Community-Based Services Manual (CBSM)

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Community-Based Services Manual (CBSM)

CBSM Waiver programs

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Caregiver living expenses

Page posted: 10/1/03		Page reviewed: 11/30/22	Page updated: 11/30/22
Legal authority	Federally approved BI, CAC, CADI and DD waiver plans
Definitions	Caregiver living expenses: Certain expenses incurred by an unrelated caregiver who lives in the same home as a person age 18 or older who receives waiver services when the caregiver also provides an approved service. Unrelated caregiver: A person who is not related by blood, marriage or adoption to any degree. Legally responsible individual: Any of the following people: · Parent (biological and adoptive) of a minor child. · Legal guardian, as determined by a court of law. · Conservator, as determined by a court of law.
Eligibility	A person is eligible for their unrelated caregiver to be reimbursed through caregiver living expenses when the person: · Has an unrelated caregiver residing in the same home. · Is an adult. · Lives in their own home (refer to CBSM – Requirements for a person’s own home). · Receives an approved service provided by the live-in, unrelated caregiver (refer to the covered services section).
Covered services	Covered services are the portion of rent and food reasonably attributed to the live-in, unrelated caregiver when they also provide an approved service. For purposes of this service, DHS defines food as three meals per day or any other full nutritional regimen. Approved services Reimbursement for caregiver living expenses is available if the live-in, unrelated caregiver provides one of the following waiver services: · Consumer directed community supports (CDCS). · Extended home care nursing (HCN) (Community Alternative Care [CAC] only). · Extended personal care assistance (PCA). · Individualized home supports with training. · Individualized home supports without training.
Non-covered services	Not covered within the service Reimbursement for caregiver living expenses is not allowed: · For people related by blood, marriage or adoption, or for other legally responsible individuals. · In a residence owned or leased by a Medical Assistance-enrolled service provider. · When the live-in, unrelated caregiver owns the home. Services that cannot be authorized with caregiver living expenses A person cannot receive reimbursement for caregiver living expenses when they receive the following services: · Community residential services. · Crisis respite – daily, out of home. · Customized living (including 24-hour customized living). · Family residential services. · Integrated community supports.
Secondary information	Services under all waiver/AC programs must meet the requirements listed in the services section of CBSM – Waiver/AC programs overview.
Provider standards and qualifications	The live-in, unrelated caregiver must meet the provider standards and qualifications for the approved waiver service they provide (refer to the covered services section).
Lead agency responsibilities and approval of expenses	The lead agency must: · Ensure the Minnesota Health Care Programs (MHCP) enrollment status of the caregiver if the service requires enrollment. · Ensure the expenses of the live-in, unrelated caregiver are reasonable. · Identify and document in the support plan the role and expectations of the live-in, unrelated caregiver outside of the approved waiver service(s) they provide (e.g., roommate agreement). · Use Caregiver Living Expenses Worksheet, DHS-4929 (PDF) to calculate coverage of caregiver-claimed expenses.
Authorization, rates and billing	The lead agency authorizes caregiver living expenses at the market rate, based on Caregiver Living Expenses Worksheet, DHS-4929 (PDF). For more information, refer to CBSM – Market rate services and Long-Term Services and Supports Service Rate Limits, DHS-3945 (PDF).
Additional resources	Caregiver Living Expenses Worksheet, DHS-4929 (PDF) CBSM – CDCS CBSM – Extended HCN CBSM – Extended PCA CBSM – Individualized home supports CBSM – Market rate services CBSM – Requirements for a person’s own home CBSM – Resource: Overnight support for people in their own home CBSM – Waiver, AC and ECS processes and procedures CBSM – Waiver/AC programs overview Long-Term Services and Supports Service Rate Limits, DHS-3945 (PDF)

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