Home

Web User Manual For Chemical Dependency Treatment Programs

1. Month Review form opioid replacement therapy clients only The purpose of the six month review form is to assess the progress of the opioid replacement therapy client after every six months of treatment services The six month review form collects information on living arrangement labor force status job training status services provided peer support group participation arrests and alcohol and drug usage The six month form also captures the current status of the six dimensions associated with the chemical health severity ratings The six month review form should be completed at the end of every six month period approximately 180 days that the client is in treatment DAANES Web User Manual 4 May 2010 Discharge form The purpose of the discharge form is to obtain information on the client s status at discharge This form includes reason for discharge clinical chemical dependency diagnoses medication and other therapies provided disabilities or barriers to treatment post treatment environment and living situation occupational status at discharge involvement in peer support groups discharge referrals child protection involvement physical sexual abuse history length of stay cost of treatment and payment sources discharge also captures the current status of the six dimensions z severity ratings The discharge form should be completed on the day the client is di program
2. providers must comply Minnesota Rules Part 9530 70 participation in S CIL this eter tye cel them withthe completion of DAANES reporting forms Recipient Recipient Reciplent Service Effective Through Name ID PMi Birthdate _ Agreement Date 2 0 MINNESOTAN 12345678 11 21 1991 12345678910 04 07 08 04 1508 REVENUE PROCEDURE SERVICE LINE CODE CODE DESCRIPTION 91 0169 ROOM amp BOARD Quantity Units 8 Start Date 04 07 08 Rate United 30 00 End Date 04 15 08 Total Amount 240 00 Line Item Status APPROVED Provider Number 1234567890 123S00000X HEVENUE PROCEDURE SERVICE LINE CODE CODE DESCRIPTION 02 0944 0020 TREATMENT METHADONE Quantity Units 8 Start Date 04 07 08 RatelUited 15 00 End Date 04 15 08 Total Amount 120 00 Line Item Status APPROVED Provider Number 1234567890 123500000X This information is available in other forms lo people with disabilities by calling 651 431 2460 voice contact us through the Minnesota Relay Service at 1 800 827 3529 TTY DAANES Web User Manual 62 May 2010 Eligibility Verification System EVS EVS can be accessed by telephone or from the MN ITS website on the internet EVS uses voice prompts to walk the caller through menu options If the caller does not respond to the voice prompts the menu options will be repeated EVS confirms each entry by repeating the entry to the caller and asking for c
3. DAANES north ai User Test user Admission ID 79995 SAS Ciena CFE CEEE Taes AIDED Sce 8 rest HB Placement Information Criminal Justice Cien Profle Prier CD Treatment Excesence Chi Protecion Alcohol and Drus Use CH Severi stings During the past 30 days how many days has the client used the following Any alcohol ri rH Het Does the client current smoke cigarettes C Yes C No C Unknown Substance Abuse Probl at admi Primary Substance Abuse Problem m Secondary Substance Abuse Problem Ternary Substance abuse Broblem Seoci 57739 checkitrecortis COMPLETE DAANES Web User Manual 31 May 2010 During the past 30 days how many days has the client used the following Enter the number of days the client used alcohol and or illicit drugs in the past 30 days Responses may range from 0 to 30 or 99 for unknown Any alcohol Illicit drugs Client s history of injection drug use Select the category which corresponds to how recently the client has injected drugs Code the appropriate time frame even for a single instance of injection use Within the past 30 days i ast 6 months but not in the past 30 days ast 12 months but not in the past 6 months More
4. SEARCH SCREEN The search screen is used for locating and selecting admission records for updating and for entering six month review and discharge information into the system The search screen permits the user to search one of the following items only one field at a time PMI number client initials date of birth SSN date of admission or admission ID The search results may be sorted in either ascending or descending order by any of the columns which have their titles underlined Select a record to edit or to add new information by moving the mouse pointer over the Edit or Add button located in the designated column on the left side of the screen and clicking the left mouse button The selected screen admission six month or discharge will be displayed On the right side of the list are status columns which indicate the completeness of the admission and discharge information 1 indicates incomplete information a 2 indicates a complete and error free record An Add button will appear in the discharge or six month columns when the admission form is a complete error free record Client records are frozen 120 days after the discharge form has been completed Frozen records are available for viewing by clicking on the word Display Errors identified on frozen records may be corrected by contacting the DAANES support staff at DHS Provide DHS with the admission ID number of the record which needs correction along with the curren
5. Is the client currently enrolled in school or a job training program Select the category that best describes the client s current enrollment Not enrolled Enrolled full time Enrolled part time Unknown Referrals at discharge Indicate whether each referral was made by selecting Yes or No A discharge referral implies some active involvement of program staff in locating the resource and providing the client with information a contact person Do not count a general recommendation to seek help Additional CD treatment CD aftercare support group professionally led CD aftercare support group self help CD board and lodging Non CD supportive housing Domestic abuse treatment program Individual counseling therapy Family counseling therapy Detox Medical care services Vocational program Legal assistance Law enforcement corrections Court court services County social service agency CD servic County social service agency other services VAlveteran service organizations DAANES Web User Manual 49 May 2010 Child Protection Tab Discharge Form Admission ID 79895 NISI Cert iais LIL AF NFN Cheri DOB Lasts often SS admission Dale GMUOONWY Date en her Rx o bee General Service Dslvary Social Environment Chid Protecion Aleshol and rug Abuse CH Severity Ratings Financia
6. Employed part time means paid employment including self employment less than 35 hours per week Occasional seasonal work means paid employment on a seasonal or otherwise irregular bas Sheltered employment is used only for disabled clients in structured work training settings Homemaker can be used only if there is one or more dependents in the household besides the client Paid employment and student status supersede this category Student is used when the client is enrolled in school or on summer or holiday break Full time employment status supersedes this category but other categories do not Retired is used only when the client has met the minimum retirement age and has retired from the work force Disabled is used if the client is unable to work because of a physical or mental condition Sheltered employment status supersedes this category Inmate of an institution is to be used if the client is in a jail a prison or institution Laid off unemployed looking for work means that the client is laid off from a position or is otherwise not employed but is physically and mentally able to work and intends to or is looking for work Unemployed not looking for work means that the client is not employed but is phy mentally able to work but does not intend to look for work and Other means that none of the categories listed above accurately describes the client DAANES Web User Manual 48 May 2010 Unknown
7. Notification of Data Collection form The purpose of the Notification of Data Collection form is to inform the client that the program will collecting and disclosing client specific information to the Department of Human Services for the purposes of research and program evaluation The notice also informs the client that confidentiality will be maintained and that their identity will not be disclosed DATA PRIVACY The Department of Human Services is authorized and directed under Minnesota Statutes 254A 03 d to gather and disseminate facts and information about alcoholism and other drug dependency and abuse to public and private agencies and the courts so requesting such information for guidance to and assistance in prevention treatment and rehabilitation Authorization to collect chemical dependency information is also granted under Title 42 Part 2 52 a of the Code of Federal Regulations which states that information on alcohol and drug abuse patient records may be disclosed whether or not the patient gives consent to qualified personnel for the purpose of conducting scientific research management audits financial audits or program evaluation Safeguarding the client s rights to data privacy and confidentiality as provided under the Minnesota Data Practices Act and the Code of Federal Regulations is of primary concern to the DHS DAANES has been designed to protect these rights The client s name is no
8. a Total Charges Source of payment enter percentages to sum 100 Self pay Private health insurance non managed care Private health insurance managed care Consolidated CD treatment fund MHCP MA GMAC MirnesotaCare Medicare County funds Free care no charge Other COMPLETE Hours of treatment services provided Enter the total hours of treatment services provided to the client during the treatment episode Residential programs enter a zero Non residential programs enter the total number of hours provided Days of room and board provided Enter the total number of days for which room and board services were provided to the client during the treatment episode This field is for residential programs only Outpatient programs are to enter a zero Total charges dollars Enter the total charges incurred during the client s treatment episode Total charges refers to the amount billed for services regardless of source of payment and the amount actually reimbursed Round off to the nearest whole dollar fifty cents or more would be rounded up to ihe next whole dollar If free care is given estimate what would have been billed Source of payment For each of the sources of payment categories enter the percentage of the total costs of the client s treatment episode that each source covered The sum of the nine categories should equal 100
9. Seneca Service Delivery Sedal Enwienment CR Protection and Drug Abuse Ch Severi Ratings Financial tyformaton Clint Dering the post 30 days how many days hs the cient used the following aac mita 7 Substance Abuse Problem at Discharge Primary Substance Abuse Problem secondary Substance Abus rertary Substance Abuse Problem cnocctrocodis COMPLETE DAANES Web User Manual 51 2010 During the past 30 days how many days has the client used the following Enter the number of days the client used alcohol and or illicit drugs in the past 30 days Responses may range from 0 to 30 or 99 for unknown Any alcohol Illicit drugs Primary Substance Abuse Problem Secondary Substance Abuse Problem Tertiary Substance Abuse Problem If the client still has perceived substance abuse problems at the time of discharge select primary secondary and tertiary problems If there are no problems select None First select primary substance of abuse which corresponds to the substance associated with the most severe problems the client has experienced Then select the secondary which corresponds to the substance next in problem severity Finally select the tertiary which corresponds to the third substance in problem severity Nicotine Tobacco may be coded as a secondary tertiary substance abuse problem None Benzodiazepines Alcohol Other t
10. Bree CO Treatment Fxpeciencs Cui Protect Ash and Dru Le CH Seve Ring Cient Coverage 50 PMI Nbr Service Agreement Number Current chemical Dependency Treatment 7 Select X ate of change 25787010 1s opioid replacement therapy planned for treatment Yes methadone C Yes buprenorphine Yes other No Primary source of referral P Select E Secondary source of referral Pse Did a specialty court refer the client to this episode of treatment F g Primary condition surrounding admission to treatment Psa Legal stotus at admission E COMPLETE Client Coverage Type Select the payment source for the client s treatment services This is auto filled from the information selected on the Home screen but may be changed here CCDTF Consolidated Chemical Dependency Treatment Fund MHCP Minnesota Health Care Programs Managed Care All other sources Client s Personal Master Index number PMI For CCDTF or MHCP clients enter the client s eight digit Personal Master Index PMI number found on the service agreement for CCDTF clients or the insurance card for MHCP clients Only the eight digits of the PMI number should be recorded for MHCP clients and not the initial letter usually M G or X The PMI is auto filled from the information entered on the Home screen Service Agreement number For CCDTF clients only enter the eleven digits of the servi
11. Enrolled full time Enrolled part time Unknown DAANES Web User Manual 27 May 2010 Primary source of income or support during the 30 days prior to treatment Select the category which corresponds to the client s primary source of income for the 30 da prior to admission If the client had no source of income prior to admission indicate None If the client has income but none of the categories accurately depicts the primary source use Other If the source of income is unknown select Unknown Disability benefits Savings or investments Job Public Assistance Retirement pension Other Spouse parents None Relatives friends Unknown What is the client s current labor force status Select the category which corresponds to the client s primary labor force status during the month prior to admission If none of the categories is appropriate use Other Employed full time means paid employment including self employment 35 hours or more per week Employed part time means paid employment including self employment less than 35 hours per week Occasional seasonal work means paid employment on a seasonal or otherwise irregular basis Sheltered employment is used only for disabled clients in structured work training settings Homemaker can be used only if there is one or more dependents in the household besides the client Paid employment and student status supersede this category Student is employment s ied
