounter with consumer

WHERE BH-TEDS module

WHEN N/A

WHERE N/A

WHEN

WHERE

no co-located services for 1 year or last allowable colocated service

BH-TEDS module

These are the consumers that are seen by our staff a limited number of times at an integrated health facility. Staff need to submit their BH-TEDS admission and discharge in the BH-TEDS module. ADMISSION 1. At (or soon after) the first encounter with the consumer, go into the BH-TEDS module. Select Start MH Treatment Episode

2. Before you do anything, select “Not Collected for this Co-Located Service”. Many of the fields will now automatically prefill with ‘NA co-located”.

3. Under Service Treatment Information, the date/time = date of the first face-to-face encounter with the consumer. Select the appropriate treatment setting; if the setting is not listed in the dropdown, select State Mental Health Agency.

4. As you continue through the form, some additional fields will automatically prefill with “not applicable.” Fill in everything EXCEPT these “not applicable” fields – you’ll get a confusing error message if you accidentally fill one in. 5. At the end of the form, select Save and Exit. DISCHARGE 1. When the consumer has received the maximum number of co-located services, or has gone more than 1 year without a co-located service, go to the BH-TEDS module. Find the State Psychiatric Hospital BH-TEDS episode and click Discharge Episode

2. Under Service Treatment Information, the date/time = the date/time of the last encounter with the consumer. 3. Fill in everything EXCEPT these “not applicable” fields – you’ll get a confusing error message if you accidentally fill one in. 4. At the end of the form, select Save and Exit.