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Community-Based Services Manual (CBSM)

Community-Based Services Manual (CBSM)


AASD and DSD eList announcement

Date: April 11, 2023
To: Lead agency or provider staff who enter data in the Medicaid Management Information System (MMIS) for home care, Alternative Care (AC), Essential Community Supports (ECS) or waiver service agreements/screening documents
From: DHS Aging and Adult Services and Disability Services divisions
Purpose: To announce that the DHS Service Agreement and Screening Document (SASD) Support Team will stop accepting requests by fax
Effective: April 17, 2023
Contact: SASD Support Team Portal

SASD Support Team discontinuing fax forms

Beginning April 17, 2023, the SASD Support Team no longer will accept/process forms received by fax. Instead, lead agencies and providers must submit requests using the submit button on the following online forms:

  • · MA Home Care Technical Change Request, DHS-4074.
  • · Personal Care Assistance (PCA) Technical Change Request, DHS-4074A.
  • · PCA Request Form (for lead agency use), DHS-4292.
  • · Screening Deletion Request, DHS-4689A.

    • Helpful tips and reminders:

    For home care and PCA forms:

  • · If you need help completing a form, use the link to the instructions, which is located near the top of each form.
  • · Users no longer are required to submit signatures on PCA forms when requesting a new provider. Instead, users must attest to having the necessary signature on file.
  • · If the service agreement end date is unknown, enter an end date that is one year past the start date. DHS will authorize all dates that are available.

    • For screening deletions:

  • · The document kept date and screening document number fields refer to the last document that will remain in MMIS after the deletion. All documents after the selected kept date and document will be deleted.
  • · Users are required to attest that they have made all screen prints and/or have the documentation to rebuild screenings in MMIS as needed following the deletion.

    • Previous eList announcements

    AASD LEAD AGENCY ARCHIVE | DSD LEAD AGENCY ARCHIVE | DSD STAKEHOLDER ARCHIVE

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