Treatment Planning in Avatar - SF, DPH · Treatment Planning in Avatar: CYF Substance Abuse Clients...

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N. Israel, PhD, SFDPH OQM for CYF-SOC v1 01/10/2012

Treatment Planning in Avatar:

CYF Substance Abuse Clients

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Table of Contents

Page

Purpose 3

1. Opening the Treatment Plan 5

2. Completing the Face Page 8

3. Entering and Filing Objectives 11

4. Entering and Filing Interventions for an Objective 16

5. Entering the Next Objective(s) 17

6. Notification 21

7. Previewing the Treatment Plan 22

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Table of Contents (cont).

9. Editing the Plan 27

10. Submitting your Treatment Plan 31

11. Printing your Treatment Plan 32

12. Additional Help 34

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Purpose

The purpose of this manual is to walk you step-by-step through each of the screens

and mouse-clicks necessary to record a Substance Abuse Treatment Plan in the Ava-

tar Electronic Health Record system. It is meant as a beginning tool; over time you

may learn features and tips that allow you to enter this information even more

quickly. That‘s fantastic. Please share those with all of us (e-mail me at my address

below and I‘ll be happy to send out your tip and those of others). In the meantime,

here‘s a manual to get you on your way.

Best,

Nathaniel Israel

[email protected]

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1. Begin by logging in to the Avatar

record system.

2. Click on ‗Select Client.‘

1. Opening the Treatment Plan

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1. Type in the name of your client. If there

are multiple persons with a similar name,

choices will appear in a menu below. Click

on the appropriate client, and click ‗OK.‘


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1. Follow this menu path to the

Treatment Plan.

2. Because this is a new Treatment Plan,

simply click ―Add.‖ If this were an Edit

of an existing Treatment Plan, we would

select it and then click ―Edit.‖

TIME-SAVER TIP: If your client is already open in

―My Session‖ you can access Forms and Reports

by right-clicking on the client‘s name.


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1. Enter the date the Plan was initiated.

2. Enter the Plan name. Use a convention

which will allow you to instantly identify which

Assessment (Initial, first Reassessment, second

Reassessment, etc) the Plan refers to.

3. Choose the Plan type, based

on which Assessment it refers

to.

4. Indicate the next review date; this will send

you an alert seven days before the date you indi-

cate. You can either type the date in directly, or

you can type in ‗t+90‘ and hit ‗Enter.‘ This will

automatically calculate the date ninety days from

today and enter that in the Next Review Date Box.

Here‘s the first screen on the Treatment Plan. There

are five required fields (in red).

2. Completing the Face Page

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1. Since we‘re just starting the Plan, click

on ‗Draft.‘

2. For charting purposes, indicate the

date and times you‘ve worked on this

Treatment Plan. Add the date and time

spent every time you work on the

Treatment Plan. This helps justify your

time for billing, and reduces audit risk.

3. For this and every other tab on the

Treatment Plan, click ‗File‘ when you are

done. Then click ‗OK.‘


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1. Avatar will ask you if you want to default a previous Treat-

ment Plan forward. For Treatment Plans based on the CANS

Reassessment, you can default the previous plan forward and

then change the Problems, Goals, Objectives and Interventions

which need to be changed. Since this is our Initial Treatment

Plan, we will click ‗No.‘

2. This alert lets us know that the Treatment Plan face

page has been filed. Now we‘ll move to the task of fill-

ing in the Treatment Plan.


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1. Once you‘ve filed the page, click on the ―Objectives

and Interventions‖ Tab. When you do this, you may

get this warning. This warning is a glitch which has

been reported to NetSmart, but which has yet to be

fixed. As long as you have already filed the first page,

ignore it by clicking on ‗No.‘

You can either write in the Objective from scratch, or use the

Library to help you write the Objective. Objectives must ad-

dress a substance abuse problem, or impairment associated

with a substance abuse problem. In this example, we‘ll use

the Library to help us.

2. Start by clicking on the ‗Library‘ drop-down

menu. Select ‗CYF 5-18 TPOC Objectives.‘

3. Entering and Filing Objectives

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The Treatment Plan Objectives are written for each of

the CANS items in the Behavioral Health Assessment,

which is not currently used by Substance Use Treat-

ment Providers. So ignore all of these items, except

the Substance Use Items. You can find these by

scrolling down in the library to the three items

which start with ‗Substance Use.‘ Then choose the

appropriate Objective.

Here we have chosen the Objective ―Client

will identify triggers to using substances, per

client report‖ by clicking on the box beside

the Objective. All of these Objectives need to

be customized for your particular client; we

will cover editing Objectives later in this

Manual.


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1. Click on the Library Objective which appears

in the blue Objective menu.

When you click on it, it will appear in the text

box below. Edit the Objective to fit your client‘s

individual treatment needs.

