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Minnesota Department of Human Services Community-Based Services Manual (CBSM)
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Moratorium on corporate foster care and community residential setting development

Page posted: 12/8/09

Page reviewed: 8/31/17

Page updated: 8/31/17

Legal authority

Minn. Stat. §245A.03, subd. 7, Minn. Stat. §256B.03, Minn. Stat. §256B.0911, Minn. Stat. §256B.092, Minn. Stat. §256B.49, Minn. Stat. §256B.493

Definitions

Corporate foster care setting: A licensed foster care setting where the license holder does not reside. This setting typically uses a shift-staff model of support (i.e., paid staff work shifts on a 24-hour basis).

Community residential setting: A licensed foster care setting where the license holder does not reside and everyone who lives in the setting is on the same disability waiver. This setting typically uses a shift-staff model of support.

Overview

The 2009 Minnesota Legislature authorized a moratorium on the growth of licensed adult and child corporate foster care and community residential settings.

Effective Sept. 1, 2009, the legislature established a statewide capacity threshold for the duration of the moratorium. This threshold is based on results of an ongoing needs determination process. In 2011, the legislature established a statewide capacity reduction of "up to 128" corporate foster care/community residential setting beds. This requirement was met by the June 30, 2014, deadline.

The moratorium remains in effect.

Scope

DHS licenses for corporate foster care and community residential settings are subject to the moratorium and de-licensing of vacancies and closures.

Lead agency management

Moratorium liaisons

The corporate foster care moratorium liaison at each county manages the day-to-day capacity process for corporate foster care settings.

Duties

The moratorium liaison where the setting is/would be located is the liaison who:

1. Serves as the contact person between the lead agency, county licensing agent, DHS Licensing Division and DHS Disability Services Division (DSD) regarding moratorium and capacity issues
2. Works with lead agencies and provider partners to manage the corporate foster care moratorium and the need for new development and closures
3. Understands the corporate license capacity/moratorium exceptions and identifies opportunities to evaluate and adjust capacity to meet people's needs while reflecting individual choices
4. Works with people who receive services, their teams, the lead agency and provider(s) to determine if a corporate foster care setting is the best and most integrated community living option and, if so, determines priority needs for services in the corporate foster care setting
5. Works with people who receive services, their teams and the lead agency to identify and monitor situations where people currently served in corporate foster care could — based on their preferences and needs — be provided with less intensive services in alternative or less restrictive settings (e.g., with a companion who could provide the same care, etc.)
6. Completes and submits DSD requests for all new corporate foster care development (including exceptions and closures)
7. Processes DSD-approved forms with county licensing staff
8. Attaches applicable DSD-approved forms to all corporate foster care licensing application materials and sends to the DHS Licensing Division.

Ch. 144D

The lead agency submits licensing applications for settings registered under Minnesota Statues, Chapter 144D directly to DHS Licensing (outside of this DSD process).

Submitting DSD requests

County moratorium liaisons should use the applicable sections of the Disability Services’ Request to Close or Develop New Corporate Foster Care form, DHS-6021 (PDF) to:

  • • Request permanent closure of a licensed corporate foster care home and the provider seeks a rate adjustment
  • • Permanently close a bed(s)
  • • Close a bed(s) with the intent to repurpose it with a different provider
  • • Change premise (i.e., close a bed and move to a new location with the same provider)
  • • Request a change of ownership
  • • Recommend new corporate foster care development(s)
  • • Request an exception to the licensing moratorium
  • • Request a permanent 5th bed license.
  • Approval of requests does not guarantee rates or licensing: They are separate DHS processes.

    Exceptions

    A corporate foster care or community residential setting may receive an exception from the licensing moratorium when it:

  • • Allows movement to the community for people who no longer need the level of care provided at the Minnesota State Security Hospital or Anoka Metro Regional Treatment Center
  • • Is licensed under Minnesota Statutes, Chapter 144D (i.e., settings where 80 percent or more of the residents are 55 years or older)
  • • Is necessary to serve people on the Community Alternative Care (CAC) or Brain Injury – Neurobehavioral Hospital (BI–NB) waivers
  • • Is necessary due to the closure of a nursing facility, ICF/DD, regional treatment center or restructuring of state-operated facilities and closure plans are in place
  • Exceptions with additional eligibility criteria

    Exceptions with additional eligibility criteria are available for people:

  • • Transitioning from residential care waiver services to foster care services (see section on transition criteria)
  • • Receiving services under chapter 245D and living in an unlicensed setting before May 1, 2017, that should be licensed [this exception does not apply to people living in their own home] (see section on 245D/previously unlicensed criteria)
  • Requirement

    In both these situations, the person must receive information from his/her case manager about options for services, providers and service locations to help him/her make an informed choice.

    Transitioning from residential care to foster care

    For a moratorium exception for a person transitioning from residential care waiver services to foster care services:

  • • The lead agency must determine that the person’s foster care services are not more than the cost of the person’s services provided in the residential care waiver service setting.
  • 245D/previously unlicensed

    This scenario allows for a moratorium exception when the following is true:

  • • The person receives services licensed under Minnesota Statutes, Chapter 245D
  • • The person resides in an unlicensed setting before May 1, 2017, and the setting requires a license.
  • For this exception:

  • • The lead agency must determine that the person's services provided in the licensed corporate foster care/community residential setting are not more than the cost of his/her services provided in the unlicensed setting.
  • This exception is available until June 30, 2018. It does not apply to people who live in their own home (see CBSM — Requirements for a person’s own home.)

