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Full Service Partnership Outcomes Forms and Web-Based Data Entry

NOW AVAILABLE: REVISED MENTAL HEALTH SERVICES ACT (MHSA)
FULL SERVICE PARTNERSHIP (FSP) OUTCOMES ASSESSMENT FORMS

The REVISED MHSA FSP Outcomes Assessment forms are now available.
Counties are advised to discontinue use of the 6/2/06 version of the
FSP Outcomes Assessment forms as soon as possible.

MHSA Full Service Partnership Outcomes Assessment forms are to be used
by counties once local MHSA Plans are approved
and MHSA Full Service Partner service delivery begins.

Click here to download the revised FSP outcomes forms.

IMPORTANT INFORMATION REGARDING REVISED FSP OUTCOMES ASSESSMENT FORMS

The NEW revision date for the FSP Outcomes Assessment forms is 5/1/07 (located in the top, right corner of each form). A document entitled, FSP Forms Revisions as of May 1, 2007, provides a detailed outline of these revisions.  Counties/providers must work with DMH and attend trainings/workshops prior to utilizing these forms.

These forms are primarily for use by counties who will be using the DMH Data Collection Reporting System (DCR), but may also be helpful as a visual aid for counties who are planning to collect data locally for XML submission.

Training

Currently, DMH is pilot testing the Enhanced DCR system. It is expected that this system will be in production in June 2007, at which time POQI staff will begin providing Enhanced DCR and Updated Approver Designee training to counties. Information regarding these trainings will be posted on the POQI MHSA Training website in May 2007.

INSTRUCTIONS FOR COUNTIES USING THE PREVIOUS VERSION OF THE FSP OUTCOMES ASSESSMENT FORMS

Counties who have been collecting data using the previous version of the FSP Outcomes Assessment forms (i.e., 6/2/06) are advised to begin using the revised forms as soon as possible since these reflect the latest changes and mirror the layout of the Enhanced DCR. 

Counties Collecting FSP Outcomes Assessment Data –Data Entry Pending for Enhanced DCR Deployment
Counties that have been collecting FSP Outcomes Assessment forms, but have been holding onto completed forms with a version date of 6/2/06 pending roll-out of the Enhanced DCR will be required to convert their data during data-entry into the Enhanced DCR system once it is made available and training has been completed. The rules for conversion are specified in the FSP Outcomes Assessment Forms Conversion Rules document.

Interim DCR Counties
Counties who have been collecting data using the previous version of the FSP Outcomes Assessment forms (i.e., 6/2/06) and have been entering this data into the interim DCR system will be contacted by DMH Information Technology staff to prepare for conversion from the interim to the enhanced DCR .  NOTE:  The Interim DCR will be taken off-line on May 4, 2007, in preparation for this conversion process.

XML Counties
Counties who will be collecting data locally and submitting via XML will be expected to submit files in accordance with the XSD that is posted to the DMH Information Technology Web Services (ITWS) website.  Counties that have been collecting data using the previous version of the FSP Outcomes Assessment forms (i.e., 6/2/06) will need to convert their data to meet these specifications. The FSP Outcomes Assessment Forms Conversion Rules and FSP Forms Revisions as of May 1, 2007 documents may also be helpful for this process.

If you have any questions, please email POQI Support at POQI.Support@dmh.ca.gov.

BACKGROUND & DEVELOPMENT OF THE FSP OUTCOMES ASSESSMENT FORMS

Based on the AB2034 evaluation model, the Performance Measurement Advisory Committee developed initial requirements for measuring individual-level performance outcomes for Full Service Partners (FSPs). For all FSPs identified and served, providers must submit the data captured by these assessment forms. Three types of assessments (i.e., Partnership Assessment Form, Key Event Tracking and Quarterly Assessment) were developed for the age groups specified in the “Mental Health Services Act Community Services and Supports, Three-Year Program and Expenditure Plan Requirements, Fiscal Years 2005-06, 2006-07, 2007-08” document, including children/youth (0-15 years), transition age youth (16-25 years), adults (26-59 years), and older adults (60+ years).

The Partnership Assessment Form (PAF), completed when the partnership is established, captures history and baseline data. The Key Event Tracking (KET) is completed when a change occurs in key areas. The Quarterly Assessment (3M) is completed every three months. The table (below) shows the domains that are collected for each assessment type.

Assessment Types

Partnership Assessment Form (PAF)	Key Event Tracking (KET)	Quarterly Assessment (3M)
Administrative Information	Administrative Information	Administrative Information
Residential (includes hospitalization & incarceration)	Residential (includes hospitalization and incarceration)
Education	Education	Education
Employment	Employment
Sources of Financial Support		Sources of Financial Support
Legal Issues / Designations	Legal Issues / Designations	Legal Issues / Designations
Emergency Intervention	Emergency Intervention
Health Status		Health Status
Substance Abuse		Substance Abuse
ADL / IADL - Older Adults Only		ADL / IADL – Older Adults Only