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186 Special Needs Funding

Page posted: 07/01/02

Page reviewed: 12/15/10

Page updated: 11/27/2007

Legal Authority

Minn. Stat. §256B.501, subd. 1 and Minn. R. parts 9510.1020 to 9510.1140

Background

The purpose of special needs funding is to provide person-specific needed services when the costs of the services are not included in the per diem of the DT&H. Provision of and payment for these services is intended to meet short-term needs so persons may access their day services.

Definition

186 Special Needs Funding: One-time reimbursement of consultation, equipment, short-term staff intervention and/or training costs.

Eligibility

Persons who reside in community-based ICFs/DD are eligible for 186 special needs funding if the application shows the person:

  • • Is eligible for Medical Assistance
  • • Resides in an ICF/DD
  • • Is diagnosed with a developmental disability or related condition
  • • Has severe maladaptive behavior or severe physical disability or medical condition
  • Providers are eligible for special needs funding if all of the following are met:

  • • Existing DT&H program or services offered by the provider cannot be modified to meet the person’s needs within the provider’s approved per diem rates
  • • DT&H program historical cost per diem does not include the cost of providing the same or similar person with these staff interventions
  • • DT&H provider is willing to serve or continue to serve a person who is eligible for and receives a special needs funding
  • Special needs funding cannot exceed twelve months and 1440 staff hours. Funding is reviewed for approval once the county determines that other funding sources or alternatives for services have been exhausted.

    Duration

    Special needs funding may be approved for up to 12 months with a maximum of two renewals.

    Documentation

    Supporting documentation, including an addendum to the client’s ISP must indicate the need for services that special needs funding is being requested to support.

    The provider completes the Provider Application for Special Needs Funding DHS-4677D (PDF). The county determines if the provider and the person or persons identified in the application meet the eligibility requirements.

    Quarterly reports from the provider and case manager are submitted to DHS.

    Approvals and Denials

    A letter of approval or denial of the request will be sent from the Disability Services Division, ICF/DD manager within 30 working days of receipt of the complete application.

    If the request is denied, ICF/DD manager will specify the reason(s) for denial, based on the requirements for approval within the statute and rule governing the special needs funding.

    Requests for reconsideration of denials must address these reasons specifically. Such requests must be received by the Department within 10 days of notice of the decision to deny the request.

    If the request for reconsideration is denied, the commissioner's decision is final. However, persons whose services are denied, terminated or reduced may appeal that action. All appeals of county action shall be heard and decided in accordance with Minn. Stat. §256.045.

    Billing

    All billing for 186 special needs funding must be submitted using the CMS-1500 form. Contact the Provider Help Desk with questions regarding completion of the billing form.

    Provider Call Center

    (651) 431-2700 or (800) 366-5411
    TTY: 1 (866) 273-5276
    Fax: (651) 431-7425

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