MN DHS-6249-ENG 2010 free printable template
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Revised 9/3/2010 LOCUS Recording Form Date of assessment: Recipient MA #: Provider name, NPI and service type: Recommended Level of Care: Actual Level of Care provided: Service(s) recipient is receiving
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How to fill out MN DHS-6249-ENG
How to fill out MN DHS-6249-ENG
01
Start by obtaining the MN DHS-6249-ENG form from the official Minnesota Department of Human Services website or your local DHS office.
02
Read the instructions carefully before filling out the form.
03
Fill in your personal information in the designated sections, including your name, address, and contact details.
04
Provide details about your household composition, including the names and ages of all household members.
05
Complete the income section by listing all sources of income for each household member.
06
Document any assets you may have, such as savings accounts, properties, or vehicles.
07
Review your completed form for accuracy and completeness.
08
Sign and date the form where indicated.
09
Submit the form either online, by mail, or in person at your local DHS office as per the instructions.
Who needs MN DHS-6249-ENG?
01
Individuals and families applying for assistance programs such as food support, cash assistance, or health care coverage through the Minnesota Department of Human Services.
02
Current recipients of assistance who need to report changes in household composition or income.
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People Also Ask about
What is a locus score of 14?
A composite score of at least 14 but no more than 16 is required for treatment at this level. Definition: This level of care provides treatment to clients who need intensive support and treatment, but who are living either independently or with minimal support in the community.
What is a good locus score?
A composite score of at least 14 but no more than 16 is required for treatment at this level. Definition: This level of care provides treatment to clients who need intensive support and treatment, but who are living either independently or with minimal support in the community.
What is the locus assessment in Illinois?
LOCUS: – A system for evaluating the current status of clients and their needs based on six evaluation parameters. parameters. 1) Risk of Harm; 2) Functional Status; 3) Medical, Addictive and Psychiatric Co-Morbidity; 4) Recovery Environment; 5) Treatment and Recovery History; and 6) Engagement.
How do you score the locus?
The LOCUS is based on a set of parameters that an individual is scored along.These parameters are: Risk of Harm. Functional Status. Medical, Addictive and Psychiatric Co-morbidity. Recovery Environment. Treatment and Recovery History. Engagement and Recovery Status.
What is the locus scale?
The LOCUS assessment tool is completed by answering questions divided into six categories, called 'dimensions,' that describe different aspects of a person and their illness. Questions in each of the 6 dimensions can have a score from 1 to 5.
What is a locus score of 2?
2 - Low Risk of Harm a- No current suicidal or homicidal ideation, plan, intentions or severe distress, but may have had transient or passive thoughts recently or in the past.
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What is MN DHS-6249-ENG?
MN DHS-6249-ENG is a form used in Minnesota for reporting specific information related to services provided by the Department of Human Services.
Who is required to file MN DHS-6249-ENG?
Individuals or organizations providing certain human services in Minnesota are required to file MN DHS-6249-ENG.
How to fill out MN DHS-6249-ENG?
To fill out MN DHS-6249-ENG, users must provide the required information accurately, ensuring all sections of the form are completed as per the instructions provided.
What is the purpose of MN DHS-6249-ENG?
The purpose of MN DHS-6249-ENG is to facilitate the collection of data necessary for monitoring and evaluating human services in Minnesota.
What information must be reported on MN DHS-6249-ENG?
Information that must be reported on MN DHS-6249-ENG includes details about the services provided, the demographics of clients served, and relevant outcomes of those services.
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