Evaluation of Provider
Offline use
If you will not have internet access while conducting the evaluation, it is important to use the correct PDF document for this evaluation. Open the Person's Evaluation of Provider tab, and write down the name of the eDoc generated by the system. Choose the corresponding link from the list below.
- Adult day services (S5100/S5102)
- Day training & habilitation (T2020/T2021)
- Prevocational services (T2014/T2015)
- Structured day program (T2020/T2021)
- Behavior programming (H0025)
- Consumer directed community supports (CDCS) (T2028)
- Chore (S5120)
- Crisis respite (T1005/S9125)
- Home delivered meals (S5170)
- Home health aide (T1004/T1021)
- Homemaker (S5130)
- Home care nursing (LPN, RN) (T1002/T1003)
- Respite (S5150/S5151/H0045)
- Skilled nursing (G0154/T1030)
- Specialist service (T2013)
- Independent Living Skills (ILS) (H2032)
- In-Home Family Support (S5125/S5126)
- Personal Care Assistance (PCA) (T1019)
- Personal Support (S5135)
- Companion (S5135)
- Supported Employment Services (T2019/T2018)
- Adult Foster Care (S5140/S5141)
- Child Foster Care (S5145)
- Supportive Living Services (T2016/T2017/T2032)
- Customized Living Services (T2030/T2031)
- Residential Care Services (T2032/T2033)
Save button
After entering or editing information on this page, click the Save button.
Close button
After you have finished entering data in the evaluation and are ready to submit the data, click the Close button. A dialog box will appear asking you to confirm that you want to close the evaluation. To close the evaluation, click "Yes". To continue working in the evaluation, click "No".
After the evaluation is closed, none of the data in the evaluation can be edited.
Service Provider
The name of the provider is prepopulated from the CSSP.
NPI
The provider's unique 10-digit National Provider Identifier (NPI) is prepopulated from the CSSP.
Service/HCPC
Prepopulates the name and code of the service to be evaluated.
General Evaluation Notes
Radio buttons indicate you may choose only one answer.
Check boxes indicate you may choose multiple answers.
Some responses to questions will add additional questions to the evaluation.
Follow up action needed
If there is text indicating that follow up action is needed for the person's response to a question, use the Additional Comments text field to indicate what additional action was taken.
Question 15
If the person's answer is "Yes", use the text field to document additional information.
Additional Comments
Use this text field to document actions taken for question responses with the text "(For case manager: Follow up action needed.)".
More information
View the training module Evaluation of the Service Provider.
Based on my Experience
The symbol indicates something that may not work as you might expect. We'll explain the issue, as well as any special procedures or workarounds.
You can also click the "Highlight all Based on my Experience tips" switch to highlight all of the items on the page.
Highlight all Based on my Experience tipsFeedback
Search
To search for a word or phrase on the current page, hold down the Control key and press the F key (Ctrl + F). Enter your search text in the text field that appears at the top of the screen.
Browser settings
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Internet Explorer and Edge: The magnifying glass with a plus sign will allow you to increase and decrease the “zoom” on your screen display.
Chrome: The ellipsis will bring up a menu of options. Choose zoom to change your screen display.
Resources
CountyLink
Latest information, known issues reports, feature requests and more.
PolicyQuest
The Disability and Aging PolicyQuest is an automated Web-based system for lead agencies to submit policy questions. The public can view the responses.
Acronym and abbreviation list
A list of acronyms and abbreviations commonly used across the department is posted on InfoLink.
CBSM
The Community-Based Services Manual (CBSM) is a reference tool for lead agencies who administer home and community-based services that support older Minnesotans and people with disabilities.
How to get help
A list of steps to take if you cannot find an answer to your policy question in the CBSM.
Build and Print: CSP/CSSP Crosswalk
A list of each tab in the Support Plan, whether the content in the tab is editable, and where the information from the tab prints.
Handling MN Information Securely
