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Group Residential Housing (GRH) Supplemental Services

Date: 09-02-2016

Overview

The GRH program serves adults with disabilities or older adults (65+) who have low income and live in settings authorized by a county or tribe. Supplemental service recipients are at risk of institutional placement or homelessness. Supplemental services provide additional supports for some recipients of GRH room and board payments that pay for housing expenses like rent, food and household supplies. Individuals are not eligible for supplemental services if they receive PCA or waiver services, or live in adult foster care settings. At application and once a year, recipients must show a need for ongoing support to maintain stable housing verified by a qualified professional.

The GRH supplemental service rate was established by the Minnesota Legislature in 1993 at a maximum of $426.37 per month, per recipient. Legislative actions have changed the rate over time. The most recent change was effective July 1, 2013, when the supplemental service rate increased to $482.84. Counties and tribes negotiate the supplemental service rates with providers and cannot exceed the maximum unless authorized by the Legislature.

Due to a general moratorium on the authorization of new supplemental service rates in Minnesota, county or tribe approval for supplemental service funding is only granted under special exceptions named in Minnesota statute 256I, and is limited.

The use of supplemental service rate is limited to GRH recipients who reside in one of the following settings:

  • • Board and lodging with special services
  • • Supervised living facilities
  • • Boarding care homes that are not certified for Medicaid
  • • Registered housing with services establishments
  • • Supportive housing for people who have experienced long term homelessness
  • Eligible Providers

    Providers eligible to provide, bill and be paid by MHCP for providing GRH supplemental services must:

  • • Have a signed GRH agreement with the county or tribe where the residence is located
  • • Be an enrolled MHCP provider
  • • Have a service authorization for each client being served. Service authorizations are generated by DHS with information provided by the county and authorized services for an individual
  • MHCP Enrollment

    MHCP requires you to enroll each location that provides supplemental services. MHCP allows you to add GRH supplemental services to an existing Home and Community Based Services (HCBS) enrollment record. Review below for the processes to follow.

    A practice location is where services are being provided as listed below:

  • • Residential practice location - If you provide supplemental services to recipients in a GRH setting or program where all residents live in one residential setting, the practice location is the residential setting.
  • • Office practice location - If you provide supplemental services to recipients in a GRH setting or program where residents live in multiple, scattered-site locations, the practice location is the office setting from which employees are sent out to provide the services (for example, a scattered site long-term homeless supportive housing program).
  • To enroll each practice location, complete and submit the following forms and documents to MHCP Provider Enrollment at 651-431-7462 as noted below.

    Enrolling a New GRH Location

    To enroll a new GRH location, complete the following:

  • Group Residential Housing (GRH) Supplemental Services Provider Enrollment Application (DHS-5924) (PDF)
  • Disclosure of Ownership and Control Interest of an Entity (DHS-5259) (PDF)
  • EFT Vendor Number Notification (DHS-3725) (PDF)
  • • Copy of the the signed GRH agreement with the lead agency (county or tribe) to provide supplemental services signed by the lead agency
  • Adding GRH Supplemental Services to an Existing HCBS Enrollment Record:

    To add GRH supplemental services, complete the following:

  • Group Residential Housing (GRH) Supplemental Services – Provider Enrollment Application (DHS-5924) (PDF)
  • • Copy of the current GRH agreement with the lead agency to provide supplemental services signed by the lead agency
  • MCHP Provider Enrollment processes applications in the order received. If you have already submitted your application, Provider Enrollment is working on it and will contact you in writing if anything further is needed. 

    MNITS
    MHCP requires those who provide supplemental services register for a MN−ITS account. You will receive a welcome letter with your MN−ITS registration information once you are approved as an MHCP enrolled provider.