12. sex living arrangement education occupation previous treatment chemical use legal status and referral information and for publicly funded clients Minnesota health care programs placement information None of the forms will have your name on them confiden le wil be used This information will be used by DHS for internal research program evaluation and auditing purposes only Federal confidentiality regulations 42 C F R Part 2 prohibit the disclosure of client data obtained in tho course of these data collection efforts for purposes other than the original purposes for which it was intended Unless otherwise allowed or required by law no identifying information about you will be released without your express written authorization If you have any questions about this notice you may contact DHS at 651 431 2630 You will be given a copy of this notice to keep Thank you Toe cu by program stall Olient Name Program Name This notice was given and explained to the client on Date rogram Sails PART ONE CLIE cory PART TWO FILE COPY DAANES Web User Manual 6 May 2010 GENERAL INSTRUCTIONS Provide as much information as possible The client s consent is not required in order to release information Any information known to the program staff or available from the client record should be completed The DAANES web application uses six types of data entry controls Text
13. 99 for unknown In the past 30 days how many times did the client attend self help programs e g AA NA Select the category which corresponds to the client s attendance to self help programs No attendance past month 16 30 times past month 1 3 times past month Some attendance but frequency unknown 4 7 times past month Unknown 8 15 times past month DAANES Web User Manual 47 May 2010 In the past 30 days did the client have interaction with family and or friends that are supportive of recovery Select the appropriate radio button Yes No Unknown In the past 30 days where has the client been Select the category which corresponds to the client s living situation Homeless no fixed address including shelters Dependent living dependent children and or adults living in a supervised setting Independent living including on own self supported and non supervised group homes Children living with their family Unknown Will the client be living in an environment conducive to recovery Use both clinical judgment and client perceptions to make a determination Select the appropriate radio button Yes No Unknown What is the client s current labor force status Select the category which corresponds to the client s primary occupational status after leaving treatment If none of the categories is appropriate use Other Employed full time means paid employment including self employment for 35 hours or more per week
14. Collection form DHS 2598 The purpose of the admission form is to obtain basic client demographic and background information at admission Only one admission form needs to be completed for the total episode of treatment per site regardless of changes in level of care or the intensity of service provided to the client The admission form provides information on the client s conditions surrounding admission legal status referral sources demographics living arrangements education veteran status occupational status source of financial support involvement in peer support groups previous treatment and detoxification admissions A substance use history details substance use frequency age of onset and route of administration for a variety of substances It also includes a clinical determination of primary secondary and tertiary substances of abuse Legal questions address whether the client is currently under court jurisdiction driver s license revocations lifetime arrests recent arrests convictions and child protection involvement The admission form also captures the clinical results for the six dimensions associated with the chemical health severity ratings Finally key information is collected for linking to the Consolidated Chemical Dependency Treatment Fund CCDTF These fields include the client s PMI number and service agreement number The admission form should be completed within the first 5 days after admission to the program
15. box To enter information in a text box move the mouse pointer over the text box and click the left mouse button A curser will appear in the text box Then type the alpha or numeric information requested Date box To enter information in a date box move the mouse pointer over the date box and click the left mouse button A curser will appear in the date box Then type the date in month day year format or use the calendar function by moving the mouse pointer to the right side of the box over the down arrow click the left mouse button to reveal a calendar 05 08 2010 Radio buttons To select a radio button response move the mouse pointer over the word or button and click the left mouse button The circle will darken next to the choice you selected Yes C C Unknown Drop down lists To select a response move the mouse pointer to the right side of the box over the down arrow click the left mouse button and the list will be shown use the scroll bar on the right side to see all possible choices Select Control button To execute a control button function move the mouse pointer over the button and click the left mouse button Click to Update Check box To select a check box response move the mouse pointer over the check box or label and click the left mouse button The box will fill with a check in the choice you selected Check if record is COMPLETE DAANES Web User Manual 7 May 2010 Com
16. button How many children Enter the number of children up to 10 Code 10 if the client has more than 10 children Enter 88 if no children and 99 for unknown Is the cl ient currently involved with child protection services Select the appropriate radio button Yes No Not applicable no children Unknown DAANES Web User Manual 30 May 2010 Does the involvement result from Select the category which corresponds to the reason for involvement with child protection services Alleged abuse or neglect by client Alleged abuse or neglect by someone else Alleged abuse or neglect by client and someone else Some other reason Not applicable no children no child protection involvement Unknown Are any of the children living with someone else due to a child protection court order or other actions by child protection services Select the appropriate radio button Yes No Not applicable no children no child protection involvement Unknown How many of the children are living with someone else for these reasons Enter the number of children up to 10 Code 10 if the number is more than 10 children Enter 88 if no children no child protection involvement and 99 for unknown For how many children has the client lost parental rights Enter the number of children up to 10 Code 10 if the number is more than 10 children Enter 88 if no children no child protection involvement and 99 for unknown Alcohol and Drug Use Tab
17. did the cont attend sel holp programs e g AA Na 58 E the past 30 days cid the client have interaction with famiy and or friends that are supportive of recovery C Yes C No C Unknown the past 30 days where has the client been living most of the time F Senat Wil cient be living in an environment conducive te recovery C Yes C No C Unknown What is the client s current labor force status 1s the chant currently enrolled in school or a job training program Select E Referrals at discharge mark all that apply Additional CD Treatment C Yes Cno CD aftercare support group professionally led C ves C no eftercare support group self help Cyes Cno CD board and lodging Cyes Cno Non CD supportive housing C ves Domestic abuse treatment program Cyes C No Individual counseling therapy Cyes C No Family counseling therapy C ves C NS Detox Cyes Ono Medical care services Cyes Cno Vocational program Cyes No Legal assistance Cyes C Ns Law enforcement corrections Cno Court court services C Yes C No County social service agency CD services C Yes C No County social service agency other services C Yas C No Veterans Service Organizations Cyes Ono checkifrecoris COMPLETE In the past 30 days how many times has the client been arrested Enter the number of times the client was arrested in the past 30 days The acceptable range is from 0 to 98 and enter
18. displayed Print the results and correct all errors by accessing the records from the Search screen Navigate to the file s location by clicking the browse button and using the Choose file screen auxi north Lookin Ey DANES cata Oe User Test User adn batchi be dn barche bt de batch tt iz Desktop DISCHARGE Fie nane Adm bachata tel le Tiesofuee al Fieste Cancel DAANES Web User Manual 57 May 2010 The admission file to be uploaded is shown in the text box DAANES north tal Ec Upload tx Brows ose Your Fl To Use Em Error listing after the upload process has completed thsi Minnesota Department of Human Services DAANES XM EM EU 63e Data has been processed There were errors ClientInitals SNJH Client DOB 11 15 1368 Client SSH 1234 Admission Date 057 1 2008 Dimension 1 is in eror serial 0001 The invalid value was setto NULL Client initials WLJHJ Client DOB 04 25 1985 Client SSN 1234 Admission Date 05 11 2008 Primary Condition is in error serial 0002 The invalid value was set to NULL Client Initials OSLNG Client DOB 10 05 1955 Client SSN 1234 Admission Date 0511 2008 Was the client injailis in serial 0003 The inval
19. employment including self employment for less than 35 hours per week Occasional seasonal work means paid employment on a seasonal or otherwise irregular basis Sheltered employment is used only for disabled clients in structured work training setti Homemaker can be used only if there is one or more dependents in the household besides the client Paid employment or student status supersede this category Student is used when the client is enrolled in school or on summer or holiday break Full time employment status supersedes this category but other categories do not Retired is used only when the client has met the minimum retirement age and has retired from the work force Disabled is used if the client is unable to work because of a physical or mental condition Sheltered employment status supersedes this category Inmate of an institution is to be used if the client is in a jail a prison or institution Laid off unemployed looking for work means that the client is laid off from a position or is otherwise not employed but is physically and mentally able to work and intends to or is looking for work Unemployed not looking for work means that the client is not employed but is physically and mentally able to work but does not intend to look for work Other means that none of the categories listed above accurately describes the client Unknown DAANES Web User Manual 35 May 2010 Is the client currently enro
20. gender and date of birth or PMI and asks for confirmation for today s date for a previous date if EVS identifies the correct client if EVS identifies the wrong client if the caller wants EVS to spell the client s last name Indicates what coverage the client has Listen for coverage details DAANES Web User Manual 63 May 2010 COVERAGE DETAILS Funding streams include both fee for service as well as state contracted pre paid mechanisms Fee for Service The Consolidated Chemical Dependency Treatment Fund CCDTF is the single fee for service funding stream for clients who meet the following el Clients are entitled to receive CD treatment services if they meet both 1 Financial eligibility eligible for Medical Assistance MA General As Minnesota Supplemental Assistance MSA or current household size and income guidelines at 100 Federal Poverty Guidelines FPG nce Medical Care GAMC or And 2 Clinical eligibility according to Minnesota Rules parts 9530 6600 through 9530 6655 Rule 25 Counties and tribes are responsible for providing Rule 25 assessments and determining client eligibility as of the date of the Rule 25 assessment Providers bill the CCDTF on a fee for service basis DHS then collects the state and federal share from GAMC and Medical Assistance Counties also pay a percentage of the client s treatment costs Pre Paid This incl
21. other is selected enter the language in the text box provide Spanish Hmong Somali Other specify Were the treatment services that you received respectful of your culture Select the appropriate radio button Yes No Unknown DAANES Web User Manual 56 May 2010 BATCH UPLOADING of DATA Providers who operate their own computerized case management system may incorporate the DAANES data elements into their own system and submit the required DAANES data using the batch uploading procedure Please contact the DAANES system administrator for specifications on record structures and data editing requirements Click on the Upload button to activate the Batch Upload screen RR DAANES ronha Upload Choose Your Fle To Brows DSCHARGE UPLOAD nose Yau Upload socuormisevew UPLOAD Browse Records for each form type admission six month review and discharge are uploaded from separate data files Upload a file by clicking on the browse button next to the form type you wish to upload A file open screen Choose File will appear Navigate to the file s location click on the file name and then click on the Open button The file name will appear in the text box next to the form type to be uploaded Click on the Upload button at the bottom center of the form The system will upload and process the data After processing a detailed listing of errors for each record will be
22. relationship with a higher power or the Creator and or connecting reconnecting with their cultural spiritual beliefs and practices Coordination of Services Coordination of client services received outside of the treatment setting including referral and follow up Therapeutic Recreation Therapeutic recreation to provide the client with an opportunity to participate in recreational activities without the use of mood altering chemicals and to learn to plan and select leisure activities that do not involve the inappropriate use of chemic Employment or Educational Services Counseling services specifically designed to improve the client s ability to seek and maintain employment Teaches the client skills in interviewing completing applications writing resumes and searching for jobs Childcare Services provided to the family which help the client to participate in the treatment process Transportation Services Transportation is provided between the treatment facility and another place or to and from an activity in the client s plan of care DAANES Web User Manual 39 May 2010 How many take home doses of narcotic replacement medications was the client given at the last visit Enter the number of take home doses issued to the client at their last visit to the clinic The acceptable range is from 0 to 31 DAANES Web User Manual 40 May 2010 DISCHARGE FORM The discharge form should be completed on the
