DSD MMIS Reference Guide

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DSD MMIS Reference Guide

DSD MMIS Reference Guide Type B Home Care General Information (SA letters, COR queue, reports)

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PCA Assessment Fields in MMIS

Page posted: 08/16/12		Page reviewed: 4/4/11	Page updated: 7/25/12
PCA assessment	Use information on the Personal Care Assistance (PCA) Assessment and Service Plan (DHS-3244) form to complete the assessment fields in MMIS. Assessment fields are on the AHC1 and AHC2 panels of a Type B service agreement (SA). Assessment fields in MMIS are completed: · following a face-to-face assessment to authorize PCA services · following a face-to-face assessment when PCA services are reduced · following a face-to-face assessment when PCA services are terminated or denied because recipient does not meet PCA access criteria · following a face-to-face assessment when recipient declines PCA services · when entering a service update · when requesting an increase of PCA due to change in condition · when requesting emergency start of PCA services
AHC1 panel	Enter the assessor's phone number in the PHONE field (at the top of the Recipient Referrals page on the PCA Assessment and Service Plan). Identify the public health nurse or assessor that completed the PCA assessment in the SPRVNSN NURSE NAME: LAST, FIRST fields (Signature section near the end of the PCA Assessment and Service Plan form). Indicate the type of services prior authorized by typing an X in CD field for PC (PCA) and PC SUPERVISION when applicable. Enter the primary diagnosis code in the DIAGNOSIS 1 field (required). Enter additional diagnosis codes in the DIAGNOSIS 2 and DIAGNOSIS 3 fields when applicable. MMIS calculates and auto-populates the HOME CARE RATING and TOTAL TIME fields on the AHC1 panel after function key F9 is used. · The total time calculation includes additional time supported by the PCA assessment. · MMIS does not auto-populate the HOME CARE RATING and TOTAL TIME fields when the SA date span is less than 46 days. MMIS does not auto-populate the HOME CARE RATING and TOTAL TIME fields when the recipient does not meet PCA access criteria. MMIS posts exception code 402 – NOT PCA OR CSG ELIG.
Completion of PCA assessment fields in MMIS	The names of MMIS assessment fields match the Complex Health-Related Needs (section 6), Behaviors (section 7) and Activities of Daily Living (section 8) boxes on the PCA Assessment and Service Plan (DHS-3244) form. Complex health-related needs Type an X in complex health-related needs fields in MMIS when the corresponding box is checked Y (yes) in section 6 (Complex Health-Related Needs) of the PCA Assessment and Service Plan (DHS-3244). Leave complex health-related needs fields blank in MMIS when the corresponding complex health-related needs box is checked N (no). Behaviors MMIS behavior fields include Cognitive, Resistive, Aggression and Level 1 Behavior. Type an X in a behavior field in MMIS when the behavior box is checked Y (yes) in section 7 (Behaviors) of the PCA Assessment and Service Plan (DHS-3244). Leave the behavior fields blank in MMIS when the behavior box is checked N (no). Activities of Daily Living (ADL) Type an X in ADL fields in MMIS when ADL activity boxes is checked Y (yes) in section 8 (Activities of Daily Living) of the PCA Assessment and Service Plan (DHS-3244). Leave the ADL field blank when the corresponding ADL activity box is checked N (no). Referral completed Enter Y (yes) in the REF COMP field when a referral to other services is completed. Enter NA (not applicable) when a referral to other services is not required. Referral to other services box follows section 8 (Activities of Daily Living) on the PCA Assessment and Service Plan (DHS-3244). PCA provider owned or controlled housing Enter Y (yes), N (no) or U (uncertain) in the PROV OWN/CTRL field. This is a required field. Provider owned or controlled housing box follows section 8 (Activities of Daily Living) on the PCA Assessment and Service Plan (DHS-3244). Enter any notes related to the provider owner on the AHC3 panel. Ventilator dependent Type an X in the EN field if the recipient is on a ventilator a minimum of 6 hours per day for a minimum of 30 days. Leave the EN field blank when EN rating is not applicable. EN (ventilator dependent) box is located in section 2 (Covered PCA Service Areas) in the 'Summary based on your assessment' page of the PCA Assessment and Service Plan (DHS-3244). Document on the AHC3 panel the recommended dollar amount per month for home care rating EN. EN units/day and dollar amount are located in section 3 (authorization Summary) in the 'Summary based on your assessment' page of the PCA Assessment and Service Plan (DHS-3244). Family Support Grant (FSG) Effective 08/01/2012 FSG is no longer indicated on the CSG service agreement. Enter N (no) or leave blank the FSG field on SA for CSG. Leave the FSG field blank on a service agreement for PCA. There is not a box for FSG on the PCA Assessment and Service Plan (DHS-3244).
AHC2 panel	1. Enter the valid value of X in MMIS assessment fields when the dependency box is checked Y (yes) on the PCA Assessment and Service Plan (DHS-3244). Leave the field blank when N (no) is checked. 2. Enter a valid value for other fields on AHC2 panel as indicated below. 3. MMIS posts exception codes (EC) when assessment field entry is not a valid value or other programming applies. 4. MMIS adds 30 minutes of time to the base HCR for Complex Health Related Needs, Behaviors and critical ADL fields noted with an * (asterisks) below. Complex Health-Related Needs TUBE FEEDING field EC 587 PRTR THYP field Parenteral / IV Therapy, EC 590 WOUNDS field EC 593 RESP ASSIST field Respiratory Interventions, EC 551 CATHETERS field Catheter Insertion and Maintenance, EC 599 BOWEL PROGRAM field EC 624 NEUROLOGICAL field Neurological Intervention, EC 627 OTHER field Other congenital or acquired disease, EC 407 and 633 OTHER field must be left blank if less than 6 ADL = X COMMENT field Document other disease when OTHER field valid value = X Valid value = text EC 863 Behaviors LEVEL 1 BEHAV field Level 1 Behavior, requires the immediate response of another person Reflected in HCR Base Units calculation when indicated as X (yes) EC 402 and 406 COGNITIVE field Increased vulnerability due to cognitive deficits or socially inappropriate behavior, EC 581 RESISTIVE field Resistive to care, verbal aggression, EC 575 AGGRESSION field Physical aggression towards self, others or destruction of property, EC 584 Activities of Daily Living DRESSING field EC 515 GROOMING field EC 518 BATHING field EC 521 EATING field Critical ADL, EC 524 TRANSFERS field Critical ADL, EC 527 MOBILITY field Critical ADL, EC 530 POSITIONING field EC 533 *TOILETING field Critical ADL, EC 536 PROV OWN/CTRL field PCA provider owned or controlled housing, EC 401 and 403 Valid value = Y (yes), N (no), U (uncertain) SHARED SERV field If shared services field valid value = X then the SHR field on ASA3 panel must be coded with a Y EC 554, 305 and 869 COMMENTS field Document the rate of shared services when SHARED SERV = X EC 132 REF COMP field Valid value = Y (yes) or N/A (not applicable) to indicate if assessor completed a referral to other services. EC 436 FSG field FSG (Family Support Grant) is no longer entered on a Type B SA for CSG (Consumer Support Grant). Valid value = N (no) or blank EC 886 EN field Recipient is on a ventilator a minimum of 6 hours per day for a minimum of 30 days and EN home care rating applies. CS and MT fields CS and MT home care ratings are no longer valid effective 01/01/10, EC 888
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