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MnCHOICES User Manual - Minnesota Department of Human

1. The Current Assessment screen of the Assessment displays ALL MnCHOICES Assessments have a Lead Agency When a MnCHOICES Assessment is created the Lead Agency is set to the user s Lead Agency MnCHOICES User Manual Draft 1 1 09 20 13 65 Page Ha i Minnesota Dopartmant of Human Services nt HORCES Ronon take Angee Grrerernert Lee Profe Logout Assesment Ann Anderson Assesment hk 1847 Certified Assessor Pebea 8 Lead Agency Dakota Public Hea th LenishtyY SUTTA L scvpitiom Cholaltv Loo Fript ituuut Graser Aner l maler DU Sirenia DH LIC Soei Doa PLA Service p eee ss Pindi iE 3 Reason for Contact amp Referral Source eden for Ceeggcr Sa fens Seier Source What n the earan for gent call bahay Demographic indormruton Lead Apgeeg AN Comesn ston i Releer al Daim Mirthnd ea Wi Teche M ng Kee Guarini E Emergency Terimi Are em calling abe yourself or samene che Kent min Dpwgcg 0 Waah Tatars ale Tat Ridinerting you te Deep aphic Inderenation Daab or Relaped o GO To Demographic Indomatio T uru fae DIPA Level I Miami Olness Quatt of Lite Da Da Haihh Pup Potada Meer A Cenit Femna NEW ASSESSMENT NAVIGATION Each Domain has a number to the right of it to signify the total number of required questions NOT yet answered within that domain Within each domain are groups with numbers to the right that signify the number of required questions NOT yet answered
2. Save Disposition Pending WwW Closed Outcome complete Abandoned Comments NMotificationBox Assessment is closed now e Closed Abandoned occurs when an Assessment is started but NOT sufficiently completed due to unforeseen circumstances to run eligibility rules e g person decides not to pursue eligibility determination person dies etc If a MnCHOICES Assessment has a status of Open or Pending it may be Closed with an outcome of Abandoned at any time ths Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor pwheg78 Lead Agency Dakota Public Health Current Assessment Eligibility Summary Dispositions Eligibility Log I Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement Save Disposition Pending Ww Closed Outcome Complete pbansoned Comments MnCHOICES User Manual Draft 1 1 09 20 13 87 Page OUTCOME COMMENTS Outcome comments may be entered when the disposition is set to Pending or Closed The comments may be updated at any time ths Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1883 Certified Assessor pwheg78 Lead Agency Dakota Pub
3. Screening Documents a 2 7 Read About this Domain Employment Volunteering amp Training 28 Complete all appropriate Employment Volunteering amp Training domain information for each group Volunteer Activities Barriers Summary amp Supports Referrals amp Goals Employment I Li Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement Person Information Routines and Preferences Quality of Life ADLs eee Geer NOTE this screen ae shot is not correct for Safety Self Preservation Preferences q uestions in communi Employment Routines Psychosocial hel 4 D D kl Communication Kee are some things that you enjoy doing Employment Volunteering amp Training About this Domain D Volunteering amp How do you want to spend your time Training 1 Barriers 0 Summary amp Supports 1 e D Employment P Volunteer Activities _ amp vg Do you like where you live housing city county etc mployment No Yes Chose not to answer Housing amp Environment 1 ei Se ke Comments Self Direction 0 Serv
4. a Pee een Reason for Contact amp Referral Source Reason for Contact amp Referral Source fr Demographic I nformation What is the reason for your call today Lead Agency amp Communication Referral Date Method Information aaa asa 4 29 2013 15 Face to Face sf Decision Making o e P Guardianship amp Emergency Contact Are you calling about yourself or someone else Health Insurance Payers 0 WwW Myself Someone else amp Providers OBRA Level 1 o HEH Developmental o Disability or Related gt gt Go To Demographic Information Condition rsch OBRA Level 1 Mental 0 Illness Redirecting you to Demographic Information Referral Reason 0 S Assessment Type Intake Summary Quality of Life 13 gt ADLs gt IADLs gt Health 10 Psychosocial 19 Memory amp Cognition 3 Safety Self Preservation 4 Cancan R E MnCHOICES User Manual Draft 1 1 09 20 13 68 Page 2 Expand the Quality of Life domain and select About this Domain Quality of Life ths Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs
5. cece cee cee eee eeeeeeeeeeaeeeeaeeeeeaeees 92 HEALTH RISK ASSESSMENT HRA STATUSES ccc cccceeeeeeeeeeeeeeeeeeeaeeeeseeeeeaeeeeeaeees 93 ADD AN FIRA NAVIGATION ssiscvcerstersearsneeveevnenenentwunyneabwoamnearnundes avuterinenupua lus ayaurnrabpentucaylaawie s 93 HEALTH RISK ASSESSMENT FULL DRAN 100 HEALTH RISK ASSESSMENT FULL HRAF ORBRIECTIME 0 ecceeeeeeeeeeeeeeeeeeeeeeeeeeeees 100 HEALTH RISK ASSESSMENT FULL HRAF STATUEN 100 OFFLINE ER 101 OFFLINE OBJEC TY E 101 PERSON OFFLINE EE 102 ASSESSMENT EEN 102 ee LAUNCH ORF Be EE 102 TRANSFER OIE BE 102 HEALTH RISK ASSESSMENT HRA OFFLINE 0 e cece cece cece tees eee ee eae eeeseeeeeaeeeeaaes 102 OFELINE NAVIGATION EE 103 VINCHOICES ASSESSMENT IREPORT EE 109 MNCHOICES ASSESSMENT REPORT ORIECTINE ccc ceeececeeeeeeee eee eeeeeeeeeeeeaeeeeaees 110 PREQUENTEY ASKED QUESTIONS E 110 TROUBLE SHOOTING osc2icscmcuteranietenent a 111 CEOS EE 111 MnCHOICES User Manual Draft 1 1 09 20 13 2 Page UPDATES gt 09 20 13 o Saving data entered edited on documents o Logging in when performing MnCHOICES tasks for multiple lead agencies o Additional information about Workload Grid in Assignment Queue MnCHOICES User Manual Draft 1 1 09 20 13 3 Page INTRODUCTION MnCHOICES is an assessment and support planning process for persons with long term service and support needs MnCHOICES streamlines the assessment process and replaces the following four assessments Developmental Disability DD S
6. St Paul Disability or Related SS i i Condition Street Address Line 2 State MN Zip 55105 Zip 4 SCH OBRA Level 1 Mental Street Address Line 3 County Ramsey Illness Riera Barm Directions Comments Assessment Type Intake ee Phone Numbers E Mail Home Home Work Ete Work Cell Comments lt lt Back To Decision Making amp Emergency Contact Q gt gt Go To Health Insurance Payers amp Providers MnCHOICES User Manual Draft 1 1 09 20 13 41 Page 9 Complete all appropriate Health Insurance Payers amp Providers information Current Case Dispositions Transfer Intake Questions for Ann Anderson 4 Intake Health Insurance Payers amp Providers Reason for Contact amp Referral Source Demographic Information Lead Agency amp Communication Information Decision Making Guardianship amp Emergency Contact Health Insurance Payers amp Providers OBRA Level 1 Developmental Disability or Related Condition OBRA Level 1 Mental Illness Referral Reason Assessment Type Intake Summary Are you certified disabled by Social Security or through the State Medical Review Team SMRT process WwW No 9 Yes W Unsure Certification Pending Is the individual on medical assistance W No No applied and found not eligible Yes 2 Pending Comments Does the individual have any type
7. lt lt Back To Decision Making Guardianship amp Emergency Contact MnCHOICES User Manual Draft 1 1 09 20 13 43 Page 11 Complete all appropriate OBRA Level 1 Developmental Disability or Related Condition information Current Case L Dispositions Transfer Intake Questions for Ann Anderson a Intake OBRA Level 1 Developmental Disability or Related Condition Reason for Contact amp Referral Source Demographic Long Term Care Consultation Program Information OBRA Level 1 Criteria Screening for Developmental Disabilities or Mental Illness This form must be completed for a person seeking admission to a Medical Assistance MA certified nursing or boarding care facility OR as part of a community assessment D a a s Lead Agency amp Communication Information Decision Making Guardianship amp Emergency Contact Health Insurance Payers amp Providers OBRA Level 1 Developmental Disability or Related 1 Does the person have a diagnosis of developmental disability or related condition YES Lei NO Condition eme EE Developmental Disability or Related Condition In order to consider a person for referral for further evaluation and determination of need for specialized services an individual may meet ANY of the following criteria diagnosis history or evidence of Developmental Disability OBRA Level 1 Mental 2 Has this person ever been considered to have developmenta
8. PCA Service Agreement gt Person Information CG Baan of Life gt _ gt About this Domain Quality of Life Routines and 4 Preferences Strengths and 2 Accomplishments Relationships Traditions and Rituals Future Plans Referrals amp Goals Quality of Life gt ADLs 9 IADLs 7 Health 10 gt Psychosocial gt Memory amp Cognition gt Safety Self Preservation Sensory amp Communication Employment Volunteering amp Training Housing amp Environment gt Self Direction Service Related Rights and Choices About this Domain Quality of Life Relationships Defining their own quality of life is what matters the most to the person To learn about what is important to the individual and what brings them satisfaction happiness and comfort It includes s Routines and preferences e Strengths and accomplishments Traditions and future plans lt lt Back To Referral Reason Assessment Type Intake Summary Michal Smull gt gt Go To Routines and Preferences 3 Read About this Domain Quality of Life 4 Complete all appropriate Quality of Life domain information for each group Routines and Preferences Strengths and Accomplishments Relationships Traditions and Rituals Future Plans and Referrals amp Goals Quality of Life If Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout
9. conduct a search and view search results 1 If you are NOT already on the Person Search select Person in the menu bar Person Intake Assignment Assessment User Profile Logout 2 Inthe Search By panel select the PMI Person Master Index HA Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person Search _ Name DOB Gender Search Information j PMI Start Search Clear Info MnCHOICES User Manual Draft 1 1 09 20 13 13 Page 3 Inthe Search Information panel enter the PMI and select the Start Search button The PMI is an 8 digit numeric character with leading zeroes The Clear Info button resets the search criteria values While a search is running the Start Search and Clear Info buttons are disabled Once the search is complete the two buttons are enabled again l HA Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person Search Search By PMI SSN J Name DOB Gender Search Information PMI 00000001 SS E q Start Search b Clear Info Also you may search by SSN TIP The Social Security Number does NOT need any dashes HA Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person Search Search By PMI 2 SSN Name DOB Gender Search Information
10. f d wie 5 20 2013 Heath Rick New WW Assessment Assessment 4 29 2013 Intake Ready To A Declined 5 28 2013 Update Person Add Intake Add Reassessment Add HRA 3 Select OK button NotificationBox Ea As there is no Assessment Date document can not be viewed MnCHOICES User Manual Draft 1 1 09 20 13 95 Page 4 Go to the Assignment Queue 5 Select an Assign To person 6 Select the Assign button ths Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Workload Refresh Data egen active Assessments ActvenRas Glass Marcia 3 Worscheck Heidi Assignment Doc Type Last Name 4 First Name 4 Date of Birth Age Physical Address i Zip Code County Assign To Assign o HRA Anderson Ann 4 29 2013 1 mths Assign INTAKE Anderson Ann 4 29 2000 13yrs Glass Marcia Assign Rehbein Michael INTAKE Flinstone 11 25 1975 37 yrs 8893 Rock Quary Bedrock Worecheck Herd Assign ZZDHS Hemmila bk vid Done Internet Protected Mode On f e R100 v MnCHOICES User Manual Draft 1 1 09 20 13 96 Page 7 Goto the Assessment Queue 8 Select an Assessment Date 9 Select View button Hki Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Queue Refresh Data Check Out for Offline Use Assessor Worscheck Hei Id Last Name MI Asse
11. iness Street Address Line 2 State Zip Zip 4 Referral Reason Street Address Line 3 County Assessment Type Intake Summary Directions Comments Phone Numbers Home Comments Work Ext Comments Cell Comments E Mail MnCHOICES User Manual Draft 1 1 09 20 13 38 Page 4 Select the Go To Lead Agency amp Communication Information button TIP To return to a previous group use either the buttons at the bottom of each screen or alternatively select from the left navigation panel Hki Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Current Case Dispositions Transfer Intake Questions for Ann Anderson Intake Demographic Information Reason for Contact amp l Referral Source PMI SWIND amp SSN 00000001 Demographic Information ad Agny i Address Physical Location Effective Date fis gt Communication Sheek Adde mnel City Information Decision Making Street Address Line 2 State Zip Zip A Guardianship amp Street Address Line 3 County Emergency Contact Health Insurance Payers Directions Comments amp Providers OBRA Level 1 Phone Numbers Developmental Disability or Related Home Comments Condition Work Ext Comments OBRA Level 1 Mental Illness Cell Comments Referral Reason Assessment Type Intake E Mail cul eg Home Comments Work Comments Type of telephone service used Preference to be contacted LJ Voice _ E mail L T
12. 14 Expand the Psychosocial domain and select About this Domain Psychosocial I Pat Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions 1 Eligibility Log d Print Export Assessment Answers Transfer 1 DD Screening Docs LTC Screening Docs PCA Service Agreement Quality of Life About this Domain Psychosocial ADIs To gather information related to psychological and social factors including Wee e Behavior and emotions and symptoms of diseases Health e Addictions sychosocial To identify potential referrals for additional assessment and treatment About this Domain Psychosocial lt lt Back To Referrals amp Goals Health gt gt Go To Behavior Emotion Symptoms Behavior Emotion 18 Symptoms Pediatric Symptom 0 Checklist PSC 17 Suicide Screen 1 Alcohol Substance 0 Abuse Tobacco Gambling Referrals amp Goals 0 Psychosocial Memory amp Cognition Safety Self Preservation Sensory amp Communication Employment Volunteering amp Training Housing amp Environment Self Direction Service Related Rights and Choices Caregiver 15 Read About this Domain Psychosocial 16 Complete all appropriate Psychosocial domain information for each group Behavior Emotion Symp
13. 81 Page 41 Expand the Assessment Information domain and select About this Domain Assessment Information TIK A Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement Pestnintornabon About this Domain Assessment Information Quality of Life ADLs To collect needed data about the assessment including e Type of assessment gt IADLs 7 e Reason for assessment Who was present at assessment Health Psychosocial lt lt Back To Referrals amp Goals Caregiver gt gt Go To Present at Assessment Memory amp Cognition Safety Self Preservation Sensory amp Communication Employment Volunteering amp Training Housing amp Environment Self Direction Service Related Rights and Choices Caregiver Assessment Information About this Domain P Assessment Information Administrative Information gt Assessor Conclusions Screening Documents 1 42 Read About this Domain Assessment Information 43 Complete all appropriate Assessment Information domain information for each group Administrative Information IRAI Minnesota Department of Human
14. Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement gt Person Information 4 Quality of Life About this Domain Quality of Life _ Routines and 4 Preferences p Strengths and 2 Accomplishments Relationships Traditions and Rituals 4 1 Future Plans 2 IW gt Referrals amp Goals Quality of Life gt ADLs gt IADLs gt Health gt Psychosocial gt Memory amp Cognition gt Safety Self Preservation n Sensory amp Communication Employment Volunteering amp Training gt Housing amp Environment gt Self Direction Service Related Rights and Choices Routines and Preferences Routines Preferences What is a typical day like for you What are some things that you enjoy doing Comments How do you want to spend your time Do you like where you live housing city county etc W No 2 Yes V Chose not to answer Additional Comments PO e MnCHOICES User Manual Draft 1 1 09 20 13 69 Page 5 Expand the ADLs domain and select About this Domain ADLs I L t Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessmen
15. Assessor Conclusions Screening Documents 1 30 Read About this Domain Housing amp Environment 31 Complete all appropriate Housing amp Environment domain information for each group Housing and Environment Referrals amp Goals Housing amp Environment I Li Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health current Assessment Summary Dispositions Eligibility Log Il Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement gt Person Information Routines and Preferences i NOTE this ADs eegen screen shot is not correct for gegen Geste questions in Geer EE Housing A Environment Health a Psychosocial Memory amp Cognition Employment Volunteering amp Training 4 Housing amp Environment About this Domain How do you want to spend your time Housing amp S Environment Housing and Environment Referrals amp Goals Do you like where you live housing city county etc Housing amp W No Yes W Chose not to answer Environment Erroa Self Direction Service Related Rights and Choices Additional Comments Caregiver Assessment Information Assessor Conclusions MnCHOICES User Manual Draft 1 1 09 20 13 78 Pag
16. Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary d Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement Person Information Quality of Life ADLs IADLs Health Psychosocial Memory amp Cognition Safety Self Preservation Sensory amp Communication Employment Volunteering amp Training Housing amp Environment Self Direction Service Related Rights and Choices Caregiver Assessment Information Assessor Conclusions 2 screening Documents p Developmental Disabilities DD Personal Care Assistance PCA zc Long Term Care LTC lt lt Back To Waiver Developmental Disabilities DD No Yes Do you want to complete a DD screening document for this assessment gt gt Go To Long Term Care LTC MnCHOICES User Manual Draft 1 1 09 20 13 84 Page 48 On the Eligibility Summary tab select Determine Eligibility button The Eligibility Summary evaluates program and service eligibility and displays the results ALL required Assessment questions MUST be answered before eligibility can be determined Eligibility MUST be re determined each time an Assessment question answer is changed The user MUST ensure that the last run of eligibility rules
17. Grid displays counts of the Assessor s active NOT Closed assessments and Health Risk Assessments HRA s The Workload Grid lists ALL the Assessors that are assigned to the same Lead Agency as the current user and are assigned the Edit Assessments HRA s security access It does NOT include users who ONLY have Create Assessment HRA s security access because they canNOT complete an assessment or HRA The Workload Grid is sorted by default according to Last Name The sort order may be changed by simply selecting another column header e The Workload Grid only displays the names of Assessors who have assessments and or HRAs assigned to them and in an open or pending status If an Assessor does not have any assigned open pending assessments or HRAs they will NOT appear on the Workload Grid Their name WILL appear on the Assign To list HA Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Workload Refresh Data o active Assessment Glass Marcia 13 Worscheck Heidi 1 Active HRAS e 3 MnCHOICES User Manual Draft 1 1 09 20 13 56 Page e The Assignment Grid displays a list of ALL Health Risk Assessments HRA s MnCHOICES Assessments and Intakes within the current user s Lead Agency For Intakes it displays those that are Ready for Assignment and NOT Closed When the Intake is Ready for Assignment the Intake still appears on the Intake Queue and ca