23. status O 1 oneek n record COMPLETE Sex Select the client s gender Male Female DAANES Web User Manual 24 May 2010 Race Select the category which corresponds to the race of the client based the client s self identification For Hispanic clients select the race and indicate the ethnicity on the next item Choose Other if none of the first seven categories accurately depicts the client s race White Black American Indian Asian Native Hawaiian Pacific Islander Alaskan Native Mixed Other Hispanic ethnici Select the category which corresponds to the client s ethnicity regardless of race Not of Hispanic origin Puerto Rican Mexican Cuban Other Hispanic Current marital status Select the category which corresponds to the current marital status of the client on the day of admission Single never married includes those whose only marriage was annulled Divorced if remarried or cohabiting code that response instead Separated refers to married persons not living together whether or not the separation is legal Widowed if remarried or cohabiting code that response instead Married refers to persons who are legally married Cohabiting refers to common law marriages and those individuals who live together as sexual partners Unknown In the past 30 days where has the client been living most of the time Select the category which corresponds to where the cl
24. the upper right area of any of the data entry screens Deletion of Erroneous DAANES Records Erroneously created records may be deleted from the system by contacting the DAANES support staff You will need to provide DHS with your ISATS provider number and the admission ID number of the record you wish to delete The admission ID may be found on the far right column of the Search form or in the upper right area of any of the data entry screens DAANES Web Administrator Each chemical dependency treatment provider who reports on the DAANES web information system is required to designate a staff person to be the local DAANES web administrator The local DAANES web administrator is the designated individual who is responsible for facilitating the DAANES data collection efforts at the facility They provide onsite training to counselors and other staff who are responsible for completing the DAANES forms They are responsible for managing staff access to the DAANES web system as described in the User Management section of this manual Finally they are the liaison between the CD treatment provider and the Department of Human Services for all communications related to the DAANES information system DAANES Web User Manual 8 2010 CLIENT IDENTIFIERS Client Identifiers consist of the Client s Initials 5 characters Date of Birth Last 4 Digits of Social Security Number and Admission Date The client identifying informat
25. to the client s reservation residency Not residing on reservation Bois Forte Fond du Lac Grand Portage Leech Lake Lower Sioux Mille Lacs Band Prairie Island Red Lake Shakopee Upper Sioux White Earth Other Unknown Prairie Island Red Lake Shakopee Upper Sioux White Earth Other reservation Unknown DAANES Web User Manual May 2010 Pregnancy status at admission Select the category which corresponds to the client s pregnancy status Pregnant Not Pregnant Not sure Male Veteran status Select the category which corresponds to the client s veteran status Code Yes served in combat zone if the client was exposed to combat during any war or other international conflict No Yes no combat Yes served in combat zone Unknown Education Select the category associated with the client s highest level of educational attainment Grade School Some high school but no degree High school graduate GED Associate degree vocational certificate Some college but no degree College graduate Graduate professional degree Unknown Years of schooling Enter the high of technical s schooling t grade completed by the client A GED would be equivalent to 12 years Years hool college and graduate school should be added to 12 to get the total years of Is the client currently enrolled in school or a job training program Select the category that best describes the client s current enrollment Not enrolled
26. use continued problem potential Dimension 6 Recovery environment Select the category which corresponds to the client s current ratings No problem Minor problem Moderate problem Serious problem Extreme problem Unable to assess DAANES Web User Manual 36 May 2010 Alcohol and Drug Use Tab DAANES EX north Star esc Te User Six Month Form Admission ID 79896 IESU Gies LSF IFAM Cheri D08 MUDD Digs cf Cent 339 Admission Repo Dale MUDOM PoE E a 251 eel ee Socal Envrenmer CH Seventy Ratings Acor and Drug Use Sense During tha past 30 days how many days has the dlient used the following alcool Abuse fran Fe Secondary Substance Abuse Problem 7 Select g I Substance Abuse Problem 7 Select a check rocora COMPLETE During the past 30 days how many days has the client used the following Enter the number of days the client used alcohol and or illicit drugs in the past 30 days Responses may range from 0 to 30 or 99 for unknown Any alcohol Illicit drugs Primary Substance Abuse Problem Secondary Substance Abuse Problem Tertiary Substance Abuse Problem If the client still has perceived substance abuse problems at the time of the six month re
27. Click to Add or Click 10 Update button in the lower right corner To check for errors check the box next to the label Check if record is Complete and then click the Click to Add or Click to Update button Warning the data will not be SAVED if there are errors identified in the information you have entered when the record is marked complete and you click the Update button Either correct the errors or uncheck the record complete box to save your data Fey escas DAANES m m Revel Password User Test User Six Month Form Admission ID 79995 eo Casta Digs A Cieni S34 Admission Dae MMOD Repor 555 m pu boo won Enron CH Seventy Ratings and Drug Use Service Delvery In the past 30 days how many times has the chent been arrested the past 30 days how many times did the cient attend salt help programs e g Aa Nap E 1n the past 30 days did the client have interaction with family and or friends that are supportive of recovery C Yes C No C Unknown In the past 30 days where has the client been most of the time See What is the client s currant labor force status 15 the client currently enrolled in schoo or job taining program F Seea s Tcheckirecrdis COMPLETE Social Environment Tab In the past 30 day
28. DAANES Web User Manual For Chemical Dependency Treatment Programs MINNESOTA DEPARTMENT OF HUMAN SERVICES PERFORMANCE MEASUREMENT amp QUALITY IMPROVEMENT May 2010 DAANES Contact Information Web Address For assistance Email Mail Site Location https DAANES DHS STATE MN US DAANES Data Coordinator 651 431 2631 DAANES System Administrator 651 431 2630 DHS DAANES STATE MN US Vicki Busch STATE MN US DAANES Data Processing Unit Performance Measurement amp Quality Improyement Division Minnesota Department of Human Services PO Box 64986 Saint Paul Minnesota 55164 0986 Elmer L Andersen Building 540 Cedar Street Saint Paul Minnesota 55155 DAANES Web User Manual May 2010 CONTENTS Page Introduction and Overview of DAANES 4 Data Privacy 5 Notification of Data Collection 6 General Instructions 7 Client Identifiers 9 User Management 10 Provider Contact Information 13 User Login Screen 15 Home Screen Navigation buttons 16 Search Screen 17 Admission Form 18 Six Month Review Form 34 Discharge Form 41 Batch Uploading of Data 57 Reports 59 Obtaining client PMI numbers 60 DAANES Web User Manual 3 May 2010 INTRODUCTION AND OVERVIEW OF DAANES The purpose of this manual is to assist program staff in using the DAANES web application in order to comply with mandatory data reporting requirements The manual contains a detailed discussion of all forms and proced
29. If the source of payment is an out of state government agency source code Other Self pay includes payment for treatment services made by the client client s relatives or friends DAANES Web User Manual 54 2010 Private health insurance non HMO means that payment for treatment services was made by private individual or group employer health insurance policy This category includes CHAMPUS Private health insurance HMO means that treatment services were covered through a private or group employer HMO health insurance policy Consolidated CD Treatment Fund means that payment for treatment services was made through the Consolidated Chemical Dependency Treatment Fund MHCP MA GMAC MinnesotaCare covers the following public programs where service delivery is directed by managed care organizations MCO s Medicaid or Medical Assistance MA General Assistance Medical Care or MinnesotaCare Medicare County funds non Consolidated Fund means that payment for treatment services was made by the county from county social service funds Community Social Services Act CSSA block grant funds or other funds Free care no charges means that the cost of treatment services was absorbed in full by the treatment program Other means that all or part of the client s charges were paid by sources not listed above Client Satisfaction Tab thei st Human Services DAANES m EXE pb FE
30. TT Discharge Form sra Deparim Admission ID 78995 Giestinkals 1 1 Cier DOB MWODNYYY Last Digis of Chen SS Admission Daie UMDONYYY Discharge Dale MEDAYVYV mone bzw 8 pa I m General Service Delivery Environment Chi Protection Alesha Drug Abuse CH Severty stings inane Inrmason Cier Gerson How much ware you helped by the counseling or you got Saloa E Did you rocaiva treatment sarvices in a language that you could understand vos C No C Unknown 1f no what language do you usualy speak Select E Other specify Wera the treatment services that you received respectful of your culture C Yes C Ne C Unknown COMPLETE The following questions should be asked of the client at discharge This may be accomplished by creating a paper questionnaire which the client can complete prior to discharge How much were you helped by the counseling treatment you got Select the category which corresponds to the client s response Not at all A little Somewhat A lot Unknown DAANES Web User Manual 55 2010 Did you receive treatment services in a language that you could understand Select the appropriate radio button Yes No Unknown If no what language do you usually speak Select the category which corresponds to the client s response If
31. a revocation use Never Revoked For purposes of this question a revocation includes a formal revocation or a license that has been denied while formal proceedings are pending Currently under revocation Revoked during past 12 months but not currently revoked Revoked at least once in lifetime but not in the past 12 months Never Revoked Not applicable Unknown Client Profile Tab DAANES north 3a Kartmen of Human Services Admission Form Admission ID 79995 SSE Taos Dale ODI pores Tox eun E Faces infomation Sirial Cian ere Prior cb Treatment Experience Child Protection Aisha and Drug ue CH Severity Raine so Sam Hispanic E Currant marital status FS E the past 30 days where has the cient been living most of the tine I Usual Living Situation Pse County of Residence 59617 E OR State of Residence See a Tribe Enrolment E Reside on the Reservation Seet E Pregnancy status at admission E Veteran status H Education 2 Years of schooling Is the clent currently enrolled in school or job training progam Sasa E Primary source of income or support during the 30 days prior to treatment hospitalization or incarceration What is the client s current labor force
32. ate field enter the client s date of birth in MM DD Y Y YY format Last four digits of Social Security Number SSN Enter the last four digits of the client s Social Security Number in the text box provided Tf the client does not have a Social Security Number cannot remember or refuses to provide it enter 9999 Admission Date Tn the date field enter the client s date of admission into the treatment program in MM DD YYYY format or click on the down arrow on the right side of the text box to access the calendar function PMI number In the text box provided enter the 8 digits of the client s Personal Master Index PMI Number Only the eight digits of the PMI number should be entered not the initial letter usually an G or X The PMI number for CCDTF clients may be obtained from the service agreement letter sent to the provider for each client placed under the CCDTF program If the client is enrolled in MA GAMC or MinnesotaCare this item must completed The PMI number is located on the Minnesota Health Care Program MHCP card DAANES Web User Manual 9 USER MANAGEMENT Each chemical dependency treatment provider is responsible for managing staff access to the web application and maintaining facility contact information This is accomplished by using the User Management form and the Facility form The User Management form permits the local DAANES web administrator to add modify and
33. casa verre ot Human services DAANES oci Discharge Form Admission ID 79995 SATS Gies CGF FS Chen DOS DONN Last Digis of Cien S54 DischageDae MMO T mw fec ferences gt bw B C WEITEM ET SISSE amber of arii sessions provided diring treatment Detoxification Acohalorug testing att ob and bu care Ling sts development Group counseling Relationship famiy counseing Spiritual support Coordination of services Therapeutic recreation Employment or education services childcare Transportation T check records COMPLETE Record the number of service sessions provided during treatment For each of the service categories report the number of occurrences each service was provided to the client during treatment There is a count of ONE each time the service is provided regardless of the duration of time This is not an exhaustive list of services some CD programs may not provide some of the services listed If the service was not provided enter a zero in the quantity box Detoxification A service that provides short term care on a 24 hour basis for the purpose of detoxifying clients and facilitating access to chemical dependency treatment as indicated by an assessment of needs Alcohol Drug testing Alcohol drug testing is us
