Waiver/AC service provider overview
Page posted: 1/23/14 | Page reviewed: 12/5/17 | Page updated: 12/31/20 | |
Legal authority | Federally approved BI, CAC. CADI, DD and EW waiver plans, federally approved AC 1115 demonstration, Minn. Stat. Chapter 245D, Minn. Stat. §256B.4912, subd. 1 and 5, Minn. Stat. §256B.4912, subd.1 (b) and (c), Minn. Stat. Chapter 245C | ||
Overview | All home and community-based waiver and Alternative Care (AC) service providers must comply with Medical Assistance (MA) and federally approved state service standards. All providers must work within their license, certification or other requirements. DHS categorizes waiver/AC services into two groups: DHS enrollment-required services and DHS or lead agency approval-option services. DHS enrollment-required servicesDHS enrollment-required services must be delivered by providers enrolled with DHS as Minnesota Health Care Programs (MHCP) providers. For a list of services, refer to the DHS enrollment-required services section. DHS or lead agency approval-option servicesDHS or lead agency approval-option services can be delivered by MHCP-enrolled providers or qualified vendors approved by willing lead agencies. For a list of services, refer to the DHS or lead agency approval-option services section. Lead agency approvalFor information about how the lead agency approves an approval-option service provider, refer to CBSM – Lead agency oversight of waiver/AC approval-option service vendors. For training on this policy and process, refer to TrainLink Course – Lead agency oversight of HCBS waiver/AC approval-option service vendors. | ||
DHS enrollment-required services | All DHS enrollment-required services also require providers to have a license or certification. Each service links to an individual CBSM page with more information. Services licensed by DHS or MDHTo deliver the following DHS enrollment-required services, the provider must have a license from DHS or the Minnesota Department of Health (MDH): In some cases, a person who receives Chapter 245D basic support services can use an excluded provider who meets requirements on CBSM – Exclusions from 245D licensure. Services requiring certificationTo deliver the following DHS enrollment-required services, the provider must have a service-specific certification: Age requirementAll enrolled individual providers must be 18 years of age or older, with the exception of CDCS and chore services. This does not limit people who are 16-17 years old from working for an agency when they are in compliance with federal or state labor laws. | ||
DHS or lead agency approval-option services | DHS or lead agency approval-option services include direct-delivery services and purchased-item services. For information about how the lead agency approves an approval-option service provider, refer to CBSM – Lead agency oversight of waiver/AC approval-option service vendors. For training on this policy and process, refer to TrainLink Course – Lead agency oversight of HCBS waiver/AC approval-option service vendors. Approval-option: direct-delivery servicesA direct-delivery service is delivered by a person in or around the home, or in a non-commercial vehicle. Direct-delivery services include: Approval-option: purchased-item servicesPurchased item services include: | ||
Caregiver living expenses | Caregiver living expense providers must meet the provider standards and qualifications for the waiver service delivered by the live-in caregiver. A lead agency determines eligibility for this service following the policies described on CBSM – Caregiver living expenses. | ||
Required DHS background studies for direct-contact services | People who provide direct-contact services (as defined in Minn. Stat. §245C.02, subd. 11) must have a background study that meets the requirements of Minn. Stat. Ch. 245C. For more information, refer to DHS – Background studies. The following HCBS waiver services are considered direct-contact services: ResponsibilityMHCP providers must meet background study requirements as a part of the enrollment or licensure process. Lead agencies that approve vendors to deliver the subset of approval-option: direct delivery services that are direct-contact services need to follow the DHS background study process. For instructions, refer to CBSM – DHS background study process for lead agencies that approve service vendors. | ||
Training | MHCP-enrolled providersMost providers that enroll with DHS as an MHCP home and community-based waiver/AC service provider must complete: For more MHCP provider training opportunities, refer to DHS – MHCP provider training. College of Direct SupportThe College of Direct Support, in partnership with DHS, offers a collection of optional, web-based courses designed for: For more information, refer to DHS – College of Direct Support. | ||
Search for providers | To find waiver/AC service providers, search MinnesotaHelp.info: | ||
Additional resources | MHCP-enrolled providersDHS – MHCP provider types 245D licenseDHS – Licensing for HCBS 245D providers Service rates and billing codesCBSM – Market rate services | ||
Questions? | If you have questions about: ProvidersIf you are a provider, contact the MHCP Provider Resource Center. | ||
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