Home and community-based service licenses and service settings

245D-HCBS program license

Providers of home and community-based services subject to licensure under chapter 245D will be required to hold a 245D-HCBS program license. The program license is issued for the provision of services statewide. The provider must be qualified to provide each service identified on its license.

  • • Read about Home and Community-Based Service Licenses requiring a 245D license
  • Service settings

    A provider with a 245D-HCBS program license may provide these services in a variety of settings, including a person’s own or family home, in the community, or in settings requiring an additional facility license. However, depending on the setting, there may be limits as to which 245D services can be provided.

    A provider who delivers services in a licensed facility may only deliver the services allowed for that type of setting. The types of licensed facilities in which 245D services may be provided are:

    245D licensed settings

  • Day services facility
  • Community residential setting
  • Other licensed settings

  • Child foster care – family or corporate
  • Family adult foster care
  • Supervised living facility
  • ICF/DD
  • Day services facility (DSF)

    Day services facilities are licensed under 245D (245D-DSF). DHS performs the licensing functions for these sites.

    Services that may be provided in this setting include:

  • • Day training and habilitation (DT&H)
  • • Prevocational
  • • Structured day

  • Minn. Statutes, sections 245D.21 to 245D.22; and 245D.27 to 245D.31, establish standards for day services facilities.

    Foster care homes

    When is a child or adult foster care license holder required to obtain a 245D-HCBS program license?

    If a family or corporate child or adult foster care license holder is the provider of any of the following services to residents in the foster care home, the foster care license holder is required to hold a 245D-HCBS program license.

  • • Out-of-home respite for persons with disabilities, including DD, or persons age 65 and older
  • • Out-of-home crisis respite for persons with developmental disabilities
  • • Supported living services for persons with developmental disabilities
  • • Foster care services for persons with disabilities
  • When is a child or adult foster care license holder not required to obtain a 245D-HCBS program license?

    If the foster care license holder does not provide a 245D licensed service to the residents in the foster care home or a different 245D licensed provider comes into the foster care home to provide a 245D service, the foster care license holder is not required to hold a 245D-HCBS program license. In this case, there is no change to the foster care license.

    The following services are not licensed under 245D, regardless of the funding source for the service:

  • • Foster care services for persons age 65 and older under the Elderly Waiver (EW) or the Alternative Care (AC) programs
  • • Customized living services for persons with disabilities or age 65 and older
  • When is a corporate adult foster care license required to convert to 245D-CRS license?

    If a corporate adult foster care license holder is the provider of any of the following services to all residents in the corporate AFC home, the corporate AFC license holder is required to convert the Rule 203 AFC license to a 245D-CRS license.

  • • Out-of-home crisis respite for persons with developmental disabilities
  • • Supported living services for persons with developmental disabilities
  • • Foster care services for persons with disabilities; excluding foster care services under the Elderly Waiver (EW) or Alternative Care (AC) programs
  • When is a corporate adult foster care license not required to convert to 245D-CRS license?

    Unless all residents in a corporate adult foster care home are receiving a service licensed under 245D, the provider is not required to convert the Rule 203 AFC license to a 245D-CRS license.

    Important Please Note: None of the following types of providers are required to convert their foster care license to a 245D-CRS license:

  • • Corporate or family child foster care homes, regardless of the services provided, do not convert their licenses
  • Family adult foster care homes, regardless of the services provided, do not convert their licenses

    Community residential setting (CRS)

    Community residential settings are licensed under 245D (245D-CRS). These are residential sites where one of the 245D services listed here is provided to all residents of the home and the license holder does not live in the home. The county agency performs some of the licensing functions for these sites.

    245D services that may be provided in this setting include:

  • • Out-of-home respite for persons with disabilities, including DD, or persons age 65 and older
  • • Out-of-home crisis respite for persons with developmental disabilities
  • • Supported living services for persons with developmental disabilities
  • • Foster care services for persons with disabilities
  • Minn. Statutes, sections 245D.21 to 245D.22; and 245D.27 to 245D.31, establish standards for community residential settings. 245D-CRS homes were previously corporate adult foster care (AFC) sites.

