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Minnesota Department of Human Services Community-Based Services Manual (CBSM)
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Waiver/AC service provider overview

Page posted: 1/23/14

Page reviewed: 12/19/16

Page updated: 12/19/16

Legal authority

Federally approved BI, CAC. CADI, DD and EW waiver plans, Alternative Care (AC) program (Minn. Stat. §256B.0913), Minnesota Statutes, Chapter 245D, Minn. Stat. §256B.4912, subd.1 and 5

Overview

All home and community-based waiver and Alternative Care (AC) service providers must comply with Medical Assistance (MA) and federally approved, state service standards.

We categorize waiver/AC services into two groups:

DHS enrollment-required services

(Formerly Tier 1 services)

DHS enrollment-required services must be delivered by providers enrolled with DHS as Minnesota Health Care Programs (MHCP) providers. For a list of services, see the DHS enrollment-required services section on this page.

DHS or lead agency approval-option services

(Formerly Tier 2 and Tier 3 services)

DHS or lead agency approval-option services can be delivered by MHCP-enrolled providers or qualified vendors approved by willing lead agencies. For a list of services, see the DHS or lead agency approval-option services section on this page.

Lead agency approval

For information about how the lead agency approves an approval-option service provider, see CBSM — Lead agency oversight of waiver/AC approval-option service vendors. For training on this policy and process, see TrainLink – Lead Agency Oversight of HCBS Waiver/AC Approval-Option Service Vendors.

Navigate this page

We are in the process of integrating AC and EW information into the CBSM waiver/AC service pages. Until we complete this process, refer also to the service information on MHCP Provider Manual – EW and AC.

DHS enrollment-required services

(Formerly Tier 1 services)

All DHS enrollment-required services also require providers to have a license or certification. We organize the DHS enrollment-required services by required license/certification. Each service links to individual pages with more information.

Services licensed under 245D

Basic support services

To deliver the following DHS enrollment-required services, the provider must have a license under Minnesota Statutes, Chapter 245D as a basic support service provider:

  • 24-hour emergency assistance / non-equipment
  • Adult companion services (excludes providers who have a license under Minnesota Statutes, Chapter 144A or who are an adult companion provider under the Corporation for National and Community Services Senior Companion Program)
  • Homemaker (excludes providers who have a license under Minnesota Statutes, Chapter 144A or who deliver cleaning services only)
  • Night supervision
  • Personal support
  • Respite.
  • Intensive support services

    To deliver the following DHS enrollment-required services, the provider must have a license under Minnesota Statutes, Chapter 245D as an intensive support service provider:

    Services licensed by DHS or MDH

    To deliver the following DHS enrollment-required services, the provider must have a license from the Department of Human Services (DHS) or Department of Health (MDH):

  • Adult day services
  • Adult day services bath
  • Customized living
  • Extended home care services (nursing, home health aide and therapies)
  • Family adult day services (FADS)
  • Homemaker (excludes providers who have a license under Minnesota Statute, Chapter 245D or who deliver cleaning services only)
  • Residential care services.
  • Services requiring certification

    To deliver the following DHS enrollment-required services, the provider must have a service-specific certification:

    DHS or lead agency approval-option services

    (Formerly Tier 2 and Tier 3 services)

    DHS or lead agency approval-option services include direct-delivery services and purchased-item services.

    Approval-option: direct-delivery services

    (Formerly Tier 2 services)

    A direct-delivery service is delivered by an individual in or around the home, or in a non-commercial vehicle. Direct-delivery services include:

    Approval-option: purchased-item services

    (Formerly Tier 3 services)

    Purchased item services include:

    Caregiver living expenses

    Caregiver living expense providers must meet the provider standards and qualifications for the waiver service delivered by the live-in caregiver. A lead agency determines eligibility for this service following the policies described on CBSM – Caregiver living expenses.

    Required DHS background studies for direct-contact services

    Minn. Stat. §256B.4912, subd.1 (3b) (3c), requires that staff who provide direct contact (as defined in Minn. Stat. §245C.02, subd. 11) meet the background study requirements of Minnesota Statutes, Chapter 245C. Service owners and managerial officials must meet the requirements of Chapter 245C before they enroll with MHCP or are approved by a lead agency (in the case of an approval-option service).

    Responsibility

    MHCP providers are directed through background study requirements as a part of the enrollment or licensure process.

    Lead agencies that approve vendors to deliver the subset of approval-option: direct delivery services that are direct-contact services need to follow the DHS background study process. For instructions, see CBSM – DHS background study process for lead agencies that approve service vendors.

    Training

    MHCP-enrolled providers

    Most providers that enroll with DHS as an MHCP, home and community-based waiver/AC service provider must complete:

  • HCBS Waiver/AC – Provider Training 101 prior to enrollment
  • HCBS Waiver/AC – Waiver Billing Lab within six months of enrollment.
  • For more MHCP provider training opportunities, see DHS – Provider training.

    College of Direct Support

    The College of Direct Support, in partnership with DHS, offers a collection of optional, web-based courses designed for:

  • • Direct support staff
  • • Lead agency staff
  • • People with disabilities and their families
  • • Others who support people with disabilities.
  • For more information, see DHS – College of Direct Support.

    Search for providers

    To find waiver/AC service providers, search MinnesotaHelp.info®.

  • • Lead agency staff and people who use services may use the instructional guide, DHS-6933 (PDF) for help navigating MinnesotaHelp.info®.
  • • Providers may view the video tutorials for help navigating the provider portal section of MinnesotaHelp.info®. In the provider portal, the provider can add and subsequently modify information about his or her agency
  • Additional resources

    MHCP-enrolled providers

    MHCP Provider Manual – HCBS programs provider enrollment
    MHCP Provider Manual – HCBS waiver services

    MHCP Provider Manual – EW and AC

    MHCP Provider Manual – Billing for waiver and AC programs

    MHCP enrolled providers – HCBS waiver and AC programs

    245D license

    DHS – 245D licensing for HCBS
    DHS – Policies and forms for providers licensed under 245D

    Sample Self-Monitoring Checklist (PDF)

    DHS – Licensing Division contacts

    CBSM – How do I become a 245D-licensed HCBS waiver or AC provider?

    Service rates and billing codes

    For service rates and billing codes, see Long-Term Services and Supports Service Rate Limits, DHS-3945 (PDF).

    Questions?

    If you have questions about:

  • • 245D licensing requirements, call 651-431-6500
  • • BI, CAC, CADI and DD waivers, email the DSD Response Center at DSD.ResponseCenter@state.mn.us
  • • AC and EW programs, search/submit to Disability and Aging PolicyQuest
  • • MMIS, contact the Resource Center at DHS.ResourceCenter@state.mn.us or 888-968-8463
  • • MDH licenses, credentials or registration, see MDH Health Regulation – Facilities and Providers.
  • Providers

    If you are a provider and have questions, contact the MHCP Provider Call Center.

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    © 2017 Minnesota Department of Human Services Updated: 10/24/17 10:34 AM | Accessibility | Terms/Policy | Contact DHS | Top of Page | Updated: 10/24/17 10:34 AM