18. Personal Hygiene Grooming Equipment Toilet Use Continence Support Toilet Use Continence Support Equipment Mobility Walking and Wheeling Mobility Walking and Wheeling Equipment Positioning Positioning Equipment Transfers Transfers Equipment Referrals amp Goals ADLs I rat Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions Eligibility Log Print Export Assessment Answers d Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement 4 ADLs Routines and Preferences About this Domain o ADLs Routines gt Eating gt Eating Equipment Pp Sos NOTE this Bathing Equipment Dressing L Preferences SC re e n S h ot GE EE What are some things that you enjoy doing be Dec is not correct a for questions in ADLs What is a typical day like for you ele ed 1 How do you want to spend your time uppo Support Equipment gt Toilet Use Continence 0 gt Mobility Walking and 1 Wheeling Do you like where you live housing city county etc eme Tang and O W No 9 Yes Chose not to answer Wheeling Equipment Comments Positioning 1 Positioning Equipment 0 Transfers 1 Additional Comments Transfers Equip
19. Strengths and accomplishments Relationships Traditions and future plans Demographic Information Lead Agency amp Communication Information Defining their own quality of life is what matters the most to the person Michal Smull Decision Making o Guardianship amp d lt Back To Referral Reason Assessment Type Intake Summary TI d gt gt Go To Routines and Preferences Emergency Contact Health Insurance Payers O amp Providers OBRA Level 1 o Developmental Disability or Related Condition OBRA Level 1 Mental o Illness p Referral Reason o Assessment Type Intake Summary 4 Quality of Life 13 About this Domain o Quality of Life Routines and 4 Preferences Strengths and 2 Accomplishments Relationships 4 Traditions and Rituals 1 1 Complete any information NOT previously done in the Person Information domain and verify information that was collected during the Person Search and Intake TIP You may tab to each field Tabbing order is left to right and top to bottom 1a Minnesota Department of Human Services MnCHOICES ASSESSMENT Saved Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement
20. User Manual Draft 1 1 09 20 13 Decision Making Guardianship amp Emergency Contact Health Insurance Payers amp Providers OBRA Level 1 Developmental Disability or Related Condition QERA Level 1 Mental Illness Referral Reasons Assessment Type Intake summary Are you calling about yourself or someone else Lei Myself _ Someone else Redirecting you to Demographic Information gt gt Go To Demographic Information 4 37 Page 3 Complete all applicable Demographic Information TIP You may need to scroll to the bottom of the screen or use the arrow keys to view ALL of the questions ths Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Current Case Dispositions Transfer Intake Questions for Ann Anderson d aie Demographic Information Reason for Contact amp Referral Source Legal N Demographic SES Information First Name Middle Name Last Name Suffix Lead Agency amp bm amp Communication Information Date of Birth Gender Marital Status Decision Making fis Male Female Legally separated v Guardianship amp Emergency Contact Pp STE Health Insurance Payers PMI SWNDX SSN amp Providers 00000001 OBRA Level 1 Developmental S gt Disability or Related Address Physical Location Effective Date fas Condition _ _ Street Address Line 1 City OBRA Level 1 Mental R l
21. User Profile Logout Person and Activities for Ann Anderson Main Address amp Phone Race amp Language Messages from Server First Name Middle Name Ann LastName Anderson 1 al Date of Birth MnCHOICES Person ID 7200004910 Marital Status Le Est Date of Birth 4 29 2000 SWNDX Person ID SSN fe Gender O Male Female Clearing Status 1 PMI Document History n Date Created Document Type Sub Type Assessment Date Date Closed e Health Risk 3 29 2013 ZE Closed 3 29 2013 9 29 2013 Assessment view 4 29 2013 Intake Ready To 4 Deeg 5 28 2013 Update Person Add Intake Add Reassessment Add HRA MnCHOICES User Manual Draft 1 1 09 20 13 99 Page HEALTH RISK ASSESSMENT FULL HRAF HEALTH RISK ASSESSMENT FULL HRAF OBJECTIVE The objective of a Health Risk Assessment Full HRAF is when necessary to conduct a comprehensive MnCHOICES Assessment based on findings during an HRA prepopulate a The MnCHOICES Assessment prepopulates from the information entered in a Health Risk Assessment HRA When a user closes a Health Risk Assessment HRA with a disposition of HRA Full is Required an HRAF is created If a person has one or more previously completed MnCHOICES Assessments the most recent answers to ALL those questions pre populate the HRAF Answers from the parent HRA pre populate the HRAF Answers to the person demographics questions in the HRAF pre populate from the person mas
22. Yes Remove this application 2 The DHS MnCHOICES icon disappears from your desktop and Start menu 28 Log into MnCHOICES as normal For further information on logging into MnCHOICES please refer to the Login Section of this manual Login MnCHOICES User Manual Draft 1 1 09 20 13 109 Page MNCHOICES ASSESSMENT REPORT thd MNCHOICES ASSESSMENT REPORT OBJECTIVE The objective of the MnCHOICES Assessment Report is to provide a paper copy of all document subtypes Health Risk Assessment Health Risk Assessment Full New and Reassessment for appeals and forwarding to Lead Agencies MnCHOICES User Manual Draft 1 1 09 20 13 110 Page FREQUENTLY ASKED QUESTIONS Q can t see the questions on the right hand side of the screen What do I do A Your zoom needs to be set from 95 to 105 Q Can I access MnCHOICES from any computer A Yes As long as their user account is still valid a user may access MnCHOICES from any PC that meets the minimum technical requirements Depending upon the firewall configuration of the user s current internet provider however the user may NOT be able to determine eligibility Q Does MnCHOICES work on a Notebook or Tablet A Currently MnCHOICES technical issues on a Notebook or Tablet are NOT supported by the Help Desk TROUBLE SHOOTING e Itis standard practice to have a MnCHOICES Mentor for questions issues prior to contacting the Help Desk The Help Desk is available for Mentor
23. after all required questions have been answered Disposition the outcome of an Intake MnCHOICES Assessment Health Risk Assessment or a Health Risk Assessment Full Document History a listing that displays all the documents for a person Document Subtype a subcategory of a document type all subtypes of a given document have the same questions choices and show hide rules e g MnCHOICES Assessment subtypes are New Reassessment and Health Risk Assessment Full Health Risk Assessment subtype is Health Risk Assessment and Intake subtype is Intake Document Type a category of a record structure for capturing MnCHOICES information e g MnCHOICES Assessment Health Risk Assessment and Intake Domain a high level category for MnCHOICES Assessment questions Effective Date the date that the address became active Eligibility Summary after answering all required questions in a MnCHOICES Assessment it displays the eligibility results and details for level of care program services grants and additional supporting information that are automatically determined Estimated Date of Birth used for age determination when an actual Date of Birth is not known Event Log a record of significant actions that are person or system driven Exact Match search criteria for exact information entered Export HRA to XML File a button that saves the Health Risk Assessment questions and answers to an Extensible Markup Language XML file for integration with
24. and Intakes within the current user s Lead Agency Assignment Queue an array that displays both the Workload and Assignment Grids for the users Lead Agency Certified Assessor a person with the required credentials to perform a MnCHOICES Assessment Clearing Status a code used to indicate whether a person is a client or client representative in addition it is an indicator of whether a client is cleared for Person Search Results Close HRA a button that ends the Health Risk Assessment with a chosen disposition Closed a document type status that indicates that the document is complete and not editable MnCHOICES User Manual Draft 1 1 09 20 13 112 Page Community Support Plan CSP a support plan developed by the person and certified Assessor following a MnCHOICES assessment that provides resource and service options to meet the identified strengths preferences and assessed needs currently this plan is being done outside of the MnCHOICES application Complete a document type status that indicates that the document has finished successfully Date Closed the date that the status of the document type was changed to complete Date Created the date that an instance of the document type was developed Date of Birth DOB a required piece of information or estimated Date of Birth used to create a MnCHOICES Assessment for a person Determine Eligibility a button that invokes level of care program services and case mix determination
25. assessed need any additional accommodations J No Yes Screen Reader LTCC County lt lt Back To Demographic Information Ce gt gt Go To Decision Making Guardianship amp Emergency Contact gt MnCHOICES User Manual Draft 1 1 09 20 13 40 Page 7 Complete all appropriate Decision Making Guardianship amp Emergency Contact information Navigation and questions are age appropriate For example if the person is over 18 years of age the button and left navigation is labeled Decision Making Emergency Contact instead of Decision Making Guardianship amp Emergency Contact 8 Select the Go To Health Insurance Payers amp Providers button Hy Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Current Case Dispositions Transfer Intake Questions for Ann Anderson a iake Decision Making Guardianship amp Emergency Contact Reason for Contact amp Referral Source ives Demographic Are the parent s the legal representatives Information CJ No Yes Lead Agency amp Communication EMERGENCY CONTACT Inf ti First Name _ Middle Name M L Last Name _ Relationship _ l Decision Making Ben Ben Benson Ka Guardianship amp Spa i l EE Address of Emergency Contact Health Insurance Payers Type amp Providers Home k OBRA Level 1 Developmental Street Address Line 1 111 Candy Street City
26. for Ann Anderson Current Case a Intake Reason for Contact amp Referral Source km Reason for Contact amp Referral Source What is the reason for your call today PP Demographic Information EE Referral Date Method Lead Agency Pr lt M id Ane Communication Information Decision Making Guardianship amp O Myself L 3 Someone else Emergency Contact Health Insurance Payers amp Providers OBRA Level 1 Developmental Disability or Related Condition OBRA Level 1 Mental Illness Are you calling about yourself or someone else gt gt Go To Demographic Information Referral Reason Assessment Type Intake Summary If you select Someone Else for the Intake question Are you calling about yourself or someone else additional questions appear HA Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Current Case Dispositions Event Log Transfer Intake Questions for ann anderson 4 Intake Reason for Contact amp Referral Source p Reason for Contact amp Referral Source i Demographic What is the reason for your call today Information Referral Date Method Lead Agency amp Krtzreeeem lr e Communication Information Decision Making Guardianship amp L 7 Myself omeone else Emergency Contact Health Insurance Payers Caller amp Providers First Name Middle Name M1
27. for inclusion in the person s record If the person is not being admitted to a facility but is seeking community services retain this form in the person s county record Illness Reassessment Referral Reason Assessment Type Intake Summary CHANGE NO CHANGE gt gt Go To OBRA Level 1 Mental Illness lt lt Back To Health Insurance Payers amp Providers Print lt MnCHOICES User Manual Draft 1 1 09 20 13 45 Page 13 Complete all appropriate OBRA Level 1 Mental Illness information Current Case Dispositions Transfer 4 Intake Reason for Contact amp Referral Source Demographic Information Lead Agency amp Communication Information Decision Making Guardianship amp Emergency Contact Health Insurance Payers amp Providers OBRA Level 1 Developmental Disability or Related Condition OBRA Level 1 Mental Illness Referral Reason Assessment Type Intake Summary Intake Questions for Ann Anderson OBRA Level 1 Mental Illness Long Term Care Consultation Program Screening for Developmental Disabilities or Mental Illness This form must be completed for a person seeking admission to a Medical Assistance MA certified nursing or boarding care facility OR as part of a community assessment s Doctor Phone Dr Benson 555 555 5555 In order to refer a person for further evaluatio
28. items Person If the user has access security to the Person Search page the Person menu item opens the Person Search page To view further information on the Person Search page please refer to the Person Search Section of the manual Person Search Intake If the user has access security to the Intake Queue page the Intake menu item opens the Intake Queue page To view further information on the Intake Queue page please refer to the Intake Section of the manual Intake Assignment If the user has access security to the Assignment Queue page the Assignment menu item opens the Assignment Queue page To view further information on the Assignment Queue page please refer to the Assignment Section of the manual Assignment Assessment If the user has access security to the Assessment Queue page the Assessment menu item opens the Assessment Queue page To view further information on the Assessment Queue page please refer to the Assessment Queue Section of the manual Assessment User Profile All users have access to the Usser Profile page MnCHOICES User Manual Draft 1 1 09 20 13 10 Page Ae http 10 1 218 101 mnchoices default aspx EditPerson S Bai t X loj Bing Pr File Edit View Favorites Tools Help xX Snagit RB amp LL Favorites ep HI Suggested sites Customize Links Web Slice Gallery Windows Media S Windows 18 EditPerson Page Z e amp v Pages Safetyy
29. ka Ja mam elen Ier me ee e 4 k a r aper MnCHOICES User Manual Draft 1 1 09 20 13 21 Page The Main tab for the Person and Activities For Panel displays 4 Complete all the appropriate information TIP First Name Middle Name Last Name Birth and Gender are required HA Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person and Activities for Main Address amp Phone Race amp Language Messages from Server First Name Ann Middle Name Last Name Anderson suffix Date of Birth 4 29 2000 MnCHOICES Person ID Marital Status e Est Date of Birth SWNDX Person ID SSN YY Gender Male Female Clearing Status PMI Document History mmm Date Created Document Type Sub Type Assessment Date Date Closed Insert Person MnCHOICES User Manual Draft 1 1 09 20 13 22 Page 5 Select the Address amp Phone tab 6 Complete all appropriate information TIP One address and an effective date are required for a disposition TIP Scroll down or use arrow keys to complete all information HA Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person and Activities for Ann Anderson Main Address amp Phone Race amp Language Messages from Server Physical Address same as copy Insert Update Addresses Street Address Line 1 111 Elm Str
30. l l Check Out All Assessments for Offline Mode 4 Select the OK button i Hki Minnesota Department of Human Services MnCHOICES ASSESSMENT Saved Person Intake Assignment Assessment User Profile Logout pwheg78 Check Out Assessments for Offline for Dakota Public Health MnCHOICES User Manual Draft 1 1 09 20 13 103 Page 5 Select the OK button TIP After your first login on a new computer fewer pop ups occur MnCHOICES 64 bit batch file saved to Isolated Storage 6 Select the OK button MinCHOICes 32 bit batch file saved to Isolated Storage 7 Select the OK button 8 Select the OK button Mo HCH ES RuleSet saved to Isolated Storage 9 Select the OK button Ilog Executable saved to Isolated Storage a MnCHOICES User Manual Draft 1 1 09 20 13 104 Page 10 The Check Out Assessments for Offline screen displays Hs Minnesota Department of Human Services MnCHOICES REQUIRED Data Saved for Offline Mode Person Intake Assignment Assessment User Profile Logout pwheg78 Check Out Assessments for Offline for Dakota Public Health Please Right Click on the box below and then click on Install DHS MnCHOICES onto this computer Cn After the popup windows counts down from two please click on Install After MnCHOICES starts in Offline Mode and you see the Retreiving Data message this browser should close automatically with
31. other systems Group topic areas within a domain MnCHOICES User Manual Draft 1 1 09 20 13 113 Page HRA Assessment ID a unique number that is automatically assigned by the system to the Health Risk Assessment Insert Person a button that adds the Person record to the database Intake a preliminary screening used to gather information about the person to determine if the person would like an Assessment Intake Queue displays all Open and Ready for Assignment Intakes for the logged in Lead Agency Landing Page the screen that displays when you log into the MnCHOICES system Last Updated By the name of the person that last updated the Intake Last Updated Date the date when the Intake was last updated Lead Agency a county tribe or health plan MnCHOICES A single comprehensive assessment and support planning process for people with long term service and support needs that determeines eligibility for programs and services results in a support plan and is used for people of all ages and disability types It uses a web based application with of line capability and the internet is not used when completing assessments It is a policy rule based application that aligns rules regulations statutes etc to determine level of care case mix and eligibility for programs and services MnCHOICES Assessment an electronic questionnaire that combines 3 assessments Long Term Care Consultation Developmental Disabilities and Personal Care
32. select ONLY one option Yes or No for the question Is an interpreter needed If you uncheck a question ALL sub group questions will be hidden and the answers will be cleared 10 Select the Insert Update Races button HA Minnesota Department of Human Services Mot HO ES Person Intake Assignment Assessment User Profile Logout Person and Activities for Ann Anderson Main Address amp Phone Race amp Language Messages from Server Are you of Spanish Hispanic Latino descent 2 No Yes _ Unable to determine abandoned child Declined Unknown What is your primary language Amharic x Is an intepreter needed W Note Yes Insert Update Races What is your race American Indian Alaskan Native Asian Black or African American Caucasion Pacific Islander Unknown Declined American Indian Alaskan Native Subgroup v Alaskan Native Lower Brule Sioux Tribe Shakopee Mdewakaton Sioux Community v Bad River Band of Lake Superior Chippewa Lower Sioux Indian Community Sisseton Wahpeton Sioux Tribe v Bay Mills Indian Community Menominee Indian Tribe Sokaogon Chippewa Mole Lake Community Bois Forte Nett Lake Band of Chippewa Indians Mille Lacs Band of Chippewa Indians Spirit Lake Tribe Candian Tribe Minnesota Chippewa Tribe cannot identify specific band St Croix Chippewa Pham rosen wn e Dien Cim ne Teta Malala senn ann Teihana Minn Nidan Cen ss ellen en Panle Cin ne Teika v TIP After adding updating addres
33. telephone conversation Complete via Mail a document type disposition that indicates that the document was finished successfully through mail Complete via Face to Face a document type disposition that indicates that the document was finished successfully through an in person interview Complete MnCHOICES Assessment Required the system creates a Health Risk Assessment Full If an HRA is Closed with a disposition of Complete MnCHOICES Assessment Required the system populates ALL answers from the MnCHOICES HRA to the MnCHOICES HRAF Abandoned a disposition of a document type with a status of closed an unfinished Health Risk Assessment HEALTH RISK ASSESSMENT HRA STATUSES Valid HRA Statuses are Open occurs when the Add HRA button is selected and an HRA is created Pending occurs when a certified Assessor has completed the Health Risk Assessment HRA and is waiting for additional information to complete the Health Risk Assessment HRA Closed occurs when a Health Risk Assessment HRA is finished An HRA may be edited ONLY by users with Edit HRA security access and with a status of Open If the status of any existing HRA is set to Closed ONLY then does the system allow the creation of an HRA MnCHOICES User Manual Draft 1 1 09 20 13 93 Page ADD AN HRA NAVIGATION 1 Select Add HRA button The system requires that a person be 18 years or older to add a MNCHOICES HRA The person s age is calculated from the Date of Birth