    How to request an exception

    To request an exception, the corporate foster care moratorium liaison for where the setting is located completes Section D of the 6021 form.

    Voluntary closure rate adjustment

    Licensed providers can both:

  • • Obtain approval to voluntary close corporate foster care homes
  • • Receive a rate adjustment during the closure period.
  • This rate adjustment process is not available for retroactive closures or partial-home closures. A provider interested in a partial-home closure or licensed capacity reduction of a home should directly contact the county of residence's moratorium liaison.

    How to obtain approval

    A provider may obtain approval to close a licensed corporate foster care setting with the related rate adjustment by:

    1. Writing the proposal on the Voluntary Closure Application, DHS-6021B (PDF)
    2. Submitting the form to the moratorium liaison where the setting is located
    3. Working in cooperation with the county of residence and case managers from the county of financial responsibility (CFR) to identify a closure plan, relocation plan and planned rate adjustment.

    Once agreement has been reached, the moratorium liaison where the setting is located:

    1. Completes the DHS-6021B form (PDF):
    2. Completes Section A of the 6021 form.
    3. Submits the 6021 form using the submit button on the form
    4. Attaches a saved version of the completed 6021B to the email.
    5. Sends to DHS.

    DHS role

    DHS reviews documentation and bases decisions on the following:

  • • Alternatives that are available with closure
  • • Choices of the people who live in the residence
  • • Consideration of the need for homes in the region
  • • Licensing and certification status of the residence
  • • Plan adherence to existing policy and applicable laws.
  • DHS approves the request, denies the request or asks for additional information. Once DHS reaches a final decision, DHS notifies the county of residence's moratorium liaison and provider in writing. This application process is confidential until the provider has received approval of its application from DHS.

    If the provider obtains approval

    Within five working days of receiving DHS approval, the provider gives written notification to:

  • • The county of financial responsibility, which authorizes the licensed services for the residents of the affected setting
  • • Current and prospective residents, and any legal representatives and family members involved.
  • This notification must occur at least 45 days before the implementation of the DHS-approved closure proposal.

    Change of premise or ownership

    A provider must notify the moratorium liaison where the setting is located when it wants to either:

  • • Move a setting to another location (known as a “change of premise”)
  • • Sell a setting to another qualified provider (known as a “change of ownership”).
  • Change of premise example

    An example of a move, or change of premise, is when a provider asks to relocate services from one location to a different, not-yet-licensed location. As part of the move, the provider is willing to give up its license for the setting it is leaving with the expectation that it will receive a license for identical or less capacity at the new location.

    Change of ownership example

    An example of a sale, or change of ownership, is when a provider decides to retire and another provider offers to buy the licensed business. The current provider no longer would be licensed for the location. The expectation would be that the new provider would receive a license for identical or less capacity at the same location.

    Lead agency responsibilities

    If a provider wants to either move a setting to another location or sell a setting to another qualified provider, the lead agency has the following responsibilities:

    1. The assigned case manager(s) must review service and setting options with each person who lives in the affected home.
    2. The county of financial responsibility confirms the review took place. (If it did, proceed to step 3. If not, return to step 1).
    3. The moratorium liaison completes applicable portion of Section B in the DHS-6021 form (PDF)
    4. Submits to DHS for approval.

    If DHS approves the change, it will notify the moratorium liaison with the approval decision. The liaison alerts the county licensing staff so they can process the change.

    Closure of vacant beds

    As required by 2012 legislation (Minn. Stat. §245A.03, subd. 7(c)), DHS provides a process for counties to recommend the de-licensing of current unused beds in a corporate foster care home to accomplish the consolidation or closure of settings.

    Note: Counties are not required to de-license a particular number of beds.

    Considerations

    The county must address service planning & fiscal considerations, such as the following, before it makes a de-licensing recommendation:

  • • County(s) of financial responsibility and the provider must agree on new service levels that will be in place after de-licensing
  • • County(s) of financial responsibility must use the Rate Management System (RMS) to determine a new rate after de-licensing.
  • How de-licensing will affect rates:

  • • A reduction in licensed capacity will increase the rate calculated by RMS
  • • Rate stabilization (banding) in place prior to de-licensing will continue after de-licensing.
  • How to recommend de-licensing

    If a county wants to recommend de-licensing, the moratorium liaison should use the following process:

    1. Complete the applicable portion of Section B in the DHS-6021 form (PDF), which includes, but is not limited to:

  • • A request for information about location
  • • Reason for de-licensing
  • • Number of beds to be de-licensed
  • • Effective date
  • • How long the bed(s) has been unused/vacant
  • • Relevant licensing history
  • • Notice to provider regarding de-licensing
  • • Notice to county(s) of financial responsibility (if applicable).
  • 2. Attach a copy of the formal notice sent to the provider to the DHS-6021 form

    3. Submit to DSD for approval.

    DHS role

    DHS bases decisions on the following:

  • • Capacity within the county and region to meet needs
  • • Preferences and concerns of people who live in the residence
  • • Licensing and certification status of the residence (e.g., conditional)
  • • Plan adherence to existing policy and applicable laws.
  • Once the process in complete, DHS returns the DHS-6021 form to the moratorium liaison.

    If the county obtains approval

    If the county obtains DHS approval, the moratorium liaison forwards the approved DHS-6021 form to the county licensing agent for processing with DHS Licensing.

    Additional resources

    If you have questions, contact the DSD residential fiscal policy planner at FCMoratorium@state.mn.us.

    CBSM

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