***This version of the Health Care Programs Manual has been replaced and is no longer in effect. Please see the current Health Care Programs Manual for policy in effect as of December 1, 2006.***
The terminology used to describe people with disabilities has changed over time. The Minnesota Department of Human Services ("Department") supports the use of "People First" language. Although outmoded and offensive terms might be found within documents on the Department's website, the Department does not endorse these terms.
MDHS Health Care Programs Manual (Eligibility Policy through 11/30/06)
Chapter 0918 - Other Related Programs
All chapters are numbered beginning with 09. The first chapter is 0901 (Table of Contents).
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Clients may be eligible for other programs to help with medical care or maintenance needs. Give clients information about programs that may meet their needs.
Some programs are administered by DHS or county agencies. Others are administered by other local, state, or federal government agencies or by other entities.
See the following sections for information on health programs that may help clients meet some of their medical needs:
§0918.03 Long Term Care Consultation (LTCC)
§0918.05 Alternative Care - AC
§0918.07 Child and Teen Checkups - C&TC
§0918.09 Hill-Burton Act
§0918.11 Minnesota Comprehensive Health Association
§0918.13 Minnesota Children with Special Health Needs
§0918.15 HIV/AIDS Programs
See the following sections for information on programs that may help clients meet their nutritional needs:
§0918.17 Food Stamps and Related Programs
§0918.19 Women, Infant, and Child (WIC) and MAC
§0918.21 School Lunch Program
See the following sections for information on programs that may help clients with maintenance needs or provide financial assistance for specific expenses. Some of these programs may help with medical needs as well.
§0918.23 DHS Cash Assistance Programs
§0918.25 Family Support Grant Program
§0918.27 Consumer Support Grant Program
§0918.29 Workers' Compensation
§0918.31 Veterans' Benefits
§0918.33 Reemployment Insurance
§0918.35 Repatriation Program
§0918.37 Telephone Assistance Plan - TAP
§0918.39 Social Services
§0918.41 Publicly Assisted Housing
§0918.43 Low Income Home Energy Assistance Program
§0918.45 Child Care Subsidy Funds
§0918.47 Relative Custody Assistance Program
The purpose of the Long Term Care Consultation (LTCC) program is to prevent inappropriate nursing or certified boarding care facility placements. Everyone seeking admission to a nursing or certified boarding care facility must be screened before admission regardless of pay or source.
Refer people seeking admission to a nursing home or certified boarding care facility to the county LTCC team. The county LTCC team will determine whether the person needs a nursing home or certified boarding care facility level of care by assessing the person's health and psychosocial needs. The team must inform people of available alternatives to institutionalization and recommend either a facility placement or community-based care. The person may choose between community-based and facility care. However, MA will not pay for nursing or certified boarding care for people who choose to enter a facility when the county LTCC team has determined that the person does not meet nursing/boarding facility level of care criteria. The LTCC team enters this risk status on the LTC Screening Document.
Verify that MA applicants or enrollees have either had or are exempt from LTCC screening before admission. MA will not pay for nursing facility or certified boarding care services received before the LTCC date indicated on the LTC Screening Document.
People who refuse long term care consultation or who are not determined to be at risk or in need of a nursing or certified boarding facility level of care may not receive:
These people may receive other MA services such as home care.
LTCC screening and completion of the LTC Screening Document are also required for people at risk of long term hospital placement to receive services through CAC or the TBI Neurobehavioral waiver and for people requesting services through AC. See §0907.23.07 (MA Waiver Programs: CAC), §0907.23.13 (MA Waiver Programs: TBI), and §0918.05 (Alternative Care - AC).
Alternative Care (AC) provides funding for home and community-based services for people who would otherwise need nursing facility care. People who are enrolled in or would be eligible for MA without a spenddown or EW waiver obligation are not eligible for AC. People who would be eligible for SIS-EW but choose AC are not eligible for MA at the same time (except for eligibility during a retroactive period and while MA is pending as described in §0913.13.07 (Relationship Between AC and SIS-EW). People whose income exceeds the SIS may be eligible for AC and MA with a spenddown. See §0907.23.11 (MA Waiver Programs: EW) and §0913.21 (Allowable Medical Bills to Meet Spenddown). People can receive AC and QMB, SLMB, QI and/or PDP at the same time. See §0907.21.09 (Medicare Supplement Programs).
