Deficit Reduction Act, 2005 (PL 109) §6071 (PDF), Patient Protection and Affordable Care Act, 2010 §2403 (PDF), Minn. Stat. §256B.04, subd. 20

Overnight assistance: MHM service a person may receive after moving to the community. This service can include onsite monitoring, availability and response as needed to address safety and security needs to support a person as they adjust to the community. Overnight assistance must be:

Demonstration case management (DCM): MHM service a person may receive after moving to the community. This service monitors and evaluates the person’s MHM community services and supports as they adjust in the community. DCM must be:

Transition coordination: MHM service that provides coordination of activities to support a person who resides in a qualified institution to gain access to medical, social, education, financial, housing and other services and supports that are necessary to move to the community. For more information, refer to MHM Manual – Transition coordination.

Transition coordinator: Professional who carries out the transition coordination service and supports a person to move from a qualified institution to the community with MHM.

Lead agency: County, tribal nation or managed care organization (MCO).

A person is eligible to receive overnight assistance for up to 365/366 days after their move into the community if they meet all the following criteria:

Waiver interaction

If the person enrolls in a home and community-based services (HCBS) waiver program, they cannot receive overnight assistance in addition to their waiver services.

Covered services could include, but are not limited to:

MHM overnight assistance does not include:

Overnight assistance is available during the person’s 365/366 days of MHM community service, after their move from an qualified institution. This service requires prior authorization. For more information, refer to the authorization, rates and billing section below.

A person can only receive MHM overnight assistance for up to 12 hours in a 24-hour period.

Overnight assistance is a DHS enrollment-required service. For more information, refer to MHCP Provider Manual – MHM.

The provider must:

License requirements

The provider must do both of the following:

1. Complete Overnight Assistance Provider Assurance Statement

2. Be one of the following:

Background studies

Minn. Stat. Ch. 245C requires a licensed program to conduct background studies. Providers who have direct contact with the person must have a completed background study (for a complete list, refer to Minn. Stat. §245D.03). A provider must complete and submit individual background studies using New Electronically Transmitted Study (NETStudy) through DHS licensing.

Service authorization

The lead agency (or transition coordinator if the person does not have a lead agency) assigns an MHM demonstration case manager. The demonstration case manager is responsible to authorize the person’s MHM post-transition community services. They can approve dates of service for up to 180 days. Additional 90-day periods are allowed with DHS approval and cannot exceed 360 days total.

This service requires a service authorization. DHS pays the provider as indicated on the service agreement.

For instructions about authorizing MHM community services and how to receive prior authorization and request additional units, refer to MHM Manual – Services.

Rate

The lead agency or provider claims the actual cost of the services provided. The rates cannot exceed the rate limit in Long-Term Services and Supports (LTSS) Service Rate Limits, DHS-3945 (PDF).

Billing

The provider must plan and deliver services based on the person's needs, as documented in the person’s TPT. All submitted claims must be based on actual services delivered.

The provider must not incur overnight assistance expenses until they receive a service authorization letter (SAL) in their MN-ITS SAL mailbox.

These services must be reasonable and necessary for a person to remain in their qualified community residence.