34. ce agreement number for the client found on the service agreement letter Fill this field with 8 s for all other clients This is auto filled from the information selected on the Home screen Note The DHS claims payment system will deny payments on claims associated CCDTF service agreements where a DAANES admission record has not been entered and validated on the DAANES system The DAANES system will update the DHS claims payment system for validated admission records Monday Friday nights Claims may be entered into the claims payment system after the service agreement has been updated by the system Review report 7 Service Agreements Missing DAANES Admission Records to identify service agreements which require a DAANES admission record for CCDTF reimbursement DAANES Web User Manual 19 May 2010 Multiple service agreements for one episode of treatment Some clients may have multiple service agreements for one DAANES admission record In order to receive reimbursement for the additional service agreements associated with a treatment episode you will need to replace the current service agreement number shown on the placement information tab with the new service agreement You may only replace the service agreement number on an admission record once each day and each new number enter will need to be validated by checking the record complete box and clicking the update button The DHS claims payment system will be updated each night Monda
35. ction of the person or the public or to assure that the proposed patient is available for a pending commitment hearing Civil court hold orders are governed by Minnesota Statutes section 253B 07 Criminal court order A directive that a person go to treatment as part of a criminal sentence as an alternative to a jail sentence or as a condition of probation This response should not be used if the client is on probation or parole and the court is not requiring that the person go to treatment This response should be used if the treatment placement is the result of a probation or supervised release parole revocation proceeding and is a condition of continued supervised release or probation Court commitment CD A civil court order requiring a person to participate in a treatment program after a court commitment process in probate court This is not to be used for an admission ordered by a criminal court juvenile court or a civil court involved in another process such as child protection or parental rights issues Court commitment procedures are governed by Minnesota Statutes Chapter 253B Civil court order A court order or consent decree whereby the client is required to participate in chemical dependency treatment as part of the settlement of a civil matter This should be used if the client is required to go to treatment as part of a family court matter involving parental rights for example as a conditio
36. d Locked Out r Active Administration Home DAANES Web User Manual 12 May 2010 PROVIDER CONTACT INFORMATION Each chemical dependency treatment provider is responsible for maintaining their contact information This is accomplished by using the Facility screen The local DAANES web administrator will have access to this form for updating contact information Click on the Admin button to activate the User Management screen then click on the Facility tab and finally click on the Update Facility button to activate the Facility screen Once you have updated the information click on the Save button at the bottom of the screen to save your changes and return to the User Management screen The following items are updateable phone and fax numbers mailing information director information coordinator information and email addresses Department of Human Services DAANES i monita ETS Tome search J uncon D ResciPassword User Waragement VEO taiea DAANES oda T e ECER Inl Desa Dor TERES ers Site City Minneapolis YES Malin Name heme Dependency Inc Address First Avenue ating city screen continues to
37. day of discharge or the day after discharge The discharge form contains eight tabs General Service Delivery Social Environment Child Protection Alcohol and Drug Use Chemical Health Severity Ratings Financial Information and Client Satisfaction Remember to SAVE your data by clicking on the Click to Add or Click to Update button in the lower right corner To check for errors check the box next to the label Check if record is Complete and then click the Click 10 Add or Click to Update button Warning the data will not be SAVED if there are errors identified in the information you have entered when the record is marked complete and you click the Update button Either correct the errors or uncheck the record complete box to save your data General Tab Minnesota Department of Human Services DAANES north ta J Discharge Form Admission ID 79995 Diet nals CFTE Cien DOS QARDOAWY asta Digte of S5 ats RID Discharge Date MOONY T moon Ree sw a Tex LE a f m Seneca Seno Scil Environment Chi recon Alcohol end Drug Abuse rt Severi atn Facil omen Saisir Current Chemical Dependency Treatment msa Reason for Discharge EE zi SM Chemical Dependency Diagnosis Primary Diagnosis Select Secondary Diagnosis the clien
38. deactivate staff access to the application Providers need to contact the DAANES system administrator to have a staff member registered as the local DAANES web administrator Click on the Admin button to activate the User Management form Min Department of Human Services DAANES nonni STI E CUNCTI mem Login tte 1 username SS mese 5 GI LL 1 Group Admins _ Add User add a staff member to the DAANES web application complete the fields in the Add User area of the form and click the Add User button Login ID The login ID for a staff member is created with the following structure the first initial from the first name followed by the full last name followed by an sign followed by your I SATS provider number Example Ed Doe with provider number MN999999 EDOE MN999999 Special Note Login IDs have to be unique to the DAANES web system Two staff members cannot have the same login ID If John W Smith and Jane E Smith are employed by the same provider the local web administrator will need to use their middle initials to create unique login IDs for each staff member JWSMITH MN999999 and MN999999 DAANES Web User Manual 10 May 2010 Name Enter the full name of the staff member first name and last name Password Enter the initial password for
39. dmission record is started on the Home screen by entering the admission date client s initials date of birth last four digits of the SSN and the source of funding which will cover the client s treatment episode Consolidated Chemical Dependency Treatment Fund CCDTF Minnesota Healthcare Programs or self pay all other sources After selecting the coverage type enter the additional information requested If not available at this time the information may be entered later on the admi screen under the placement information tab For CCDTF clients enter the client s PMI number and service agreement number and for MHCP enter the client s PMI number Then click the Submit button to activate the Admission form When the Admission form is activated the system assigns an admission identification number to the record which is displayed in the upper right area of all the data entry screens and is also located in the far right column of the Search screen The admission ID number is useful for tracking clients on the DAANES system and for communicating with DAANES support staff at DHS fhe sion Department of Human Services DAANES north Stat EUIS Prema Storthelow to enter a new admission or click on the Search button fo update existing record Admission Date MMIDDYYYYY m tse ream lem pos a Lasta piots orcnentsse P
40. ds that are complete and error free CCDTF Service Agreements Missing DAANES Admission Records This report lists service agreements that the claims payment system has not received a validated DAANES admission record The DHS claims payment system will deny payments on claims associated with service agreements listed in this report This report lists service agreements created by county tribal placing authorities and presents the service agreement number the county tribal authority the starting date for service and the client s PMI number ta Department of Human Services DAANES orth Sai Ja ais 20 een REPORTS s on a report description for a ful report ints nocding Si Month Revow tmothadone clinics oniy BLAU cients who nave Completed Treatment Service Agreements Missing Admission Records DAANES Web User Manual 59 2010 OBTAINING CLIENT PMI NUMBERS What is the PMI Number The Personal Master Index PMI number is an 8 digit unique identifier assigned by DHS to an individual who is eligible to receive health care services through any of Minnesota s public health care programs Medical Assistance Medicaid MA General Assistance Medical Care GAMC and MinnesotaCare With the transition of the Consolidated Chemical Dependency Treatment Fund into the Medicaid Management Information System MMIS individuals who receive trea
41. e All enrollees are public program members The PMI number is on the card Medica A 10 digit number beginning with the digits 59 identifies the enrollee as a public program member The 8 digits after the 59 constitute the PMI number PrimeWest The PMI number is on the member card Health Metropolitan Public program members are identified by one of 10 group numbers uses its own Health Plan member identification number on the card South Country Health Alliance The label PMI and PMI number is on the member card UCare The Care Type identifies the enrollee as a public program member UCare MA UCare GAMC or MinnesotaCare The PMI number is on the card DAANES Web User Manual 60 May 2010 Samples of Minnesota Health Care Programs Prepaid Health Plan HMO Enrollee Cards La Blue Advantage c po mee 1 e Types t toma Qus Nem aedi mm m Eyegasses NONG uoc Me pe seer Pu RABIN PARAL FCS MHP RIRN BIN F PON PONI Rai GRE A HealthPartners 55555555 fine Ene m me esre ons Er im scis neque sna Set 00 manne Sum iir merar NONG GENERAL VEDICTE 244 HEME GENERAL 612 547 2300 Caner Brard 12 Moty Minnesota Health Care P
42. e of the treatment setting including referral and follow up Therapeutic Recreation Therapeutic recreation to provide the client with an opportunity to participate in recreational activities without the use of mood altering chemicals and to learn to plan and select leisure activities that do not involve the inappropriate use of chemical Employment or Educational Services Counseling services specifically designed to improve the client s ability to seek and maintain employment Teaches the client skills in interviewing completing applications writing resumes and searching for jobs Childcare Services provided to the family which help the client to participate in the treatment process Transportation Services Transportation is provided between the treatment facility and another place or to and from an activity in the client s plan of care DAANES Web User Manual 46 May 2010 Social Environment Tab Ty usc sire uation DAANES wet Discharge Form Admission ID 79995 oieta Cien D08 MANDO Last Digte of Chen Admission Daie ona Los Sl p sam m Sood the past 30 days how many Ses has the cit been arested id Protection Alcohol and Drug Abuse CH Severty Ratings Information Client Satisfactie 1m the past 30 days how many timas
43. eatment facility Completed program means that the client completed the program as scheduled Patient left means that the client left the program with or without notice to the staff This includes a failure to show for outpatient sessions Patient Conduct means that program staff requested that the client leave the program because the client s behavior was disruptive to or uncooperative in the treatment setting Expiration of civil commitment or hold order means that the client left on the expiration of a civil commitment or hold order without completing treatment Transferred to other program means that the client was transferred to another program either because the client had other problems which needed more immediate attention or because it was determined that another program could better meet the needs of the client s that the client was assessed as inappropriate either because the client did not meet admission criteria after evaluation or that the program could not provide adequate services If the client was transferred rather than discharged outright use Transferred to other program Lost financial support means that the client was unable to continue in the program because he she was unable to pay for further treatment services Incarcerated means that the client was unable to continue treatment services because of confinement in a jail other correctional facility Death is to be used if the client died while in the
44. ed to determine the presence of biomarkers of substances in the client Education about alcohol and other drugs An educational event providing information regarding substance use and or dependence Medical Care Care provided by a licensed medical professional to address a medical health need or prevention DAANES Web User Manual 45 May 2010 Living Skills Development Living skills development to help the client learn bas skills necessary for independent living Individual Counseling A counseling session between one client and treatment staff to address substance abuse problems including goal setting treatment plan updates and therapeutic interventions Group Counseling A form of psychotherapy that involves sessions guided by a therapist and attended by several clients who address their substance abuse problems together Relationship Family Counseling Any therapeutic activities designed to improve the quality of the client s family life Services for Co occurring Mental Illness Coordinated or fully integrated services to individuals who have at least in addition to a substance abuse disorder ychiatric disorder Spiritual support Spiritual and motivational activities aimed at helping the client establish a relationship with a higher power or the Creator and or connecting reconnecting with their cultural spiritual beliefs and practices Coordination of Services Coordination of client services received outsid
