Description | Reports | Contact

Description

Purchase of Service agency contracts specify the reporting requirements. These requirements are necessary to meet state and federal reporting requirements, as well as, to provide accountability to the Department, elected officials, and the public that funds are being used effectively and efficiently in meeting the needs of consumers.

Reports

Client Reporting

Purchase of Service agencies are required to submit monthly client registration and/or client service participation reports in a format provided by the County.

As a Department of Human Services, DCDHS is required to submit data to the State's Human Services Reporting System (HSRS). The Human Services Reporting Systems (HSRS) is a reporting tool used to collect data on several social service and disability service programs operated by counties and funded by federal, state, and local funds. County agencies use this system to report to the State on the individual clients they are serving, the services they provide, and the funds expended. Much of their state and federal funding is either directly or indirectly determined by what is reported into this system. Millions of dollars of the federal funding used to serve clients is contingent upon this reporting.

The report to be submitted depends on the type of service being provided.

Client Registration Form (600 Form)

The Client Registration Form is used for reporting of client specific demographic information. It is to be completed by the Purchase of Service (POS) agency/program for each client at the time the client is first served. One form is to be submitted for each client to the appropriate Data Entry staff by the fifth working day of the month following the date the client began receiving services.

Monthly Client Services Report

• 610.10 - DD Case Management
• 610.11 - Case Management including Hospitalization Hours
• 610.20 - Case Management for Senior Centers and Household Information
• 610.3 - Standard Case Management

The Monthly Client Services Report collects unit of service and closing reason information on consumers receiving publicly funded services (excluding those receiving alcohol and other drug abuse services which use the AODA Monthly Client Report). Reports for January through November are due on the tenth (10th) of the following month. The December report is due no later than January 5.

AODA Supplemental Form

The AODA Supplemental Form is used to capture required information on persons receiving publicly funded alcohol and other drug abuse services, their characteristics, and their participation in services. Data is collected at the time the consumer is first served by the POS program.

610 Form for AODA Monthly Client Report
610 Form Instruction Manual

The AODA Monthly Client Report collects unit of service information on consumers receiving alcohol and other drug abuse services. Reports for January through November are due on the tenth (10^th) of the following month. The December report is due no later than January 5^th.

Mental Health Supplemental Form

The Mental Health Supplemental Form is used to collect required information on demographic and service data for people served through the public mental health system. Data is to be collected at the beginning of an episode of services. Updates are expected at six-month intervals thereafter for consumers in target groups of H or L.

Expense Reports

Providers are required to submit quarterly expense reports. These are due no later than the 25^th of the month following the end of the quarter. Programs paid under the unit of service reimbursement method are exempt from submitting the expense reports.

Expense Report

Quarterly Reports

Beginning on May 1 of each year, providers are required to file Quarterly Reports with their Contract Manager. Reports shall include:

1. Information on client waiting lists.
2. Quantity of services by Agreement/client category.
3. Progress or problems in achieving Agreement goals and performance outcomes,
4. Progress or problems associated with overall Provider operations,
5. Other information as may reasonably be required by the County,
6. The fourth quarter report is to also include a description of:
   1. Agency and program objectives for that year;
   2. Achievement of or progress toward those objectives;
   3. Problems encountered in meeting the objectives.
7. Reports on services provided in specific geographic areas as identified to the Provider by the County.

Quarterly Transportation Report

The Quarterly Transportation Report is used by POS agencies providing transportation services. This captures aggregated information on the mobility of passengers, number of one-way trips by purpose, and service miles and hours.

Contact

For more information regarding specific reporting requirements, contact the assigned Contract Manager.

For information regarding data entry, contact:

Kim Rymer, Office Supervisor
Dane County Department of Human Services
1202 Northport DR/3rd FL
Madison, WI 53704
(608) 242-6478
rymer@co.dane.wi.us

Last Revised: June 20, 2008