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Remote support – Individualized home supports and supported living services for adults in own home

Page posted: 7/1/18

Page reviewed:

Page updated: 10/24/18

Legal authority

Federally approved BI, CAC, CADI and DD waiver plans, Minn. Stat. 13.36, subd. 1(c) (Government Data Practices Act), Minn. Stat. Chapter 245D

Definition

Remote support: A real-time, two-way communication between the provider and the person. Remote support:

  • • Supplements direct in-person service delivery of individualized home supports and supported living services for adults in their own home (SLS)
  • • Meets the intermittent or unscheduled support needs for a person to live and work in the most integrated setting.
  • Real-time, two-way communication: Remote support delivered through one of the following methods:

  • • Telephone
  • • Secure written electronic messaging (e.g., texting) (Note: this does not include email or fax)
  • • Secure video conferencing.
  • Background

    A person may receive individualized home supports or supported living services for adults in their own home (SLS) through:

  • • In-person service delivery (see CBSM – Individualized home supports or CBSM – Supported living services for adults in own home)
  • • Remote support service delivery.
  • The policy for direct support provided remotely is separate from the monitoring technology policy (see CBSM – Monitoring technology usage).

    Eligibility

    To receive remote support, a person must live in his/her own home (see CBSM – Requirements for a person’s own home) and receive in-person individualized home supports or supported living services for adults in their own home.

    In-person support must be scheduled a minimum of once a week when receiving remote support.

    A person may receive in-person support and remote support on the same day.

    Covered services

    Remote supports must be in the scope of individualized home supports or supported living services and are limited to:

  • • Check-ins (e.g., reminders, verbal cues, prompts)
  • • Consultation (e.g., counseling, problem solving).
  • Either the person or the service provider staff may initiate the remote support contact.

    Remote support is covered when it:

  • • Is chosen as a service delivery method by the person (or guardian, as applicable)
  • • Helps the person achieve an identified goal in the coordinated services and supports plan (CSSP)
  • • Is supported by an assessed need
  • • Is in the scope of the services specified in the coordinated services and supports plan.
  • Non-covered services

    Remote support does not cover:

  • • Services that duplicate other Minnesota state plan or waiver services
  • • Technology used to gather data using sensing or biometric devices transmitted via telephone or internet.
  • Providers may not:

  • • Bill for direct support delivered remotely when the exchange between the person and the provider is social in nature
  • • Bill for direct support delivered remotely when real-time, two-way communication does not occur (e.g., leaving a voicemail, unanswered written electronic messaging).
  • • Use Global Positioning System (GPS), personal emergency response system (PERS) and video surveillance to provide remote check-in or consultative supports.
  • Secondary information

    All transmitted written electronic messages must be retrievable for review. Providers must choose a storage method that makes the written electronic messages retrievable.

    A provider must follow the same data privacy laws, restrictions and guidelines in the Minnesota Health Care Program (MHCP) Provider Agreement, DHS-4138 (PDF).

    Service amount

    Remote support is a unit-based service authorized in 15-minute increments. A maximum of 730 hours can be authorized in a year (365 days), which is an average of two (2) hours per day.

    A person may use remote support in a flexible manner that meets his/her needs within the total yearly authorized units.

    Service amount exception request

    The lead agency may send an exception request for the delivery of greater than the average of two (2) hours per day of remote support to DHS by completing the Remote support exception form, DHS-7759A.

    Exception request for additional hours

    In the exception request, the case manager must describe all of the following:

  • • How has the person identified he/she wants to receive remote support to meet his/her assessed needs?
  • • How does two hours of remote support per day not meet the person’s needs?
  • • How will the additional hours of remote support will be used?
  • • What previous strategies were attempted/considered to meet the person’s needs within the two-hour limitation? What was the result of these strategies?
  • • How will the person know the increased hours meet his/her needs?
  • • How will the team know the increased hours are meeting the person’s assessed needs?
  • • Is this a temporary or ongoing request? Explain why.
  • Documentation

    To deliver remote support services, providers must document the following in the person’s record:

  • • Staff who delivered services
  • • Date of service delivery
  • • Start and end time of service delivery with a.m. and/or p.m. notations
  • • Length of time of service delivery
  • • Method of contact (i.e., telephone, secure written electronic communication or secure video conferencing)
  • • Location of staff (i.e., office or community) where remote support service delivery occurred.
  • Coordinated services and supports plan (CSSP) and CSSP addendum

    In the CSSP and CSSP addendum, documentation should include:

  • • Person’s specific goal(s) to meet assessed need(s) for which delivery of remote support is needed
  • • Approved method(s) of remote support delivered to the person to meet assessed need(s)
  • • Amount, frequency and duration of remote support use.
  • Recommended practices for review of service delivery

    The following are recommended practices:

  • • The provider reviews with the person and case manager 45 days after initial approval of remote support service delivery to monitor and document how the amount of remote support and method(s) of delivery are meeting the person’s health and safety needs and planned goals
  • • At a frequency agreed upon in the CSSP, the provider reviews, documents and reports to the case manager how remote support method(s) meet the person’s established goal(s) in the plan and any indication of changes to the person’s health and safety needs.
  • Provider standards and qualifications

    Individualized home supports and supported living services are DHS enrollment-required services. For more information, see CBSM – Waiver/AC service provider overview.

    License requirement

    An individualized home supports and supported living services provider must have a license under Minnesota Statutes, Chapter 245D as an intensive support services provider.

    Reporting

    A provider licensed under 245D must report all uses of controlled procedures, emergency use of manual restraint and prohibited procedures according to Minn. Stat. 245D.06, subd. 5 to DHS via the Behavioral Intervention Report Form, DHS-5148.

    Authorization, rates and billing

    Individualized home supports and supported living services are framework services. The lead agency uses the Rate Management System (RMS) to determine rates. For more information, see CBSM – Rate Management System and Long-Term Services and Supports (LTSS) Service Rate Limits, DHS-3945 (PDF).

    The lead agency authorizes individualized home supports:

  • • In-person at a 15-minute or daily rate
  • • Remote support at the 15-minute rate.
  • In-person individualized home supports 15-minute and in-person individualized home supports daily cannot be authorized at the same time.
  • Remote support cannot be authorized without in-person individualized home supports.
  • Additional resources

    CBSM – BI, CAC, CADI and DD waivers general process and procedures
    CBSM – Habilitation services – residential – supported living services for adults in own home

    CBSM – Individualized home supports

    TrainLink – Disability Services Division training archive
    (look for individualized home supports presentations from June 20, 2018, and July 16, 2018)

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