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MMIS Long-Term Services and Supports Manual

MMIS Long-Term Services and Supports Manual

Elderly Waiver (EW) customized living (CL) authorization process

Page posted: 8/3/26

You cannot approve service agreement lines for CL when you:

  • · Enter a new EW service agreement with CL lines.
  • · Add CL lines to an existing EW service agreement.

    • Instead, you must save the service agreement with suspended CL lines. MMIS will automatically route the service agreement to DHS staff to review and compare the information in the service agreement against the information in the person’s most recent support plan.

    New service agreements

    Lead agency actions before DHS review

    When you enter a new EW service agreement with CL line item(s):

    1. Keep the CL line item(s) with T2031 or T2031 TG in a suspended (S) status.

    2. Approve all other service line items.

    3. Change the header status to either:

  • · Suspended (S) status.
  • · Partially suspended (T) status. MMIS will send a letter for other approved, pend or denied services if the header status is T. For more information, refer to MMIS LTSS Manual – MMIS-generated letters.

    • 4. Press F9 to display exception codes. Notice that MMIS posts two exception codes related to the CL service:

  • · Exception code 140 (header/line item status suspended): The header status and/or one or more line item status are suspended.
  • · Exception code 414 (EW CL needs DHS review): T2031 or T2031 TG cannot be approved. This exception code prevents you from approving lines and routes the service agreement to DHS queue for review when you save it in MMIS.

    • 5. Resolve all exception codes posting against the CL and/or other lines, other than exception codes 140 and 414. These exception codes will continue to post until after you change the suspended status at the header and/or at all line items and DHS has completed the review of the service agreement.

    6. Leave the CL lines in suspense and the header status in suspense or partially suspended to allow the service agreement to route to DHS for review with the person’s support plan.

    7. Press F3 to save the service agreement. MMIS will automatically route it to the DHS queue the following day.

    8. Confirm the service agreement routed successfully by viewing the service agreement in inquiry mode (not change [C] mode). The ASA1 screen will show CURR LOC/DT 584 (date) in the top right corner. This is the DHS queue.

    DHS actions

    DHS will review the service agreement within five business days of the date the service agreement is saved in MMIS. There are three possible outcomes from the DHS review:

    1. Approve the CL line item(s): DHS’ review supports approval of the service agreement line item(s). DHS will do all the following, which will also generate MMIS letters:

  • · Change the line item(s) status to approve (A).
  • · Change the header status to approve (A) if possible (i.e., if there are no other lines with suspended [S] status).
  • · Route the service agreement back to the county/Tribal Nation queue.

    • 2. Suspend the CL line item(s): DHS’ review does not support approval of the service agreement line item(s). DHS will do all of the following:

  • · Not change the suspended (S) status of the line item(s) or header.
  • · Add the county of service code to the OVR LOC field on the ASA2 screen to route the service agreement back to the county/Tribal Nation’s queue.
  • · Update the DHS comment screen to include information you need to provide or action you need to take for DHS to approve the lines.

    • 3. Deny the CL line item(s): This situation is rare and is usually related to other information in MMIS that is in conflict with information contained in the CL line(s).

    Lead agency actions after DHS review

    You can check for the service agreement in your agency’s queue or in inquiry mode using the person master index (PMI) number or authorization number. If the ASA1 screen contains your agency’s 3-digit code and date in the CURR LOC/DT field in the top right corner, DHS has completed the review.

    If DHS left the CL lines in suspended status:

    1. Check the DHS comment screen for an explanation.

    2. Make corrections to address the comments. You can also add comments to the DHS comment screen. Do not add comments to the provider or recipient comment screen. For more information, refer to MMIS LTSS Manual – Service agreement screens.

    3. Follow the instructions above to resubmit the service agreement to DHS for review and approval.

    Note: Make sure to remove your agency code from the OVR LOC field on the ASA2 screen so the service agreement will route to the DHS queue.

    Approved or pended service agreements

    When you add CL lines to an approved or pended service agreement:

    1. Keep the CL line item(s) T2031 or T2031 TG in a suspended status.

    2. Change the header status as follows:

  • · If current status is A, change to T.
  • · If current status is P, change to S.

    • 3. Press F9 to display exception codes. Notice that MMIS posts two exception codes related to the CL service:

  • · Exception code 140 (header/line item status suspended): The header status and/or one or more line item status are suspended.
  • · Exception code 414 (EW CL needs DHS review): T2031 or T2031 TG cannot be approved. This exception code prevents you from approving lines and routes the service agreement to the DHS queue for review when you save it in MMIS.

    • 4. Follow steps 5-8 above to route the service agreement to DHS for review and approval.

    Personal emergency response systems (PERS) and CL

    Line items for PERS may overlap with the 24-hour CL line item on EW service agreements if the same provider is not providing both services. For more information, refer to CBSM – PERS.

    Additional resources

    CBSM – PERS
    MMIS LTSS Manual – MMIS-generated letters
    MMIS LTSS Manual – Service agreement screens

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