1. Coordinated Care Initiative (CCI) Data Sharing Stakeholder Workgroup November 30, 2012 California Department of Social Services Adult Programs Division

2. Overview – CMIPS II Screens that Include Recipient Data Person Homepage - Demographics Case Home – IHSS Case Details Household Evidence Service Evidence Service Details Program Evidence Disaster Preparedness

3. Person Home – Recipient Demographics

4. Person Home Screen-Recipient Data Recipient Demographic Data including: Name County Address Phone Number Social Security Number Date of Birth Gender Ethnicity Primary Language – Spoken and Written

5. Case Home – Case Information

6. Case Home Screen – Recipient Data Case data including: IHSS Case Number IHSS Case Status IHSS Referral/Application Dates County/District Office Case Owner (Social Worker) In Home Visit Date Medi-Cal Eligibility Dates Number in Household Mail Designee Companion Case Indicator State Hearing Indicator

7. Household Evidence – Residence Information/Household Members

8. Household Evidence Screen – Recipient Data Recipient household data including: Living Arrangement Residence Type Household Members Number of rooms both shared and used exclusively by the recipient Available appliances – stove, washer, dryer, etc.

9. Service Evidence – Assessment Information

10. Service Evidence Screen- Recipient Data Assessment data including: Functional Ranks Service Types Weekly/Monthly Indicator by Service HTG Indicator (+ or – if the Individual Assessed Need is outside of HTGs) Total Assessed Need Adjustments – Proration Individual Assessed Need Combined hours for Alternative Resources, Refused Services, and Voluntary Services Net Adjusted Need

11. Service Details – Specific to Each Service

12. Service Details Screen – Recipient Data Service detail data including: Total Assessed Need Adjustments Alternative Resources Voluntary Services Refused Services Additional information needed by service – forms, etc. Comments

13. Program Evidence – Authorization and Funding Source

14. Program Evidence Screen – Recipient Data Program case data including: Authorization Start and End Dates Home Visit Date Reassessment Due Date Presumptive Eligibility IHSS Aid Code Advance Pay Indicator Restaurant Meals Allowance Indicator Mode of Service FFP Indicator Parent/Spouse Provider Indicators

15. Disaster Preparedness – Level of Impairment and Special Needs

16. Disaster Preparedness Screen – Recipient Data Disaster preparedness data including: Degree of Contact – specifies the amount of contact needed in case of disaster (critical, urgent, moderate, etc.) Special Impairment Indicator – specifies needs (severely impaired, lacks transportation, lives in isolated area, blind, deaf, receives protective supervision, etc.) Life Support Supply Indicator – specifies life support needs (respirator, insulin, oxygen, paramedical, etc.) Extreme Weather Indicator – what degree of contact is needed in extreme heat/cold weather

17. Questions?