8200, Authorizing CCSE Services Without Using the Wizard

Revision 17-8; Effective September 1, 2017

All CCSE services except CMPAS can be authorized using the wizards.

CCSE services can also be authorized without using the wizards by manually making entries in each required record. Services authorized without using the wizards will store information in the SASO database, but not in the CCSE database. Manually completed cases will not be included in statistical reports generated from the CCSE database.

Many of the records required for each Community Care service are required by more than one service within the Community Care Service Group. However, only one open record at a time is required regardless of how many services are being authorized with the exception of the Service Authorization record. One Service Authorization record is required for each service.

It is critical that all required records cover all authorization periods. There must be no gaps in dates or overlapping Begin and End dates.

All Service Group 7 records are open-ended. Entries are required only when a change occurs.

8200.1 Individual — CCSE Services Without the Wizards

Revision 17-1; Effective March 15, 2017

The Client Details record will be system generated with information from the SAVERR database or from information entered by the case worker in the Create New Client window.

The Create New Client function should only be used when the case worker has verified that the individual does not have an existing SAVERR number. When the Create New Client function is used, SASO assigns an individual number that will be written to SAVERR within three days. During this time, the SASO record is checked against SAVERR. If the system finds that the individual already has a SAVERR number, the case worker will have to recreate the SASO authorization using the original SAVERR number.

Accurate biographical information must be entered in the Create New Client window to avoid issuance of duplicate numbers.

8200.2 Address Folder — CCSE Services Without the Wizards

Revision 17-1; Effective March 15, 2017

The Address folder records the individual's addresses. Create separate address records to record an individual's home or mailing address (if different than 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). The line automatically 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 second 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.

  1. 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.
  2. Type the city in the City field.
  3. Select the state from the drop-down list in the State field. The system defaults to TX-Texas.
  4. 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 phone 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.

  1. Type the city in the City field.
  2. Select the state from the drop-down list in the State field. The system defaults to TX-Texas.
  3. 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.

8200.3 Authorizing Agent/Case Worker — CCSE Services Without the Wizards

Revision 17-1; Effective March 15, 2017

The case worker Authorizing Agent record is used for identifying who the case is assigned to when generating regional and unit statistical reports. The information in the case worker Authorizing Agent folder will be used in generating the Provider Referral Supplement.

To register a case worker Authorizing Agent record:

  1. Select the Folder icon for Authorizing Agent in the Case Worker directory.
  2. Select Add and the Authorizing Agent record will appear.
  3. Select CW-Case Worker from the drop-down list in the Type field.
  4. Select 7-Community Care from the drop-down list in the Group field.
  5. Select YES if there is no other existing case worker Authorizing Agent record. Select NO if there is another existing record in the Send to TMHP field.
  6. Type the date the case was assigned to the case worker or today's date in the Begin Date field. Leave the End Date field at default zeros.
  7. Type the case worker's BJN in the Auth Agent field. Type the BJN without dashes (for example, 04599C09). For statistical reporting purposes, this is the most important field.
  8. Leave the Agency field at the default selection 324-DHS.
  9. Type the case worker's name in the Name field.
  10. Type the case worker's phone number in the Phone field. Include the area code, phone number and extension. Type "0000" if no extension exists.
  11. Type the case worker's Mail Code (without dashes) in the Mail Code field.

When the Case Worker Changes

When the individual is assigned to another case worker, enter an End Date in the existing case worker Authorizing Agent record and create another record with the new information using these same instructions. To avoid gaps or overlaps in the case worker Authorizing Agent records, the End Date of the existing record should be one day before the Begin Date of the new record.

Currently, although SASO will accept multiple Authorizing Agent records, Texas Medicaid and Healthcare Partnership (TMHP) will only accept two Authorizing Agent records when a SASO file is transmitted to TMHP. Therefore, until this problem is resolved, select NO in the Send To TMHP field for all updates.

8200.4 Eligibility for Title XX Services — CCSE Services Without the Wizards

Revision 17-1; Effective March 15, 2017

One Eligibility record is required for all Title XX Community Care – Service Group 7 authorizations. Only one open record is required regardless of how many Title XX services the individual is receiving.

When the Create New Client function is used to create an initial authorization, the Enrollment and Eligibility records must be submitted to the SASO database before the remaining records are completed.

To register eligibility for Title XX Community Care authorizations:

  1. Select the Folder icon for Title XX Eligibility in the Eligibility directory.
  2. Select Add and the Eligibility record will appear.
  3. Select CC-CCSE-ELIGIBLE from the drop-down list in the Type Elig-Code field.
  4. Type the date the individual is eligible to receive CCSE Title XX services in the Begin Date field. The Begin Date must match the earliest date the Title XX CCSE services are being authorized. Leave the End Date field at default zeros.
  5. Select 7-COMMUNITY CARE from the drop-down list in the Service Group field.
  6. Select A-TITLE XX from the drop-down list in the Category field.
  7. Select 1-TITLE XX from the drop-down list in the Cov. Code field.
  8. Select A-TITLE XX from the drop-down list in the Type Program field.

This record will remain open until the individual stops receiving a Title XX CCSE service.

To close this record:

No changes to this record are required when the individual's Title XX eligibility is reassessed unless the individual is determined to be ineligible. When the individual stops receiving all Title XX services, enter the last day of service in the End Date field.

8200.5 Enrollment — CCSE Services Without the Wizards

Revision 17-1; Effective March 15, 2017

An individual should be enrolled in only one service group at a time. Only one Enrollment record should be open at a time regardless of how many services the individual is receiving. This record will remain open until the individual transfers to another service group or stops receiving Long-term Services and Supports (LTSS).

When the Create New Client function is used to create an initial authorization, the Enrollment and Eligibility records must be submitted to the SASO database before the remaining records are completed.

To register enrollment for Community Care – Service Group 7:

  1. Select the Folder icon for Enrollment in the Program and Service directory.
  2. Select Add and the Enrollment record will appear.
  3. Select 7-COMMUNITY CARE from the drop-down list in the Service Group field.
  4. If the individual meets criteria for MFP, select Rider 37/28 (FAC to COMM) from the Enrolled From drop-down menu. If the individual does not meet MFP criteria, completion of this field is optional. Warning: Do not select Nursing Facility for individuals who meet MFP criteria.
  5. Type the beginning date of Community Care services in the Begin Date field. Leave the End Date field at default zeros.

When Changes Occur

No changes to this record are required if the individual transfers from one service within Community Care (Service Group 7) to another service in Community Care.

If the individual transfers to another service group without an overlap of services, enter the last day the individual received Community Care – Service Group 7 as the End Date of this record.

If the individual transfers to another service group and there was an overlap in services, enter the day the terminated service stopped as the End Date of this record. Create a new record for the new service with a Begin Date of the day the new service started, even if dates overlap.

If the individual stops receiving LTSS, enter the last day the individual received services as the End Date of this record.

8200.6 Location — CCSE Services Without the Wizards

Revision 17-1; Effective March 15, 2017

The Location record is used to register the county and region in which an individual resides. This information is used in statistical reporting by region and county. The individual's county is also matched against a provider agency's list of authorized counties.

When an individual who has never received any HHSC LTSS is registered in SASO, the Location record will be system generated from the information entered on the Create New Client window. The Location record will be created before the service authorization is filed to the HHSC database.

When an individual who has never received any HHSC LTSS is registered in SASO and already has a SAVERR number, the Location record will not be created until the initial individual file is submitted to the HHSC database. Once the service authorization is submitted and filed to the SASO database, the Location record is system generated from information on SAVERR.

Warning: To avoid creating duplicate Location records, the authorizing agent should never add a Location record before the initial individual file is submitted to the HHSC database.

If the county identified in the Location record is incorrect (because the county on SAVERR is actually the guardian's county, the individual has moved or any other reason), the location information must be corrected. SAVERR updates SASO every month on the day after SAVERR cutoff. Therefore, the most effective way to correct the county is to correct the county in SAVERR. Since Medicaid for the Elderly and People with Disabilities (MEPD), Social Security Administration or Texas Works staff must do most of these corrections, timely updates to SAVERR may not be possible. The county information can be corrected in SASO. However, the corrected record must be Forced or SAVERR will rewrite the information at the next SAVERR/SASO reconciliation.

To correct the location information:

  1. Select the Folder icon for Location in the Client directory.
  2. Select the existing open record from the list in the tree directory or the SASO List Data window on the right-hand side of the screen.
  3. Type the day before the new county will be registered in the End Date field.
  4. Select the Folder icon for Location in the Client directory.
  5. Select Add and a blank Location record will appear.
  6. Select the appropriate county from the drop-down list in the County field.
  7. Type the date the new county is being registered in the Begin Date field. Leave the End Date field at default zeros.

In order for SAVERR to not overwrite this record, move to the Force field and set the Force Flag. Enter comments explaining why the record is being forced.

8200.7 Phone — CCSE Services Without the Wizards

Revision 17-1; Effective March 15, 2017

The Phone folder documents an individual's phone number and is mandatory for ERS recipients. 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.

8200.8 Level of Service/Form 2060 — CCSE Services Without the Wizards

Revision 17-1; Effective March 15, 2017

One open Level of Service Form 2060, Needs Assessment Questionnaire and Task/Hour Guide, record is required for individuals receiving Adult Foster Care (AFC), Emergency Response Services (ERS), Family Care (FC), Home-Delivered Meals (HDM), Primary Home Care (PHC), Residential Care (RC) Services and Special Services to Persons with Disabilities (SSPD). Only one record should be open at a time regardless of how many Community Care – Service Group 7 services the individual is receiving. This record is used to document the individual's functional eligibility based on the Form 2060 score.

To register a Form 2060 level of service record:

  1. Select the Folder icon for Level of Service in the Medical directory.
  2. Select Add and the Level of Service record will appear.
  3. Select 20-2060 score from the drop-down list in the Type field.
  4. Select 7-COMMUNITY CARE from the drop-down list in the Service Group field.
  5. Leave the Contract No. field blank.
  6. Type the 2060 score in the Level field.
  7. Type the date the individual is functionally eligible for Community Care – Service Group 7 services in the Begin Date field. The Begin Date must match the earliest date the individual was authorized to begin receiving services. Leave the End Date field at default zeros.

This record remains open until the individual's score changes, the individual transfers to another service group, or the individual stops receiving a service that requires this record.

Retroactive PHC and CAS authorizations:

If the applicant is determined eligible for ongoing services based on the Form 2060 score, type the ongoing 2060 score with a Begin Date of the first day of the retroactive period.

If the applicant is determined ineligible for ongoing services based on the Form 2060 score, type 24 as the 2060 score with the Begin Date and End Date for the retroactive period.

Create a second Level of Service record for the individual's priority level. Always use Level 1, Non-Priority, with a Begin Date of the first day of the retroactive period.

When the Form 2060 score changes:

If the individual's Form 2060 score changes, enter an End Date in the existing open 2060 Level of Service record. Using these same instructions, add another record with the new information. To avoid gaps or overlaps in the records, the End Date of the existing record should be one day before the Begin Date of the new record.

When the individual transfers to another service within Service Group 7:

If this record is required for the new service, leave the record open. If the individual stops receiving all services that require a 2060 Level of Service record, enter the last day the individual received services as the End Date.

When the individual transfers to another service group:

If the individual transfers to another service group, enter the last day the individual received services as the End Date.

8210 Adult Foster Care (AFC) Without the Wizards

Revision 17-1; Effective March 15, 2017

The following records are either system generated or created by the case worker to authorize AFC – Service Code 18. Detailed instructions for completing each record are found in 8200, Authorizing CCSE Services Without Using the Wizards, and in this section.

When the Create New Client function is used for an initial service authorization, the Enrollment and Eligibility records must be submitted to the SASO database before the remaining records are completed. In all other situations, all the records may be completed before submitting to the SASO database.

  • Individual
  • Address
  • Authorizing Agent – Case Worker
  • Eligibility
  • Enrollment
  • Location
  • Phone
  • Level of Service – Form 2060, Needs Assessment Questionnaire and Task/Hour Guide
  • Service Authorization

Do not create a co-payment record for CCSE AFC individuals. CCSE AFC individuals pay room and board but do not pay a co-payment. Room and board is an agreement between the individual and the provider. It is not registered in SASO.

8211 Service Authorization — AFC Services Without the Wizards

Revision 17-1; Effective March 15, 2017

To register a service authorization for AFC:

  1. Select the Folder icon for Service Authorization in the Program and Service directory.
  2. Select Add and the Service Authorization record will appear.
  3. Select 7-COMMUNITY CARE from the drop-down list in the Service Group field.
  4. Select 18-ADULT FOSTER CARE from the drop-down list in the Service Code field.
  5. Leave the Agency field at the default selection 324-DHS.
  6. Select 5-DAILY from the drop-down list in the Unit Type field.
  7. Type 1 in the Units field.
  8. Type the date the individual is authorized to receive AFC services in the Begin Date field. Leave the End Date field at default zeros.
  9. Type the AFC provider contract number in the Contract No. field. Do not type leading zeros.
  10. Select Submit from the Command Menu or the toolbar to submit the authorization.

