Open, reopen or change a program with the long-term care (LTC) screening document

Page posted: 8/3/26

This page includes instructions for the following assessment results:

· Assessment result 01 (open): The first home and community-based services (HCBS) program the person accesses (used only once in MMIS).

· Assessment result 11 (reopen): A program the person accessed previously and is accessing again.

· Assessment result 10 (change program): A different program than what the person accessed previously.

MMIS LTSS Manual – LTC screening document screens includes more detailed information about completing the screening document screens on this page.

Overview of eligibility determinations

The person’s eligibility must be established before you can create service agreements or before DHS can pay the Elderly Waiver (EW) capitation amount to managed care organizations (MCOs). For more information, refer to MMIS LTSS Manual – LTC screening document and HCBS program eligibility spans.

A person’s eligibility for HCBS is based on the following financial eligibility and service eligibility determinations:

· The eligibility worker determines financial eligibility for Medical Assistance (MA)-funded waiver programs and records it in the recipient subsystem.

· The lead agency determines financial eligibility for the Alternative Care (AC) and Essential Community Supports (ECS) programs, records it in the screening document and adds it to the recipient subsystem when they approve and save the screening document.

· The lead agency determines service eligibility through an assessment and records it in the LTC screening document in MMIS.

The lead agency records a person’s eligibility for waiver, AC or ECS in the LTC screening document in three ways:

· Following assessment using activity type 02 or activity type 04.

· Within 60 days after an assessment using administrative activity type 07.

· Within 90 days after an assessment using the eligibility update activity type 09. For detailed instructions about eligibility updates, refer to MMIS LTSS Manual – LTC screening document eligibility updates.

Eligibility at assessment (activity type 02 or 04)

After the lead agency completes the assessment:

1. Type X next to screenings on the main menu, then press the transmit key to open the key panel screen.

2. Use action code I (inquiry) to determine if the person has previously saved LTC screening documents. For detailed instructions, refer to MMIS LTSS Manual – Use inquiry mode with LTC screening documents.

3. Press F3 to return to the key panel screen and take the appropriate action, based on the inquiry:

· No previous LTC documents: Use action code A (add).

· Previously saved LTC screening document(s): Use action code C (change).

4. Complete the rest of the key panel screen using:

· Document type L.

· Person’s person master index (PMI) number.

5. Press the transmit key to open either:

· ALT1 screen of a blank screening document.

· ALT1 screen of a copy of the last approved screening document.

6. Complete the entire ALT1 screen and enter:

· Person’s birthdate.
Note: You must always enter the person’s birthdate, even if you are working from a copy of the last approved screening document.

· Referral date.
Note: You must update this date to reflect the current activity if there is already a referral date from the last approved screening document.

· Activity type 02 (assessed in the community) or activity type 04 (assessed in an institution or residential treatment setting).

· Date of the assessment in the activity type date field.

7. Press the transmit key to move to the ALT2 screen and complete the entire ALT2 screen.

8. Press the transmit key to move the ALT3 screen and complete the entire ALT3 screen.

9. Press the transmit key to move the ALT4 screen and complete the entire ALT4 screen.

10. Use the applicable assessment result on the ALT4 screen:

· 01: No previous HCBS program.

· 10: Changing to a different program than previously used in the past.

· 11: Reopening a program previously used in the past.

11. Use an effective date (i.e., assessment result date) on the ALT4 screen that:

· Reflects the date the person meets all program eligibility criteria (e.g., MA is in effect or nursing facility discharge date).

· Is not before the activity type date of the assessment.

· Is up to 60 days after the activity type date of the assessment.

12. Enter the code for the appropriate program type on the ALT4 screen. For program codes, refer to MMIS LTSS Manual – Assessment results and program types.

13. Press the transmit key to move to the ALT5 screen and complete the service plan summary.

14. Press transmit to move to either:

· Comment screens for Brain Injury (BI), Community Alternative Care (CAC), Community Access for Disability Inclusion (CADI) and EW programs. Enter comments, as applicable.

