Integrated community supports (ICS) transition plans

Page updated: 4/12/24

This resource applies to CBSM – Integrated community supports (ICS). Lead agencies and providers should use the following instructions and scenarios to:

· Determine when a provider can choose to develop an ICS setting.

· Determine when a provider must develop an ICS setting.

· Transition a setting to an ICS setting.

· Provide people with information about their choices in who provides their services, regardless of their living setting.

· Understand the rolling implementation of ICS.

· Understand ICS service authorizations and timelines.

Scenarios

This page includes information about the following scenarios.

Instructions for current customized living settings:

· Scenario 1: Customized living settings in which some people are on the Elderly Waiver (EW)

· Scenario 2: Customized living settings in which all people are on BI or CADI waivers

Instructions for other settings:

· Scenario 3: Settings in which the provider does not own, operate or have a direct or indirect financial relationship to the property or housing

Expired scenarios

This page also includes the following expired scenarios about supported apartment programs owned and operated by the HCBS provider, for historical reference:

· Scenario 4 (expired): Supported apartment programs in which all people are on Brain Injury (BI) or Community Access for Disability Inclusion (CADI) waivers

· Scenario 5 (expired): Supported apartment programs in which people are on a combination of disability waivers

· Scenario 6 (expired): Supported apartment programs in which all people are on Community Alternative Care (CAC) or Developmental Disabilities (DD) waivers

Instructions for current customized living settings

A current customized living setting means the setting is operational on or before Dec. 31, 2020. These settings must comply with the current customized living service setting location requirements and size requirements. For more information, refer to the setting requirements section on CBSM – Customized living.

Current customized living settings are not required to transition to ICS settings. However, some providers have the option to do so. The following scenarios apply to current customized living settings.

Scenario 1: Customized living settings in which some people are on EW

If any people in the customized living setting are on EW, the setting cannot transition to an ICS setting. ICS is not an available service on EW. All people who live in the customized living setting will continue to receive customized living. For more information, refer to the non-covered services section on CBSM – ICS.

Scenario 2: Customized living settings in which all people are on BI or CADI waivers

If all people in the customized living setting are on BI or CADI waivers, the provider may choose to transition from a customized living setting to an ICS setting when the setting meets the definition of an ICS setting on CBSM – ICS.

Timeline

If the provider chooses to transition from customized living services to ICS, the setting and each person’s service plan will transition on a rolling basis. This means each person who lives in the setting will continue to receive customized living services until one of the following occurs:

· The person has a change in service need.

· The person has their annual reassessment and new service agreement.

· The person decides to terminate services with the provider.

During the transition period, the setting will be both:

· Licensed as an assisted living facility.

· Enrolled as an ICS setting (refer to the setting requirements section on CBSM – ICS).

During the setting’s time-limited transition from customized living to ICS:

· DHS Provider Eligibility and Compliance will monitor the transition and end the provider’s customized living setting enrollment record after all people transition to ICS.

· The provider will end the assisted living licensure at the location.

Directions for providers

Providers that want to transition a customized living setting to an ICS setting must complete the following steps:

· Apply for a 245D license (if needed) by contacting DHS Licensing.
Note: For information about the license application, refer to DHS – Licensing for HCBS 245D providers.

· Submit a Setting Capacity Report, DHS-8062 to DHS for each ICS setting that includes the total number of units that will be used to provide ICS, regardless of waiver type.
Note: If the provider operates an assisted living campus license, contact DHS at hcbs.settings@state.mn.us before submitting the setting capacity report. Limitations related to collocated settings may apply. For more information, refer to the setting requirements section on CBSM – ICS.

· Contact the Minnesota Department of Health (MDH) to coordinate the closure of the assisted living license using MDH – Assisted living licensure contact information.

· Receive verification from DHS that the setting meets the definition and requirements of an ICS setting.

· Update their 245D service license to include ICS.

· Contact DHS Provider Eligibility and Compliance through the Provider Help Desk at 651-431-2700 and visit MHCP Provider Manual – HCBS programs provider enrollment for additional information and forms to create an enrollment record for ICS and enroll each approved ICS setting.

· Notify all people who receive services, their legal representatives and case managers about the intent to transition from customized living to ICS, including the date the customized living services registration will end and how the change will affect their services.

Directions for case managers

When a case manager receives notification from a provider that they intend to transition from a customized living setting to an ICS setting, the case manager must:

· Contact the person affected by the change to determine whether they prefer to continue living in their current home or want to move as a result of the change.
Note: If the person wants to remain in their current home, they have the choice to either receive ICS from the current customized living provider or receive other supports from a different provider.

· Maintain the person’s current authorization for customized living until they have their annual reassessment or need a service change, whichever comes first.

Instructions for other settings

Scenario 3: Setting in which the provider does not own, operate or have a direct or indirect financial relationship to the property or housing.

If the provider does not own, operate or have a direct or indirect financial relationship to the setting, the provider is not required to develop an ICS setting.

The provider must continue to follow current own home policy with transitional leases listed on CBSM – Requirements for a person’s own home, as necessary.

