Minnesota Minnesota

Community-Based Services Manual (CBSM)

Community-Based Services Manual (CBSM)


Alternative Care (AC) conversion case management

Page posted: 9/3/14

Page reviewed: 5/9/25

Page updated: 5/9/25

Legal authority

Federally approved AC 1115 demonstration, Minn. Stat. §256B.0913

Definition

AC conversion case management: Case management activities that coordinate and support the discharge planning process to help people relocate to community-based settings.

Overview

AC conversion case management is a form of case management that provides coordination of activities to help a person residing in a qualified setting gain access to services and supports to move to the community.

Eligibility

This service is available to people who meet all the following requirements:

1. Reside in one of the following qualified settings:

  • · Certified boarding care home.
  • · Hospital.
  • · Intermediate care facility.
  • · Nursing facility.

    • 2. Will relocate to the community.

    3. Will receive services through the AC program.

    Covered services

    Covered activities include, but are not limited to:

  • · Develop and implement a relocation plan with the person.
  • · Coordinate and monitor the overall implementation of the relocation plan.
  • · Communicate with the person, legal representative (if applicable), informal supports, service providers and others as necessary to implement the relocation plan.
  • · Coordinate referrals and help the person access services.
  • · Coordinate efforts with the discharge planner, legal representative and/or others.

    • The case manager will contact and communicate with the person based on the person’s preferences and needs.

    Non-covered services

    Non-covered services include:

  • · Services covered by another billing source, such as private insurance or other third-party payers.
  • · Time and services provided by the institution’s discharge planner.

    • Limitations

    A person can access this service for up to 180 consecutive days from the date of admission. The 180-day limit is a “per admission” limit. A person may receive another 180 days of service if they are readmitted to a qualified setting.

    Authorization, rates and billing

    When a person on the AC program enters a qualified setting, they will continue to receive support through case management so they can relocate back to the community. In this situation, the lead agency must:

  • · End the AC service agreement line items effective the admission date.
  • · Enter a new line item for case management conversion (T1016 – no modifier) with a begin date of the admission date.

    • MMIS does not add the cost of conversion case management to the total authorized amount, so it is not applied against the total cap amount.

    When the person returns to the community, the lead agency must close the case management conversion line item and reenter the community services on the service agreement for the new period of community stay.

    A person may initially open to the AC program with only conversion case management during a period of 180 days in a qualified setting. The lead agency must enter an exit document and close the service agreement when a person remains in a qualified setting after 180 days.

    If the person becomes eligible for Medical Assistance (MA), the lead agency must close the AC program and enter a new screening document for relocation service coordination targeted case management (RSC-TCM). For more information, refer to CBSM – RSC-TCM.

    The lead agency authorizes conversion case management at the pre-determined rate. For more information, refer to Long-Term Services and Supports Service Rate Limits, DHS-3945 (PDF).

    Additional resources

    CBSM – AC
    CBSM – Waiver, AC and ECS case management
    CBSM – RSC-TCM

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