[{"_1":2,"_99":-5,"_100":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,75,87],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":68,"_72":73,"_74":73},"mediaId",6223700,"mediaKeyId","3566743-278d50188b2aa6c6dcd014ca0f1e9458","parentId",3566743,"title","Training details travel, telehealth, crisis and no-show rules for Ashland and Bayfield CCS providers","audioSeconds",1970,"startMs",2696000,"endMs",4666000,"viewUrl","/Search/View?dp=1&key=3566743-278d50188b2aa6c6dcd014ca0f1e9458&start=2696&end=4666","thumbnailUrl","https://assets.pipeline.soar.com/3566743-278d50188b2aa6c6dcd014ca0f1e9458/thumbnail_2696000.jpg","articleUrl","/articles/6223700/Ashland-County/Wisconsin/Training-details-travel-telehealth-crisis-and-no-show-rules-for-Ashland-and-Bayfield-CCS-providers","mediaUrl","https://secure.pipeline.soar.com/6223700-d1f8897dffd4e8159bee479801123129/orig.mp4?Expires=1770649253&Signature=Ou~DNMKgLMMSwOUGGCIPIrKH5EWxF3nVHxI23ZjVfXd-F04jU-~JEt~Prz1zMdC3Gidlte8uJoH2QHRHH4DbXmqxeH4DBB8oIKSFY2ZPmvogZT946cXc-ONGTzbFft6FaecX4Ompfk29o~5z9FPU~LFwvO1KqeR47rk2UsJxrzhpDzBfW9bwt6t8udmNev-~mlMrqnV0bS-T6guiYuSyDAPk8Qbh4Q5TtkK~IopRGyi2OjBIpMCQgP63lGo3217-sJ6xXJVz6jLTaLVgiFB~M2nygSu1GLNK9TeS211mI4LQljwAMmDfei29o8OXJNZsAzLH1cjk99x5oZIPKawnYQ__&Key-Pair-Id=KUT5TJCACFTXG","author","Ashland County, WI","date","2025-05-28T21:56:01Z","article","Julie Winter, quality control and improvement coordinator for the Ashland Bayfield County CCS programs, summarized county policies providers must follow regarding travel, telehealth, crisis response and handling of participant no-shows.

Winter described different travel rules in the two counties: in Bayfield County, providers may ride with a participant in a personal vehicle while providing a billable support, provided the time in-vehicle is related to the authorized service. By contrast, Winter said Ashland County policy prohibits providers from riding with participants in personal vehicles under any circumstance. She recommended providers review the travel policy for additional details, including that travel beyond three hours is not covered.

Telehealth rules: Winter said telehealth must use a HIPAA-compliant connection; common consumer services such as FaceTime and free Zoom do not meet the county’s telehealth standard. Telehealth must be real-time audio or audio-and-video; email, text, or voicemail alone do not qualify as telehealth. Winter noted that participants cannot be required to accept telehealth and providers are not required to offer telehealth if they decline in advance.

Crisis policy and documentation: Winter explained CCS is not a crisis-intervention service; when providers encounter a participant in crisis they must help connect the participant to the appropriate crisis resources and document the activity. She said the county’s crisis policy uses two crisis types—basic-needs crises and safety crises—and that staff should consult the policy and the Columbia Suicide Severity Rating Scale when assessing immediate safety risks. Crisis contacts or team notifications must occur within 24 hours.

No-show and non-bill documentation: Winter advised providers to record non-bill notes for cancellations and no-shows so the service facilitator can track engagement and, if necessary, follow the no-show policy. The county’s typical process described in the training is an intervention after three no-shows or late cancellations; facilitators attempt outreach and determine whether supports continue. Documentation of non-engagement is required before supports are administratively ended.