34. to learn about MnCHOICES update their personal settings or modify their password View a button that opens an Intake or Assessment Workload Grid displays counts of the Assessor s active NOT Closed assessments and Health Risk Assessments HRA s MnCHOICES User Manual Draft 1 1 09 20 13 116 Page
35. 1 1 09 20 13 26 Page PERSON MAINTENANCE NAVIGATION If a person has one or more previously completed Intakes or MnCHOICES Assessments answers to ALL questions shall be pre populated from the most recent Intake or MnCHOICES Assessment Person demographics are editable in Person Maintenance ONLY NOT within the Intake OR Assessment As a result the Person demographics are updated in ALL Intakes Health Risk Assessments and Assessments that are NOT closed within Person Maintenenct Person information is NOT updatable in SSIS counties from MnCHOICES 1 On the Main tab modify any enabled information including First Name Middle Name Last Name Suffix Date of Birth Estimated Date of Birth Gender Marital Status and Social Security Number The MnCHOICES Person ID SWNDX ID Clearing Status and PMI Number are display ONLY and NOT editable This information canNOT be entered when adding a new person 2 Select the Update Person button He Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person and Actiwities for Main Address amp Phone Race amp Language Messages from Server First Name Middle Name n O Last Name Anderson Suffix JR j Date of Birth D MnCHOICES Person ID Marital Status Legally sepatated Est Date of Birth 4 29 2000 D SWNDX Person ID SSN Of Gender 2 Male Fem
36. 11 ELM STREET City ST PAUL Effective date 5 8 2013 Street Address Line 2 State MN Zip 55101 Zip 4 e Street Address Line 3 County Dakota v Directions Comments Home Address same as Physical Address v F copy Effective date lt M d yyyy gt Street Address Line d City State Zip Zip 4 e Street Address Line 2 Street Address Line 3 County Directions Comments Mailing Address same as Sal copy Street Address Line 1 City Effective date lt M d yyyy gt Street Address Line 2 State Zip Zip 4 The address and the effective date copy from one address area to another the Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person and Activities for Ann Anderson Main Address amp Phone Race amp Language Messages from Server Physical Address same as Home Address v copy Insert Update Addresses Street Address Line 1 111 ELM STREET City ST PAUL Effective date 5 8 2013 Street Address Line 2 State MN Zip 55101 Zip 4 Street Address Line 3 County Dakota Directions Comments Home Address same as Physical Address v copy Street Address Line 1 111 ELM STREET City Effective date 5 8 20
37. 13 Street Address Line 2 State MN Zip 55101 Zip 4 E Street Address Line 3 County Dakota v Directions Comments Mailing Address same as s copy Street Address Line 1 City Effective date lt M d yyyy gt State e Zip Zip 4 Street Address Line 2 MnCHOICES User Manual Draft 1 1 09 20 13 29 Page 7 Select the Insert Update Addresses Insert Update Phones and or Insert Update Emails buttons The Insert Update Addresses Insert Update Phones and Insert Update Emails buttons save any updates to that information TIP ONLY put numbers NO special characters in the phone number box TIP You may need to scroll down to view the buttons ths Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person and Activities for New Person Main Address amp Phone Race amp Language Messages from Server Street Address Line 3 County Dakota v Directions Comments Mailing Address same as bad copy Street Address Line 1f City i Effective date lt M d yyyy gt E Street Address Line 2 State Zip Zip 4 Street Address Line 3 County Directions Comments E Phone Number and Email Home 5555555555 Comments Work Ext Comments
38. 29 2000 F E April 29 2013 April 2013 We 3 10 17 24 Done Internet Protected Mode On fg R100 v MnCHOICES User Manual Draft 1 1 09 20 13 63 Page The Assessment Date displays for the Assessment TIP Once a MnCHOICES Assessment is completed it is recommended to NOT change the Assessment Date ths Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Queue Refresh Data Check Out for Offline Use Assessor Worscheck Hei Assessment Date 4 Date of Birth Assign To 1847 RSR Anderson Ann An MnCHOICES Assessment 4 29 2013 4 29 2000 13 F el 4 Select an Assignee to the Assessment ALL users that have the same Lead Agency as the current user and have the security access to Edit Assessment Health Risk Assessment Assessment Help Desk are in the Assign To drop down menu The current user MUST have Assignment security access to change an Assessor Assess Page Windows Internet Explore Ka a Cd eat http 10 1 218 101 mnchoices default aspx AssessmentDash k las gt lt Ki Bing A F File Edit View Favorites Tools Help x Snagit Be r Favorites Je HI Suggested Sites Customize Links Web Slice Gallery S Windows Media Windows GIL las rerni 1 B8 AssessmentDash x fl Assessment Synony m gt amp v Pagev Safety Tools ssessor First Name M
39. 9 20 13 60 Page ASSESSMENT MnCHOICES ASSESSMENT OBJECTIVE The objective of the MnCHOICES Assessment is to determine what supports will help the person to live their life and then toghether with the person develop a safe an appropriate plan based on what is important to and for the person It is an electronic assessment that combines Long Term Care Consultation Developmental Disabilities Screening and Personal Care Assistance Assessments It is a converstation with a person to help determine eligibility for long term service and supports MnCHOICES include new assessments reassessments and Health Risk Assessment Full s ALL MnCHOICES assessments have the same questions and answer options depending on the age of the person PRE POPULATION OF ASSESSMENT Prior to a user accessing the Assessment for the first time the system pre populates some answers to save you considerable time If a person has one or more previously completed MnCHOICES Assessments answers to ALL questions are pre populated from the most recent MnCHOICES Assessment Answers from the current Intake pre populate the Assessment overwriting previously entered answers on the closed Assessment that were copied to the New Assessment In addition answers to the person demographics questions in the Assessment are pre populated with the information from the Person Maintenance screen overwriting answers copied from a closed Assessment If a person has an existing Intake He
40. As each required question is answered the numbers lessen by 1 ALL required questions have an asterisk on both ends of the question Ultimately the goal is to have ALL numbers equal 0 to demonstrate completion of the Assessment Required questions are necessary to e Run the eligibility summary using the information gathered in the Assessment to determine level of care case mix and possible program and service eligibility e Develop a Community Support Plan based on what is important to and for the person If you uncheck a question ALL sub group questions will be hidden and the answers will be cleared thy Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor pwheg78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement Pe ee ne ee Reason for Contact amp Referral Source Reason for Contact amp 0 EE What is the reason for your call today Demographic 1 Information Lead Agency amp 2 Communication Referral Date Method Information T 4 29 2013 Jus Face to Face z Emergency Contact Are you calling about yourself or someone else Health Insurance Payers 0 WwW Myself Someone else amp Providers OBRA Level 1 0 Redirecting you to Demographic
41. Assessment or Health Risk Assessment e Closed Abandoned a disposition of a document type with a status of closed an unfinished Intake MnCHOICES Assessment or Health Risk Assessment MnCHOICES Assessments do NOT have a disposition until the status is Closed e Complete assessments where ALL required questions have been answered and eligibility rules are current e Abandoned a disposition of a document type with a status of closed an unfinished Intake MnCHOICES Assessment or Health Risk Assessment The valid outcomes for a Health Risk Assessment HRA are MnCHOICES User Manual Draft 1 1 09 20 13 54 Page e Complete occurs when the client refused an HRA e Complete via Phone a document type status that indicates that the document was finished successfully through a telephone conversation e Complete via Mail a document type status that indicates that the document has finished successfully through mail e Complete via Face to Face a document type status that indicates that the document has finished successfully through an in person interview e Complete Assessment Required the system creates a Health Risk Assessment Full ASSESSMENT DATE ONLY MnCHOICES Assessments and Health Risk Assessments have an Assessment Date Intakes do NOT have an Assessment Date Assessment Date may be edited in the Assessment Queue Users may NOT view or edit a MnCHOICES Assessment or Health Risk Assessment without an Assessment Date INTAKE QUEUE e
42. Assistant Assessments MnCHOICES Assignment when there is no assigned Assessor in the Assessment Queue the ability to set the Assessor for a person MnCHOICES Health Risk Assessment HRA a subset of questions from the MnCHOICES Assessment It is intended for persons of age 65 and older that are enrolled in Managed Care MnCHOICES Health Risk Assessment Full HRAF a MnCHOICES Assessment created from a Health Risk Assessment all answers are pre populated by the Health Risk Assessment MnCHOICES Person ID a system assigned unique identifier for a person MnCHOICES Reassignment the ability to change the assigned Certified Assessor to another Certified Assessor in that Lead Agency s Assessment Queue MnCHOICES Transfer the ability to change the Lead Agency of any open document New Assessment an assessment used for a person currently NOT on a long term care program or receiving long term care services MnCHOICES User Manual Draft 1 1 09 20 13 114 Page Offline Mode running the MnCHOICES application locally not connected via the Internet and determining eligibility when out of the office offline mode is the recommended mode to use Online Mode when you are connected to the MnCHOICES application via the Internet Open the status type of a MnCHOICES document indicating that the document is NOT Closed Pending or Abandoned appropriate security allows adding and editing information in the MnCHOICES Assessment Health Risk Assessm
43. Cell Comments Home E mail AAnderson yahoo com Comments Personal e mail address Work E mail Comments Insert Update Phones LI Insert Update Emails D thy Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person and Activities for New Person Main Address amp Phone Race amp Language Messages from Server Physical Address same as __ s _copy Street Address Line 1 111 Elm Street City Eagan Effective date 5 22 2013 Street Address Line 2 S State MN v Zip 55123 zip 4 Street Address Line 3 County Dakota v Directions Comments Home Address same as Physical Address v copy Street Address Line 1 111 Elm Street l City Eagan Effective date 5 22 2013 ra Street Address Line 2 State MN v Zip 55123 E 4 Street Address Line 3 County Dakota Directions Comments Mailing Address same as bd copy Street Address Line 1 City Effective date lt M ms Street Address Line 2 State Zip Zip 4 MnCHOICES User Manual Draft 1 1 09 20 13 30 Page thy Minnesota Department of Human Services MnCHOICES Successfull Inserting or Updating of Address Person Intake Assignment Assessment User Profile Logout Person and Activities for Ann Anderson Address amp Phone R
44. D sN Gender O Male Female Clearing Status PMI Document History mmm Date Created Document Type Sub Type Status Outcome Assessment Date Date Closed me MinCHOICES view 4 29 2013 Kempen eb New Assess Pending 4 29 2013 Closed to 4 29 2013 Intake Closed MinCHOICES 4 29 2013 Assessment Update Person Add Intake Add Reassessment Add HRA MnCHOICES User Manual Draft 1 1 09 20 13 89 Page SCREENING DOCUMENTS The system populates screening document information for Long Term Care Developmental Disabilities and Personal Care Assistance to help faciliate data entry into MMIS Screening document information for each type LTC DD and PCA may be printed or viewed SAVING ASSESSMENT DATA ENTERED Whenever you enter or update information in the Assessment you want to be sure that it is saved Do e Click on a different domain before closing e Click on a different question group before closing or e Click on another tab on your dashboard such as Eligibility Summary DD Screening Docs or Logout Don t just e Click on the X in the upper right hand corner of the screen e Close the browser MnCHOICES User Manual Draft 1 1 09 20 13 90 Page REASSESSMENT REASSESSMENT OBJECTIVE A Reassessment is used to re determine eligibility if a person is currently receiving publicly funded long term services and supports If a person has one or more previously completed MnCHOICES Assessments the
45. HA Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person Search Search By O PMI Options Q Exact Match SSN Starts With Name DOB Gender LJ Soundex Search Information Gender First Name Ann Last Name Anderson Male Date of Birth Age To Female Start Search Person not found in MnCHOICES Search State instead Clear Info Person search results NCHOICES Search Fa ES EEE RE EEE Select Anderson F 4 29 2 O Select Anderson Anni F 4A 29 2 a Add Person Search results are view ONLY If multiple names per person are returned a row for each name displays Names may NOT be related to the search criteria e g maiden name If the person is found in SWNDX and local county records exist the system returns client demographic details e g phone race etc and ALL addresses from the most recently cleared local county record If the person is found in SWNDxX and local county records do NOT exist the system ONLY returns person information e g name DOB gender address etc and physical address MnCHOICES User Manual Draft 1 1 09 20 13 16 Page 4 Inthe Person Search Results panel select the individual Person search results WinCHOICES Search ug BE Se SEENEN O Select Anderson n F A 29 2 O Select Anderson Ann F A 29 2 The Main Tab for Person and Activities appears ths Minnesota Depa
46. I Type Assessment Date Date of Birth Age Gender PMI Offline Assign To We Ann Ani MnCHOICES Assessment 4 29 2013 4 29 2000 13yrs i Worscheck Heidi V S Glass Marcia ZZDHS Hemmila David Done Internet Protected Mode On du e R100 e 5 Select the Assign button MnCHOICES User Manual Draft 1 1 09 20 13 64 Page ths Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Queue Refresh Data Check Out for Offline Use Assessor Worscheck Hei Last Name First Name MI Type Assessment Date 4 Date of Birth Age Gender PMI Offline Assign To A Anderson Ann An MnCHOICES Assessment 4 29 2013 4 29 2000 13 F o C 6 Select the Refresh Data button After the assignment is complete refresh the data so the assigned document no longer displays on the Assessment Queue H Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Queue Refresh Data Check Out for Offline Use Assessor Worscheck Hei S_ First Name Assessment Date Date of Birth Age Assign To Person J J 429203 D y Assign _ 7 Select on the View button l ths Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Queue Refresh Data Check Out for Offline Use Assessor Worscheck Hei
47. Information Developmental Disability or Related gt gt Go To Demographic Information Condition OBRA Level 1 Mental 0 Illness Referral Reason D t Type Intake Summary Quality of Life ADLs IADLs Health Psychosocial Memory amp Cognition MnCHOICES User Manual Draft 1 1 09 20 13 66 Page ALL of the following domains have a first screen describing the domain called About this Domain Quality of Life ADLs IADLs Health Psychosocial Memory amp Cognition Safety Self Preservation Sensory amp Communication Employment Volunteering amp Training Housing amp Environment Self Direction Service Related Rights and Choices Caregiver Assessment Information and Assessor Conclusions the Minnesota Department of Human Services MnCHOICES ASSESSMENT Saved Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor pwheg78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement About this Domain Quality of Life Ab i i o Quality of Life To learn about what is important to the individual and what brings them satisfaction happiness and comfort It includes Routines and 4 Preferences 4 Quality of Life 13 Routines and preferences Strengths and accomplishments Relationships Traditi
48. Last Name OBRA Level 1 Developmental Disability or Related Are you calling about yourself or someone else Caller Address Condition OBRA Level 1 Mental Illness Referral Reason Street Address Line 1 City Assessment Type Intake F Simaa Street Address Line 2 State Zip Zip 4 Street Address Line 3 County Directions Comments Phone Numbers E Mail Home Home Work Ext Work Cell Comments MnCHOICES User Manual Draft 1 1 09 20 13 36 Page INTAKE NAVIGATION 1 Complete all applicable Reason for Contact amp Referral Source information fields TIP You may tab to each field Tabbing order is left to right and top to bottom 2 Select the Go To Demographic Information button or alternatively select Demographic Information from the left navigation panel Minnesota Department of Human Services MnCHOICES thes Person Intake Assignment Assessment User Profile Logout Current Case Dispositions Transfer Intake Questions for Ann Anderson Reason for Contact amp Referral Source A Intake Reason for Contact amp Referral Source Demographic Information What is the reason for your call today _ Referral Date Method Lead Agency amp 4 29 2013 Face to Face i Communication Information MnCHOICES
49. Last Updated By the name of the user that last updated the Intake Updating answers on the Intake or Person Demographics that flow to the Intake cause the Last Updated By to change e Last Updated Date the date a question was last entered on the Intake Updating answers on the Intake or Person Demographics that flow to the Intake cause the Last Updated Date to change The default sort order for the Intake Queue is by Last Name The sort order may be changed by simply selecting a column header SAVING INTAKE DATA ENTERED Whenever you enter or update information in the Intake document you want to be sure that it is saved Do e Click on a different question group before closing or e Click on another tab on your dashboard such as Logout Don t just e Click on the X in the upper right hand corner of the screen e Close the browser MnCHOICES User Manual Draft 1 1 09 20 13 95 Page ASSIGNMENT ASSIGNMENT OBJECTIVE The objective of Assignment is associating Assessors with their responsibilities to conduct a MnCHOICES Assessment ONLY the assigned certified Assessor may edit their assigned MnCHOICES Assessment s The assessment displays for a certified Assessor The assigned Assessor for the assessment can be changed TIP Information from coverage calls are emailed to the assigned certified Assessor who updates the assessment as appropriate ASSIGNMENT QUEUE The Assignment Queue consists of two tables e The Workload
50. Lei Eireren Terier Related Fights arid Chame Additional Comments Caregiver Asean Iedeupantan Apar Lr tui MnCHOICES User Manual Draft 1 1 09 20 13 75 Page 23 Expand the Sensory amp Communication domain and select About this Domain Sensory amp Communication I L t Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement About this Domain Sensory amp Communication Quality of Life ADLs IADLs To assess and collect information about the individual s Vision and hearing Health Sensory functioning d Ability to communicate Psychosocial To identify ref Is f et need M moiy amp Cognition o identify referrals for unm s Safety Self Preservation e lt lt Back To Referrals amp Goals Safety Self Preservation gt gt Go To Vision Sensory amp Communication About this Domain _ Sensory amp Communication Vision Hearing Functional Communication Sensory Integration Supports Needed Referrals amp Goals Sensory amp Communication Employment Volunteering amp Training Housing amp Environment Self Direction Service Related Rights a
