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County of Financial Responsibility

Page posted: 3/07/05

Page reviewed: 2/24/11

Page updated: 8/15/05

Legal Authority

42 CFR 483.440, Minn. Stat.§252.282, Minn. Stat. §256B.092, Minn. Stat. §256B.501, Minn. Stat. §256B.5012 - §256B.5015


County of financial responsibility: Entity who assumes responsibility for all monitoring and implementation of necessary paperwork and action related to a person from the county for whom they are financially responsible living in an Intermediate Care Facility for Persons with Developmental Disabilities.

CFR Duties

The county of financial responsibility has many primary responsibilities to persons who utilize the ICF/DD system.

The CFR conducts or arranges for diagnostic evaluations in order to determine whether persons have or may have a developmental disability and/or related condition. If the CFR determines a person has a developmental disability or related condition, the county informs the person that case management services are available.

The administrative functions of case management provided to or arranged for persons include the following:

1. Review of eligibility for services
2. Screening
3. Intake
4. Diagnosis
5. Review and authorization of services based upon an individualized service plan
6. Response to requests for conciliation conferences and appeals to ICF/DD level of care.

Lead Agency Case Manager Responsibilities

Lead agency case managers are responsible to:

  • • Assure admission to an ICF/DD is the choice of the person and meets identified needs
  • • Assure ICF/DD follows guidelines for temporary service suspension and termination of services
  • • Assure Individual Support Plans are current, relevant and meets requirements for active treatment
  • • Base ICF/DD closures, downsizing or relocation plans on identified choices of the people and local system needs planning processes
  • • Complete and amend LSNP based on identified needs using DHS guidelines
  • • Comply with all legal and system requirements for short-term admission to an ICF/DD from the Developmental Disabilities Waiver if this option is chosen and part of the ISPs
  • • Determine if Day Training and Habilitation or services during the day is the choice of the person and meets the identified needs according to a current ISP
  • • Determine if permanent partial or full retirement is the choice of the person and assure retirement occurs for the person regardless of funding
  • • Determine if special needs requests are relevant and appropriate based on the legal definitions of use and cost detail requested (these include variable rate adjustments and 186 special needs funding
  • • During yearly planning for people residing in ICFs/DD, request therapeutic leave days from DHS as a part of the planning process prior to using any of the allowable days
  • • Make appropriate payments related to 10% county share
  • • Request/grant host county concurrence based on needs of the person for ICF/DD services
  • • Utilize moving protocol when people move from ICFs/DD to assure all personal possessions and records are accounted for and available upon request
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