Minnesota Minnesota

Community-Based Services Manual (CBSM)

Community-Based Services Manual (CBSM)


Specialist services

Page posted: 10/1/03

Page reviewed: 11/30/22

Page updated: 11/30/22

Legal authority

Federally approved BI, CAC, CADI and DD waiver plans, Minn. Stat. §245D.03

Definition

Specialist services: Services provided by an expert or professional designed to promote, support and augment staff and caregiver competency to meet a person’s needs in one or more of the areas listed in the eligibility section.

Eligibility

To be eligible for specialist services, the person must have a documented need in one or more of the following areas:

1. Augmentative communication.

2. Behavior and mental health symptom support to:

  • · Strengthen effective emotional and behavioral functioning.
  • · Manage harmful symptom expression or conduct that could endanger themselves and others.

    • 3. Community safety training and support.

    4. Functional motor skills.

    5. Personal health.

    6. Skills to live independently.

    7. Social, leisure and recreational skills.

    Covered services

    Specialist services cover:

  • · Assessments, program development, evaluation and monitoring specific to outcomes identified in the person’s support plan, when related to one or more of the areas listed in the eligibility section.
  • · Training and supervision of staff and caregivers necessary to achieve competency in one or more of the areas listed in the eligibility section.

    • Non-covered services

    Not covered within the service

    Specialist services do not cover administrative costs to provide other waiver services.

    Behavior and mental health symptom support cannot duplicate positive support services or crisis respite services (refer to CBSM – Positive support services and CBSM – Crisis respite services).

    Services that cannot be authorized with specialist services

    Specialist services do not cover services that duplicate other:

  • · Minnesota state plan services.
  • · Waiver services.

    • Remote support

    Specialist services can be delivered through remote support. Services delivered through remote support must meet all the requirements listed on CBSM – Remote support.

    Secondary information

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

    Examples

    Example 1

    Mateo has significant hearing loss, and his speech/language pathologist recommends a communication device he can use in everyday settings. An assistive technology professional will provide specialist services to:

  • · Develop programs to increase Mateo’s communication skills.
  • · Train staff and caregivers on the effective use of the device.
  • · Evaluate the effectiveness of the device in meeting Mateo’s communication needs across various community settings.
  • · Ensure a plan and process is in place for Mateo to continue using the device over time.

    • Example 2

    Thuy enjoys meeting new people, playing softball and spending time with her friends. Recently, she experienced a stroke that affects her ability to socialize with others. A specialist services provider completed a basic assessment and created a plan to:

  • · Provide staff with written guidance to support Thuy in social situations, including prompting and cueing for social, leisure and recreational behaviors.
  • · Train staff on how to practice skills with Thuy before events.
  • · Demonstrate and model prompting and cueing procedures so staff know what to do and when to do it.
  • · Provide ongoing training to staff on adjustments to Thuy’s plan, based on her recovery and skill acquisition.

    • Example 3

    Landy is on a medically prescribed diet and has a diagnosis of Prader-Willi Syndrome. They live in a community residential setting and receive in-clinic services from an exercise physiologist to reduce incidents of food consumption dangerous to their health. An expert/professional will provide specialist services to:

  • · Train staff on daily food monitoring and meal planning.
  • · Train staff to use environmental cues for healthy eating.
  • · Train staff on how to motivate Landy to walk daily.
  • · Provide similar training to Landy’s parents so their parents know what to do during family visits to support them with healthy eating and activities.

    • Lead agency responsibilities

    The lead agency is responsible to:

  • · Identify the specific experience, skills and qualifications the specialist services provider must have to meet the person’s needs.
  • · Document the specialist services provider’s specific experience, skills and qualifications in the support plan.
  • · Monitor and evaluate the specialist services based on identified outcomes.

    • Provider standards and qualifications

    Specialist services are DHS enrollment-required services. For more information, refer to CBSM – Waiver/AC service provider overview.

    License requirement

    A specialist services provider must have a license under Minn. Stat. Ch. 245D as an intensive support services provider.

    Additional requirements

    A specialist services provider must have the specific experience, skills and qualifications required to meet the person’s needs as identified in their support plan.

    Background study

    To provide specialist services, providers must have a background study. For more information, refer to CBSM – Waiver/AC service provider overview – Required DHS background studies for direct-contact services.

    Reporting

    A provider licensed under 245D must report all uses of controlled procedures, emergency use of manual restraint and prohibited procedures according to Minn. Stat. §245D.06, subd. 5 to DHS via the Behavioral Intervention Report Form, DHS-5148.

    Authorization, rates and billing

    The lead agency authorizes specialist services at the market rate. For more information, refer to CBSM – Market rate services and Long-Term Services and Supports Service Rate Limits, DHS-3945 (PDF).

    Specialist services providers may bill for indirect time to:

  • · Prepare and finalize assessments.
  • · Evaluate service outcomes.
  • · Monitor specific program implementation, program development and training and supervision of staff and caregivers.

    • The rate accounts for all other indirect time.

    Additional resources

    CBSM – Market rate services
    CBSM – Positive support services
    CBSM – Remote support
    CBSM – Waiver, AC and ECS general processes and procedures
    CBSM – Waiver/AC service provider overview
    CBSM – Resource: Guidance on support technology and service planning
    Long-Term Services and Supports Service Rate Limits, DHS-3945 (PDF)
    RMS User Manual – Quick reference guide on billable indirect time

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