51. Minnesota Department of Human Services MnCHOICES User Manual Draft 1 1 NOTE This is the VERY first draft of the MUM and it has not been fully vetted Users may find information terms in the MUM that conflict with instructions received for Beta testing or information learned during navigation training Allin all MUM Draft 1 0 is a viable resource but users are encouraged to provide feedback on sections that need more clarification or topics and tools that need to be added Minnesota Department of Human Services wem _ er CHOICES Table of Contents INTRODUCTION osa a toseetizuaise E S S 3 EOIN eee E E ee en ee ee ee E ee ee eee 5 LOGIN OBJE C VE 5 LOGIN NAVIGA HORN BE 5 ale Iewen T EANDING PACES OBJE OF TVE cerien a E EE 7 MnCHOICES LANDING PAGE LOOGIN cece cece cere eee eee ee ee eeeae nessa eesaaeeeaeeeesaeeeas 8 SSIS LAUNCH LANDING PAGE 00 ccc cece cence eect e cent eee ee ee eae nessa essa eeeaaeeesaaeesaeeeeseeeesaeeeesaes 8 SSIS LAUNCH LANDING PAGE NAVIGATION 8 MAIN NIE EE 10 pce KEE 13 OO OB RE 13 PERSON SEARCH NAVIGATION 13 PERSON SEARCH FROM SSIS LAUNCH csesprendeecreaeranapreniesynceeescnnnaneenpeeenetaetia sneer 18 PEROON AOD INA VIG TION EE 19 PERSON MAINTENANCE NAVIGATION 26 INTAR cern ee re ee ne ee ee ee eee eee 33 NTARE OBJECTIVE E 33 AUDDINTARENAVIGATION renne 33 NTARE NA WGI NOUN aeee acieaus cain sane pn acnans aawesane pa asmana sa pevaneeeuoaeapaneaiaeaiesanesanscarapanasancons 3 DOCUMENT TY
52. PE rreren certs EE hasan SE ENEE EEE ee EER EEEE EEE SE E E EEEE 50 DOCUMENT SUB IYPES ere ere re et en eee er 50 ATAKE RT RR eree nee e E E E S season salvation ve seqpene ee eaataa maengeseue tian 51 IERT 51 DiS e0 SUS Clee Seer er ee rr err tre 54 Ao E SO NENT DATE deiere 55 IR ER ET 55 EI OC RRE 55 ASSIGNMENT OBJECTIVE 1 0 2 0 cece ccee cece cece tere eee seater eee eeeaa ee eaa ee eaa esse eesaaeeesaaeesaaeeeaeeeesaaees 56 ASSIGNMENT QUEUE sie venasteprineusnsinwerashisirneu eintn enasiupyanasirirlexaisbupiyneetsumniunuehispiynenusuaraenehepiyneaisbatreascd 56 ASSIGNMENT NAVIGATION cererea E 57 AoE TC ee ae nner eae eee E eee 60 MnCHOICES ASSESSMENT OBJECT IVE cece cece eee e eect eee eeeeeeeeeeeaeeeeseeeesaeeesaeeesaees 61 MnCHOICES User Manual Draft 1 1 09 20 13 1 Page NEI EI aler el E NEE EE 61 PD E RE EE 61 MnCHOICES ASSESSMENT QUEUE NAVIGATION 62 PERTINENT ASSESSMENT QUEUE COUUMNG cece cece ee ee cette eee eeeaeeeeeaeeeeaeeeeeaeees 62 NEW ASSESSMENT NAVIGATION 66 MnCHOICES ASSESSMENT DISPOSITIONS wisissscxsscastvrcacpassseavaeheneacneusseevsanrmeacpmavaceeelaawiess 86 OUTCOME COMMENT Sysnstauutatieas Ee aca aaa 88 VinCHOICES ASSESSMENT STAT E 89 SCREENING DOCUMENT EE 89 REAS SES OIVIEIN BEE 90 Ki E Wl RE 91 REASSCESOVIENT INAV IGA LION ico isacantteictnnte ieee EE 91 wl Be ME Ed E HE e e EE 92 HEALTH RISK ASSESSMENT HRA OBJECTIVE 0 oe ecee cece cece i 92 HEALTH RISK ASSESSMENT HRA DISPOSITIONS 0 0
53. RAF The system allows ONLY Assessments with a status of Open or Pending to be taken offline ONLY the user assigned to that Assessment and in that Lead Agency has the ability to take the Assessment offline When in offline mode users with security access of View Assessments may view other Assessments offline Users may check out Assessments offline from the Assessment Queue ALL Assessments assigned to that user are checked out offline When in offline mode the MnCHOICES Application may be accessed by 1 Clicking on the DHS MnCHOICES icon on their desktop this icon was created during check out for offline use 2 User clicks on DHS MnCHOICES from their start menu DAS MNCAOI After logging in in offline mode the application opens to the Assessment Queue When in offline mode ONLY Assessments can be performed or edited The user canNOT perform person searches Intakes nor create add a new Assessment HRA or reassessment The user checks in ALL Assessments for ONLINE use from the Assessment Queue When opening MnCHOICES again in online mode the data entered during offline mode is present If the computer crashes while in offline mode the user MUST call the SSIS Help Desk to have Assessments brought back online MnCHOICES User Manual Draft 1 1 09 20 13 101 Page PERSON OFFLINE Person Information is view ONLY with the exception of Home and Mailing Address ASSESSMENT OFFLINE Offline mode allows the user to p
54. Race amp Language Messages from Server First Name Ann Middle Name Ann Last Name Anderson Suffix x Date of Birth 4 29 2000 D MnCHOICES Person ID Marital Status Est Date of Birth SWNDX Person ID SSN 444444444 Gender O Male Female Clearing Status PMI Document History Date Created v Document Type Sub Type status Outcome Assessment Date Date view 5 8 2013 Intake Ready To Assign Add HRA Update Person Add Intake Add Reassessment New occurs when a client has never had a MnCHOICES assessment A MnCHOICES Assessment of type New Assessment is created when an Intake is Closed with a disposition of Assessment Accepted and the certified Assessor is assigned He Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person and Activities for Ann Anderson Main Address amp Phone Race amp Language Messages from Server First Name Middle Name Ann 1 LastName Anderson suffix __ Date of Birth 4 29 2000 D MnCHOICES Person ID Marital Status Est Date of Birth D swnpx Person ID SSN Ir f Gender O Male Female Clearing Status PAI Document History weng Date Created Document Type Sub Type Status Outcome e Assessment Date Date Closed wm MnCHOICES SE New Sg 4 29 2013 Acceccment New asses New 4 29 2013 h Closed occurs if the Disposition is Assessment Accepted and
55. Referral Source In order to consider a person for referral for further evaluation and determination of need for specialized services an individual may meet ANY of the following criteria i is hi i f d Disability Beete diagnosis history or evidence of Developmental Disability Information 1 Does the person have a diagnosis of developmental disability or related condition J VES J NO Lead Agency amp Communication 2 Has this person ever been considered to have developmental disability or a related condition YES W NO Information in the past Decision Making 3 Is there any presenting evidence cognitive or behavioral that may indicate the presence of YES W NO Guardianship amp Emergency Contact Health Insurance Payers amp Providers developmental disability or related condition 4 Has the person been referred for nursing or boarding care facility placement by an agency that YES No serves persons with developmental disability or related condition OBRA Level 1 Developmental Disability or Related Condition OBRA Level 1 Mental If you have answered YES to ANY of the previous questions refer the person to the County offices for persons with developmental disabilities or related conditions for evaluation and determination of need for specialized services If the person is being admitted to a certified nursing or boarding care facility and is NOT subject to a level II referral forward this form to the facility
56. S Valid Document Sub Types are the following New Assessment if a person is NOT on a program or receiving services a new assessment is used to determine eligibility NOTE When lead agencies launch reassessments even though people who need reassessments are currently on a program or receiving services their very first reassessment in MnCHOICES when there has not been a previous New Assessment is called a New Assessment Reassessment if a person is currently on a program or receiving services a reassessment is used to re determine eligibility Health Risk Assessment Full HRAF the MnCHOICES Assessment resulting from a Health Risk Assessment HRA MnCHOICES User Manual Draft 1 1 09 20 13 50 Page INTAKE DISPOSITIONS Selecting a Disposition causes the system to change the intake status When a new Intake is created the disposition is set to blank The Intake Dispositions are Closed Assessment Accepted occurs when a person agrees to schedule an assessment Closed Assessment Declined occurs when a person does NOT choose to schedule an assessment Closed Assessment Abandoned occurs when an Intake which is started but NOT sufficiently completed to result in an assessment Open occurs when the Assessment is assigned and NOT being worked on Pending occurs when an Assessor has worked on the Assessment but is waiting on another piece of information INTAKE STATUSES There are four Intake Statuses that appear in the Documen
57. SSN 111111111 Start Search Clear Info MnCHOICES User Manual Draft 1 1 09 20 13 14 Page or Name DOB or Age Range Gender TIP Date of Birth DOB needs to have a four digit year TIP At least one character is required in the First Name and at least two characters in the Last Name text box First Name and Last Name text boxes are NOT case sensitive If the search criteria Name DOB and Gender are selected the Options Exact Match Starts With and Soundex display The default is Starts With Soundex is for users that may be uncertain of a name spelling The Options Exact Match and Starts With ONLY display for a MnCHOICES search and if the search criteria Name DOB and Gender are selected If you don t receive your desired search results use the button Person not found in MnCHOICES Search State instead to manually search the State database HA Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person Search Search By PMI Options Exact Match ta SSN LJ Starts With Name DOB Gender A Soundex Search Information Gender First Name Tam O Last Name Anderson t Male Date of Birth 4 29 2013 as Lei Female _ Start Search __ Person not found in MnCHOICES Search State instead __Clear Info MnCHOICES User Manual Draft 1 1 09 20 13 15 Page In the Person Search Results panel the individual for the searched PMI displays
58. Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions I Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement Wee Eeer Routines and Preferences Quality of Life ADLs 9 D DL What is a typical day like for you NOTE this screen Routines SE shot is not correct Memory amp Cognition Safety Self Preservation Fees fo r q u esti O n S i n eri eer Assessment Employment D Volunteering amp Training nfo rm ati O n Housing amp Environment 1 7 S How do you want to spend your time Service Related Rights 1 a and Choices Caregiver R 4 Assessment Information Do you like where you live housing city county etc About this Domain W No WW Yes Chose not to answer Assessment Comments Information O O O kan Administrative Information Additional Comments Assessor Conclusions Screening Documents MnCHOICES User Manual Draft 1 1 09 20 13 82 Page 44 Expand the Assessor Conclusions domain and select About this Domain Assessor Conclusions I rat Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Ag
59. TY C Mail CH Videaphone LC Telephone lt lt Back To Reason for Contact amp Referral Source MnCHOICES User Manual Draft 1 1 09 20 13 39 Page 5 Complete all appropriate Lead Agency amp Communication Information 6 Select the Go To Decision Making Guardianship amp Emergency Contact button ths Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Current Case Dispositions Transfer Intake Questions for Ann Anderson Reason for Contact amp Referral Source Demographic Information Lead Agency amp Communication Information Decision Making Guardianship amp Emergency Contact Health Insurance Payers amp Providers OBRA Level 1 Developmental Disability or Related Condition OBRA Level 1 Mental Illness Referral Reason Assessment Type Intake Summary ie Lead Agency amp Communication Information County Responsibility County of Service COS County of Residence COR County of Financial Responsibility CFR Dakota 019 Dakota 019 gt Are you of Spanish Hispanic Latino descent No Yes Unable to determine abandoned child Declined Unknown What is your race American Indian Alaskan Native Asian Black or African American Caucasian Pacific Islander Unknown Declined What is your primary language Lakota v Is an interpreter needed No Yes Does the person to be
60. To 4 Assign ke Anderson 4 29 2000 13 yrs AEE NewAssign H Grooper Miles 8 14 1935 77 yrs 8955 Lexington Circle Pines Anoka Glass Marcia Worscheck Heidi ZZDHS Hemmila David Glass Marcia Worscheck Heidi ZZDHS Hemmila David Glass Marcia Worscheck Heidi ZZDHS Hemmila David Glass Marcia Worscheck Heidi ZZDHS Hemmila David Glass Marcia H LeeGlass Mark 8 14 1990 22 yrs 9482 Larson st Jasper Dakota Done Internet Protected Mode On as R100 v MnCHOICES User Manual Draft 1 1 09 20 13 59 Page 2 Select the New Assign button for the desired assignment ths Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Workload Refresh Data lastName Active Assessments Active HRAS e Glass Marcia 5 Assignment Last Name First Name Date of Birth Age Physical Address City Zip Code Grooper Miles 8 14 1935 77 yrs 8955 Lexington Circle Pines LeeGlass Mark 8 14 1990 22 yrs 9482 Larson st Jasper County Assign To Assign Newassign D Anoka NewAssign Dakota Newassion 3 The Assignee s name and active assessments HRA s displays in the Workload table Person Intake Assignment Assessment User Profile Logout Workload Refresh Data LastName Active Assessments Active HRAs Glass Marcia 5 Worscheck Heidi MnCHOICES User Manual Draft 1 1 0
61. Tools v H i Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person and Activities for Ann Anderson Main Address amp Phone Race amp Language Messages from Server Physical Address same as Home Address ell copy g Insert Update Addresses j Street Address Line 1 111 ELM STREET City ST PAUL Effective date 5 8 2013 bs Street Address Line 2 State MN v Zip 55101 Zip 4 Street Address Line al County Dakota s Directions Comments Home Address me copy same as e Street Address Line 1 Mailing Address Effective date lt gn Street Address Une 2 V x Zip Zip 4 Street Address Line 3 County BE Directions Comments Mailing Address same as x copy Street Address Line 1 City H Effective date i ol Street Address Line 2 State e Zip Zip 4 a Done Internet Protected Mode On th v R100 MnCHOICES User Manual Draft 1 1 09 20 13 28 Page 6 Select the Copy button of where the address is copying to the Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person and Activities for Ann Anderson Main Address amp Phone d Race amp Language Messages from Server Physical Address same as Home Address x copy Insert Update Addresses Street Address Line 1 1
62. Toolsy 23 Person Intake Assignment Assessment User Profile Logout D GES e About MnCHOICES Person and Activities for Ann Anderson Settings Main Address amp Phone Race amp Language Messages from Server FirstName Ann Middle Name nn Last Name Anderson Suffix v Date of Birth D MNCHOICES Person ID 20 Marital Status gt Est Date of Birth 4 29 2000 D SWNDxX Person ID SSN Gender Male Female Clearing Status PMI Document History a oC pte Casen 4 29 2013 Intake Open Open Update Person Add Intake Add Reassessment Add HRA Done Internet Protected Mode On as R100 v The User Profile menu item opens the sub menus About MnCHOICES and Settings The About MnCHOICES page gives a MnCHOICES overview and points to remember for the certified Assessor MnCHOICES User Manual Draft 1 1 09 20 13 11 Page ths Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Overview of the MnCHOICES Assessment Application MnCHOICES Build 600 20 is an assessment and support planning process for persons with long term care needs Persons of all ages and income can request an assessment Only certified assessors can complete the MnCHOICES assessment Certified assessors are professionals who have met the training and e
63. a Street Address Line 1 City Street Address Line 2 State Zip Zip 4 Street Address Line 3 County Directions Comments 22 Select the Check In for Online Use button He Minnesota Department of Human Services MnCHOICES Assessment User Profile Logout Assessment Queue Check In for Online Use Sub Type Assessment Date Date of Birth Age GH 1904 Anderson Ann Health Risk Assessment 5 29 2013 4 29 2013 Lmbe F 1847 Anderson Ann Ani MnCHOICES Assessment New Assessment 4 29 2013 4 29 2000 13 yrs F 23 Select the Check In All Assessments for Online Mode button He Minnesota Department of Human Services MnCHOICES Assessment User Profile Logout pwheg 8 Check In Assessments for ONLINE MODE for 199643500 Check In All Assessments Tor Online Mode MnCHOICES User Manual Draft 1 1 09 20 13 108 Page 24 Right click on the large rectangular box Hy Minnesota Department of Human Services MnCHOICES Assessment User Profile Logout pwheg78 Check In Assessments for ONLINE MODE for 199643500 Please Right Click on the box below and then click on Remove this application Click to Confirm Removal and that will take MnCHOICES out of Offline Mode and close this window pT Don t worry when you open MnCHOICES in Online Mode from your regular link all your data will be there 25 Select Remove this application Silverlight Remove this application 26 Select
64. a certified Assessor is selected or the Disposition is Abandoned or Assessment Declined If the Intake is in a Closed Status it may be viewed but NOT be edited MnCHOICES User Manual Draft 1 1 09 20 13 53 Page He Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person and Activities for Ann Anderson Main Address amp Phone Race amp Language Messages from Server First Name Ann Middle Name Ann Last Name Anderson Suffix z Date of Birth 4 29 2000 e MnCHOICES Person ID Marital Status v Est Date of Birth D SWNDxX Person ID SSN Gender Male Female Clearing Status PMI Document History a assessment Date pate ciosea MnCHOICES ven 4 29 2013 New Assess New 4 29 2013 Assessment Closed to 4 29 2013 Intake MnCHOICES 4 29 2013 Assessment Update Person Add Intake Add Reassessment Add HRA DOCUMENT OUTCOME The Outcome indicates at a high level the result of the assessment The valid outcomes for an Intake are e Assessment Accepted a disposition that creates a MnCHOICES Assessment e Assessment Declined a disposition signifying that Intake was closed and the person decided to NOT have a MnCHOICES Assessment created The valid outcomes for a MnCHOICES Intake Assessment or HRA Document are as follows e Closed Complete a disposition of a document type of status of closed a successfully finished Intake MnCHOICES
65. ace amp Language Messages from Server Physical Address same as Home Address z copy Insert Update Addresses Street Address Line 1 111 ELM STREET City ST PAUL Effective date 5 8 2013 Street Address Line 2 State MN Zip 55101 Zip 4 Street Address Line e County Dakota e Home Address same as Physical Address v copy Street Address Line 1 111 ELM STREET City ST PAUL Effective date 5 8 2013 Street Address Line 2 State MN Zip 55101 Zip 4 e Street Address Line 3 County Dakota e Directions Comments Mailing Address same as copy Street Address Line 1 City Effective date lt M d yyyy gt Street Address Line 2 State v Zip Zip 4 MnCHOICES User Manual Draft 1 1 09 20 13 31 Page 8 Select the Race amp Language tab 9 Modify any enabled information You may select multiple Race options Some questions have hidden sub group questions For example if you respond American Indian Alaskan Native to the question What is your race the system displays the question and options for American Indian Alaskan Native sub group You may select multiple responses to the sub group In addition the system will display the question and responses for Tribal Status You may select ONLY one tribal status You may select ONLY one language Radio buttons may be either selected or unselected You may
66. acility or boarding care facility refer the person to the county local mental health authority for completion of a Level I evaluation and determination of need for specialized services e Ifthe person is seeking a community placement retain the form in person s record and refer the client to others county social services county mental health office physician health plan to receive necessary mental health services If your answer is NO to ANY of the questions above e And the person is seeking admission to an MA certified nursing facility or boarding care facility send the form to the admitting facility for inclusion in the person s records e And the person is seeking community placement retain the form in the person s file If in the future the person is admitted to a nursing facility review the form for accuracy and send to the facility Reassessment O CHANGE NO CHANGE Signature of Screener ial as _ _ eas lt lt Back To OBRA Level 1 Developmental Disability or Related Condition gt gt Go To Referral Reason Assessment Type Intake Summary D Print km MnCHOICES User Manual Draft 1 1 09 20 13 47 Page 15 Complete all appropriate Referral Reason Assessment Type Intake Summary information 16 Select the Dispositions tab HA Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Current Case Dispositions J Transfer In