See 8300, Changes to CCSE Authorizations Without the Wizards, for instructions for making changes to this record.

8220 Consumer Managed Personal Attendant Services (CMPAS) Without the Wizards

Revision 17-1; Effective March 15, 2017

The following records are either system generated or created by the case worker to authorize CMPAS – Service Code 27. Detailed instructions for completing each record are found in 8200, Authorizing CCSE Services Without Using the Wizards, and in this section.

When the Create New Client function is used for an initial service authorization, the Enrollment and Eligibility records must be submitted to the SASO database before the remaining records are completed. In all other situations, all the records may be completed before submitting to the SASO database.

  • Individual
  • Address
  • Authorizing Agent – Contract Manager
  • Authorizing Agent – Agency
  • Eligibility
  • Enrollment
  • Location
  • Phone
  • Applied Income – Co-pay
  • Service Authorization – Agency Model
  • Service Authorization – CDS Model

8221 Authorizing Agent/Contract Manager — CMPAS Services Without the Wizards

Revision 17-1; Effective March 15, 2017

To register a contract manager Authorizing Agent record:

  1. Select the Folder icon for Authorizing Agent in the Case Worker directory.
  2. Select Add and the Authorizing Agent record will appear.
  3. Select OT-OTHER from the drop-down list in the Type field.
  4. Select 7-Community Care from the drop-down list in the Group field.
  5. Select YES if there is no other existing contract manager Authorizing Agent record, and select NO if there is an existing record in the Send to TMHP field.
  6. Type the first date of service or today's date in the Begin Date field. Leave the End Date field at default zeros.
  7. Type the contract manager's BJN in the Auth Agent field. Type the BJN without dashes (for example, 04599C09). For statistical reporting purposes, this is the most important field.
  8. Leave the Agency field at the default selection 324-DHS.
  9. Type the contract manager's name in the Name field.
  10. Type the contract manager's phone number in the Phone field. Include the area code, phone number and extension. Type 0000 if no extension exists.
  11. Type the contract manager's Mail Code in the Mail Code field.

8222 Authorizing Agent/Agency — CMPAS Services Without the Wizards

Revision 17-1; Effective March 15, 2017

To register an agency Authorizing Agent record:

  1. Select the Folder icon for Authorizing Agent in the Case Worker directory.
  2. Select Add and the Authorizing Agent record will appear.
  3. Select OT-OTHER from the drop-down list in the Type field.
  4. Select 7-Community Care from the drop-down list in the Group field.
  5. Select YES in the Send to TMHP field.
  6. Type the date the case was assigned to the agency or today's date in the Begin Date field. Leave the End Date field at default zeros.
  7. Type Direct in the Auth Agent field.
  8. Leave the Agency field at the default selection 324-DHS.
  9. Type the name of the CMPAS provider agency in the Name field.
  10. Type the telephone number of the CMPAS provider agency in the Phone field.

Agency Changes

When the individual transfers to another agency, enter an End Date in the existing agency Authorizing Agent record. Using these same instructions, add another record with the new information.

8223 Applied Income/Co-Pay — CMPAS Services Without the Wizards

Revision 17-1; Effective March 15, 2017

This record registers the co-pay for CMPAS. If the co-pay for the initial month in which the CCSE individual receives CMPAS is prorated, then two Applied Income records must be created. The CCSE case worker will register the prorated co-pay amount in the first record and create a second record to register the ongoing co-pay amount. If one of these records is for a month prior to the month the information is being entered, a Force is required.

To register initial co-pay information for a CMPAS individual:

  1. Select the Folder icon for Applied Income in the Program and Service directory.
  2. Select Add and the Applied Income/Co-pay record will appear.
  3. Select CO-CO-PAY (AMOUNT OR PERCENTAGE) from the drop-down list in the A/I Type field.
  4. Select 2-CO-PAY (PERCENTAGE) from the drop-down list in the Co-Pay Type.
  5. Type the percentage of the cost of services that the individual is responsible for paying in the Percent field.
  6. Type the date that the individual is responsible for paying the percentage of the cost of services in the Begin Date field. Leave the End Date field at default zeros.

Co-Pay Changes

When the co-pay changes, enter an End Date in the existing Applied Income record. Using these same instructions, create another record with the new information.

8224 Service Authorization/Agency Model — CMPAS Services Without the Wizards

Revision 17-1; Effective March 15, 2017

To register a service authorization for a CMPAS individual using the Agency Model:

  1. Select the Folder icon for Service Authorization in the Program and Service directory.
  2. Select Add and the Service Authorization record will appear.
  3. Select 7-COMMUNITY CARE from the drop-down list in to the Service Group field.
  4. Select 27-CLIENT MANAGED ASSISTED SERVICES from the drop-down list in the Service Code field.
  5. Leave the Agency field at the default selection 324-DHS.
  6. Select 1-WEEK from the drop-down list in the Unit Type field.
  7. Type the number of hours per week of CMPAS services the individual is authorized to receive in the Adj. Units field.
  8. Type the date the individual is authorized to receive CMPAS services in the Begin Date field. Leave the End Date field at default zeros.
  9. Type the CMPAS provider contract number in the Contract No field. Do not type leading zeros.
  10. Select Submit from the Command Menu or the toolbar to submit the authorization.

See 8300, Changes to CCSE Service Authorizations Without the Wizards, for instructions for making changes to this record.

8225 Service Authorization/CDS Model — CMPAS Services Without the Wizards

Revision 17-1; Effective March 15, 2017

To register a service authorization for a CMPAS individual using the CDS Model:

  1. Select the Folder icon for Service Authorization in the Program and Service directory.
  2. Select Add and the Service Authorization record will appear.
  3. Select 7-COMMUNITY CARE from the drop-down list in to the Service Group field.
  4. Select 27A-CMPAS Consumer Directed Services from the drop-down list in the Service Code field.
  5. Leave the Agency field at the default selection 324-DHS.
  6. Select Y – Per Auth from the drop-down list in the Unit Type field.
  7. Type the number of dollars per year of CMPAS services the individual is authorized to receive in the Adj. Units field.
  8. Type the date the individual is authorized to receive CMPAS services in the Begin Date field. Leave the End Date field at default zeros.
  9. Type the CMPAS provider contract number in the Contract No field. Do not type leading zeros.
  10. Select Submit from the Command Menu or the toolbar to submit the authorization.

