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Multipurpose Senior Services Program

The California Department of Aging (CDA) administers programs that serve older adults, adults with disabilities, family caregivers, and residents in long-term care facilities throughout the State. These services are provided locally by contracted agencies. This webpage is intended for those who provide, or seek to provide, Multipurpose Senior Services Program (MSSP) services.

For Providers & Partners - Program Narrative and Fact Sheets

For Consumers - Multipurpose Senior Services Program

MAGL NumberSubjectRevision Date
17-01MSSP Advisory and Guidance Letter (MAGL)6/24/2019
Manual Section Subject
Philosophy Philosophy Statement
Table of Contents Table of Contents
Summary of Changes Summary of Changes
Chapter 1 Introduction
Chapter 2 Site Staffing
Chapter 3 Program Components
Chapter 4 Quality Assurance and Program Review
Chapter 5 Participant Records and Information
Chapter 6 Participant Rights
Chapter 7 Information System Components
Chapter 8 Service Vendors
Chapter 9 Site Budget and Claims Reimbursement
Chapter 10 Equipment
List of Appendices List of Appendices, Alphabetical
Appendix 01 Right to State Medi-Cal Hearing: Welfare and Institutions Code Sections 10950 – 10967
Appendix 02 Termination of MSSP Services (Notice of Action)
Appendix 02 - Spanish Terminación de Servicios MSSP (Notificación de Acción)
Appendix 03 File Specifications
Appendix 04 Notice of Action – Change in MSSP Services
Appendix 04 - Spanish Notificacion de Accion – Cambio en los Servicios MSSP
Appendix 05 State Hearing Notice: Your Right to Appeal This Decision
Appendix 05 - Spanish Notificacion de Audencia Estatal: Su Derecho a Apelar Contra Esta Decision
Appendix 05a Request for State Hearing Form
Appendix 05a - Spanish Formulario de Solicitud de Audiencia Estatal
Appendix 06 Withdrawal of Request for State Hearing Form DPA 315
Appendix 07 Medi-Cal Aid Codes
Appendix 08 CDA Waiver Referral
Appendix 09 Application for the Multipurpose Senior Services Program
Appendix 09 - Spanish Solicitud de Ingreso en el Programa MSSP
Appendix 10 Application for MSSP Under Medi-Cal Institutional Deeming Procedures
Appendix 10 - Spanish Solicitud de Ingreso en MSSP Segun los Procedimientos de Consideracion Institutional de Medi-Cal
Appendix 11 Deinstitutional Services
Appendix 11a Deinstitutional Services Request
Appendix 11a - Spanish Deinstitutional Services Request
Appendix 11b - Cover Deinstitutional Services Assessment (Optional)
Appendix 11b Deinstitutional Services Assessment
Appendix 11c Deinstitutional Services Functional Needs Assessment Grid
Appendix 11d Deinstitutional Services Functional Needs Assessment Grid - Instructions
Appendix 11e Deinstitutional Care Plan
Appendix 11e - Spanish Plan de Deinstitucionalizacion de Cuidado
Appendix 11f Deinstitutional Care Plan Form Instructions
Appendix 11h Deinstitutional Services Data Tracking Form
Appendix 12 Client Rights in MSSP
Appendix 12 - Spanish Derechos del Cliente en el MSSP
Appendix 13 Your Rights Under California Welfare Programs Brochure
Appendix 14 Authorization for Use and Disclosure of Protected Health Information
Appendix 14 - Spanish Autorización para Use y Divulgación de Información de Salud Protegida
Appendix 15 Level of Care Criteria: California Code of Regulations (CCR) Title 221 Sections 51118, 51120, 51124, 51334, and 51335
Appendix 16 Level of Care Certification (LOC)
