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Consumer Directed Community Support (CDCS) Manual

Consumer Directed Community Support (CDCS) Manual


CDCS service category: Environmental modifications and provisions

This page does not include policy for unbundled service categories. For the new version of this page, refer to CDCS Manual – Unbundled service category: Environmental modifications – home modifications and CDCS Manual – Unbundled service category: Environmental modifications – vehicle modifications.

Page posted: 4/9/19

Page reviewed:

Page updated: 5/22/19

Legal authority

Federally approved BI, CAC, CADI, DD and EW waiver plans, Alternative Care program (Minn. Stat. §256B.0913)

Unbundling project

Effective Feb. 1, 2025, DHS will start the rolling implementation of the CDCS unbundling project. The current CDCS policy and CDCS unbundling project policy will be in effect at the same time. For more information, refer to the Dec. 10, 2024, eList announcement.

This page does not include policy for unbundled service categories.

Definition

Environmental modifications and provisions: Supports, services and goods provided to a person to maintain a physical environment that:

  • · Helps the person live and participate in their community
  • · Is required to support the person’s health and safety.
  • Covered services

    Examples of services, supports or goods billed under this service category include:

  • · Home modification.
  • · Vehicle modification.
  • · Assistive technology.
  • · Monitoring technology.
  • · Transportation.
  • · Environmental supports.
  • · Supplies and equipment.
  • · Special diets.
  • · Adaptive clothing.
  • · Home-delivered meals.
  • BI, CAC, CADI and DD assessments

    The following assessments are paid through the county/tribal nation waiver budget and must be included on separate service agreement line items:

  • · Assistive technology assessment.
  • · Environmental accessibility adaptations home assessment.
  • · Environmental accessibility adaptations vehicle assessment.
  • EW and AC assessments

    The following assessments are paid through the CDCS budget and authorized as environmental modifications and provisions or specialized equipment and supplies:

  • · Environmental accessibility adaptations home assessment.
  • · Environmental accessibility adaptations vehicle assessment.
  • Limitations

    BI, CAC, CADI and DD

    Lead agencies are required to follow the service limit and exception process (if applicable) of $40,000 per service agreement/waiver year for environmental accessibility adaptations. For more information, refer to the BI, CAC, CADI and DD service limits section of CBSM – Environmental accessibility adaptations.

    EW and AC

    For all people on AC and EW (including people using CDCS), lead agencies must follow the service limits located on Long-Term Services and Supports Service Rate Limits DHS-3945 (PDF) per service agreement/waiver year for environmental accessibility adaptations, which includes both CDCS vehicle modifications and home modifications. For more information, refer to the AC and EW service limits section of CBSM – Environmental accessibility adaptations.

    Home and vehicle modifications, assistive technology and monitoring technology
    (BI, CAC, CADI, DD)

    For assistive technology, monitoring technology and home and vehicle modifications, a person on BI, CAC, CADI or DD must pay the first $5,000 from their CDCS budget during the service agreement/waiver year of the expenditure(s). Regardless of the number of modifications and technology items needed during the plan year, the person’s annual contribution is limited to $5,000.

    When costs exceed $5,000 and the lead agency approves additional funding, the lead agency can use its overall waiver allocation (when applicable) to pay for item(s). The lead agency should authorize these costs on the service agreement separately outside of the person’s individual CDCS budget (see Instructions for Completing and Entering the LTCC Screening Document and Service Agreement into MMIS, DHS-4625 [PDF]).

    If a person chooses to use more than $5,000 from his/her budget to pay for more assistive technology, monitoring technology or home and vehicle modifications, they can choose to do so.

    Monitoring technology

    A person who wants to use CDCS funds to purchase monitoring technology must follow service guidelines on CBSM – Monitoring technology usage.

    Home and vehicle modifications, assistive technology and monitoring technology
    (EW, AC)

    A person on EW and AC uses funds from their individual CDCS EW or AC budgets to pay for home and vehicle modifications or assistive technology.

