There are seven action types that indicate the need for an exit document:

The county/tribal nation must enter an exit screening document into MMIS within 90 days of the action date. If they do not, an exception code appears.

Enter a DD screening document to note that a person relocated to out of state. Do this when a person moves out of Minnesota and is no longer eligible for services or public assistance through the state of Minnesota.

Follow these steps:

1. Enter assessment result 05, 14 or 16 in field 47a.

2. Enter exit reason 07 in field 47b (leave field blank if the person was not on the waiver).

3. Sign the paper copy of the DD screening document.

4. Enter the document into MMIS.

5. Send a notice of action (DHS-2828A) to the person and their legal representative (if any).

Enter a DD screening document to note the death of a person. The action date of this DD screening document is the date the person dies.

Follow these steps:

1. Enter assessment result 05, 14 or 16 in field 47a.

2. Enter exit reason 08 in field 47b (leave field blank if the person was not on the waiver).

3. Sign the paper copy of the DD screening document.

4. Enter the document into MMIS.

5. Send a Notice of Action, DHS-2828A (PDF) to the person’s legal representative (if any).

Enter a DD screening document to note that a person is no longer financially eligible for services or public assistance. Do this when a person has financial resources that exceed the amount to qualify for publicly funded programs.

Follow these steps:

1. Enter assessment result 05 ,14 or 16 in field 47a.

2. Enter exit reason 09 in field 47b (leave field blank if the person was not on the waiver).

3. Sign the paper copy of the DD screening document.

4. Enter the document into MMIS.

5. Send a Notice of Action, DHS-2828A (PDF) to the person and their legal representative (if any).

Enter a DD screening document to note some other reason for the person exiting the county/tribal nation caseload (e.g., transition to an ICF/DD). Describe the situation and reason for the exit in the notes section of the paper DD screening document and the comment screen in the MMIS document.

Follow these steps:

1. Enter assessment result 05, 14 or 16 in field 47a.

2. Enter exit reason 10 in field 47b (leave field blank if the person was not on the waiver).

3. Sign the paper copy of the DD screening document.

4. Enter the document into MMIS.

5. Send a Notice of Action, DHS-2828A (PDF) to the person and their legal representative (if any).

Enter a DD screening document to note when a person will remain in the community without services. The action date of this DD screening document is the date the person exits the waiver.

Follow these steps:

1. Enter assessment result 05, 14 or 16 in field 47a.

2. Enter exit reason 12 in field 47b (leave field blank if the person was not on the waiver).

3. Sign the paper copy of the DD screening document.

4. Enter the document into MMIS.

5. Send a Notice of Action, DHS-2828A (PDF) to the person and their legal representative (if any).

Enter a DD screening document to note when the person will remain in the community with services. The action date of this DD screening document is the date the person exits the waiver.

Follow these steps:

1. Enter assessment result 05, 14 or 16 in field 47a.

2. Enter exit reason 14 in field 47b (leave field blank if the person was not on a waiver).

3. Sign the paper copy of the DD screening document.

4. Enter the document into MMIS.

5. Send a Notice of Action, DHS-2828A (PDF) to the person and their legal representative (if any).

Enter a DD screening document to note when a person will experience a facility stay. The action date of this DD screening document is the date the person exits the waiver.

Follow these steps:

1. Enter assessment result 05, 14 or 16 in field 47a.

2. Enter exit reason 16 in field 47b (leave field blank if the person was not on the waiver).

3. Sign the paper copy of the DD screening document.

4. Enter the document into MMIS.

5. Send a Notice of Action, DHS-2828A (PDF) to the person and their legal representative (if any).

For information about this situation, refer to CBSM – How to transfer resources in the WMS for CFR changes – BI, CAC, CADI and DD.

If necessary because of MMIS edits, DHS will review the DD screening document and either approve it or return it to the county/tribal nation for changes.