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Minnesota Department of Human Services ICF/DD Manual
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Services During the Day

Page posted: 07/01/02

Page reviewed: 2/22/11

Page updated: 12/21/07

Legal Authority

Minn. Stat. §256B.501, subd. 3m and Minn. Stat. §256B.5015, subd. 2

Background

Services during the day for persons who live in an Intermediate Care Facility for Persons with Developmental Disabilities provide flexibility and the choice to select and use the program option that best meets the person’s needs as identified in the Individual Service Plan.

Current options for persons include:

  • • DT&H program funded as a pass through payment of the ICF/DD
  • • Retirement from DT&H that could be funded using variable rate funding
  • • Retirement from DT&H while remaining in the ICF/DD with no additional increase in the facility rate
  • • Services during the day provided by some entity other than a Day Training and Habilitation
  • The ICF/DD and DT&H provider are required to provide active treatment and meet all of the federal regulations that govern a person who resides in an ICF/DD, no matter which of the options above, is used.

    Definition

    Services during the day: Services or supports provided to a person that enables the person to be fully integrated into the community. Services during the day may include a variety of supports to enable the person to exercise choices for community integration and inclusion activities. DT&H is not a part of this option.

    Eligibility

    Services during the day must comply with active treatment requirements for persons who reside in an ICF/DD. Services may not be provided by the residential service provider, unless the person or their legal representative is:

  • • Agrees in writing to provision of services during the day by the residential service provider, consistent with the ISP
  • • Given a choice of providers
  • Services during the day can be provided by any of the following:

  • • ICF/DD where the person resides
  • • ICF/DD other than where the person resides
  • • Separate entity that is monitored and paid for as a “pass through” by the ICF/DD where the person resides
  • A person can receive services during the day from someone other than the ICF/DD when that is the choice of the person or their legally authorized representative. The ICF/DD is responsible to arrange, oversee and bill for the services provided. The ICF/DD will pay the provider of the service at a rate that does not exceed the rate approved by the DHS.

    Duration

    Provide services during the day in full-day increments for up to five days per week. The following schedule changes are possible if the person’s needs change with prior approval:

  • • Services may increase up to five days per week
  • • Services may decrease to zero days per week
  • Documentation

    Once a person chooses the services during the day option, their ISP must be modified to:

  • • Describe how health, safety, protection and habilitation needs will be met (including how frequent and regular contact with persons other than the residential service provider will occur)
  • • Document the schedule, location and provider of services
  • Services comply with active treatment requirements as defined under the CFR Title 42, 483.440.

    Approvals and Denials

    The case manager uses the ICF/DD Services During the Day Option application form DHS-4677F (PDF) to request this option. Once DSD staff receives the form, the rate is determined. The county and services during the day provider sign the ICF/DD Services During the Day Option Agreement DHS-4677G (PDF). DSD staff notifies the case manager of the approval and the daily rate in writing.

    Funding

    Services during the day, excluding DT&H services, are funded as a pass-through payment. Rates for these services cannot exceed 75 per cent of a person’s DT&H services costs prior to the service change. The rate is determined by DHS and is not negotiable by the county or provider. The rate must be applied only to the person who requested services during the day.

    The pass-through payments for services during the day are paid separately by DHS and are not included in the ICF/DD facility total payment rate.

    Billing

    A person will not be able to attend both a DT&H and services during the day on the same day. Only one of these two services may be billed on any given day. For example, a person can choose to have services during the day on Monday, Tuesday and Wednesday provided by the residential provider and attend DT&H Thursday and Friday.

    The ICF/DD who has signed the services during the day agreement with the county will bill for services during the day by submitting the HCFA-1500 form. The facility may bill DHS for the approved amount of services identified in the service agreement under procedure code H2016.

    Contact the DHS Provider Call Center with questions regarding completion of the HCFA-1500.

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    © 2017 Minnesota Department of Human Services Updated: 10/24/17 10:47 AM | Accessibility | Terms/Policy | Contact DHS | Top of Page | Updated: 10/24/17 10:47 AM