· ALT6 screen for the AC and ECS programs. Complete the ALT6 screen.

15. Press F9 to display exception codes.

16. Resolve the exception codes.

17. Press F3 to save the document. This step is important. You must save the document even if exception codes remain. MMIS will save the completed data and allow you to return to the document for additional work.

18. Press F3 to return to the LTC screening document key panel.

19. Press F3 to continue to log out of MMIS.

Eligibility after assessment (activity type 07 within 60 days)

You can use activity type 07 to open, reopen or change the person to a new program within 60 days of a previous in-person assessment (activity type 02 or 04). The activity type date of activity type 07 must be within 60 days of the activity type date of the in-person assessment (activity type 02 or 04). It must follow a saved, approved LTC screening document that recorded the in-person assessment.

To use activity type 07 after an assessment:

1. Type X next to screenings on the main menu, then press the transmit key to open the key panel screen.

2. Use:

· Action code C (change).

· Document type L.

· Person’s PMI number.

3. Press the transmit key to open a copy of the last saved, approved document. This document must be an assessment using activity type 02 or 04.

Note: Because you are using a copy of the last screening document, nearly all fields will be populated. The fields you can change will appear as green fields, and protected fields will appear as white.

4. Enter the following information on the ALT1 screen:

· Person’s birthdate in the DOB field.

· Activity type 07 in the ACTIVITY TYPE field.

· Activity type date associated with the case manager activity in the ACT DT field.

· Certified assessor/case manager/care coordinator provider number in the CM/HP/CA NBR field.

5. Update any other information on the ALT1 screen as necessary.

6. Press the transmit key to move to the ALT2 screen. Review and change information, as needed.

7. Press the transmit key to move to the ALT3 screen. Review and change information, as needed.

8. Press the transmit key to move to the ALT4 screen and complete the mandatory fields.

9. Enter the assessment result 01, 10 or 11 on the ALT4 screen.

10. Enter an effective date (i.e., assessment result date) on the ALT4 screen that reflects the date the person meets all program eligibility criteria (e.g., MA is in effect or nursing facility discharge date). The effective date can be either:

· The date of activity type 02 or 04.

· Up to 60 days from that date when all other eligibility criteria are met.

11. Enter the appropriate program type on the ALT4 screen. For program codes, refer to MMIS LTSS Manual – Assessment results and program types.

12. Press the transmit key to move to the ALT5 screen and complete the service plan summary.

13. Press the transmit key to move to the ALT6 screen, which will only appear if the person is on the AC or ECS program, and complete the fields for those program types.

14. Press F9 to display exception codes.

15. Resolve exception codes.

16. Press F3 to save the document. This step is important. You must save the document even if exception codes remain. MMIS will save the completed data and allow you to return to the document for additional work.

17. Press F3 to return to the screening key panel.

18. Press F3 to continue to log out of MMIS.

Changes between AC and EW programs (activity type 07)

You can use activity type 07 at any time when a person needs to change between AC and EW programs.

A person cannot be in more than one HCBS program at a time. To change a person between AC and EW, you must enter two documents using activity type 07:

· An exit document to close AC or EW. For instructions, refer to MMIS LTSS Manual – Close an HCBS program.

· A second document to reopen or change to AC or EW.

Change from AC to EW

A person changes from AC to EW when they become eligible for MA.

First, you must close the AC program:

1. Close the AC service agreement. For instructions, refer to MMIS LTSS Manual – Close a service agreement.

2. Press F3 until you return to the MMIS main menu.

3. Type X next to screenings on the main menu, then press the transmit key to open the key panel screen.

4. Use:

· Action code C (change).

· Document type L.

· Person’s PMI number.

5. Press the transmit key to open a copy of the last saved, approved document.
Note: Because you are using a copy of the last screening document, nearly all fields will be populated. Most fields are protected using activity type 07. The fields you can change will appear as green fields, and protected fields will appear as white.

6. Enter the following information on the ALT1 screen:

· Person’s birthdate in the DOB field.

· Activity type 07 in the ACTIVITY TYPE field.

· Activity type date associated with the case manager activity in the ACT DT field.

· Certified assessor/case manager/care coordinator provider number in the CM/HP/CA NBR field.

7. Press the transmit key to move to the ALT2 screen. Review and change information on the ALT2 screen, as needed and allowed.

8. Press the transmit key to move to the ALT3 screen. Review and change information on the ALT3 screen, as needed and allowed.

9. Press the transmit key to move to the ALT4 screen and complete the mandatory fields. Enter assessment result/exit reason 19.

10. Use the tab key to enter the second code required under the assessment result/exit reason heading. This second code indicates what will happen after the closing of the program. You can enter:

· 10: Change program.

· 11: Reopen (if the person was previously on EW).

11. Enter an effective date (i.e., assessment result date) to close AC. The effective date:

· Cannot be before the end date of the closed AC service agreement.

· Cannot be after the last day of the month that follows the current month.

· Can be retroactive to the MA start date.

12. Press the transmit key two times to move to the ALT6 screen and complete the fields as needed.

13. Press F9 to display exception codes.

14. Resolve exception codes.

15. Press F3 to save the document. This step is important. You must save the document even if exception codes remain. MMIS will save the completed data and allow you to return to the document for additional work.

16. Press F3 to return to the screening key panel.

If the AC exit document was approved and saved in MMIS, you can follow the instructions to open or reopen the EW program.

To open or reopen the EW program:

1. Ensure the AC exit document is approved and saved in MMIS, then return to the screening document key panel screen.

2. Use:

· Action code C (change).

· Document type L.

· Person’s PMI number.

3. Press the transmit key to open a copy of the last saved, approved document.
Note: Because you are using a copy of the last screening document, nearly all fields will be populated. Most fields are protected using activity type 07. The fields you can change will appear as green fields, and protected fields will appear as white.

4. Enter the following information on the ALT1 screen:

· Person’s birthdate in the DOB field.

· Activity type 07 in the ACTIVITY TYPE field.

· Activity type date associated with the case manager activity in the ACT DT field.

· Certified assessor/case manager/care coordinator provider number in the CM/HP/CA NBR field.

5. Press the transmit key to move to the ALT2 screen. Review and change information on the ALT2 screen, as needed and allowed.

6. Press the transmit key to move to the ALT3 screen. Review and change information on the ALT3 screen, as needed and allowed.

7. Press the transmit key to move to the ALT4 screen and complete the mandatory fields. Enter the appropriate assessment result:

· 10: Change program.

· 11: Reopen (if the person was previously on EW).

Note: This should match the value on the screening document used to close the AC program.

8. Enter an effective date (i.e., assessment result date) to open EW. The effective date:

· Cannot be before the effective date of the AC exit.

· Cannot be after the last day of the month that follows the current month.

· Can be retroactive to the MA start date.

9. Update the CDCS field on the ALT4 screen, as applicable (Y to N or N to Y).

10. Change the program type to EW conversion or diversion.

11. Press F9 to display exception codes.

12. Resolve exception codes.

13. Press F3 to save the document. This step is important. You must save the document even if exception codes remain. MMIS will save the completed data and allow you to return to the document for additional work. If the document is approved when you save it, it will create a 12-month eligibility span for EW.

14. Press F3 to return to the screening key panel.

15. Press F3 to continue to log out of MMIS.

Change from EW to AC

A person changes from EW to AC because they have become ineligible for MA but are financially eligible for AC.

First, you must close the EW program:

1. Close the EW service agreement with an end date that is the last date of MA eligibility. For instructions, refer to MMIS LTSS Manual – Close a service agreement.

2. Type X next to screenings on the main menu, then press the transmit key to open the key panel screen.

3. Use:

· Action code C (change).

· Document type L.

· Person’s PMI number.

4. Press the transmit key to open a copy of the last saved, approved document.
Note: Because you are using a copy of the last screening document, nearly all fields will be populated. Most fields are protected using activity type 07. The fields you can change will appear as green fields, and protected fields will appear as white.

5. Enter the following information on the ALT1 screen:

· Person’s birthdate in the DOB field.

· Activity type 07 in the ACTIVITY TYPE field.

· Activity type date associated with the case manager activity in the ACT DT field.

· Certified assessor/case manager/care coordinator provider number in the CM/HP/CA NBR field.

6. Press the transmit key to move to the ALT2 screen. Review and change information on the ALT2 screen, as needed and allowed.

7. Press the transmit key to move to the ALT3 screen. Review and change information on the ALT3 screen, as needed and allowed.

8. Press the transmit key to move to the ALT4 screen and complete the mandatory fields. Enter assessment result 17.

9. Use the tab key to enter the second code required under the assessment result/exit reason heading. This second code indicates what will happen after the closing of the program. You can enter:

· 10: Change program.

· 11: Reopen (if the person was previously on AC).

10. Enter an effective date to close EW. The effective date:

· Cannot be before the end date of the closed EW service agreement.

· Cannot be greater than the end of the month following the current month.

· Can be retroactive to the MA end date.

11. Do not change the program type.

12. Press F9 to display exception codes.

13. Resolve exception codes.

14. Press F3 to save the document. This step is important. You must save the document even if exception codes remain. MMIS will save the completed data and allow you to return to the document for additional work.

15. Press F3 to return to the screening key panel.

If the EW exit document was approved and saved in MMIS, you can follow the instructions to open or reopen the AC program.

To open or reopen the AC program:

1. Ensure the EW exit document is approved and saved, then return to the screening document key panel screen.

2. Use:

· Action code C (change).

· Document type L.

· Person’s PMI number.

3. Press the transmit key to open a copy of the last saved, approved document.
Note: Because you are using a copy of the last screening document, nearly all fields will be populated. Most fields are protected using activity type 07. The fields you can change will appear as green fields, and protected fields will appear as white.

4. Enter the following information on the ALT1 screen:

· Person’s birthdate in the DOB field.

· Activity type 07 in the ACTIVITY TYPE field.

· Activity type date associated with the case manager activity in the ACT DT field.

· Certified assessor/case manager/care coordinator provider number in the CM/HP/CA NBR field.

5. Press the transmit key to move to the ALT2 screen. Review and change information on the ALT2 screen, as needed and allowed.

6. Press the transmit key to move to the ALT3 screen. Review and change information on the ALT3 screen, as needed and allowed.

7. Press the transmit key to move to the ALT4 screen and complete the mandatory fields. Enter the appropriate assessment result:

· 10: Change program.

· 11: Reopen (if the person was previously on AC).

8. Enter an effective date to open AC. The effective date:

· Cannot be before the effective date of the EW exit.

· Cannot be greater than the end of the month following the current month.

· Can be retroactive to the MA end date.

9. Update the CDCS field, as applicable (Y to N or N to Y).

10. Change the program type to AC.

11. Press the transmit key to move to the ALT6 screen and complete the fields.

12. Press F9 to display exception codes.

13. Resolve exception codes.

14. Press F3 to save the document. This step is important. You must save the document even if exception codes remain. MMIS will save the completed data and allow you to return to the document for additional work. If the document is approved when you save it, it will create a 365-day eligibility span for AC.

15. Press F3 to return to the screening key panel.

16. Press F3 to continue to log out of MMIS.

Additional resources

MMIS LTSS Manual – Assessment results and program types
MMIS LTSS Manual – Close a service agreement
MMIS LTSS Manual – Close an HCBS program
MMIS LTSS Manual – Exception codes in the LTC screening document
MMIS LTSS Manual – LTC screening document and HCBS program eligibility spans
MMIS LTSS Manual – LTC screening document eligibility updates
MMIS LTSS Manual – LTC screening document screens
MMIS LTSS Manual – Record a reassessment
MMIS LTSS Manual – Use inquiry mode with LTC screening documents