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AASD and DSD eList announcement

Date: Jan. 9, 2024
To: Lead agency assessors, case managers, care coordinators and supervisors
From: DHS Aging and Adult Services and Disability Services divisions
Purpose: To remind lead agencies about face-to-face visit requirements and inform them of the new long-term services and supports (LTSS) remote reassessment policy
Effective: Nov. 1, 2023
Contact: For BI, CAC, CADI and DD questions, use the DSD Contact Form. For AC, ECS and EW questions, email dhs.aasd.hcbs@state.mn.us

Case management, care coordination and assessment requirements

As of Nov. 1, 2023, DHS:

· Implemented a new LTSS remote reassessment policy.

· Resumed face-to-face visit requirements for case management and care coordination.

New LTSS remote reassessment policy

DHS implemented a new LTSS remote reassessment policy on Nov. 1, 2023. This policy replaced the policy that allowed remote reassessments for six months after the federal COVID-19 public health emergency.

For annual reassessments on or after Nov. 1, 2023, remote reassessments conducted by interactive video or phone may substitute for in-person reassessments in some circumstances:

· BI, CAC, CADI and DD: Remote reassessments may substitute for two consecutive reassessments (including the 65th birthday reassessment), followed by an in-person reassessment in the third year.

· AC, ECS and EW: Remote reassessments may substitute for one annual reassessment, followed by an in-person reassessment in the second year.

As of Nov. 1, 2023, lead agencies must review past assessments to determine if a person meets the requirements to complete their next reassessment remotely. For more information, refer to the July 18, 2023, eList announcement.

Face-to-face visits requirements for case management and care coordination

As of Nov. 1, 2023, lead agencies must meet minimum case management and care coordination face-to-face visit requirements for people who use:

· Alternative Care (AC) program.

· Brain Injury (BI) Waiver.

· Community Access for Disability Inclusion (CADI) Waiver.

· Community Alternative Care (CAC) Waiver.

· Developmental Disabilities (DD) Waiver.

· Elderly Waiver (EW).

· Essential Community Supports (ECS) program.

This applies to people whose waiver year ends on or after Nov. 1, 2023.

Minimum required frequencies for face-to-face visits

The timelines below represent the minimum required frequencies for face-to-face visits. The frequency of face-to-face visits should increase based on the person’s needs.

BI, CAC, CADI and DD

The waiver case manager must have a minimum of two face-to-face contacts with the person within the 12-month period. The person’s annual reassessment may count as one face-to-face contact when case management activities are performed at the time of the visit.

AC, ECS and EW

The waiver, AC and ECS case manager/care coordinator must conduct at least one face-to-face visit per 12-month period. This visit can be included as part of the person's annual reassessment if the assessor is also the case manager/care coordinator.

Note: If a person is unable to meet in person, a phone or virtual meeting will not meet face-to-face requirements unless the remote contact occurred before Nov. 1, 2023.

Recommended practices

DHS encourages case managers to:

· Inform the person that minimum face-to-face requirements resumed on Nov. 1, 2023.

· Discuss and honor the person’s in-person visit needs, preferences and choices.

To help the person and their family feel comfortable with in-person visits, the case manager should encourage them to decide the visit:

· Topics.

· Participants.

· Location.

· Time.

· Structure.

If a person prefers phone visits, the case manager should:

· Ask questions to understand the person’s concerns.

· Explain limits to their ability to understand and address the person’s needs without face-to-face visits.

· Create an environment that encourages the person to share their opinions, advocate for their goals and engage in building their support plan.

When exiting a person for not meeting the face-to-face requirements, the case manager should:

· Consult their supervisor and any applicable lead agency practices.

· Follow continuous coverage requirements and the unwind period (through June 30, 2024).

For more information, review the April 11, 2023, eList announcement.

Lead agency review and care plan audit measurement

DHS counts each visit held remotely before Nov. 1, 2023, as a face-to-face visit. Visits on and after Nov. 1, 2023, must occur in person to meet minimum face-to-face requirements. The following scenarios clarify the change in requirements:

· For waiver spans that begin on or after Nov. 1, 2023, visits must occur in person to meet face-to-face requirements.

· For waiver spans that begin before Nov. 1, 2023, and end after Nov. 1, 2023, DHS counts each remote visit before Nov. 1, 2023, as a face-to-face visit that counts toward compliance requirements.

More information

For more information about case management requirements, refer to CBSM – Waiver, AC and ECS case management.

For more information about requirements for in-person and remote reassessments, refer to CBSM – Assessment applicability and timelines.

Previous eList announcements

AASD LEAD AGENCY ARCHIVE | DSD LEAD AGENCY ARCHIVE | DSD STAKEHOLDER ARCHIVE

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Community-Based Services Manual (CBSM)