Home

DAANES Web User Manual - Minnesota Department of

1. General Service Delivery Social Environment Child Protection Alcohol and Drug Abuse CH Severity Ratings Financial Information Client Satisfaction During the past 30 days how many days has the client used the following Any alcohol L Illicit drugs Substance Abuse Problem at Discharge ___ of Days in last 30 Primary Substance Abuse Problem Select Secondary Substance Abuse Problem Select y Tertiary Substance Abuse Problem Select I Check if record is COMPLETE Click to Add DAANES Web User Manual 51 October 2015 During the past 30 days how many days has the client used the following Enter the number of days the client used alcohol and or illicit drugs in the past 30 days Responses may range from 0 to 30 Any alcohol Illicit drugs Primary Substance Abuse Problem Secondary Substance Abuse Problem Tertiary Substance Abuse Problem If the client still has perceived substance abuse problems at the time of discharge select primary secondary and tertiary problems If there are no problems select None First select primary substance of abuse which corresponds to the substance associated with the most severe problems the client has experienced Then select the secondary which corresponds to the substance next in problem severity Finally select the tertiary which corresponds to the third substance in problem severity Nicoti
2. DAANES Web User Manual 47 October 2015 In the past 30 days did the client have interaction with family and or friends that are supportive of recovery Select the appropriate radio button Yes No Unknown In the past 30 days where has the client been living most of the time Select the category which corresponds to the client s living situation Homeless no fixed address including shelters Dependent living dependent children and or adults living in a supervised setting Independent living including on own self supported and non supervised group homes Children living with their family Unknown Will the client be living in an environment conducive to recovery Use both clinical judgment and client perceptions to make a determination Select the appropriate radio button Yes No Unknown What is the client s current labor force status Select the category which corresponds to the client s primary occupational status after leaving treatment If none of the categories is appropriate use Other Employed full time means paid employment including self employment for 35 hours or more per week Employed part time means paid employment including self employment less than 35 hours per week Occasional seasonal work means paid employment on a seasonal or otherwise irregular basis Sheltered employment is used only for disabled clients in structured work training settings Homemaker can be used only if there is one or m
3. 01 Alcohol 02 Cocaine powder 03 Crack 04 Marijuana Hashish 05 Heroin 06 Non prescription Methadone 07 Other Opiates Synthetics 08 PCP 09 Other Hallucinogens Psychedelics 10 Methamphetamine 11 Other Amphetamines 12 Other Stimulants Chemical Health Severity Ratings CON Sl LAIA A Se ee OSOVNN SaBSaaasa Dimension 1 Acute Intoxication Withdrawal Potential Dimension 6 Recovery Environment eese Client s history of injection drug use 1 2 3 4 5 9 Within the past 30 days More than 12 months ago Never injected Unknown Sere re rer Does the client currently smoke cigarettes 1 Yes 2 No 9 Unknown Route of Administration Oral Smoking Snorting Injection Oral Smoking Snorting Injection Oral Smoking Snorting Injection Benzodiazepines Other Tranquilizers Barbiturates Other Sedatives Hypnotics Ketamine Ecstasy other club drugs Inhalants Over The Counter Medications Other Nicotine Tobacco secondary or tertiary only No secondary or tertiary substance Unknown 0 No problem 1 Minor problem 2 Moderate problem 3 Serious problem 4 Extreme problem 5 Unable to assess Dimension 2 Biomedical Conditions and Complications ccccececceeeeeeeeeeneeceeeeeeeseeeeaeeeeeeeeeseesneaeees Page 3 of 3 Information Within the past 6 months but not in the past 30 days Within the past 12 months but not i
4. Non Opiate Client Opiate Client ISATS ID MN000001 Admission Date MM DD YYYY Client Initials L1L3F1F3M Client DOB MM DD YYYY E Last 4 Digits of Client SS OTP providers who provide both abstinence based treatment and OTP services must select the type of client being admitted by clicking the appropriate radio button If the provider selects Opiate Client the OTP central registry fields are displayed otherwise the provider completes the standard DAANES client identifying fields DAANES Web User Manual 17 October 2015 Search Screen The search screen is used for locating and selecting admission records for updating and for entering six month review and discharge information into the system The search screen permits the user to search on one or more of the following items PMI number client initials date of birth SSN date of admission or admission ID To search for a record enter the criteria in the appropriated text boxes and click the Search button Click on the Clear button to start a new record search The search results may be sorted in either ascending or descending order by any of the columns which have their titles underlined Select a record to edit or to add new information by moving the mouse pointer over the Edit or Add button located in the designated column on the left side of the screen and clicking the left mouse button The selected screen admission six month or discharge will be d
5. Service Delivery Social Environment Child Protection Alcohol and Drug Abuse CH Severity Ratings Financial Information Client Satisfaction Current Chemical Dependency Treatment Select Reason for Discharge Expiration of civil commitment of hold order Substance Use Disorder Diaanosis Primary Diagnosis Select Secondary Diagnosis Select Does the client have any of the following conditions or complications Hearing Impairment C Yes C No Visual Impairment C Yes C No Physical Handicap C Yes C No Development Disability C Yes C No Mental Illness C Yes C No Speech Pathology C Yes C No Learning Disability C Yes C No Brain Injury C Yes C No English Not Primary Language Yes No Functional Illiteracy C Yes C No Has client been a victim of abuse Select Has client been a perpetrator ofabuse Select Which of the following were used as part of CD treatment for the client Methadone C Yes C No Other opioid replacement C Yes C No Antabuse C Yes C No Naltrexone C Yes C No Other anti craving medication Yes No Anti depressant medication C Yes C No Anti anxiety medication C Yes C No Other prescribed medications C Yes C No Other specify Acupuncture C Yes C No E Check if record is COMPLETE Click to Update DAANES Web User Manual 41 October 2015 Discharge Date Enter the client s date of discharge from the program in MM DD YYYY format by either typing or
6. on the secondary source of referral If none of the categories appropriately depicts the client s source of referral select Other Self family relative friend Detox center School Mental health center Employer EAP Other residential facility Law enforcement County social service agency CD services Courts County social service agency child protection Probation parole County social service agency other services DUI DWI AA other support group Pre petition screening Community professional agency e g clergy diversion program Information and referral agency Corrections Tribal agency Health care facility professional Other CD treatment program No Secondary Did a specialty court refer the client to this episode of treatment If the client was referred by the court select the appropriate category No Yes Family dependency treatment court Yes Adult drug court Yes Mental health court Yes Juvenile drug court Yes Community court Yes DWI court Yes Other Yes Truancy court Unknown Primary condition surrounding admission Select the primary condition surrounding admission of the client to treatment Treatment to avoid jail Treatment as condition of probation parole Treatment to retain driver s license license plates Treatment or lose custody of children Treatment to regain custody of children Treatment to avoid loss of relationship or living situation Treatment to maintain employment school enrollment Treatment
7. CFR as well as the pre paid health plan for continued funding under the pre paid element DAANES Web User Manual 66 October 2015 Minnesota Health Care Programs MHCP MN ITS Interactive User Guide http mn its dhs state mn us N ITS Objective Verify Eligibility for MHCP Recipients Performed by MN ITS Users This User Guide instructs providers to use the MN ITS Interactive Eligibility Request feature to verify eligibility on the Single Eligibility Inquiry tab one at a time or the Multiple Eligibility Inquiry tab up to 50 at a time Background A recipient s eligibility through MHCP may terminate or change Since there are no eligibility dates on the MHCP ID card providers are strongly encouraged to verify recipient eligibility prior to rendering services Use MN ITS Interactive e Complete all bolded required fields e Complete other non bolded situational fields as appropriate e Underlined items are linked to definitions and additional information about that item including information about completing a field code definitions for fields or instructional information e Some fields are grouped together in boxes of associated information Field titles with an asterisk indicate that the information is situational If you complete one asterisked field within a boxed section of a screen you must complete all asterisked fields in that section of the screen Verify MHCP Eligibility for a Single Reci
8. What is the client s current labor force status E Select y Is the client currently enrolled in school or a job training program gt Select Referrals at discharge mark all that apply Additional CD Treatment C Yes No CD aftercare support group professionally led C Yes C No CD aftercare support group self help C Yes C No CD board and lodging CyYes No Non CD supportive housing C Yes No Domestic abuse treatment program C Yes C No Individual counseling therapy C Yes No Family counseling therapy C Yes No Detox C Yes UC No Medical care services C Yes C No Vocational program C Yes No Legal assistance C Yes C No Law enforcement corrections C Yes No Court court services C Yes UC No County social service agency CD services C Yes C No County social service agency other services C Yes C No VA Veterans Service Organizations C Yes C No I Check if record is COMPLETE Click to Add In the past 30 days how many times has the client been arrested Enter the number of times the client was arrested in the past 30 days The acceptable range is from 0 to 98 and enter 99 for unknown In the past 30 days how many times did the client attend self help programs e g AA NA Select the category which corresponds to the client s attendance to self help programs No attendance past month 16 30 times past month 1 3 times past month Some attendance but frequency unknown 4 7 times past month Unknown 8 15 times past month
9. de PON 9600 oe a dl dd a ne A a oe Minnesota Health Care m th MHCP Prasat this card svory tims you ge Tor medical core Member Number 1234567890 Member Nane JANE A DOE Birth Date 11 15 2005 Gontor FEMALE Re BIN 610459 Mors iafirmaztos an bach of card PMAP Name SAMPLE JOSEPH Q Wr 07123436701 DOR 2 10 1961 Group SCHA POD CUINICLOCATION EXkctive Date 01 01 2007 Pa 01234567 Sve Type Medical Ex Care Type SCHAMA Phone S S 5 SS555 Odce Visit Copay 5 Noa Emergency ER Ere Gastos PN SHOD RXBin 610455 PRIME TUSRAPENTICS 2 500 Stinson Boulevard N E Waze Minnoapolis MN 55413 612 676 3200 or 1 800 203 7225 Issuer 80840 DOB lt mm dd yyyy gt ID lt 00099999999 gt PMI lt XXXXXXXX gt Name lt SAMPLE CARD U2320A gt Care Type lt UCARE PMAP MNCARE GAMC gt Svc Type lt XOOKKXXKKKAXKKXKKK gt POP EXXXXAXXXXXKXKXAXXXXKXXXXKXXXAXXXK gt Account lt w00000 Adult Copay non pregnant Rx Brand Generic lt x x gt OV lt x gt Glasses lt u x gt Non Emergency ER lt x gt Inpatient Hospital 10 with oxx annual max Printed 10 09 DAANES Web User Manual 62 October 2015 Sample CCDTF Service Agreement Letter State of Minnesota Department of Human Services PO Box 64977 Saint Paul MN 55164 0977 APRIL 03 2008 hilera BEST TREATMENT PROVIDER 123 MAIN STREET OUR TOWN MN 55555 8888 Provider ID 1234567890 Our r
10. October 2015 Eligibility Verification System EVS EVS can be accessed by telephone or from the MN ITS website on the internet EVS uses voice prompts to walk the caller through menu options If the caller does not respond to the voice prompts the menu options will be repeated EVS confirms each entry by repeating the entry to the caller and asking for confirmation Prior to ending the call EVS allows the caller to request information on the same client for a different date of service or to review eligibility information for a different client It is important to listen to the entire message because EVS may indicate a client is eligible for multiple programs i e medical assistance and prepaid health plan PROCEDURE Gather Information e Provider s 10 digit National Provider Identification NPI number e Either the client s 8 digit PMI number OR social security number and date of birth e Recipient s first and last name e Date of service Contact EVS e 800 657 3613 toll free or 651 431 4399 metro or MN ITS e Follow the prompts Caller enters Welcomes the caller to the MHCP Automated 7 for recipient information Inquiry Service Prompts the caller to enter their 10 digit NPI Provider s 10 digit NPI provider number provider number followed by the key Asks which information the caller will use for 1 for identification number PMI the Recipient Inquiry OR 2 for social security number
11. UPLOAD Choose Your File To Upload Browse SIX MONTH REVIEW UPLOAD Choose Your File To Upload Error listing after the upload process has completed ths Minnesota Department of Human Services DAANES minnesot north Star Home Search Upload Reports Admin Reset Password Logout User Test User Data has been processed There were 3 errors Client Initials SMJH Client DOB 11 15 1968 Client SSN 1234 Admission Date 05 11 2008 Dimension 1 is in error serial 0001 The invalid value was set to NULL Client Initials VWLJHJ Client DOB 04 25 1985 Client SSN 1234 Admission Date 05 11 2008 Primary Condition is in error serial 0002 The invalid value was set to NULL Client Initials OSLNG Client DOB 10 05 1956 Client SSN 1234 Admission Date 05 11 2008 Was the client in jail is in error serial 0003 The invalid value was setto NULL DAANES Web User Manual 58 October 2015 Reports The DAANES web application currently provides six reports to assist providers in tracking the status of their client records and two summary reports Each of the tracking reports lists the client s initials date of birth last four digits of the social security number date of admission the client s admission ID and the staff person who last updated the record The lists can be sorted in ascending and descending order by moving the mouse pointer over the underlined column headings and clicking the left mouse butto
12. abuse Legal questions address whether the client is currently under court jurisdiction driver s license revocations lifetime arrests recent arrests convictions and child protection involvement The admission form also captures the clinical results for the six dimensions associated with the chemical health severity ratings Finally key information is collected for linking to the Consolidated Chemical Dependency Treatment Fund CCDTF These fields include the client s PMI number and service agreement number The admission form should be completed within the first 5 days after admission to the program Six Month Review form opioid replacement therapy clients only The purpose of the six month review form is to assess the progress of the opioid replacement therapy client after every six months of treatment services The six month review form collects information on living arrangement labor force status job training status services provided peer support group participation arrests and alcohol and drug usage The six month form also captures the current status of the six dimensions associated with the chemical health severity ratings The six month review form should be completed at the end of every six month period approximately 180 days that the client is in treatment DAANES Web User Manual 4 October 2015 Discharge form The purpose of the discharge form is to obtain information on the client s status at discharge This form incl
13. at the last visit Enter the number of take home doses issued to the client at their last visit to the clinic The acceptable range is from 0 to 31 DAANES Web User Manual 40 October 2015 Discharge Form The discharge form should be completed on the day of discharge or the day after discharge The discharge form contains eight tabs General Service Delivery Social Environment Child Protection Alcohol and Drug Use Chemical Health Severity Ratings Financial Information and Client Satisfaction Remember to SAVE your data by clicking on the Click to Add or Click to Update button in the lower right corner To check for errors check the box next to the label Check if record is Complete and then click the Click to Add or Click to Update button Warning the data will not be SAVED if there are errors identified in the information you have entered when the record is marked complete and you click the Update button Either correct the errors or uncheck the record complete box to save your data General Tab Ha Minnesota Department of Human Services DAANES north Sar a ae a eee J Home PY searen E EEEE e Test ser Discharge Form Admission ID 79995 ISATS ID Client Initials L1L3F1F3M Client DOB MMWDD YYYY Last 4 Digits of Client SS Admission Date MM DD YYYY Discharge Date MM DD YYYY MN000001 ABCDE 1234 0470972010 E 8 General
14. conditions and complications Dimension 3 Emotional behavioral cognitive conditions and complications Dimension 4 Readiness for change Dimension 5 Relapse continued use continued problem potential Dimension 6 Recovery environment Select the category which corresponds to the client s current ratings No problem Minor problem Moderate problem Serious problem Extreme problem Unable to assess DAANES Web User Manual 37 October 2015 Alcohol and Drug Use Tab Ha Minnesota Department of Human Services DAANES north Star Home Ree Bete Goren J Admin Reset Password J Logout User Test User Six Month Form Admission ID 79995 ISATS ID Client Initials L1L3F1F3M Client DOB MM DD YYYY Last 4 Digits of Client SS Admission Date MM DD YYYY Report Date MM DD YYYY ABCDE 04 12 1985 Hal 1234 05 010 05 18 2010 El Social Environment CH Severity Ratings Alcohol and Drug Use Service Delivery During the past 30 days how many days has the client used the following Any alcohol Ei Ilicit drugs Primary Substance Abuse Problem seleat El Secondary Substance Abuse Problem Select El Tertiary Substance Abuse Problem Seet El I Check if record is COMPLETE Click to Add During the past 30 days how many days has the client used the following Enter the number of days the client use
15. counseling or treatment you got Select the category which corresponds to the client s response Not at all A little Somewhat A lot Unknown DAANES Web User Manual 55 October 2015 Did you receive treatment services in a language that you could understand Select the appropriate radio button Yes No Unknown If no what language do you usually speak Select the category which corresponds to the client s response If other is selected enter the language in the text box provide Spanish Hmong Somali Other specify Were the treatment services that you received respectful of your culture Select the appropriate radio button Yes No Unknown DAANES Web User Manual 56 October 2015 Batch Uploading of Data Providers who operate their own computerized case management system may incorporate the DAANES data elements into their own system and submit the required DAANES data using the batch uploading procedure Please contact the DAANES system administrator for specifications on record structures and data editing requirements Click on the Upload button to activate the Batch Upload screen Ha Minnesota Department of Human Services DAANES north Star AAA a al Seren If Uno E co TE er Teste Upload ADMISSION UPLOAD Choose Your File To Upload Browse DISCHARGE UPLOAD Choose Your File To Upload Browse SIX MONTH REVIEW UPLOAD Choose Your File To Upload Browse Records for
16. determined from the client s health plan identification card Most Public Prepaid Health Plans include the PMI number on the card although there are some exceptions Here are the specifics for the eight Public Prepaid Health Plans in Minnesota not all plans operate in every county Blue Plus and The words Minnesota Health Care Programs on the card identify the client as a First Plan Blue public program member The 9 digit ID number on the card beginning with the digit 8 incorporates the PMI number which constitute the last 8 digits HealthPartners The words HealthPartners Care identify the client as a public program member The PMI number is on the member card Itasca Medical Care All enrollees are public program members The PMI number is on the card Medica A 10 digit number beginning with the digits 59 identifies the enrollee as a public program member The 8 digits after the 59 constitute the PMI number PrimeWest The PMI number is on the member card Health Metropolitan Public program members are identified by one of 10 group numbers MHP uses its own Health Plan member identification number on the card South Country Health Alliance The label PMI and PMI number is on the member card UCare The Care Type identifies the enrollee as a public program member UCare MA UCare GAMC or MinnesotaCare The PMI number is on the card DAANES Web User Manual 61 October 2015 Samples of M
17. each form type admission six month review and discharge are uploaded from separate data files Upload a file by clicking on the browse button next to the form type you wish to upload A file open screen Choose File will appear Navigate to the file s location click on the file name and then click on the Open button The file name will appear in the text box next to the form type to be uploaded Click on the Upload button at the bottom center of the form The system will upload and process the data After processing a detailed listing of errors for each record will be displayed Print the results and correct all errors by accessing the records from the Search screen Navigate to the file s location by clicking the browse button and using the Choose file screen Look in Sy DAANES_data a ee ADMISSION adm_batch1 txt Adm_batch2 txt dis_batch1 txt dis_batch2 txt History 44 Desktop DISCHARGE o e My Documents SIX MONTHI PRIMOS AJ ic File name Adm batch2 ta Open Files of type fall Files y Cancel Upload Cancel The admission file to be uploaded is shown in the text box DAANES Web User Manual 57 October 2015 Ha Minnesota Department of Human Services DAANES minnesot north tar PA eee Home Search Upload Reports Admin Reset Password Logout User Test User Upload ADMISSION UPLOAD Choose Your File To Upload Adm_batch2tx Browse DISCHARGE
18. of the client s family life Services for Co occurring Mental Illness Coordinated or fully integrated services to individuals who have at least one psychiatric disorder in addition to a substance abuse disorder Spiritual support Spiritual and motivational activities aimed at helping the client establish a relationship with a higher power or the Creator and or connecting reconnecting with their cultural spiritual beliefs and practices Coordination of Services Coordination of client services received outside of the treatment setting including referral and follow up Therapeutic Recreation Therapeutic recreation to provide the client with an opportunity to participate in recreational activities without the use of mood altering chemicals and to learn to plan and select leisure activities that do not involve the inappropriate use of chemicals Employment or Educational Services Counseling services specifically designed to improve the client s ability to seek and maintain employment Teaches the client skills in interviewing completing applications writing resumes and searching for jobs Childcare Services provided to the family which help the client to participate in the treatment process Transportation Services Transportation is provided between the treatment facility and another place or to and from an activity in the client s plan of care How many take home doses of narcotic replacement medications was the client given
19. secondary and tertiary enter the number of days the client used that substance during the past 30 days Responses for use during the past 30 days may range from 0 to 30 or 99 for unknown Service Delivery Tab Ha Minnesota Department of Human Services DAANES north Star SSS ee ee Six Month Form Admission ID 79995 ISATS ID Client Initials L1L3F1F3M Client DOB MM DD YYYY Last 4 Digits of Client SS Admission Date MM DD YYYY Report Date MM DD YYYY MN000001 ABCDE 1234 05 18 2010 dal Social Environment CH Severity Ratings Jl Alcohol and Drug Use lI Service Delivery Number of service sessions provided in the past 6 months for Detoxification Alcohol Drug testing Education about alcohol and other drugs Medical care Living skills development Individual counseling Group counseling Relationship family counseling Services for co occurring mental illness Spiritual support Coordination of services Therapeutic recreation Employment or education services Childcare Hoga Transportation How many take home doses of narcotic replacement medication was the client given at the last visit I Check if record is COMPLETE Click to Add Record the number of service sessions provided in the past 30 days For each of the service categories report the number of occurrences each services was provided to the client during the past 30 d
20. substances selected as primary secondary and tertiary Oral means ingested through the mouth and swallowed Smoking refers to inhaling the smoke from substances that are burned Snorting refers to inhaling the substance through the nose Injection use includes intravenous IV use intramuscular IM use and subcutaneous use under the skin or skin popping Age at first use of the identified primary secondary and tertiary substances Enter the age of the client s first use for each of the substances selected as primary secondary and tertiary For alcohol enter the age associated with first use to intoxication Chemical Health Severity Ratings Tab A Ha Minnesota Department of Human Services DAANES north har AAA I Home I searen J ramin J Reset Passwort Y toron EAT Admission Form Admission ID 80987 ISATS ID Client Initials L1L3F1F3M Client DOB MM DD YYYY Last 4 Digits of Client SS Admission Date MM DD YYYY nooo ascos foana 19es 8 haa Pm A Placement Information Criminal Justice Client Profile Prior CD Treatment Experience Child Protection Alcohol and Drug Use CH Severity Ratings Dimension 1 Acute Intoxication Withdrawl Potential Seect El Dimension 2 Biomedical Conditions and Complications sele El Dimension 3 Emotional Behavioral Cognitive Conditions and Complications Seect El Dimension 4 Readiness to Change FSelect El Dimension 5 Relapse Continued Use Con
21. to retain professional license Treatment required to retain government benefits Financial pressures caused by drug alcohol use Other None DAANES Web User Manual 22 October 2015 Legal status at admission Select the client s legal status at admission Emergency court hold order Use this for emergency admissions and court hold orders Emergency admissions are made by a peace or health officer on behalf of a person who is chemically dependent and in danger of harming self or others or intoxicated in public Emergency admissions are governed by Minnesota Statutes section 253B 05 Court hold orders are made by a civil court of jurisdiction in order to admit a person either for the protection of the person or the public or to assure that the proposed patient is available for a pending commitment hearing Civil court hold orders are governed by Minnesota Statutes section 253B 07 subdivision 6 Criminal court order A directive that a person go to treatment as part of a criminal sentence as an alternative to a jail sentence or as a condition of probation This response should not be used if the client is on probation or parole and the court is not requiring that the person go to treatment This response should be used if the treatment placement is the result of a probation or supervised release parole revocation proceeding and is a condition of continued supervised release or probation Court commitment CD A civil court order r
22. 013 a Placement Information Criminal Justice Client Profile l Prior CD Treatment Experience Child Protection Alcohol and Drug Use CH Severity Ratings Sex Select Race Select y Hispanic ethnicity Select y Current marital status Select h In the past 30 days where has the client been living most of the time Sete Usual Living Situation Select County of Residence Select 7 or State of Residence Select Tribe Enrollment Select Reside on the Reservation Select Pregnancy status at admission Select y Veteran status E Select X Education E Select Years of schooling Is the client currently enrolled in school or a job training program Select z Primary source of income or support during the 30 days prior to treatment hospitalization or incarceration E Select What is the client s current labor force status Select hd I Check if record is COMPLETE Click to Update Sex Select the client s gender Male Female DAANES Web User Manual 25 October 2015 Race Select the category which corresponds to the race of the client based the client s self identification For Hispanic clients select the race and indicate the ethnicity on the next item Choose Other if none of the first seven categories accurately depicts the client s race White Black American Indian Asian Native Hawaiian Pacif
23. 5 Counties and tribes are responsible for providing Rule 25 assessments and determining client eligibility as of the date of the Rule 25 assessment Providers bill the CCDTF on a fee for service basis DHS then collects the state and federal share from GAMC and Medical Assistance Counties also pay a percentage of the client s treatment costs Pre Paid This includes clients who are enrolled in Minnesota State Contracted Pre Paid Health Plans PPHP s Pre paid MA Pre paid GAMC MinnesotaCare As of July 1 2008 state contracted pre paid health plans are responsible for providing all CD treatment services to their enrollees Chemical use assessments must be provided according to Minnesota Rules parts 9530 6600 through 9530 6655 Rule 25 The PPHP pays the provider and bills DHS for room and board services in non hospital residential programs Mid treatment enrollment dis enrollment Chemical dependency treatment providers are responsible for monitoring continued client PPHP enrollment on a month to month basis This includes continued enrollment loss of enrollment or initiation of new enrollment or re enrollment Ifa client loses enrollment during the treatment episode the provider must contact the client s county of financial responsibility CFR to determine eligibility for the CCDTF for continued funding under FFS Ifa client becomes enrollment in a PPHP during the treatment episode the provider must contact the client s
24. DAANES Web User Manual For Chemical Dependency Treatment Programs MINNESOTA DEPARTMENT OF HUMAN SERVICES Alcohol and Drug Abuse Division October 2015 DAANES Contact Information Web Address https DAANES DHS STATE MN US For assistance DAANES Data Coordinator 651 431 2631 DAANES System Administrator 651 431 2630 Email DHS DAANES STATE MN US or Vicki Busch STATE MN US Mail DAANES Data Processing Unit Alcohol and Drug Abuse Division Minnesota Department of Human Services PO Box 64977 Saint Paul Minnesota 55164 0977 Site Location Elmer L Andersen Building 540 Cedar Street Saint Paul Minnesota 55155 DAANES Web User Manual 2 October 2015 Table of Contents Page Introduction and Overview Of DAANES cccceecseesseceseeeesseceseeeenaeceneessaecesneeeaeeceeeeeenaeceeneeeaaeceneeenaeeeee 4 Data Private S beth ls AN 5 Notification of Date Collection nenen e E A E E E E RE 6 General IMStructrons 23 cc essccss ctu sees E A da ates sete ah tetas E E E 7 Client Identifiers ici i ik ease eed aces estes he ee de ea eee 9 User Mind we a ke ed ote ee TA 10 Provider Contact Informatica a 13 User Logit Screen pri e ail shea anton Gatoni di bind cios 15 Home Screens ce a e eset eto te ibe eh ee a eek Maret Ua ates 16 Home Screen for Opioid Treatment Program Providers ooocononnnonnconononcnoncnnnonnnnnn conc conc crono noco nono nccnncnnos 17 Search Screen A Se eset asd cea E das dance ota A E E E A
25. EE 18 Admission FOr ti e diia 19 SIX Month Review Forti e 35 Discharge Por dida 41 Batch Uploading of Data esmas tiara dal eeeb nies 57 Repo Sinai inn ds 59 Obtaining Client PMI Numbers naceni onie oren u EEr EE i eE ono nc nn narco non non neon a neon anno 61 DAANES FOM S eien an E EE ET EARTE AE GEN 69 DAANES Web User Manual October 2015 Introduction and Overview of DAANES The purpose of this manual is to assist program staff in using the DAANES web application in order to comply with mandatory data reporting requirements The manual contains a detailed discussion of all forms and procedures All program staff should familiarize themselves with the instructions contained in this manual before using the DAANES data collection system Staff members should contact their local DAANES administrator for additional information and assistance The Drug and Alcohol Abuse Normative Evaluation System DAANES has been designed to provide policy makers planners service providers and others in Minnesota with access to current information about chemical dependency treatment activities across the continuum of care The Department of Human Services is required by statute to collect sufficient information to evaluate the efficiency and effectiveness of treatment for chemical dependency In addition the federal Substance Abuse and Mental Health Services Administration SAMHSA of the Department of Health and Human Services has mandatory reporting re
26. NES Web User Manual 50 October 2015 Alleged abuse or neglect by client Alleged abuse or neglect by someone else Alleged abuse or neglect by client and someone else Some other reason Not applicable no children no child protection involvement Unknown Are any of the children living with someone else due to a child protection court order or other actions by child protection services Select the appropriate radio button Yes No Not applicable no children no child protection involvement Unknown How many of the children are living with someone else for these reasons Enter the number of children up to 10 Code 10 if the number is more than 10 children Enter 88 if no children no child protection involvement and 99 for unknown For how many children has the client lost parental rights Enter the number of children up to 10 Code 10 if the number is more than 10 children Enter 88 if no children no child protection involvement and 99 for unknown if all items are unknown Alcohol and Drug Use Tab Ha Minnesota Department of Human Services DAANES north Star AAA AAA Home Search A e O J Reset Password ME ec resis Discharge Form Admission ID 79995 ISATS ID Client Initials L1L3F1F3M Client DOB MMDD YYYY Last 4 Digits of Client SS Admission Date MM DD YYYY Discharge Date MM DD YYYY vinoo0001 ABCDE 04 12 1985 Ez 1234 05 08 2010 E E
27. Probation Parole 20 Information and referral 07 DUI DWI agency 08 Prepetition screening 21 Tribal agency Diversion program 22 Other 09 Corrections 99 No secondary source of 10 Health care facility professional referral 11 CD treatment program 12 Detox center 13 Mental health center 14 Other residential facility 15 County social service agency CD services 16 County social service agency child protection 17 County social service agency other services Did a specialty court refer the client to this episode of treatment 0 No 6 Yes Mental health court 1 Yes Adult drug court 7 Yes Community court 2 Yes Juvenile drug court 8 Yes Other 9 Unknown 3 Yes DWI court 4 Yes Truancy court 5 Yes Family dependency treatment court Primary Condition Leading to Admission to Treatment 01 Treatment to avoid jail or prison 02 Treatment as condition of probation parole 03 Treatment to retain driver s license license plates 04 Treatment or lose custody of children 05 Treatment to regain custody of children 06 Treatment to avoid loss of relationship or living situation 07 Treatment to maintain employment school enrollment 08 Treatment to retain professional license 09 Treatment required to retain government benefits 10 Financial pressures caused by drug alcohol use 11 Other 12 None Legal Status at Admission 1 Emergency court hold order 5 Juven
28. Protection Alcohol and Drug Use CH Severity Ratings During the past 30 days how many days has the client used the following Any alcohol O Illicit drugs D Client s history of injection drug use Select y Does the client currently smoke cigarettes Yes No Unknown Substance Abuse Problem at Admission Usual Route a 1st Use Primary Substance Abuse Problem Select Select y Secondary Substance Abuse Problem Select Select Tertiary Substance Abuse Problem Select had Select y I Check if record is COMPLETE Click to Click to Update DAANES Web User Manual 32 October 2015 During the past 30 days how many days has the client used the following Enter the number of days the client used alcohol and or illicit drugs in the past 30 days Responses may range from 0 to 30 Any alcohol Illicit drugs Client s history of injection drug use Select the category which corresponds to how recently the client has injected drugs Code the appropriate time frame even for a single instance of injection use Within the past 30 days Within the past 6 months but not in the past 30 days Within the past 12 months but not in the past 6 months More than 12 months ago Never injected Unknown Does the client currently smoke cigarette Select the appropriate radio button Yes No Unknown Primary Substance Abuse Problem Secondary Substance Abuse Problem Ter
29. T Admission Form Admission ID 80987 ISATS ID Client Initials L1L3F1F3M Client DOB MM DD YYYY Last 4 Digits of Client SS Admission Date MM DD YYYY 04 12 1985 E 1234 01 01 2013 e Placement Information Criminal Justice Client Profile Prior CD Treatment Experience Child Protection I Alcohol and Drug Use cH Severity Ratings In the past 30 days how many times has the client been arrested Ei How many times has the client been arrested in their lifetime L In the past 30 days was the client in jail C Yes C No Unknown In the past 30 days was the client in prision C Yes C No Unknown Is the client currently under the jurisdiction of the court or on probation parole C Yes C No Unknown Has driver s license been revoked because of a driving incident involving alcohol or other drugs Select z I Check if record is COMPLETE Click to Update In the past 30 days how many times has the client been arrested Enter the number of times the client was arrested in the past 30 days The acceptable range is from 0 to 98 Enter 99 for unknown How many times has the client been arrested in their lifetime Enter the number of times the client was arrested in their lifetime The acceptable range is from 0 to 98 Enter 99 for unknown In the past 30 days was the client in jail Select the appropriate radio button Yes No Unknown In the past 30 days was the client in prison Select the appropriate ra
30. This excludes institutional and group living situations With spouse or partner only With minor children only With spouse partner and children With one parent With two parents With foster parents With relatives With friends With others means that the client is living in an institutional or group living situation Unknown County or State of Residence Select from the lists the client s county or state of residence For a client who is a Minnesota resident select the client s county of residence For a client who is not a Minnesota resident select the client s state of residence Canadian or other Foreign Citizen Tribal Enrollment Select the category which corresponds to the client s tribal enrollment Not Enrolled Bois Forte Fond du Lac Grand Portage Leech Lake Lower Sioux Mille Lacs Band Reside on the Reservation Prairie Island Red Lake Shakopee Upper Sioux White Earth Other Unknown Select the category which corresponds to the client s reservation residency Not residing on reservation Bois Forte Fond du Lac Grand Portage Leech Lake Lower Sioux Mille Lacs Band Prairie Island Red Lake Shakopee Upper Sioux White Earth Other reservation Unknown DAANES Web User Manual 27 October 2015 Pregnancy status at admission Select the category which corresponds to the client s pregnancy status Pregnant Not Pregnant Not sure Male Veteran status Select the category which corresp
31. Title 42 Part 2 52 a of the Code of Federal Regulations which states that information on alcohol and drug abuse patient records may be disclosed whether or not the patient gives consent to qualified personnel for the purpose of conducting scientific research management audits financial audits or program evaluation Safeguarding the client s rights to data privacy and confidentiality as provided under the Minnesota Data Practices Act and the Code of Federal Regulations is of primary concern to the DHS DAANES has been designed to protect these rights The client s name is not used on the data forms Instead a special client identifier is used which maintains the anonymity of the client while still enabling DAANES to track clients across the continuum of care The DAANES client identifier consists of initials from the client s name first and third letters from the first and last name and middle initial the client s date of birth and the last four digits of the client s social security number DAANES Web User Manual 3 October 2015 Notification of Date Collection The Minnesota Data Practices Act requires that clients be informed that the treatment facility will be disclosing client information to DHS for the purposes of research and program evaluation To facilitate this program staff present and explain the DAANES Notification of Data Collection form to the client at admission After the client has reviewed the form and any questions hav
32. and date of birth Prompts the caller to enter either the client s 8 Client s 8 digit identification number or the digit identification number PMI or the client s social security number and date of client s social security number and date of birth birth Asks if the caller is inquiring about today s date 1 for today s date or a previous date 2 for a previous date Identifies the client by gender and date of birth 1 if EVS identifies the correct client or PMI and asks for confirmation 2 if EVS identifies the wrong client 3 if the caller wants EVS to spell the client s last name Indicates what coverage the client has Listen for coverage details DAANES Web User Manual 65 October 2015 COVERAGE DETAILS Funding streams include both fee for service as well as state contracted pre paid mechanisms Fee for Service The Consolidated Chemical Dependency Treatment Fund CCDTF is the single fee for service funding stream for clients who meet the following eligibility criteria Clients are entitled to receive CD treatment services if they meet both 1 Financial eligibility Are eligible for Medical Assistance MA General Assistance Medical Care GAMO or Minnesota Supplemental Assistance MSA or Meet current household size and income guidelines at 100 Federal Poverty Guidelines FPG And 2 Clinical eligibility according to Minnesota Rules parts 9530 6600 through 9530 6655 Rule 2
33. appropriate date in MMDDCCYY format is in this field You can verify eligibility for the previous 12 months but not for a future date 6 Enter a combination of two or more fields of subscriber information Refer to the Minnesota Uniform Companion Guide for search scenarios 7 Click the Add button below the search fields to create the list of recipients for whom you will verify eligibility The word Response is underlined and located at the end of each recipient line This is the 271 Response for each inquiry Remember to change the date of service for each recipient To delete an entry click the NPI on the line you wish to remove and then click the Delete button 8 Repeat as needed to a maximum list of 50 9 After you have completed your list click the underlined Response in the first line of the list to open the 271 Response You may move from one response to the next using the Previous or Next options at the top of the page Understanding your Eligibility Response 271 The Eligibility Response includes your NPI date of service subscriber number birth date age and gender at the top of the page A Print button is at the top left of the page a Close button is at the top right of the page On the Multiple Eligibility transaction response you will see numbers in the center with Previous and Next at each end Below that information is the eligibility information which includes Major programs Waiver eligibility Prepa
34. are responsible for managing staff access to the DAANES web system as described in the User Management section of this manual Finally they are the liaison between the CD treatment provider and the Department of Human Services for all communications related to the DAANES information system DAANES Web User Manual 8 October 2015 Client Identifiers Client Identifiers consist of the Client s Initials 5 characters Date of Birth Last 4 Digits of Social Security Number and Admission Date The client identifying information is entered on the Home form to create a new admission record and may be revised at the top of any of the Admission screens Review carefully the instructions for completing the specific elements that comprise the Client Identifiers Client s Initials Using the client s legal name not a nickname will help ensure consistency as well as facilitating analysis of client readmission patterns across the continuum of care In the text box from left to right across the five spaces enter the client s initials in the following manner In the first space enter the 1st letter of the client s Last name In the second space enter the 3rd letter of the client s Last name If the client does not have a third letter in the last name enter an asterisk In the third space enter the 1st letter of the client s First name In the fourth space enter the 3rd letter of the client s First name If the client does not have a
35. ays There is a count of ONE each time the service is provided regardless of the duration of time This is not an exhaustive list of services some CD programs may not provide some of the services listed If the service was not provided enter a zero in the quantity box Detoxification A service that provides short term care on a 24 hour basis for the purpose of detoxifying clients and facilitating access to chemical dependency treatment as indicated by an assessment of needs Alcohol Drug testing Alcohol drug testing is used to determine the presence of biomarkers of substances in the client DAANES Web User Manual 39 October 2015 Education about alcohol and other drugs An educational event providing information regarding substance use and or dependence Medical Care Care provided by a licensed medical professional to address a medical health need or prevention Living Skills Development Living skills development to help the client learn basic skills necessary for independent living Individual Counseling A counseling session between one client and treatment staff to address substance abuse problems including goal setting treatment plan updates and therapeutic interventions Group Counseling A form of psychotherapy that involves sessions guided by a therapist and attended by several clients who address their substance abuse problems together Relationship Family Counseling Any therapeutic activities designed to improve the quality
36. ctive involvement of program staff in locating the resource and providing the client with information or a contact person Do not count a general recommendation to seek help Additional CD treatment CD aftercare support group professionally led CD aftercare support group self help CD board and lodging Non CD supportive housing Domestic abuse treatment program Individual counseling therapy Family counseling therapy Detox Medical care services Vocational program Legal assistance Law enforcement corrections Court court services County social service agency CD services County social service agency other services VA veteran service organizations DAANES Web User Manual 49 October 2015 Child Protection Tab Ha Minnesota Department of Human Services DAANES north Star AAA a eee eee Teme Co oo User Test User Discharge Form Admission ID 79995 ISATS ID Client Initials L1L3F1F3M Client DOB MM DD YYYY Last 4 Digits of Client SS Admission Date MM DD YYYY Discharge Date MM DD YYYY MNO000001 ABCDE 04 12 1985 i 1234 a General Service Delivery Jl Social Environment J Child Protection Alcohol and Drug Abuse CH Severity Ratings Financial Information Jl Client Satisfaction Does the client have children under 18 years of age Yes C No Unknown How many children Is the client currently involve
37. d alcohol and or illicit drugs in the past 30 days Responses may range from 0 to 30 Any alcohol Illicit drugs Primary Substance Abuse Problem Secondary Substance Abuse Problem Tertiary Substance Abuse Problem If the client still has perceived substance abuse problems at the time of the six month review select primary secondary and tertiary problems If there are no problems select None First select primary substance of abuse which corresponds to the substance associated with the most severe problems the client has experienced Then select the secondary which corresponds to the substance next in problem severity Finally select the tertiary which corresponds to the third substance in problem severity Nicotine Tobacco may be coded as a secondary tertiary substance abuse problem None Benzodiazepines Alcohol Other tranquilizers Cocaine powder Barbiturates Crack Other sedatives or hypnotics Marijuana hashish Ketamine Heroin Ecstasy other club drugs Non prescription methadone Inhalants Other opiates and synthetics Over the counter medications PCP Other Other hallucinogens or psychedelics No secondary or tertiary substance Methamphetamine Nicotine Tobacco secondary or tertiary only Other amphetamines Other stimulants Unknown DAANES Web User Manual 38 October 2015 Number of days used in the last 30 days of the identified primary secondary and tertiary substances For each of the substances select as primary
38. d with child protection services Yes C No Not applicable no children Unknown Does the involvement result from a Select Are any of the children living with someone else due to a child protection court order or other actions by child protection services Yes C No Not applicable no children no child protect involvement Unknown How many of the children are living with someone else for these reasons For how many children has the client lost parental rights I Check if record is COMPLETE Click to Add The child protection questions relate to children who are under 18 years of age for whom the client is the natural or adopted parent or for whom the client has legal guardianship Does the client have children under 18 years of age Select the appropriate radio button Yes No Unknown Note If No or Unknown is selected the system will auto fill the balance of the child protection items when you check the record is complete box and click the update button How many children Enter the number of children up to 10 Code 10 if the client has more than 10 children Enter 88 if no children and 99 for unknown Is the client currently involved with child protection services Select the appropriate radio button Yes No Not applicable no children Unknown Does the involvement result from Select the category which corresponds to the reason for involvement with child protection services DAA
39. dio button Yes No Unknown Is the client currently under the jurisdiction of the court or on probation parole Select the appropriate radio button Yes if the client is currently under the jurisdiction of the court or on probation parole No if the client is neither under the jurisdiction of the court nor on probation parole Unknown if the client left before you could get the information DAANES Web User Manual 24 October 2015 Has driver s license been revoked because of a DWI Select the category which corresponds to the answer that best describes the status of the client s driver license Use Not Applicable only if the client has never had a license If the client has a license but has never had a revocation use Never Revoked For purposes of this question a revocation includes a formal revocation or a license that has been denied while formal proceedings are pending Currently under revocation Revoked during past 12 months but not currently revoked Revoked at least once in lifetime but not in the past 12 months Never Revoked Not applicable Unknown Client Profile Tab Ha Minnesota Department of Human Services DAANES north star A eS ee Se ee es IPS SET eT Home J Aamin Reset Password Logout User Test User Admission Form Admission ID 80987 ISATS ID Client Initials L1L3F1F3M Client DOB MM DD YYYY Last 4 Digits of Client SS Admission Date MM DD YYYY MN000001 04 12 1985 E 01 01 2
40. dit ASDFG 5 26 1958 1234 88888888 11 25 2012 1 80984 Edit TESTA 12 12 1960 1234 88888888 5 4 2012 1 80983 Edit Add TESTC 6 27 1955 9165 03825503 4 8 2012 2 80982 Edit Add TESTA 3 2 1984 4161 88888888 11 8 2012 2 80981 Edit Add AFJKE 6 5 1978 5555 88888888 10 10 2012 2 80980 Edit Add E 1 1 1950 1249 88888888 1 1 2012 2 80979 Edit Add QWERT 10 28 1965 4356 12345678 10 2 2012 2 80978 Edit Edit TYUO 11 11 1987 1234 12345678 10 1 2012 2 11 2 2012 2 80977 Edit Add Add ZXYW 5 12 1990 1234 88888888 10 2 2012 2 80975 Edit Add D D D 6 5 1956 8989 88888888 7112 2012 2 80974 Display Display Add REWLS 1 25 1960 0000 88888888 7125 2012 2 7 26 2012 2 80973 Display Display WWWWW 10 25 1986 1234 87612345 8 23 2012 2 8 26 2012 2 80972 Edit REFLS 5 25 1960 4545 88888888 8 3 2012 1 80971 Displaying Page 1 of 125 DAANES Web User Manual 18 October 2015 Admission Form A new admission record is started on the Home screen by entering the admission date client s initials date of birth last four digits of the SSN Clicking the Submit button will activate the Admission form When the Admission form is activated the system assigns an admission identification number to the record which is displayed in the upper right area of all the data entry screens and is also located in the far right column of the Search screen The admission ID number is useful for tracking clients on the DAANES system and for com
41. e been answered the staff person dates and initials the form The client is given a copy to keep and a copy is placed in the client s file Since this is not a consent form it does not require the client s signature DHS 2598 ENG 2 14 DAANES Notification of Data Collection This program will be collecting and disclosing the statistical information specified below to the Minnesota Department of Human Services DHS as required by Minnesota Statute 254A 03 subd 1 d and Title 42 Parts 2 52 and 2 53 of the Code of Federal Regulations The information includes age race sex living arrangement education occupation previous treatment chemical use legal status and referral information and for publicly funded clients Minnesota health care programs placement information None of the forms will have your name on them a confidential code will be used This information will be used by DHS for internal research program evaluation and auditing purposes only Federal confidentiality regulations 42 C F R Part 2 prohibit the disclosure of client data obtained in the course of these data collection efforts for purposes other than the original purposes for which it was intended Unless otherwise allowed or required by law no identifying information about you will be released without your express written authorization If you have any questions about this notice you may contact DHS at 651 431 2470 You will be given a copy of this no
42. e living with someone else for these reasons 88 No children child protection involvement 99 Unknown For how many children has the client lost parental rights 88 No children child protection involvement 99 Unknown 10 01 2015 Drug and Alcohol Abuse Normative Evaluation System DAANES Discharge Form Alcohol and Drug Use During the past 30 days how many days has the client used the following 99 Unknown Alcohol Illicit drugs Substance Abuse Problems at Discharge Primary Substance Abuse Problem Days used in the past 30 days Secondary Substance Abuse Problem Days used in the past 30 days Tertiary Substance Abuse Problem Days used in the past 30 days Substance Abuse Codes 00 None 01 Alcohol 02 Cocaine powder 03 Crack 04 Marijuana Hashish 05 Heroin 06 Non prescription Methadone 07 Other Opiates Synthetics 08 PCP 09 Other Hallucinogens Psychedelics 10 Methamphetamine 11 Other Amphetamines 12 Other Stimulants 13 Benzodiazepines 14 Other Tranquilizers 15 Barbiturates 16 Other Sedatives Hypnotics 17 Ketamine 18 Ecstasy other club drugs 19 Inhalants 20 Over The Counter Medications 21 Other 22 Nicotine Tobacco secondary or tertiary only 98 No secondary or tertiary substance 99 Unknown Chemical Health Severity Ratings 0 No problem 1 Minor problem 2 Moderate problem 3 Serious probl
43. ecords indicated that WALLEY COUNTY has entered and approved a service agreement for your organization to provide chemical dependency treatment services to J Q MINNESOTAN The approved service s are listed below along with information regarding eligibility dates rates and other codes If you have any questions regarding this service agreement please contact WALLEY COUNTY The Total Amounts listed below reflect the possible maximum payment Actual reimbursement may be less ted below have Recipient Recipient Recipient Service Effective Through Name 1D PMI Birthdate Agreement Date Date J Q MINNESOTAN 12345678 11 21 1991 12345678910 04 07 08 04 15 08 REVENUE PROCEDURE SERVICE LINE CODE CODE MOD DESCRIPTION 01 0169 ROOM amp BOARD Quantity Units 8 Start Date 04 07 08 Rate United 30 00 End Date 04 15 08 Total Amount 240 00 Line item Status APPROVED Provider Number 1234567890 123S00000X REVENUE PROCEDURE SERVICE LINE CODE CODE MOD DESCRIPTION 02 0944 H0020 A TREATMENT METHADONE Quantity Units 8 Start Date 04 07 08 Rate United 15 00 End Date 04 15 08 Total Amount 120 00 Line ltem Status APPROVED Provider Number 1234567890 123S00000X This information is available in other forms to people with disabilities by calling 651 431 2460 voice or contact us through the Minnesota Relay Service at 1 800 627 3529 TTY DAANES Web User Manual 63 October 2015 DAANES Web User Manual 64
44. ection Alcohol and Drug Abuse CH Severity Ratings Financial Information Client Satisfaction Dimension 1 Acute Intoxication Withdrawl Potential F Seea El Dimension 2 Biomedical Conditions and Complications Select yl Dimension 3 Emotional Behavioral Cognitive Conditions and Complications Select y Dimension 4 Readiness to Change Select El Dimension 5 Relapse Continued Use Continued Problem Potential F Seea yl Dimension 6 Recovery Environment F Seet yl I Check if record is COMPLETE Click to Add For each of the six chemical health severity dimensions rate the client s status at the time of discharge Dimension 1 Acute intoxication withdrawal potential Dimension 2 Biomedical conditions and complications Dimension 3 Emotional behavioral cognitive conditions and complications Dimension 4 Readiness for change Dimension 5 Relapse continued use continued problem potential Dimension 6 Recovery environment Select the category which corresponds to the client s current ratings No problem Minor problem Moderate problem Serious problem Extreme problem Unable to assess DAANES Web User Manual 53 October 2015 Financial Information Tab Ha Minnesota Department of Human Services DAANES north Star AAA ee ee N TEE Eo ES E E A E SS ser Test user Discharge Form Admission ID 79995 ISATS ID Client Initials L1L3F1F3M Client DOB MM DD YYYY Last 4 D
45. ection Alcohol and Drug Use CH Severity Ratings Does the client have children under 18 years of age C Yes C No Unknown How many children Is the client currently involved with child protection services C Yes C No Not applicable no children Unknown Does the involvement result from Select zl Are any of the children living with someone else due to a child protection court order or other actions by child protection services Yes C No Not applicable no children no child protect involvement Unknown How many of the children are living with someone else for these reasons For how many children has the client lost parental rights CI I Check if record is COMPLETE Click to Update Does the client have children under 18 years of age Select the appropriate radio button Yes No Unknown Note If No or Unknown is selected the system will auto fill the balance of the child protection items when you check the record is complete box and click the update button How many children Enter the number of children up to 10 Code 10 if the client has more than 10 children Enter 88 if no children and 99 for unknown Is the client currently involved with child protection services Select the appropriate radio button Yes No Not applicable no children Unknown DAANES Web User Manual 31 October 2015 Does the involvement result from Select the category which corresponds to the
46. em 4 Extreme problem 5 Unable to assess Dimension 1 Acute Intoxication Withdrawal Potential Dimension 2 Biomedical Conditions and Complications Dimension 3 Emotional Behavioral Cognitive Conditions and Complications Dimension 4 Readiness for Change Dimension 5 Relapse Continued Use Continued Problem Potential Dimension 6 Recovery Environment Financial Information Hours of treatment services provided Days of room and board provided Total Charges dollars only O O PO A AA Sources of payment enter percentages to sum to 100 Self pay Private health insurance non managed care Private health insurance managed care CCDTF Consolidated CD Treatment Fund MHCP MA GAMC MinnesotaCare Medicare County funds non CCDTF Free care no charge Other Client satisfaction The following items are to be asked of the client How much were you helped by the counseling or treatment you got __ 1 Not at all 2 A little 3 Somewhat 4 A lot 9 Unknown Did you receive treatment services in a language that you could __ understand 1 Yes 2 No 9 Unknown If no what language do you usually speak 1 Spanish 2 Hmong 3 Somali 4 Other specify Were the treatment services that you received respectful of your culture 1 Yes 2 No 9 Unknown Page 3 of 3 10 01 2015
47. equiring a person to participate in a treatment program after a court commitment process in probate court This is not to be used for an admission ordered by a criminal court juvenile court or a civil court involved in another process such as child protection or parental rights issues Court commitment procedures are governed by Minnesota Statutes Chapter 253B Civil court order A court order or consent decree whereby the client is required to participate in chemical dependency treatment as part of the settlement of a civil matter This should be used if the client is required to go to treatment as part of a family court matter involving parental rights for example as a condition of obtaining or retaining the custody of children in a child protection proceeding Juvenile court placement A court order for a minor to participate in treatment as a result of a juvenile dependency or delinquency matter Juvenile courts are provided with broad placement authority under Minnesota Statutes Chapter 260 A placement hold is to be considered a juvenile court placement whenever the court has required that the minor be placed in a chemical dependency program either by the county or the caretakers of the child None None of the above apply Unknown DAANES Web User Manual 23 October 2015 Criminal Justice Tab Ha Minnesota Department of Human Services DAANES north Star E J nome Eo i umioaa J ramin Reset Password I tocou EAS
48. er ID from the list Select System This is set to Treatment by the system Email Enter the staff member s email address Leave this field blank if the staff member does not have an email address User Management Facility Login ID User Name Group Name Login ID jsmith mn000001 Name John Smith Password eeeccececeeeese Confirm Password eeeccscceseeee Group MN000001 Select System Is Group Admin a Email john smith CD com After all fields are completed click the Add User button to add the user to the system A message will be displayed either indicating that the user was added successfully or that an error was encountered DAANES Web User Manual 11 October 2015 Modify Unlock Reset Password Deactivate Users To perform any of the following tasks Modify Unlock Reset Password Deactivate Users associated with an existing user login ID use the Search for User function to locate the staff member to be modified From the search results select the login ID to be edited by clicking on the login ID located in the first column of the list Ha Minnesota Department of Human Services DAANES north tar Search El EA Pain Y Reset Password frogo LogniD Name Email Approved Locked Out Active test mn000001 TestUser v User Test User Ls Vv vw test2 MNO000001 Test User2 Test User2 test com Vv fa Vv fa ismith mn000001 John S
49. ered employment 05 Homemaker 06 Student 07 Retired 08 Disabled 09 Inmate of institution 10 Laid off unemployed looking for work 11 Laid off unemployed not looking for work 12 Other 99 Unknown Is the client currently enrolled in school or job training program 1 Not enrolled 3 Enrolled part time 2 Enrolled full time 9 Unknown Chemical Health Severity Ratings Dimension 1 Acute Intoxication Withdrawal Potential __ Dimension 2 Biomedical Conditions Complications Dimension 3 Emotional Behavioral Cognitive Conditions and Complications __ Dimension 4 Readiness for Change Dimension 5 Relapse Continued Use Continued Problem Potential Dimension 6 Recovery Environment Alcohol and Drug Use During the past 30 days how many days has the client used the following 99 Unknown Alcohol Illicit drugs Substance Abuse Problems at Review Primary Substance Abuse Problem Days used in the past 30 days Secondary Substance Abuse Problem Days used in the past 30 days Tertiary Substance Abuse Problem Days used in the past 30 days Substance Abuse Codes 00 None 13 Benzodiazepines 01 Alcohol 14 Other Tranquilizers 02 Cocaine powder 15 Barbiturates 03 Crack 16 Other Sedatives 04 Marijuana Hashish Hypnotics 05 Heroin 17 Ketamine 06 Non prescription Methadone 18 Ecstasy club drugs 07 Other Opiates Synthet
50. ervices If the client was transferred rather than discharged outright use Transferred to other program Lost financial support means that the client was unable to continue in the program because he she was unable to pay for further treatment services Incarcerated means that the client was unable to continue treatment services because of confinement in a jail or other correctional facility Death is to be used if the client died while in the program Other is to be used only when none of the other choices reflect the reason for discharge Substance Use Disorder Diagnosis Select the ICD 10 substance use disorder diagnostic codes from the list The diagnosis is based on all information available to staff at the time of the client s discharge The primary diagnosis should represent the substance associated with the most severe problems the client has had whether medical psychological social legal or occupational This will often be the substance directly responsible for the treatment admission but this may not always be the case Some clients will have only one diagnosis use of only one substance meets diagnostic DAANES Web User Manual 42 October 2015 criteria This is true of many alcohol users for example In these cases secondary diagnosis should be coded as no secondary diagnosis For clients who use two or more substances with comparable frequency one needs to be coded as primary and one as secondary Consider all the harmful ef
51. ex PMI number found on the service agreement for CCDTF clients or the insurance card for MHCP clients Only the eight digits of the PMI number should be recorded for MHCP clients and not the initial letter usually M G or X The PMI is auto filled from the information entered on the Home screen Service Agreement number For CCDTF clients only enter the eleven digits of the service agreement number for the client found on the service agreement letter Fill this field with 8 s for all other clients This is auto filled from the information selected on the Home screen DAANES Web User Manual 20 October 2015 Note The DHS claims payment system will deny payments on claims associated CCDTF service agreements where a DAANES admission record has not been entered and validated on the DAANES system The DAANES system will update the DHS claims payment system for validated admission records Monday thru Friday nights Claims may be entered into the claims payment system on the following day after the service agreement has been updated by the system Check the CTF Service Agreements Previously Processed list box to verify the service agreement number has been cleared for reimbursement Multiple service agreements for one episode of treatment Some clients may have multiple service agreements for one DAANES admission record In order to receive reimbursement for the additional service agreements associated with a treatment episode you w
52. fects and use patterns to make a determination of a primary diagnosis even in the case of an apparent tie Alcohol Use Disorder Mild F10 10 Alcohol Use Disorder Moderate Severe F10 20 Cannabis Use Disorder Mild F12 10 Cannabis Use Disorder Moderate Severe F12 20 Hallucinogen Use Disorder Mild F16 10 Hallucinogen Use Disorder Moderate Severe F16 20 Inhalant Use Disorder Mild F18 10 Inhalant Use Disorder Moderate Severe F18 20 Opioid Use Disorder Mild F11 10 Opioid Use Disorder Moderate Severe F11 20 Sedative Hypnotic Anxiolytic Use Disorder Mild F13 10 Sedative Hypnotic Anxiolytic Use Disorder Moderate Severe F13 20 Stimulant Related Disorder Cocaine Mild F14 10 Stimulant Related Disorder Cocaine Moderate Severe F14 20 Stimulant Related Disorder Amphetamine Other Stimulants Mild F15 10 Stimulant Related Disorder Amphetamine Other Stimulants Moderate Severe F15 20 Other Substance Use Disorder Mild F19 10 Other Substance Use Disorder Moderate Severe F19 20 Tobacco Use Disorder Mild Only Secondary Z72 00 Tobacco Use Disorder Moderate Severe Only Secondary F17 20 No Secondary Diagnosis 999 99 Disabilities or barriers to treatment Select Yes or No for each disability or barrier to treatment which is exhibited by the client Hearing impairment is coded if the client has a hearing impairment even if a hearing aid minimizes the impairment Visual impairment is coded if the clie
53. g self employment for 35 hours or more per week Employed part time means paid employment including self employment for less than 35 hours per week Occasional seasonal work means paid employment on a seasonal or otherwise irregular basis Sheltered employment is used only for disabled clients in structured work training settings Homemaker can be used only if there is one or more dependents in the household besides the client Paid employment or student status supersede this category Student is used when the client is enrolled in school or on summer or holiday break Full time employment status supersedes this category but other categories do not Retired is used only when the client has met the minimum retirement age and has retired from the work force Disabled is used if the client is unable to work because of a physical or mental condition Sheltered employment status supersedes this category Inmate of an institution is to be used if the client is in a jail a prison or institution Laid off unemployed looking for work means that the client is laid off from a position or is otherwise not employed but is physically and mentally able to work and intends to or is looking for work Unemployed not looking for work means that the client is not employed but is physically and mentally able to work but does not intend to look for work Other means that none of the categories listed above accurately describes the client Unkn
54. goal setting treatment plan updates and therapeutic interventions Group Counseling A form of psychotherapy that involves sessions guided by a therapist and attended by several clients who address their substance abuse problems together Relationship Family Counseling Any therapeutic activities designed to improve the quality of the client s family life Services for Co occurring Mental Illness Coordinated or fully integrated services to individuals who have at least one psychiatric disorder in addition to a substance abuse disorder Spiritual support Spiritual and motivational activities aimed at helping the client establish a relationship with a higher power or the Creator and or connecting reconnecting with their cultural spiritual beliefs and practices Coordination of Services Coordination of client services received outside of the treatment setting including referral and follow up Therapeutic Recreation Therapeutic recreation to provide the client with an opportunity to participate in recreational activities without the use of mood altering chemicals and to learn to plan and select leisure activities that do not involve the inappropriate use of chemicals Employment or Educational Services Counseling services specifically designed to improve the client s ability to seek and maintain employment Teaches the client skills in interviewing completing applications writing resumes and searching for jobs Childcare Service
55. have children under 18 year of age I 1 Yes 2 No 9 Unknown How many children 88 No children 99 Unknown Is the client currently involved with child protection services 1 Yes 2 No 8 No children 9 Unknown Does this involvement result from 1 2 3 4 8 9 Alleged abuse or neglect by client Alleged abuse or neglect by someone else Alleged abuse or neglect by client and someone else Some other reason No children no child protection involvement Unknown UD Are any of the children living with someone else due to a child protection court order or other actions by child protection services 1 2 8 9 Yes No No children no child protection involvement Unknown Sere SH How many of the children are living with someone else for these reasons 88 No children no child protection involvement 99 Unknown For how many children has the client lost parental rights 88 No children no child protection involvement 99 Unknown Page 2 of 3 10 01 2015 Drug and Alcohol Abuse Normative Evaluation System DAANES Alcohol and Drug Use During the past 30 days how many days has the client used the following 99 Unknown Alcohol Illicit drugs Substance Abuse Problems at Admission Code Substance Primary Substance Secondary Substance Tertiary Substance Number of Days Used in Past 30 Days circle LI Substances Abuse Codes
56. have updated the information click on the Save button at the bottom of the screen to save your changes and return to the User Management screen The following items are updateable phone and fax numbers mailing information director information coordinator information and email addresses Ha Minnesota Department of Human Services DAANES north tar SEN ae E EE a EE E oo Eos oo CO O IA teo User Management Facility 1 Update Facility ISATS ID MNo00001 MHCP Provider ID 123456789 NPI Provider ID 1234567890 Facility Name 1 Chemcial Dependency SenicesInc Site Address 1234 First Avenue pr 1 O 1 Site chy NN Site State MN Site Zip 555 Phone 612 555 5555 x 5555 Fax 612 pess 5585 Mailing Name Chemical Dependency SevicesInc pe Mailing Address 1234 First Street EL AAA TT a Mailing City Minneapolis tt st lt i s C screen continues to the next page DAANES Web User Manual 13 October 2015 continuation of the Facility screen from the previous page Mailing State mn Mailing Zip 55555 Director Prefix Mr Director First Name ohn Director Last Name Smith Director Title Director Director Email fred conner CDS com Coordinator Prefix Ms Coordinator First Name Judy Coordinator Last Name Smith Coordinator Title Coordinator Coordinator Email judy jo
57. he left mouse button and the list will be shown use the scroll bar on the right side to see all possible choices Select Control button To execute a control button function move the mouse pointer over the button and click the left mouse button Click to Update Check box To select a check box response move the mouse pointer over the check box or label and click the left mouse button The box will fill with a check in the choice you selected M Check if record is COMPLETE DAANES Web User Manual 7 October 2015 Completion of the DAANES data collection forms All forms should be completed on an ongoing basis as clients are admitted and discharged from the treatment facility DAANES data collection forms should be completed in the following manner The Admission form should be completed on the day of admission or within the first 5 days after admission to the program The Six Month Review form should only be completed for opioid replacement therapy clients Opioid replacement therapy clients are identified on the admission form under the Placement Information tab The Six Month Review form should be completed on the day that the client has been in treatment for six months 180 days from the date of admission or within 3 days following each 180 day time period The discharge form should be completed on the day the client is discharged from the program All data must be entered and completed free of errors by the 5
58. hnson CDS com Six Month Indicator Provider Type 51 E Provider Web Site www state mn mn us DAANES Web User Manual 14 October 2015 User Login Screen Enter HTTPS daanes dhs state mn us in the address field of your browser to access the DAANES web application and start by logging into the application Enter your User ID login ID and password then click the OK button with the left mouse button to log into the DAANES web application If you enter your password incorrectly three times your login ID will be locked out and you will need to contact your local web administrator to have your login ID unlocked If you are a local web administrator you will need to contact the DAANES system administrator at the Department of Human Services to have your login ID unlocked If you are successful in logging into the DAANES application you will be forwarded to the main DAANES web page Home screen 2 Login Windows Internet Explorer 101 xj SNA O ESE Lt File Edit View Favorites Tools Help Uy Favorites DAANES Treatment User ID I Password Por north han DAANES Web User Manual 15 October 2015 Home Screen The Home screen is the control center for the DAANES web application The Home screen is the starting point for entering new admissions by first entering the date of admission client initials date of birth last four digits of social security number and then clicking
59. hole dollar fifty cents or more would be rounded up to the next whole dollar If free care is given estimate what would have been billed Source of payment For each of the sources of payment categories enter the percentage of the total costs of the client s treatment episode that each source covered The sum of the nine categories should equal 100 If the source of payment is an out of state government agency source code Other Self pay includes payment for treatment services made by the client client s relatives or friends DAANES Web User Manual 54 October 2015 Private health insurance non HMO means that payment for treatment services was made by a private individual or group employer health insurance policy This category includes CHAMPUS Private health insurance HMO means that treatment services were covered through a private or group employer HMO health insurance policy Consolidated CD Treatment Fund means that payment for treatment services was made through the Consolidated Chemical Dependency Treatment Fund MHCP MA GMAC MinnesotaCare covers the following public programs where service delivery is directed by managed care organizations MCO s Medicaid or Medical Assistance MA General Assistance Medical Care GAMC or MinnesotaCare Medicare County funds non Consolidated Fund means that payment for treatment services was made by the county from county social service funds Community Social Service
60. ic Islander Alaskan Native Mixed Other Hispanic ethnicity Select the category which corresponds to the client s ethnicity regardless of race Not of Hispanic origin Puerto Rican Mexican Cuban Other Hispanic Current marital status Select the category which corresponds to the current marital status of the client on the day of admission Single never married includes those whose only marriage was annulled Divorced if remarried or cohabiting code that response instead Separated refers to married persons not living together whether or not the separation is legal Widowed if remarried or cohabiting code that response instead Married refers to persons who are legally married Cohabiting refers to common law marriages and those individuals who live together as sexual partners Unknown In the past 30 days where has the client been living most of the time Select the category which corresponds to where the client has been living Homeless no fixed address including shelters Dependent living dependent children and or adults living in a supervised setting Independent living including on own self supported and non supervised group homes Children living with their family Unknown DAANES Web User Manual 26 October 2015 Usual living situation Select the category which corresponds to the client s usual type of living situation Alone means that the client is living alone and independently
61. ics 19 Inhalants 08 PCP a OTC Medications 09 Other Hallucinogens 21 Other Psychedelics 22 Nicotine Tobacco 10 Methamphetamine 98 No secondary or 11 Other Amphetamines tertiary substance 12 Other Stimulants 99 Unknown Number of service sessions provided in the past six months Detoxification oe O Alcohol Drug testing Education about alcohol and other drugs Medical care Living skills development Individual counseling Group counseling Relationship family counseling Services for co occurring mental illness Spiritual support Coordination of services Therapeutic recreation Employment or education services Childcare Transportation How many take home doses of narcotic replacement medication was the client given at the last visit range 0 to 31 10 01 2015 Drug and Alcohol Abuse Normative Evaluation System DAANES Discharge Form I SATS Provider ID Client Initials Date of Birth I I I I I I SSN L1 L3 F1F3 M MM D D Y YYY last 4 digits Date of Admission _ I II I I I L M M D D Y Y Y Y MHCP Client PMI ID _ 1 1 CCDTF Service Agreement I 1 L L 1 1 Date of Discharge A ee Does the client have any of the following conditions or MM DD YYYY complications Mark all that apply with a 1 General Current Chemical Dependency Treatment 1 Hospital inpatient 2 Residential less than 30 days p
62. id health plan Minnesota Restricted Recipient e Spenddowns Program MRRP Special transportation Other heaith insurance Copay Medicare coverage Hospice Fee for service benefit limits Print or save the 271 Response for your records 2 270 271 Verify MHCP Eligibility Last updated 04 07 2010 DAANES Web User Manual 68 October 2015 DAANES Forms DAANES Web User Manual Drug and Alcohol Abuse Normative Evaluation System Client Initials Date of Birth L1 L3 F1F3 M M Date of Admission TERS E A S a D le EE M M D D YoY YoY Insurance type 1 CCDTF 2 MHCP 3 All other sources DAANES JE ES e PA RE O O Admission Information I SATS Provider ID SSN I L DD Y YYY last 4 digits MHCP Client PMI ID _ I CCDTF Service Agreement __ I 1 L 1 1 1 L L L Placement Information Current Chemical Dependency Treatment 1 Hospital inpatient 2 Residential less than 30 days planned 3 Residential more than 30 days planned 4 Non residential 5 Methadone clinic Is opioid replacement therapy planned for treatment 0 Yes methadone 1 Yes buprenorphine 2 Yes other 3 No First source Second source Primary Sources of Referral 01 Self family relative friend 02 School 03 Employer EAP 04 Law enforcement 18 AA other support group 19 Community professional 05 Courts agency e g clergy 06
63. igits of ClientSS Admission Date MM DD YYYY Discharge Date MM DD YYYY NE General Service Delivery Social Environment Child Protection Alcohol and Drug Abuse CH Severity Ratings Financial Information Client Satisfaction 05 08 2010 Hours of treatment services provided Days of room and board provided JHO Total Charges Source of payment enter percentages to sum 100 Self pay Private health insurance non managed care Private health insurance managed care Consolidated CD treatment fund MHCP MA GMAC MinnesotaCare Medicare County funds non CCDTF Free care no charge OHOOOOOUO0O Other I Check if record is COMPLETE Hours of treatment services provided Enter the total hours of treatment services provided to the client during the treatment episode Residential programs enter a zero Non residential programs enter the total number of hours provided Days of room and board provided Enter the total number of days for which room and board services were provided to the client during the treatment episode This field is for residential programs only Outpatient programs are to enter a zero Total charges dollars Enter the total charges incurred during the client s treatment episode Total charges refers to the amount billed for services regardless of source of payment and the amount actually reimbursed Round off to the nearest w
64. ile court placement 2 Criminal court order 6 None 3 Court commitment CD 9 Unknown 4 Civil court order Criminal Justice In the past 30 days how many times has the client been arrested 99 Unknown How many times has the client been arrested in their lifetime 99 Unknown In the past 30 days was the client in jail 1 Yes 2 No 9 Unknown In the past 30 days was the client in prison 1 Yes 2 No 9 Unknown Is client currently under the jurisdiction of the court or on probation parole 1 Yes 2 No 9 Unknown Has driver s license been revoked because of a driving incident involving alcohol or other drugs 1 Currently under revocation 2 Revoked during the past 12 months 3 Revoked at least once in lifetime 4 Never revoked 5 Not applicable 9 Unknown Client Profile Sex 1 Male 2 Female Race 1 White 5 Native Hawaiian Pacific Islander 2 Black 6 Alaskan Native 3 American Indian 7 Mixed 4 Asian 8 Hispanic Ethnicity 1 Not of Hispanic Origin 2 Puerto Rican 3 Mexican 4 Cuban 5 Other Hispanic Current Marital Status 1 Single never married 5 Married 2 Divorced 6 Cohabiting 3 Separated 9 Unknown 4 Widowed In the past 30 days where has the client been living most of the time 1 Homeless no fixed address includes shelters 2 Dependent living dependent children and or adults living in a supervised sett
65. ill need to replace the current service agreement number shown on the placement information tab with the new service agreement You may only replace the service agreement number on an admission record once each day and each new number enter will need to be validated by checking the record complete box and clicking the update button The DHS claims payment system will be updated each night Monday thru Friday for the currently active service agreement which is entered on the placement information tab Check the CTF Service Agreements Previously Processed list box to verify the service agreement number has been cleared for reimbursement CTF Service Agreements Previously Processed This text box lists all previously processed CCDTF service agreement numbers entered for this admission record The service agreement numbers listed have been updated on the DHS claims payment system by DAANES system Current Chemical Dependency Treatment Select the type of chemical dependency treatment that is planned for the client at the time of admission After the admission record has been completed and validated this item may be updated to reflect a change in the client s intensity of treatment service such as a transition from residential to non residential so long as the services occur within the same location and episode of treatment A change in this item also requires a date to be entered in the Date of Change item Hospital inpatient Residential les
66. ing 3 Independent living including on own self supported and non supervised group homes 4 Children living with their family 9 Unknown Page 1 of 3 10 01 2015 Drug and Alcohol Abuse Normative Evaluation System DAANES Admission Information Usual Living Situation 01 Alone 02 With spouse or partner only 03 With minor children only 04 With spouse partner and children 05 With one parent 06 With two parents 07 With foster parents 08 With relatives 09 With friends 10 With others 99 Unknown County of residence Minnesota residence only State of residence Non Minnesota residence Tribal Enrollment 01 Bois Forte 02 Fond du Lac 03 Grand Portage 04 Leech Lake 05 Lower Sioux 06 Mille Lacs Band 07 Prairie Island Reside on reservation 08 Red Lake 09 Shakopee 10 Upper Sioux 11 White Earth 12 Other 13 Not Enrolled Not Residing 99 Unknown Pregnancy Status at Admission 1 Pregnant 2 Not pregnant 3 Not sure 4 Male Veteran Status 1 No 2 Yes no combat 3 Yes served in combat zone 9 Unknown Education 1 Grade school 2 Some high school but no degree 3 High school graduate GED 4 Associate degree vocational certificate 5 Some college but no degree 6 College graduate 7 Graduate professional degree 9 Unknown Years of Schooling range 00 25 or 99 unknown Lp I
67. innesota Health Care Programs Prepaid Health Plan HMO Enrollee Cards O heras me Y of Minnesota Blue Advantage Name gt PP021 ZA ELIZABETH SAMPLENAME D FBOXZ1234567 Wember CROP PROVIDER NAME LINE 1 PROVIDER NAME LINE 2 Sve Types Office Vist Copay ER Copay NomER Copay Eyeglasses Copay Brand Name Copay Gener Copay Baiso SELECT RxBIN RAPON VIC are RxBIN 610415 RxGrp T394 FARM Issuer 80840 ID Name Member Name Care Type Varies Svc Type Minnesota Health Care Program Pharmacy Pharmacy Name Chiropractor Chisopractor Name PCP PCP Name PCP Phone Number RxPCN PCS REN IN pn Rx PCN PCN Issuer letropolitan Health Plan i 1D Group 999999998 1300 Rx ID 0999999998 Name JOHN 1 MA 1300 E es Assistance psw ERSO OS Tr RX Copay Value DEE Denta 0 Medical Home CLINIC ID Prime West ki EALTH Ser 80840 ov Name IP RxBIN 610455 RxPCN Care Type lt Program gt ia HealthPartners 10 55555555 Group 418 January Name John Doe Care Type HealthPartners Care PMI01062363 H Dental Pkg GSP Office 4 00 Rx BIN 610468 RXPGNHP See Contract ER 00 Urgent 2 00 Deductible 0 00 PCP Code PCP or Network PCP Phone Medical 244 HCMC GENERAL MEDICINE 612 347 2300 Preventive Dental 244 HCMC GENERAL MEDICINE 612 347 2300 Rx 1 Generic 3 Brand 12 Monthly Max CLM SBM BX BIN 003585
68. isplayed On the right side of the list are status columns which indicate the completeness of the admission and discharge information A 1 indicates incomplete information a 2 indicates a complete and error free record An Add button will appear in the discharge or six month columns when the admission form is a complete error free record Client records are frozen 120 days after the discharge form has been completed Frozen records are available for viewing by clicking on the word Display Errors identified on frozen records may be corrected by contacting the DAANES support staff at DHS Provide DHS with the admission ID number of the record which needs correction along with the current response and the updated response Erroneously created records may be deleted from the system by contacting the DAANES support staff with admission ID Ha Minnesota Department of Human Services DAANES north Star AAA SSE AAA AAA one ENE rama resapasswoa Y togon ERTS Search Search for PMI AdmissionID Client Initials Admission Date From E Client DOB E Admission Date To E Client Partial SSN ISATS ID MN000001 Admission Discharge Six Month Client Initials Client DOB Client SSN Client Admission Date Admin Status Client Discharge Date Discharge Status Admission ID Edit Edit PPPPP 10 10 1970 1234 12398765 12 18 2012 2 11 22 2013 2 80986 Edit Add ASASA 1 1 1955 4444 88888888 12 11 2012 2 80985 E
69. lanned 3 Residential more than 30 days planned 4 Non residential 5 Methadone clinic Reason for Discharge 01 Completed program 02 Patient left without staff approval 03 Patient conduct behavioral 04 Expiration of civil commitment or hold order 05 Transferred to other program 06 Assessed as inappropriate 07 Lost financial support 08 Incarcerated 09 Death 10 Other Substance Use Disorder Diagnosis Primary Diagnosis Secondary Diagnosis Lp ICD 10 Codes F10 10 Alcohol Use Disorder Mild F10 20 Alcohol Use Disorder Moderate Severe F12 10 Camnabis Use Disorder Mild F12 20 Camnabis Use Disorder Moderate Severe F16 10 Hallucinogen Use Disorder Mild F16 20 Hallucinogen Use Disorder Moderate Severe F18 10 Inhalant Use Disorder Mild F18 20 Inhalant Use Disorder Moderate Severe F11 10 Opioid Use Disorder Mild F11 20 Opioid Use Disorder Moderate Severe F13 10 Sedative Hypnotic Anxiolytic Use Disorder Mild F13 20 Sedative Hypnotic Anxiolytic Use Disorder Moderate Severe F14 10 Stimulant Related Disorder Cocaine Mild F14 20 Stimulant Related Disorder Cocaine Moderate Severe F15 10 Stimulant Related Disorder Amphetamine Other Stimulants Mild F15 20 Stimulant Related Disorder Amphetamine Other Stimulants Moderate Severe F19 10 Other Substance Use Disorder Mild F19 20 Other Substance Use Disorder Moderate Severe 272 00 Tobacco Use Diso
70. me attendance unknown 3 4 7 times past month 9 Unknown 4 8 15 times past month Page 2 of 3 Referrals at discharge Mark all that apply with a 1 Additional CD treatment CD aftercare professionally led support group CD aftercare self help support group CD board and lodging Non CD supportive housing Domestic abuse treatment program Individual counseling therapy Family counseling therapy Detox Medical care services Vocational program Legal assistance Law enforcement corrections Court court services County social service agency CD services County social service agency other services VA Veterans Service Organizations Child Protection Does the client have children under 18 year of age Il 1 Yes 2 No 9 Unknown How many children 88 No children 99 Unknown Is the client currently involved with child protection services 1 Yes 2 No 8 No children 9 Unknown Does this involvement result from 1 Alleged abuse or neglect by client 2 Alleged abuse or neglect by someone else 3 Alleged abuse or neglect by client and someone else 4 Some other reason 8 No children no child protection involvement 9 Unknown Are any of the children living with someone else due to a child protection court order or other actions by child protection services __ 1 Yes 2 No 8 No children child protection involvement 9 Unknown How many of the children ar
71. mith john smith CD com K E vA E dministration Home After clicking on the login ID the Modify User form will be displayed From this form the local web administrator can change the user s name reset the user s password change the user s email address lock unlock the user s access to the system and activate deactivate the user s login ID Once changes have been made click on the Update button to submit the changes to the system To unlock a staff member uncheck the Locked Out check box and check Active check box When a staff member leaves employment with your program uncheck the Active check box and check the Locked Out check box then click the Update button to submit the change Login ID jsmith mn000001 Name John Smith Password Reset Password Group MN000001 Treatment Treatment s Group Admin E fjohn smith CD com Vv O Vv Update Administration Home Administration Home DAANES Web User Manual 12 October 2015 Provider Contact Information Each chemical dependency treatment provider is responsible for maintaining their contact information This is accomplished by using the Facility screen The local DAANES web administrator will have access to this form for updating contact information Click on the Admin button to activate the User Management screen then click on the Facility tab and finally click on the Update Facility button to activate the Facility screen Once you
72. municating with DAANES support staff at DHS Ha Minnesota Department of Human Services DAANES north tar AAA AA O ee User Test User ino Start below to enter a new admission or click on the Search button to update existing record ISATS ID MN000003 Admission Date MM DD YYYY noo a Client initials L1L3F1F3M ClientpO8 mwnorwwY ed Last 4 Digits ofClientss J Submit A new OTP admission record is started on the Home screen by registering the client with the State of Minnesota s OTP central registry This is accomplished by completing the following fields Admission Date First Name Middle Name leave blank if no middle name Last Name Date of Birth Full 9 digits of the Social Security Number Optional fields are Immigration Naturalization ID Driver s License PMI and Other Government ID Clicking the Submit button will register the client with the central registry auto populate the DAANES identifying fields and link to the new admission form Ha Minnesota Department of Human Services DAANES north star E oa A e O TT E eee Start below to enter a new admission or click on the Search button to update existing record Opiate Treatment Non Opiate Client Opiate Client ISATS ID MNO00000 Admission Date MM DDIYYYY FAA 8 Client Initials L1L3F1F3M Client DOB MM DD YYYY E Last 4 Digits of Client SS Search for client in Registry Firstname Middenam Last Name Da
73. n The two summary reports are similar to the reports DHS distributes semi annually to providers the Minnesota Department of Human Services DAANES north tar EE A Ea oo ooo ran E toon eeu REPORTS Click on a report description for a full report 1 All Clients in Treatment 2 All Clients with an Incomplete Admission 3 All Clients with an Incomplete Discharge 4 All Clients with an Incomplete Six Month Review methadone clinics only 5 All Clients needing a Six Month Review methadone clinics only 6 All Clients who have Completed Treatment 7 Admission Summary Report 8 Discharge Summary Report All Clients in Treatment This report lists all clients who are currently in treatment All Clients with an Incomplete Admission This report lists clients who have admission records with missing information or an unchecked record complete box All Clients with an Incomplete Discharge This report lists clients who have discharge records with missing information or an unchecked record complete box All Clients with an Incomplete Six Month Review methadone clinics only This report lists clients who have six month review records with missing information or an unchecked record complete box All Clients needing a Six Month Review methadone clinics only This report lists clients who are due for a six month review Clients will appear on this report after 180 days from the date of admission All Clients wh
74. n the past 6 months Drug and Alcohol Abuse DAANES Six Month Normative Evaluation System Review Form I SATS Provider ID Client Initials Date of Birth I I I I SSN L1 L3 F1 F3 M M D D Y YYY last 4 digits Date of Admission _ I I I I I I M M D D YYY Y MHCP Client PMI ID 1 1 1 L CCDTF Service Agreement __ I 1 1 L L L L Report Date L L LL M DD YYY Social Environment In the past 30 days how many times has the client been arrested 99 Unknown In the past 30 days how many times did the client attend self help programs e g AA NA I 1 No attendance 2 1 3 times 3 4 7 times 4 8 15 times 5 16 30 times 6 Some attendance Freq unknown 9 Unknown In the past 30 days did the client have interaction with family and or friends that were supportive of recovery __ 1 Yes 2 No 9 Unknown In the past 30 days where has the client been living most of the time __ 1 Homeless no fixed address includes shelters 2 Dependent living dependent children and or adults living in a supervised setting 3 Independent living including on own self supported and non supervised group homes 4 Children living with their family 9 Unknown What is the client s current labor force status fe 01 Employed full time 35 hours week 02 Employed part time lt 35 hours week 03 Occasional seasonal work 04 Shelt
75. ne Tobacco may be coded as a secondary tertiary substance abuse problem None Benzodiazepines Alcohol Other tranquilizers Cocaine powder Barbiturates Crack Other sedatives or hypnotics Marijuana hashish Ketamine Heroin Ecstasy other club drugs Non prescription methadone Inhalants Other opiates and synthetics Over the counter medications PCP Other Other hallucinogens or psychedelics No secondary or tertiary substance Methamphetamine Nicotine Tobacco secondary or tertiary only Other amphetamines Unknown Other stimulants Number of days used in the last 30 days of the identified primary secondary and tertiary substances For each of the substances select as primary secondary and tertiary enter the number of days the client used that substance during the past 30 days Responses for use during the past 30 days may range from 0 to 30 DAANES Web User Manual 52 October 2015 Chemical Health Severity Ratings Tab Ha Minnesota Department of Human Services DAANES north tad PA AAA AAA M I Home Search f Admin Reset Password Logout User Test User Discharge Form Admission ID 79995 ISATS ID Client Initials L1L3F1F3M Client DOB MM DD YYYY Last 4 Digits of Client SS Admission Date MM DD YYYY Discharge Date MM DD YYYY IOE E naas Y ZE ZINE a General Service Delivery Social Environment Child Prot
76. nt has difficulty with vision even while wearing glasses or contact lenses If the difficulty is corrected do not code this response Physical handicap includes severe orthopedic impairments resulting from birth defect disease or injury Code this response if the client uses a wheelchair cane or walker or has an artificial limb even if the client does not consider the condition a handicap Developmental disability means general intellectual functioning significantly below average existing concurrently with defects in adaptive behavior and manifested during the development period Mental illness means that the client has cognitive behavioral or emotional dysfunction associated with a mental health disorder Speech pathology refers to communication disorders such as stuttering impaired articulation a speech impairment or a voice impairment Learning disability refers to a disorder of one or more of the basic processes involved in understanding or in using language spoken or written which may manifest itself in deficiencies in the ability to listen think speak read write spell or do mathematical calculation The term includes perceptual handicaps minimal brain dysfunction and dyslexia The term does not include learning problems which result primarily from visual hearing or motor handicaps developmental disability or environmental cultural or economic disadvantage DAANES Web User Manual 43 October 2015 Brain injur
77. o have Completed Treatment This report lists clients who have been discharged from treatment with records that are complete and error free DAANES Web User Manual 59 October 2015 Admission Summary Report This report produces a summary report from the information collect on the admission form Users may select either to run the report for their facility or for all facilities labeled Statewide Users may also select on a specific CD Treatment Environment Funding Source and on admission date ranges The report is viewable by using Adobe Acrobat Reader software which you will need to install on your computer Ha Minnesota Department of Human Services Discharge Summary Report DAANES northstar J Home En Upload ET Reset Password Logout User Test User Admisssion Summary Report M Facility Or I statewide CD Treatment Enviroment Select E Funding Source Select ba Date of Report From E Date of Report To a Run Report Return Report List This report produces a summary report from the information collect on the discharge form Users may select either to run the report for their facility or for all facilities labeled Statewide Users may also select on a specific CD Treatment Environment Funding Source and on admission date ranges Ha Minnesota Department of Human Services DAANES north star Home J Search Upload ET Reset Password Logout User Test User Discharge Summary Report I Facility or I state
78. omesa or Drama Y Reser Password Y ios EAT Admission Form Admission ID 80987 ISATS ID Client Initials L1L3F1F3M Client DOB MM DD YYYY Last 4 Digits of Client SS Admission Date MM DD YYYY Placement Information Criminal Justice Client Profile Prior CD Treatment Experience Child Protection Alcohol and Drug Use CH Severity Ratings Client Coverage Type E Select z Client s PMI Nbr 88888888 Service Agreement Number 88888888888 CTF Service Agreements Previously Processed Current Chemical Dependency Treatment Fse E Date of Change o1o172013 Is opioid replacement therapy planned for treatment Yes methadone Yes buprenorphine Yes other C No Primary source of referral Seet E Secondary source of referral E Select gt Did a specialty court refer the client to this episode of treatment FsSea A Primary condition surrounding admission to treatment aser E Legal status at admission select I Check if record is COMPLETE Click to Update Client Coverage Type Select the payment source for the client s treatment services This is auto filled from the information selected on the Home screen but may be changed here CCDTF Consolidated Chemical Dependency Treatment Fund MHCP Minnesota Health Care Programs Managed Care All other sources Client s Personal Master Index number PMI For CCDTF or MHCP clients enter the client s eight digit Personal Master Ind
79. onds to the client s veteran status Code Yes served in combat zone if the client was exposed to combat during any war or other international conflict No Yes no combat Yes served in combat zone Unknown Education Select the category associated with the client s highest level of educational attainment Grade School Some high school but no degree High school graduate GED Associate degree vocational certificate Some college but no degree College graduate Graduate professional degree Unknown Years of schooling Enter the highest grade completed by the client A GED would be equivalent to 12 years Years of technical school college and graduate school should be added to 12 to get the total years of schooling Is the client currently enrolled in school or a job training program Select the category that best describes the client s current enrollment Not enrolled Enrolled full time Enrolled part time Unknown DAANES Web User Manual 28 October 2015 Primary source of income or support during the 30 days prior to treatment Select the category which corresponds to the client s primary source of income for the 30 days prior to admission If the client had no source of income prior to admission indicate None If the client has income but none of the categories accurately depicts the primary source use Other If the source of income is unknown select Unknown Disability benefits Savings or investments Job Public Assi
80. or MinnesotaCare this item must be completed The PMI number is located on the Minnesota Health Care Program MHCP card DAANES Web User Manual 9 October 2015 User Management Each chemical dependency treatment provider is responsible for managing staff access to the DAANES web application and maintaining facility contact information This is accomplished by using the User Management form and the Facility form The User Management form permits the local DAANES web administrator to add modify and deactivate staff access to the application Providers need to contact the DAANES system administrator to have a staff member registered as the local DAANES web administrator Click on the Admin button to activate the User Management form p ths Minnesota Department of Human Services DAANES north star haa SSE SS ee a A Home If search opos Jamin Reset Password Y ion EA Admission ID User Management Facility Login ID Name A Password Confirm Password Group Select System Treatment Is Group Admin M Emait Add User To add a staff member to the DAANES web application complete the fields in the Add User area of the form and click the Add User button Login ID The login ID for a staff member is created with the following structure the first initial from the first name followed by the full last name followed by an sign followed by your I SATS provider number Example Ed Doe wi
81. ore dependents in the household besides the client Paid employment and student status supersede this category Student is used when the client is enrolled in school or on summer or holiday break Full time employment status supersedes this category but other categories do not Retired is used only when the client has met the minimum retirement age and has retired from the work force Disabled is used if the client is unable to work because of a physical or mental condition Sheltered employment status supersedes this category Inmate of an institution is to be used if the client is in a jail a prison or institution Laid off unemployed looking for work means that the client is laid off from a position or is otherwise not employed but is physically and mentally able to work and intends to or is looking for work Unemployed not looking for work means that the client is not employed but is physically and mentally able to work but does not intend to look for work DAANES Web User Manual 48 October 2015 Other means that none of the categories listed above accurately describes the client Unknown Is the client currently enrolled in school or a job training program Select the category that best describes the client s current enrollment Not enrolled Enrolled full time Enrolled part time Unknown Referrals at discharge Indicate whether each referral was made by selecting Yes or No A discharge referral implies some a
82. orm Social Environment In the past 30 days how many times has the client been arrested 99 Unknown In the past 30 days how many times did the client attend self help programs e g AA NA 1 No attendance past month 5 16 30 times past month In the past 30 days did the client have interaction with family and or friends that were supportive of recovery 1 Yes 2 No 9 Unknown In the past 30 days where has the client been living most of the time 1 Homeless no fixed address includes shelters 2 Dependent living dependent children and or adults living in a supervised setting 3 Independent living including on own self supported and non supervised group homes 4 Children living with their family 9 Unknown Will client be living in an environment conducive to recovery 1 Yes 2 No 9 Unknown What is the client s current labor force status 01 Employed full time 35 hours week 02 Employed part time lt 35 hours week 03 Occasional seasonal work 04 Sheltered employment 05 Homemaker 06 Student 07 Retired 08 Disabled 09 Inmate of institution 10 Laid off unemployed looking for work 11 Laid off unemployed not looking for work 12 Other 99 Unknown Is the client currently enrolled in school or job training program 1 2 3 9 Not enrolled Enrolled full time Enrolled part time Unknown RN 2 1 3 times past month 6 So
83. ors check the box next to the label Check if record is Complete and then click the Click to Add or Click to Update button Warning the data will not be SAVED if there are errors identified in the information you have entered when the record is marked complete and you click the Update button Either correct the errors or uncheck the record complete box to save your data thei Minnesota Department of Human Services DAANES north star AAA AA AAA ioe Bf search A ee CO SS MET eer Six Month Form Admission ID 79995 ISATS ID Client Initials L1L3F1F3M Client DOB MM DD YYYY Last 4 Digits of Client SS Admission Date MM DD YYYY Report Date MM DD YYYY ABCDE E 05718 2010 E 1234 05 08 2010 Social Environment CH Severity Ratings Alcohol and Drug Use Service Delivery In the past 30 days how many times has the client been arrested In the past 30 days how many times did the client attend self help programs e g AA NA Select gt In the past 30 days did the client have interaction with family and or friends that are supportive of recovery Yes No Unknown In the past 30 days where has the client been living most of the time Select y What is the client s current labor force status Select Is the client currently enrolled in school or a job training program Select I Check if
84. own DAANES Web User Manual 36 October 2015 Is the client currently enrolled in school or a job training program Select the category that best describes the client s current enrollment Not enrolled Enrolled full time Enrolled part time Unknown Chemical Health Severity Ratings Tab Ha Minnesota Department of Human Services DAANES north Star AAA AA se O ee ee al El Damn If Reset Password Yoo REET Six Month Form Admission ID 79995 ISATS ID Client Initials L1L3F1F3M Client DOB MM DD YYYY Last 4 Digits of Client SS Admission Date MM DD YYYY Report Date MM DD YYYY MN000001 JABCDE 04 12 1985 8 1234 05 08 2010 os 18 2010 3 Social Environment CH Severity Ratings Alcohol and Drug Use Service Delivery Dimension 1 Acute Intoxication Withdrawl Potential Select El Dimension 2 Biomedical Conditions and Complications F Seet yl Dimension 3 Emotional Behavioral Cognitive Conditions and Complications Select yl Dimension 4 Readiness to Change F Seet El Dimension 5 Relapse Continued Use Continued Problem Potential F Seet El Dimension 6 Recovery Environment Select yl I Check if record is COMPLETE Click to Add For each of the six chemical health severity dimensions rate the client s status at the time of the two month review Dimension 1 Acute intoxication withdrawal potential Dimension 2 Biomedical
85. pient 1 Login to MN ITS 2 Select MN ITS from the left hand menu 3 Select Eligibility Request 270 from the left hand menu MN ITS Interactive auto populates the NPI UMPI based on your login and opens on the single eligibility tab 4 The Date of Service field auto populates with the current date Ensure the appropriate date in MMDDCCYY format is in this field You can verify eligibility for the previous 12 months but not for a future date 5 Refer to the Minnesota Uniform Companion Guide for search scenarios 6 Click the Submit button on the left side of the screen to generate an Eligibility Response Verify MHCP Eligibility for Multiple Recipients The Multiple Eligibility Inquiry tab allows you to verify eligibility for up to 50 MHCP recipients in one transaction The search fields are the same as on the Single Eligibility Inquiry tab The difference is that the responses are indicated in a list below the search fields 1 Log in to MN ITS dl 270 271 Verify MHCP Eligibility Last updated 04 07 2010 DAANES Web User Manual 67 October 2015 MN ITS User Guide Verify MHCP Eligibility 2 Select MN ITS from the left hand menu 3 Select Eligibility Request 270 from the left hand menu MN ITS Interactive auto populates the NPI UMPI based on your login 4 Select the Multiple Eligibility Inquiry tab at the top of your screen 5 The Date of Service field auto populates with the current date Ensure the
86. quirements through the National Outcomes Measurements NOMs monitoring system SAMHSA requires that all treatment providers who receive any state or federal funds report on this system for all treatment admissions regardless of funding source In Minnesota DAANES is used to meet both state and federal reporting requirements Information is collected and submitted on clients using web forms at three points in time Admission Six Month Review opioid replacement therapy clients only and Discharge Additionally DAANES requires one paper form for administrative purposes Notification of Data Collection form DHS 2598 Admission form The purpose of the admission form is to obtain basic client demographic and background information at admission Only one admission form needs to be completed for the total episode of treatment per site regardless of changes in level of care or the intensity of service provided to the client The admission form provides information on the client s conditions surrounding admission legal status referral sources demographics living arrangements education veteran status occupational status source of financial support involvement in peer support groups previous treatment and detoxification admissions A substance use history details substance use frequency age of onset and route of administration for a variety of substances It also includes a clinical determination of primary secondary and tertiary substances of
87. r password Logs the user off the DAANES application and returns the user to the login screen Warning make sure you click the Click to Update button to save your data before logging out Click to Update Found at the bottom of all data entry screens clicking on this button will SAVE the data entered on the screens and will return the user to the main DAANES Home screen or the Search screen An message will be displayed in the upper left area of the indicating that the record was updated fea Check if record is COMPLETE Warning the data will not be SAVED if there are errors identified in the information you have entered when the record is marked complete and you click the Update button Either correct the errors or uncheck the record complete box to save your data When checked the record is edited for errors If errors are found by the system the errors will be listed at the top of the screen If no errors are found the system will return you to either the Home screen or the Search screen and a message will be displayed in the upper left hand area of the screen indicating that the record has been updated The record status will be update to a value of 2 on the Search screen for that client s record DAANES Web User Manual October 2015 Home Screen for Opioid Treatment Program Providers Ha Minnesota Department of Human Services DAANES north Star AAA AA AA AA E AAA Na So Use ne Sta
88. rapy For example count even a few days of antidepressant medication or a single acupuncture visit If you select Other prescribed medications enter in the name s of medication s in the text box Methadone Other opioid replacement therapy Antabuse Naltrexone Other anti craving medication Anti depressant medication Anti anxiety medication Other prescribed medications specify Acupuncture DAANES Web User Manual 44 October 2015 Service Delivery Tab Ha Minnesota Department of Human Services DAANES north Star AAA AAA AAA A Mal Searcn J voces co FEY oser Tes user Discharge Form Admission ID 79995 ISATS ID Client Initials L1L3F1F3M Client DOB MM DD YYYY Last 4 Digits of Client SS Admission Date MM DD YYYY Discharge Date MM DD YYYY VINO00001 1234 05 08 2010 3 E ABCDE General Service Delivery Social Environment Child Protection Alcohol and Drug Abuse CH Severity Ratings Financial Information Client Satisfaction Number of service sessions provided during treatment Detoxification Alcohol Drug testing Education about alcohol and other drugs Medical care Living skills development Individual counseling Group counseling Relationship family counseling Services for co occurring mental illness Spiritual support Coordination of services Therapeutic recrea
89. rder Mild Only Secondary F17 20 Tobacco Use Disorder Moderate Severe Only Secondary 999 99 No Secondary Diagnosis Hearing impairment Visual impairment Physical handicap Developmental disability Mental illness Speech pathology Learning disability Brain injury English not primary language Functional illiteracy Has client been a victim of abuse 1 No 2 Yes physical only 3 Yes sexual only 4 Yes physical and sexual 9 Unknown Has client been a perpetrator of abuse 1 No 2 Yes physical only 3 Yes sexual only 4 Yes physical and sexual 9 Unknown Which of the following were used as part of CD treatment for the client Mark all that apply with a 1 Methadone Other opioid replacement Antabuse Naltrexone Other anti craving medication Anti depressant medication Anti anxiety medication Other prescribed medications Specify Acupuncture Number of service sessions provided during treatment Detoxification Alcohol Drug testing Education about alcohol and other drugs Medical care Living skills development Individual counseling Group counseling Relationship family counseling Services for co occurring mental illness Spiritual support Coordination of services Therapeutic recreation Employment or education services Childcare Transportation Page 1 of 3 10 01 2015 Drug and Alcohol Abuse Normative Evaluation System DAANES Discharge F
90. reason for involvement with child protection services Alleged abuse or neglect by client Alleged abuse or neglect by someone else Alleged abuse or neglect by client and someone else Some other reason Not applicable no children no child protection involvement Unknown Are any of the children living with someone else due to a child protection court order or other actions by child protection services Select the appropriate radio button Yes No Not applicable no children no child protection involvement Unknown How many of the children are living with someone else for these reasons Enter the number of children up to 10 Code 10 if the number is more than 10 children Enter 88 if no children no child protection involvement and 99 for unknown For how many children has the client lost parental rights Enter the number of children up to 10 Code 10 if the number is more than 10 children Enter 88 if no children no child protection involvement and 99 for unknown if all items are unknown Alcohol and Drug Use Tab Ha Minnesota Department of Human Services DAANES north star E SS AE al Ey co ETT er Test veer Admission Form Admission ID 80987 ISATS ID Client Initials L1L3F1F3M Client DOB MM DDIYYYY Last 4 Digits of Client SS Admission Date MM DD YYYY MN000001 ABCDE 04 12 1985 8 1234 01 01 2013 5 Placement Information Criminal Justice Client Profile Prior CD Treatment Experience Child
91. record is COMPLETE Click to Add Social Environment Tab In the past 30 days how many times has the client been arrested Enter the number of times the client was arrested in the past 30 days The acceptable range is from 0 to 98 and 99 for unknown In the past 30 days how many times did the client attend self help programs e g AA NA Select the category which corresponds to the client s attendance to self help programs No attendance past month 1 3 times past month 4 7 times past month 8 15 times past month 16 30 times past month Some attendance but frequency unknown Unknown DAANES Web User Manual 35 October 2015 In the past 30 days did the client have interaction with family and or friends that are supportive of recovery Select the appropriate radio button Yes No Unknown In the past 30 days where has the client been living most of the time Select the category which corresponds to the client s living situation Homeless no fixed address including shelters Dependent living dependent children and or adults living in a supervised setting Independent living including on own self supported and non supervised group homes Children living with their family Unknown What is the client s current labor force status Select the category which corresponds to the client s current labor force status If none of the categories are appropriate use Other Employed full time means paid employment includin
92. rt below to enter a new admission or click on the Search button to update existing record Opiate Treatment Non Opiate Client Opiate Client ISATS ID MN000000 Admission Date MM DD YYYY E Client Initials L1L3F1F3M Client DOB MMIDDIYYYY E Last 4 Digits of Client SS Search for client in Registry First Name AAA Middle Name Last Name Date ofBin Sad su ImmigrationNaturalization SS Driver s License Number l PMI Number L o i Other Government Issue ID Number EM OTP providers are required to register clients with the State of Minnesota s OTP central registry This is accomplished by completing the following fields Admission Date First Name Middle Name if client does not have a middle name leave field blank Last Name Date of Birth Full 9 digits of the Social Security Number Optional fields are Immigration Naturalization ID Driver s License PMI and Other Government Issue ID Clicking the Submit button will register the client with the central registry auto populate the DAANES identifying fields and link to the new admission form Home Screen for OTP providers who provide both abstinence based treatment and OTP services ths Minnesota Department of Human Services DAANES northstar PA SS SS SS SS S J Home search voices reo J ramin Reset password Y icon EAT Start below to enter a new admission or click on the Search button to update existing record Opiate Treatment
93. s Act CSSA block grant funds or other funds Free care no charges means that the cost of treatment services was absorbed in full by the treatment program Other means that all or part of the client s charges were paid by sources not listed above Client Satisfaction Tab Ha Minnesota Department of Human Services DAANES north Star AA A A eee a a a a a AAA E area oo E oo Co oo User Tet User Discharge Form Admission ID 79995 ISATS ID Client Initials L1L3F1F3M Client DOB MM DD YYYY Last 4 Digits of Client SS Admission Date MM DD YYYY Discharge Date MM DD YYYY ABCDE a General Service Delivery Social Environment Child Protection Alcohol and Drug Abuse CH Severity Ratings Financial Information Client Satisfaction 1234 How much were you helped by the counseling or treatment you got E Select Did you receive treatment services in a language that you could understand Yes No Unknown If no what language do you usually speak Select x Other specify Were the treatment services that you received respectful of your culture Yes No Unknown I Check if record is COMPLETE Click to Add The following questions should be asked of the client at discharge This may be accomplished by creating a paper questionnaire which the client can complete prior to discharge How much were you helped by the
94. s lifetime If unknown enter 999 Number of lifetime treatment episodes Enter the total number of previous admissions to any chemical dependency treatment program in the client s lifetime Do not count detoxification and aftercare admissions If unknown enter 99 In the past 30 days how many times did the client attend self help programs e g AA NA Select the category which corresponds to the client s attendance to self help programs No attendance past month 1 3 times past month 4 7 times past month 8 15 times past month 16 30 times past month Some attendance but frequency unknown Unknown In the past 30 days did the client have interaction with family and or friends that are supportive of recovery Select the appropriate radio button Yes No Unknown DAANES Web User Manual 30 October 2015 Child Protection Tab The child protection questions relate to children who are under 18 years of age for whom the client is the natural or adopted parent or for whom the client has legal guardianship ths Minnesota Department of Human Services DAANES north tar AAA rome search I unces oo User Test User Admission Form Admission ID 80987 ISATS ID Client Initials L1L3F1F3M Client DOB MM DD YYYY Last 4 Digits of Client SS Admission Date MM DD YYYY ABCDE 04 12 1985 5 1234 01 01 2013 f Placement Information Criminal Justice Client Profile Prior CD Treatment Experience Child Prot
95. s provided to the family which help the client to participate in the treatment process Transportation Services Transportation is provided between the treatment facility and another place or to and from an activity in the client s plan of care DAANES Web User Manual 46 October 2015 Social Environment Tab Ha Minnesota Department of Human Services DAANES north tar aaa Se anes Home Se Upload Reports ET Reset Password J Logout User Test User Discharge Form Admission ID 79995 ISATS ID Client Initials L1L3F1F3M ClientDOB MM DD YYYY Last 4 Digits of Client SS Admission Date MM DD YYYY Discharge Date MM DD YYYY mnooo001 ABCDE 04 12 1985 3 1234 05 08 2010 El EN General Service Delivery Social Environment Child Protection Alcohol and Drug Abuse CH Severity Ratings Financial Information Client Satisfaction In the past 30 days how many times has the client been arrested L In the past 30 days how many times did the client attend self help programs e g AA NA Select In the past 30 days did the client have interaction with family and or friends that are supportive of recovery C Yes C No Unknown In the past 30 days where has the client been living most of the time Select y Will client be living in an environment conducive to recovery Yes C No Unknown
96. s than 30 days planned Residential more than 30 days planned Non residential Methadone Date of Change This item is locked grayed out and is initialized with the date of admission Once the admission record has been completed and validated this item may be updated if the client transitions to a different intensity of treatment services such as change from residential to non residential so long as the services occur within the same location and episode of treatment Select the type of chemical dependency treatment that the client is transitioning to and then enter the date of the change The date must be at least one day greater than the date of admission for the first transition entered and must be at least one day greater than the previous transition date for each additional entry Note Do not change this date when entering additional service agreement numbers only if there is a change in treatment services DAANES Web User Manual 21 October 2015 Is opioid replacement therapy planned for treatment Select the appropriate radio button Note Answering Yes to this item will create an ADD button under the Six month Six month Review form column on the search screen Yes methadone Yes other Yes buprenorphine No Primary and secondary source of referral Select up to two sources of referral which led to the client being admitted to this facility If only one source of referral is identified then selected No secondary
97. s the client currently enrolled in school or job training program 1 Not enrolled 2 Enrolled full time 3 Enrolled part time 9 Unknown Primary Source of Income 01 Disability benefits 02 Job 03 Retirement pension 04 Spouse parents 05 Relatives friends 06 Savings or investments 07 Public assistance 08 Other 09 None 99 Unknown What is the client s current labor force status 01 Employed full time 35 hours week 02 Employed part time lt 35 hours week 03 Occasional seasonal work 04 Sheltered employment 05 Homemaker 06 Student 07 Retired 08 Disabled 09 Inmate of institution 10 Laid off unemployed looking for work 11 Laid off unemployed not looking for work 12 Other 99 Unknown Prior CD Treatment Experience Number of Lifetime Detoxification Admissions 999 Unknown Number of Lifetime Treatment Episodes in any Chemical Dependency Treatment Program do not include detox 99 Unknown In the past 30 days how many times did the client attend self help programs e g AA NA 1 No attendance past month 5 16 30 times past month 2 1 3 times past month 6 Some attendance unkown 3 4 7 times past month 9 Unknown 4 8 15 times past month In the past 30 days did the client have interaction with family and or friends that were supportive of recovery 1 Yes 2 No 9 Unknown Child Protection Does the client
98. stance Retirement pension Other Spouse parents None Relatives friends Unknown What is the client s current labor force status Select the category which corresponds to the client s primary labor force status during the month prior to admission If none of the categories is appropriate use Other Employed full time means paid employment including self employment 35 hours or more per week Employed part time means paid employment including self employment less than 35 hours per week Occasional seasonal work means paid employment on a seasonal or otherwise irregular basis Sheltered employment is used only for disabled clients in structured work training settings Homemaker can be used only if there is one or more dependents in the household besides the client Paid employment and student status supersede this category Student is used when the client is enrolled in school or on summer or holiday break Full time employment status supersedes this category but other categories do not Retired is used only when the client has met the minimum retirement age and has retired from the work force Disabled is used if the client is unable to work because of a physical or mental condition Sheltered employment status supersedes this category Inmate of an institution is to be used if the client was in a jail prison or other institution Laid off unemployed looking for work means that the client is laid off from a position or is other
99. te of Birth AA Ei su Immigration Naturalization Drivers License Number PMI Number Other Government Issue ID Number EN If the client has an active record in the OTP registry the following error is displayed and you need to contact DHS OTP Registry Record Exists The client you are attempting to admitto an Opiate Treatment Facility is already enrolled Please contact DHS DAANES Web User Manual 19 October 2015 The admission form has seven tabs Placement Information Criminal Justice Client Profile Prior CD Treatment Experience Child Protection Alcohol and Drug Use and Chemical Health Severity Ratings After entering information remember to SAVE your data by clicking on the Click to Update button in the lower right corner To check for errors check the box next to the label Check if record is Complete and then click the Click to Update button After the record has been saved by the system the system will return the user to either the Home screen or the Search screen with a confirmation message that the information has been updated Warning the data will not be SAVED if there are errors identified in the information you have entered when the record is marked complete and you click the Update button Either correct the errors or uncheck the record complete box to save your data Placement Information Tab thei Minnesota Department of Human Services DAANES north tar AAA ee Pr
100. th day of the month following the event being recorded DAANES information may be revised at anytime within 4 months after the discharge record is completed After 4 months you will need to contact the DAANES support staff at the Department of Human Services to make changes You will need to provide DHS with your ISATS provider number the admission ID number of the record which needs correction along with the current response and the updated response for the field The admission ID may be found on the far right column of the Search form or in the upper right area of any of the data entry screens 4 Deletion of Erroneous DAANES Records Erroneously created records may be deleted from the system by contacting the DAANES support staff You will need to provide DHS with your ISATS provider number and the admission ID number of the record you wish to delete The admission ID may be found on the far right column of the Search form or in the upper right area of any of the data entry screens DAANES Web Administrator Each chemical dependency treatment provider who reports on the DAANES web information system is required to designate a staff person to be the local DAANES web administrator The local DAANES web administrator is the designated individual who is responsible for facilitating the DAANES data collection efforts at the facility They provide onsite training to counselors and other staff who are responsible for completing the DAANES forms They
101. th provider number MN999999 EDOE MN999999 Special Note Login IDs have to be unique to the DAANES web system Two staff members cannot have the same login ID If John W Smith and Jane E Smith are employed by the same provider the local web administrator will need to use their middle initials to create unique login IDs for each staff member JWSMITH MN999999 and JESMITH MN999999 Name Enter the full name of the staff member first name and last name Password Enter the initial password for the staff member Staff members should change their password when they log into the DAANES web application for the first time or anytime after the password is reset by the administrator DAANES Web User Manual 10 October 2015 Confirm Password Reenter the password to verify that the password was entered correctly Password Requirements The Department of Human Services requires complex passwords for users The following requirements are to be incorporated into the password structure 1 Must be a minimum of 8 characters in length 2 Must contain alpha and numeric characters 3 Must contain upper and lower case characters 4 Must contain at least one special or punctuation character for example amp The login ID associated with a password will be locked after three unsuccessful login attempts Once locked the local DAANES web administrator will need to be contacted to have the login ID unlocked Group Select your ISATS provid
102. the Submit button to navigate to the admission form All other functions are accessed from the Home screen by clicking on the appropriate navigation button The Home screen is illustrated below along with descriptions of the navigation buttons Opioid Treatment Program OTP providers are required to enter additional information in order to register the client with the OTP central registry The OTP provider Home screen is presented on the next page Ha Minnesota Department of Human Services A search renons ISATS ID MN000003 Admission Date MwoDYw SS Client Initials L1L3F1F3M ClientDos mwbowrwYy EA Last 4 Digits ofClientss __ Start below to enter a new admission or click on the Search button to update existing record DAANES north star J Admin Reset Password J Loaout User Test User MN3 Main Navigation Buttons Home Returns the user to the main DAANES screen Home screen Search Activates the search screen for locating a specific client record to updating Upload Activates the upload screen for batch submission of data Reports Activates the reports screen for running standard reports Activates the user management form for adding modifying and deactivating users Facility contact information is also updated from this screen This button is only visible if the user is a local web administrator Reset Password Activates a separate window which permits the user to change thei
103. third letter in the first name enter an asterisk In the fifth space enter the first letter of the client s Middle name or the Middle initial If the client does not have a middle initial enter an asterisk For two letter names or no middle initial If the client s first or last name has only one or two letters fill the second space of the two designated spaces with an asterisk Similarly if the client does not have a middle name or initial fill that space with an asterisk Date of birth In the date field enter the client s date of birth in MM DD YYYY format Last four digits of Social Security Number SSN Enter the last four digits of the client s Social Security Number in the text box provided If the client does not have a Social Security Number cannot remember or refuses to provide it enter 9999 Admission Date In the date field enter the client s date of admission into the treatment program in MM DD Y Y Y Y format or click on the down arrow on the right side of the text box to access the calendar function PMI number In the text box provided enter the 8 digits of the client s Personal Master Index PMI Number Only the eight digits of the PMI number should be entered not the initial letter usually an M G or X The PMI number for CCDTF clients may be obtained from the service agreement letter sent to the provider for each client placed under the CCDTF program If the client is enrolled in MA GAMC
104. tiary Substance Abuse Problem First select primary substance of abuse which corresponds to the substance associated with the most severe problems the client has experienced Then select the secondary which corresponds to the substance next in problem severity Finally select the tertiary which corresponds to the third substance in problem severity The secondary and tertiary categories may indicate no identified substances Nicotine Tobacco may be coded as a secondary or tertiary substance abuse problem Alcohol Benzodiazepines Cocaine powder Other tranquilizers Crack Barbiturates Marijuana hashish Other sedatives or hypnotics Heroin Ketamine Non prescription methadone Ecstasy other club drugs Other opiates and synthetics Inhalants PCP Over the counter medications Other hallucinogens or psychedelics Other Methamphetamine No secondary or tertiary substance Other amphetamines Nicotine Tobacco secondary or tertiary only Other stimulants Unknown Number of days primary secondary and tertiary substances used in the last 30 days For each of the substances selected as primary secondary and tertiary enter the number of days the client used that substance during the past 30 days Responses for use during the past 30 days may range from 0 to 30 DAANES Web User Manual 33 October 2015 Usual route of the identified primary secondary and tertiary substances Select the usual route of administration most frequent for each of the
105. tice to keep Thank you To be filled out by program staff Client Name Program Name This notice was given and explained to the client on Date Program Staff Initials DAANES Web User Manual 6 October 2015 General Instructions Provide as much information as possible The client s consent is not required in order to release information Any information known to the program staff or available from the client record should be completed The DAANES web application uses six types of data entry controls Text box To enter information in a text box move the mouse pointer over the text box and click the left mouse button A curser will appear in the text box Then type the alpha or numeric information requested Date box To enter information in a date box move the mouse pointer over the date box and click the left mouse button A curser will appear in the date box Then type the date in month day year format or use the calendar function by moving the mouse pointer to the right side of the box over the down arrow click the left mouse button to reveal a calendar 05 08 2010 E Radio buttons To select a radio button response move the mouse pointer over the word or button and click the left mouse button The circle will darken next to the choice you selected Yes No Unknown Drop down lists To select a response move the mouse pointer to the right side of the box over the down arrow click t
106. tinued Problem Potential F Seea El Dimension 6 Recovery Environment F Seea El F Check if record is COMPLETE Click to Update For each of the six chemical health severity dimensions rate the client s status at the time of admission Dimension 1 Acute intoxication withdrawal potential Dimension 2 Biomedical conditions and complications Dimension 3 Emotional behavioral cognitive conditions and complications Dimension 4 Readiness for change Dimension 5 Relapse continued use continued problem potential Dimension 6 Recovery environment Select the category from the drop lists which corresponds to the client s ratings No problem Minor problem Moderate problem Serious problem Extreme problem Unable to assess DAANES Web User Manual 34 October 2015 Six Month Review Form The six month review form should be completed every six months 180 days for clients who are receiving opioid replace therapies by the treating provider Clients are identified as opioid replace therapy patients on the Place Information Tab of the Admission Form The form should be completed when the client appears on the report listing clients who are due for a six month review The six month review form contains four tabs Social Environment Chemical Health Severity Ratings Alcohol and Drug Use and Service Delivery Remember to SAVE your data by clicking on the Click to Add or Click to Update button in the lower right corner To check for err
107. tion Employment or education services Childcare VIII IIA 0 0 Transportation I Check if record is COMPLETE Click to Add Record the number of service sessions provided during treatment For each of the service categories report the number of occurrences each service was provided to the client during treatment There is a count of ONE each time the service is provided regardless of the duration of time This is not an exhaustive list of services some CD programs may not provide some of the services listed If the service was not provided enter a zero in the quantity box Detoxification A service that provides short term care on a 24 hour basis for the purpose of detoxifying clients and facilitating access to chemical dependency treatment as indicated by an assessment of needs Alcohol Drug testing Alcohol drug testing is used to determine the presence of biomarkers of substances in the client Education about alcohol and other drugs An educational event providing information regarding substance use and or dependence Medical Care Care provided by a licensed medical professional to address a medical health need or prevention DAANE S Web User Manual 45 October 2015 Living Skills Development Living skills development to help the client learn basic skills necessary for independent living Individual Counseling A counseling session between one client and treatment staff to address substance abuse problems including
108. udes reason for discharge clinical chemical dependency diagnoses medication and other therapies provided disabilities or barriers to treatment post treatment environment and living situation occupational status at discharge involvement in peer support groups discharge referrals child protection involvement physical sexual abuse history length of stay cost of treatment and payment sources The discharge also captures the current status of the six dimensions associated with the chemical health severity ratings The discharge form should be completed on the day the client is discharged from the program Notification of Data Collection form The purpose of the Notification of Data Collection form is to inform the client that the program will be collecting and disclosing client specific information to the Department of Human Services for the purposes of research and program evaluation The notice also informs the client that confidentiality will be maintained and that their identity will not be disclosed Data Privacy The Department of Human Services is authorized and directed under Minnesota Statutes 254A 03 d to gather and disseminate facts and information about alcoholism and other drug dependency and abuse to public and private agencies and the courts so requesting such information for guidance to and assistance in prevention treatment and rehabilitation Authorization to collect chemical dependency information is also granted under
109. using the calendar function Current Chemical Dependency Treatment Select the client s chemical dependency treatment at the time of discharge Hospital inpatient Residential less than 30 days planned Residential more than 30 days planned Non residential Methadone Reason for discharge Select the category which is the most appropriate description of the client s reason for discharge from the treatment facility Completed program means that the client completed the program as scheduled Patient left means that the client left the program with or without notice to the staff This includes a failure to show for outpatient sessions Patient Conduct means that program staff requested that the client leave the program because the client s behavior was disruptive to or uncooperative in the treatment setting Expiration of civil commitment or hold order means that the client left on the expiration of a civil commitment or hold order without completing treatment Transferred to other program means that the client was transferred to another program either because the client had other problems which needed more immediate attention or because it was determined that another program could better meet the needs of the client Assessed as inappropriate for this program means that the client was assessed as inappropriate either because the client did not meet admission criteria after evaluation or that the program could not provide adequate s
110. wide CD Treatment Enviroment Select El Funding Source Select El Date of Report From Date of Report To E E Run Report Return Report List DAANES Web User Manual 60 October 2015 Obtaining Client PMI Numbers What is the PMI Number The Personal Master Index PMI number is an 8 digit unique identifier assigned by DHS to an individual who is eligible to receive health care services through any of Minnesota s public health care programs Medical Assistance Medicaid MA General Assistance Medical Care GAMC and MinnesotaCare With the transition of the Consolidated Chemical Dependency Treatment Fund into the Medicaid Management Information System MMIS individuals who receive treatment through the Consolidated Fund are also assigned a PMI number How do I know if a treatment client is publicly funded and how do I obtain the PMI Number All treatment clients who are referred through the Consolidated Fund or by a Public Prepaid Health Plan are publicly funded and have a PMI Number For Consolidated Fund referrals the Notification Letter sent to the treatment provider by DHS contains the PMI number called the Recipient ID Number All Minnesota Health Care Program enrollees MA GAMC MinnesotaCare have an MHCP ID Card which includes the PMI number called the Member Number For referrals from Prepaid Health Plans HMOs the identification of a treatment client as a public program member can be
111. wise not employed but is physically and mentally able to work and is looking for work Unemployed not looking for work means that the client is not employed but is physically and mentally able to work but is not looking for work Other means that none of the categories listed above accurately describes the client DAANES Web User Manual 29 October 2015 Prior CD Treatment Experience Tab Ha Minnesota Department of Human Services DAANES romo sera north Han EMO EEE MA user Test user Admission Form Admission ID 80987 ISATS ID Client Initials L1L3F1F3M Client DOB MM DD YYYY Last 4 Digits of Client SS Admission Date MM DDIYYYY MN000001 ABCDE 04 12 1985 f 1234 01 01 2013 E Placement Information Criminal Justice Client Profile Prior CD Treatment Experience Child Protection Alcohol and Drug Use CH Severity Ratings Number of lifetime detoxification admissions Number of lifetime treatment episodes in any chemical dependency treatment program do not include detox In the past 30 days how many times did the client attend self help programs e g AA NA Select y In the past 30 days did the client have interaction with family and or friends that are supportive of recovery C Yes C No Unknown I Check if record is COMPLETE Click to Update Number of lifetime detoxification admissions Enter the total number of admissions to any detoxification facility in the client
112. y refers to damage to the brain or its coverings from an external force not of a degenerative or congenital nature The damage may produce an altered state of consciousness and may result in a decrease in cognitive behavioral or physical functioning Resulting impairments may be temporary or permanent and may cause partial or total functional disability or psychosocial maladjustment English not primary language means that the client uses a language other than English as a primary means of verbal or written communication Functional illiteracy means that the client s reading and or writing skills are deficient to the point of impeding the ability to complete forms or homework assignments or other reading or writing tasks associated with treatment Has the client been a victim of abuse Consider both childhood and adult experiences Select the category which corresponds to the client s experiences No Yes physical only Yes sexual only Yes physical and sexual Unknown Has the client been a perpetrator of abuse Consider both adolescent and adult experiences Select the category which corresponds to the client s experiences No Yes physical only Yes sexual only Yes physical and sexual Unknown Which of the following were used as part of CD treatment for the client For each category listed indicate whether the therapy was used during the client s CD treatment regardless of frequency or duration of that particular the

DAANES Web User Manual - Minnesota Department of

Contents

Download Pdf Manuals

Related Search

Related Contents