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Minnesota Department of Human Services Community-Based Services Manual (CBSM)
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Individual community living supports (ICLS)

Page posted: 3/30/17

Page reviewed:

Page updated: 10/31/17

Legal authority

Federally approved Elderly Waiver Plan, Alternative Care (AC) program (Minn. Stat. §256B.0913)

Definitions

Individual community living supports (ICLS): Bundled service that includes six service categories. ICLS services offer assistance and support for people who need reminders, cues, intermittent/moderate supervision or physical assistance to remain in their own homes.

ICLS Planning Form, DHS-3751: Required communication and planning tool for the person, lead agency and ICLS provider.

Covered services

ICLS covers assistance and support for eligible people 65 years and older who use Elderly Waiver (EW) or the Alternative Care (AC) Program. It includes the following service categories:

  • • Active cognitive support
  • • Adaptive support service
  • • Activities of daily living (ADLs)
  • • Household management
  • • Health, safety and wellness
  • • Community engagement.
  • Active cognitive support

    The “active cognitive support” category includes interventions intended to address cognitive issues and challenges important to the person. Active cognitive supports are the only ICLS services that the person can receive both in-person and remotely. For more information, see settings under secondary information.

    Examples of ICLS services covered under this category include:

  • • Problem solving the person’s concerns related to daily living
  • • Providing assurance to the person
  • • Observing and redirecting to address behavioral, orientation or other cognitive concerns.
  • Adaptive support service

    The “adaptive support service” category includes services intended to help the person adopt ways to meet his or her needs. ICLS adaptive support services:

  • • Encourage the person’s self-sufficiency
  • • Reduce the person’s reliance on human assistance.
  • Examples of ICLS services covered under this category include:

  • • Verbal, visual and/or touch guidance to help a person complete a task
  • • Developing and demonstrating cuing or reminder tools (e.g., calendars, lists)
  • • Providing verbal, visual and/or touch guidance to help the person complete a task
  • • Helping the person understand written assistive technology directions or instructions from the manufacturer or health professional so the person can maintain independence.
  • Activities of daily living (ADLs)

    The “ADLs” category includes services intended to assist the person with ADLs.

    Household management

    The “household management” category includes services intended to help the person manage his or her home. Examples of ICLS services covered under this category include:

  • • Assisting with cleaning, meal planning/preparation, and shopping for household/personal needs
  • • Assisting with budgets and money management
  • • Assisting with communications (e.g., sorting mail, accessing email, placing phone calls, making appointments)
  • • Providing transportation when transportation is integral to ICLS household management goals and community resources and/or informal supports are not available. 
  • Health, safety and wellness

    The “health, safety and wellness” category includes services intended to help the person maintain his or her overall well-being. Examples of ICLS services covered under this category include:

  • • Identifying changes in health needs, and notifying the case manager and/or informal caregivers as needed
  • • Coordinating or implementing changes to mitigate environmental risks in the home
  • • Providing reminders about and assistance with exercises and other health maintenance/improvement activities
  • • Providing medication assistance (e.g., medication refills, reminders, administration, and/or preparation)
  • • Monitoring the person’s health according to written instructions from a licensed health professional
  • • Using medical equipment devices or adaptive technology according to written instructions from a licensed health professional.
  • Community engagement

    The “community engagement” category includes services intended to help the person have meaningful integration and participation in his or her community. Examples of ICLS services covered under this category include:

  • • Facilitating the person in socially valued roles through engagement in relevant activities that lead to desired outcomes
  • • Helping the person access activities, services and resources that facilitate meaningful community integration and participation
  • • Helping the person develop and/or maintain his or her informal support system
  • • Providing transportation when it is integral to ICLS community engagement goals and community resources and/or informal supports are not available.
  • Non-covered services

    ICLS does not cover:

  • • Specialized and/or adapted equipment for remote support
  • • Transportation mileage (for other options, see the transportation section).
  • EW only

    The person cannot receive ICLS if he or she receives any of the following EW-funded services:

  • • Consumer directed community supports (CDCS)
  • • Customized living
  • • Foster care
  • • Residential care.
  • Planning form

    The purpose of the ICLS Planning Form, DHS-3751 (PDF) is to communicate to the ICLS provider the specific ICLS service components the person will receive. In the form, the case manager/care coordinator:

  • • Identifies the individual goals the ICLS service is intended to support
  • • Describes and provides detail about the type of services the person will receive within each ICLS service category
  • • Calculates the total amount of ICLS services the person will receive each week (i.e. total number of units)
  • • Calculates the total costs each week.
  • Process

    The case manager/care coordinator completes the ICLS Planning Form, DHS-3751 with the person. The person, case manager/care coordinator and provider must sign the completed form. Both the lead agency and provider must keep a copy of the completed and signed form.

    Service amount

    The person can receive up to 12 hours of face-to-face ICLS services per day (i.e., 48 15-minute units per day).

    The person can receive 15 minutes of remote service per day.

    Settings

    The person can receive active cognitive support services either:

  • • In-person
  • • Remotely via real-time, two-way communication between the person and the provider (e.g. phone, live video, etc.).
  • The person must receive all other service categories in-person. The person must receive in-person ICLS services in a single-family home or apartment that he/she or his/her family owns or rents (as demonstrated by a lease agreement). In a rental scenario, the person or his/her family must maintain control over the individual unit.

    The person must receive ICLS services in-person once per week.

    Transportation

    An ICLS provider also may enroll with Minnesota Health Care Programs (MHCP) as a waiver/AC transportation provider. An ICLS provider who is also an MHCP-enrolled waiver/AC transportation provider can bill for both ICLS and transportation (using the mileage rate) when they are provided on the same day. The provider may not bill ICLS and transportation at the same time.

    For the current waiver transportation mileage rates, see Long-Term Services and Supports (LTSS) Service Rate Limits, DHS-3945 (PDF).

    Provider standards and qualifications

    ICLS is a DHS enrollment-required service. For more information, see CBSM – Waiver/AC service provider overview.

    License requirements

    An ICLS provider must meet one of the following license requirements:

  • • Have a license under Minnesota Statutes, Chapter 245D as a basic support service provider
  • • Have a comprehensive home care license under Minnesota Statutes, Chapter 144A with a home and community-based services designation.
  • Additional requirements

    An ICLS provider cannot:

  • • Be an arranged home care provider for a housing with services establishment where the person resides
  • • Be related to the person by blood, marriage, or adoption
  • • Be the person’s legal guardian or conservator
  • • Be the person’s landlord
  • • Have any financial interest in the person’s housing.
  • Authorization, rates and billing

    The lead agency authorizes ICLS at the state-established, 15-minute rate.

    The lead agency uses separate codes to authorize in-person services and remote services.

    For more information, including current rates and codes, see Long-Term Services and Supports (LTSS) Service Rate Limits, DHS-3945 (PDF).

    Additional resources

    CBSM – Alternative Care
    CBSM – Elderly Waiver

    CBSM – Rate methodologies for AC, ECS and EW service authorization

    New Service for Elderly Waiver and Alternative Care: Individual Community Living Support, DHS bulletin #17-25-02 (PDF)

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