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Minnesota Department of Human Services Community-Based Services Manual (CBSM)
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Financial management of the BI, CAC and CADI waivers

Page posted: 8/1/04

Page reviewed: 12/2/15

Page updated: 3/15/17

Legal authority

Federally approved BI, CAC and CADI waiver plans, Minn. Stat. §256B.49, subd. 17, Minn. Stat. §256B.49, subd. 27

Definitions

CCB waivers: CAC, CADI and BI waivers

Budget overview

Each fiscal year, DHS gives lead agencies a CCB waiver budget to manage waiver authorizations. DHS includes home-care costs for waiver participants in the lead agency's budget.

Budget management requirements

Lead agencies have requirements to both:

  • • Assure access to waivers
  • • Limit overspending.
  • For more information, see the budget requirements section on CBSM – Financial management of the waivers – overview.

    New enrollment

    When it enrolls a new person, the lead agency must choose if the person will start a waiver with new funding (a conversion or a diversion) or use existing funding.

    New resource allocations

    DHS awards new resources to lead agencies that use diversion and conversion allocations. DHS allocates new CADI diversion allocations to lead agencies each July. CAC and BI diversions are available from a statewide pool at this time as well. Lead agencies may view their new resource allocations in the Waiver Management System.

    Conversion

    DHS will award a lead agency a funded conversion allocation when:

  • • A person exits a nursing facility and immediately enrolls in the waiver (CADI and BI-NF conversions)
  • • A person exits a hospital and immediately enrolls in the waiver (CAC and BI-NB conversions)
  • See CBSM – CCB conversions and diversions for more information.

    Diversion

    Lead agencies use a diversion to serve an eligible person without exiting a nursing facility or hospital.

    Reuse allocations

    When a recipient exits a waiver, a lead agency may use the exiting person's existing funds to either:

  • • Serve a new recipient
  • • Pay for additional costs of existing recipients.
  • When a recipient exits the waiver and re-enters during the same fiscal year, the lead agency must use a reuse allocation, unless one is not available.
  • Additional funding

    If a lead agency does not have sufficient available funds or allocations to serve all eligible CADI, CAC or BI recipients, contact the DSD Response Center for assistance. A lead agency may receive additional CADI new resource allocations if necessary.

    Changes between nursing-facility and hospital level of care (LOC)

    Change from nursing-facility to hospital LOC

    A lead agency follows these steps when a person changes from nursing-facility(CADI or BI-NF) to hospital level of care:

    1. Determine person’s eligibility based on assessment and waiver eligibility criteria.
    2. Close the service agreement after prorating and reducing line item units, if closed early.
    3. Enter an exit-screening document.
    4. Enter a new screening document and service agreement indicating a change to hospital level of care.

    Change from hospital LOC to nursing facility LOC

    A lead agency follows these steps when a person changes from hospital level of care to nursing-facility level of care (CADI or BI-NF):

    1. Determine person’s eligibility based on assessment and waiver eligibility criteria.
    2. Close the service agreement after prorating and reducing line item units, if closed early.
    3. Enter an exit-screening document.
    4. Enter a new screening document and service agreement indicating a change to nursing facility level of care.

    New hospital-level waiver recipients

    Lead agencies may access additional funding for a new CAC or BI-NB waiver recipient when the person requires significantly more funding than a new resource allocation will create. The following criteria must be met:

    1. The lead agency does not have the sufficient funds in their budget to serve the person, based on DHS evaluation.
    2. The waiver applicant is in a hospital or at imminent risk of being placed in a hospital.
    3. Additional funding is necessary for direct care support such as nursing care.

    To request additional funding for new hospital-level waiver recipients, the lead agency may contact the DSD Response Center.

    Transfer resources for CFR changes

    For instructions on how to transfer resources when a person on a CCB waiver changes county of financial responsibility (CFR), see CBSM – How to transfer resources in the WMS for CFR changes.

    Additional resources

    CBSM – CCB conversions and diversions
    CBSM – Financial management of the DD Waiver

    CBSM – Financial management of the waivers – overview

    CBSM – How to transfer resources in the WMS for CFR changes

    CBSM – Tribal administration of HCBS programs

    CBSM – Waiver Management System (WMS)

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