Documents produced within the MnCHOICES Application
Page posted: 4/21/25
This page informs lead agencies about the documents in MnCHOICES.
For additional information, refer to CBSM – Forms for long-term services and supports (LTSS) assessment, eligibility and support plans.
Document title | Purpose | Old title | Who generates the document in the system | Completion timeline | Who receives the document |
Assessment results | Provides detailed information about MnCHOICES assessment eligibility determination | MnCHOICES eligibility summary | Certified assessor | Not applicable | |
MnCHOICES assessment | Provides a copy of information documented in the MnCHOICES assessment | MnCHOICES assessment report | Certified assessor | Not applicable | |
Assessment summary | Provides a summary of what the certified assessor discovered through the assessment process and identifies next steps based on a person’s needs | Community support plan (CSP) | Certified assessor | Provided with every MnCHOICES assessment, no later than 60 calendar days from the assessment | |
Functional assessment | Provides the functional assessment section of the MnCHOICES assessment (typically not printed) | MnCHOICES functional assessment | Not applicable | Person/legal representative (upon request), but this document can create confusion because it is not the complete MnCHOICES assessment | |
Supplemental summary charts | Provides information for the delivery of Community First Services and Supports (CFSS) services, based on assessment results | PCA provider report | Certified assessor | Sent after the CFSS service delivery plan is approved to the CFSS agency provider | |
Health risk assessment (HRA) | Provides a copy of information in the managed care organization (MCO) HRA | New printed document | Care coordinator | Not applicable | |
Assessment and program acknowledgement | New printed document | Certified assessor | After every assessment | Person/legal representative when a handwritten signature is collected Note: When signed electronically, the signed copy of this document is printed as a part of the assessment summary. | |
Support plan print | Provides a summary of the person’s choice of supports and/or services and the person’s preferences for the delivery of supports/services | Coordinated services and supports plan (CSSP) | No later than 60 calendar days from the assessment Note: Care coordinators must follow MCO timelines. | ||
About me | Highlights important information from the about me section, including a person’s care team | New printed document | Not applicable | ||
Care coordination next steps indicator report | New printed document | Not applicable | |||
CFSS to PCA conversion worksheet Note: Use this document only for assessments completed before Oct. 1, 2024. This form is not relevant for assessments completed after Oct. 1, 2024. All time authorized is at the CFSS level. | Converts CFSS MnCHOICES programming to the PCA rules, used when the MnCHOICES assessment has a CFSS home care rating of “P,” “Q” or “R” | New printed document | Person/legal representative |
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