To receive Alternative Care funding for home and community-based services, a person must meet all the following conditions:
The Child and Teen Checkups (C&TC) Program is Minnesota's name for the federal Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program. C&TC promotes early and preventive health care for children through comprehensive screening for health problems at an early stage. This allows treatment before the problem becomes more serious and expensive to treat. Children from birth to age 21 who are eligible for MinnesotaCare or MA are eligible for the C&TC Program. Participation on the part of the children/families is voluntary.
C&TC includes an administrative services component (outreach and follow-up). County agencies may choose to provide the administrative services directly OR they may contract with another agency for these services. The agency that provides administrative services (either the county agency or a contracted agency) is the county C&TC agency.
Federal regulations require the state to have an 80% participation rate for children eligible for C&TC screening. County C&TC agencies must make the initial contact with eligible children and their families to provide information about the purpose and benefits of the program. County C&TC agencies must also inform families that support services such as transportation, interpreter services, and appointment scheduling assistance are available. If the family needs support services, C&TC agencies must obtain the request orally or in writing. The C&TC agency must enter this information into the CATCH II electronic tracking system to allow county C&TC coordinators to assist with support services when needed.
County C&TC agencies receive lists of newly eligible MA and MinnesotaCare children from MMIS. The C&TC agency contacts the families to offer services and determine if the family wishes to participate. Financial workers and enrollment representatives who have contact with families during the application process are encouraged to inform families that C&TC is a benefit of the MA and MinnesotaCare programs and that the county C&TC agency will contact them with more information.
Congress passed the Hill-Burton Act in 1964. This Act gives hospitals and other health facilities money to build and remodel. Facilities which receive these funds agree to provide a limited amount of services to people who cannot pay for health care.
Hill-Burton facilities choose the type of services to provide at no or reduced charge. They do this in an annual allocation plan. Because of this, services provided vary among facilities. The facility where people apply for the program will tell them what types of free or reduced charge services it provides, and what income levels qualify for the program.
People may apply for Hill-Burton funds before or after they receive care (including bills for care already sent to a collection agency). They may apply at any Hill-Burton assisted facility, including hospitals, nursing homes, and clinics.
Tell people who are not eligible for MA, GAMC, EMA, or EGAMC about the Hill-Burton program. People who are eligible for MA or GAMC with a spenddown may also be eligible for Hill-Burton funds for all or part of the spenddown amount. However, any expenses covered by Hill-Burton funds before MA or GAMC is approved may not be used to meet a spenddown.
The Minnesota Comprehensive Health Association (MCHA) provides health insurance to people who have been turned down for individual coverage in the private market. To be eligible, people must have been Minnesota residents for at least 6 months before making application. They must provide proof of denial of private coverage within the past 6 months unless they have been treated for certain presumptive conditions within the past 3 years.
MCHA often has high premiums as well as deductibles and co-pays. People most likely to benefit from MCHA are those who are ineligible for any of the Health Care Programs because of income or assets who have pre-existing medical conditions that prevent private coverage. Some people with large spenddowns may benefit from MCHA. Some people may have a 6-month waiting period before MCHA will cover certain pre-existing conditions.
Refer people who are interested in applying or receiving more information to MCHA's customer service line at 1-866-894-8053 or 651-456-5290, or 651-456-8700 for TTY.
Minnesota Children with Special Health Needs (MCSHN) is administered by the Minnesota Department of Health.
MCSHN provides an information and referral telephone line for families, teachers, social workers, and others to help identify and locate resources and services for children with special health needs and their families.
Refer interested families to MCSHN at 651-215-8956 or 1-800-728-5420.
DHS has several programs to help people with HIV gain access to medical care. The programs are open to residents of St. Croix and Pierce counties in Wisconsin as well as to Minnesota residents. All of the programs have an income limit of 300% FPG and a cash asset limit of $25,000.
The HIV/AIDS insurance program pays medical and dental insurance premiums for eligible people, including COBRA extension policies, Medicare supplement policies, and private coverage. People are not eligible if they have insurance for which an employer pays more than 50% of the premium.
The HIV/AIDS drug reimbursement program pays the patient's portion of the cost of many major drugs used to treat or prevent HIV-related conditions. People must be uninsured or insured with a drug co-payment. MA, GAMC, and MinnesotaCare enrollees are not eligible.