45. eer recuse Six Month Form Admission ID 79995 Chontnwats Lirir3w DOE Digits of ClentSS Admission Date MODNY Ropon Date MMCDAYY _ eas pa Bm E Sese Environment CH Severity nios and Drug Use Service Delivery Number of service sessions provided in the past 6 months for Detoxification Alcohoi orug testing Education about alcohol and other drugs Medical care Living sls development Individual counseling Group counseling Relationship femily counseling Services for co occurring mental ness Spiritual support Coordination of services Therapeutic recreation Employment or education services childcare NAAN Transportation How many take home doses of narcotic replacement medication was the client given at the last visit checkitrecontis COMPLETE Record the number of service sessions provided in the past 30 days For each of the service categories report the number of occurrences each services was provided to the client during the past 30 days There is a count of ONE each time the service is provided regardless of the duration of time This is not an exhaustive list of services some CD programs may not provide some of the services listed If the service was not provided enter a zero in the quantity box Detoxification A service that provides short te
46. eligibility for the previous 12 months but not for a future date 5 Referto the Minnesota Uniform Companion Guide for search scenarios 6 Click the Submit button on the left side of the screen to generate an Eligibility Response Verify MHCP Eligibility for Multiple Recipients The Multiple Eligibility Inquiry tab allows you to verify eligibility for up to 50 MHCP recipients in one transaction The search fields are the same as on the Single Eligibility Inquiry tab The difference is that the responses are indicated in a list below the search fields 1 Log in to MN ITS 2707271 Verily MHCP Eligibility Last updated 04 07 2010 DAANES Web User Manual 65 May 2010 MN ITS Usor Guido Very MHCP Eigbity 2 Select MN ITS from the left hand menu 3 Select Eligibility Request 270 from the left hand menu MN ITS Interactive auto populates the NPI UMPI based on your login 4 Selectthe Multiple Eligibility Inquiry tab at the top of your screen 5 The Dato of Service field auto populates with the current date Ensure the appropriate date in MMDDCCYY format is in this field You can verify eligibility for the previous 12 months but not for a future date 6 Enter a combination of two or more fields of subscriber information Refer to the Minnesota Uniform Companion Guide for search scenarios the Add button below the search fields to create the list of recipients for whom you will verify eligibility The word R
47. entified primary secondary and tertiary substances Select the usual route of administration most frequent for each of the substances selected as primary secondary and tertiary Oral means ingested through the mouth and swallowed Smoking refers to inhaling the smoke from substances that are burned Snorting refers to inhaling the substance through the nose Injection use includes intravenous IV use intramuscular IM use and subcutaneous use under the skin or skin popping Age at first use of the identified primary secondary and tertiary substances Enter the age of the client s first use for each of the substances selected as primary secondary and tertiary For alcohol enter the age associated with first use to intoxication Chemical Health Severity Ratings Tab Mines Department of Human Services DAANES north far Reports e Admission Form Admission ID 79995 SEI Sana CLES Tec DoS META sion Fak GORDON E E Placement information criminal Jusses clans Profil rier CO Treatment Exoerisnes child Protection and Drug Use CH Severity Ratna Dimension 1 Acute Intoxicat Withdraw Potential s Dimension 2 Siomecical Conditions and Complications Dimension 3 EmotionaVSchavioraV Cognitive Conditions and Complications Saad s Dimensi
48. es a language other than English as primary means of verbal or written communication Functional illiteracy means that the client s reading and or writing skills are deficient to the point of impeding the ability to complete forms or homework assignments or other reading or writing tasks associated with treatment Has the client been a victim of abuse Consider both childhood and adult experiences Select the category which corresponds to the client s experiences No Yes physical only Yes sexual only Yes physical and sexual Unknown Has the client been a perpetrator of abuse Consider both adolescent and adult experienc Select the category which corresponds to the client s experiences Unknown Which of the following were used as part of CD treatment for the client For each category listed indicate whether the therapy was used during the client s CD treatment regardless of frequency or duration of that particular therapy For example count even a few days of antidepressant medication or a single acupuncture visit If you select Other prescribed medications enter in the name s of medication s in the text box Methadone Other opioid replacement therapy Antabuse Naltrexone Other anti craving medication Anti depressant medication Anti anxiety medication Other prescribed medications specify Acupuncture DAANES Web User Manual 44 May 2010 Service Delivery Tab Blk
49. esponse is underlined and located at the end of each recipient line This is the 271 Response for each inquiry Remember to change the date of service for each recipient To delete an entry click the NPI on the line you wish to remove and then click the Delete button 8 Repeat as needed to a maximum list of 50 9 Alter you have completed your list click the underlined Response in the first line of the list to open the 271 Response You may move from one response to the next using the Previous Next options at the top of the page Understanding your Eligibility Response 271 The Eligibility Response includes your NPI date of service subscriber number birth date age and gender at the top of the page A Print button is at the top l ft of the page Close bution ic at the top right of the page On the Multiple Eligibility transaction response you will see numbers in the center with Previous and Next at each end Below that information is the eligibility information which includes Major programs Waiver eligibility Prepaid health plan Minnesota Restricted Recipient Spenddowns Program MRRP Special transportation Other health insurance Medicare coverage Hospice Fee for service benefit limits Print or save the 271 Response for your records 2 270271 Very Last updated 04 07 2010 DAANES Web User Manual 66 May 2010 DAANES Web User Manual 67 2010
50. etime treatment episodes in any chemical dependency treatmant program do not include detox T In the past 30 days how many times did the client attend self help programs eg AA 7 Select z n the past 30 days did the client have interaction with family and or friends that are supportive of recovery C unknown T Checkitrecordis COMPLETE Number of lifetime detoxification admissions Enter the total number of admissions to any detoxification facility in the client s lifetime If unknown enter 999 Number of lifetime treatment episodes Enter the total number of previous admissions to any chemical dependency treatment program in the client s lifetime Do not count detoxification and aftercare admissions If unknown enter 99 In the past 30 days how many times did the client attend self help programs e g AA NA Select the category which corresponds to the client s attendance to self help programs No attendance past month 1 3 times past month 4 7 times past month 8 15 times past month 16 30 times past month Some attendance but frequency unknown Unknown In the past 30 days did the client have interaction with family and or friends that are supportive of recovery Select the appropriate radio button Yes No Unknown DAANES Web User Manual 29 May 2010 Child Protection Tab The child protection questions relate to children who are under 18 years of age for whom
51. id value was setto NULL DAANES Web User Manual 58 May 2010 REPORTS The DAANES web application currently provides seven reports to assist providers in tracking the status of their client records Each report lists the client s initials date of birth last four digits of the social security number date of admission the client s admission ID and the staff person who last updated the record The lists can be sorted in ascending and descending order by moving the mouse pointer over the underlined column headings and clicking the left mouse button All Clients in Treatment This report lists all clients who are currently in treatment Clients with an Incomplete Admission This report lists clients who have admission records with missing information or an unchecked record complete box Clients with an Incomplete Discharge This report lists clients who have discharge records with missing information or an unchecked record complete box All Clients with an Incomplete Six Month Review This report lists clients who have six month review records with m unchecked record complete box sing information or an Clients needing a Six Month Review This report lists clients who are due for a six month review Clients will appear on this report after 180 days from the date of admission All Clients who have Completed Treatment This report lists clients who have been discharged from treatment with recor
52. ient has been living Homeless no fixed address including shelters Dependent living dependent children and or adults living in a supervised setting Independent living including on own self supported and non supervised group homes Children living with their family Unknown DAANES Web User Manual 25 May 2010 Usual living situation Select the category which corresponds to the client s usual type of living situation Alone means that the client is iving alone and independently This excludes institutional and group living situations With spouse or partner only With minor children only With spouse partner and children With one parent With both parents With one natural parent amp one step parent With foster parents With relatives With friends With others means that the client is living in an institutional or group living situation Unknown County or State of Residence Select from the lists the client s county or state of residence For a client who is a Minnesota resident select the client s county of residence For a client who is not a Minnesota resident select the client Tribal Enrollment tate of residence Canadian or other Foreign Citizen Select the category which corresponds to the client s tribal enrollment Not Enrolled Bois Forte Fond du Lac Grand Portage Leech Lake Lower Sioux Mille Lacs Band Reside on the Reservation Select the category which corresponds
53. ificantly below average existing concurrently with defects in adaptive behavior and manifested during the development period mental retardation Mental illness means that the client has cognitive behavioral or emotional dysfunction ated with a mental health disorder Speech pathology refers to communication disorders such as stuttering impaired articulation a speech impairment or a voice impairment Learning disability refers to a disorder of one or more of the basic processes involved in understanding or in using language spoken or written which may manifest itself in deficiencies in the ability to listen think speak read write spell or do mathematical calculation The term includes perceptual handicaps minimal brain dysfunction and dyslexia The term does not include learning problems which result primarily from visual hearing or motor handicaps mental retardation or environmental cultural or economic disadvantage DAANES Web User Manual 43 May 2010 Brain injury refers to damage to the brain or its coverings from an external force not of a degenerative or congenital nature The damage may produce an altered state of consciousness and may result in a decrease in cognitive behavioral or physical functioning Resulting impairments may be temporary or permanent and may cause partial or total functional disability or psychosocial maladjustment English not primary language means that the client us
54. igibility Request feature to verify eligibility on the Single Eligibility Inquiry tab one at time or the Multiple Eligibility Inquiry tab up to 50 at a time A recipients eligibility through MHCP may terminate or change Since there are no eligibility dates on the MHCP ID card providers are strongly encouraged to verify recipient eligibility prior to rendering services Background Use MN ITS Interactive Complete all bolded required fields Complete other non bolded situational fields as appropriate Underlined items are linked to definitions and additional information about that item including information about completing a field code definitions for fields or instructional information Some fields are grouped together in boxes of associated information Field titles with an asterisk indicate that the information is situational If you complete one asterisked field within a boxed section of a screen you must complete all asterisked fields in that section of the screen Verify MHCP Eligibility for a Single Recipient 1 Login to MN ITS 2 Select MN ITS from the left hand menu 3 Select Eligibility Request 270 from the left hand menu MN ITS Interactive auto populates the NPI UMPI based on your login and opens on the single eligibility tab 4 The Date of Service field auto populates with the current date Ensure the appropriate date in MMDDCCYY format is in this field You can verify
55. ion is entered on the Home form to create a new admission record and may be revised at the top of any of the Admission screens Review carefully the instructions for completing the specific elements that comprise the Client Identifiers Client s sing the client s legal name not a nickname will help ensure consistency as well as facilitating analysis of client readmission patterns across the continuum of care In the text box from left to right across the five spaces enter the client s initials in the following manner In the first space enter the Ist letter of the client s Last name In the second space enter the 3rd letter of the client s Last name If the client does not have a third letter in the last name enter an asterisk In the third space enter the Ist letter of the client s First name In the fourth space enter the 3rd letter of the client s First name If the client does not have a third letter in the first name enter an asterisk In the fifth space enter the first letter of the client s Middle name or the Middle initial If the client does not have a middle initial enter an asterisk For two letter names or no middle initial If the client s first or last name has only one or two letters fill the second space of the two designated spaces with an asterisk Similarly if the client does not have a middle name or initial fill that space with an asterisk Date of birth In the d
56. ive Conditions and Complications 2 2 Dimension 4 Readiness to Change Faa Dimension 5 Ralapse Cantinued Use Conbnued Problem Potential Fee Dimension 6 Recovery Environment Ticheckitecdis comers For each of the six chemical health severity dimensions rate the client s status at the time of discharge Dimension 1 Acute intoxication withdrawal potential Dimension 2 Biomedical conditions and complications Dimension 3 Emotional behavioral cognitive conditions and complications Dimension 4 Readiness for change Dimension 5 Relapse continued use continued problem potential Dimension 6 Recovery environment Select the category which corresponds to the client s current ratings No problem Minor problem Moderate problem Serious problem Extreme problem Unable to assess DAANES Web User Manual 53 2010 Financial Information Tab COEM DAANES north Sa UEM EXE voiced DIY 0 0 8 KEZZN Reset Possword oot Discharge Form Admission ID 79995 BASD CFIN ClentODE WMO Lasts Dis of Gin 888 Admission Date GAMODNYY Date WOO aoo res m Gere Series Delivery Seal Child Protein Aleonel and Drug abuse CH Sever Ratings Francia informs ciam Hours of treatment services provided Days of roam and board provided
57. l informatn Clan Satisfaction Does the client have children under 18 years ofage C Yes C No C Unknown How many chidren Ts the cient curently involved with child protection services Oves No C Not applicable no children C Unknown Does the invelvarnent fom Are any of the children living with someone else due to child protection court order or other actions by child protection services ves CoC Not applicable no childreryno child protect involvement Unknown ins otk cht iin Wt _ For how many children has tha cient lost parental rights checkitrecordis COMPLETE The child protection questions relate to children who are under 18 years of age for whom the client is the natural or adopted parent or for whom the client has legal guardianship Does the client have children under 18 years of age Select the appropriate radio button Yes No Unknown Note If No or Unknown is selected the system will auto fill the balance of the child protection items when you check the record is complete box and click the update button How many children Enter the number of children up to 10 Code 10 if the client has more than 10 children Enter 88 if no children and 99 for unknown Is the client currently involved with child protection services Select the appropriate radio button Yes No Not applicable no children Unk
58. lease solect a Covorago Type and mn tho neide por Coversao Type vents Pus Senica gresment Number C MHCP Managed Care Al Other Sources The admission form has seven tabs Placement Information Criminal Justice Client Profile Prior CD Treatment Experience Child Protection Alcohol and Drug Use and Chemical Health Severity Ratings After entering information remember to SAVE your data by clicking on the Click to Update button in the lower right corner To check for errors check the box next to the label Check if record is Complete and then click the Click to Update button After the record has been saved by the system the system will return the user to either the Home screen or the Search screen with a confirmation message that the information has been updated Warning the data will not be SAVED if there are errors identified in the information you have entered when the record is marked complete and you click the Update button Either correct the errors or uncheck the record complete box to save your data DAANES Web User Manual 18 May 2010 Placement Information Tab i ee ee DAANES m ipsuni Admission ID 79995 Admission Form EAE Gentis CIE TANGO ron or mission te WATERY sm Informatbon Crna Ghent raf
59. lled in school or a job training program Select the category that best describes the client s current enrollment Not enrolled Enrolled full time Enrolled part time Unknown Chemical Health Severity Ratings Tab H Minnesota Department of Human Services DAANES orth Sar oo ETE co Us Te nr Six Month Form Admission ID 79896 a m checkitrecordis COMPLETE ME TSS CAFI FAN cieni MANDY 568 Admission Dae Repon Dae Fromm fex ee Ewa Socal Environment CH Severity Aleshel and Drug Use Service Dalivery Dimension 1 Acute withdrawl Potential Dimension 2 Biomedical Conditions and Complications Dimension 3 Emotona Benssiora cognve Conditions and Complication s Dimension 4 Readiness to Change Dimension 5 telapse Continued Use Continued Problem Potential sl Dimension 6 Recovery Environment For each of the six chemical health severity dimensions rate the client s status at the time of the two month review Dimension 1 Acute intoxication withdrawal potential Dimension 2 Biomedical conditions and complications Dimension 3 Emotional behavioral cognitive conditions and complications Dimension 4 Readiness for change Dimension 5 Relapse continued
60. lock Reset Password Deactivate Users To perform any of the following tasks Modify Unlock Reset Password Deactivate Users associated with an existing user login ID use the Search for User function to locate the staff member to be modified From the search results select the login ID to be edited by clicking on the ogin ID located in the first column of the list partment of Human Services DAANES north Ug CERN ET User Test ser Test User 3 m ies Test User emtngmnooooni John Sith jomemmacncm gy m mj m dministation Hame After clicking on the login ID the Modify User form will be displayed From this form the local web administrator can change the user s name reset the user s password change the user s email address lock unlock the user s access to the system and activate deactivate the user s login ID Once changes have been made click on the Update button to submit the changes to the system To unlock a staff member uncheck the Locked Out check box and check Active check box When a staff member leaves employment with your program uncheck the Active check box and check the Locked Out check box then click the Update button to submit the change Modify User Login ID smithmno00001 Bohn smith ResetPassword Password Group 000001 IsGroup Admin Email ohn smith cD com Approve
61. n of obtaining or retaining the custody of children in a child protection proceeding Juvenile court placement A court order for a minor to participate in treatment as a result of a juvenile dependency or delinquency matter Juvenile courts are provided with broad placement authority under Minnesota Statutes Chapter 260 A placement hold is to be considered a juvenile court placement whenever the court has required that the minor be placed in a chemical dependency program either by the county or the caretakers of the child None None of the above apply Unknown DAANES Web User Manual 22 May 2010 Criminal Justice Tab DAANES north ai fis of Human Services Home Search A A o aer Tel User Admission Form Admission ID 79995 ENSE area Dae MUON Hi Placement information Criminsiusics client Profile Prior Treatment experiance child Protection Alcohol Drug ues cH severi Ratings In the past 30 days how many times has the cient been arrested 7 How many times has the cient been arrested in their feme the past 30 days was the chent in jai C Yes No C Unknown the past a0 days was the cient in prision C No unknown 1s the client currently under the jurisdiction of the court or on probation
62. nown Does the involvement result from Select the category which corresponds to the reason for involvement with child protection services Alleged abuse or neglect by client Alleged abuse or neglect by someone else DAANES Web User Manual 50 May 2010 Alleged abuse or neglect by client and someone else Some other reason Not applicable no children no child protection involvement Unknown Are any of the children living with someone else due to a child protection court order or other actions by child protection services Select the appropriate radio button Yes No Not applicable no children no child protection involvement Unknown How many of the children are living with someone else for these reasons Enter the number of children up to 10 Code 10 if the number is more than 10 children Enter 88 if no children no child protection involvement and 99 for unknown For how many children has the client lost parental rights Enter the number of children up to 10 Code 10 if the number is more than 10 children Enter 88 if no children no child protection involvement and 99 for unknown Alcohol and Drug Use Tab DAANES orth harge Form Admission ID 79995 TATED cuentas LIIF Cie DOB INDIA Lest Dions or 55 Daie WWOONYYYI Discharge Date OH iz EJ
63. ntrol center for the DAANES web application The Home screen is the starting point for entering new admissions by first entering the date of admission client initials date of birth last four digits of social security number then selecting the client s funding coverage type and finally clicking the Submit button other functions are accessed from the Home screen by clicking on the appropriate navigation button The Home screen is illustrated on the next page along with descriptions of the navigation buttons DAANES Web User Manual 15 May 2010 HOME SCREEN DAANES north a HE win Start below to enter new omission or cick on the Search buon update records Admission Dat moo cione sere tento08 eoe s LastDiats et cientsse Peas sets Gorge teana m ne anon nasser ovo oe Senos Aareementwumber NHCP care lent Main Navigation Buttons Home Logout Returns the user to the main Logs the user off the DAANES screen Home screen DAANES application and returns the user to the login screen Warning make sure you click the Click to Update button to save your data before Search logging out Activates the search screen for locating a specific client record to updating Click to Update Found at the bottom of all Upload 1 data entry screens clicking on this button will SAVE the data entered on the screens and will return
64. of admission for the firs transition entered and must be at least one day greater than the previous transition date for each additional entry ion Is opioid replacement therapy planned for treatment Select the appropriate radio button Note Answering Yes to this item will create an ADD button under the Six month Six month Review form column on the search screen Yes methadone Yes buprenorphine Yes other No DAANES Web User Manual 20 May 2010 Primary and secondary source of referral Select up to two sources of referral which led to the client being admitted to this facility If only one source of referral identified then selected No secondary on the secondary source of referral If none of the categories appropriately depicts the client s source of referral select Other Self family relative friend Detox center School Mental health center Employer EAP Other residential f Law enforcement County social service agency CD services Courts County social service agency child protection Probation parole DUI DWI Pre petition screening diversion program Corrections Health care facility profe CD treatment program County social service agency other services AA other support group Community professional agency e g Information and referral agency Tribal agency ional Other No Secondary lergy Did a specialty court refer the client to thi
65. on 4 Readiness to change Dimension s Relopze Continued Use Centinuod Problem Potential 34a Dimension 6 Recovery Environment Tchectirrecodis covrcere For each of the six chemical health severity dimensions rate the client s status at the time of admission Dimension 1 Acute intoxication withdrawal potential Dimension 2 Biomedical conditions and complications Dimension 3 Emotional behavioral cognitive conditions and complications Dimension 4 Readiness for change Dimension 5 Relapse continued use continued problem potential Dimension 6 Recovery environment Select the category from the drop lists which corresponds to the client s ratings No problem Minor problem Moderate problem Serious problem Extreme problem Unable to assess DAANES Web User Manual 33 May 2010 SIX MONTH REVIEW FORM The six month review form should be completed every six months 180 days for clients who are receiving opioid replace therapies by the treating provider Clients are identified as opioid replace therapy patients on the Place Information Tab of the Admission Form The form should be completed when the client appears on the report listing clients who are due for a six month review The six month review form contains four tabs Social Environment Chemical Health Severity Ratings Alcohol and Drug Use and Service Delivery Remember to SAVE your data by clicking on the
66. onfirmation Prior to ending the call EVS allows the caller to request information on the same client for a different date of service or to review eligibility information for a different client It is important to listen to the entire message because EVS may indicate a client is eligible for multiple programs i e medical assistance and prepaid health plan PROCEDURE Gather Information Provider s 10 digit National Provider Identification NPI number Either the client s 8 digit PMI number OR social security number and date of birth Recipient s first and last name Date of service Contact EVS 800 657 3613 toll free or 651 431 4399 metro or MN ITS Follow the prompts Caller enters Welcomes the caller to the MHCP Automated 7 for recipient information Inquiry Service Prompts the caller to enter their 10 digit NPI Provider s 10 digit NPI provider number provider number followed by the ke Asks which information the caller will use for _ I for identification number PMI the Recipient Inquiry OR 2 for social security number and date of birth Prompts the caller to enter either the client s 8 Client s 8 digit identification number or the digit identification number PMI or the client s social security number and date of client s social security number and date of birth birth Asks if the caller is inquiring about today s date or a previous date Tdentifies the client by
67. parole C Yes C No Unknown Has driver s license been revoked because of a driving incident involving alcohol or other drugs E cheskitrecerdis CONPLETE In the past 30 days how many times has the client been arrested Enter the number of times the client was arrested in the past 30 days The acceptable range is from 0 to 98 Enter 99 for unknown How many times has the client been arrested in their lifetime Enter the number of times the client was arrested in their lifetime The acceptable range is from 0 to 98 Enter 99 for unknown In the past 30 days was the client in jail Select the appropriate radio button Yes No Unknown In the past 30 days was the client in prison Select the appropriate radio button Yes No Unknown Is the client currently under the jurisdiction of the court or on probation parole Select the appropriate radio button Yes if the client is currently under the jurisdiction of the court or on probation parole No if the client is neither under the jurisdiction of the court nor on probation parole Unknown if the client left before you could get the information DAANES Web User Manual 23 May 2010 Has driver s license been revoked because of DWI Select the category which corresponds to the answer that best describes the status of the client s driver license Use Nor Applicable only if the client has never had a license If the client has a license but has never had
68. pletion of the DAANES data collection forms All forms should be completed on an ongoing basis as clients are admitted and discharged from the treatment facility DAANES data collection forms should be completed in the following manner The Admission form should be completed on the day of admission or within the first 5 days after admission to the program The Six Month Review form should only be completed for opioid replacement therapy clients Opioid replacement therapy clients are identified on the admission form under the Placement Information tab The Six Month Review form should be completed on the day that the client has been in treatment for six months 180 days from the date of admission or within 3 days following each 180 day time period The discharge form should be completed on the day the client is discharged from the program data must be entered and completed free of errors by the Sth day of the month following the event being recorded DAANES information may be revised at anytime within 4 months after the discharge record is completed After 4 months you will need to contact the DAANES support staff at the Department of Human Services to make changes You will need to provide DHS with your ISATS provider number the admission ID number of the record which needs correction along with the current response and the updated response for the field The admission ID may be found on the far right column of the Search form or in
69. program Other is to be used only when none of the other choices reflect the reason for discharge DSM Chemical Dependency Diagnosis Select the DSM chemical dependency diagnostic codes from the list They are identical to those provided in the DSM IV TR manual with four exceptions Phencyclidine Abuse 304 70 Hallucinogen dependence 304 80 Inhalant abuse 305 80 and Polysubstance dependence 306 00 Different code numbers have been assigned to these so that statewide and provider reports can distinguish drugs that DSM IV TR combines DAANES Web User Manual 42 May 2010 The DSM chemical dependency diagnosis is based on all information available to staff at the time of the client s discharge The primary diagnosis should represent the substance associated with the most severe problems the client has had whether medical psychological social legal or occupational This will often be the substance directly responsible for the treatment admission but this may not always be the case Some clients will have only one diagnosis use of only one substance meets diagnostic criteria for abuse or dependence This is true of many alcohol users for example In these secondary diagnosis should be coded as no secondary diagni For clients who use two or more substances with comparable frequency one needs to be coded primary and one as secondary Consider all the harmful effects and use patterns to make a determination of a primary diagnosis e
70. ranquilizers Barbiturates Other sedatives or hypnotics arijuana hashish Ketamine Heroin Ecstasy other club drugs Non prescription methadone Inhalani Other opiates and synthetics Over the counter medications PCP Other Other hallucinogens psychedelics secondary or tertiary substance Methamphetamine Nicotine Tobacco secondary or tertiary only Other amphetamines Unknown Other stimulants Number of days used in the last 30 days of the identified primary secondary and tertiary substances For each of the substances select as primary secondary and tertiary enter the number of days the client used that substance during the past 30 days Responses for use during the past 30 days may range from 0 to 30 or 99 for unknown DAANES Web User Manual 52 May 2010 Chemical Health Severity Ratings Tab Fi sis iion thon Scan DAANES et Ez FEE pem User Tet User Discharge Form Admission ID 79995 Comum Gre DOB UNDOV Lasta Digits st Admission DateWMDONYY Discharge Dae MOONY wee asco 88 Bow I General Servi sry Social Environment Ales use CH Seventy Rats Rear information Clent Satieaction Dimension 1 Acute intexication Withdrawl Potential Dimension 2 Biomedical Conditions and Complications Dimension 3 Emotiona Behavioral Cogrit
71. rm care on a 24 hour basis for the purpose of detoxifying clients and facilitating access to chemical dependency treatment as indicated by an assessment of needs Alcohol Drug testing Alcohol drug testing is used to determine the presence of biomarkers of substances in the client DAANES Web User Manual 38 May 2010 Education about alcohol and other drugs An educational event providing information regarding substance use and or dependence Medical Care Care provided by a licensed medical professional to address a medical health need or prevention ing Skills Development Living skills development to help the client learn basic skills necessary for independent living Individual Counseling A counseling session between one client and treatment staff to address substance abuse problems including goal setting treatment plan updates and therapeutic interventions Group Counseling A form of psychotherapy that involves sessions guided by a therapist and attended by several clients who address their substance abuse problems together Relationship Family Counseling Any therapeutic activities designed to improve the quality of the client s family life Services for Co occurring Mental Illness Coordinated or fully integrated services to individuals who have at least one psychiatric disorder in addition to a substance abuse disorder Spiritual support Spiritual and motivational activities aimed at helping the client establish a
72. rograms MHCP Member Number 1234567890 JANE A DOE this card every tins yeu ge for atedicel core issuer Health Pan lt 11 15 200 EE omae ae 4005 ig donas Gender FEMALE a So Der 610459 ui mer as FUAR 19 HEALTH Mene SAMPLE Dune one zum EL NET 2 a EE mE Ibn 10485 Oe pei E CE ME Poo APPRIME SSS eiie Ware ee Issuer 80840 DOB lt mmiddlyyyy gt Siae PE Rs puero Ea Kcd E a zg pcr EFE iene SLE aL mM DAANES Web User Manual 61 May 2010 Sample CCDTF Service Agreement Letter State of Minnesota Department of Human Services PO Box 64977 Saint Paul MN 55164 0977 APRIL 03 2008 BEST TREATMENT PROVIDER 123 MAIN STREET OUR TOWN MN 55555 8888 Provider ID 1234567890 Our records indicated that WALLEY COUNTY has entered and approved a service agreement for your organization to provide chemical dependency treatment services to J Q MINNESOTAN The approved service s are listed below along with information regarding eligibility dates rates and other codes If you have any questions regarding this service agreement please contact WALLEY COUNTY The Total Amounts listed below reflect the possible maximum payment Actual reimbursement may be less
73. s how many times has the client been arrested Enter the number of times the client was arrested in the past 30 days The acceptable range is from 0 to 98 and 99 for unknown In the past 30 days how many times did the client attend self help programs e g AA NA Select the category which corresponds to the client s attendance to self help programs No attendance past month 1 3 times past month 4 7 times past month 8 15 times past month 16 30 times past month Some attendance but frequency unknown Unknown DAANES Web User Manual 34 May 2010 In the past 30 days did the client have interaction with family and or friends that are supportive of recovery Select the appropriate radio button Yes No Unknown In the past 30 days where has the client been living most of the time Select the category which corresponds to the client s living situation Homeless no fixed address including shelters Dependent living dependent children and or adults living in a supervised setting Independent living including on own self supported and non supervised group homes Children living with their family Unknown What is the client s current labor force status Select the category which corresponds to the client s current labor force status If none of the categories are appropriate use Other Employed full time means paid employment including self employment for 35 hours or more per week Employed part time means paid
74. s episode of treatment If the client was referred by the court select the appropriate category No Yes Adult drug court Yes Juvenile drug court Yes DWI court Yes Truancy court Yes Family dependency treatment court Yes Mental health court Yes Community court Yes Other Unknown Primary condition surrounding admission Select the primary condition surrounding admission of the client to treatment Treatment to avoid jail Treatment as condition of probation parole Treatment to retain driver s license license plates Treatment or lose custody of children Treatment to regain custody of children Treatment to avoid loss of relationship or living situation Treatment to maintain employment school enrollment Treatment to retain professional licens Treatment required to retain government benefits Financial pressures caused by drug alcohol use Other None DAANES Web User Manual 21 May 2010 Legal status at admission Select the client s legal status at admi Emergency court hold order Use this for emergency admissions and court hold orders Emergency admissions are made by a peace or health officer on behalf of a person who is chemically dependent and in danger of harming self or others or intoxicated in public Emergency admissions are governed by Minnesota Statutes section 253B 05 Court hold orders are made by a civil Court of jurisdiction in order to admit a person either for the prote
75. t have any of the following conditions complications Hearing Impairment C yes Cno Visual Impairment Cno Physical Handicap Cyes Cno Development Disability Cyes Cno Mental iness C Yes Cno Speech Pathology C Yes Cno Leaming Disability C Yes C No Brain Injury C Yes C No English Not Primary Language Cyes Functional thteracy Ono Has client been a victim of abuse rec Has client been perpetrator of abuse Saa Which of the following wore used as part af Cb weatment for the client Methadone C Yes Other opioid replacement C Yes C fio Antabuse Cno Naltrexone C Yes Cno Other anti craving mediation C Yes C No anti depressant medication C vas Anti anidety medication Oves Other prescribed medications C ves C No specify acupuncture check record 1s COMPLETE DAANES Web User Manual 2010 Discharge Date Enter the client s date of discharge from the program in MM DD Y Y YY format by either typing or using the calendar function Current Chemical Dependency Treatment Select the client s chemical dependency treatment at the time of discharge Hospital inpatient Residential less than 30 days planned Residential more than 30 days planned Non residential Methadone Reason for discharge Select the category which is the most appropriate description of the client s reason for discharge from the tr
76. t response and the updated response Erroneously created records may be deleted from the system by contacting the DAANES support staff with admission ID DAANES ve ou asian Dae om z Client DOB Admission Dale To po amissionDiSchar e e iempon ClentSSN A mission Date Admin status Date Discharae tatus Ramission EM Mi TTT 2 H Eu 24000 B sn EH Deor Niem igas sems 2 2 m Decr wame 301890 swew B 2 sia Dear RERET wasg asss Goo 12 00 i nate gt ES Edi XSDFH aand 4321 42008 2 mum Disi Daily MW de i mae 2 E Display JHTMP 8 9 1092 432 88858888 2 nior 2 mum CEN Yebra Bangs 1238 2 B mom Edi add POPOV 1 1285 anana mum Edit Add Add HNSNJ 1 1305 2345 28888888 12008 ado do OBJNE 1 1 1985 0123 38858888 1102008 2 33323 12000 2 di 390 WALI 1201965 2345 88858888 1412008 2 EMI Dilan Page DAANES Web User Manual 17 May 2010 ADMISSION FORM A new a
77. t used on the data forms Instead a special client identifier is used which maintains the anonymity of the client while still enabling DAANES to track clients across the continuum of care The DAANES client identifier consists name first and third letters from the first and last name and middle initial the client s date of birth and the last four digits of the client s social security number DAANES Web User Manual 5 May 2010 NOTIFICATION OF DATA COLLECTION The Minnesota Data Practices Act requires that clients be informed that the treatment facility will be isclosing client information to DHS for the purposes of research and program evaluation To facilitate program staff present and explain the DAANES Notification of Data Collection form to the client at admission After the client has reviewed the form and any questions have been answered the staff person dates and initials the form The client is given a copy to keep and a copy is placed in the client s file Since this is not a consent form it does not require the client s signature 1685 DAANES Notification of Data Collection This program will be collecting and disclosing the statistical information specified below to the Minnesota Department of Human Services DHS as required by Minnesota Statute 254A 03 subd 1 d and Title 42 Parts 2 52 and 2 53 of the Code of Federal Regulations The information includes age race
78. than 12 months ago Never injected Unknown Does the client currently smoke cigarette Select the appropriate radio button Yes No Unknown Primary Substance Abuse Problem Secondary Substance Abuse Problem Tertiary Substance Abuse Problem First select primary substance of abuse which corresponds to the substance associated with the most severe problems the client has experienced Then select the secondary which corresponds to the substance next in problem severity Finally select the tertiary which corresponds to the third substance in problem severity The secondary and tertiary categories may indi identified substances Nicotine Tobacco may be coded as a secondary or tertiary s problem Alcohol Benzodiazepines Cocaine powder Other tranquilizers Barbiturates Marijuana hashish Other sedatives or hypnotics Heroin Ketamine Non prescription methadone Ecstasy other club drugs Other opiates and synthetics Inhalan PCP Over the counter medications Other hallucinogens psychedelics Other Methamphetamine No secondary or tertiary substance Other amphetamines Nicotine Tobacco secondary or tertiary only Other stimulants Unknown Number of days primary secondary and tertiary substances used in the last 30 days y enter the number of day s for use during the past 30 days the client used that S may range from 0 to 30 99 for unknown DAANES Web User Manual 32 May 2010 Usual route of the id
79. the user to the main DAANES screen Home screen the search screen An message will be displayed Reports the upper left area of the indicating that the record Activates the reports screen was updated for running standard reports C Activates the upload screen for batch submission of data Check if record is COMPLETE Admin Warning the data will not be SAVED if there LS activates the user are errors identified in the information you have management form for adding modifying and entered when the record is marked complete and deactivating users Facility contact information is you click the Update button Either correct the also updated from this screen This button is only errors or uncheck the record complete box to save visible if the user is a local web administrator your data When checked the record is edited for errors If errors are found by the system the errors will be listed at the top of the screen If no errors are Reset Password found the system will return you to either the Home I Activates a separate window screen or the Search screen and a message will be which permits the user to change their password displayed in the upper left hand area of the screen indicating that the record has been updated The record status will be update to a value of 2 on the Search screen for that client s record DAANES Web User Manual 16 May 2010
80. the client is the natural or adopted parent or for whom the client has legal guardianship H pr DAANES m SE eee Admission ID 79995 ncs f Human Servicos Admission Form SS asin bate MUDD paranes E prozno Placement Information Justice Ciert Profile Pror CO Trestment Expesence Protector Alcohol and Drug Use Severity Ratings Does the client have children under 18 years of age Ces C No C unknown How many chidren 1s the cient curently involved with child protection servicas C Yas C No C Not applicable no children C unknawn oes the invelvernent result fom Feen Aro any of the childran living with someone alse due to a child protection court order or other actions by child protection services Yes C No C Not applicable no chidren no child protect involvement unknown How many of the children are living with someone else for these reasons For how many children has the cient lost parental rights T cheat recoeis COMPLETE Does the client have children under 18 years of age Select the appropriate radio button Yes No Unknown Note If No or Unknown is selected the system will auto fill the balance of the child protection items when you check the record is complete box and click the update
81. the next page DAANES Web User Manual 13 May 2010 continuation of the Facility screen from the previous page Mamas m Director prenie irector Firstname rectortasename ri rector ier Dieser Director mal com Coordinate Fest name lane Coordinator Last name th amp ane com DAANES Web User Manual 14 May 2010 USER LOGIN SCREEN Enter HTTPS daanes dhs state mn us in the address field of your browser to access DAANES web application and start by logging into the application Enter your User ID login ID and password then click the OK button with the left mouse button to log into the DAANES web application If you enter your password incorrectly three times your login ID will be locked out and you will need to contact your local web administrator to have your login ID unlocked If you are a local web administrator you will need to contact the DAANES system administrator at the Department of Human Services to have your login ID unlocked If you are successful in logging into the DAANES application you will be forwarded to the main DAANES web page Home screen tik won rode ct ra DAANES north Fa E tere The Home screen is the co
82. the staff member Staff members should change their password when they log into the DAANES web application for the first time or anytime after the password is reset by the administrator Confirm Password Reenter the password to verify that the password was entered correctly Password Requirements The Department of Human Services requires complex passwords for users The following requirements are to be incorporated into the password structure 1 Must be a minimum of 8 characters in length 2 Must contain alpha and numeric characters 3 Must contain upper and lower case characters 4 Must contain at least one special or punctuation character for example amp The login ID associated with password will be locked after three unsuccessful login attempts Once locked the local DAANES web administrator will need to be contacted to have the login ID unlocked Group Select your ISATS provider ID from the list Email Enter the staff member s email address Leave this field blank if the staff member does not have an email address UserManagement Facility Password 0 Confirm Password IsGroup Admin Email john smith CD cam DAANES Web User Manual 1 May 2010 After all fields are completed click the Add User button to add the user to the system message will be displayed either indicating that the user was added successfully or that an error was encountered Modify Un
83. tment through the Consolidated Fund are also assigned a PMI number How do I know if a treatment client is publicly funded and how do I obtain the PMI Number treatment clients who are referred through the Consolidated Fund or by a Public Prepaid Health Plan are publicly funded and have a PMI Number For Consolidated Fund referrals the Notification Letter sent to the treatment provider by DHS contains the PMI number called the Recipient ID Number AII Minnesota Health Care Program enrollees MA GAMC MinnesotaCare have an MHCP ID Card which includes the PMI number called the Member Number For referrals from Prepaid Health Plans HMOs the identification of a treatment client as a public program member can be determined from the client s health plan identification card Most Public Prepaid Health Plans include the PMI number on the card although there are some exceptions Here are the specifics for the eight Public Prepaid Health Plans in Minnesota not all plans operate in every county Blue Plus and The words Minnesota Health Care Programs on the card identify the client as a First Plan Blue public program member The 9 digit ID number on the card beginning with the digit 8 incorporates the PMI number which constitute the last 8 digits HealthPartners The words HealthPartners Care identify the client as a public program member The PMI number is on the member card Itasca Medical Car
84. udes clients who are enrolled in Minnesota State Contracted Pre Paid Health Plans PPHP s Pre paid MA Pre paid GAMC MinnesotaCare As of July 1 2008 state contracted pre paid health plans are responsible for providing all CD treatment services to their enrollees Chemical use assessments must be provided according to Minnesota Rules parts 9530 6600 through 9530 6655 Rule 25 The PPHP pays the provider and bills DHS for room and board services in non hospital residential programs Mid treatment enrollment dis enrollment Chemical dependency treatment providers are responsible for monitoring continued client PPHP enrollment on month to month basis This includes continued enrollment loss of enrollment or initiation of new enrollment or re enrollment If aclient loses enrollment during the treatment episode the provider must contact the client s county of financial responsibility CFR to determine eligibility for the CCDTF for continued funding under FFS faclient becomes enrollment in a PPHP during the treatment episode the provider must contact the client s CFR as well as the pre paid health plan for continued funding under the pre paid element DAANES Web User Manual 64 May 2010 Minnesota Health Care Programs MHCP MN ITS Interactive User Guide N ITS Objective Verify Eligibility for MHCP Recipients Performed by MN ITS Users This User Guide instructs providers to use the MN ITS Interactive El
85. ures All program staff should familiarize themselves with the instructions contained in this manual before using the DAANES data collection system Staff members should contact their local DAANES administrator for additional information and assistance The Drug and Alcohol Abuse Normative Evaluation System DAANES has been designed to provide policy makers planners service providers and others in Minnesota with access to current information about chemical dependency treatment activities across the continuum of care The Department of Human Services is required by statute to collect sufficient information to evaluate the efficiency and effectiveness of treatment for chemical dependency In addition the federal Substance Abuse and Mental Health Services Administration SAMHSA of the Department of Health and Human Services has mandatory reporting requirements through the National Outcomes Measurements NOMs monitoring system SAMHSA requires that all treatment providers who receive any state or federal funds report on this system for all treatment admissions regardless of funding source In Minnesota DAANES is used to meet both state and federal reporting requirements Information is collected and submitted on clients using web forms at three points in time Admission Six Month Review opioid replacement therapy clients only and Discharge Additionally DAANES requires one paper form for administrative purposes Notification of Data
86. ven in the case of an apparent tie Polysubstance dependence should be avoided as the primary diagnosis it may be used only when The client uses three or more s ibstances at identical frequency levels and One or two of these substances cannot be deemed to have caused more serious problems than the other s Polysubstance dependence hould be used as the secondary diagnosis only when One substance has been identified and coded as primary and The client us s an additional two or more substances at comparable frequency levels and One of these substances cannot be deemed to have caused more serious problems than the other s Disabilities or barriers to treatment Select Yes or No for each disability or barrier to treatment which is exhibited by the client Hearing impairment is coded if the client has a hearing impairment even if a hearing aid minimizes the impairment Visual impairment is coded if the client has difficulty with vision even while wearing gi contact lenses If the difficulty is corrected do not code this response Physical handicap includes severe orthopedic impairments resulting from birth defect disease or injury Code this response if the client uses a wheelchair cane or walker or has an artificial limb even if the client does not consider the condition a handicap Developmental disability means general intellectual functioning sign
87. view select primary secondary and tertiary problems If there are no problems select None First select primary substance of abuse which corresponds to the substance associated with the most severe problems the client has experienced Then select the secondary which corresponds to the substance next in problem severity Finally select the tertiary which corresponds to the third substance in problem severity Nicotine Tobacco may be coded as a secondary tertiary substance abuse problem None Alcohol Cocaine powder Crack Marijuana hashish Heroin Non prescription methadone Other opiates and synthetics PCP Other hallucinogens or psychedelics Methamphetamine Other amphetamines Other stimulants Benzodiazepines Other tranquilizers Barbiturates Other sedatives or hypnotics Ketamine Ecstasy other club drugs Inhalants Over the counter medications Other No secondary or tertiary substance Nicotine Tobacco secondary or tertiary only Unknown DAANES Web User Manual 37 May 2010 Number of days used in the last 30 days of the identified primary secondary and tertiary substances For each of the substances select as primary secondary and tertiary enter the number of days the client used that substance during the past 30 days Responses for use during the past 30 days may range from 0 to 30 or 99 for unknown Service Delivery Tab TIE sisi icis as oras DAANES nent sos ooo w
88. when the client is enrolled in school or on summer or holiday break Full time atus supersedes this category but other categories do not Retired is used only when the client has met the minimum retirement age and has retired from the work force Disabled is used if the client is unable to work because of a physical or mental condition Sheltered employment status supersedes this category Inmate of an institution is to be used if the client was in a jail prison or other institution Laid off unemployed looking for work means that the client is laid off from a position or is otherwise not employed but is physically and mentally able to work and is looking for work Unemployed not looking for work means that the client is not employed but is physically and mentally able to work but is not looking for work Other means that none of the categories listed above accurately describes the client DAANES Web User Manual 28 May 2010 Prior CD Treatment Experience Tab DAANES north Sa Emm EN set Tel teer Admission Form Admission ID 79995 Sas CEEE a EEA bale Tes __ 8 Placement Infomation Caminal Justice Clent Profle CD Trentment Expeence Chic Protecion Alcohol and Drug Use CH Seventy Ratings Number of lifetime detoxification admissions Number of lif
89. y Friday for the currently active service agreement which is entered on the placement information tab Check report 7 Service Agreements Missing DAANES Admission Records to verify the service agreement number has been cleared for reimbursement Current Cher al Dependency Treatment Select the type of chemical dependency treatment that is planned for the client at the time of admission After the admission record has been completed and validated this item may be updated to reflect a change in the client s intensity of treatment service such residential to non residential so long as the services occur within the same location and episode of treatment A change in this item also requires a date to be entered in the Date of Change item Hospital inpatient Residential less than 30 days planned Residential more than 30 days planned Non residential Methadone Date of Change This item is locked grayed out and is initialized with the date of admission Once the admi record has been completed and validated this item may be updated if the client transitions to a different intensity of treatment services such as change from residential to non residential so long as the services occur within the same location and episode of treatment Select the type of chemical dependency treatment that the client is transitioning to and then enter the date of the change The date must be at least one day greater than the date

Web User Manual For Chemical Dependency Treatment Programs

Contents

Download Pdf Manuals

Related Search

Related Contents