Federally approved BI, CADI, DD and EW waiver plans, Minn. Stat. §256B.0913, Minn. Stat. §256B.0922, Minn. Stat. Ch. 245A, Minn. R. 9555.9600 to 9555.9730, Minn. Stat. Ch. 256S, Minn. Stat. §256B.092, Minn. Stat. §256B.49

Adult day services: Individualized program of activities designed to meet the assessed health and social needs of an older adult outside their residence during the day. Adult day services include the delivery of supervision, care, assistance, training and activities directed toward achieving specific outcomes, as identified in the person’s support plan.

If a person receives family adult day services, refer to CBSM – Family adult day services for policy information.

Remote adult day services: An individualized and coordinated set of services provided via live, two-way communication by an adult day services center.

Live, two-way communication: Real-time audio or audio and video transmission of information between a person receiving services and an actively involved staff member.

Institution: For the purposes of this page, “institution” means:

Prong 1 setting: Setting located in a publicly or privately owned institution. For example, the waiver service setting and the institution share the same address, share a common wall or are connected by a walkway, skywalk or other enclosed corridor.

Prong 2 setting: Setting located adjacent to a publicly owned institution. For example, the waiver service setting touches the institution or its property with no intervening parcel of land between the two settings.

Publicly owned institution: Institution financed and operated by a county, state, municipality, or other unit of government. A privately owned nursing facility is not a public institution.

This page includes information about:

Adult day services must provide the supports necessary either to maintain or improve a person’s ability to care for themselves. Adult day services cover:

Activities

Activities must:

Meals and snacks

In-person adult day services cover a mid-morning and mid-afternoon snack. If a person receives in-person adult day services for more than 4.5 hours, adult day services also cover a meal. The meal must meet requirements in:

Adult day services do not cover:

The authorizations policy in this section is effective Jan. 11, 2021, for people on Brain Injury (BI), Community Access for Disability Inclusion (CADI) and Developmental Disabilities (DD) waivers. DHS sent an eList announcement on Jan. 22, 2021, to announce this policy. For background information about this policy change, refer to DHS – Home and community-based services (HCBS) settings transition plan.

The limitations for new authorizations and setting location do not apply to adult day services funded by Alternative Care (AC), Essential Community Supports (ECS) or the Elderly Waiver (EW).

Authorizations

New authorizations

A new authorization refers to an authorization for a person who has not received adult day services prior to Jan. 11, 2021.

New authorizations for adult day services for a person on BI, CADI or DD on or after Jan. 11, 2021, may only occur when all of the following criteria are met:

Existing authorizations

People who received adult day services prior to Jan. 11, 2021, regardless of age, may continue to use adult day services when all of the following criteria are met:

Setting connected to an institution

The lead agency cannot authorize adult day services when the adult day setting is adjoined to or on the same property as an institution (as described in the definition section) if that institution has any financial interest in the setting or services provided in the setting.

Collocated settings

When a single provider leases or owns more than one service setting located on the same or adjoining property, the lead agency can only authorize services in one of the settings. A service setting includes a setting used to deliver any of the following services:

Collocated setting exceptions

Setting status: The provider maintains ownership/control of the setting, and the 2017/2018 HCBS attestation/validation process determined HCBS setting compliance. In this situation:

Setting status: There was a sale or transfer of ownership to a new provider, and the 2017/2018 HCBS attestation/validation process determined HCBS setting compliance. In this situation:

Prong 1 and prong 2 settings

Effective March 18, 2023, new adult day service providers cannot bill for waiver services in settings in or adjacent to an institution (as described in the definition section) until approved by DHS and the Centers for Medicare & Medicaid Services (CMS) through the heightened-scrutiny process. For more information, refer to DHS – Requirements for new HCBS settings.

Lead agency instructions

Lead agencies should:

Provider instructions

To start the heightened-scrutiny process, new adult day service providers must email the DHS Aging and Adult Services HCBS unit at dhs.aasd.hcbs@state.mn.us with the subject “Heightened Scrutiny” and include the provider’s name, setting address and contact information.

Remote adult day services is not a new service. It is a new method to deliver adult day services to people who both:

Starting July 1, 2023, adult day services can be delivered through a combination of in-person and remote delivery. Adult day services delivered remotely must:

Online training

DHS released an on-demand, online training for lead agency staff and providers to better understand the new remote adult day services option. To find the course, visit TrainLink and search for course code “AASD-RADS” or course title “Remote Adult Day Services: Training for Lead Agencies and Providers.”

Eligibility

A person must be eligible for and receiving in-person adult day services to receive remote adult day services. The same provider must deliver both in-person and remote adult day services to the person.

Licensing requirements

Adult day services centers that provide remote adult day services must meet all requirements listed in the provider standards and qualifications section on this page, including the additional requirements specific to remote adult day services.

Technology considerations

When authorizing remote adult day service, the lead agency must consider:

Remote support does not fund the enabling technology used for remote support service delivery. The person could use the following services to purchase the technology:

Staffing ratios

If a person uses a device with two-way interactive video, they can receive remote adult day services with up to seven other people at the same time.

If a person uses a device without two-way interactive video, they must receive one-to-one remote adult day services.

Rates and authorization

The rate for remote adult day services is the same rate as in-person adult day services. For instructions, refer to the authorization, rates and billing section on this page.

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

Service amount

A person who receives remote adult day services must receive in-person adult day services at least quarterly, as documented in their support plan.

In a 24-hour period, a person may receive:

AC and EW only

Under AC and EW, a person must receive in-person or remote adult day services for two or more hours per day, for one or more days per week, on a regularly scheduled basis.

Needs determination process (BI, CAC, CADI and DD only)

The needs determination process applies to adult day services for people on BI, CAC, CADI and DD waivers. If a provider or lead agency wants to develop, expand or terminate adult day services, they must follow the process on CBSM – Day services needs determination.

Note: The needs determination process is not needed to add remote support to an adult day service provider’s license.

Adult day services are DHS enrollment-required services. For more information, refer to CBSM – Waiver/AC provider enrollment and standards.

License requirements

All adult day services providers must:

Additional requirements for remote adult day providers

Providers who provide remote adult day services also must comply with the additional requirements in:

Licensed adult day service providers must request approval from DHS Licensing to provide remote adult day services. Providers who want to add remote adult day to their license should contact their licensor or call the HCBS Help Desk at 651-431-6624. Once approved, DHS will add remote services to the provider’s adult day license.

Providers must deliver remote services during the days and hours of in-person services specified on the license of the adult day care center or adult day services center.

Refer to the finding an adult day services provider section on this page for instructions to identify a licensed provider.

Eligible providers

AC, ECS and EW

Under AC, ECS and EW, the following providers may provide adult day services:

Exemption (AC, ECS and EW only)

Under AC, ECS and EW, a nursing facility, hospital or boarding care setting that serves five or fewer people who are not residents or patients in the setting may deliver adult day services under its facility license. The provider is not required to obtain an adult day services license (Minn. R. 9555.9610, subp. 2). Providers that meet this adult day license exemption must comply with federal HCBS settings requirements, as outlined in the HCBS Applicant Assurance Statement, DHS-7618 (PDF).

BI, CADI and DD

Under the BI, CADI and DD waivers, the following providers may provide adult day services:

Background study

To provide adult day services, providers must have a background study. For more information, refer to CBSM – Waiver/AC service provider overview – Required DHS background studies for direct-contact services.

Below is program-specific information about authorization, rates and billing for adult day services. For more information, refer to Long-Term Services and Supports (LTSS) Service Rate Limits, DHS-3945 (PDF).

AC, ECS and EW

Under AC, ECS and EW, the lead agency authorizes in-person and remote adult day services at the state-established, 15-minute rate.

Remote adult day services

The rate for remote adult day services is the same rate as in-person adult day services. For service dates on or after July 1, 2023, lead agency staff will authorize remote adult day services in MMIS using the adult day HCPC code (S5100) with a new modifier (U4). Refer to LTSS Service Rate Limits, DHS-3945 (PDF) for current rates.

BI, CADI and DD

Under the BI, CADI and DD waivers, adult day services are framework services. The lead agency uses the Rate Management System (RMS) to determine rates. For more information, refer to CBSM – RMS.

The lead agency may authorize adult day services at a daily or 15-minute rate.

Exception for BI, CADI and DD

On a day when the person receives an adult day services bath, the lead agency must authorize adult day services using the 15-minute rate.

Remote adult day services

The rate for remote adult day services is the same rate as in-person adult day services. For service dates on or after July 1, 2023, lead agency staff will authorize remote adult day services in MMIS using the adult day HCPC code (S5100) with a new modifier (U4). Refer to LTSS Service Rate Limits, DHS-3945 (PDF) for current rates.

For a list of licensed adult day services providers in Minnesota, refer to DHS licensing information lookup or Minnesota Aging & Disability Resources.

To search for adult day service providers that provide remote adult day on the DHS licensing information lookup, use the following steps:

1. In the license type drop down menu, select “adult day care services,” and then select the “remote services” box.

2. Click “Search.”

3. Select a provider and click on the license details link.

4. If the provider is approved for remote adult day services, that information will appear within the details screen of the license, under the “license to provide” section.

CBSM – Adult day services bath
CBSM – Assistive technology
CBSM – Briefcase resource document: Transportation and day and employment services
CBSM – Day services needs determination
CBSM – Environmental accessibility adaptations
CBSM – Specialized equipment and supplies
CBSM – Waiver, AC and ECS general process and procedures
CBSM – Family adult day services
CBSM – Rate methodologies for AC, ECS and EW service authorization
CBSM – Waiver/AC service provider overview
DHS – Requirements for new HCBS settings
RMS User Manual