The HIV/AIDS dental program pays for routine preventive and restorative dental care. MA and GAMC enrollees and people with dental insurance are not eligible.
The HIV/AIDS nutrition program pays up to $50 per month for enteral nutritional supplements and generic multiple vitamins, and Lactaid prescribed by a physician. People are not eligible if they can receive these products through MA, GAMC, or MinnesotaCare.
Refer people who want to apply or receive more information to:
Dept. of Human Services
444 Lafayette Road
St. Paul, MN 55155-3872
Applications are also available at many community and clinic-based sites serving people with HIV.
The Food Stamp program is administered through the U.S. Department of Agriculture. It provides benefits that can be used to purchase allowable food items from participating grocers.
Most benefits in Minnesota are issued through Electronic Benefit Transfer (EBT).
Food Stamp eligibility is based on income, assets, and household size. People do not have to receive or be eligible for cash assistance or the health care programs to receive Food Stamps.
Minnesota provides state-funded food benefits to MFIP recipients who do not qualify for the food portion of the MFIP grant due to their citizenship status.
The Minnesota Food Assistance Program (MFAP) provides food benefits to non-MFIP participants who meet all Food Stamp eligibility requirements except for citizenship status.
The county agency determines eligibility for Food Stamps and the state food programs. People must complete a CAF to apply for Food Stamps or MFAP. See the Combined Manual for complete information on Food Stamp eligibility.
The Women, Infant, and Child Nutrition Program (WIC) helps improve the diets of pregnant women and children. People receiving MFIP, FS, and MA are automatically income eligible. Tell pregnant women and families who have children under age 5 about the program.
The WIC program:
Children may participate in the program until age 5. Mothers who breast feed their children may qualify for the program during the first year following their child's birth.
To receive WIC benefits, applicants must have a health assessment showing they need help with nutritional foods. They must also fall within certain income guidelines if they are not receiving MFIP, FS, or MA. WIC has higher qualifying income guidelines than most programs. People may be working and still qualify for the program.
People can apply for the WIC program at their local public health or community action agencies or call the WIC program to get the name and address of the WIC program nearest them. The WIC toll free number is 1-800-WIC-4030.
Women, infants, and children who live on the Red Lake Indian Reservation may receive food and recipes from the Mothers and Children (MAC) program instead of WIC. People may not receive MAC and WIC at the same time. MAC is administered by the Department of Health and is called the Commodity Supplemental Food Program on the Red Lake Indian Reservation.
To participate in MAC, a person must be a pregnant, a new mother, or have an infant or child under 6 years old and have income within MAC guidelines. Pregnant women remain eligible for MAC for 6 weeks after the baby is born. New mothers are usually certified for 6 months and may continue to receive MAC until the child is 1 year old. Children may be certified to receive MAC for 6 months at a time and may be eligible up to age 6.
Refer interested people to the Department of Health at 651-676-5000.
The School Lunch Program is a federally funded program providing free and reduced-price lunches to low income school children in grades 1 through 12. Children receiving MFIP or FS will usually be eligible for the program without formal application. In August of each year, MAXIS sends data to all school districts to be used in certifying children receiving MFIP or Food Stamps for the school lunch program. See the Combined Manual for more information.
Children who do not receive MFIP or FS may be eligible for the School Lunch Program if their family income is within the program limits. Families may apply directly to the children's school.
DHS administers several programs to provide for people’s maintenance needs. People apply for the programs described in this section at their local county agency.
The Minnesota Family Investment Plan (MFIP) provides monthly cash payments and employment services to pregnant women and families with children who meet MFIP criteria. Some families may qualify for a one-time diversionary assistance payment instead of the monthly grant.
General Assistance (GA) provides monthly cash payments to adults without children who meet a GA eligibility category and other GA criteria. People who get GA qualify for automatic GAMC unless they meet an MA basis of eligibility.
Minnesota Supplemental Aid (MSA) provides a monthly cash supplement to certain people who receive SSI and/or RSDI. People who receive MSA qualify for automatic MA.
Refugee Cash Assistance (RCA) provides monthly cash payments to refugees without children who do not qualify for SSI during their first 8 months in the U.S. People who qualify for RCA are automatically eligible for MA if they do not otherwise qualify for regular MA.