Expired instructions for supported apartment programs owned and operated by the HCBS provider

Supported apartment programs are arrangements in which the provider that controls the setting also provides home and community-based services (HCBS). As of Jan. 11, 2021, all supported apartment programs in which the enrolled provider owns, operates or has direct/indirect financial connection to the building had to use one of the following transition scenarios. These scenarios no longer apply and are for historical reference only.

Scenario 4 (expired): Supported apartment programs in which all people are on BI or CADI waivers

The transition period from a supported apartment program to an ICS setting no longer applies. DHS required supported apartment programs in which all people were on BI or CADI waivers to fully transition to ICS by Dec. 31, 2022.

DHS posted the information in this section on Dec. 28, 2020. It no longer applies and is for historical reference only.

If all people receiving HCBS from the provider that controls the setting are on BI or CADI waivers, the provider must do one of the following:

· Stop providing waiver services to people living in the setting.

· No longer own, operate or have direct/indirect financial connection to the property.

· Develop an ICS setting.

Timeline

As of Jan. 11, 2021, people on BI and CADI waivers have been transitioning to ICS on a rolling basis. This means each person who lives in the setting continues to receive their current services until one of the following occurs:

· The person has a change in service need.

· The person has their annual reassessment and new service agreement.

· The person decides to terminate services with the provider.

Directions for providers

Current 245D license holders that need to develop an ICS setting must complete the following steps:

· Submit a Setting Capacity Report, DHS-8062 to DHS for each ICS setting that includes the total number of units that will be used to provide ICS, regardless of waiver type.

· Receive verification from DHS that the setting meets the definition and requirements for an ICS setting.

· Update their 245D service license to include ICS.

· Contact DHS Provider Eligibility and Compliance through the Provider Help Desk at 651-431-2700 and visit MHCP Provider Manual – HCBS programs provider enrollment for additional information and forms to create an enrollment record for ICS and enroll each approved ICS setting.

· Notify all people who receive services, their legal representatives and case managers about the intent to develop an ICS setting, including information about how the change will affect their services.

Directions for case managers

When a case manager receives notification from a provider that they intend to develop an ICS setting at a current supported apartment program, the case manager must:

· Contact the person affected by the change to determine whether they prefer to continue living in their current home or want to move as a result of the change.
Note: If the person wants to remain in their current home, they have the choice to either receive ICS from the current provider or receive other own-home supports from a different provider.

· Maintain the person’s current authorization for services until they have their annual reassessment or need a service change, whichever comes first.

Scenario 5 (expired): Supported apartment programs in which people are on a combination of disability waivers (BI, CAC, CADI and DD)

The transition period from a supported apartment program to an ICS setting no longer applies. The Dec. 20, 2022, DSD eList: ICS available on CAC and DD waivers altered the timelines stated below and provided clarification for transitions specific to people on the CAC or DD waiver. DHS required supported apartment programs in which people were on a combination of disability waivers (BI, CAC, CADI, and DD) to fully transition to ICS by Feb. 29, 2024.

DHS posted the information in this section on Dec. 28, 2020. It no longer applies and is for historical reference only.

If all people receiving HCBS from the provider that controls the setting are on a combination of BI, CAC, CADI or DD waivers, the provider must do one of the following:

· Stop providing waiver services to people living in the setting.

· No longer own, operate, or have direct or indirect financial connection to the property.

· Develop an ICS setting (see note below).

Note: There are service authorization exceptions for people on CAC and DD waivers who live in a support apartment program that becomes an ICS setting, described in the timeline for people on CAC and DD waivers section.

Timeline for people on BI and CADI waivers

For people on BI and CADI waivers, ICS can be authorized as of Jan. 11, 2021. People who choose not to receive ICS can choose to receive other own-home services when delivered by a provider who does not control the setting.

As of Jan. 11, 2021, people on BI and CADI waivers have been transitioning to ICS on a rolling basis. This means each person who lives in in the setting continues to receive their current services until one of the following occurs:

· The person has a change in service need.

· The person has their annual reassessment and new service agreement.

· The person decides to terminate services with the provider.

Timeline for people on CAC and DD waivers

For people on CAC and DD waivers, ICS is not an available service option until Jan. 1, 2023.

People on CAC and DD waivers can live in a setting in which ICS is provided to people on the BI and CADI waivers. They do not need to move. During the two-year transition period (i.e., 2021–2023), people on CAC and DD waivers can choose to receive:

· Services from a provider who does not control the setting.

· Own-home services from the provider who controls the setting when they develop an interim service plan to transition to ICS in 2023.

People who receive one or more own-home service impacted by the Waiver Reimagine service streamlining will receive the corresponding streamlined service (refer to CBSM – Waiver Reimagine streamlined service crosswalk).

A person’s interim service plan must be developed with the person, provider and lead agency to ensure the transition to ICS occurs in 2023.

Beginning Jan. 1, 2023, people on CAC and DD waivers will transition to ICS on a rolling basis. This means each person who lives in the setting will continue to receive their current services until one of the following occurs:

· The person has a change in service need.

· The person has their annual reassessment and new service agreement.