Appendix 17 Client Enrollment/Termination Information Form
Appendix 18 - Intro Initial Health Assessment
Appendix 18 - Cover Initial Health Assessment Cover Sheet (Optional)
Appendix 18a Initial Health Assessment
Appendix 18b Client’s Physicians and Other Health Professionals (Optional)
Appendix 18c Client’s Medications Including: Nonprescription Medications, Vitamins, and Minerals
Appendix 18d Initial Health Assessment Summary
Appendix 19 Initial Psychosocial Assessment
Appendix 19 - Cover Initial Psychosocial Assessment Cover Sheet (Optional)
Appendix 19a Initial Psychosocial Assessment
Appendix 19b Psychological Functioning
Appendix 19c Psychological Functioning Instructions and Definitions
Appendix 19d Functional Needs Assessment Grid
Appendix 19e Functional Needs Assessment Grid Instructions
Appendix 19f Cognitive Screening Tools Approved by CDA
Appendix 19h Initial Psychosocial Assessment Summary
Appendix 20 - Cover Reassessment Cover Sheet
Appendix 20 Reassessment
Appendix 20a Functional Needs Assessment Grid
Appendix 20b Functional Needs Assessment Grid Instructions
Appendix 20c Cognitive Screening Tools Approved by CDA
Appendix 20e Client’s Physicians and Other Health Professionals (Optional)
Appendix 20f Client’s Medications Including: Nonprescription Medications, Vitamins, and Minerals
Appendix 20g Reassessment Summary
Appendix 21 Supplemental Assessment Tool
Appendix 21a Determine Your Nutritional Health
Appendix 22 Care Plan
Appendix 22 - Spanish Plan de Cuidado
Appendix 22a Care Plan Instructions
Appendix 23 Institutionalization Form (Optional)
Appendix 24 Negotiated Risk Agreement Form
Appendix 24a Negotiated Risk Agreement Example Client A
Appendix 24b Negotiated Risk Agreement Example Client B
Appendix 25 Service Planning and Utilization Summary
Appendix 26 Provider Qualifications: Licensure and Certification
Appendix 27 MSSP Service Vendor Application
Appendix 28 MSSP Vendor Licensing Form
Appendix 31 Site Rate Sheet Sorted by Procedure Code
Appendix 33 Benchmark Memorandum
Appendix 34 Equipment
Appendix 34a Report of Property Furnished/Purchased with Agreement Funds
Appendix 34b Report of Property Furnished/Purchased with Agreement Funds - Instructions
Appendix 34c Request to Dispose of Property
Appendix 36 Title III Services of the Older Americans Act
Appendix 41 Requesting an Exemption to Minimum Qualifications for Care Management Staff
Appendix 41a Nurse Care Manager Exemption Criteria
Appendix 41b Social Work Care Manager Exemption Criteria
Appendix 41c Supervising Care Manager Exemption Criteria
Appendix 41d Nurse Care Manager Training and Development Pathway
Appendix 41e Nurse Care Manager/ Social Work Care Manager Exemption Training and Development Plan
Appendix 41f Social Work Care Manager Training and Development Pathway
Appendix 41g Supervising Care Manager Training and Development Pathway
Appendix 41h Supervising Care Manager Exemption Training and Development Plan
Appendix 41i Nurse Care Manager/ Social Work Care Manager Exemption Recommended Orientation Checklist
Appendix 41j Supervising Care Manager Exemption Recommended Orientation Checklist
Appendix 42 Institutional Deeming Waiver Aid Codes Department of Health Services Letter Number: 03-22
Appendix 44 Memorandum of Understanding between the California Departments of Social Services and Aging regarding the In-Home Supportive Services Program
Appendix 49a Utilization Review Tool - Client Record
Appendix 49b Utilization Review Tool - Vendor

