Clinical Forms
Please read the following before downloading any forms.

As of October 1, 2003, all mental health providers serving Genesee County consumers began using a standardized clinical record set.  On October 1, 2009, all primary mental health providers went live in the electronic medical record (EMR), called "CHIP."  We plan for the remainder of the network, including Substance Use Disorder (SUD) providers, to join the system October 1, 2010.  The clinical forms and related handouts and administrative documents you see here are made available for several reasons.  First, paper alternatives need to be accessible in the highly unlikely event CHIP is unavailable for whatever reason.  It is important to understand that the paper versions are approximations of electronic screens within CHIP.  Live CHIP is always presumed to be most current.  Secondly, the forms are made available because other PIHPs, CMHs, behavioral health organizations, and rehabilitation programs may find them useful.  Finally, consumers and stakeholders may wish to review documentation requirements related to the delivery of services funded with state and federal dollars.

The Genesee Health System (GHS) PIHP believes the content of CHIP conforms with expectations laid down by the Federal Centers for Medicare and Medicaid Services (CMS), the state regulatory agency (MDCH), at least one accrediting body (CARF), and most third party insurances including Medicare.  The PIHP further believes that the content, developed with input from the Network, is largely consistent with other accrediting bodies’ expectations.  This standardizes the experience of the consumers and families who receive services from more than one GHS provider, and ideally avoids unnecessary duplication.  This is a primary rationale for a network-wide EMR.

By mandating the uniform record, the PIHP does not imply that “forms” are equal to “care.” Downloading these forms will not automatically ensure high-quality consumer care – although they do provide an outline for comprehensive, person-centered, well organized services.

Regardless of individual opinions about clinical usefulness, care cannot be paid for by state and federal funders, or by commercial insurance companies, unless it is documented according to rules, regulations (CFR), and standards of care.  The content of CHIP (and these paper representations) reflects the PIHP's educated best judgment about how to most efficiently meet legal obligations to these stakeholders.  CHIP is integrated with a set of policies, procedures, practice guidelines, and contractual obligations that apply to the entire GHS Network of providers.

Using the GHS PIHP's uniform record in no way guarantees perfect, or even improved, performance in any audit or review.  Reviewers and auditors are interested in, among other things, what the clinicians enter in the record, which should describe supports, services, and outcomes that meet expectations.  CHIP prompts for items the reviewers and auditors look for, so it certainly makes the process easier all the way around.

As the entity responsible for ensuring that federal monies are spent appropriately (according to medical necessity), the GHS PIHP is primarily concerned with MDCH’s interpretation of CMS-driven federal regulations, along with the Michigan Mental Health Code.  Consequently, there is a strong emphasis on adequate documentation of person/family centered planning and accountability for service delivery and outcomes.  It is important to recognize that elements of person-centered planning are required in the records of persons served with mental health problems and/or developmental disabilities, including those with concurrent substance abuse problems, as long as the services are paid for by the GHS PIHP.  For the most part, the only exception to the person-centered planning rule is the group of substance abuse providers funded through Substance Abuse Coordinating Agency funds.

These forms and handouts are Microsoft Word documents, or in some cases, PDF files, compressed in the Zip format.  Several free unzip applications are available, as is Adobe Acrobat for opening the PDF files.  The “Summary of Due Dates and Time Frames” found in the “Handouts” folder contains specific information about how and when each form is used.  Contract providers will notice a folder of “required” forms and a folder of “optional” forms.  The latter includes additional GHS forms that may be of help but are not required.

These forms (and their CHIP counterparts) are constantly in a state of upgrade, driven primarily by events such as the annual MDCH audit and perpetual changes in the state’s expectations.  Therefore, providers are encouraged to use established venues for communication, such as within CHIP and the OPSC, where notices of updates will appear.  User input is also collected and addressed to the greatest degree possible, especially as CHIP is implemented throughout FY 10. 

As always, please direct your questions and concerns to the Provider Relations Department at (810) 762-5236.