Federally approved Brain Injury (BI), Community Alternative Care (CAC), Community Access for Disability Inclusion (CADI) and Elderly Waiver (EW) plans, Minn. Stat. §256B.0913 (Alternative Care [AC] program), Minn. R. 9505.0310, Minn. Stat. §256B.0922 (Essential Community Supports [ECS] program)

Specialized equipment and supplies: Devices (including assistive technology), controls, medical appliances or supplies specified in the person’s support plan.

For the federal definition of assistive technology, refer to MN Guide to Assistive Technology – Definition.

A person is eligible to receive specialized equipment and supplies if the item allows the person to do one of the following:

Specialized equipment and supplies includes:

Note: The purchase price includes necessary training or instruction on the use of specialized equipment and supplies.

Additional covered services for AC and EW

In addition to the above covered services, specialized equipment and supplies through AC and EW also includes:

ECS

Under ECS, specialized equipment and supplies is limited to PERS (refer to CBSM – PERS).

Specialized equipment and supplies does not cover:

In addition, an item is not covered if it restricts a person’s rights or restrains them, and either:

An electronic tablet is funded through the MA state plan as durable medical equipment if the person uses it only for purposes of augmentative communication.

An electronic tablet is funded through the waiver/AC program under specialized equipment and supplies if the person uses the device to do one or more of the following:

The lead agency may authorize funding for used equipment when the equipment has been evaluated by one of the following professionals:

The professional evaluating the equipment must ensure:

The waiver will not fund used equipment when sold to a second member of the same family. For the purposes of this policy, family is defined as parents, siblings and children — any of whom are related by birth, marriage or adoption.

BI, CAC and CADI

For waivers that begin or renew before Jan. 1, 2024, the person may receive up to $3,909 of specialized equipment and supplies per waiver year.

For waivers that begin or renew on or after Jan. 1, 2024, the person may receive up to $10,000 of specialized equipment and supplies per waiver year.

For this purpose, a waiver year is calculated based on a 365-day period, which is determined by counting back from the service agreement header end-date. It may include previous service agreements if the 365-day period crosses previous service agreements. Once the service limit has been reached, additional spending must wait until the next waiver year. There are no exceptions to this limitation.

AC and EW

The person may receive specialized equipment and supplies up to the case mix budget cap, as authorized in the person’s support plan.

The lead agency should work with the provider to include a clear description of the item in the claim that matches the description of the item in the service agreement.

Services under all waiver/AC programs must meet the requirements listed in the services section of CBSM – Waiver/AC programs overview.

Assistive technology devices or equipment

For AC, BI, CAC, CADI and EW, assistive technology is available through specialized equipment and supplies.

For DD, assistive technology is available through CBSM – Assistive technology.

The following providers may enroll with Minnesota Health Care Programs (MHCP) to provide specialized equipment and supplies:

The lead agency authorizes specialized equipment and supplies at the market rate. For more information, refer to CBSM – Market rate services and Long-Term Services and Supports Service Rate Limits, DHS-3945 (PDF).

For information about lead agency and MHCP-enrolled provider responsibilities during the authorization and billing process, refer to MHCP Provider Manual – Specialized equipment and supplies authorization and billing responsibilities.

PERS

For AC and EW, PERS is available under the specialized equipment and supplies service. PERS has different service limits and authorization codes. For more information, refer to the PERS-specific entries on Long-Term Services and Supports Service Rate Limits, DHS-3945 (PDF) and CBSM – PERS.

For BI, CAC, CADI and DD, PERS is available under CBSM – 24-hour emergency assistance.