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Waiver/AC provider enrollment and standards

Page posted: 1/23/14

Page reviewed: 1/27/16

Page updated: 1/27/16

Legal authority

BI, CAC. CADI, DD and Elderly waiver plans, Alternative Care program, Minn. Stat. chapter 245D, Minn. Stat. §256B.4912, subd.1 and 5 and Minn. Stat. §256B.0913

Background

HCBS waiver and AC services fall into three tiers, each of which define the way service providers are approved and services are regulated.

Providers of Tier 1 HCBS waiver and AC services must enroll with the DHS Minnesota Health Care Provider (MHCP) program.

Tier 1 services

Tier 1 services require enrollment as an MHCP provider and include the following home and community-based services listed below. All providers that require a DHS or Minnesota Department of Health license are Tier 1 providers.

Note

The services with asterisks (*) below are linked to a disability waiver service page, but also are offered under EW and/or AC. See the MHCP Provider Manual EW/AC service page for more information.

Services licensed under 245D

Basic support services

Intensive support services

Non-245D services licensed by DHS

Services requiring certification

Tier 2 community market services

Tier 2 community market services are delivered by MHCP providers or lead agency-approved vendors and include the following:

Tier 3 receipt services

Tier 3 receipt services are delivered by MHCP providers or lead agency-approved vendors and include the following:

Provider requirements

All HCBS waiver and AC service providers must comply with state service standards.

Tier 1 service providers must enroll with DHS as MHCP providers.

MHCP enrollment, while encouraged for Tier 2 community market and Tier 3 receipt service providers, is optional where lead agencies elect to offer an alternative arrangement.

Whether operating as MHCP providers or, where permitted, lead agency-approved service vendors, all providers of waiver services must meet and comply with state service standards.

Licensed providers

Many Tier 1 services require DHS or MDH licensure as well as MHCP enrollment. Service pages include information and navigable links clarifying mandatory licensure requirements.

Services involving direct contact with HCBS waiver/AC program participants

Minn. Stat. §256B.4912, subd.1 (3b) (3c), requires staff that provide direct contact, as defined in Minn. Stat. §245C.02, subd. 11 meet the requirements of chapter 245C prior to provide waiver services and part of ongoing enrollment. Service owners and managerial officials overseeing the management or policies of services that provide direct contact must meet the requirements of chapter 245C prior to reenrollment with Minnesota Health Care Programs or, for new providers, prior to initial enrollment with Minnesota Health Care Programs if they have not already done so as part of the service licensure requirements. Service pages include information and navigable links on the background study process and filing procedures.

Training

Providers newly enrolling with the MHCP home and community-based waiver and the Alternative Care programs must complete both the:

Lead agency oversight

HCBS waiver/AC service vendors who are not MHCP Providers vendors

Lead agencies that elect to have non-enrolled service vendors deliver Tier 2 community market and Tier 3 receipt services must assure vendor qualification and service delivery in compliance with state standards. For more information on the requirements associated with this optional lead agency function (including required document templates), go to Lead agency oversight of tier 2 and tier 3 service vendors.

New tool to search for providers

To find providers of waiver and Alternative Care (AC) services, search MinnesotaHelp.info®. DHS developed an instructional guide (PDF) to assist lead agencies and service recipients navigate MinnesotaHelp.info®.

Tutorial videos for waiver service providers can help providers navigate the provider portal section of MinnesotaHelp.info®. In the provider portal, the provider can add, change or delete information about their agency that is stored in the MinnesotaHelp.info® database. The provider portal includes a link to the tutorial videos in the “Request Inclusion” box on the left hand side of the page.

Additional resources

245D license resources

DHS licensing

MDH licensing

Training

HCBS technical assistance

  • • For questions about the new 245D licensing standards for providers, email DHS.245Dlicensehelp@state.mn.us
  • • For technical assistance on policies related to programs, contact the DSD Response Center
  • New provider resources

    The HCBS waiver and alternative care provider resource document provides links to resources and step-by-step instructions for MHCP enrollment and 245D licensure.

    Enrollment resources

    Provider directory

    Waiver billing codes

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    Updated: 1/27/16 2:50 PM | Accessibility | Terms/Policy | Contact DHS | Top of Page | Updated: 1/27/16 2:50 PM