Federally approved BI, CAC, CADI and DD waiver plans, Minn. Stat. §245D.03

Positive support services (formerly behavioral support): Services that consist of developing, implementing and monitoring a person-centered, individually designed, proactive plan to address challenging behaviors. A waiver positive support professional develops this plan to enhance a person’s quality of life through the process of teaching or increasing positive behavior. When possible, the person leads the process to develop a positive behavior support plan and/or positive support transition plan.

Positive support services include:

A person can receive positive support services in their home or in the community.

Positive support services cannot replace or duplicate services available through other funding sources (e.g., Medicare, Medicaid and private insurance).

Positive support services can be delivered through remote support. Services delivered through remote support must meet all the requirements listed on CBSM – Remote support.

Before initial authorization of positive support services, the lead agency must:

1. Obtain documentation of a mental health diagnostic, cognitive, neuropsychological or neurological assessment.

2. Document recommendations from the diagnostic assessment in the support plan.

3. Help the person access recommended services available through other funding sources.

4. Update the support plan to ensure state plan mental health and positive support services are integrated and coordinated.

When the person lives in a setting where the residential provider also provides positive support services, the lead agency must inform the person that they have the choice of getting positive support services from a provider different from the residential provider. The lead agency also must ensure there is documentation of the person's choice of positive support providers.

There are three staff levels associated with positive support services:

Each staff level has different qualifications, roles and responsibilities with progressive levels of authority, competency, training, need for supervision and experience. For more information about each staff level, refer to CBSM – Positive support services staff levels.

Multiple staff level authorizations

When authorizing this service, the lead agency always must authorize a waiver positive support professional. Additionally, the lead agency can authorize a waiver positive support analyst and/or specialist based on the following factors:

Some components of positive support services do not involve direct support to the person. The providers may bill the following services and support activities as indirect time to support people:

For more information on billable indirect services, refer to Rate Management System User Manual – Quick reference guide on billable indirect time.

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

License requirements

A positive support provider must have a license under Minn. Stat. Ch. 245D as an intensive support services provider.

Background study

To provide positive support 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.

Reporting

A provider licensed under 245D must report all uses of restrictive interventions, including the emergency use of manual restraint and prohibited procedures according to Minn. Stat. §245D.06, subd. 5 and all other incidents required under Minn. R. 9544.0110 to DHS via the Behavioral Intervention Report Form, DHS-5148.

Requirements for each staff level

For information about specific qualifications, roles and responsibilities, refer to the following sections on CBSM – Positive support services staff levels:

Positive support services are framework services. The lead agency uses the Rate Management System (RMS) to determine rates. For more information, refer to CBSM – Rate Management System and Long-Term Services and Supports (LTSS) Service Rate Limits, DHS-3945 (PDF).

Lead agencies and providers can reference the following forms when implementing or evaluating positive support services: