Federally approved Elderly Waiver (EW) Plan, Minn. Stat. Ch. 256S, Alternative Care (AC) program (Minn. Stat. §256B.0913), Essential Community Supports (ECS) program (Minn. Stat. §256B.0922)

The lead agency uses one of the following methods to determine rates for services it authorizes under the Alternative Care (AC), Essential Community Supports (ECS) and Elderly Waiver (EW) programs:

The following sections describe these methods in detail.

For specific AC, ECS and EW service rate limits and monthly budget caps, refer to Long-Term Services and Supports (LTSS) Service Rate Limits, DHS-3945 (PDF).

DHS establishes rates for most AC, ECS and EW services.

AC and EW services

The lead agency authorizes the following AC and EW services at the state-established rate:

ECS services

The lead agency authorizes the following ECS services at the state-established rate:

Note about case management

The case management service follows the state-established rate only when provided by a county or tribal nation. If the county or tribal nation contracts with another agency to provide this service, it may pay the contracted agency at a lower rate.

The lead agency authorizes some AC, ECS and EW services at market rates. In general, a market rate is the typical price charged for a service in the community market. Market rate services:

When determining a market rate, the lead agency should consider local rates for comparable services not provided through Medical Assistance (MA).

The following are not appropriate methods of determining a market rate:

AC and EW services

The lead agency authorizes the following AC and EW services at the market rates, up to the published rate maximums:

ECS services

The lead agency authorizes the following ECS services at the market rates, up to the published rate maximums:

The lead agency uses the Residential Services Tool (RS Tool) to determine rates for the following EW residential services:

For more information, refer to DHS – EW residential services.

The RS Tool allows the lead agency to set foster care service rates up to a person’s case mix budget cap and customized living service rates up to statewide limits by case mix. Minn. Stat. §256S.202 defines the limits for customized living and 24-hour customized living services.

When customized living limits (non-24-hour) were first established, the limits varied by geography based on a person’s county of residence. Effective Jan. 1, 2023, DHS implemented a single set of statewide limits, rather than varying limits based on a person’s geography. DHS set these statewide limits at exactly 50% of the case mix budgets in effect on Jan. 1, 2023. This approach aligns the limits with statute and simplifies program administration. This percentage will never exceed 50%, but it may change in the future if case mix budgets receive larger increases than CL limit increases.

DHS establishes individual budget caps for people who use CDCS under the AC and EW programs, which are published in LTSS Service Rate Limits, DHS-3945 (PDF).

For more information about CDCS, refer to CBSM – CDCS.

The lead agency authorizes transportation at either the:

Use the following guidance to authorize mileage and trip rates: