Federally approved BI, CAC, CADI, DD and EW waiver plans, 42 C.F.R. 440.180, Minn. Stat. §256B.092, Minn. Stat. §256B.49, Minn. Stat. Ch. 256S, Minn. Stat. §256B.0913, Minn. Stat. §256B.492, Minn. Stat. §256B.0992

Lead agencies: Counties, tribal nations and managed care organizations (MCOs).

Waiver and Alternative Care (AC) programs provide home and community-based services (HCBS) to meet the needs of people with disabilities and older adults. Minnesota developed HCBS waivers to meet the needs of people who choose to receive services and supports in their home or community, rather than in an institutional setting. For eligible people, these service options are available in addition to services covered by Medical Assistance (MA).
Note: People who choose the AC program do not have MA services.

A person must be a Minnesota resident and meet eligibility requirements specific to each waiver/AC program.

Each waiver/AC program is based on an agreement between DHS and the federal Centers for Medicare & Medicaid Services (CMS) that complies with federal requirements. These agreements are called waiver plans or AC protocols. They describe:

DHS manages the waiver/AC programs, lead agencies administer the programs and providers deliver services within the requirements of the programs.

People with disabilities and older adults may qualify for waiver/AC programs if they choose to live in the community and require certain levels of care. The following programs are available to people who meet eligibility criteria:

Each waiver/AC program includes certain services, which are listed on each program's CBSM page.

Services under all waiver/AC programs must:

Non-covered services

Services under all waiver/AC programs are not covered if they:

DHS is responsible to:

Lead agencies are responsible to:

For more information about managed care responsibilities, refer to DHS – MCO contract information, forms and resources.

For more information about tribal nation responsibilities, refer to CBSM – Tribal administration of HCBS programs.

Waiver/AC service providers must:

For information about how to administer the programs, refer to CBSM – Waiver, AC and ECS general processes and procedures.

AC

Certified assessors enter the person's program eligibility for AC using the following long-term care (LTC) screening document fields:

The date will set the begin-date of the eligibility span on the RELG screen in MMIS. The code displayed on the RELG screen for AC program eligibility is "AC."

BI, CAC, CADI, DD and EW

Financial workers enter the person's disability or other eligibility status on the RELG screen in MMIS. This documents part of waiver program eligibility. The following codes are the only codes financial workers may enter for program eligibility:

Additional information about codes 09, 10 and 25

Many children who are eligible for Title IV-E adoption assistance (09), MN adoption assistance (10) and Title IV-E foster care (25) also are certified disabled and receiving waiver services. The eligibility status for these children must remain coded as 09, 10 or 25 for funding purposes.

Additional information for financial workers about "D" code (BI, CAC, CADI and DD only)

Financial workers must add a “D” code to the indicator field in MMIS on the RELG screen to indicate "disabled" for purposes of waiver program eligibility. For more information, refer to the MMIS User Manual.