MSSP Waiver Renewal Announcement

The Department of Health Care Services (DHCS) and the California Department of Aging (CDA) are committed to engaging in a public process for the renewal of the Multipurpose Senior Services Program (MSSP) Waiver.

For all proposed changes to the §1915(c) Home and Community-Based Waiver Application PDF File for MSSP, a 30-day public comment period will begin February 5, 2019 and end March 5, 2019. Please submit all comments regarding the proposed MSSP Waiver Renewal to MSSPService@aging.ca.gov or via hard copy to:

California Department of Aging
MSSP Branch
1300 National Drive #200
Sacramento, CA 95834
ATTN: Amber Kraw

Please save the date: February 20, 2019, from 2:30 pm to 3:30 pm, as DHCS and CDA are hosting a webinar to review the proposed changes to the §1915(c) Home and Community-Based Waiver Application for MSSP, answer questions and accept public comments.

MSSP Waiver Renewal Public Comments, Questions and Responses

MSSP Coordinated Care Initiative Transition Plan

The Department of Health Care Services (DHCS) has released a revised framework for transitioning the Multipurpose Senior Services Program (MSSP) to managed care. The framework outlines the steps and process moving forward in transitioning MSSP to a managed care benefit in the Coordinated Care Initiative (CCI) counties, including plan-readiness reviews, consumer protections, and a stakeholder engagement process. DHCS released both redline and clean versions of the framework, showing the specific changes made in response to stakeholder feedback.

As proposed in the Governor’s January 2017 budget, the MSSP transition into managed care has been delayed to no sooner than January 1, 2020. More information can be found at www.CalDuals.org.

Statewide Transition Plan for Home and Community-Based Settings

The California Department of Health Care Services (DHCS) has released a draft Statewide Transition Plan (STP) as required by new Federal regulations. These new regulations, effective March 17, 2014, establish requirements for settings eligible for Medicaid Home and Community-Based Services funding. The draft Statewide Transition Plan, and information on providing input required to finalize the plan, is available on the DHCS website.

MSSP Waiver Renewal Process Announcement: July 1, 2019 – June 30, 2024

The Department of Health Care Services (DHCS) and the California Department of Aging (CDA) are committed to engaging in a public process for the renewal of the Multipurpose Senior Services Program (MSSP) Waiver.

For all proposed changes to the §1915(c) Home and Community-Based Waiver Application PDF File for MSSP, a 30-day public comment period will begin February 5, 2019 and end March 5, 2019. Please submit all comments regarding the proposed MSSP Waiver Renewal to MSSPService@aging.ca.gov or via hard copy to:

California Department of Aging
MSSP Branch
1300 National Drive #200
Sacramento, CA 95834
ATTN: Amber Kraw

Please save the date: February 20, 2019, from 2:30 pm to 3:30 pm, as DHCS and CDA are hosting a webinar to review the proposed changes to the §1915(c) Home and Community-Based Waiver Application for MSSP, answer questions and accept public comments.

What is a Security Incident?

A security incident is defined as an occurrence involving a CDA authorized user that actually or potentially jeopardizes the confidentiality, integrity, or availability of an information system or the information the system processes, stores, or transmits or that constitutes a violation or imminent threat of violation of security policies, security procedures or acceptable use policies.

Examples of security incidents include, but are not limited to:

  • Stolen items such as a laptop; thumb drives, backpack containing work-related files
  • Faxing client’s information to an unintended recipient

View our Information Security Definitions for an explanation of terms used in Information Security.

Reporting a Security Incident

For step-by-step instructions on how to report a security incident, visit our Security Incident Reporting Procedures page. The forms identified in the step-by-step instructions can be found below.

For information on contractors and their subcontractors, view our note regarding CDA Contractors and their Subcontractors.

Information Security Forms

Information Integrity and Security Statement

All CDA authorized users shall sign and return a Information Integrity and Security Statement (CDA 1024) to ensure the authorized user is aware of, and agrees to comply with, its obligations to protect CDA information assets from unauthorized access and disclosure, prior to contract execution.

Privacy & Information Security Awareness Training

Complete the California Department of Aging Privacy and Information Security Awareness Training for Authorized Users module within the following timeframes:

  • Within 30 days of the start date of the Contract/Agreement
  • Within 30 days of the start date of any new employee, Subcontractor, or volunteer

Contractors must maintain Certificates of Completion on file and provide them to CDA upon request

Program Resources

Click here to access program resources.