Page updated: 12/1/25

Legal authority

Federally approved EW waiver plan, 42 C.F.R. 440.180, Minn. Stat. Ch. 256S, Minn. Stat. §256B.0913

Applicability

This page applies to AC and EW only. For information on adjusting CDCS budgets for the disability waivers, refer to CDCS Manual – CDCS partial-year budgets for disability waivers.

Definitions

Monthly CDCS budget: Total monthly dollar amount for AC/EW CDCS that is based on the person’s assessed case mix. DHS establishes individual monthly budget caps for people who use CDCS in Long Term Services and Supports (LTSS) Service Rate Limits, DHS-3945 (PDF). The person can use their dollars flexibly throughout the service agreement.

Lead agency: County, tribal nation or managed care organization.

Overview

This page describes how the lead agency calculates a partial-year CDCS budget for a person on AC or EW, if necessary. The lead agency must adjust the person’s budget when they:

The lead agency calculates the person’s partial-year budget by multiplying the monthly maximum by the number of months in the person’s service agreement.

Switching between CDCS and traditional AC/EW services

Switching from CDCS to traditional AC/EW

If the person switches from CDCS to traditional AC/EW services, the amount of their remaining budget is the traditional AC/EW monthly amount multiplied by the number of months left in the eligibility span.

Person not enrolled in an MCO

The county/tribal nation must:

1. End the CDCS lines on the person’s service agreement.

2. Follow the instructions in Instructions for Completing and Entering the LTCC Screening Document and Service Agreement into MMIS DHS-4625 (PDF) to enter a new screening document that ends CDCS and starts traditional AC/EW.

Person enrolled in an MCO

The MCO follows its own processes and procedures for making service agreement changes.

Switching from traditional AC/EW to CDCS

Person not enrolled in an MCO

If the person switches from traditional AC/EW services to CDCS, the amount of the remaining budget is the CDCS monthly amount multiplied by the number of months left in the eligibility span. The county/tribal nation must:

1. End the traditional AC/EW lines on the person’s service agreement.

2. Follow the instructions in the CDCS section of the Instructions for Completing and Entering the LTCC Screening Document and Service Agreement into MMIS DHS-4625 (PDF) to enter a new screening document that ends traditional AC/EW and starts CDCS.

Person enrolled in an MCO

The MCO follows its own process for service agreement adjustments and follows the instructions in the CDCS section of the Instructions for Completing and Entering the LTCC Screening Document and Health Risk Assessment into MMIS for the MSC+ and MSHO Programs, DHS-4669 (PDF) to enter a new screening document that ends traditional EW and starts CDCS.

Moving between AC CDCS and EW CDCS

If the person switches from AC CDCS to EW CDCS or from EW CDCS to AC CDCS, the lead agency does not extend their eligibility span. The case mix budget limit changes to the new program’s limit for the remaining months left in the eligibility span. The lead agency must follow all procedural steps to make the program change for the person.

Facility stays up to 121 days (EW only)

If the person resides in a facility for 121 or fewer days, the county/tribal nation follows the process on CBSM – Temporary waiver exits and restarts: MMIS actions.

Resuming CDCS for person not enrolled in an MCO

Person returns to the community within 30 days

When the person returns to the community within 30 days, the county/tribal nation must:

1. Work with the person and their financial management services (FMS) provider to determine the amount the person spent before they entered the facility.

2. Adjust the total requested amount (TOT REQ) of the existing CDCS line to the total amount the person spent.

3. Subtract the amount entered in step 2 from the person’s annual CDCS budget.

4. Add a new CDCS line to the existing service agreement with:

Person returns to the community between 30 and 121 days

When the person returns to the community between 30 and 121 days, the county/tribal nation must enter a new service agreement with a CDCS line. The county/tribal nation must:

1. Work with the person and their FMS provider to determine the remaining balance of the person’s CDCS budget by deducting the amount the person spent before entering the facility from their annual CDCS budget.

2. Enter a CDCS line on the ASA3 screen of the new service agreement with:

Resuming CDCS for person enrolled in an MCO

If the person uses EW CDCS through an MCO, the MCO follows its own process for CDCS service agreement adjustments.

Case mix budget exceptions

If the person exits AC/EW before the end of their service agreement, the lead agency must follow the instructions on CBSM – AC and EW budgets and case mix caps for premature exit.