Emergency Assistance (EA) provides one-time payments to meet families’ emergent needs such as shelter and utility payments. People may receive EA once in a 12-month period. Emergency General Assistance (EGA) provides similar payments to adults without children and families who do not qualify for EA. People do not have to receive MFIP or GA to qualify for EA or EGA.
Emergency Minnesota Supplemental Aid (EMSA) provides emergency payments to MSA recipients.
The Group Residential Housing (GRH) program helps pay for the cost of care for residents of some non-MA facilities, including some board and care homes, adult foster care, and Institutions for Mental Diseases (IMD’s).
See the Combined Manual for complete information on the above cash assistance programs.
The Family Support Grant Program is a state-funded program that provides funds to help families provide home care for dependents with mental retardation or related conditions. The purpose of the program is to prevent or delay residential placements. County agencies administer the program.
The program provides a monthly maximum subsidy grant of $250 to eligible families for the special needs of their dependents as approved in an individual service plan. County agencies may grant an amount over $250 for emergencies in cases where dependents need extra resources to meet their health and welfare needs. This period must not exceed 90 days per fiscal year.
Special needs include items such as special equipment, medical care, medications, special diet, respite care, special clothing, education, therapeutic programs, diagnostic assessments, related transportation, modifications to the home and vehicle, and other services or items that assist the family and dependent. Reimbursable items must be necessary and unavailable through other funding sources.
To be eligible, the dependent must:
For further information, consult the Minnesota Social Services Manual.
Exclude Family Support Grant payments in determining eligibility for the health care programs.
The Consumer Support Grant Program (CSG) is a state-funded program that provides funds to help people with functional limitations and their families to purchase and secure supports which people need to live independently in the community. Participation in the CSG program is optional for counties. Participation is limited to people residing in participating counties.
CSG provides support grants to people or families as an effective alternative to existing programs and services, such as the Developmental Disability Family Support Grant program, the Alternative Care program, and MA home care services. CSG will not pay for services already provided through one of these programs. See §0918.25 (Family Support Grant Program) and §0918.05 (Alternative Care - AC).
CSG provides a monthly payment to the client or his/her representative for the purchase of supports needed to maintain the client in the home. People residing in institutional or congregate care settings may not receive CSG. CSG pays for goods and services that are over and above the normal cost of caring for a person, such as respite care, assistance with daily living, homemaker, chore and adaptive aids from friends, neighbors, relatives, or any other responsible person the client knows and trusts.
People may not use CSG for services for which there are other public or private funds or resources available. People enrolled in Managed Care cannot receive CSG funds. People or their families are not eligible for CSG if their income is at a level which would require them to pay a parental fee. See §0906.13.09 (Parental Fees).
Services and/or items requiring the use of CSG funds must meet ALL of the following criteria:
To be eligible, the client must meet all the following criteria:
The county social service agency applies on the client's behalf to DHS for the program. The application must specify the needs of the family and how the family will use the subsidy.
For more information on the CSG program, see DHS Bulletin #96-66-3.
Exclude CSG payment income in determining eligibility for the health care programs.
Workers' Compensation is an employer paid insurance program that covers the medical expenses and lost wages of workers injured on the job. People may be eligible for cash payments, payment of medical expenses related to the injury, or both.
Refer people who report job injuries to apply for Workers' Compensation if they have not already done so. Count Workers' Compensation cash payments as unearned income for the health care programs. Notify Benefit Recovery of pending and active Workers' Compensation claims. See §0910.13 (Third Party Liability).
VETERANS' BENEFITS 0918.31
The U.S. Department of Veterans Affairs (USDVA) provides services to people who have served in the U.S. armed forces. USDVA also provides some benefits to dependents of veterans. Benefits provided by USDVA include hospital treatment and pensions for service related disabilities.
Veterans who are eligible for the health care programs do not have to receive treatment at the USDVA hospital as a condition of eligibility. However, notify Benefit Recovery if veterans are eligible for treatment. See §0910.03 (Types of Other Coverage).
Veterans who apply for MA nursing home care must also apply for the aid and attendance program through the USDVA. The aid and attendance program helps pay for long term care facility (LTCF) care for some veterans and surviving spouses. The program may also, under some circumstances, help pay for care to veterans who reside at home but need care. This benefit is known as homebound veterans benefits.