· The person decides to terminate services with the provider.

Directions for providers

Current 245D license holders that need to develop an ICS setting must complete the following steps:

· Submit a Setting Capacity Report, DHS-8062 to DHS for each ICS setting that includes the total number of units that will be used to provide ICS, regardless of waiver type.

· Receive verification from DHS that the setting meets the definition and requirements for an ICS setting.

· Update their 245D service license to include ICS.

· Contact DHS Provider Eligibility and Compliance through the Provider Help Desk at 651-431-2700 and visit MHCP Provider Manual – HCBS programs provider enrollment for additional information and forms to create an enrollment record for ICS and enroll each approved ICS setting.

· Notify all people who receive services, their legal representatives and case managers about the intent to develop an ICS setting, including information about how the change will affect their services.

Directions for case managers

When a case manager receives notification from a provider that they intend to develop an ICS setting at a current supported apartment program, the case manager must:

1. Contact the person affected by the change to determine whether they prefer to continue living in their current home or want to move as a result of the change:

· If the person is on the BI or CADI waiver and wants to remain in their current home, they have the choice to either receive ICS from the current provider or receive other own-home supports from a different provider.

· If the person is on the CAC or DD waiver and wants to remain in their current home, they have the choice to either receive services from the current provider until 2023 or receive services from a different provider.

2. Maintain the person’s BI or CADI current authorization (if applicable) for services until they have their annual reassessment or need a service change, whichever comes first.

3. Begin to authorize ICS on Jan. 1, 2023, for each person on the CAC and DD waiver who lives in an ICS setting at the time of their annual reassessment or if they need a service change.

Scenario 6 (expired): Supported apartment programs in which all people are on CAC or DD waivers

The transition period from a supported apartment program to an ICS setting no longer applies. The Dec. 20, 2022, DSD eList: ICS available on CAC and DD waivers altered the timelines stated below and provided clarification for transitions specific to people on the CAC or DD waiver. DHS required supported apartment programs in which people were on CAC and DD waivers to fully transition to ICS by Feb. 29, 2024.

DHS posted the information in this section on Dec. 28, 2020. It no longer applies and is for historical reference only.

If all people receiving HCBS from the provider that controls the setting are on CAC or DD waivers, the provider must do one of the following:

· Stop providing waiver services to people living in the setting by Jan. 1, 2023.

· No longer own, operate or have direct/indirect financial connection to the property by Jan. 1, 2023.

· Develop an ICS setting (see note below).

Note: The provider may develop and enroll ICS settings prior to 2023, but people on CAC or DD waivers cannot be authorized to receive ICS until Jan. 1, 2023. See the timeline section for interim service planning requirements.

Timeline

For people on CAC and DD waivers, ICS is not an available service option until Jan. 1, 2023.

During the two-year transition period (i.e., 2021–2023), people on CAC and DD waivers who live in an ICS setting can receive own-home services from the provider who controls the setting when they develop an interim service plan to transition to ICS in 2023.

People who receive one or more own-home service impacted by the Waiver Reimagine service streamlining will receive the corresponding streamlined service (refer to CBSM – Waiver Reimagine streamlined service crosswalk).

A person’s interim service plan must be developed with the person, provider and lead agency to ensure the transition to ICS occurs in 2023. The interim service plan must include the provider’s plan to develop an ICS setting prior to or beginning Jan. 1, 2023.

Beginning Jan. 1, 2023, people on CAC and DD waivers will transition to ICS on a rolling basis. This means each person who lives in the setting will continue to receive their current services until one of the following occurs:

· The person has a change in service need.

· The person has their annual reassessment and new service agreement.

· The person decides to terminate services with the provider.

Directions for providers

Prior to or beginning Jan. 1, 2023, 245D license holders that need to develop an ICS setting must complete the following steps:

· Submit a Setting Capacity Report, DHS-8062 to DHS for each ICS setting that includes the total number of units that will be used to provide ICS, regardless of waiver type.

· Receive verification from DHS that the setting meets the definition and requirements for an ICS setting.

· Update their 245D service license to include ICS.

· Contact DHS Provider Eligibility and Compliance through the Provider Help Desk at 651-431-2700 and visit MHCP Provider Manual – HCBS programs provider enrollment for additional information and forms to create an enrollment record for ICS and enroll each approved ICS setting.

· Notify all people who receive services, their legal representatives and case managers about the intent to develop an ICS setting, including information about how the change will affect their services.

Directions for case managers

When a case manager receives notification from a provider that they intend to develop an ICS setting at a current supported apartment program, the case manager must:

· Contact the person affected by the change to determine whether they prefer to continue living in their current home or want to move as a result of the change.
Note: If the person is on the CAC or DD waiver and wants to remain in their current home, they have the choice to either receive services from the current provider until 2023 or receive services from a different provider.

· Maintain the person’s current authorization for services until they have their annual reassessment or need a service change, whichever comes first.

· Begin to authorize ICS on Jan. 1, 2023, for each person on the CAC and DD waiver who lives in an ICS setting at the time of their reassessment or if they need a service change.