LEVEL 4 LEVEL 3 LEVEL 2 LEVEL 1 Areas of Functioning (4 points) (3 points) (2 points) (1 HEALTH STATUS (continued) Client has unmanaged Client has chronic Client has chronic Client has no co- acute or chronic co- that are not that are morbidities; DISEASE CO-MORBIDITIES morbidities. OR well managed. manageable with minimal (e.g. HTN, DM. AND/OR medical assistance. Client has well CHF, Hepatitis etc.) Client is pregnant and not managed chronic actively access prenatal and does care not need assistance with treatment Score: program. Client has no dental Client has no dental Client does not have a Client is currently in provider and reports provider and reports regular dentist or has not active dental care and has ORAL HEALTH NEEDS current tooth or mouth episodic pain and/or seen a dentist in more seen a dentist within the pain and severe sensitivity in than six months; last six months; discomfort; AND/OR OR AND/OR Client reports or MCM Client reports not Client reports practicing OR practicing daily oral observes missing teeth; daily oral hygiene; Client reports or MCM hygiene and/or Client AND/OR AND/OR observes decayed or dentures need adjusting Client reports episodic or Client has no complaints rotten teeth; but Client reports no pain moderate difficulty eating of tongue, tooth or AND/OR or discomfort; and; Client or taking medication. gum pain; and MCM Client reports difficulty reports no difficulty eating observes and/or Client eating difficulty or taking or taking medication. reports that teeth and medication due to oral gum are healthy. health problems. Score:
Areas of Functioning LEVEL 4 (4 points) LEVEL 3 (3 points) LEVEL 2 (2 points) LEVEL 1 (1 HEALTH STATUS (continued) DISEASE CO-MORBIDITIES (e.g. HTN, DM. CHF, Hepatitis etc.) Score: Client has unmanaged acute or chronic co- morbidities. AND/OR Client is pregnant and not actively access prenatal care Client has chronic that are not well managed. Client has chronic that are manageable with minimal medical assistance. Client has no co- morbidities; OR Client has well managed chronic and does not need assistance with treatment program. ORAL HEALTH NEEDS Score: Client has no dental provider and reports current tooth or mouth pain and severe discomfort; OR Client reports or MCM observes decayed or rotten teeth; AND/OR Client reports difficulty eating difficulty or taking medication due to oral health problems. Client has no dental provider and reports episodic pain and/or sensitivity in AND/OR Client reports or MCM observes missing teeth; AND/OR Client reports episodic or moderate difficulty eating or taking medication. Client does not have a regular dentist or has not seen a dentist in more than six months; OR Client reports not practicing daily oral hygiene and/or Client dentures need adjusting but Client reports no pain or discomfort; and; Client reports no difficulty eating or taking medication. Client is currently in active dental care and has seen a dentist within the last six months; AND/OR Client reports practicing daily oral hygiene; AND/OR Client has no complaints of tongue, tooth or gum pain; and MCM observes and/or Client reports that teeth and gum are healthy.
ELECTRONIC_Standardized_Michigan_HIV_MCM_Acuity_Pilot_Tool_2.2016_517969_7.docx