Refer people who might be eligible for veteran's benefits to:
United States Department of Veterans Affairs
Regional Office and Insurance Center
1 Federal Drive
St. Paul, Minnesota 55111-4007
or to their local county veteran's officer.
The Minnesota Department of Veterans Affairs provides cash and medical assistance for temporarily disabled veterans and their dependents. They also provide educational assistance for veterans, dependents of POW/MIAs, and war orphans.
The cash assistance program serves as interim assistance pending the approval of another program's benefits or as short-term assistance up to a maximum of 6 months. Statewide MFIP, AFDC, and GA recipients are ineligible to receive this veterans' cash assistance program.
The veterans' medical assistance program provides payment for emergency medical care, some non-emergency medical care costs for up to a maximum of $1,000 per admission, and dental care up to a maximum of $700 per person per year. Count medical reimbursement payments as unearned income in the month received.
To apply, people must contact the Department of Veterans Affairs at 612-296-2562 or the county veterans service officer at the county courthouse in their county of residence.
Count state and federal veterans assistance payments as unearned income for the health care programs. Deduct educational expenses from veterans' educational payments. See §0911.09.07 (Student Financial Aid Income).
Veterans may be eligible to reside in a state veterans' home. These homes are not MA-covered facilities.
Unemployment Insurance (UI) is regulated by the Minnesota Employment Services Law, and is administered by the Department of Economic Security. UI provides income for some people who have lost their jobs. UI was previously known as Reemployment Compensation.
Refer potentially eligible people to apply for Unemployment Insurance.
Count UI as unearned income for the health care programs.
The Repatriation Program provides temporary financial assistance for needy U.S. citizens and their dependents returning from a foreign country because of destitution, illness, war, invasion, or a similar crisis.
Temporary financial assistance, which is provided in the form of a loan, includes cash, medical assistance, and social services. The client must sign a repayment agreement. Assistance furnished by county agencies through the Repatriation Program is limited to 90 days from the date of arrival in the U.S. and is fully reimbursable from the federal government.
Advise clients of their potential eligibility and their right to apply for other cash or medical assistance programs or for food stamps at the time they apply for temporary repatriate assistance. However, clients are not required to apply for other programs.
Repatriates who have settled in their final location are not eligible for Statewide MFIP and repatriation assistance at the same time.
For more information, see IB #91-22B or contact the Refugee and Immigrant Assistance Division, Department of Human Services.
The Telephone Assistance Plan (TAP) provides help with local telephone bills of low income aged or disabled people. People submit a TAP Application Form (DHS-2870) to:
Telephone Assistance Plan
444 Lafayette Road
St. Paul, Minnesota 55155-3859
TAP aid appears as a credit on the monthly telephone bill. DHS determines eligibility for this program after people submit an application.
Tell people who might be eligible about TAP and provide them with an application if requested. People can also get TAP application forms from their local telephone companies and facilities and institutions serving disabled or aged people.
To qualify for TAP, applicants must have a social security number and:
People may also qualify for Lifeline Credit if they are eligible for MA, SSI, Food Stamps, HUD housing assistance, or Low Income Home Energy Assistance Program (LIHEAP). Applicants do not need to be age 65 and over or disabled to qualify. People must apply directly to their local telephone company.
Each county has a social services section to provide social-related services.
Services for children include:
Services for adults and families include:
For more information on social services, refer to the Minnesota Social Services Manual. Refer people in need of social services to the county social services unit. County agencies and MinnesotaCare must make a written referral to social services for people who may be vulnerable adults and children who may be victims of child abuse.
Publicly assisted housing is government owned and operated or subsidized housing for low income people, senior citizens, and disabled people. The availability of public housing aid varies among communities.
The amount of aid depends on income and family size. Normally, eligible people pay 30% of their adjusted gross income toward the total amount of their rent and utilities.
People must complete an application and meet the eligibility requirements of the U.S. Department of Housing and Urban Development (HUD) and the local public housing agency (PHA). People may apply at any PHA office.
Some communities have a joint effort between government and private rental property owners to rehabilitate dwelling units to provide rental subsidies for low income people. Local residents and people displaced by public action may receive preference for vacancies.