See 8300, Changes to CCSE Service Authorizations Without the Wizards, for instructions for making changes to this record.

8230 Day Activity and Health Services (DAHS) Without the Wizards

Revision 17-1; Effective March 15, 2017

The following records are either system generated or completed by the CCSE case worker and the HHSC regional nurse for Title XIX and Title XX DAHS – Service Code 29 authorizations.

When the Create New Client function is used for an initial service authorization, the Enrollment and Eligibility records must be submitted to the SASO database before the remaining records are completed. In all other situations, all the records may be completed before submitting to the SASO database.

Using the instructions in 8200, Authorizing CCSE Services Without Using the Wizards, the CCSE case worker completes these records:

  • Individual
  • Address
  • Authorizing Agent – Case Worker
  • Eligibility for Title XX DAHS Only
  • Enrollment
  • Location
  • Phone

Using the following instructions, the HHSC nurse completes these records to create an authorization for Title XIX or Title XX DAHS:

  • Diagnosis
  • Authorizing Agent – Nurse
  • Authorizing Agent – Practitioner
  • Service Authorization

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.

8231 Diagnosis — DAHS Services Without the Wizards

Revision 17-6; Effective June 28, 2017

To register diagnosis code(s) for a Title XIX or Title XX DAHS individual:

  1. Select the Folder icon for Diagnosis in the Medical directory.
  2. Select Add and the Diagnosis record will appear.
  3. Select 7-COMMUNITY CARE in the Service Group field.
  4. Type the date the diagnosis codes are effective in the Begin Date field. For an initial case, this is the date the individual is approved for Title XIX or Title XX DAHS services. Leave the End Date field at default zeros.
  5. Type the numeric code(s) for the individual's primary diagnosis in the Diagnosis fields. If the individual has additional diagnoses from practitioner's orders for PHC, list all diagnosis codes. Up to five diagnoses codes can be entered. There should be only one Diagnosis record for Service Group 7, even if the individual is receiving both PHC and DAHS.
  6. Select 10-ICD-10-CM CODE from the drop-down list in the Version field.

This record will remain open until the individual stops receiving a service that requires this record or there is a change in diagnosis.

8232 Authorizing Agent/Nurse — DAHS Services Without the Wizards

Revision 17-1; Effective March 15, 2017

To register a nurse authorizing agent for a Title XIX or Title XX DAHS individual:

  1. Select the Folder icon for Authorizing Agent in the Case Worker directory.
  2. Select Add and the Authorizing Agent record will appear.
  3. Select NU-NURSE from the drop-down list in the Type field.
  4. Select 7-COMMUNITY CARE from the drop-down list in the Group field.
  5. Select YES if there is no other existing nurse Authorizing Agent record in the Send to TMHP field. Select NO if there is another existing record.
  6. Type the date this individual was assigned to the nurse or the date of the Enrollment record in the Begin Date field. Leave the End Date field at default zeros.
  7. Move to the Auth Agent field and enter the BJN for the nurse.
  8. Leave the Agency field at the default selection 324-DHS.
  9. Type the nurse's name in the Name field.
  10. Type the nurse's phone number in the Phone field. Type the area code, phone number and extension. Type 0000 if no extension exists.
  11. Type the nurse's Mail Code in the Mail Code field.

This record will remain open until the case is assigned to another nurse, the individual transfers to another service that does not require this record or the individual stops receiving services.

Nurse Changes

When the individual is assigned to another nurse, enter an End Date in the existing nurse Authorizing Agent record. Using these same instructions, create another record with the new information. To avoid gaps or overlaps in the nurse Authorizing Agent records, the End Date of the existing record should be one day before the Begin Date of the new record.

Currently, although SASO will accept multiple Authorizing Agent records, TMHP will only accept two Authorizing Agent records when a SASO file is transmitted to TMHP. Until this problem is resolved, select NO in the SEND TO TMHP field for all updates.

8233 Authorizing Agent/Practitioner — DAHS Services Without the Wizards

Revision 17-1; Effective March 15, 2017

The HHSC regional nurse registers the practitioner Authorizing Agent record. If the practitioner authorizing agent is not registered for a Title XIX or Title XX DAHS individual, the authorization will reject.

To register a practitioner Authorizing Agent for a Title XIX or Title XX DAHS individual:

  1. Select the Folder icon for Authorizing Agent in the Case Worker directory.
  2. Select Add and the Authorizing Agent record will appear.
  3. Select P-PRACTITIONER from the drop-down list in the Type field.
  4. Select 7-COMMUNITY CARE from the drop-down list in the Group field.
  5. Leave the Send to TMHP field at the default (blank) or select NO. The practitioner registration does not require an entry in this field.
  6. Type the beginning date of the practitioner's orders in the Begin Date field. Leave the End Date field at default zeros. The Begin Date must be equal to or earlier than the first day the individual is being authorized to receive services.
  7. Enter the practitioner's license number in the Auth Agent field.
  8. Select HHSC from the drop-down list in the Agency field.
  9. Type the practitioner's last name in the Name field.
  10. Type the practitioner's phone number in the Phone field. Type the area code, phone number and extension. Type 0000 if no extension exists.
  11. Leave the Mail Code field blank.

8234 Service Authorization — DAHS Services Without the Wizards

Revision 17-1; Effective March 15, 2017

The HHSC regional nurse completes the Service Authorization record for Title XIX or Title XX DAHS cases when services are approved.

To register a Service Authorization for a Title XIX or Title XX DAHS individual:

  1. Select the Folder icon for Service Authorization in the Program and Service directory.
  2. Select Add and the Service Authorization record will appear.
  3. Select 7-COMMUNITY CARE from the drop-down list in the Service Group field.
  4. Select 29-DAHS from the drop-down list in the Service Code field.
  5. Leave the Agency field at the default selection 324-DHS.
  6. Select 1-WEEK from the drop-down list in the Unit Type field.
  7. Type the number of units per week of DAHS services the individual is authorized to receive in the Adj. Units field.
  8. Type the date the individual is authorized to receive DAHS services in the Begin Date field. Leave the End Date field at default zeros.
  9. Type the DAHS provider contract number in the Contract No field. Do not type leading zeros.
  10. Select Submit from the Command Menu or the toolbar to submit the authorization.

See 8300, Changes to CCSE Authorizations Without the Wizards, for instructions for making changes to this record.

8240 Emergency Response Services (ERS) Without the Wizards

Revision 17-1; Effective March 15, 2017

The following records are either system generated or created by the case worker to authorize ERS – Service Code 20. Detailed instructions for completing each record are found in 8200, Authorizing CCSE Services Without Using the Wizards, and in this section.

When the Create New Client function is used for an initial service authorization, the Enrollment and Eligibility records must be submitted to the SASO database before the remaining records are completed. In all other situations, all the records may be completed before submitting to the SASO database.

  • Individual
  • Address
  • Authorizing Agent – Case Worker
  • Eligibility
  • Enrollment
  • Location
  • Phone
  • Level of Service – Form 2060, Needs Assessment Questionnaire and Task/Hour Guide
  • Service Authorization

8241 Service Authorization — ERS Services Without the Wizards

Revision 17-1; Effective March 15, 2017

To register a Service Authorization for an ERS individual:

  1. Select the Folder icon for Service Authorization in the Program and Service directory.
  2. Select Add and the Service Authorization record will appear.
  3. Select 7-COMMUNITY CARE from the drop-down list in the Service Group field.
  4. Select 20-ERS from the drop-down list in the Service Code field.
  5. Leave the Agency field at the default selection 324-DHS.
  6. Select 2-MONTH from the drop-down list in the Unit Type field.
  7. Type 1 in the Adj. Units field.
  8. Type the date the individual is authorized to receive ERS services in the Begin Date field. Leave the End Date field at default zeros.
  9. Type the ERS provider contract number in the Contract No. field. Do not type leading zeros.
  10. Select Submit from the Command Menu or the toolbar to submit the authorization.

See 8300, Changes to CCSE Authorizations Without the Wizards, for instructions for making changes to this record.

8250 Family Care (FC) Without the Wizards

Revision 17-1; Effective March 15, 2017

The following records are either system generated or created by the case worker to authorize FC – Service Code 17. Detailed instructions for completing each record are found in 8200, Authorizing CCSE Services Without Using the Wizards, and in this section.

When the Create New Client function is used for an initial service authorization, the Enrollment and Eligibility records must be submitted to the SASO database before the remaining records are completed. In all other situations, all the records may be completed before submitting to the SASO database.

  • Individual
  • Address
  • Authorizing Agent – Case Worker
  • Eligibility
  • Enrollment
  • Location
  • Phone
  • Level of Service – Form 2060, Needs Assessment Questionnaire and Task/Hour Guide
  • Level of Service – Priority
  • Service Authorization
  • Service Item

8251 Level of Service/Priority — FC Services Without the Wizards

Revision 17-1; Effective March 15, 2017

All FC individuals must have a priority level registered on the Level of Service record. This record is used to tell the billing system which rate the provider is authorized to use for each individual. SASO will accept the authorization without this record but provider claims will reject.

To register the Priority Level of Service record for an FC individual:

  1. Select the Folder icon for Level of Service in the Medical directory.
  2. Select Add and the Level of Service record will appear.
  3. Select PR-PRIORITY from the drop-down list in the Type field.
  4. Select 7-COMMUNITY CARE from the drop-down list in the Service Group field.
  5. Leave the Contract No. blank.
  6. Type 1 for Non-Priority cases or 2 for Priority cases in the Level field.
  7. Type the date the individual is eligible for this level of service in the Begin Date field. The Begin Date must match the first day the individual is authorized to receive this level of FC services. Leave the End Date field at default zeros.

Priority Changes

When the individual's priority level changes, enter an End Date in the existing record. Using these same instructions, create another record with the new information. To avoid gaps or overlaps in the Priority Level of Service records, the End Date of the existing record should be one day before the Begin Date of the new record.

8252 Service Authorization — FC Services Without the Wizards

Revision 17-1; Effective March 15, 2017

To register a Service Authorization for an FC individual:

  1. Select the Folder icon for Service Authorization in the Program and Service directory.
  2. Select Add and the Service Authorization record will appear.
  3. Select 7-COMMUNITY CARE from the drop-down list in the Service Group field.
  4. Select 17C-PERSONAL ASSISTANCE SERVICES PAS from the drop-down list in the Service Code field.
  5. Leave the Fund field at the default setting. No entry is required in this field unless an individual who is eligible for full Medicaid benefits is being authorized to receive FC. For these situations, a Force is required to change the Fund.
  6. Leave the Agency field at the default selection 324-DHS.
  7. Select 1-WEEK from the drop-down list in the Unit Type field.
  8. Type the number of PAS hours per week the individual is authorized to receive in the Adj. Units field.
  9. Type the date the individual is authorized to receive FC services in the Begin Date field. Leave the End Date field at default zeros.
  10. Type the FC provider contract number in the Contract No field. Do not type leading zeros.

See 8300, Changes to CCSE Authorizations Without the Wizards, for instructions for making changes to this record.

8253 Service Item — FC

Revision 17-1; Effective March 15, 2017

The Service Item record is used to register tasks. At least one task authorized on Form 2101, Authorization for Community Care Services, must be registered for FC. Additional tasks can be registered, if desired.

To register a Service Item record for an FC individual:

  1. Select the Folder icon for Service Item in the Program and Service directory.
  2. Select Add and the Service Item record will appear.
  3. Select 7-COMMUNITY CARE from the drop-down list in the Service Group field.
  4. Select 17-PERSONAL ASSISTANCE SERVICES PAS from the drop-down list in the Service Code field.
  5. Select T-TASK from the drop-down list in the Type field.
  6. Type the two-digit code for one task authorized on Form 2101 in the Item field.
  7. Type the date that the individual is eligible for CCSE services in the Begin Date field. Leave the End Date field at default zeros.
  8. Select Submit from the Command Menu or the toolbar to submit the authorization.

When the individual stops receiving a registered task:

If the individual stops receiving the registered task, enter an End Date in the existing record. Using these same instructions, create another record with another task. To avoid gaps or overlaps in the Service Item records, the End Date of the existing record should be one day before the Begin Date of the new record.

When the individual transfers from FC to PHC:

When an individual transfers from FC to PHC, this record can remain open if the registered task is a personal care task and the individual is still authorized to receive the registered task. If the individual stops receiving PHC or FC, enter the last day of service as the End Date for this record.

8260 Meals Without the Wizards

Revision 17-1; Effective March 15, 2017

The following records are either system generated or created by the case worker to authorize Meals Service – Group 25. Detailed instructions for completing each record are found in 8200, Authorizing CCSE Services Without Using the Wizards, and in this section.

When the Create New Client function is used for an initial service authorization, the Enrollment and Eligibility records must be submitted to the SASO database before the remaining records are completed. In all other situations, all the records may be completed before submitting to the SASO database.

  • Individual
  • Address
  • Authorizing Agent – Case Worker
  • Eligibility
  • Enrollment
  • Location
  • Phone
  • Level of Service – Form 2060, Needs Assessment Questionnaire and Task/Hour Guide
  • Service Authorization

8261 Service Authorization — Meals Services Without the Wizards

Revision 17-1; Effective March 15, 2017

To register a Service Authorization for a Meals Services individual:

  1. Select the Folder icon for Service Authorization in the Program and Service directory.
  2. Select Add and the Service Authorization record will appear.
  3. Select 7-COMMUNITY CARE from the drop-down list in the Service Group field.
  4. Select 25-MEALS from the drop-down list in the Service Code field.
  5. Leave the Agency field at the default selection 324-DHS.
  6. Select 1-WEEK from the drop-down list in the Unit Type field.
  7. Type the number of meals the individual is authorized to receive per week in the Adj. Units field.
  8. Type the date the individual is authorized to receive meals in the Begin Date field. Leave the End Date field at default zeros.
  9. Type the meals provider's contract number in the Contract No field. Do not type leading zeros.
  10. Select Submit from the Command Menu or the toolbar to submit the authorization.

See 8300, Changes to CCSE Service Authorizations Without Using the Wizards, for instructions for making changes to this record.

8270 Primary Home Care (PHC) Without the Wizards

Revision 17-1; Effective March 15, 2017

The following records are either system generated or completed by the CCSE case worker for non-CAS (Service Code 17) and the HHSC regional nurse for CAS (Service Code 17D) authorizations.

Using the instructions in 8200, Authorizing CCSE Services Without Using the Wizards, and the following additional instructions, the CCSE case worker completes these records:

  • Individual
  • Address
  • Authorizing Agent – Case Worker
  • Enrollment
  • Location
  • Phone
  • Level of Service – Form 2060, Needs Assessment Questionnaire and Task/Hour Guide
  • Level of Service – Priority
  • Service Item
  • Service Authorization

8271 Level of Service/Priority — PHC Services Without the Wizards

Revision 17-1; Effective March 15, 2017

All PHC individuals must have a priority level registered on the Level of Service record. This record is used to tell the billing system which rate the provider is authorized to use for each individual. SASO will accept the authorization without this record but provider claims will reject.

To register the Priority Level of Service record for a PHC individual:

  1. Select the Folder icon for Level of Service in the Medical directory.
  2. Select Add and the Level of Service record will appear.
  3. Select PR-PRIORITY from the drop-down list in the Type field.
  4. Select 7-COMMUNITY CARE from the drop-down list in the Service Group field.
  5. Leave the Contract Number blank.
  6. Type 1 for Non-Priority cases or 2 for Priority cases in the Level field.
  7. Type the date the individual is eligible for this level of service in the Begin Date field. The Begin Date must match the first day the individual is authorized to receive this level of PHC services. Leave the End Date field at default zeros.

Priority Changes

When the individual's priority level changes, enter an End Date in the existing record. Using these same instructions, create another record with the new information. To avoid gaps or overlaps in the Priority Level of Service records, the End Date of the existing record should be one day before the Begin Date of the new record.

8272 Service Item — PHC Services Without the Wizards

Revision 17-1; Effective March 15, 2017

The Service Item record is used to register tasks. At least one personal care task authorized on Form 2101, Authorization for Community Care Services, must be registered for PHC. Additional tasks can be registered, if desired.

To register Service Item records for a PHC individual:

  1. Select the Folder icon for Service Item in the Program and Service directory.
  2. Select Add and the Service Item record will appear.
  3. Select 7-COMMUNITY CARE from the drop-down list in the Service Group field.
  4. Select 17-PERSONAL ASSISTANCE SERVICES PAS from the drop-down list in the Service Code field.
  5. Select T-TASK from the drop-down list in the Type field.
  6. Type the two-digit code for one personal care task authorized on Form 2101 in the Item field.
  7. Type the date that the individual is eligible for CCSE services in the Begin Date field. Leave the End Date field at default zeros.
  8. Select Submit from the Command Menu or the toolbar to submit the authorization.

This record remains open until the individual no longer receives this task or stops receiving either PHC or FC.

When the individual stops receiving a registered task:

If the individual stops receiving the registered personal care task, enter an End Date in the existing record. Using these same instructions, create another record with another personal care task. To avoid gaps or overlaps in the Service Item records, the End Date of the existing record should be one day before the Begin Date of the new record.

When the individual stops receiving PHC or FC:

No change is required to this record when an individual transfers between PHC and FC, as long as the individual is still authorized to receive the registered task. If the individual stops receiving PHC or FC, enter the last day of service as the End Date for this record.

Using the following instructions, the HHSC nurse completes these records to create an authorization for CAS:

  • Authorizing Agent – Nurse
  • Authorizing Agent – Practitioner
  • Service Authorization

8273 Authorizing Agent/Nurse — CAS Services Without the Wizards

Revision 17-1; Effective March 15, 2017

To register a nurse Authorizing Agent record for a CAS individual:

  1. Select the Folder icon for Authorizing Agent in the Case Worker directory.
  2. Select Add and the Authorizing Agent record will appear.
  3. Select NU-NURSE from the drop-down list in the Type field.
  4. Select 7-COMMUNITY CARE from the drop-down list in the Group field.
  5. Select YES from the drop-down list in the Send to TMHP field if there is no other existing nurse Authorizing Agent record. Select NO if there is another existing record.
  6. Type the date this individual was assigned to the nurse or the date of the Enrollment record in the Begin Date field. Leave the End Date field at default zeros.
  7. Type the BJN for the nurse in the Auth Agent field.
  8. Leave the Agency field at the default selection 324-DHS.
  9. Type the nurse's name in the Name field.
  10. Type the nurse's phone number in the Phone field. Type the area code, phone number and extension. Type 0000 if no extension exists.
  11. Type the nurse's Mail Code in the Mail Code field.

This record remains open until the case is assigned to another nurse, the individual transfers to another service that does not require this record, or the individual stops receiving services.

Nurse Changes

When the individual is assigned to another nurse, enter an End Date in the existing nurse Authorizing Agent record. Using these same instructions, create another record with the new information. To avoid gaps or overlaps in the nurse Authorizing Agent records, the End Date of the existing record should be one day before the Begin Date of the new record.

Currently, although SASO will accept multiple Authorizing Agent records, TMHP will only accept two Authorizing Agent records when a SASO file is transmitted to TMHP. Until this problem is resolved, select NO in the SEND TO TMHP field for all updates.

8274 Authorizing Agent /Practitioner — PHC Services Without the Wizards

Revision 17-1; Effective March 15, 2017

The case worker registers the practitioner Authorizing Agent record for a PHC individual and the HHSC regional nurse enters information for a CAS individual. If the practitioner authorizing agent is not registered for a PHC or CAS individual, the authorization will reject.

To register a practitioner Authorizing Agent record for a PHC or CAS individual:

  1. Select the Folder icon for Authorizing Agent in the Case Worker directory.
  2. Select Add and the Authorizing Agent record will appear.
  3. Select P-PRACTITIONER from the drop-down list in the Type field.
  4. Select 7-COMMUNITY CARE from the drop-down list in the Group field.
  5. Leave the Send to TMHP field at the default of No. The practitioner registration does not require an entry in this field.
  6. Type the beginning date of the practitioner's orders in the Begin Date field. Leave the End Date field at default zeros. The Begin Date must be equal to or earlier than the first day the individual is being authorized to receive services.
  7. Type the practitioner's license number in the Auth Agent field.
  8. Select HHSC from the drop-down list in the Agency field.
  9. Type the practitioner's last name in the Name field.
  10. Type the practitioner's phone number in the Phone field.
  11. Leave the Mail Code field blank.

8275 Service Authorization — PHC Services Without the Wizards

Revision 17-1; Effective March 15, 2017

The case worker will complete the Service Authorization record for PHC and the HHSC regional nurse will complete the Service Authorization record for CAS cases when services are approved.

To register a Service Authorization record for an initial PHC or CAS individual:

  1. Select the Folder icon for Service Authorization in the Program and Service directory.
  2. Select Add and the Service Authorization record will appear.
  3. Select 7-COMMUNITY CARE from the drop-down list in the Service Group field.
  4. Select 17-PERSONAL ASSISTANCE SERVICES (PAS) or 17D-COMMUNITY ATTENDANT (CAS) from the drop-down list in the Service Code field.
  5. Leave the Agency field at the default selection 324-DHS.
  6. Move to the Unit Type field and select 1-WEEK from the drop-down list.
  7. Type the number of PAS hours per week that the individual is authorized to receive in the Adj. Units field.
  8. Type the date the individual is authorized to receive PHC or CAS services in the Begin Date field. This date will match the mail date unless it is a negotiated start date. Leave the End Date field at default zeros.
  9. Type the PHC provider's contract number in the Contract No field. Do not type leading zeros.

When creating a Service Authorization record for CDS PAS, a Service Authorization record for Service Code 63V must also be created:

  1. Select the Folder icon for Service Authorization in the Program and Service directory.
  2. Select Add and the Service Authorization record will appear.
  3. Select 7-COMMUNITY CARE from the drop-down list in the Service Group field.
  4. Select 63-V CDS Monthly Administrative Fee.
  5. Leave the Agency field at the default selection 324-DHS.
  6. Move to the Unit Type field and select 2-Month.
  7. Type 1.00 in the Units field.
  8. Type the date the individual is authorized to receive CDS PHC services in the Begin Date field. Leave the End Date field at default zeros.
  9. Type the CDS PHC provider's contract number in the Contract No field. Do not type leading zeros.

See 8300, Changes to CCSE Service Authorizations Without Using the Wizards, for instructions for making changes to this record.

Retroactive PHC Authorizations

For retroactive PHC or CAS authorizations, Form 2101, Authorization for Community Care Services, is completed for the retroactive period and a second Form 2101 is completed if the individual is eligible for ongoing services. For the retroactive period, the Begin Date is the service initiation date if all other criteria are met. The End Date is the day prior to the initiation of ongoing services or the date of notification of ineligibility.

If the applicant is determined ineligible for ongoing services, one Service Authorization record for the retroactive period is required.

8280 Residential Care Services (RC or Emergency Care) Without the Wizards

Revision 17-1; Effective March 15, 2017

The following records are either system generated or created by the case worker to authorize Residential Care Services, which includes RC and Emergency Care. These services are authorized using Service Code 19. Detailed instructions for completing each record are found in 8200, Authorizing CCSE Services Without Using the Wizards, and in this section.

When the Create New Client function is used for an initial service authorization, the Enrollment and Eligibility records must be submitted to the SASO database before the remaining records are completed. In all other situations, all the records may be completed before submitting to the SASO database.

  • Individual
  • Address
  • Authorizing Agent – Case Worker
  • Eligibility
  • Enrollment
  • Location
  • Phone
  • Applied Income – Co-Pay (for Supervising Living Only)
  • Level of Service – Form 2060, Needs Assessment Questionnaire and Task/Hour Guide
  • Service Authorization

8281 Applied Income — RC Services Without the Wizards

Revision 17-1; Effective March 15, 2017

This record is used to record the co-pay for RC and must be completed even if the co-pay amount is $0. If the co-pay for the initial month the CCSE individual enters an RC facility is prorated, then two Applied Income records must be created – one record to register the prorated co-pay amount and a second record to register the ongoing co-pay amount. If one of these records is for a month prior to the month the information is being entered, a Force is required.

To register initial co-pay information for an RC individual:

  1. Select the Folder icon for Applied Income/Co-pay in the Program and Service directory.
  2. Select Add and the Applied Income/Co-pay record will appear.
  3. Select CO-CO-PAY (Amount or Percentage) from the drop-down list in the A/I Type field.
  4. Select 1-CO-PAY (Amount) from the drop-down list in the Co-Pay Type field.
  5. If the co-pay amount for the initial month is prorated, continue. If the amount is not prorated, skip to Step #13.
  6. Type the amount of co-pay the CCSE individual is responsible for paying for the initial month in the Amount field.
  7. Type the first day of the initial month in the Begin Date field.
  8. Type the last day of the initial month in the End Date field.
  9. Select the Folder icon for Applied Income/Co-Pay in the Program and Service directory.
  10. Select Add and the Applied Income/Co-Pay record will appear.
  11. Select CO-CO-PAY (Amount or Percentage) from the drop-down list in the A/I Type field.
  12. Select 1-CO-PAY (Amount) from the drop-down list in the Co-Pay Type field.
  13. Type the full amount of co-pay the individual is responsible for paying in the Amount field.
  14. Type the first day of the month the individual is responsible for paying the full amount of co-pay in the Begin Date field. Leave the End Date field at default zeros.

Co-pay changes:

When the co-pay changes, enter an End Date in the existing Applied Income record. Using these same instructions, create another record with the new information.

When RC services terminate, end the co-pay record:

  1. Terminate the RC service authorization.
  2. Open the Applied Income/Co-Pay folder and select the Open Co-Pay record.
  3. If the end date is in the past, click on the Force box (it contains a check mark). Enter comments in the pop-up box and click on Unforce. If the end date is the current date or a future date, enter the end date and submit.
  4. Enter the End Date used to terminate RC in the End Date field.
  5. Click on the Force box again (this time there is no check mark in the box). Enter comments, click on Force and Submit.

8282 Service Authorization — RC Services Without the Wizards

Revision 17-1; Effective March 15, 2017

To register a Service Authorization record for RC (RC Apt., RC Non-Apt. or Emergency Care):

  1. Select the Folder icon for Service Authorization in the Program and Service directory.
  2. Select Add and the Service Authorization record will appear.
  3. Select 7-COMMUNITY CARE from the drop-down list in the Service Group field.
  4. Select the appropriate service code from the drop-down list in the Service Code field.
  5. Leave the Agency field at the default selection 324-DHS.
  6. Select 5-DAILY from the drop-down list in the Unit Type.
  7. Type 1 in the Adj. Units field.
  8. Type the date the individual is authorized to receive RC services in the Begin Date field. Leave the End Date field at default zeros.
  9. Type the RC provider's contract number in the Contract No field. Do not type leading zeros.
  10. Select Submit from the Command Menu or the toolbar to submit the authorization.

To register a Service Authorization record for RC Room and Board charges for individuals certified for RC prior to Sept. 1, 2003:

  1. Select the Folder icon for Service Authorization in the Program and Service directory.
  2. Select Add and the Service Authorization record will appear.
  3. Select 7-COMMUNITY CARE from the drop-down list in the Service Group field.
  4. Select the appropriate service code from the drop-down list in the Service Code field.
    • 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.
  5. Leave the Agency field at the default selection 324-DHS.
  6. Select 2-MONTHLY for room and board.
  7. Type the ongoing monthly room and board amount in the Adj. Units field.
  8. Type the date the individual is authorized to receive RC services in the Begin Date field. Leave the End Date field at default zeros.
  9. Type the RC provider's contract number in the Contract No field. Do not type leading zeros.
  10. 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 record for RC bedhold charges:

  1. Select the Folder icon for Service Authorization in the Program and Service directory.
  2. Select Add and the Service Authorization record will appear.
  3. Select 7-COMMUNITY CARE from the drop-down list in the Service Group field.
  4. Select 19H-ASSISTED LIVING BEDHOLD from the drop-down list in the Service Code field.
  5. Leave the Agency field at the default selection 324-DHS.
  6. Select 5-DAILY from the drop-down list in the Unit Type field.
  7. Type 1 in the Adj. Units field.
  8. 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.
  9. Type the RC provider's contract number in the Contract No field. Do not type leading zeros.
  10. Select Submit from the Command Menu or the toolbar to submit the authorization.

See 8300, Changes to CCSE Authorizations Without the Wizards, for instructions for making changes to these records.

8290 Special Services to Persons with Disabilities (SSPD) Without the Wizards

Revision 20-3; Effective September 1, 2020

The following records are either system generated or created by the case worker to authorize SSPD Service Code 28. Detailed instructions for completing each record are found in 8200, Authorizing CCSE Services Without Using the Wizard, and in this section.

When the Create New Client function is used for an initial service authorization, the Enrollment and Eligibility records must be submitted to the SASOO database before the remaining records are completed. In all other situations, all the records may be completed before submitting to the SASOO database.

  • Individual
  • Address
  • Authorizing Agent – Case Worker
  • Authorizing Agent – Agency
  • Eligibility
  • Enrollment
  • Location
  • Phone
  • Level of Service – Form 2060, Needs Assessment Questionnaire and Task/Hour Guide, for Day Care
  • Service Authorization

8291 Authorizing Agent/Agency — SSPD Services Without the Wizards

Revision 17-1; Effective March 15, 2017

To register an agency Authorizing Agent record for an SSPD individual:

  1. Select the Folder icon for Authorizing Agent in the Case Worker directory.
  2. Select Add and the Authorizing Agent record will appear.
  3. Select OT-OTHER from the drop-down list in the Type field.
  4. Select 7-COMMUNITY CARE from the drop-down list in the Group field.
  5. Select NO in the Send to TMHP field.
  6. Type the effective date for the authorizing agent to authorize services in the Begin Date field. Leave the End Date field at default zeros.
  7. Type the word Direct in the Auth Agent field.
  8. Leave the Agency field at the default selection 324-DHS.
  9. Type the name of the SSPD provider agency in the Name field.
  10. Type the phone number of the SSPD provider agency in the Phone field. Type the area code, phone number and extension. Type 0000 if no extension exists.

8292 Service Authorization — SSPD Services Without the Wizards

Revision 20-3; Effective September 1, 2020

To register a Service Authorization record for an SSPD recipient:

  1. Select the Folder icon for Service Authorization in the Program and Service directory.
  2. Select Add and the Service Authorization record will appear.
  3. Select 7-COMMUNITY CARE from the drop-down list in the Service Group field.
  4. Select 28-SSPD or 28A-SSPD from the drop-down list in the Service Code field.
  5. Select HHSC from the drop-down list in the Agency field.
  6. Select 1-WEEK for 28-SSPD or 2-Month for 28A-SSPD Case Management from the drop-down list in the Unit Type field.
  7. For 28-SSPD, type the number of units per week for Day Care, Counseling and Interpreter Services in the Adj. Units field. For 28A-SSPD Case Management, type 1 in the Adj. Units field.
  8. Type the date the person is authorized to receive SSPD services in the Begin Date field. Leave the End Date field at default zeros.
  9. Type the SSPD provider contract number in the Contract No field. Do not type leading zeros.
  10. Select Submit from the Command Menu or the toolbar to submit the authorization.

See 8300, Changes to CCSE Authorizations Without the Wizards, for instructions for making changes to this record.