8100, Community Care Authorizations

8110 Authorizing CCSE Services Using the SASO Wizards

Revision 17-8; Effective September 1, 2017

The following Community Care Services Eligibility (CCSE) services can be authorized using the Service Authorization System Online (SASO) wizards:

• Adult Foster Care (AFC)
• Day Activity and Health Services (DAHS)
• Emergency Response Services (ERS)
• Family Care (FC)
• Home-Delivered Meals (HDM)
• Primary Home Care (PHC)
• Residential Care (RC) Services
• Community Attendant Services (CAS)
• Special Services to Persons with Disabilities (SSPD)

Note: The wizards cannot be used to authorize Consumer Managed Personal Attendant Services (CMPAS). See 8220, Consumer Managed Personal Attendant Services (CMPAS) Without the Wizards, for instructions on CMPAS.

8111 Wizard Sequencing — CCSE

Revision 17-1; Effective March 15, 2017

Each SASO CCSE is a prompting sequence that takes the user through a series of windows required for authorization or denial of services.

The five wizards used to authorize, terminate or monitor services are:

• Financial wizard — Community Care Services Eligibility (CCSE)
• Functional wizard — CCSE
• Authorization wizard — CCSE
• Community Living Assistance and Support Services (CLASS) wizard
• Monitoring wizard — CCSE

When authorizing services, users should complete the Financial wizard first, the Functional wizard second and the Authorization wizard last. Information from the Financial and Functional wizards must be submitted prior to accessing the Authorization wizard.

If the Functional wizard is accessed first, the user will see a pop-up Client Error window at the end of the wizard with instructions to complete the Financial wizard before an eligibility decision can be made. Both the Financial and Functional wizards must be completed and information from those wizards submitted before the Authorization wizard can run properly.

If the user closes a wizard prior to completion in order to access other records, then returns to that wizard, the first window in the sequence will display. Click on NEXT in each window to get to the desired location in the wizard.

8112 Automatically Populated Folders by the SASO Wizards — CCSE

Revision 17-1; Effective March 15, 2017

Once all five wizards completed, the system automatically populates the following folders and/or forms:

• Applied Income/Co-Pay (Residential Care Cases)
• Authorizing Agent
• Case Ownership
• Diagnosis
• Enrollment
• Level of Service
• Service Authorization
• Service Item
• Title XX Eligibility
• Community Care Fact Sheet
• Form 2059, Summary of Client's Need for Service
• Form 2060, Needs Assessment Questionnaire and Task/Hour Guide
• Form 2064, Eligibility Worksheet
• Form 2101, Authorization for Community Care Services
• Monitoring Report
• Provider Referral Supplement
• Task/Hour Guide

8113 Records that Require User Entries Prior to Completing the SASO Wizards — CCSE

Revision 17-1; Effective March 15, 2017

Prior to working through the SASO wizards, the user must complete the following records:

• Address
• Phone (mandatory for ERS only)
• Other Information
• Case Ownership (if changes are needed)
• Service Request

The user must submit the case to SASO once the address, phone and other information folders are completed. This creates or updates the Location record.

8114 Address Folder — CCSE Services Using the SASO Wizard

Revision 17-1; Effective March 15, 2017

The Address folder records the individual's addresses. The user creates separate address records to record an individual's home or mailing address (if different from the home address), a responsible party's address and/or an executor's address. Information from this folder prints on the Provider Referral Supplement.

To register a home or mailing address:

1. Select the Folder icon for Address in the Client directory.
2. Select Add and the Address record will appear.
3. Select the Type code from the drop-down list in the Type field. The system defaults to 05-Mailing/Home.
4. Type the intake date as the effective Begin Date for initials. Type the effective date of the address in the Begin Date field for changes.
5. Type the address in the Address field.
6. The Tel. No. field is used to record the phone number of the executor only. Do not use this field to record the individual's phone number
7. Type the city in the City field.
8. Select the state from the drop-down list in the State field. The system defaults to TX-Texas.
9. Type the ZIP code in the ZIP Code field.

To register a responsible party's address:

1. Select the Folder icon for Address in the Client directory.
2. Select Add and the Address record will appear.
3. Select the Type code 04-Other from the drop-down list in the Type field. The system defaults to 05-Mailing/Home.
4. Type the intake date as the effective Begin Date for initials. Type the effective date of the address in the Begin Date field for changes.
5. Type the following in the address lines:

Line 1 – Enter the responsible party's name (First, Middle, Last). This line starts with "C/O" for "in care of."

Line 2 – Enter the first line of the responsible party's address (usually a street number or a P.O. Box).

Line 3 – Enter the first line of the responsible party's address (if needed, such as for an apartment number).

Note: Do not enter identifiers, such as daughter, directions to the home or any other miscellaneous text in any of these fields.

6. Type the phone number of the responsible party in the Tel. No. field, including the area code. Do not use parentheses. For example, enter 555-123-4567.
7. Type the city in the City field.
8. Select the state from the drop-down list in the State field. The system defaults to TX-Texas.
9. Type the ZIP code in the ZIP Code field.

To register an executor's address:

1. Select the Folder icon for Address in the Client directory.
2. Select Add and the Address record will appear.
3. Select the Type code EX-Executor from the drop-down list in the Type field. The system defaults to 05-Mailing/Home.
4. Type the intake date as the effective Begin Date for initials. Type the effective date of the address in the Begin Date field for changes.
5. Type the following in the address lines:

Line 1 – Enter the executor's name (First, Middle, Last).

Line 2 – Enter the first line of the executor's address (usually a street number or a P.O. Box).

Line 3 – Enter the second line of the executor's address (if needed, such as for an apartment number).

Line 4 – Enter the executor's telephone number, including the area code. Do not use parentheses. For example, enter 555-123-4567. Note: Do not enter identifiers, such as daughter, directions to the home or any other miscellaneous text in any of these fields.

6. Type the city in the City field.
7. Select the state from the drop-down list in the State field. The system defaults to TX-Texas.
8. Type the ZIP code in the ZIP Code field.

Address Changes:

When an address changes, add a record using these same instructions and enter the new Begin Date. This record is an exception to the rule of entering an End Date in the existing record before creating another record. SASO reads the most recent address with a HOME type as the individual's current address.

8115 Case Ownership — CCSE Services Using the SASO Wizard

Revision 17-1; Effective March 15, 2017

The Case Ownership folder displays information about the caseload in which the individual resides. The Authorization wizard automatically creates a record with data about the first case worker who submits information about the individual.

Once a budgeted job number (BJN) record is populated and submitted to the server, the BJN field is disabled. Use the following instructions to delete the original BJN record and create a new record with changes, if needed.

1. Select the Folder icon for Case Ownership in the Case Worker directory.
2. Click the original BJN record to highlight.
3. Select the Cancel button from the menu bar.
4. Submit the individual record.
5. After the record is submitted, again select the Folder icon for Case Ownership in the Case Worker directory.
6. Select the Add button from the menu bar.
7. Type the BJN of the employee in the BJN field.
8. Type the Mail Code (without dashes) of the employee in the Mail Code field. The other fields in this window automatically populate when the user accesses the Mail Code field.
9. Submit the individual record.

8116 Other Information — CCSE Services Using the SASO Wizard

Revision 17-1; Effective March 15, 2017

The Other Information folder contains additional information about the individual. Information from this record prints on the Provider Referral Supplement.

1. Select the Folder icon for Other Information in the Client directory.
2. Select the individual's marital status from the drop-down menu in the Marital Status field.
3. Select the language requiring translation from the drop-down menu in the Translation Needs field, if applicable.
4. Type directions to the individual's residence in the Directions field.

8117 Phone/Community Care — CCSE Services Using the SASO Wizard

Revision 17-1; Effective March 15, 2017

The Phone folder documents an individual's phone number. For ERS recipients, entering a land line (phone number) is mandatory. Additional records can be created to record numbers for relatives, friends or a responsible party.

To register phone information:

1. Select the Folder icon for Phone in the Client directory.
2. Select Add and the Phone record will appear.
3. The system defaults to HO-HOME in the Type field. Select OT-OTHER from the drop-down menu to register additional phone numbers.
4. Type the date the phone number is valid in the Begin Date field. This can be the same date as the Begin Date for enrollment.
5. Type the phone number in the Phone No field. There is no End Date field for a phone record.

To cancel a phone record:

1. Select the Folder icon for Phone in the Client directory.
2. Select the phone record to be cancelled.
3. Select CANCEL on the SASO toolbar.

When the records are completed, the user will submit them. By completing this step, the Location record will be created automatically.

8118 Service Request /Community Care — CCSE Services Using the SASO Wizard

Revision 17-1; Effective March 15, 2017

The Service Request folder displays the services for which an individual is to be screened. Entries in this folder are required before the wizards can be completed. The system defaults to CCSE.

For initial applications:

1. Select the Folder icon for Service Request in the Wizards directory.
2. Select the program for which the individual is applying or leave at the default.
3. Select each service for which the individual is to be screened. There are no edits in this window to prevent selecting mutually exclusive services.
4. When all requested services are selected, select the Folder icon for the appropriate wizard in the Wizards directory.

For updates, additions or changes:

1. Select the Folder icon for Service Request in the Wizards directory.
2. Select the program for which the individual is applying.
3. Select each service already open and any new services for which the individual is to be screened. There are no edits in this window to prevent selecting mutually exclusive services.

Business rules will run only on services selected in this window. Wizards overwrite old information as the user progresses through the windows. If currently open services are not selected in addition to the new services requested, data on currently open services may be deleted.

4. When all requested services are selected, move to the Folder icon for the appropriate wizard in the Wizards directory.

8120 Financial Wizard

Revision 17-1; Effective March 15, 2017

The Financial wizard is a prompting sequence of windows used to assess financial eligibility for CCSE services. It can also be used to verify Medicaid eligibility for other programs. Windows are conditional and will only display, if needed. Some windows are for statistical data collection purposes only. The Financial wizard must run before the Functional and Authorization wizards can be completed to authorize services. For Personal Assistance Services (PAS), each time the financial eligibility changes, the Functional wizard must be processed.

If an application is being denied due to functional eligibility and financial eligibility has not been determined, the case worker may enter zeros in the financial information to be able to proceed to the functional wizard.

After selecting the program in the Service Request window, open the Financial wizard:

1. Select the Folder icon for the Financial wizard in the Wizards directory.
2. Progress through the wizard by completing the entries in each window, then select NEXT.

8120.1 Service Request Window (Read Only) — Financial Wizard

Revision 17-1; Effective March 15, 2017

The Service Request window in the Financial wizard displays information in read-only mode about the program or services to be tested.

1. The status of the current service authorizations, if any, will display as Open or Closed. To make changes in the Service Request window, return to the Service Request folder.
2. Select NEXT.

8120.2 Categorical Eligibility Window — Financial Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Categorical Eligibility window displays information in read-only mode about open Medicaid-related cases, active Supplemental Nutrition Assistance Program (SNAP) cases and managed care. If no information is displayed, the individual has no open eligibility records on the System for Applications, Verifications, Eligibility Reports and Referral (SAVERR). Benefit information from the SAVERR database is updated each time an individual record is retrieved into the Financial or Functional wizards.

A red "H" is displayed in the Medicaid Related Coverage field when the SAVERR record is on hold. If a case is on hold, the SASO record for Medicaid-funded services (PHC and Title XIX DAHS) will process only if the hold is removed or if the Service Authorization record is Forced.

Select NEXT.

8120.3 CAS Eligible Window — Financial Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The CAS Eligible window is a conditional window that displays only when the individual is applying for PAS and does not receive Medicaid.

1. Select Yes if the individual passes CAS screenable requirements. Follow appropriate procedures to process a CAS application.
2. Select No if the individual does not meet CAS screenable requirements.
3. Select NEXT.

8120.4 Decline QI1 Window — Financial Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Decline QI1 window is a conditional window that displays only when the individual receives Qualified Individual (QI)1. The individual must be willing to decline QI coverage in order to receive CAS.

1. Select Yes if the individual is willing to decline QI coverage.
2. Select No if the individual is not willing to decline QI coverage.
3. Select NEXT.

8120.5 Urgent Need Window — Financial Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Urgent Need window is a conditional window that displays only when the individual is applying for PAS and is not categorically eligible.

1. Select Yes if the individual meets the criteria for a verbal (expedited) referral.
2. Select No if the individual does not meet the criteria for a verbal (expedited) referral.
3. Select NEXT.

8120.6 Potential Eligibility Window — Financial Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Potential Eligibility window is a conditional window that displays only when the individual meets the criteria for a verbal (expedited) referral for FC.

If No is selected in the Potential Eligibility window, the wizard will display conditional Income and Resource windows to record financial information and verifications. If Yes is selected, the wizard will skip the Income and Resource windows.

1. Select No if the individual appears to be within the income and resource limits for FC based on the signed application, and financial verifications are available.
2. Select Yes if the individual appears to be within the income and resource limits for FC based on the signed application, but financial verifications are not available.
3. Select No if the individual does not appear to be within the income and resource limits for FC based on the signed application.
4. Type the date that the individual's financial eligibility is determined based on information on the signed application.
5. Select NEXT.

When financial verifications are received after services have been started, the user must re-enter this screen and select No in order to access the Income and Resource windows to record the verifications.

8120.7 Couple Information Window — Financial Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Couple Information window is a conditional window that displays information used to determine the income/resource limits for financial eligibility determination. The window will not display if the individual is a Supplemental Security Income (SSI) recipient.

1. The window defaults to No.
2. Select Yes if the individual is married and living in the same household with the spouse.
3. Select NEXT.

8120.8 Income Window — Financial Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Income window is a conditional window used to record the value of countable income and the method of verification for that income. The wizard automatically calculates total countable income as each entry is made in the Amount column.

1. Type the dollar amount of all countable income in the fields under the Amount column.
2. Select the method of verification from the drop-down menu in the Verification column for each type of income.
3. Select the check box under the Doc Filed column if verification for a particular type of income is filed in the case folder.
4. Select NEXT.

8120.9 Resources Window — Financial Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Resources window is a conditional window used to record the value of countable resources and the method of verification for those resources. The wizard automatically calculates total countable resources as each entry is made in the Amount column.

1. Type the dollar amount of all countable resources in the fields under the Amount column.
2. Type the dollar amount of the individual's current monthly income in the Less Monthly Income field if those monies are included in the checking account, savings account or cash on hand totals.
3. Select the method of verification from the drop-down menu in the Verification column for each resource.
4. Select the check box under the Doc Filed column if verification for a particular resource is filed in the case folder.
5. Select NEXT.

8120.10 Financial Totals Window — Financial Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Financial Totals window displays financial information about a categorically eligible couple or individual. The information is used for statistical purposes.

1. For individuals receiving CAS, Medical Assistance Only (MAO) or SNAP:

• Type the total income and resources amounts for the couple in the Total Income and Total Resources fields if the individual is married and living in the same household with a spouse; or
• Type the total income and resources amounts for the individual in the Total Income and Total Resources fields in other circumstances.

This window does not display for individuals receiving SSI only.

2. Select NEXT.

8120.11 Financial Eligibility Summary Window — Financial Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Financial Eligibility Summary window displays total countable income and resources for non-categorically eligible individuals. The window indicates whether the individual is within or exceeds income and resource limits. Overall financial eligibility displays as Passed or Failed. The window also displays the date financial eligibility is determined.

1. Type the date the application was received in MM/DD/YYYY format.
2. Select NEXT.

8120.12 Workers Checklist Window — Financial Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Workers Checklist window displays information about individual rights and responsibilities, referral to Area Agencies on Aging (AAA) and citizenship status. The window also displays whether an individual is financially eligible for Title XIX, CAS or Title XX services, or if the individual is not financially eligible for CCSE services.

1. Select Rights and Responsibilities Discussed with the Client to certify that the discussion of rights and responsibilities has taken place.
2. Select Form 2307 given to the individual to certify that Form 2307, Rights and Responsibilities, was given to the individual.
3. Select Referral to AAA if the individual is referred to AAA.
4. Select Client not a U.S. citizen/is under 18 to indicate that the individual voluntarily acknowledges not having U.S. citizenship or that the individual does not meet the age requirement.
5. Select GENERATE once the Financial wizard is complete.
6. Select OK.

8130 Functional Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Functional wizard prompts the user through windows required to assess functional eligibility. Some windows are conditional and will display only if needed. The Financial wizard must run before the Functional wizard can be completed to authorize services.

To open the Functional wizard:

1. Select the Folder icon for Service Request in the Wizards directory.
2. Select the program for which the individual is applying.
3. Select each service for which the individual is to be screened. There are no edits in this window to prevent selecting mutually exclusive services.
4. Select the Folder icon for the Functional Wizard in the Wizards directory.
5. Progress through the wizard by completing the entries in each window, then select NEXT.

If the user has followed this procedure to access the Financial wizard and is moving directly from the Financial wizard to the Functional wizard, he does not have to repeat Steps 1 and 3 prior to opening the Functional wizard. Begin with Step 4.

8130.1 Service Request Window (Read Only) — Functional Wizard

Revision 17-1; Effective March 15, 2017

The Service Request window in the Functional wizard displays information in read-only mode about the program or services to be tested.

1. The status of current service authorizations, if any, will display as Open or Closed. To make changes in the Service Request window, return to the Service Request folder.
2. Select NEXT.

8130.2 Interview Window — Functional Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Interview window displays information about the most recent interview.

To delete previous assessment information, select Clear Assessment. Selecting Clear Assessment clears previous information from all of the screens in the Functional wizard.

1. Select the Type of Assessment, Primary Contact and Location specific to the current interview.
2. The Interview Date box displays the current date. Type a different date in the box, if necessary.
3. Type the date services are requested in the Intake Date box.
4. Type the date the case worker received Form 2110, Community Care Intake, in the Assignment Date box.
5. Type the date the application is denied for an individual with no active service authorization record in the Application Denied Date box. For example, if an individual files an application for services, but dies before those services are authorized, enter the denial date in this box.
6. Select the reason for the denial from the drop-down list in the Denied Reason box.
7. Select NEXT.

8130.3 Household Window — Functional Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Household window displays information about other persons living in the household with the individual.

1. Select YES if there are any other adults or CCSE individuals residing in the household. Default entries may appear in this field on reviews. Change the selection, if necessary.
2. Type the name of any other adult (whether they are an individual or not) or CCSE individual (regardless of age) who lives in the household.
3. For each name listed:

• Select the CCSE box if the other person receives any CCSE service.
• Select the Companion box if there is another person in the household who receives CCSE PAS.
• Type the client number if the other person has a number.

4. Select NEXT.

8130.4 Health Concerns Window — Functional Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Health Concerns window displays information about current health conditions resulting in functional limitations or physical, mental or emotional impairment for the individual. Individuals in DAHS must have a medical diagnosis. Individuals receiving CAS or Title XIX PAS must have a medical need.

1. Select each condition that describes the individual's current health.
2. Select Other for a condition not listed. Type a description of the condition in the box provided (maximum 254 characters).
3. Select NEXT.

8130.5 Depression Details Window — Functional Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Depression Details window displays questions about depression. If either of the first two questions is selected, the response boxes on the next four questions are activated.

1. Select each question to which the individual's response is Yes. The wizard will automatically enter a score in the Impairment Scoring window, based on the responses in this window. The score is editable only in this window.
2. Select NEXT.

8130.6 Impairment Scoring Window — Functional Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Impairment Scoring window displays functional assessment information (Form 2060, Needs Assessment Questionnaire and Task/Hour Guide).

1. For each task listed, select an Impairment Score of 0 – 3 from the drop-down menu or type a score of 0 – 3 in the Impairment Score field.

Press ENTER or use the mouse to move to the next field. Use the scroll bar to the right of the window to scroll down through all of the functional tasks. Continue until all functional tasks have been scored.

2. Type comments in the Task Comments box (maximum 254 characters). A separate Task Comments box is available for each functional task. Comments will print out on Form 2060 next to the appropriate task.

If a caregiver partially assists with a task and it will be purchased, enter the part of the task or scheduled time the caregiver will do the task. This task will be marked as P/C. Example: Sue Jones, daughter, can lay out bathing supplies, but can't help the individual into the bath tub.

If a caregiver is not available during the time purchased tasks are delivered, but provides care at all other times, the case worker may enter one comment for the entire Form 2060. Since bathing is the first task, a comment may be entered in bathing that applies to all tasks. Example: Sue Jones, daughter, assists with all tasks in the evenings and on weekends.

It is not necessary to list the caregiver under other tasks unless the caregiver is performing all of the task (C) or part of the task during the service schedule (P/C).

If an agency is providing part of a task, enter the schedule for the agency in the Comments section. Example: ABC Home Health provides bathing on M-W-F and individual needs task purchased on T-Th.

3. For PAS, select To Be Purchased for each task that will be purchased.

Note: If the applicant does not meet the minimal functional score required to qualify for PAS, do not select tasks in the To Be Purchased column. Do not complete this information because the applicant does not qualify for PAS services.

4. Select View Activities to display a Task/Time Allocation window for that task. View Activities is selected by default for the laundry, meal preparation and escort tasks.
5. The Activities Selected column displays as "read only" once activities are selected on the Task/Time Allocation window for a specific task.
6. Select the SET DATE button when the functional assessment is completed or updated. The current date will be entered and cannot be changed.

This date will default to zeros each time the Functional wizard is opened. The date must be set again at each update. Do not set the date if Form 2060 is not administered.

7. Select NEXT.

8130.7 Task Purchased Details Window(s) — Functional Wizard — CCSE

Revision 17-1; Effective March 15, 2017

When the individual lives with another person, the Task Purchased Details window displays for each purchased cleaning, meal preparation, shopping and laundry task.

1. Select the reason(s) that justify purchasing each task.

• If the household member has stated he is unwilling and refuses to perform the task, check "Household member refuses to perform task." This individual will be listed as a "Do Not Hire."
• If the household member works full time, check "Household member is unable to perform task."

2. Select NEXT.

8130.8 Support Assisting Client Window — Functional Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Support Assisting Client window is used to enter or view information about support currently being provided. Impairment scores previously selected in the Impairment Scoring window display in read-only mode. P will display for each purchased task. Unless there are actually two supports for a task, only one code should appear on the printed Form 2060, Needs Assessment Questionnaire and Task/Hour Guide. If the task is purchased and there is no other support, then the blank is selected for the primary support type.

1. Select a primary support type from the drop-down menu for each functional task listed.
   • If a task is being purchased and the individual does not receive assistance from a caregiver or other agency in performing the task, and the impairment score is 1 or 2, select self from the drop-down menu or leave the default blank to indicate a not applicable response.
   • If a task is being purchased and a caregiver, other agency or the individual assists some of the time, select the appropriate primary support type from the drop-down menu. The part of the task the caregiver or other agency performs should be noted in the comment section for that task on the Impairment Scoring window.
   • If a task is not being purchased because a caregiver, other agency or the individual performs the task all of the time, select the appropriate primary support type from the drop-down menu.
2. If the primary support type is caregiver, type the name and relationship in the Support Name field beside each functional task. If the primary support type is agency, type the name of the agency in the Support Name field beside each functional task.

Once a name is typed in the Support Name field, that name will automatically display each time the same primary support type is selected. This field is editable. If another caregiver is assisting with other tasks, type the name and relationship in the Support Name field beside the functional task.

3. The Support Quality and Reliability column displays when the impairment score is 3 for any of the four priority tasks (feeding, toileting, transfer or meal preparation), and the task is to be purchased. Select a score from the drop-down menu to describe the quality and reliability of the available support.
4. Select NEXT.

8130.9 Caregiver Support Details Window — Functional Wizard — CCSE

Revision 17-1; Effective March 15, 2017

For a purchased task, a Caregiver Support Details window displays for each caregiver listed in the Support Assisting Client window. The caregiver name displays in read-only mode at the top of the screen.

1. Select the reason(s) why the caregiver cannot fully perform the purchased task. The reason will default to blank each time the Functional wizard is opened and must be re-entered for each update.
2. Select Yes or No to indicate if the caregiver is a paid attendant.
3. Select NEXT.

8130.10 Paid Attendant Window — Functional Wizard — CCSE

Revision 17-1; Effective March 15, 2017

1. If Yes is selected indicating the caregiver is a paid attendant, this window appears. It is no longer applicable and will be removed at a future date.
2. Select NEXT.

8130.11 Other Agency Support Details Window — Functional Wizard — CCSE

Revision 17-1; Effective March 15, 2017

For a purchased task, an Other Agency Support window displays for each agency listed in the Support Assisting Client window. The agency name displays in read-only mode at the top of the screen.

1. Select the reason(s) why the other agency cannot fully perform the purchased task.
2. Select NEXT.

8130.12 Task/Time Allocation Window — Functional Wizard — CCSE

Revision 17-1; Effective March 15, 2017

A Task/Time Allocation window displays by default for the laundry, meal preparation and escort tasks. It also displays for any other tasks that have View Activities selected on the Impairment Scoring window. Impairment scores previously selected display in read-only mode. Rules processed in this window determine whether the Supervisor window is required. If the individual lives with another person, an asterisk displays beside a purchased general household task.

1. Type the number of minutes per day and days per week or the minutes per week in the appropriate field.
   • For meals purchased through HDM only, no entries are required in the number of Minutes per Day, Days per Week and Minutes per Week fields.
   • For the escort task, type how often the task is to be performed. If the task is to be performed less than once per month, no entry is required in Minutes per Day or Minutes per Week fields.
2. Select the activities associated with performing the task.
   • For laundry, select Washer or Dryer, if the individual has one.
   • For meal preparation, select the specific meal(s), breakfast, lunch or dinner, to be purchased through PAS. Do not check "lunch" if lunch is purchased through HDM only. Use comments to document if lunch is also delivered through PAS on days not provided by HDM.
   • For meal preparation, select whether meals will be purchased through HDM only, HDM/PAS or PAS only.
   • For escort, if frequency in Days per Week is more than 1, then supervisory approval is required.
3. Select NEXT.

8130.13 Task/Hour Guide Summary Window — Functional Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Task/Hour Guide Summary window displays a summary of information entered on individual Task/Hour Tasks windows. The tasks and impairment scores display in read-only mode when the individual is being screened for PAS eligibility. If the individual lives with another person, an asterisk displays beside a purchased general household task.

Use this window to enter the time allocation for any task where a Task/Time Allocation window was not completed.

1. To add or delete purchased tasks or to change impairment scores, return to the Impairment Scoring window by selecting the BACK button.
2. To enter or modify time allocations, type the number of minutes per day and days per week or the minutes per week in the appropriate box beside each task. Changes made on this window will automatically update the Task/Time Allocation window.
3. Select the SET DATE button to record completion of the task/hour guide. Once the date is set for an assessment, it cannot be changed.
4. Select NEXT.

This date will default to zeros each time the Functional wizard is opened. The date must be reset at each update. Do not set the date if the individual is not being screened for PAS eligibility.

8130.14 Supervisor Window — Functional Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Supervisor window displays when supervisory approval to exceed maximum times is required.

1. Select YES if supervisory approval is received to exceed the maximum daily or weekly times for a purchased task for any individual.
2. Type the date of approval.
3. Select the method of approval from the drop-down menu.
4. Select NEXT.

8130.15 CCSE Attendant Hours Adjustment Window — Functional Wizard

Revision 17-1; Effective March 15, 2017

The CCSE Attendant Hours Adjustment window displays the total impairment score in read-only mode (not including the feeding/eating task).

The priority status displays and can be changed from Priority to Non-Priority.

Authorization calculations based on task/hour information and available aid and attendance (A & A) hours display in read-only mode. The wizard calculates the A & A hours to be deducted from the total authorization based on the monthly amount entered and the current maximum attendant care rate.

1. Select No to change from Priority to Non-Priority.
2. If the individual is using A & A or Home-bound Elderly funds to purchase services that meet the intent of A & A or Home-bound Elderly benefits, select the explanation(s) of how A & A or Home-bound Elderly benefits are being used. Leave the Monthly Amount box blank.
3. If the individual is using all or part of monthly A & A or Home-bound Elderly funds to purchase services which do not meet the intent of A & A or Home-bound Elderly benefits, type the whole dollar amount being misspent in the Monthly Amount box. Do not select an explanation.
4. The Current Status of Medical Need displays as "read only" based on entries made by the nurse in the Authorization wizard. The current status of medical need is not editable in this window.
5. Select NEXT.

8130.16 Six Hour Window — Functional Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Six Hour window displays when less than six hours per week of personal attendant service is authorized.

1. Select the reason an individual receives less than six hours per week of personal attendant services.
2. Select NEXT.

8130.17 Home Environment Window — Functional Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Home Environment window displays information about the location and condition of the individual's residence, the existence or lack of barriers to service delivery in the home environment, and the availability of assistive devices and transportation.

1. Under Residence, select the best description of the individual's living arrangement.
2. Under Assistive Devices, select any device(s) currently available at the individual's residence. Select Other for any item not on the list and type an explanation in the box (maximum 254 characters).
3. Under Laundry, select the best description of available appliances.
4. Under Adequate, Unsafe and Questionable, select the item(s) that describe the condition of the residence.
5. Under Miscellaneous, select special-equipped vehicle for transport if the individual has a specially equipped vehicle.
6. Select NEXT.

8130.18 Emergency Response Services Window — Functional Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Emergency Response Services window displays only when ERS is requested.

1. Select YES if the ERS applicant is home alone for eight or more hours each day or lives with an incapacitated person who cannot call for help or otherwise assist in an emergency.
2. Select NEXT.

8130.19 Eligibility Determination Window — Functional Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Eligibility Determination window displays the results of the functional eligibility determination. A green check mark indicates that the individual is eligible for a specific service. A red X indicates that the individual is not eligible for a specific service. A message displays if the Financial wizard has not already been completed or if there is a discrepancy between current SAVERR information and the information in the Financial wizard.

The Functional wizard will deny PHC or PHC CDS if the individual is under age 21. The user will receive a pop-up message, "PHC failed because the individual is under 21 years old, or no birth date was recorded."

1. Select Generate once the Functional wizard is completed
2. Select OK.
3. Click on the Submit button on the SASO navigator bar to file records to SASO.

The Functional wizard will deny PHC or PHC CDS if the individual is under age 21. The user will receive a pop-up message, "PHC failed because the individual is under 21 years old, or no birth date was recorded."

4. Click on the Search button on the SASO navigator bar to re-pull the case or double-click on the individual's name in the SASO List Data window.

Records to be populated by the wizards will display in the appropriate folders, but will not contain all required information until after the Authorization wizard has been completed.

8140 Authorization Wizard

Revision 17-6; Effective June 28, 2017

The Authorization wizard can be accessed directly without going through the Financial and Functional wizards to change providers, authorize a pending service or terminate some open services.

At the beginning of the Authorization wizard, the system will prompt the user to redo the Financial/Functional wizard if there is a discrepancy between current SAVERR information and the information in the Financial wizard. This will also occur if open services were unselected on the Service Request window, which results in data being lost.

8141 Service Request Folder — Authorization Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Service Request folder displays the services on which action is to be taken. Entries in this folder are required before the Authorization wizard can be completed.

For initial applications:

1. Select the Folder icon for Service Request in the Wizards directory.
2. Select the program for which the individual is applying.
3. Select each service for which Form 2101, Authorization for Community Care Services, is to be created. Unselect any marked services on which no Form 2101 is needed. There are no edits in this window to prevent selecting mutually exclusive services.
4. When all requested services are selected, select the Folder icon for the Authorization wizard in the Wizards directory.

For updates, additions or changes:

1. Select the Folder icon for Service Request in the Wizards directory.
2. Select each service in which changes will be made. Unselect any marked services on which no changes occur. There are no edits in this window to prevent selecting mutually exclusive services.
3. When all requested services are selected, move to the Folder icon for the Authorization wizard in the Wizards directory.

8142 Eligibility Details Window — Authorization Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Eligibility Details window displays the results of the financial and functional eligibility determination. A green check mark indicates that the individual is eligible for a specific service. A red X indicates that the individual is not eligible for a specific service.

White radio buttons in the window default to one of the following for each service:

• Accept if the individual or applicant is eligible for a particular service.
• Reject if the individual or applicant is not eligible for a particular service.
• Terminate if the individual is no longer eligible for a particular service and there is an open service authorization.

To indicate the action to be taken for each service, change the radio buttons as follows:

1. Select Reject if the applicant didn't request the service, and there is no open service authorization.
2. Select Deny if the applicant requested to be screened for a particular service, and Reject is displayed.
3. Select Provider Transfer if the individual has requested a new provider for an ongoing service. Do not select Provider Transfer for an ongoing CAS service authorization when an agency transfer is completed in conjunction with an annual assessment.
4. Select Terminate if there is an open authorization for a service and the service needs to be discontinued.
5. Select NEXT.

8143 Service Code Selection Window — Authorization Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Service Code Selection window displays only if PAS, RC or SSPD are selected on the Service Request window.

1. Select one service code for each requested service. If the service being authorized is CDS-related, choose the service code under the CDS column. Only one code can be selected per category.

Note: Continue to authorize both RC and room and board at annual reassessment for those RC individuals who were authorized for RC before Sept. 1, 2003, and who did not have adequate income to pay their full room and board fee. When reauthorizing RC services for these individuals, be sure to select the room and board option for the appropriate living arrangement. For example, when authorizing 19K – RC Apartment, select 19O – RC – Room and Board – Apt.

2. Select NEXT.

8144 Service Arrangement Window — Authorization Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Service Arrangement window displays a list of services as marked on the Service Request window. For each service:

1. Select View Provider if a new provider will be selected for an initial or ongoing authorization, or if there is a change in the provider delivering a service.

Notes:

• When authorizing RC services and room and board for those individuals authorized for RC prior to Sept. 1, 2003, be sure to select View Provider for both the RC and room and board authorizations.
• When authorizing CDS, Service Code 63V will also appear with Service Code 17V.

2. Select Client, Doctor or Rotation to indicate how the provider is to be selected. The field defaults to Client, but is editable.
3. Select the county in which the individual will receive the service. The field defaults to the county in the SASO location folder, but is editable.
4. Select NEXT.

8145 Provider Selection Window — Authorization Wizard — CCSE

Revision 17-1; Effective March 15, 2017

A Provider Selection window displays when View Provider is selected on the Service Arrangement window. All providers for a particular service in the selected county will display in alphabetical order by name. If the service being authorized is CDS-related, the wizard will display only those contract providers that are CDS for that service and program group and county.

1. Select the provider to deliver services by using the arrow keys on the computer keyboard or by using the Enter key.
2. When the red arrow is pointing to the correct provider, double click on the provider name or contract number. Information about the selected provider name will display at the top of the screen.

Note: When authorizing RC room and board individuals authorized for RC prior to Sept. 1, 2003, be sure to select the same provider selected for the RC service.

3. Select NEXT.

8146 Worker's BJN and Nurse's BJN Window — Authorization Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Worker's BJN and Nurse's BJN window displays in read-only mode the worker information from the Ownership folder. When the nurse is completing the service authorization, the nurse's BJN displays in read-only mode.

Select NEXT.

8147 Information for Authorize Window — Authorization Wizard — CCSE

Revision 20-3; Effective September 1, 2020

The Information for Authorize window collects data for case workers and nurses to complete the service authorization. A separate window displays for each service to be authorized or terminated. Unique fields display on service-specific windows.

Type Authorization is displayed for each service. Type authorizations that require nurse action are:

• Authorize Initial — CAS or DAHS
• Refer Update — CAS at annual reassessment

Type authorizations that require case worker action are:

• Refer Initial — PHC, CAS and DAHS
• Authorize Initial — All services except CAS and DAHS
• Authorize Update — All services
• Refer Update — CAS with or without changes at annual reassessment
• Authorize Terminate

1. Edit the date Form 2101, Authorization for Community Care Services, is mailed to the contracted agency in the Form 2101 field. The system defaults to today's date. Edit the date, if necessary, for the mail date.
2. For the Begin Date field, enter information according to the following:
   1. PHC:
      • Initial Referral — Pending, the case worker leaves the Begin Date field blank.
      • Authorization — The case worker enters the mail date (Same as Item #1) in the Begin Date field.
   2. CAS:
      • Initial Referral — Pending, the case worker leaves the Begin Date field blank.
      • Authorization — The HHSC nurse enters the mail date (same as Item #1) in the Begin Date field.
   3. DAHS:
      • Initial Referral — Pending, the case worker leaves the Begin Date field blank.
      • Authorization of Case Worker Referral — The HHSC nurse enters the mail date in the Begin Date field.
      • Authorization of Facility Initiated Referral — The HHSC nurse enters the date of the physician's orders in the Begin Date field.
   4. For initial referrals other than PHC, DAHS or CAS, the case worker enters the effective date of the authorization in the Begin Date field. Note: This date should match the effective date on Form 2065-A, Notification of Community Care Services.
   5. For updates, the case worker enters the date the change is to be effective in the Begin Date field. The wizard will automatically close an open authorization for that same service effective the day before the begin date on the updated authorization.
   6. For reassessments other than CDS, complete the Begin Date field according to the following:
      • For PHC reassessments with changes in services, the case worker enters the effective date of the change in the Begin Date field.
      • For CAS reassessments without changes (pending), the case worker leaves the Begin Date field blank.
      • For CAS reassessments with changes, the nurse enters the effective date of the change in the Begin Date field.
      • For CDS reassessments, the case worker enters the day following the end date of the previous authorization in the Begin Date field.
3. For the End Date field, the case worker enters information according to the following:
   1. For initial authorizations other than CDS authorizations, leave the End Date field blank.
   2. For CDS authorizations, the end date will pre-populate to be one year minus a day from the date entered in the Begin Date field.
   3. For terminations, enter the date the contracted agency is no longer authorized to deliver services in the End Date field.
4. Select the termination reason from the drop-down menu.
5. The Unit Type field will default to the correct unit type for that service. If the Unit Type field is activated, select the unit type for the service from the drop-down menu.
6. The Adj. Units field will default to the number of units for that service. If the Adj. Units field is activated, the number of units can be edited.

• For 28-SSPD, type the number of units per week for day care, counseling or interpreter services in the Adj. Units field.
• For 28A-SSPD Case Management, type 1 in the Adj. Units field.
• For RC room and board for those persons authorized prior to Sept. 1, 2003, type the difference between the current room and board amount and the individual's income in the Adj. Units field.

7. Select the PAS Incr. Approved field if supervisor approval is needed for increased hours.
8. Select the living arrangement from the drop-down menu.
9. If the person meets criteria for Money Follows the Person (MFP), select Rider 37 from the Enrolled From drop-down menu. If the person does not meet Rider 37 criteria, completion of this field is optional. Warning: Do not select "Nursing Facility" in this field for persons who meet MFP criteria.
10. For RC services, type the dollar amounts of the initial and ongoing co-payment in the appropriate fields.
11. Type documentation or comments to the provider agency in the Comments field.
12. For all PAS, enter the number of days the person is requesting services and if the person requires a specific schedule.
13. Enter the caregiver name and tasks performed, SASO Form 2060, Needs Assessment Questionnaire and Task/Hour Guide, will be sent to the provider containing that information.
14. Enter the name of any person who should not be hired and designate as "Do Not Hire."
15. Select the service authorization status from the drop-down menu:
    1. Select Authorize if:
       • initial services are being authorized by a nurse or a case worker; or
       • changes to the service plan are being authorized by a nurse or a case worker.
    2. Select Terminate if:
       • existing services are being closed by a nurse or a case worker; or
       • the "flavor" of a service is being changed based on fund type.
    3. Select Deny if:
       • initial PHC is being denied by a case worker; or
       • initial CAS or DAHS is being denied by a nurse.
    4. Select Pending if:
       • a case worker is referring a case to the provider for pre-initiation activities; or
       • the case worker completes an annual reassessment for CAS without changes.
    5. Select Reassessment Required if a nurse is requesting the case worker to reassess the case.
16. Type documentation or comments to the provider agency in the Comments field.
17. Select No Order/Statement or No medical need, if appropriate.
18. Type the name of the practitioner in the Name field.
19. Type the phone number of the practitioner in the Phone field.
20. Type the license number of the practitioner in the Lic No field.
21. Type the date of the practitioner's orders in MM/DD/YYY format in the Order Dt field.
22. Type up to five diagnosis codes in the numbered Diagnosis fields for DAHS. Each diagnosis code should have five characters.
23. Select NEXT.

8148 Information for Terminate Window — Authorization Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Information for Terminate window displays the services selected for termination on the Eligibility Details window.

1. The Form 2101, Authorization for Community Care Services, Date field defaults to the current date. This field is editable.
2. Type the end date of the service in the End Date field.
3. Select the termination reason from the drop-down menu.
4. Submit.

The system messages the user if changes in the functional assessment are needed based on the denial reason selected.

8149 Authorization Summary Window (Read Only) — Authorization Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Authorization Summary window displays the services that have been referred, authorized or terminated and the authorization status in read-only mode.

1. Select Generate once the Authorization wizard is complete.
2. Submit.

Note: When terminating an AFC or RC authorization, a pop-up message displays indicating there is an open Applied Income/Co-pay record that must be closed manually as a Force.

8150 Nurse Authorizations Using the Wizards — CCSE

Revision 17-1; Effective March 15, 2017

8151 Nurse Entries to Authorize Initial DAHS or CAS Using the Wizards — CCSE

Revision 17-1; Effective March 15, 2017

To authorize initial DAHS or CAS, the nurse must:

1. Run the Authorization wizard, including completing the Information for Authorize PAS (PHC/FC) window.
2. Submit.

When DAHS is authorized for an individual who is also receiving CLASS, DAHS is the secondary service. SASO recognizes DAHS as an overlapping service with CLASS, and no Force is required.

8152 Nurse Entries to Authorize Changes in CAS Using Wizards — CCSE

Revision 17-1; Effective March 15, 2017

To authorize changes in CAS at the annual reassessment, the nurse must:

1. Run the Authorization wizard, making any changes in the Information for Authorize PAS (PHC/FC) window.
2. Submit.

8160 Changes to CCSE Authorizations Using the Wizards

Revision 17-1; Effective March 15, 2017

The wizards will process most changes and will update all required SASO records. The wizards cannot process an action requiring a Force.

8161 Form 2060 Score Changes Using the Wizards — CCSE

Revision 17-1; Effective March 15, 2017

If the individual's Form 2060, Needs Assessment Questionnaire and Task/Hour Guide, score changes:

1. Select all currently open services in the Service Request window.
2. Run the Functional wizard, making changes as needed, including setting the date for Form 2060.
3. Submit by selecting the Submit button on the toolbar.
4. Run the Authorization wizard.
5. Submit.

8162 Adding, Changing or Terminating Services Within Service Group 7 Using the Wizards — CCSE

Revision 17-1; Effective March 15, 2017

Note: Generate and submit the Monitoring wizard before changes are made to services in the Authorization wizard.

1. Select the services to be added, changed or terminated in the Service Request window. The system will prompt the user to redo the Financial wizard if there is a discrepancy between current SAVERR information and the information in the Financial wizard. If needed, make changes to the Functional Wizard.
2. If changes were made in the Financial or Functional wizard, be sure to submit.

Making Changes Using the Authorization Wizard

The Authorization wizard can be accessed directly without going through the Financial and Functional wizards to change providers, authorize a pending service or terminate some open services.

1. In the Service Request folder, select each service in which changes will be made. Unselect any marked services on which no changes occur. There are no edits in this window to prevent selecting mutually exclusive services.
2. When all requested services are selected, move to the Folder icon for the Authorization wizard in the Wizards directory.
3. The Eligibility Details window displays the results of the financial and functional eligibility determination. A green check mark indicates that the individual is eligible for a specific service. A red X indicates that the individual is not eligible for a specific service.
4. The Service Code Selection window displays only if PAS, Respite, RC or SSPD are selected on the Service Request window.
5. Select one service code for each requested service. If the service being authorized is CDS-related, choose the service code under the CDS column. Only one code can be selected per category.
6. The Service Arrangement window displays a list of services as marked on the Service Request window. For each service, view and select a provider. All providers for a particular service in the selected county will display in alphabetical order by name. If the service being authorized is CDS-related, the wizard will display only those contract providers that are CDS for that service and program group and county. When the red arrow is pointing to the correct provider, double click on the provider name or contract number. Information about the selected provider name will display at the top of the screen.
7. The Information for Authorize window collects data for case workers and nurses to complete the service authorization. A separate window displays for each service to be authorized or terminated.

Changes — RC Using the Wizards

Case workers can terminate the services that are mutually exclusive at the same time that they authorize Assisted Living (AL)/RC by selecting Terminate for those services. For RC, the wizard will close the Applied Income/Co-pay record when the end date is a future date. The wizard will not close the Applied Income/Co-pay record when terminating RC services with a prior end date.

After terminating the RC service authorization using the wizard:

1. Open the Applied Income/Co-pay Folder and select the open co-pay record.
2. Click on the Force box (it contains a check mark). Enter comments in the pop-up box and click on Unforce.
3. Enter the end date used to terminate RC in the End Date field.
4. Click on the Force box again (this time there is no check mark in the box). Enter comments, click on Force and Submit.

The following instructions are for individuals who were authorized for services before Sept. 1, 2003, and who did not have adequate income to pay their full room and board fee.

For these individuals, the user must choose AL/RC, along with AL/Room and Board, in the Service Request window.

• Select SC 19N – RC – Room and Board – Non-Apt when the service being authorized is RC Non-Apt.
• Select 19O – RC – Room and Board – Apt when the service being authorized is RC Apt.

In the Information for Authorize window, enter the difference between the current room and board fee and the individual's current income in the Adj. Units field. Example: The individual's current income is $300 per month and the current room and board amount is $398.54. Enter $98.54 in the Adj. Units field ($398.54 − $300 = $98.54).

• Type the date the individual is authorized to receive RC services in the Begin Date field. Leave the End Date field at default zeros.
• Type the RC provider contract number in the Contract No field. Do not type leading zeros.
• Select Submit from the Command Menu or the toolbar to submit the authorization.

An RC individual can reserve his space in the facility during hospital, nursing facility or institutional stays.

To register a service authorization for RC bedhold charges:

1. Select 19H-ASSISTED LIVING BEDHOLD from the drop-down list in the Service Code field.
2. Type the date the individual entered the hospital, nursing facility, etc. in the Begin Date field. Type the day before the individual was discharged from the hospital or nursing facility in the End Date field.
3. Type the RC provider contract number in the Contract No field. Do not type leading zeros.
4. Select Submit from the Command Menu or the toolbar to submit the authorization.

Changes — Transfers Between Programs

If the individual is transferring from FC to PHC, the wizard will detect the individual's eligibility for Title XIX funding and close the Title XX eligibility record, if required. The Service Authorization record will remain open.

If the individual is transferring from CAS to PHC or vice versa based on a fund code change, the wizard will detect the individual's eligibility, but will not close the Service Authorization record. In this situation, terminate the Service Authorization record, and then run the Financial, Functional and Authorization wizards to redo the Service Authorization record.

Other Changes

If the individual record has been denied in the Authorization wizard based on No Medical Need or No Order/Statement, the Functional wizard will detect the reason and fail the individual for PHC or CAS. In this situation, run the Authorization wizard to remove the selection, and then run the Functional and Authorization wizards.

If the individual's financial eligibility changes in the Financial wizard, the Functional wizard must be run to ensure that Form 2101, Authorization for Community Care Services, prints properly.

8163 Case Worker/Nurse Changes Using the Wizards — CCSE

Revision 17-1; Effective March 15, 2017

When the individual is assigned to another case worker/nurse, follow the instructions for editing the Case Ownership record. When the case worker/nurse runs the Authorization wizard, the Authorizing Agent record will be populated with information from the Case Ownership record.

8164 Change in Provider Agency Using the Wizards — CCSE

Revision 17-1; Effective March 15, 2017

To record a change in provider agency:

1. Select each service that will have a provider change in the Service Request window.
2. Select the Authorization wizard. Select View Provider on the Service Arrangement window so that the Provider Selection window will display. Select the new provider.
3. In the Information to Authorize window, enter the first day the new provider is authorized to deliver services in the Begin Date field. Select Authorize in the Service Authorization Status field. Select Next.
4. Submit.

8165 Change in Co-Pay Using the Wizards — CCSE

Revision 17-1; Effective March 15, 2017

When the co-pay changes:

1. Select all currently open services in the Service Request window.
2. Run the Functional wizard, making changes as needed.
3. Submit by selecting the Submit button on the toolbar.
4. Run the Authorization wizard, making any change in co-pay amounts on the Information for Authorize window.
5. Submit.

8166 Deleting a Registered Task Using the Wizards — CCSE

Revision 17-1; Effective March 15, 2017

To delete a registered task:

1. Select all currently open services in the Service Request window.
2. Run the Functional wizard, making changes as needed.
3. Submit by selecting the Submit button on the toolbar.
4. Run the Authorization wizard.
5. Submit.

8167 Increases or Decreases in the Number of Units Using the Wizards — CCSE

Revision 17-1; Effective March 15, 2017

When a service plan change results in an increase or decrease in the number of units:

1. Select all currently open services in the Service Request window.
2. Run the Functional wizard, making changes as needed.
3. Submit by selecting the Submit button on the toolbar.
4. Run the Authorization wizard.
5. Submit.

8168 Priority Changes Using the Wizards — CCSE

Revision 17-1; Effective March 15, 2017

The wizards automatically determine the individual's priority level and display the level on the CCSE Attendant Hours Adjustment window.

To change an individual from Priority to Non-Priority:

1. Select all currently open services in the Service Request window.
2. Run the Functional wizard, making changes as needed, including changing the priority level on the CCSE Attendant Hours Adjustment window.
3. Submit by selecting the Submit button on the toolbar.
4. Run the Authorization wizard.
5. Submit.

8168.1 Retroactive PHC and CAS Authorizations Using the Wizards — CCSE

Revision 17-1; Effective March 15, 2017

The wizards will not handle retroactive PHC authorizations at this time. See 8200, Authorizing CCSE Services Without Using the Wizards, and 8270, Primary Home Care (PHC) Without the Wizards.

8169 Transfers from Service Group 7 to Another Service Group Using the Wizards — CCSE

Revision 17-1; Effective March 15, 2017

If the individual transfers to another Service Group:

1. Use the wizards to close all Service Group 7 services. See 8162, Adding, Changing or Terminating Services Within Service Group 7 Using the Wizards — CCSE, for instructions.
2. Create an authorization for the new service group using instructions for that service.

8170 Monitoring Wizard

Revision 17-1; Effective March 15, 2017

The Monitoring wizard prompts the user through windows required to complete monitoring contacts. Some windows are conditional and will display only if needed. The Monitoring wizard can be used with open services and with services/programs that the individual wants to add. Process the Monitoring wizard before running the Authorization wizard to terminate services.

1. Complete the Service Request window to confirm services to be monitored.
2. Select the Folder icon for Monitoring wizard in the Wizards directory.
3. Progress through the wizard by completing the entries in each window, then select NEXT.

8171 Service Request Window — Monitoring Wizard

Revision 17-1; Effective March 15, 2017

The Service Request window is completed to confirm which services are to be monitored.

1. Select the program that is to be monitored.
2. Select each service for which a monitoring contact is to be made. Unselect any services not to be monitored. There are no edits in this window to prevent selecting mutually exclusive services
3. Select the Folder icon for the Monitoring wizard in the Wizards directory.

8172 Services Authorized Window — Monitoring Wizard— CCSE

Revision 17-1; Effective March 15, 2017

The Services Authorized window operates in two modes: initial and follow-up. The window displays all services selected on the Service Request window.

For an initial monitoring:

1. Unselect any service that is not to be monitored by clicking to remove the U next to that service.
2. For open services, the current provider number will be entered by default. This field is editable. If a service is not currently open, type the provider number to be printed on the monitoring report. If the provider number is left blank, the system will default to all zeros.
3. Select NEXT.

For a follow-up monitoring:

The window displays a read-only copy of the selections made at the initial monitoring.

Select NEXT.

8173 Contact Window — Monitoring Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Contact window displays information about the most recent monitoring contact.

For an initial monitoring:

1. Select Clear Monitoring to delete previous information from all of the screens in the Monitoring wizard.
2. Select the primary contact and location specific to the current monitoring contact.
3. The Interview Date box displays the current date. Type a different date in the box, if necessary.
4. Select a reason for monitoring contact. Type any comments in the box provided.
5. Select NEXT.

8174 Monitor Detail Window — Monitoring Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Monitor Detail window displays a line for each service to be monitored. Different fields are enabled depending on whether the monitoring contact is an initial or a follow-up contact.

For an initial monitoring contact:

1. Highlight the service to be monitored by using the mouse to move the arrow to the correct line.
   • Select Add to insert a new line for the service highlighted.
   • Select Delete to remove an entire line.
2. Select Problems Alleged if the individual expresses dissatisfaction with a service.
3. If the user is familiar with the reason and action codes:
   • Select the reason(s) for dissatisfaction and the action(s) to be taken from the drop-down menus.
   • Type comments in the box provided. A separate comment box is available for each action selected.
   • Repeat the process for each service to be monitored.
   • Select NEXT.
4. If the user is not familiar with the reason and action codes:
   • Select NEXT without selecting reason(s) and action(s).
   • If no reason(s) or action(s) are selected, the wizard will display the Reasons for Dissatisfaction window and the Actions Selection window where those selections can be made.

For a follow-up monitoring contact:

1. Highlight the service selected for follow-up by using the mouse to move the arrow to the correct line.
2. If findings in the follow-up contact concur with the initial findings:
   • Select Y in the Concur w/previous field.
   • Select NEXT.
3. If findings in the follow-up contact do not concur with the initial findings:
   • Select N in the Concur w/previous field.
   • Select Problems Alleged to record additional or different reasons for individual dissatisfaction.
   • If the user is familiar with the reason and action codes:
     • Select the reason(s) for dissatisfaction and the action(s) to be taken from the drop-down menus.
     • Type comments in the box provided. A separate comment box is available for each action selected.
     • Repeat the process for each service to be monitored.
     • Select NEXT.
   • If the user is not familiar with the reason and action codes, select NEXT without selecting reason(s) or action(s).
   • If no reason(s) or action(s) are selected, the wizard will display the Reasons for Dissatisfaction window and the Actions Selection window where those selections can be made.
4. If the individual has selected the CDS option or has a "flavor" of service (e.g. CAS, Service Code 17D), type this information in the Comments box.
5. Select NEXT.

8175 Reasons for Dissatisfaction Window — Monitoring Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Reasons for Dissatisfaction window displays for each service where Problems Alleged is marked, but no reason has been selected on the Monitor Detail window.

The choices displayed at the top of the window are referred to as reason groups. The individually numbered reasons displayed in the middle of the window are reason items.

1. Highlight the reason group that best categorizes the individual's dissatisfaction by using the mouse to move the arrow to the correct line.
2. Select the reason item(s) that best explain the individual's dissatisfaction. A different list of reason items displays for each reason group. U will appear beside the selected items only after both a reason group and a reason item have been selected.
3. Type comments in the box provided.
4. Select NEXT.

8176 Actions Selection Window — Monitoring Wizard — CCSE

Revision 17-1; Effective March 15, 2017

An Action Selection window displays for each reason item selected on the Reasons for Dissatisfaction window.

The reason item displays at the top of the window. The individually numbered actions displayed in the middle of the window are action items.

1. Highlight the reason item by using the mouse to move the arrow to the correct line.
2. Select up to five action items for the reason item highlighted at the top of the screen. U will appear beside the selected items only after both a reason item and at least one action item have been selected.
3. Select NEXT.

8177 Client Satisfaction Window — Monitoring Wizard — CCSE

Revision 17-1; Effective March 15, 2017

The Client Satisfaction window is the last window in the Monitoring wizard.

1. Select Overall Client Satisfaction from the drop-down menu.
2. Select the monitoring status from the drop-down menu. Choose:
   • Pending if the monitoring contact is not yet complete.
   • Follow-up Required if subsequent contacts are necessary.
   • Completed if the monitoring contact is complete.
3. Select Set Date to enter the current date in the Date field. Type a different date in the box, if necessary.
4. If the monitoring status is Pending, select Close and save the case to Draft.
5. If the monitoring status is Follow-up Required or Completed, select Generate, and then Submit.