Ending: Providers working across both counties were urged to learn the county-specific travel rules and to follow the telehealth, crisis and no-show policies closely to ensure compliance and continuity of care.","mediaType","Video","parentTitle","CCS Note & Policy Training for Providers 5 23 25","oneSentenceSummary","The session clarified differences between Ashland and Bayfield travel rules, telehealth requirements, crisis response expectations, and the county no-show policy that governs support continuation.","taxTitle","Ashland County, Wisconsin","taxId",72843,"location","headline","","shortSummary",{"_33":76,"_35":36,"_37":38,"_39":77,"_41":78,"_43":79,"_45":80,"_47":81,"_49":82,"_51":83,"_53":84,"_55":56,"_57":58,"_59":85,"_61":62,"_63":64,"_65":86,"_67":68,"_69":70,"_71":68,"_72":73,"_74":73},6223705,"Training explains CCS progress-note, billing and EHR procedures new providers must follow",5556,1075000,6631000,"/Search/View?dp=1&key=3566743-278d50188b2aa6c6dcd014ca0f1e9458&start=1075&end=6631","https://assets.pipeline.soar.com/3566743-278d50188b2aa6c6dcd014ca0f1e9458/thumbnail_1075000.jpg","/articles/6223705/Ashland-County/Wisconsin/Training-explains-CCS-progress-note-billing-and-EHR-procedures-new-providers-must-follow","https://secure.pipeline.soar.com/6223705-ea176a5b25b39bdbf281192139a2cb54/orig.mp4?Expires=1770649253&Signature=fZwDQT2gfhb7ZtkGChgX~SKWhsiqxSKduchILGC~lnzBUAMGIoKXrzMgGOPsILk6mwEHOcToZJn6QkXa8ma6wbUwrhNZuveSAhwa~a4DnvEtVhT~g6oAuCLJfMD5eA0zFfylu3T5nutMZVurJzsbZ937adzUsmZCsCP2HHqTSCDS08E~F-i~~qNn5J23jVcwmTnpwkxYmRFdGwUlBfAk34q7CorNkpRafaQ~ulwVJgaRxm6gLlBVNpBxNReV8ktO6SZulMHlb-rnzJ14j0jHPXuwmif78Ms~cz6sLPvSR9avYrbXa0~S6HSyJiTiqL97n49ukzOECbIid0VxlvvjSQ__&Key-Pair-Id=KUT5TJCACFTXG","Julie Winter, quality control and improvement coordinator for the Ashland Bayfield County CCS programs, led a training that summarized the documentation, billing and electronic-health-record procedures CCS providers must follow to receive county and Medicaid reimbursement.

Winter said providers must enter clinical progress notes for each instance of delivered support. She explained that Medicaid distinguishes billable time from necessary but non-billable activities and that documentation requirements come directly from ForwardHealth rules and the program’s progress-note rubric. “Providers do have a 15 day timeline,” Winter said, referring to the county requirement to enter billable notes within 15 days of service; in crises, she said staff must notify the team within 24 hours.

What to document: the progress note rubric requires a reason for meeting tied to the authorization, at least two observable data-based observations (not opinions) about the participant or setting, a reaction/response section describing progress made or lost and participant responses, and a plan that includes specifics about the next appointment and participant tasks. Winter stressed the state’s preference for direct quotes from participants when relevant because quotes are high-quality evidence for notes.

Echo EHR workflow and approvals: providers enter notes in the Echo electronic health record. Winter described the county workflow: providers save notes, facilitators and mental health professionals review them, and the facilitator sends an internal Echo message either approving the note for provider signature or requesting edits. A finalized (signed) note becomes part of the medical record and allows county billing staff to submit the service to Medicaid. Winter warned that once a note is signed and billed to Medicaid, it may not be reopenable and errors could trigger repayments if an audit finds non-compliant content.

Billable vs. non-billable and time rounding: Winter described billable categories (face-to-face or functionally equivalent telehealth, travel to appointment when delivering face-to-face services, and documentation time included in direct-service time) and non-billable activities (team coordination without the participant present, reminder calls/texts not tied to authorization, no-shows). She advised providers to capture non-bill notes when cancellations or no-shows occur so the county can document attempts to engage the participant. The training included a detailed explanation of rounding rules: direct-service time equals face-to-face/telehealth time plus documentation time; those totals are rounded to the nearest 15 minutes for Medicaid billing, with the minimal reported unit being 15 minutes.

Audit and correction process: Winter said providers are responsible for errors in finalized notes that lead to Medicaid recoupments; agencies are contractually responsible to repay improper claims. If an error is discovered before billing, the provider should email the service facilitator and program mental health professional to request reopening per the county’s progress-note correction policy; the facilitator will reopen the note if appropriate.

Examples and resources: the training included multiple worked examples of how to compute travel, direct-service and documentation time across in-person, telehealth and stacked-appointment scenarios, and pointed providers to a note-entry-and-monitoring process document, a rubric of required content, and sample notes available on the vendor/provider resources page.

Ending: Winter advised new providers to keep the documentation rubric and timing guidance at hand until they gain facility entering notes and stressed the program’s review steps to reduce audit risk.","The recording set out ForwardHealth and county requirements for progress notes, billable vs non-billable time, EHR workflow in Echo, signature/approval, audits, and time-rounding rules providers must follow to be reimbursed.",{"_33":88,"_35":36,"_37":38,"_39":89,"_41":90,"_43":91,"_45":92,"_47":93,"_49":94,"_51":95,"_53":96,"_55":56,"_57":58,"_59":97,"_61":62,"_63":64,"_65":98,"_67":68,"_69":70,"_71":68,"_72":73,"_74":73},6223709,"How Ashland and Bayfield County CCS programs authorize services and assign providers",895,8000,903000,"/Search/View?dp=1&key=3566743-278d50188b2aa6c6dcd014ca0f1e9458&start=8&end=903","https://assets.pipeline.soar.com/3566743-278d50188b2aa6c6dcd014ca0f1e9458/thumbnail_8000.jpg","/articles/6223709/Ashland-County/Wisconsin/How-Ashland-and-Bayfield-County-CCS-programs-authorize-services-and-assign-providers","https://secure.pipeline.soar.com/6223709-5d52992eb40a70ad66cab1b3ca59b232/orig.mp4?Expires=1770649253&Signature=RyUKHuAyKLXZbJPzEyUsMp3d0Nfh1CO8Fco-skKrlHa-YxKfUyrHN3skf-gtQbboH8tUeUkK7gc~LRjCyJDLF4APysFKJY7Sr2z-tFwwyS433fYMACqIyUw2a3d1qux~k7SqCnhIMbdN8Vq5EptlUq4DrOCp9vriK52-W~cl9RybWfUETiEBeHCPnJO5urcQVyEx8Ia4E4viMWQ2iUxcRhgo04q4gb95RFuXf6GxDhSRe6QBmxdWuSNE~UExASZF3O7DQE~J5FUuk8EAhVWymwtdzRqFIZW-aIYswBob6uUBEfhMvW5vQUqQ16hPcasuSwpglNjtY1oDzeZYWt6SJQ__&Key-Pair-Id=KUT5TJCACFTXG","A recorded training led by Julie Winter, quality control and improvement coordinator for the Ashland Bayfield County Comprehensive Community Services (CCS) programs, walked new and existing providers through how participants enter CCS and how supports are authorized.

Winter said CCS is “person centered,” and described it as a Medicaid-funded rehabilitative program that helps people with mental health and substance-use barriers stay in the community and their homes while they receive supports. She added that “CCS is completely voluntary.”

The training explained the standard authorization process: a service facilitator asks the participant for verbatim goals, identifies barriers that prevent goal achievement, checks for natural supports, and—when appropriate—suggests CCS supports and the providers authorized to deliver them. The facilitator writes those supports into the participant’s service plan; that written service plan is the document that generates the authorization that is emailed to the provider or the provider’s agency. Winter noted that mental health professionals in the program review plans for medical necessity before authorizations are finalized.

Why it matters: authorizations define the exact scope of what a provider may do for a participant. Winter used a redacted example in which a participant’s goal was “to obtain independent housing,” the barrier was “symptoms of depression,” and the authorization specified “side-by-side skill building around public and medical transportation” and “coping skills.” Providers must deliver only what the authorization permits; work outside that scope is not authorized or billable.

The training emphasized natural supports and administrative-code limits. If a participant already receives a needed task from a family member or other natural support (for example, transportation by a relative), CCS policy and state administrative code restrict providing CCS staffing for the same activity. Winter said service facilitators must document whether natural supports are present before adding CCS supports.

Program structure and shared staffing: Winter described the Ashland and Bayfield programs as a shared-services model in a rural area; some staff (including Winter) support both counties. She explained that when an agency receives an authorization, the agency supervisor—not the county—assigns which staff member will fill it. If an agency has no available staff, the authorization may sit open until a vacancy is filled; service facilitators typically offer a side-by-side introduction between participant and new provider.

Key administrative timelines and triggers summarized in the training:
- Service-plan meetings and comprehensive assessment reviews must occur at least every six months (per the administrative code cited in the training).
- Participants must be actively engaged with someone on their team at least every 90 days; failure to meet this engagement requirement can lead to administrative discharge.
- Facilitators read and check notes at least every two business days, Winter said.

Sources and evidence: the training repeatedly referenced Medicaid funding and state administrative code (DHS 36) and described ForwardHealth rules for what Medicaid will and will not reimburse. The session included examples of written service-plan language that providers should read carefully to determine scope of work.

Ending note: The training framed CCS authorizations as participant-driven, medically justified and limited to clearly authorized tasks; providers were advised to confirm authorizations, check for natural supports, and coordinate with service facilitators when availability or scope questions arise.","A recorded training explains how Comprehensive Community Services (CCS) enrolls participants, how service facilitators determine medically necessary supports, and how authorizations tie to participant goals and natural supports.","actionData","errors"]

Article not found

Training details travel, telehealth, crisis and no-show rules for Ashland and Bayfield CCS providers

Training explains CCS progress-note, billing and EHR procedures new providers must follow

How Ashland and Bayfield County CCS programs authorize services and assign providers