2. When you are finished editing the Objective,

click on the Forward arrow at the top of the

screen.


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1. You will see this screen listing the CANS Domains.

2. Click on the Domain ―Presentation—Behavioral /

Emotional Needs.‖ WARNING: DO NOT CLICK ON ANY

OTHER DOMAIN— THE OTHER DOMAINS ARE ONLY

FOR MENTAL HEALTH PROVIDERS WHO HAVE BEEN

TRAINED TO USE THE CANS ASSESSMENT TOOL.


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1. Click on the Item ―Substance Use.‖ WARNING: DO

NOT CLICK ON ANY OTHER ITEM— THE OTHER ITEMS

ARE ONLY FOR MENTAL HEALTH PROVIDERS WHO

HAVE BEEN TRAINED TO USE THE CANS ASSESSMENT

TOOL.

2. Click the forward arrow to go to the next page.

You can skip pages 3 and 4, as they list items which

are associated with domains you will not be using.


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1. You should now be at the Interventions page, page

5. On this page you will describe the interventions

needed to address this specific Objective which you

have listed.

2. Type in the Intervention(s) which will achieve this

objective. This may include several interventions.

3. File the Objective and Intervention(s).

4. Entering and Filing Interventions for an Objective

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1. Once you click on ‘File,‘ this Objective and

its Intervention have been filed.

2. To enter the next Objective, simply click on

the button above the Interventions text box.

5. Entering the Next Objective(s)

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1. Select the empty space beneath the first Objective.

Click on that space, and the text in the Objective box

will clear out. You can now enter your next Objective!

2. Here we have written out our own Objective. Whether

you start with an Objective from the Library or write one

out of your own, be sure that you‘ve stated the specific,

observable behavior which will be addressed, how often it

happens, how often it will happen when treated, and who

will report on the change in the behavior.


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1. Here we repeat the same process: we select

the ‗Presentation—Behavioral and Emotional

Needs‘ Domain, and then we go below to the

‗Substance Use‘ item and click on it.

2. Then we click on the forward Arrows to

go to page 5, to specify the Interventions

for this specific Objective.


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1. Type in the Intervention(s) which will achieve this

objective. This may include several interventions.

2. Now file the Objective and Intervention(s).

3. For each additional Objective, use the same process that we just completed: write out the Objective, file it,

click on the ―Presentation—Behavioral / Emotional Needs‘ Domain, and then on the ―Substance Use‖ item. Then

specify the Intervention(s) for that particular Objective. Do this until you have addressed all Objectives identified

for a Client.


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1. Once all of your Objectives have been filed, you‘ll need

to go to the Notification tab. Unlike other forms in Ava-

tar, unless you designate yourself for notification when

a Treatment Plan comes up for renewal, you will not get

a notification on your to-do list.

2. Click on ‗Staff.‘

3. Enter your name in the ―Select Staff Member‖

box. Then click on ―Process Search‖

4. Choose the appropriate recipient from the list

which appears in the Name / ID Number menu.

5. Under ―Plan Author‖ click ―Yes.‖ It will then

automatically fill in that Notification is required.

Add other staff names as desired. Then click

“File.”

6. Notification

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1. Once you‟re done filling in the Notification tab,

you may want to preview your Treatment Plan be-

fore you file it. There are two ways to preview your

Treatment Plan. One way is to click on the ‗Display

Objectives‘ button on the first page of the ‗Objectives

and Interventions‘ tab. This does just what it says: it

displays all the Objectives you‘ve written for the plan.

7. Previewing the Treatment Plan

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1. And here they are— the Objectives.

2. But this display doesn’t show us the full Treatment

Plan— not the Domains and Items to which the Objectives

are linked, nor the Interventions needed to address the

Objectives. Let‘s find a way to see the whole thing. Start by

clicking ‟Return.‟


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1. Now click on the „CYF Treatment Plan of Care‟ tab.

The second way to preview the Treatment Plan is to click

on ‗Print the Client Plan.‘ This generates a printable re-

port of the plan. We don‘t want to print it yet, we just

want to see it to make sure we have everything we need

on our Treatment Plan.


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1. Here‘s the whole Plan! It says ‗Draft‘ on the front be-

cause we have yet to finalize it. The Plan begins with the

narrative on Caregiver and Youth Input. Then it lists

each Objective, the Domains and Items addressed by the

Objective, and the Interventions to be used to address

the Objective.


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1. Here‘s the second page of the Plan. It has all of the Sig-

nature Lines you‘ll need for the Treatment Plan to pass

audit. Remember that even though we have an electronic

copy of the Plan, a printed, signed copy must reside in

you physical (paper) chart at all times. Otherwise there is

a risk that payment for services will be denied or re-

couped.


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1. Say we preview the Treatment Plan and we find a

mistake — say we need to delete an Objective. How do

we do that? We start by clicking on the ‗Objectives and

Interventions‘ tab.