    Child foster care homes (family or corporate)

    Child foster care sites are licensed under Minn. Rules, parts 2960.3000 to 2960.3340. In a family foster home the child foster care license holder lives in the home. In a corporate foster residence the license holder does not live in the home. The county agency performs some of the licensing functions for the child foster care sites.

    245D services that may be provided in a family or corporate child foster care setting include:

  • • Out-of-home respite for persons with disabilities, including DD, or persons age 65 and older
  • • Out-of-home crisis respite for persons with developmental disabilities
  • • Supported living services for persons with developmental disabilities
  • • Foster care services for persons with disabilities
  • Family adult foster care (AFC)

    Family adult foster care homes are licensed under DHS Rule 203 (Minnesota Rules, parts 9555.5150 to 9555.6265) and the AFC license holder does live in the home. The county agency performs some of the licensing functions for the AFC sites.

    245D services that may be provided in a family adult foster care setting include:

  • • Out-of-home respite for persons with disabilities, including DD, or persons age 65 and older
  • • Out-of-home crisis respite for persons with developmental disabilities
  • • Supported living services for persons with developmental disabilities
  • • Foster care services for persons with disabilities
  • The provider is exempt from compliance with certain Rule 203 AFC requirements when the provider holds both the AFC and the 245D-HCBS license.

    Corporate adult foster care (AFC)

    Corporate adult foster care homes are licensed under DHS Rule 203 (Minnesota Rules, parts 9555.5150 to 9555.6265) and the AFC license holder does not live in the home. The county agency performs some of the licensing functions for the AFC sites.

    245D services that may be provided in a corporate adult foster care setting include:

  • • Out-of-home respite for persons with disabilities, including DD, or persons age 65 and older
  • A corporate AFC will remain a corporate AFC. The corporate AFC only converts to a 245D-Community Residential Setting when all residents receive one of the following services:

  • • Out-of-home crisis respite for persons with development disabilities
  • • Supported living services for persons with development disabilities
  • • Foster care services for person with disabilities only; foster care services for the elderly under elderly waiver (EW) or the alternative care (AC) programs are excluded from 245D licensure
  • Supervised living facility (SLF)

    Supervised living facilities are licensed under chapter 144 by the Minnesota Department Health (MDH). MDH performs the licensing functions for the SLF.

    245D services that may be provided in the SLF setting include:

  • • Supported living services (SLS)
  • If the SLF license holder is the provider of supported living services to persons with developmental disabilities in the SLF, the SLF license holder is required to also hold a 245D-HCBS program license regardless of the funding source for the service.

    A SLF/245D-HCBS license holder is exempt from the following 245D licensing requirements:

  • • Service recipients rights under section 245D.04; the license holder is required to comply with the Health Care Bill of rights under section 144.651.
  • Intermediate care facility for persons with developmental disabilities (ICF/DD)

    Intermediate Care Facilities for Persons with Developmental Disabilities are licensed as an SLF and are ICF/DD certified. MDH performs the licensing functions for the SLF and the federal certification.

    245D services that may be provided in the ICF/DD setting include:

  • • Residential services
  • If the ICF/DD license holder is the provider of residential services to persons with developmental disabilities in the ICF/DD, the ICF/DD license holder is required to also hold a 245D-HCBS program license regardless of the funding source for the service.

    A ICF/DD/245D-HCBS program license holder is exempt from the following 245D licensing requirements:

  • • Service recipients rights under section 245D.04; the license holder is required to comply with the Health Care Bill of rights under section 144.651.
  • • The license holder is required to comply with the ICF/DD federal certification standards instead of the 245D licensing requirements in these areas:
  • • Medication administration under section 245D.05, subdivision 1b
  • • Environment under section 245D.06, subdivision 2, clauses (4) and (5)
  • • Services outcomes and supports and progress reviews under section 245D.071, subdivisions 4 and 5
  • • Coordination and evaluation of individual service delivery under section 245D.081, subdivision 2
  • • Use of volunteers to provide direct care services under section 245D.09, subdivision 7
  • • Admission and discharge register under section 245D.095, subdivision 2
  • • Data privacy policy and procedures under section 245D.11, subdivision 3
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