Federally approved BI, CAC, CADI, DD and EW waiver plans, Alternative Care (AC) program (Minn. Stat. §256B.0913), Minn. Stat. §626.557, subd. 12b

Monitoring technology supervision: The use of equipment to oversee, monitor and supervise someone who receives waiver/AC services. It can help keep people safe and support independence. The equipment used may include alarms, sensors, cameras and other devices.

Affected participant: A person who, as a roommate or significant other who lives with the person and is not a caregiver, may have their personally identifiable information viewed or recorded by the monitoring technology.

This policy applies to both new and existing monitoring technology equipment and supervision funded under one of the following home and community-based services (HCBS) programs:

For information about the services under which monitoring technology is covered, refer to the following sections on this page:

Monitoring technology equipment usage and supervision must meet the following four requirements:

1. Allow a caregiver to see, hear or locate a person
2. Be the most appropriate means (and the person’s preferred method) to address assessed need(s) and goal(s)
3. Monitor the person in real time
4. Achieve one of the following:

Monitoring technology equipment might include:

Monitoring-technology usage can include the equipment as well as remote-based staff paid to provide oversight and support of a person.

Monitoring technology cannot be for the convenience of the provider. Additionally, the following are prohibited:

Monitoring technology usage does not include:

The license holder or primary caregiver must store electronic video and audio recordings of participants for five days unless a participant or legal representative requests the recording be held longer based on:

In that case, the recordings must be maintained in a secured area for 30 days to give the investigating agency an opportunity to make a copy of the recording. The investigating agency will maintain the recordings as required in Minn. Stat. §626.557, subd. 12b.

HIPAA requirements

All video, audio or other personally identifiable information must be treated consistently with HIPAA regulations.

The use of all monitoring technology must meet the following three requirements:

The lead agency must update the person's support plan to describe how the use of the monitoring technology meets these three requirements.

Camera/video usage in bedroom

The use of a camera or video equipment in the person’s bedroom must meet the above three requirements and address a complex medical need or other extreme circumstance.

The lead agency must update the person’s support plan to describe how the use of the camera or video equipment meets these four requirements. For more information about camera and video equipment use in the bedroom, refer to the DHS approval section.

The lead agency approves and oversees the use of all monitoring technology. When camera or video equipment is located in the person’s bedroom, DHS must also approve. The case manager collaborates with the person and their team to make sure monitoring technology is appropriate. Monitoring technology cannot be used without informed consent.

Applicability

The policy applies to both:

Informed consent process

As part of the informed-consent process, the lead agency must complete and keep a copy of each of the following in the person’s file:

1. Participant Consent for Use of Monitoring Technology, DHS-6789B (PDF)
2. Affected Participant Consent for the Use of Monitoring Technology form, DHS-6789C (PDF), if applicable (for a definition of affected participant, refer to definition section)
3. The updated support plan.

Participant participation

We recognize there will be times when the person’s guardian may need to be heavily involved in this process. However, the participant, regardless of age, should be involved in the informed consent and planning process as much as possible.

When consent is not required

Participants and affected participants do not have to give consent for door and window alarms that do not record personally identifiable data when used:

Ongoing review

The lead agency must review annually. That review includes documentation in the support plan of:

The lead agency must review as soon as possible if there is a(n):

The lead agency must seek approval from DHS for all uses of cameras or video equipment in a person’s bedroom.

Initial approval process

To initiate a request for DHS approval, the case manager should complete and submit the Monitoring Technology Approval Request, DHS-6789A. It will require you to attach:

1. Participant Consent for the Use of Monitoring Technology, DHS-6789B (PDF)
2. If applicable, Affected Participant Consent for the Use of Monitoring Technology, DHS-6789C (PDF)
3. The updated support plan (with clear language about how it is necessary to address complex medical needs or other extreme circumstances, as well as the other support plan requirements described in the service and support plan requirements section).

Exception

DHS approval is not required when parents use cameras/video equipment in the bedroom to monitor minor children for health and safety purposes. The lead agency reviews these scenarios.

DHS reauthorization

Unless the lead agency requests a new review, DHS does not have to reauthorize the use of cameras/video equipment in bedrooms unless there is a(n):

Environmental accessibility adaptations

For the BI, CAC, CADI and DD waivers, the environmental accessibility adaptations (EAA) service covers approved monitoring technology equipment that is not shared (i.e., it would follow the person if/when they move). EAA includes the assessments necessary to determine the most appropriate equipment, and installation, maintenance and repairs of the equipment.

Repairs

EAA covers repairs only when they are cost-effective compared to the price to replace the item.

Shared equipment

Equipment that is shared as part of a foster care or supported living service arrangement is compensated within the framework for those services (under the “client programming and supports” component value). The lead agency may not authorize the equipment separately under EAA.

24-hour emergency assistance service

For the BI, CAC, CADI and DD waivers, the 24-hour emergency assistance service covers on-going monitoring to support a person using the technology if they meet both of the following criteria:

Specialized equipment and supplies

For the AC program and EW, the specialized equipment and supplies service covers approved monitoring technology equipment and monthly fees including:

Environmental accessibility adaptations

For the AC program and EW, the lead agency should authorize installation of monitoring technology equipment under the environmental accessibility adaptations (EAA) service when the equipment installation requires modifications to the physical structure of the home that are not easily removed.

Items authorized under EAA should use the EAA HCPC codes and follow the EAA authorization limits.

EAA includes: