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If client does not have a Case Manager/Care Coordinator, we'll need:
1) Person Centered Plan:
Housing Focused Person-Centered Plan (DHS-7307) completed by a Housing Consultant (Welcome Home can help arrange this).
2) Assessment and Proof of Disability:
Professional Statement of Need (PSN) (DHS-7122) completed by a licensed professional (therapist, social worker, doctor, etc).
EMAIL/QUESTIONS: phil@whhsc.org | Release of Information (ROI) Form
If client has a Targeted Case Manager or Moving Home MN Case Manager, we'll need:
1) Person Centered Plan:
Housing Focused Person-Centered Plan (DHS-7307) completed by the Targeted Case Manager or Moving Home MN Case Manager.
2) Assessment and Proof of Disability:
Professional Statement of Need (PSN) (DHS-7122) completed by a licensed professional (therapist, social worker, doctor, etc).
EMAIL/QUESTIONS: phil@whhsc.org | Release of Information (ROI) Form
If client has a Waiver Case Manager, we'll need:
1) Person Centered Plan:
Coordinated Services and Supports Plan (CSSP) completed by Waiver Case Manager.
If no CSSP, use Housing Focused Person-Centered Plan (DHS-7307) instead.
2) Assessment:
None needed as long as Waiver Case Manager has a completed MnCHOICES Assessment or Longterm Care Consultation (LTCC).
Alternately, we can use a Professional Statement of Need (PSN) (DHS-7122) completed by a licensed professional (therapist, social worker, doctor, etc)
3) Proof of Disability:
None needed if:
a SSI/SSDI Recipient
on a MA-DX/MA-BX/MA-EPD insurance plan
Age 65 or older
Alternately, we can use one of the following:
Professional Statement of Need (PSN) (DHS-7122) completed by a licensed professional (therapist, social worker, doctor, etc)
SMRT Determination
Medical Opinion Form completed by a medical provider.
EMAIL/QUESTIONS: phil@whhsc.org | Release of Information (ROI) Form
If client has a MSHO/MSC+ Care Coordinator, we'll need:
1) Person Centered Plan:
Submit Coordinated Care Plan (CCP)
2) Assessment:
None needed as long as Care Coordinator has a completed MnCHOICES Assessment or Longterm Care Consultation (LTCC).
Alternately, we can use a Professional Statement of Need (PSN) (DHS-7122) completed by a licensed professional (therapist, social worker, doctor, etc)
3) Proof of Disability:
None needed if:
SSI/SSDI Recipient
on a MA-DX/MA-BX/MA-EPD insurance plan
Age 65 or older
Alternately, we can use one of the following:
Professional Statement of Need (PSN) (DHS-7122) completed by a licensed professional (therapist, social worker, doctor, etc)
SMRT Determination
Medical Opinion Form completed by a medical provider.
EMAIL/QUESTIONS: phil@whhsc.org | Release of Information (ROI) Form
If client has a Coordinated Entry Assessment, we'll need:
1) Person Centered Plan:
Housing Focused Person-Centered Plan (DHS-7307) completed by a Targeted Case Manager or Moving Home MN Case Manager.
If no Case Manager, Welcome Home can help arrange a Housing Consultant to do it.
2) Assessment:
DHS Housing Stabilization Services Coordinated Entry Document (printed from ServicePoint).
Alternately, we can use a Professional Statement of Need (PSN) (DHS-7122) completed by a licensed professional (therapist, social worker, doctor, etc)
3) Proof of Disability:
No more documentation needed if:
SSI/SSDI Recipient
on a MA-DX/MA-BX/MA-EPD insurance plan
Age 65 or older
Alternately, we can use one of the following:
Professional Statement of Need (PSN) (DHS-7122) completed by a licensed professional (therapist, social worker, doctor, etc)
SMRT Determination
Medical Opinion Form completed by a medical provider.
EMAIL/QUESTIONS: phil@whhsc.org | Release of Information (ROI) Form
EMAIL/QUESTIONS: phil@whhsc.org | Release of Information (ROI) Form