2. Begin by selecting the Objective to delete. Then

click ‗Delete Objective.‘

3. If you are sure that you want to delete this Objec-

tive, click ‗Yes.‘ This will delete the Objective and

the Interventions that you have written which are

associated with the Objective.

9. Editing the Treatment Plan

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1. Now click ―OK.‖ Your Objective and the Domains,

Items, and Interventions associated with it have now

been deleted.


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1. If you have edits to make to an Objective or its as-

sociated Intervention(s), the change process is very

straightforward. Begin by selecting the Objective to

edit.

2. Once you have selected the objective, you can edit

it in the text box. Here we edit this Objective to

better conform to state billing requirements.


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1. We don‘t need to edit any of these, so we simply

continue on by clicking the forward arrows.

2. When we get to the Interventions page we can

make any needed changes to the Interventions by

editing the text in the Interventions text box.

3. To save our edits in this tab (including our

edits to the Objective), we must click on the

‗File‘ button. This way all of our changes are

saved.


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1. When you have filed all of your Objectives and Interven-

tions, you can send it to your supervisor (if unlicensed or

non-waivered) or submit it directly (if you are licensed /

waivered). To submit, you need to select a choice other

than „Draft‟ (either Final or Pending Approval). If you are

unlicensed / non-waivered, you need to also select the

Team Member to Notify.

2. Then click on ‗File.‘

10. Submitting the Treatment Plan

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1. You can print the Client Treatment Plan at any

point by going to the Client Treatment Plan tab and

clicking on ―Print the Client Plan.‖

2. When you click on it, this dialog box will appear.

Click ‗OK.‘

11. Printing the Treatment Plan

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1. When you click ‗OK,‘ a report (the Treatment

Plan!) will pull up, which you can then print by

clicking on the printer icon.

2. If you don‘t see the report come up,

look at the bar at the bottom of your

screen. It should have a box like this. Click

on this box, and the report will show up

for printing.

11. Printing the Treatment Plan

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Congratulations!

You‟ve completed the Treatment Plan Manual! If you need additional Avatar or CANS help, here are some additional

resources:

Help Type: Avatar Help Desk CANS Questions

Contact Person Rotating Staff Nate Israel

Tel. Number 415. 255. 3788 415. 255. 3428

Email address: [email protected] [email protected]

Help Type: Avatar Account Build Avatar Training

Contact: See next page for detailed info See next page for detailed info

Help Type: Avatar Billing Inquiry Line

Tel. Number 415. 255. 3557

Instructions: Leave a Voicemail message with your Name, Clinic or Program info, Telephone Number and billing

question. Calls are returned within 24 hours.

Help Type: Avatar Documentation

Instructions: You can access Avatar documentation through the SFDPH website at:

http://www.sfdph.org/dph/comupg/oservices/mentalHlth/BHIS/avatarUserDocs.asp

12. Additional Help

https://www.sfdph.org/dph/comupg/oservices/mentalHlth/BHIS/avatarUserDocs.asp

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CBHS Avatar Account Request Instructions and Training Scheduling

(per Nan Dame 10/14/2010)

Clinicians and administrative staff at both San Francisco Civil Service and Contract programs use this process to request a new CBHS

IS account and to select first and second choices for Avatar training dates.

Please go to the DPH public web site to obtain the CBHS Account Form and training schedule at this link:

http://www.sfdph.org/dph/comupg/oservices/mentalHlth/BHIS/avatarUserDocs.asp

Complete page one of the CBHS Account form with training date choices and Supervisor signature. Please try to allow at least two

weeks for training date confirmation.

Fax page 1 to the BHIS Account Coordinator at Avatar fax line: 415.252.3008 or email pdf to [email protected]. Bring page 2

with your original ―wet‖ signature to the training.

For NEW clinical staff only - complete and sign Staff ID Credentialing and Verification form. FAX staff form and supporting docu-

mentation along with page 1 of the account request form.

For clinical staff who already have a staff id number – Fax updated information, license renewals, requests for changes in practitio-

ner category directly to the compliance Office at 415 252-3032.

Confirmation of training dates will be returned via email or phone call. Training seats are not reserved until phone or email confir-

mation is received.

Staff will receive logon and password at the training.

For groups such as incoming interns who may need special combined training and alternate dates, please contact the BHIS Training

Coordinator at 415-255-3951.For users trained at programs, fax all pages and proof of training to BHIS Account Coordinator at 415

252-3008.For all other account or training related questions, please call: Avatar Help at 415-255-3788.

12. Additional Help

https://www.sfdph.org/dph/comupg/oservices/mentalHlth/BHIS/avatarUserDocs.asp

mailto:[email protected]

Treatment Planning in Avatar - SF, DPH · Treatment Planning in Avatar: CYF Substance Abuse Clients...

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