    Eligible Recipients

    Recipients of GRH supplemental services must first be eligible and receiving GRH room and board. Eligiblility includes:

  • • Certified disability, or disabling condition, or 65 years old or older
  • • Low income and low assets
  • • Reside in a setting authorized by the county or tribe with a GRH agreement
  • To qualify for the GRH supplemental services, individuals must also meet the following requirements:

  • • Need help to access and maintain housing and have a verified need for two of the following:
  • • Tenancy supports to assist an individual with finding his or her own home, landlord negotiation, securing furniture and household supplies, understanding and maintaining tenant responsibilities, conflict negotiation, and budgeting and financial education.
  • • Supportive services to assist with basic living and social skills, household management, monitoring of overall well-being, and problem solving.
  • • Employment supports to assist with maintaining or increasing employment, increasing earnings, understanding and utilizing appropriate benefits and services, improving physical or mental health, moving toward self-sufficiency, and achieving personal goals.
  • • Health supervision services to assist in the preparation and administration of medications other than injectable, the provision of therapeutic diets, taking vital signs, or providing assistance in dressing, grooming, bathing, or with walking devices.
  • • Unable to work to the level of self-support, as verified by a qualified professional.
  • • Reside in a qualified setting (see table below). Setting does not automatically qualify individuals for services.
  • Setting Type

    GRH Supplemental Services

    GROUP SETTINGS

     

    Adult foster care

     

    Board and lodging

     

    Board and lodging with special services

    X

    Hotel and restaurant

     

    Non-certified boarding care home

    X

    Supervised living facility

    X

    Registered as housing with services

    X

    Tribe certified

    X

    COMMUNITY BASED SETTINGS

     

    Long term homeless supportive housing

    X

    Registered as housing with services

    X

    Tribe certified

    X

    Covered Services

    Supplemental services minimally include, but are not limited to, oversight and up to 24-hour supervision, medication reminders, assistance with transportation, arranging for meetings and appointments, and arranging for medical and social services.

    Additional services may be covered if authorized in statute for a specific residence or category of housing.

    Noncovered Services

    The following services are not covered:

  • • Services in residential treatment settings
  • • Supplemental service funding cannot be used to pay for housing, utilities, household supplies or other things related to room or board
  • • Supplemental services provided while the recipient has an approved authorization for waiver services
  • Authorization Requirements

    GRH supplemental services require a service authorization (SA). To provide services and receive reimbursement for supplemental services you provide, you must have a service authorization for each client being served. Service authorizations are generated by DHS with information provided by the county and authorizing services for an individual.

    Information on the SA includes:

  • • Minnesota Health Care Programs (MHCP) enrolled provider authorized to provide needed services
  • • Rate of payment for the service
  • • Date or date span of authorization of service
  • • Approved procedure code(s)
  • MHCP will place the service authorization letters into the SAL folder of your MN–ITS miscellaneous received mailbox.

    Before an authorization can be approved, you must:

  • • Have a signed GRH agreement with the county or tribe where the residence is located
  • • Be an enrolled MHCP provider
  • An authorization is valid once approved unless one or more of the following occurs:

  • • The recipient becomes ineligle for services
  • • The recipient changes providers
  • • The providers enrollment status changes or is pending updates
  • • The contract ends with the county
  • Once an issue above is resolved, the authorization may be valid again.

    Billing

    Submitting Claims

    When submitting claims for GRH supplemental services:

  • • Use MN−ITS Direct Data Entry (DDE) or your own X12 compliance software (batch billing system)
  • • Use MN−ITS Professional (837P) claim. Refer to the MN−ITS User Guide for claim completion Instructions
  • • Bill only for services already provided
  • • Bill only for services approved on the authorization. Note: Services that require an SA cannot be billed on the same claim as services that do not require an SA
  • • Submit your usual and customary charges for the service
  • • Provider must enter a diagnosis code when submitting claims for all GRH supplemental services. Providers are required to use the most current, most specific diagnosis code when submitting their claims. MHCP will display the diagnosis code of the recipient onto the service authorization letter
  • • Use the information listed on your service authorization when submitting claims for reimbursement
  • • Use date spans only when you have provided services for all dates in the span
  • Use the following codes to bill for services:

  • • Supported housing per diem rate use procedure code H0043 with U5 modifier
  • • Supported housing per month rate use procedure code H0044 with U5 modifier
  • Definitions

    Refer to Minnesota Statute 256.03 for Definitions

    Legal References

    Minnesota Statute 256I Group Residential Statute

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