    Monitoring technology

    A person who wants to use CDCS funds to purchase monitoring technology must follow service guidelines on CBSM – Monitoring technology usage.

    Additional square footage

    Home modifications that add any square footage are not allowed, with the exception of an accessible bathroom. For more information, see CBSM – Additional square footage.

    Transportation costs

    Transportation costs can be covered when the need for the transportation service is due to a person’s functional limitation.

    Reimbursable transportation costs include the cost of:

  • · The transport (e.g., mileage or fares)
  • · The person providing the transportation (i.e., driver).
  • If the person requires assistance from someone while being transported, that cost is covered under the CDCS category of personal assistance. For more information, refer to CDCS Manual – Personal assistance.

    Limitations

    A person cannot use CDCS funding to:

  • · Meet transportation needs that a parent of a minor or spouse would be expected to provide if the person does not have a functional limitation (e.g., transportation to an after-school activity, day care, shopping centers or recreational events).
  • · Replace Medical Assistance state plan medical transportation (refer to MHCP Provider Manual – Nonemergency medical transportation [NEMT] services overview).
  • Environmental supports

    Environmental supports can be covered if the supports are necessary to maintain a clean, sanitary and safe home environment and the person cannot perform these tasks due to functional limitation. This includes chore-like services (e.g., lawn mowing, snow removal and heavy cleaning).

    Supplies and equipment

    Covered items include supplies and equipment not available under Medical Assistance state plan, including durable and non-durable medical supplies and equipment necessary to meet functional limitations.

    Covered supplies and equipment could include devices, controls or appliances that increase a person’s independence or community integration and improve their ability to:

  • · Perform activities of daily living (ADLs).
  • · Perform instrumental ADLs.
  • · Perceive, control or communicate with the environment.
  • For example, a person may reduce the need for meal preparation with the purchase of a microwave (not considered a major appliance) or a modified can opener.

    Limitations

    An item is not covered if it restrains a person or restricts their rights.

    Special diets

    For information about special diets, see CDCS – Guidelines for special diets.

    Adaptive clothing

    Covered adaptive clothing includes clothing that is either:

  • · Specially designed to increase a person’s independence in dressing, grooming, toileting or bathing.
  • · Designed to endure abnormal movement patterns or acting out.
  • Adaptive clothing could also include items prescribed by a physician (e.g., orthopedic shoes) that are not covered under MHCP.

    Home-delivered meals

    Home-delivered meals are meals provided to a person 18 years or older who is not able to prepare their own meals. Coverage is limited to a maximum of one meal per day.

    Provider standards and qualifications

    Home and vehicle modifications

    Providers must have a current license or certificate and meet all professional standards and/or training requirements required by state law for the services they provide.

    If state law does not mandate provider licenses, certificates or credentialing, the person who receives services documents the provider’s qualifications in their community support plan (CSP).

    All modifications must meet the applicable Minnesota codes:

  • · Home modifications must meet building codes and be inspected by the appropriate building authority.
  • · Vehicle modifications must meet any inspections requirements.
  • Transportation

    A person may designate private individuals to provide transportation when they meet the person’s needs and preferences in a cost-effective manner. Drivers can substitute for common carriers (e.g., Metro Mobility, buses, taxis, etc.) if this is a cost-effective option.

    Private drivers must have a valid driver’s license and meet state requirements for insurance coverage.

    Chore-like services

    A person who does chore-like services or heavy housekeeping tasks must meet the person’s standards and expectations. For example, the person may purchase snow removal from a person who does snowplowing or heavy housecleaning from a cleaning service. The person can choose to require the vendor to be bonded or insured.

    Additional resources

    CBSM – Additional square footage
    CDCS Manual – Guidelines for special diets
    CBSM – Monitoring technology usage
    CDCS Manual – Purchasing traditional AC/waiver goods and services under CDCS
    CDCS Manual – Service categories (pre-unbundling)

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