The Low Income Home Energy Assistance Program (LIHEAP) helps low income people pay heating costs and reduce home energy consumption through conservation and weatherization activities.
To be eligible for LIHEAP, people must meet income, asset, and other eligibility requirements.
People may apply for LIHEAP at their county's LIHEAP agency between October 1 and April 30. In addition, mail applications may be available for some households beginning August 1, at the discretion of the LIHEAP agency.
The LIHEAP agency may be a community action council or agency, economic opportunity or assistance agency, human services or social services agency, citizens action council or agency, or a reservation business committee.
The amount of help LIHEAP provides depends on the type of services and the household's size and income.
Exclude LIHEAP payments for the health care programs.
There are several child care subsidy programs to help low and moderate income families pursue employment or education leading to economic self-sufficiency by subsidizing their child care. Some are designed specifically for current and former MFIP participants. Others are open to all families that meet eligibility guidelines, subject to funding availability.
BASIC SLIDING FEE CHILD CARE PROGRAM:
The Basic Sliding Fee Child Care Program is supervised by the Department of Children, Families, and Learning (DCFL). People must meet the income guidelines, published by DCFL annually. Priorities for the Basic Sliding Fee program are:
1. Non-MFIP caretakers without a GED or high school diploma (with higher priorities for younger caretakers).
2. Non-MFIP families finishing their transition year (the 1st year following MFIP termination due to increased earnings or a combination of earnings and child support).
3. Portability pool (current child care participants who move to another county that has a waiting list).
4. Additional county-set priorities, which includes all other families within the income range.
Refer people to their county of residence to apply for basic sliding fee child care.
MFIP CHILD CARE PROGRAM:
The MFIP Child Care Program is also supervised by DCFL and is limited to certain MFIP families.
TRANSITIONAL YEAR CHILD CARE PROGRAM:
The Transitional Year Child Care Program is also supervised by DCFL and may be available for former MFIP recipients during the 1st 12 months after leaving AFDC or MFIP due to increased earnings or a combination of earnings and child support, if they need child care to retain employment.
NON-MFIP POST-SECONDARY PROGRAM:
This program is administered by the Minnesota Higher Education Services Office and offers child care assistance to non-MFIP caretakers who are pursuing post-secondary education. Refer clients to the school's financial aid office for information.
TITLE XX/CSSA CHILD CARE PROGRAM:
Title XX/CSSA Child Care Program is administered by County Social Service Agencies. The program is available for participants engaging in social and health related activities that are not covered through the other Child Care Assistance Programs administered by DCFL.
CHILD CARE RESOURCE AND REFERRAL:
Minnesota has a Child Care Resource and Referral (CCR&R) agency for each region in the state. In the metro area there is a CCR&R agency for each county. State law requires these agencies to provide up to date information on all types of licensed child care, including family day care, center care, half day programs, Head Start, drop in programs, and school-age programs.
Clients calling the designated CCR&R agency for their area will receive a computerized list matching their child care needs to those providers with openings to meet their needs. Information includes hours of care needed, ages of children, openings, rates, location, school districts, pets, smoking or non-smoking, special needs, training of provider, transportation, and program philosophy.
Clients will receive detailed information, both through phone counseling and written materials, on how to choose child care, parents' rights in choosing care, indicators of quality, how to set up a good parent/provider interview, and how to negotiate a good parent/provider contract.
For more information on the CCR&R program or agencies, contact the Child Care Resource and Referral Grants Administrator, Children's Services Division, Department of Children, Families and Learning (DCFL).
The Relative Custody Assistance Program (RCAP) provides cash assistance to relatives who accept permanent legal and physical custody of children in foster care. Eligibility and payment are based on the child's needs and income. Payments may be reduced for relatives whose family income exceeds 200% of FPG. County agencies are responsible for determining RCAP eligibility and making payments. See the Combined Manual for more information on eligibility requirements.
See §0911.09.13 (Assistance Payments Income) for information on treatment of RCAP payments for the health care programs. Children whose relatives receive RCAP are not automatically eligible for MA. Do not deem the relative's income to the child in determining MA eligibility.
For MinnesotaCare, relatives may include the child in their household or apply separately for the child. See §0908.03.05 (MinnesotaCare HH Size/Non-Parent Caretakers).Report/Rate this page