CMBHS Access Request - Texas Health and Human Services
Clinical Management for Behavioral Health Services (CMBHS) Access Request
Employee Information:
Title:
First Name:
Middle Name*:
Last Name:
Date of Birth: (or) Employee /Contract Number:
Office Phone:
Email:
Access Role(s):
(Select one or more roles using the list on the second page as your guide. See page 2 for DSHS role descriptions. Do not leave blank.)
Report Roles:
|Check all that reports this person must access to fulfill their job responsibilities. |
| Client Reports (SA) | CMBHS Curriculum Reports (SA) |
| Dashboard Reports (SA) | Mental Health Reports (MH) |
| Billing Reports (SA) | NorthSTAR Reports (SA and MH) |
| Demographic Reports (SA) | DSHS MH YES Waiver Reports (MH) |
| Management Reports (SA) | YES Waiver Reports (MH) |
| Statewide Inpatient Care Waitlist | |
|I am familiar with the job duties of the individual identified on this form and I hereby approve the indicated access to CMBHS for this |
|individual. |
| |
|I agree to notify the CMBHS Team at teresa.cabral@dshs.state.tx.us and jackie.webster@dshs.state.tx.us if the listed employee/contractor’s job|
|duties change to no longer require access to CMBHS or upon the termination or departure of the listed employee/contractor. |
|(Must be signed by a DSHS/HHSC Manager) |
| | |
|Approved by: |Date: |
DESCRIPTION OF CMBHS SECURITY ROLES FOR DSHS
|ROLE |DESCRIPTION |ACCESS |DEFAULT PAGE |
|Roles |
|DSHS System |An individual designated by DSHo setup security and |Read/Write access to client records, sets up |Change Location |
|Administrator |ongoing maintenance of CMBHS. |organizations and staff on all levels | |
|DSHS Oversight |Quality Management, Contracts Management, Fiscal Auditors,|Read-only access to all organizations, client|Change Location |
| |Regulatory, Client Rights. |records and pages | |
|DSHS User Administrator |An individual designated by the DSHS to assist user with |Read/Write access to staff setup, user id and|Find/New Staff Page|
| |limited security functions such as user ids, passwords and|password maintenance for DSHS Staff. | |
| |adding new staff to the system. | | |
|DSHS Contracts |DSHS Contracts Management Unit Staff |Read-only access to administrative, financial|Change Location |
|Specialist | |and report functions. | |
|DSHS System Support |For CMBHS Help Line employee and others who provider |Read-Write accesses to set-up and other |Change Location |
| |training and technical assistance to users. |support pages; Read-only to client records. | |
|DSHS YES Authorized |Access needed to view and document CE and IPC |Read-Write access to YES Waiver CE and IPC. |Change Location |
|Reviewer |authorization decisions for YES Waiver Clients |Read-access to client records. | |
|DSHS IT Support |Access to needed functions and pages needed to develop and|Read-Write access to set-up, roles, client |Change Location |
| |test the application |and administrative functions | |
|Reports |
|ROLE |DESCRIPTION |ACCESS |
|Client Reports |Allows access to CMBHS Business Objects reports that relate to substance abuse (SA) |Available to DSHS & SA Providers |
| |clients, clinical documentation, and treatment services. | |
|Billing Reports |Gives access to an assortment of reports that relate to DSHS- substance abuse (SA) service|Available to DSHS & SA Providers |
| |billing activities, claims and payments. | |
|Demographic Reports |Allows access to CMBHS Business Objects that relate to general demographics of clients |Available to DSHS & SA Providers |
| |served by a substance abuse (SA) services business entity. | |
|Management Reports |Gives the user access to reports for oversight of employees, quality assurance, and |Available to DSHS & SA Providers |
| |performance data at substance abuse service locations. | |
|MH Reports |Allows access to an assortment of mental health (MH) reports |Available to DSHS & MH Providers |
|NorthSTAR Reports |Gives the user access to NorthSTAR MH and SA reports |Available to DSHS & NorthSTAR |
|DSHS SA Curriculum |Allows DSHS staff access to substance abuse curriculum reports |DSHS Only |
|Reports | | |
|DSHS MH YES Waiver |Gives the user access to YES Waiver DSHS only reports about all YES Waiver clients |DSHS Only |
|Reports | | |
|YES Waiver Reports |Allows YES LMHAs and provider managing agencies access to YES Waiver reports about their |Available to DSHS & YES Waiver |
| |clients only |Providers |
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