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Community-Based Services Manual (CBSM)

Community-Based Services Manual (CBSM)


Brain Injury (BI) Waiver

In response to the COVID-19 peacetime emergency, DHS has updated policy/procedures and issued related instructional bulletins to ensure continuity of care for people in Minnesota who access services. These changes:

  • · Allow LTSS assessments and reassessments to be conducted remotely (March 23, 2020, eList).
  • · Allow case management visits to be conducted remotely (April 6, 2020, eList).
  • · Prevent eligibility in LTSS programs from being terminated (June 22, 2020, eList).
  • Page posted: 10/1/03

    Page reviewed: 6/13/23

    Page updated: 6/13/23

    Legal authority

    Federally approved BI Waiver Plan, Minn. Stat. §256B.093, Minn. Stat §256B.49

    Definition

    Brain Injury (BI) Waiver: Program that provides home and community-based services to children and adults with a diagnosis of brain injury who require the level of care provided in a specialized nursing facility or neurobehavioral hospital. These services are an alternative to institutionalization. The services help a person live as independently as possible in community settings and promote optimal health, independence, safety and community integration.

    Eligibility

    To be eligible for the BI Waiver, a person must choose to live in the community and meet all the following criteria:

    1. Be eligible for Medical Assistance (MA) based on a disability or other eligibility status (refer to the MMIS codes for HCBS waiver/AC program eligibility section on CBSM – Waiver/AC programs overview).

    2. Be certified disabled by Social Security or the State Medical Review Team (SMRT).

    3. Be younger than age 65 at the time of opening to the waiver for the first time.

    4. Be assessed using MnCHOICES to need the level of care provided in either:

  • · Nursing facility (BI-NF).
  • · Neurobehavioral hospital (BI-NB).
  • 5. Have one of the following documented diagnoses of brain injury or related neurological condition that is not congenital:

  • · Acquired or traumatic brain injury.
  • · Degenerative or genetic disease where cognitive impairment is present and becomes symptomatic on or after the person’s 18th birthday.
  • 6. Have significant cognitive and behavioral impairment as a result of the brain injury.

    7. Have the potential to benefit from rehabilitative services as determined by a MnCHOICES assessment.

    8. Have an assessed need for supports and services beyond those available through the MA state plan.

    9. Have an assessed need for one or more of the following as a result of the person’s cognitive or behavioral impairments:

  • · Provider with experience or expertise serving people with brain injuries who have cognitive or behavior impairments.
  • · Higher amount of units or rate for services.
  • Assessors should reference BI Waiver Eligibility and Documentation Checklist, DHS-3471B (PDF) as needed.

    Covered services

    Services under all waiver/AC programs must meet the requirements listed in the services section of CBSM – Waiver/AC programs overview.

    The following services are covered under the BI Waiver. For a service-specific policy page, select a service from the list:

  • · 24-hour emergency assistance
  • · Adult day services (includes family adult day services)
  • · Adult day services bath
  • · Caregiver living expenses
  • · Case management
  • · Case management aide
  • · Chore services
  • · Community residential services
  • · Consumer directed community supports (CDCS)
  • · Crisis respite
  • · Customized living (including 24-hour)
  • · Day support services
  • · Employment development services
  • · Employment exploration services
  • · Employment support services
  • · Environmental accessibility adaptations
  • · Extended home care services (includes extended home care nursing, extended home health aide, extended home care therapies, extended personal care assistance)
  • · Family residential services
  • · Family training and counseling
  • · Home-delivered meals
  • · Homemaker (cleaning, home management and assistance with activities of daily living)
  • · Independent living skills (ILS) therapies
  • · Individualized home supports (without training, with training and with family training)
  • · Integrated community supports
  • · Night supervision services
  • · Positive support services
  • · Prevocational services
  • · Respite
  • · Specialist services
  • · Specialized equipment and supplies (includes personal emergency response systems [PERS])
  • · Transitional services
  • · Transportation.
  • State and lead agency responsibilities

    Refer to the state and lead agency responsibilities section on CBSM – Waiver/AC programs overview.

    Waiver forms

    For a list of forms applicable across and/or specific to waiver programs, refer to CBSM – Forms for LTSS assessment, eligibility and support planning.

    Process and procedures

    Refer to CBSM – Waiver, AC and ECS general processes and procedures for specific information about:

  • · Access
  • · Assessments and reassessments
  • · Support planning
  • · Authorization
  • · Changing waiver programs
  • · 65 years of age
  • · Person’s own home requirements
  • · Out-of-state services
  • · Local trade area – using providers from a bordering state
  • · Termination.
  • Additional resources

    Brain Injury (BI) Waiver Program Brochure, DHS-3442 (PDF)
    CBSM – Assessment applicability and timelines
    CBSM – Financial management overview
    CBSM – Instructions for completing the physician letter of medical necessity for the BI-NB Waiver
    CBSM – MnCHOICES
    CBSM – Waiver, AC and ECS general processes and procedures
    CBSM – Waiver/AC programs overview
    CBSM – Waiver/AC service provider overview

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