67. ale Clearing Status PMI Document History Date Created Document Type Sub Type Status Outcome Assessment Date Date Closed ia mme EE e Add Intake Add Reassessment Add HRA The updated information on all the tabs save MnCHOICES User Manual Draft 1 1 09 20 13 2 Page 3 Select the Address amp Phone tab The system allows the user to maintain three different address types Physical Location Home and Mailing address The system allows the user to maintain three different phone types Home Work and Cell ALL phone types have their own separate comment boxes The system allows the user to maintain two different email tyoes Home and Work Both email types have their own separate comment boxes 4 Modify any enabled information The user may copy ALL address information from one address type to another by using the copy button When adding an Intake or Assessment the Intake or Assessment automatically populates with the Physical Location ONLY 5 Select the address to copy to from the Same As drop down menu j EditPerson Page Windows Internet Explorer A http 10 1 218 101 mnchoices default aspx EditPerson v aMi 441 X ib Bing pP e File Edit View Favorites Tools Help X Snagit RI Ly Favorites jeg DI Suggested Sites Customize Links S Web Slice Gallery S Windows Media Windows e em d EditPerson Page th v Ei v v Pager Safetyy
68. ale Clearing Status PMI Document History on Date Created Document Type Sub Type Status Outcome Assessment Date Date Closed e ae 4 29 2012 Intake Open Open be Update Person Add Intake Add Reassessment Add HRA If the status of the Intake is NOT Closed the user s Lead Agency is the same as the Intake s Lead Agency and the user has Edit Intake security access ALL the Intakes are editable MnCHOICES User Manual Draft 1 1 09 20 13 34 Page 2 Select the View button Hki Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person and Activities for Main Address amp Phone Race amp Language Messages from Server Date of Birth 4 29 2000 MnCHOICES Person ID 200004005 Marital Status e Est Date of Birth SWNDX Person ID SSN YS Gender Male Female Clearing Status PMI Document History wem Date Created Document Type Sub Type Assessment Date Date Closed me ven U IEETEGE Intake EE Update Person Add Intake Add Reassessment Add HRA The Intake questions of the current case display for the Reason for Contact amp Referral Source panel and the process of intake begins MnCHOICES User Manual Draft 1 1 09 20 13 35 Page H Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Dispositions lI Transfer Intake Questions
69. alth Risk Assessment or MnCHOICES Assessment which is NOT Closed a MnCHOICES Assessment may NOT be created ASSESSMENT QUEUE The Assessment Queue displays ALL of the non Closed documents assigned to the selected user Upon opening the Assessment Queue the current user is automatically selected from the list of users and the Assessment Grid is automatically populated with the current user s active Assessments You may select another user s Assessment lists as well The list of users is assigned to the same Lead Agency as the current user and has Edit Assessment Health Risk Assessment Help Desk security functionality Users without the security access of Edit Assessment Health Risk Assessment Edit Assessment Help Desk will have to select a user from the list of users MnCHOICES User Manual Draft 1 1 09 20 13 61 Page MnCHOICES ASSESSMENT QUEUE NAVIGATION 1 Select the Assessment in the menu bar Person Intake Assignment Assessment User Profile Logout 2 If needed select an Assessor PERTINENT ASSESSMENT QUEUE COLUMNS e Type the document type of MnCHOICES Assessment or Health Risk Assessment HRA e Age the age is automatically calculated based upon the Assessment Date and the Date of Birth If the document does NOT have an Assessment Date the age does NOT display e Offline EE to EE Ka a ba assessment for offline use File Edit View Favorites E E T E Tools EETA X Snagit Be Ly Favorites ep HI Suggeste
70. ave CuleS o C Mae G C Employment Cancel C Disab ty Diagnosis Subd r Bet gt Hesith Insurance ho Xj Age 22 years Date of death DI C Mes e Open MnChoices CWB Educaton infant a Han Dap Clean up sl est age Court Actions Birth location DI DI CJ DOC Assessments Person numbers C Workgroups amp Intakes County Persons 321321 SSIS Person 8 115994961 swnoxs 2B Select Open MnCHOICES 3 The Person and Activities For screen displays H Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person and Activities for Ann Anderson Main Address amp Phone Race amp Language Messages from Server First Name Ann Middle Name Ann Last Name Anderson Suffix v Date of Birth D MnCHOICES Person ID 200004 Marital Status v Est Date of Birth 4 29 2000 D SWNDxX Person ID SSN Gender Male Female Clearing Status l PMI Document History _ Date Created Document Type Sub Type Assessment Date Date Closed e 4 29 2013 Intake Update Person Add Intake Add Reassessment Add HRA MnCHOICES User Manual Draft 1 1 09 20 13 martaistatus re never manied z Qualifies undericwa P zf No 9 Page MAIN MENU BAR The Main Menu Bar either opens a specific page or a sub menu which lists additional menu item options The Main Menu Bar has the following menu
71. ces MnCHOICES Assessment Queue Check In for Online Use Last Name First Name Assessment Date Date of Birth 1904 Anderson Ann Health Risk Assessment 5 29 2013 4 29 2013 1 mths F 1847 Anderson Ann An MnCHOICES Assessment New Assessment 4 29 2013 4 29 2000 13 yrs F 20 The Assessments and or HRAs assigned to you display In the Assessment update any necessary information On the Menu Bar select the Assessment Queue 21 After you enter or update information in the Assessment or HRA you want to be sure that it is saved Do e Click on a different domain before closing e Click on a different question group before closing or e Click on another tab on your dashboard such as Logout Don t just e Click on the X in the upper right hand corner of the screen e Close the browser MnCHOICES User Manual Draft 1 1 09 20 13 107 Page Assessment User Profile Logout Assessment Ann Anderson Assessment id 1904 Certified Assessor pwheg73 Lead Agency 199643500 Current Assessment Event Log Print Export Assessment Answers Transfer Health Risk Assessment Legal Name First Name Middle Name Last Name Suffix Date of Birth Gender Marital Status Male Female Person Numbers PMI SWNDX SSN What is your primary language Is an interpreter needed No Yes Does the person to be assessed need any additional accommodations O No O Yes Address Physical Location Effective Date ro
72. creening Long Term Care Consultations LTCC Personal Care Assistance PCA and Private Duty Nursing PDN Outcomes of the MnCHOICES assessment include e Determination of the level of care e Case mix and e Eligibility for home and community based services and programs Assessment findings are used to develop a support plan for the individual The person centered focus of MnCHOICES provides individuals the opportunity to tell their story and helps tailor long term services and supports while utilizing their strengths preferences and assessed needs MnCHOICES is used for people of all ages and disabilitytyoes regardless of whether or not they are eligible for Minnesota Health Care Programs MnCHOICES is a web based application that uses off line capability during the assessment interview The internet is not used during the time of the assessment visit The policy rule based application aligns rules regulations and statue to determine eligibility consistently across lead agencies MnCHOICES User Manual Draft 1 1 09 20 13 4 Page LOGIN LOGIN OBJECTIVE The objective of the Login is to gain access to the MnCHOICES application LOGIN NAVIGATION 1 Inthe address bar type the MnCHOICES URL you received from your Mentor or Supervisor You will see the Login page for the Minnesota Department of Human Services MnCHOICES Hy Minnesota Department of Human Services MnCHOICES 2 On the login page o Click on the drop down ar
73. d Sites S Customize Links S Web Slice Gallery S Windows Media S Windows SS E Ze e gt ap v Pagey Safetyy Toolsv HA Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Queue e AssessmentDash Page Refresh Data Check Out for Offline Use Assessor Worscheck Hei Te ene i Worscheck Heidi n Ss E Internet Protected Mode On MnCHOICES User Manual Draft 1 1 09 20 13 62 Page 3 Add an Assessment Date by selecting the Assessment Date box When a MnCHOICES Assessment or a Health Risk Assessment is created an Assessment Date is NOT populated After the Assessment Date is edited the system removes the answers to questions that are NOT displayed The Assessment Date causes the Age to populate File Edit View Favorites Tools Help x Snagit BI He Favorites ep HI Suggested sites S Customize Links Web Slice Gallery Windows Media Windows mv vy L v Pagey Safetyy Tools s e sel Ki AssessmentDash X ifs Assessment Synony thy Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Queue Refresh Data _ Refresh Data Check Out for Offline Use Assessor Worscheck Hei View 1847 Person Anderson Ann Ani MnCHOICES Assessment IW 4
74. d corner of the screen e Close the browser MnCHOICES User Manual Draft 1 1 09 20 13 98 Page 11 Select a Disposition 12 Select Close HRA button ths Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1903 Certified Assessor pwheg78 Lead Agency Dakota Public Health Current Assessment Event Log Print Export Assessment Answers Transfer Health Risk Assessment wa WY w Te SY ourmmeunes SY GNOSE NOL tO afiswer Comments a TOBACCO USE Does the person use tobacco products ONo CC Yes Sometimes Chose not to answer Comments Housing and Environment Are there any concerns with the safety accessibility or sanitary conditions No Yes Chose not to answer Do you have any immediate health concerns O No Yes Chose not to answer Comments Complete Individual refused HRA Complete via Phone full needs assessment not required Do you need help in getting medical services Complete via Mail full needs assessment not required ONo Yes Chose not to answer Complete via Face to Face full needs assessment not required Complete assessment required move onto MnCHOICES assessment Close HRA with the following disposition Close HRA Export HRA to XML File ths Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment
75. e 32 Expand the Self Direction domain and select About this Domain Self Direction I L t Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions 1 Eligibility Log Print Export Assessment Answers 1 Transfer 1 DD Screening Docs LTC Screening Docs 1 PCA Service Agreement gt Person Eegen About this Domain Self Direction Suay ot Lie To assess the individual s interest in participating in self directed services such as gt ADLs P s PCA Choice gt IADLs Consumer Support Grant CSG Health Consumer Directed Community Supports CDCS Family Support Grant FSG gt Psychosocial Memory amp Cognition 3 lt lt Back To Referrals amp Goals Housing amp Environment gt gt Go To Self Direction gt Safety Self Preservation Sensory amp Communication Employment Volunteering amp Training Housing amp Environment Q sett Direction ie About this Domain Self Direction Self Direction Referrals amp Goals Self Direction Service Related Rights and Choices Caregiver o gt Assessment Information 5 Assessor Conclusions 16 gt Screening Documents d 33 Read About this Domain Self Direction 34 Complete all appropriate Self Direction domain information
76. e required as a minimum HA Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person Search Search By PMI t SSN 2 Name DOB Gender Search Information PMI o0000001 Start Search Clear Info MnCHOICES User Manual Draft 1 1 09 20 13 19 Page If no search results are found a notification box appears 2 Select the OK button NotificationBox eg State Search returned zero results A message notifying the user that no records have been found displays HA Minnesota Department of Human Services MnCHOICES 2 amp No matching records found for search criteria Person Intake Assignment Assessment User Profile Logout Person Search Search By PMI Source MnCHOICES O SSN State Name DOB Gender Search Information PMI 00000001 Start Search Clear Info Person search results ANCHOICES Search ka Ja mm elen Ier me IESSE Add Person MnCHOICES User Manual Draft 1 1 09 20 13 20 Page 3 Select the Add Person button Minnesota Department of Human Services MnCHOICES No matching records found for search criteria Person Intake Assignment Assessment User Profile Logout Person Search Search By Lei PMI Source MnCHOICES Q SSN State Name DOB Gender Search Information PMI 00000001 Start Search Clear Info Person search results nCHOICES Search
77. e version of assessment content and eligibility rules Screening Documents a separate document from the Assessment that is completed and entered into MMIS for billing purposes Shared Master Index SMI a web based system developed by DHS to assist counties tribes and DHS to coordinate client services across state and county systems The SMI interacts with other state and service entity systems creating a cross reference data base and a common client identifier to assist workers in tracking clients across systems The SMI provides a MnCHOICES User Manual Draft 1 1 09 20 13 115 Page common database for client demographic data and a comprehensive view of client data and program participation across program areas of MAXIS MMIS PRISM and SSIS Show Hide Rules rules that determine whether an Assessment question s or choice s are displayed based upon gender age and how other questions are answered Soundex search criteria for a combination of the Starts With option and sounds like feature Starts With search criteria for all names that start with the letters entered Status the current stage of an Intake or Assessment statuses are Open Pending or Closed SWNDX Person ID a state wide index person identifier Transfer the process of moving one document from one Lead Agency to another Update Person a button that revises any of the Person demographic information User Profile a main tab in the MnCHOICES application where a user can go
78. eet City Effective date 5 22 2013 Street Address Line 7 State MN F Zip 55123 Zip af Street Address Line jy County Dakota Home Address same as Lf copy Street Address Line 1 111 Elm Street City Effective date 5 22 2013 Street Address Line 2 State wn Zip 55123 Zip 4 Street Address Line y County Dakota Mailing Address same as k copy Street Address Line yo City oOo Effective date lt M d yyyy gt Street Address Line 2 State e Zip zip d MnCHOICES User Manual Draft 1 1 09 20 13 23 Page 7 Select the Race amp Language tab 8 Complete all appropriate information Hki Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person and Activities for Ann Anderson Main Address amp Phone Race amp Language Messages from Server Are you of Spanish Hispanic Latino descent Lei Not 2 Yes Unable to determine abandoned child Declined Unknown What is your primary language Is an intepreter needed ei Nol Yes Insert Update Races What Is your race 1 American Indian Alaskan Native _ Asian _ Black or African American _ Caucasion _ Pacific Islander 1 Unknown 1 Declined MnCHOICES User Manual Draft 1 1 09 20 13 24 Page 9 After completing all appropriate information on the Main tab select the Insert Person button to save the Person and Activities for i
79. enance function ths Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Workload D gt Refresh Data O CE LastName Active Assessments Active HRAS e 5 a Glass Marcia Assignment Date of Birth Physical Address E ASSESSMENT 8 14 1935 8955 Lexington Circle Pines Anoka view e ASSESSMENT Person LeeGlass Mark 8 14 1990 22 yrs 9482 Larson st Jasper Dakota MnCHOICES User Manual Draft 1 1 09 20 13 58 Page 1 Select an assignee from the Assign To drop down menu TIP Clicking on Assign To box makes the drop down menu appear The Assign To drop down menu is a listing of ALL users in the current user s Lead Agency with the security functionality of Edit Assessment Health Risk Assessment The Assign To drop down menu us the functionality to use to reassign a case as well g File Edit View Favorites Tools Help Tools Help x Snagt H amp Jr Favorites ep H Suggested Sites S Customize Links Web Slice Gallery E Windows Media Windows ale Assigner Page x E E Refresh Synonyms Z vy L E v Pagev Safetyy Tools v k ths Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Workload Refresh Data _ Refresh Data Wl EE Glass Marcia Assignment First Name Date of Birth Physical Address Zip Code County Assign
80. ency Dakota Public Health r SE Current Assessment Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement moony E About this Domain Assessor Conclusions IADLs To document the assessor s conclusions after synthesizing all information learned about the individual during the assessment process Health Psychosocial lt lt Back To Administrative Information gt gt Go To Diagnosis Memory amp Cognition Safety Self Preservation Sensory amp Communication Employment Volunteering amp Training Housing amp Environment 1 Self Direction Service Related Rights and Choices Caregiver Assessment Information 5 sessor Conclusions p About this Domain Assessor Conclusions Diagnosis 3 Independence Capacity O amp Informed Choice Level of Supervision amp 11 Support Vulnerable Adult Child 1 Waiver a Screening Documents 1 45 Read About this Domain Assessor Conclusions 46 Complete all appropriate Assessor Conclusions domain information for each group Diagnosis Independence Capacity amp Informed Choice Level of Supervision amp Support Vulnerable Adult Child Waiver I A Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Hea
81. ent and Intake Pending a status fora MnCHOICES Assessment document type denoting that the MnCHOICES Assessment is finished and the Certified Assessor is waiting for information to be returned from a third party Person and Activities For a tab that displays and updates person demographics and tasks e g Opening Intakes Assessments etc for that person the tab is located after selecting the Person button on the Assessment and Assignment Queues Person Button a button that allows a Certified Assessor to navigate to the Person and Activities For screen for a particular person the button may be accessed through the Intake Assignment and Assessment Queues Person Master Index PMI a unique State identifier assigned to an individual Recipient Person Menu Item a menu item that navigates to the Person Search functionality Person Search the MnCHOICES landing page used to determine whether a person exists in the MnCHOICES or state databases based upon PMI or Name DOB and Gender search criteria Ready To Assign occurs once an Intake is Closed with a disposition of Assessment Accepted and the Intake moves to a status of Ready To Assign Reassessment an additional assessment used to re determine eligibility if a person is currently on a long term care program or receiving long term care services Refresh Data a button that auto updates the Intake Assessment and Assignment Queues Result Date the date used by the system to determine th
82. erform an Assessment and run eligibility rules without an internet connection The Assessment may be taken offline and edited If the Assessment is offline the Assessor may NOT be changed SSIS LAUNCH OFFLINE If MnCHOICES is offline launching MnCHOICES from SSIS triggers an error MnCHOICESs application is running in another instance OK TRANSFER OFFLINE An offline document may NOT be transferred HEALTH RISK ASSESSMENT HRA OFFLINE Offline mode allows the user to perform an HRA without an internet connection The HRA may be taken offline and edited MnCHOICES User Manual Draft 1 1 09 20 13 102 Page OFFLINE NAVIGATION 1 Inthe Assessment Queue select the Check Out for Offline Use button ths Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Queue a Refresh Data Assessor Worscheck Hei Last Name First Name Assessment Date Date of Birth Age ky ssi 29 J29 Ez Ea 1904 RSR Anderson Ann Health Risk Assessment 5 29 2013 4 29 2013 1imths F A 2 The Assessments Ready for Checkout screen displays 3 Select the Check Out All Assessments for Offline Mode button l HA Minnesota Department of Human Services Mo HOI ES Assessments Ready for checkout Person Intake Assignment Assessment User Profile Logout pwheg 8 Check Out Assessments for Offline for Dakota Public Health
83. ether the individual understands the question if not rephrase the question If the individual appears uncomfortable answering a question use your professional judgment about whether to pursue the question When the individual chooses not to answer indicate this by using the chose not to answer option For some questions MnCHOICES includes explanatory prompts and suggestions to elicit an answer if an individual does not readily respond Watch for signs of both physical and mental fatigue during the interview if necessary take a break or schedule another time to finish the assessment Responses to some questions will be documented by checklists where multiple items can be selected for other questions marked by radio buttons only one choice can be selected 10 Reviewing and discussing personal preferences strengths concerns or personal goals are important to the person centered process 11 Some answers may trigger more immediate steps including referrals for follow up or further assessment 12 Conduct assessments for children younger than 14 with the parent or guardian present a Use your professional judgment whether to ask the child questions b Considerations include the ability of the child to understand and respond to questions the age and maturity of the child and the preferences of the parent s or guardian s 13 The employment domain is mandatory for all individuals ages 13 through 65 However complete this domain for anyone who exp
84. for each group Self Direction Referrals amp Goals Self Direction I L t Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement gt Person Information Routines and Preferences Quality of Life 5 Routines D ge NOTE this IADLs What is a typical day like for you Health screen shot Is not Wee pl correct for Safety Self Preservation 4 ee Sensory amp 5 What are some things that you enjoy doing questions In Self Communication Employment 2 zi D l re cti O n Volunteering amp Training Housing amp Environment 1 Self Direction o How do you want to spend your time About this Domain Self Direction gt Self Direction 0 Referrals amp Goals Self 0 Do you like where you live housing city county etc gt Direction W No WW Yes Chose not to answer Service Related Rights 1 Comments and Choices Caregiver D Assessment Information 5 Additional Comments Assessor Conclusions 16 A gt Screening Documents 1 MnCHOICES User Manual Draft 1 1 09 20 13 79 Page 35 Expand the Service Related Righ
85. ice Related Rights and Choices Additional Comments Caregiver 0 a Assessment Information 5 PG Assessor Conclusions 16 MnCHOICES User Manual Draft 1 1 09 20 13 77 Page 29 Expand the Housing amp Environment domain and select About this Domain Housing amp Environment I rat Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions d Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement Paon hiona About this Domain Housing amp Environment gt Quality of Life e z z a e z To gather information about the adequacy and safety of the person s current living arrangement and to assess the need for assistance in making changes ADLs and or modifications IADLs Health lt lt Back To Referrals amp Goals Employment gt gt Go To Housing and Environment Psychosocial Memory amp Cognition Safety Self Preservation Sensory amp Communication Employment Volunteering amp Training E amp Environment About this Domain ea Housing amp Environment Housing and Environment Referrals amp Goals Housing amp Environment Self Direction Service Related Rights and Choices Caregiver Assessment Information
86. in 30 seconds If it doesn t please come back to this browser and click the Close button be Close Online Mode 11 Right click in the large blank rectangular box and select Install DHS MnCHOICES onto this computer silverlight Install DHS MnCHOICES onto this computer 12 Select the Install button Eege be Security Waming Name DHS MnCHorces Site http 7 10 1 218 101 Publisher Unwertfied More options C rse H Case This application does not have a wald digital signature that werifies the publisher You should onb run software from publishers you trust More Information 13 Select the OK button MnCHOICES User Manual Draft 1 1 09 20 13 105 Page f f i Minnesota Department of Human Services MnCHOICES Retrieving Offline Tables from Local file Retrieving Data from Isolated Storage C 14 On your desktop double click the newly created DHS MnCHOICES icon DHS MnCHOICES TIP Alternatively select the newly created DHS MnCHOICES icon from your Start menu 15 The offline MnCHOICES Login screen automatically displays 16 On the Login screen select the Lead Agency and enter your Username amp Password 17 Select the Login button lead Agency e Username Password MnCHOICES User Manual Draft 1 1 09 20 13 106 Page 18 Select the Proceed button Proceed 19 On the Assessment Queue select the View button H Minnesota Department of Human Servi
87. ion 5 S Assessor Conclusions 16 F Screening Documents 1 MnCHOICES User Manual Draft 1 1 09 20 13 80 Page 38 Expand the Caregiver domain and select About this Domain Caregiver I Pat Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment d Summary Dispositions ll Eligibility Log Print Export Assessment Answers 1 Transfer 1 DD Screening Docs LTC Screening Docs PCA Service Agreement Person Information About this Domain Caregiver Quality of Life ADLs The assess the capacity of an informal caregiver to provide care and support to the individual and to identify resources to assist in the caregiving role IADLs lt lt Back To Referrals amp Goals Service Related Rights amp Choices gt gt Go To Caregivers Health Psychosocial Memory amp Cognition Safety Self Preservation Sensory amp Communication Employment Volunteering amp Training Housing amp Environment Self Direction Service Related Rights and Choices Qeareg iver P About this Domain 0 Caregiver Caregivers 0 Caregiver Interview D Referrals amp Goals 0 Caregiver Assessment Information 5 Assessor Conclusions 16 Screening Documents 1 39 Read About this Domain Caregiver 40 Complete all appropriate Caregi
88. irection Additional Comments Service Related Rights and Choices Caregiver 7 MnCHOICES User Manual Draft 1 1 09 20 13 76 Page 26 Expand the Employment Volunteering amp Training domain and select About this Domain Employment I Pat Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement Person Information About this Domain Employment Quality of Life ADLs IADLs Health Psychosocial lt lt Back To Referrals amp Goals Sensory amp Communication gt gt Go To Volunteer Activities To learn about work volunteer and education training experiences and interests Identify potential barriers Share resources to support goals and interests Memory amp Cognition Safety Self Preservation Sensory amp Communication Employment 2 olunteering amp Training gt About this Domain o Employment Volunteer Activities ee eet Barriers o Summary amp Supports 2 0 Referrals amp Goals Employment Housing amp Environment 1 Self Direction o Service Related Rights and Choices Caregiver o Assessment Information 5 Assessor Conclusions 16
89. ity Person Search To view further information on the Main Menu Bar please refer to the Main Menu Bar Section of the manual Main Menu Bar Main Menu Bar HA Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout SSIS LAUNCH LANDING PAGE If you enter MnCHOICES through SSIS the landing page is the Person and Activities page with the Main Address amp Phone and Race amp Language tabs If MnCHOICES is open when MnCHOICES is launched from SSIS the SSIS brings the browser and MnCHOICES tab to the top If a user does NOT have Access MnCHOICES security functionality SSIS disables both the non person and person launches SSIS LAUNCH LANDING PAGE NAVIGATION 1A Select Tools File View Searches Logs Window Help Testers i ei eil ba G 2 es Document Template Editor Ora D External Documents SEENEN Reassign Workgroups _ 2 MNYTD Searches General Reports fea Chart of Accounts Q SSIS Administration BAe e W SSIS Adoptions SSIS Analysis and Charting Payments ste SSIS Repository y e Claimi Disability Waiver Rates System A Open MnCHOICES i 7 EEN KH Cisia E wn sx os e MnCHOICES User Manual Draft 1 1 09 20 13 8 Page 2A Select Open MnCHOICES OR 1B From the tree view of the client select the client name New Add Existing CH Name Race Open in New Window CJ Relationship g
90. l appropriate IADLs domain information for each group Medication Management Medication Management Equipment Meal Preparation Transportation Housework Telephone Use Shopping Finances Referrals amp Goals IADLs I Li Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions 1 Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement ADLs 9 Routines and Preferences 4 IADLs Fi E a About this Domain Routines ADLs Medication 1 Management D Medication 0 P Management v Equipment Preferences Meal Preparation TP Transportation What are some things that you enjoy doing Housework e gt gt Telephone Use N OT E 3 th is Shopping Fanes How do you want to spend your time SC re e n S h ot DEE Referrals amp Goals What is a typical day like for you D is not correct Health Psychosocial Do you like where you live housing city county etc fo r q u esti O n S Memory amp Cognition W No Yes Chose not to answer i Comments in IAD Ls Safety Self Preservation Sensory amp EEN Additional Comments Employment Volunteering amp Training Housing amp Environment Self Di
91. l disability or a related condition C YES Lei NO Illness in the past Referral Reason Assessment Type Intake Summary 3 Is there any presenting evidence cognitive or behavioral that may indicate the presence of QJ YES 2 NO developmental disability or related condition 4 Has the person been referred for nursing or boarding care facility placement by an agency YES Ww NO that serves persons with developmental disability or related condition If you have answered YES to ANY of the previous questions refer the person to the County offices for persons with developmental disabilities or related conditions for evaluation and determination of need for specialized services If the person is being admitted to a certified nursing or boarding care facility and is NOT subject to a level II referral forward this form to the facility for inclusion in the person s record If the person is not being admitted to a facility but is seeking community services retain this form in the person s county record Reassessment C CHANGE D NO CHANGE Signature of Screener Date MnCHOICES User Manual Draft 1 1 09 20 13 44 Page 12 Select the Go To OBRA Level 1 Mental Illness button TIP Print the OBRA Level 1 DD screen Current Case Dispositions Event Log Transfer Intake Questions for Ann Anderson OBRA Level 1 Developmental Disability or Related Condition 4 Intake Reason for Contact amp
92. letion ee ee ee ee ee ll bn ne nee Se ee ee ee ee MnCHOICES User Manual Draft 1 1 09 20 13 46 Page 14 Select the Go To Referral Reason Assessment Type Intake Summary button TIP Print the OBRA Level 1 MI screen Current Case Dispositions Event Log Transfer 4 Intake Reason for Contact amp Referral Source Demographic Information Lead Agency amp Communication Information Decision Making Guardianship amp Emergency Contact Health Insurance Payers amp Providers OBRA Level 1 Developmental Disability or Related Condition OBRA Level 1 Mental Illness Referral Reason Assessment Type Intake Summary Intake Questions for Ann Anderson OBRA Level 1 Mental Illness J VVO UIT Heizung gt UCAUNCHL zung MMU GLE Gt rat UNC WE ur tun wz Too Ww NYU Psychiatric treatment more intensive than outpatient care partial hospitalization or inpatient hospitalization more than once in the last two years OR Within the past two years and due to the mental disorder the person has experienced an episode of significant disruption to the normal living situation for which supportive services were required to maintain functioning at home or in a residential treatment center or which resulted in intervention by housing or law enforcement officials If your answer is YES to ALL of the questions above e And the person is seeking admission to an MA certified nursing f
93. lic Health Current Assessment Eligibility Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement a C save Se Disposition Pending Closed Comments Outcome comments are entered here MnCHOICES User Manual Draft 1 1 09 20 13 88 Page MnCHOICES ASSESSMENT STATUSES There are three statuses for a MnNCHOICES Assessment The status indicates where in the lifecycle each MnCHOICES Assessment is located e Open occurs when a MnCHOICES Assessment is created e Pending occurs when a certified Assessor has completed the Assessment and is waiting for additional information to complete the MnCHOICES Assessment ONLY MnCHOICES Assessments with a status of Open can have their statuses set to Pending A status may NOT be changed from Closed to Pending e Closed occurs when a MnCHOICES Assessment is finished ONLY MnCHOICES Assessments with a status of Pending can have their statuses set to Closed Minnesota Department of Human Services MnCHOICES fhe Person Intake Assignment Assessment User Profile Logout Person and Activities for Ann Anderson Main Address amp Phone Race amp Language Messages from Server First Name Middle Name Ann 1 Last Name Anderson 1 sutfie zl Date of Birth 4 29 2000 MnCHOICES Person ID Marital Status Divorced Est Date of Birth DI swnpx Person I
94. llowed to create and view an HRA Users with Edit HRA security access are allowed to edit an HRA If a person has one or more previously completed MnCHOICES HRA s the most recent answers to ALL those questions pre populate the MnCHOICES HRA Answers to the person demographics questions in the MnCHOICES HRA are pre populated from the Person and Activities For screen overwriting previously copied answers When creating a new HRA the system generates a unique Assessment ID for the HRA An HRA is created from the Person and Activities For screen NOT from an Intake You may print the HRA HA Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1904 Certified Assessor pwheg78 Lead Agency Dakota Public Health Current Assessment Event Log Print Export Assessment Answers Transfer mmm Preview Assessment Questions Answers Print Assessment Questions and Answers Export to HTML Printers Export Directly to PDF Export Assessment to XML File Question Asked Answer TimeStamp ASSESSMENTID QUESTIONTEXT Domain MnCHOICES User Manual Draft 1 1 09 20 13 92 Page HEALTH RISK ASSESSMENT HRA DISPOSITIONS Valid HRA Dispositions are Complete a document type disposition that indicates that the document was finished successfully Complete via Phone a document type disposition that indicates that the document was finished successfully through a
95. lth Current Assessment Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement eee EE ADLs Routines and Preferences IADLs Routines Health Psychosocial E ul NOTE this screen Memory amp Cognition shot is not correct Sensory amp e e Communication Preferences fo r q u e sti O n S In Employment Volunteering amp Training Safety Self Preservation What are some things that you enjoy doing Assessor Conclusions Housing amp Environment Self Direction Service Related Rights and Choices How do you want to spend your time Caregiver S Assessment Information Yv 4 Assessor Conclusions About this Domain Do you like where you live housing city county etc Assessor Conclusions W No WW Yes Chose not to answer Diagnosis Comments Independence Capacity C gt amp Informed Choice Level of Supervision amp Support Additional Comments Vulnerable Adult Child gt Waiver Screening Documents MnCHOICES User Manual Draft 1 1 09 20 13 83 Page 47 Expand the Screening Documents domain and complete all appropriate Screening Documents information for each group Developmental Disabilities DD Long Term Care LTC Personal Care Assistance PCA IL Minnesota Department of Human Services MnCHOICES Person Intake
96. ment 0 Referrals amp Goals ADLs o IADLs 7 MnCHOICES User Manual Draft 1 1 09 20 13 70 Page 8 Expand the IADLs domain and select About this Domain IADLs I kAj Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 amp Lead Agency Dakota Public Health Current Assessment Summary ll Dispositions d Eligibility Log Print Export Assessment Answers I Transfer Il DD Screening Docs LTC Screening Docs PCA Service Agreement About this Domain IADLs Quality of Life ADEs To identify the need for support with medication management meal preparation transportation housework telephone use shopping and managing DLs finances About this Domain ADLs Meckcation 1 H Level of difficulty or need for assistance Management Challenges and strengths Need for training Medication o Management Equipment Meal Preparation Information gathered includes lt lt Back To Referrals amp Goals ADLs gt gt Go To Medication Management Transportation Housework Telephone Use Shopping Finances Referrals amp Goals ADLs Health Psychosocial Memory amp Cognition Safety Self Preservation Sensory amp Communication Employment Volunteering amp Training Housing amp Environment 9 Read About this Domain IADLs 10 Complete al
97. most recent answers to ALL those questions pre populate the reassessment Answers to the person demographics questions in the Reassessment are pre populated from the Person and Activities For screen overwriting previously copied answers Users with Create Assessment or Create Assessment Help Desk security access may create reassessments REASSESSMENT NAVIGATION 1 On the Person and Activities for panel on the Main tab select the Add Reassessment button tHe Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person and Activities for Ann Anderson Address amp Phone Race amp Language Messages from Server Main First Name Middle Name Last Name suffix __ Date of Birth 4 29 2000 D MnCHOICEs Person ID Marital Status e Est Date of Birth DI swnpx Person ID Sen O Gender O Male Female Clearing Status PMII Document History MnCHOICES 4 29 2013 New Asses New 4 29 2013 Assessment Closed to 4 29 2013 Intake Closed MnCHOICces 4 29 2013 Assessment Update Person Add Intake L Add Reassessment Add HRA MnCHOICES User Manual Draft 1 1 09 20 13 91 Page HEALTH RISK ASSESSMENT HRA HEALTH RISK ASSESSMENT HRA OBJECTIVE The MnCHOICES HRA is a subset of questions from the MnCHOICES Assessment It is intended for persons age 65 and older that are enrolled in Managed Care Users with Create HRA security access are a
98. n and determination of need for specialized mental health services the person must meet ALL of the following criteria on diagnosis level of impairment and duration of illness 1 Does the person have a major mental disorder diagnosable as listed in the Diagnostic and Q YES Statistical Manual of Mental Disorders DSM current edition excluding a primary diagnosis of dementia Alzheimer s disease or other related cognitive conditions And 2 Has the major mental disorder resulted in significantly impaired functioning in major life O YES activities that would be appropriate for the person s developmental stage within the past 3 to 6 months And 3 Does the person s treatment history indicate at least one of the following YES Psychiatric treatment more intensive than outpatient care partial hospitalization or inpatient hospitalization more than once in the last two years OR Within the past two years and due to the mental disorder the person has experienced an episode of significant disruption to the normal living situation for which supportive services were required to maintain functioning at home or in a residential treatment center or which resulted in intervention by housing or law enforcement officials If your answer is YES to ALL of the questions above And the person is seeking admission to an MA certified nursing facility or boarding care facility refer the person to the county local mental health authority for comp
99. n be edited The Intake is NOT Closed until it is assigned so users can update Intakes prior to assignment The assignment of an Intake both creates a MnCHOICES Assessment of type New Assessment that is assigned to the selected Assessor and sets the Intake Status to Closed For Health Risk Assessments HRA s and MnCHOICES Assessments if NO Assessor is assigned the Assignment Queue displays them The default sort order of the Assignment Grid is by Document Type The sort order may be changed by simply selecting another column header Users with Assignment security access may set or reassign an assignment Assignment may be done on the Assignment Queue or the Assessment Queue MnCHOICES Assessments and Health Risk Assessments MUST have an Assessor assigned however Intakes do NOT have assigned Assessors or Intake workers Intakes are NOT assigned it is the Assessment created from the Intake that is assigned ssignmen re e INTAKE RSR anderson Ann 4 29 2000 13yrs EEJ Intake RSR Flinstone Fred 11 25 1975 37yrs 8893 Rock Quary Bedrock Dakota MnCHOICES User Manual Draft 1 1 09 20 13 5 Page ASSIGNMENT NAVIGATION The Refresh Data button updates the information in the Assignment table The View button directs you to the listed document type Intake MnCHOICES Assessment and Health Risk Assessment Users MUST have appropriate security to access the various document types The Person button directs you to the Person Maint
100. ncy If the Lead Agency is a Discontinued Organization Type transfer functionality is NOT allowed and the document is set to a Closed status with a disposition of Abandoned When an Intake is transferred the Intake is removed from the Intake queue and the Intake then displays in the Intake queue of the newly assigned Lead Agency ONLY users with the Lead Agency of the document can perform a transfer For example a user in Lead Agency B canNOT transfer an open Intake from Lead Agency A Upon completion of a transfer the system closes the document and places the user at their landing page MnCHOICES User Manual Draft 1 1 09 20 13 49 Page Minnesota Department of Human Services MnCHOICES DOCUMENT TYPES Valid Document Types are the following MnCHOICES Assessment an electronic questionnaire that combines 3 assessments Long Term Care Consultation Developmental Disabilities and Personal Care Assistant Assessments HRA Full or HRAF is another term for a MnCHOICES Assessment and is used when an Assessment is created from an HRA as opposed to an Assessment created from an Intake It is explained as a sub type below Health Risk Assessment HRA a subset of questions from the MnCHOICES Assessment it is intended for persons age 65 and older that are enrolled in Managed Care Intake a preliminary screening used to gather information about the person to determine if the person would like an Assessment DOCUMENT SUB TYPE
101. nd Choices Careniver D 24 Read About this Domain Sensory amp Communication 25 Complete all appropriate Sensory amp Communication domain information for each group Vision Hearing Functional Communication Sensory Integration Supports Needed Referrals amp Goals Sensory amp Communication IA Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement ADLs Routines and Preferences IADLs Health bann Psychosocial What is a typical day like for you Memory amp Cognition A Safety Self Preservation i NOTE this Communication Preferences What are some things that you enjoy doing screen shot IS not correct for About this Domain Sensory amp Communication Vision Hearing Functional How do you want to spend your time questions in Communication Sensor Integration a Se NSO ry amp ee e Communication Sensory amp Do you like where you live housing city county etc Communication W No Yes Chose not to answer Employment Comments Volunteering amp Training Housing amp Environment Self D
102. neral Health HELPS Brain Injury Screen Medications Symptoms Conditions amp Diagnosis Treatments amp Monitoring Therapies Assessment of Feet Assessment of Pain Assessment of Sleep Referrals amp Goals Health h Minnesota Department of Human Services Mot HO ES Peman intake Assignment Arrpament UserProfile Logout Brcegtrnment Ann Anderton Ascectment id 1847 8 6Cortified Atterio PWHEGTS Lead Agency Dakota Public Health Current Ava sanaent Sirti y Dispi bins Eigil Le bi ZEapwt Bazgsaedtusrg Aines raiste DD Soneening Goes LIC Srtresgdng res PCA Servie Agreement auli 5 Routines and Preferences ADs H a health 10 Abal thr Deena D What e a typical day Hke for you Healih eS rrr i NOTE this p HELPS Grain Lea 1 Se TEE Biesen as screen shot is not correct Symptoms Conditions l What are comme Uira thal you enjoy deet amp Diagnosis See ge SC d for questions Theraps et Aent of Feet How do you want to spend your timer in Health Apetina of Pain zc iemet of Sheep Referrals fo Gasak RR Heath De you like where you five Dhouding city county etal Pupheuarial 19 Ne Yes Che meat to arwen Commenti lO ia ico S Kemeny A Coageitar i Safety Gell Frevervahon A Sensory bh H Additional Coenpnerts Com muppen Engiay ment F Nourdeemesg D Tr rere Housing amp Enviroment 1 MnCHOICES User Manual Draft 1 1 09 20 13 72 Page
103. nformation TIP You will see a blue banner running across the screen as the database is updating Hki Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person and Activities for Main Address amp Phone Race amp Language Messages from Server First Name Ann Middle Name Last Name Anderson suffix z Date of Birth 4 29 2000 MnCHOICES Person ID Marital Status Est Date of Birth SWNDX Person ID SSN fs Gender Male Female Clearing Status PMI Document History n Date Created Document Type Sub Type Assessment Date Date Closed e MnCHOICES User Manual Draft 1 1 09 20 13 25 Page When adding a new person the individual is automatically assigned a MnCHOICES Person ID Hki Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person and Activities for Main Address amp Phone Race amp Language Messages from Server First Name Middle Name Ann tast Name Anderson 1 sutfie zl Date of Birth 4 29 2000 D MnCHOICES Person ID 30000489 Marital Status m Est Date of Birth SWNDX Person ID SSN Ir Gender Male Female Clearing Status PMI Document History Date Created Document Type Sub Type Assessment Date Date Closed me BG DEE Update Person Add Intake Add Reassessment Add HRA MnCHOICES User Manual Draft
104. ngths and accomplishments Strengths and 2 s Relationships Accomplishments s Traditions and future plans Relationships Defining their own quality of life is what matters the most to the person Michal Smull Traditions and Rituals Future Plans lt lt Back To Referral Reason Assessment Type Intake Summary gt gt Go To Routines and Preferences Referrals amp Goals Quality of Life Cap 9 IADLs 7 Health 10 Psychosocial Memory amp Cognition Safety Self Preservation Sensory amp Communication Employment Volunteering amp Training Housing amp Environment Self Direction Service Related Rights and Choices MnCHOICES User Manual Draft 1 1 09 20 13 67 Page To navigate between domains and groups either use the buttons at the bottom of the screens or the left navigation I Tat Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement tree About this Domain Quality of Life R for Contact amp aimee gen S To learn about what is important to the individual and what brings them satisfaction happiness and comfort It includes Routines and preferences
105. of health insurance or pay sources O No O Yes Unsure Providers Health Care Providers Location Address V Primary Physician 111 Elm Street St Paul MN 55105 z GER kees _ Home Care Agency LI Targeted Case Manager MnCHOICES User Manual Draft 1 1 09 20 13 42 Page 10 Select the Go To OBRA Level 1 Developmental Disability or Related Condition button Current Case Dispositions Transfer Intake Questions for Ann Anderson intake Health Insurance Payers amp Providers Reason for Contact amp Cunrcers Referral Source Demographic Information Does the individual have any type of health insurance or pay sources Lead Agency amp Communication Information Providers Decision Making Health Care Providers Name Clinic Location Address Guardianship amp Emergency Contact d Primary Physician Dr Benson 111 Elm Street St Paul MN Emergency LONCE OO 55105 LI Psychiatrist W No W Yes Unsure Health Insurance Payers Ee e OBRA Level 1 Dest or Re SES fl SE Ge Ge Ee Condition OBRA Level 1 Mental Illness Referral Reason Assessment Type Intake Summary Disability or Related _ Home Care Agency LJ Targeted Case Manager Additional Comments gt gt Go To OBRA Level 1 Developmental Disability or Related Conditio T
106. ogout First Name Ann Middle Name Ann Last Name Anderson Date of Birth 4 29 2000 D MnCHOICES Person ID Marital Status Est Date of Birth e SWNDxX Person ID SSN W Male Female Clearing Status PMI Document History pe a en nL Assessment Date Date Closed Eech Update Person Add Reassessment Add HRA MnCHOICES User Manual Draft 1 1 09 20 13 33 Page A newly created Intake appears in the Document History panel with a Status of Open To view further information on Statuses please refer to the Intake Statuses Section of the manual Intake Statuses Document History is a table view of ALL documents including Intakes MnNCHOICES Assessments and Health Risk Assessments HRA s for a person By default the documents in the Document History table are displayed based upon the documents Date Created The most recent is displayed first and the oldest is displayed last You may select a table header to sort the listing according to the user s preference as well HA Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person and Activities for Messages from Server Address amp Phone Race amp Language Main First Name Middle Name Ann Last Name Anderson suffix __ Date of Birth 4 29 12000 MnCHOICES Person ID Marital Status e Est Date of Birth DI swnpx Person ID SSN fs Gender Male Fem
107. on MnCHOICES User Manual Draft 1 1 09 20 13 73 Page 17 Expand the Memory amp Cognition domain and select About this Domain Memory amp Cognition I PAT Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Person Information About this Domain Memory amp Cognition Quality of Life ADLs To identify issues associated with dementia developmental disabilities brain injury or other conditions and to identify for assessment treatment and services IADLs This domain includes screening tools to help identify the need for referrals for additional assessment and treatment It is not the assessor s role to render a medical diagnosis Health Psychosocial memory amp Cognition gt About this Domain 0 Memory amp Cognition Functional Memory and 2 Cognition Mental Status 1 Evaluation lt lt Back To Referrals amp Goals Psychosocial gt gt Go To Functional Memory and Cognition Referrals amp Goals o Memory amp Cognition gt Safety Self Preservation 4 Sensory amp 5 Communication Employment Volunteering amp Training Housing amp Environment Self Direction Service Related Rights and Choices Caregiver Assessment Information gt Assessor Conclusions Screening Documents 1 18 Read Ab
108. one Race amp Language Messages from Server First Name Middle Name LastName Anderson 1 sutfic Date of Birth 4 29 2013 MnCHOICES Person ID Marital Status Legally separated Est Date of Birth D SWNbx Person ID SSN Po Gender O Male Female Clearing Status PMI Document History mem Date Created Document Type Sub Type Status Outcome Assessment Date Date Closed e Update Person Add Intake Add Reassessment Add HRA MnCHOICES User Manual Draft 1 1 09 20 13 18 Page PERSON ADD NAVIGATION Users with Create Person security access may add a person to MnCHOICES If the user has Add Person security access MnCHOICES is launched from SSIS the SSIS person is NOT found upon a SWINDX ID search and the person has NOT previously been added MnCHOICES allows an SSIS person to be added to MnCHOICES Adding to MnCHOICES invokes the Person and Activities For screen to be populated with the person information from SSIS Users may edit this information If launching from SSIS and the user does NOT have Access Person Search security access the Person Search screen does NOT display If launching from SSIS and the user does NOT have Edit View Person security access the Person and Activities For screen does NOT display 1 On the Person Search screen search by the PMI SSN or Name DOB Gender TIP To save a person in MnCHOICES First Name Last Name Gender and Date of Birth estimated Date of Birth ar
109. ons and future plans Strengths and 2 Accomplishments Relationships Defining their own quality of life is what matters the most to the person Michal Smull Traditions and Rituals Future Plans lt lt Back To Referral Reason Assessment Type Intake Summary gt gt Go To Routines and Preferences Referrals amp Goals Quality of Life ADLs IADLs Health Psychosocial Memory amp Cognition Safety Self Preservation Sensory amp Communication Employment Volunteering amp Training Housing amp Environment Self Direction Service Related Rights and Choices To view ALL groups within a domain select the light triangle to expand the menu To hide ALL groups within a domain select the dark triangle again to condense the menu tH Minnesota Department of Human Services MnCHOICES ASSESSMENT Saved Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor pwheg78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement uality of Life About this Domain Quality of Life To learn about what is important to the individual and what brings them satisfaction happiness and comfort It includes Routines and 4 Preferences About this Domain Quality of Life s Routines and preferences Stre
110. or Estimated Date of Birth and the date of adding the HRA HA Minnesota Department of Human Services Ma HO ES Person Intake Assignment Assessment User Profile Logout Person and Activities for Ann Anderson Main Address amp Phone Race amp Language Messages from Server First Name Middle Name Ann tastName Anderson suffix __ Date of Birth MnCHOICES Person ID 299004970 Marital Status e Est Date of Birth 4 29 2000 SWNDX Person ID SSN fs Gender Male Female Clearing Status PMI Document History Date Created Document Type Sub Type Assessment Date Date Closed e EM 4 29 2013 Intake cos e a 5 28 2013 y Declined z Update Person Add Intake Add Reassessment MnCHOICES User Manual Draft 1 1 09 20 13 94 Page 2 Select View button the Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person and Activities for Ann Anderson Main Address amp Phone Race amp Language Messages from Server First Name Ann Middle Name Ann Last Name Anderson Suffix v Date of Birth MnCHOICES Person ID 200004910 Marital Status Est Date of Birth 4 29 2000 DI SWNDx Person ID SSN Gender Male Female Clearing Status PMI Document History wem mme Date Created Document Type Sub Type Status Outcome e Assessment Date Date Closed W EE
111. out this Domain Memory amp Cognition 19 Complete all appropriate Memory amp Cognition domain information for each group Functional Memory and Cognition Mental Status Evaluation Referrals amp Goals Memory amp Cognition I Pat Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement Person Information Routines and Preferences Quality of Life ADLs Routines IADLs What is a typical day like for you Health a Psychosocial 4 Memory amp Cognition 3 About this Domain 0 Preferences O i Memory amp Cognition N T E D th S What are some things that you enjoy doing screen shot is not correct for Functional Memory and 2 Cognition Mental Status 1 evaluation Referrals amp Goals 0 Memory amp Cognition How do you want to spend your time questions in Safety Self Preservation 4 a Sensory amp 5 Memory amp Communication bs Employment Do you like where you live housing city county etc Cog n iti O n Volunteering amp Training W No W Yes J Chose not to answer Comments Self Direction Service Related Rights and Choice
112. prior to closing the MnCHOICES Assessment is correct and did NOT return an error Once the Assessment is Closed eligibility rules canNOT be rerun When displaying a Closed Assessment with a disposition of Complete the Assessment Summary populates from the last run of the eligibility rules it i Minnesota Department of Human Sendo Mrt HO ES Person Intake Assignment Assesment User Profle Logout Aeon Ann Andersen Astermsent Lt L683 4 Certified Ameeeecr pwheg amp Lead Agency Daketa Public Health d TL Great Sg gt I Y RSA MO PL ep a aj I aii at r aen i ls 589 T ancl ate LA re IN d VM i i t a 49 Select OK button Processing Answers to Determine Eligibility C x J MnCHOICES User Manual Draft 1 1 09 20 13 85 Page The blue ribbon shows the eligibility is processing ths Minnesota Department of Human Services MnCHOICES Building XML file to send to Ilog Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessmen tid 1883 Certified Assessor pwheg78 Lead Agency Dakota Public Health vent Eligibility Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement c ine Eligibility Calling llog Webservice 28 2 SS 2 2 2 2 2 2 2 2 SS 2 2 2 SS 2 2 2 SS SS SS 2 EEEE E Done Internet Protected Mode On fy e 100 e MnCHOICES ASSESSMENT DISPOSITIONS A MnCHOICES As
113. rection MnCHOICES User Manual Draft 1 1 09 20 13 71 Page 11 Expand the Health domain and select About this Domain Health I Pat Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement About this Domain Health Quality of Life gt Ais To collect information about Ps e General health conditions and symptoms and effects on daily functioning ealth e Medications z z e Medical follow up About this Domain est Health Preventative health care General Health e Treatments and therapies HELPS Brain Injury To identify the need for referrals for unmet needs Screen el lt lt Back To Referrals amp Goals DLs gt gt Go To General Health Symptoms Conditions amp Diagnosis Treatments amp 3 Monitoring Therapies Assessment of Feet Assessment of Pain Assessment of Sleep Referrals amp Goals Health Psychosocial 19 Memory amp Cognition Safety Self Preservation 4 Sensory amp 5 Communication Employment 2 Volunteering amp Training 12 Read About this Domain Health 13 Complete all appropriate Health domain information for each group Ge
114. resses an interest in work or volunteering PRENaurPwWwner The Settings page gives editing My User Profile options t Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Edit My User Profile Options Delete Preloaded Questions and Rules Reset User Profile to Default Values Application Settings Application Font Size 12 Monitor Type Laptop Widescreen Monitor Desktop monitor Resolution Setting Process Automatic Manual Overall Application Width Height 1255 575 Assessment Question Area Width Height 1010 550 Must be larger than Question Area dimensions Save Settings MnCHOICES User Manual Draft 1 1 09 20 13 12 Page PERSON SEARCH PERSON OBJECTIVE The objective of the Person Search is to locate an individual within the MnCHOICES database or the state wide databases SWNDX or SMI The search begins in the MnCHOICES database If a match is found the MnCHOICES search stops If the person is NOT found in the MnCHOICES database the search continues in the state wide SWNDxX If one or more matches are found the State search stops and returns the results found The results pull the demographic information from the most recently cleared county If the person is NOT found in SWNDx the system finally searches State Master Index SMI PERSON SEARCH NAVIGATION Users with Access Person Search security may access the search page
115. row to select the Lead Agency o If you do MnCHOICES tasks for more than one lead agency you must log in separately for each agency o Type in your Username and o Type in your given password Hint Start typing the name of Lead Agency Dakota Public Health your agency and the drop down Username pwheg78 will quickly take you there Password aaeseees Login MnCHOICES User Manual Draft 1 1 09 20 13 5 Page LOGIN continued 3 Select the Login button Lead Agency Dakota Public Health Username pwheg78 a Login 4 Select the Proceed button All Local Question Choice and Rule data is up to date eee wn E MnCHOICES User Manual Draft 1 1 09 20 13 6 Page LANDING PAGES LANDING PAGES OBJECTIVE The Landing Page is the page that most users view when they log into MnCHOICES If you enter MnCHOICES through the MnCHOICES URL the Person Search screen displays Hy Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person Search Search By PMI O SSN _ Name DOB Gender Search Information PMI Start Search Clear Info Person search results NCHOICES Search SS Jee Je Im Jus EE EE EE EECH MnCHOICES User Manual Draft 1 1 09 20 13 7 Page MnCHOICES LANDING PAGE LOGIN If you directly enter MnCHOICES through the URL the landing page includes the Main Menu Bar and if you have the security functional
116. rtment of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person and Activities for Ann Anderson Main Address amp Phone Race amp Language First Name Middle Name __ LastName Anderson 1 sufix __ Date of Birth 4 29 2013 MinCHOICES Person ID 200116676 Marital Status Legally separated e Est Date of Birth SWNDX Person ID sN TI Gender Male Female Clearing Status 1 PMI Document History E Date Created Document Type Sub Type Assessment Date Date Closed on E amp O Update Person Add Intake Add Reassessment Add HRA MnCHOICES User Manual Draft 1 1 09 20 13 17 Page PERSON SEARCH FROM SSIS LAUNCH When a person launch from SSIS is invoked and MnCHOICES is NOT open MnCHOICES searches for the SSIS person in MnCHOICES by the SWINDX ID If MnCHOICES finds a SWINDX ID match when performing a search from the SSIS person launch the Person and Activities For screen is populated and displayed with the matching record If MnCHOICES does NOT find a match on the SWINDX ID when performing the search from the SSIS person launch MnCHOICES opens the search criteria screen to the person search and populates it with the first name last name date of birth and gender l Hki Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Person and Activities for Ann Anderson Main Address amp Ph
117. s Additional Comments Housing amp Environment Caregiver Assessment Information Assessor Conclusions Screening Documents 1 MnCHOICES User Manual Draft 1 1 09 20 13 74 Page 20 Expand the Safety Self Preservation domain and select About this Domain Safety Self Preservation 1a Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions Eligibility Log l Print Export Assessment Answers I Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement Person Information About this Domain Safety Self Preservation lity of Lif Kam ere The purpose of this domain is to assess the individual s ability in identifying and responding to potential or existing safety issues and to determine the ADLs level of support and supervision needed to reasonably assure the individual s health and safety in the community IADLs Health lt lt Back To Referrals amp Goals Memory amp Cognition gt gt Go To Self Preservation Psychosocial Memory amp Cognition efety Seit Preservation 4 About this Domain 0 Safety Self Preservation Self Preservation 4 Personal Safety 0 Referrals amp Goals o Safety Self Preservation Sensory amp Communication Employment Volun
118. s when they are not able to adequately resolve the question issue MnCHOICES User Manual Draft 1 1 09 20 13 111 Page GLOSSARY Abandoned a disposition of a document type with a status of closed an unfinished Intake MnCHOICES Assessment or Health Risk Assessment Add HRA a button that creates a Health Risk Assessment Add Intake a button that creates an Intake Add Reassessment a button that creates a Reassessment Age based upon a person s date of birth or estimated date of birth the age calculated using the Result Date Assessment Accepted a disposition that creates a MnCHOICES Assessment Assessment Date the date of the MnCHOICES Assessment Assessment Declined a disposition signifying that Intake was closed and the person decided to NOT have a MnCHOICES Assessment created Assessment ID a unique number that is automatically assigned by the system to the MnCHOICES Assessment Assessment Queue displays all of the non Closed documents assigned to the selected user each certified Assessor has their own Assessment Queue Assign a button that assigns the document to the Assign To user Assign To a drop down menu that is a listing of ALL users in the current user s Lead Agency with the security functionality of Edit Assessment Health Risk Assessment a list of users that have the Edit permission of the document type of the row Assignment Grid displays a list of ALL Health Risk Assessments HRA s MnCHOICES Assessments
119. ses phone numbers and or races you MUST go back to the Main tab and select the Update Person button to save MnCHOICES User Manual Draft 1 1 09 20 13 32 Page INTAKE INTAKE OBJECTIVE The objective for Intake is to collect current information about the case Intake is a preliminary screening to gather information about the person to determine if the person wants needs an assessment TIP Prior to an Intake or Assessment confirm Gender and Date of Birth At Intake the person s age is calculated using the date the Intake was created and the date of birth or estimated date of birth A child under one year of age is displayed as 0 age ONLY age appropriate questions are displayed in the Intake If an Assessor has Create Intake security access and if the person already has an Intake HRA or a MnCHOICES assessment that is NOT Closed an Assessor may create or update an Intake An Intake is created from the Person and Activities For screen When an Intake is created the Intake s Lead Agency is set to the user s Lead Agency If a person has one or more previously completed Intakes or MnCHOICES Assessments answers to ALL questions are pre populated from the most recent Intake or MnNCHOICES Assessment ADD INTAKE NAVIGATION A new Intake is created ONLY from the Add Intake button 1 Select the Add Intake button i i Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile L
120. sessment canNOT have any disposition until the Status is Closed e Pending occurs when a certified Assessor has completed the Assessment and is waiting for additional information to complete the MnCHOICES Assessment ths Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor pwheg78 Lead Agency Dakota Public Health Current Assessment Eligibility Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement Save Disposition QOkenading closed Comments e Closed Complete occurs when all necessary questions have been answered eligibility has been determined and the person will be given a Community Support Plan CSP ONLY MnCHOICES Assessments that have ALL required questions answered and eligibility rules current may be Closed with a disposition of Complete MnCHOICES User Manual Draft 1 1 09 20 13 86 Page H Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor pwheg78 Lead Agency Dakota Public Health Current Assessment Eligibility Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement
121. ssment Date Date of Birth Age Offline Assign To 1847 Anderson An MnCHOICES Assessment 4 29 2013 4 29 2000 13 yrs View 1904 Anderson Health Risk Assessment a 4 29 2013 Wednesday May 29 2013 May 2013 We 1 8 2 Done Internet Protected Mode On n e amp 100 MnCHOICES User Manual Draft 1 1 09 20 13 97 Page 10 Health Risk Assessment displays HA Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1903 Certified Assessor pwheg78 Lead Agency Dakota Public Health Current Assessment Event Log 1 Print Export Assessment Answers Transfer Health Risk Assessment Legal Name First Name Middle Name Last Name Suffix Date of Birth Gender Marital Status mm Male Female Person Numbers PMI SWNDX SSN What is your primary language Is an interpreter needed No Yes Does the person to be assessed need any additional accommodations ONo Yes Address Physical Location Effective Date fis Street Address Line 1 City Street Address Line 2 State Zip Zip 4 Street Address Line 3 County vv 4 b SAVING HRA DATA ENTERED Whenever you enter or update information in the HRA you want to be sure that it is saved Do e Click on another tab on your dashboard such as Disposition or Logout Don t just e Click on the X in the upper right han
122. t History table on the Main tab of the Person and Activities for panel Open occurs after an assessment has been created and assigned An Intake is editable when the status is Open or Ready for Assignment lf a person has an existing Intake HRA or MnCHOICES Assessment with a status of NOT Closed a MnNCHOICES Assessment canNOT be created MnCHOICES User Manual Draft 1 1 09 20 13 51 Page Person Intake Assignment Assessment User Profile Logout Person and Activities for Ann Anderson Main Address amp Phone Race amp Language Messages from Server First Name Middle Name Ann tast Name Anderson 1 sutfie zl Date of Birth 4 29 2000 MnCHOICES Person ID 2000041887 Marital Status Est Date of Birth SWNDX Person ID SSN Ir Gender Male Female Clearing Status 1 PMI Document History Date Created Document Type Sub Type Assessment Date Date Closed e E 5 8 2012 Intake Open TTT DE CC Update Person Add Intake Add Reassessment Add HRA Ready To Assign occurs once the disposition is Assignment Accepted and the case is ready to be assigned to a certified Assessor An Intake is editable when the status is Open or Ready for Assignment MnCHOICES User Manual Draft 1 1 09 20 13 52 Page Person Intake Assignment Assessment User Profile Logout Person and Activities for Ann Anderson Main d Address amp Phone
123. t User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement About this Domain ADLs Quality of Life G pots To identify the need for support in completing basic daily activities including eating bathing dressing personal hygiene grooming toileting mobility About this Domain positioning and transfers ADLs Eating Information gathered includes Level of need for oversight cuing supervision and physical assistance e Challenges and strengths Bathing s Need for training Equipment needs Eating Equipment Bathing Equipment Dressing lt lt Back To Referrals amp Goals Quality of Life gt gt Go To Eating Dressing Equipment Personal Hygiene Grooming 0 Personal Hygiene 0 Grooming Equipment Toilet Use Continence 1 Support Toilet Use Continence 0 Support Equipment Mobility Walking and 1 Wheeling _ Mobility Walking and 0 Wheeling Equipment Positioning Positioning Equipment 1 D Transfers 1 Transfers Equipment 0 0 Referrals amp Goals ADLs 6 Read About this Domain ADLs 7 Complete all appropriate ADLs domain information for each group Eating Eating Equipment Bathing Bathing Equipment Dressing Dressing Equipment Personal Hygiene Grooming
124. take Questions for Ann Anderson 4 Intake Referral Reason Assessment Type Intake Summary Reason for Contact amp Referral Source Demographic Information Lead Agency amp Communication Information Decision Making Guardianship amp Emergency Contact Health Insurance Payers amp Providers OBRA Level 1 Developmental Disability or Related Condition OBRA Level 1 Mental Illness Referral Reason Assessment Type Intake summary MnCHOICES User Manual Draft 1 1 09 20 13 Reason for Referral Caregiver _ Permanent loss of caregiver wl Supports requested Fi Temporary absence or inability of caregiver _ Other Comments O Functional Capacity Pa ADL or IADL assistance Fa Behavioral or emotional concerns LI Disonentation or confusion Other Comments Health Wl Concerns for managing health and medications NI Unstable Change in health _ Other Comments Housing Living Arrangements 48 Page 17 Select Assessment Accepted Hs Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Current Case Dispositions Transfer Disposition Assessment Accepted Assessment Declined Abandoned A dialog box displays 18 Select the OK button NotificationBox e Intake is Ready for Assignment Please go to Assignmnet tab Workers with Transfer Document used for open Intakes security access are allowed to change the Lead Age
125. teering amp Training Housing amp Environment Self Direction Service Related Rights and Choices Caregiver Assessment Information Assessor Conclusions Screening Documents 1 21 Read About this Domain Safety Self Preservation 22 Complete all appropriate Safety Self Preservation domain information for each group Self Preservation Personal Safety Referrals amp Goals Safety Self Preservation IEN Minnesota Department of Human Services MnCHGICES Peron Intake Assignment Assessment User Profle Logout Assesment Ann fmderson Assessment ld L247 Certified Assessor PWHEGIE Lead Agency Dakota Public Health Curent Assesment ENKEN kapris Eligibility Lag Drir iEeprt Asz z gmprdt Arca Transher D Sonoaning Dats LTC Scrgorong Dect POA Senior Agreement Ee Routines and Preferences Gusi of Lo Quality of Lite Routh ADLs Dls What i a typical day like for your Health p Bewerbasaraf NOTE this screen Memey amp Cognition 3 p D d Caiete Preservation A Se S h ot IS n ot CO rre ct About this Domain Whai are some things thal you enjoy doing ak a R for questions in Frona Aateio o Belesrair amp Gesi D How do ey D io spend r eme Dgietei elt deg Safety Self merere gt Preservation Tenan E Lomenemtatson Empiryment Fi P i Volunteering BN Tring Do you like where you lire housing tity county ete Housing A ratpemesn No te Chote not to answer Comments
126. ter When creating an HRAF from an HRA the system generates a unique Assessment ID that is separate from the HRA Assessment ID SAVING HRAF DATA ENTERED Whenever you enter or update information in the HRAF you want to be sure that it is saved Do e Click on a different domain before closing e Click on a different question group before closing or e Click on another tab on your dashboard such as Eligibility Summary DD Screening Docs or Logout Don t just e Click on the X in the upper right hand corner of the screen e Close the browser HEALTH RISK ASSESSMENT FULL HRAF STATUSES Valid HRAF Statuses are e Open occurs when an HRA is Closed with the disposition of Complete MnCHOICES Assessment Required e Pending occurs when a certified Assessor has completed the Health Risk Assessment Full HRAF and is waiting for additional information to complete the Health Risk Assessment Full HRAF e Closed occurs when a Health Risk Assessment Full HRAF is finished MnCHOICES User Manual Draft 1 1 09 20 13 100 Page OFFLINE MODE OFFLINE OBJECTIVE The objective of offline mode is to perform an assessment and run eligibility rules without an internet connection TIP It is recommended to perform ALL assessments offline to both assure saving ALL assessment answers and is the best practice for purposes of data privacy The system supports the following MnCHOICES Assessment Types in Offline Mode New Reassessment HRA H
127. toms Pediatric Symptom Checklist PSC 17 Suicide Screen Alcohol Substance Abuse Tobacco Gambling Referrals amp Goals Psychosocial I Pat Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer l DD Screening Docs 1 LTC Screening Docs 1 PCA Service Agreement ADLs 9 Routines and Preferences IADLs Health 10 Routines 4 Psychosocial 19 What is a typical day like for you About this Domain 0 e Psychosocial gt Behavior Emotion 18 v N OT E h Symptoms t S Pediatric Symptom D Pretorences h j Prcheckist PS1 screen shot Is D Eurie Sarei 1 What are some things that you enjoy doing f Alcohol Substance 0 a n ot LO rre ct O r gt Abuse Tobacco D Gambling a questions In _ EE 0 How do you want to spend your time s me Te Psychosocial Memory amp Cognition Safety Self Preservation p Sensory amp Communication Do you like where you live housing city county etc Employment W No WW Yes W Chose not to answer Volunteering amp Training Comments Housing amp Environment 1 Self Direction Additional Comments Service Related Rights and Choices Caregiver Assessment Informati
128. ts and Choices domain and select About this Domain Service Related Rights amp Choices I Pat Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions I Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement Quality of Life ADLs IADLs Health About this Domain Service Related Rights amp Choices To assess the individual s satisfaction with their case manager and service providers lt lt Back To Referrals amp Goals Self Direction gt gt Go To HCBS Case Manager Evaluation Psychosocial Memory amp Cognition Safety Self Preservation Sensory amp Communication Employment Volunteering amp Training Housing amp Environment Self Direction GEET Related Rights nd Choices About this Domain gt Service Related Rights amp Choices HCBS Case Manager Evaluation Guardian Conservator Evaluation Referrals amp Goals Service Related Rights amp Choices Caregiver D Assessment Information 5 Assessor Conclusions 16 36 Read About this Domain Service Related Rights and Choices 37 Complete all appropriate Service Related Rights and Choices domain information for each group HCBS Case Manager E
129. valuation Guardian Conservator Evaluation Referrals amp Goals Service Related Rights amp Choices I Pat Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions Eligibility Log Print Export Assessment Answers Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement Quality of Lite ADLs IADLs Routines Routines and Preferences Health What is a typical day like for you Psychosocial Memory amp Cognition Safety Self Preservation NOTE this screen Sensory 8 shot is not correct Communication 7 z Employment What are some things that you enjoy doing fo r q u e sti O n S I n Volunteering amp Training Housing amp Environment 1 o OF Se rvi ce Re ated Self Direction Rights and Preferences Service Related Rights and Choices About this Domain al C h H Service Related Rights O ces amp Choices HCBS Case Manager Evaluation How do you want to spend your time Do you like where you live housing city county etc W No W Yes Chose not to answer je Guardian Conservator Evaluation Comments Referrals amp Goals ee Serice Related Rights amp Choices Additional Comments Caregiver D a Assessment Informat
130. ver domain information for each group Caregivers Caregiver Interview Referrals amp Goals Caregiver I TAT Minnesota Department of Human Services MnCHOICES Person Intake Assignment Assessment User Profile Logout Assessment Ann Anderson Assessment Id 1847 Certified Assessor PWHEG78 Lead Agency Dakota Public Health Current Assessment Summary Dispositions Eligibility Log Print Export Assessment Answers l Transfer DD Screening Docs LTC Screening Docs PCA Service Agreement Riemer Routines and Preferences lityof lie 1 errs Quality of Life B gt ADLs IADLs What is a typical day like for you Health Psychosocial N OT E 3 h D h this screen shot Memory amp Cognition S Preferences Safety Self Preservation is not correct fo r Sensory amp What are some things that you enjoy doing Communication Se Ee eS H 7 H questions in Caregiver Employment Volunteering amp Training Housing amp Environment WR EE How do you want to spend your time Service Related Rights and Choices 4 Caregiver About this Domain 0 Do you like where you live housing city county etc Caregiver W No Yes LJ Chose not to answer Caregivers 0 Comments vc Caregiver Interview 0 Referrals amp Goals 0 E Caregiver Additional Comments Assessment Information 5 E D Assessor Conclusions 16 Screening Documents 1 MnCHOICES User Manual Draft 1 1 09 20 13
131. xperience requirements established by the state The MnCHOICES assessment application was developed to provide an automated uniform and comprehensive assessment and support planning process for persons with long term care needs MnCHOICES streamlines the assessment process and replaces the following four assessments e Developmental Disability Screening e Long Term Care Consultations e Personal Care Assistance e Private Duty Nursing An outcome of the MnCHOICES assessment is determination of level of care and eligibility for Home and Community based Services and programs the assessment s findings are also used to develop a support plan for the individual The person centered focus of MnCHOICES provides individuals the opportunity to rell their story and helps tailor long term services and supports to their strengths preferences and assessed needs This focus is woven throughout all the MnCHOICES domains and is supported by the assessor s interview skills that include active listening to comprehend interpret and evaluate what the individual is saying Points for the certified assessor to remember Gather information from the interview with the individual You may collect additional information from a variety of sources including an authorized representative as well as medical or other records and observations The individual is not required to answer all questions Assume all individuals have the capacity to make their own decisions Determine wh

MnCHOICES User Manual - Minnesota Department of Human

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