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Community-Based Services Manual (CBSM)

Community-Based Services Manual (CBSM)


AASD eList announcement

Date: Aug. 26 and Sept. 23, 2025
To: Lead agencies, customized living providers and other interested parties
From: DHS Aging and Adult Services Division
Purpose: To announce changes for the Elderly Waiver (EW) customized living disproportionate share program and application period
Application opens: Sept. 1, 2025
Application closes: Sept. 30, 2025
Contact: dhs.aasd.hcbs@state.mn.us

EW customized living services rate floor adjustments for disproportionate share facilities

The 2025 Minnesota Legislature approved changes that affect EW customized living services providers designated as disproportionate share facilities. The changes include:

  • · Rate floor adjustments (i.e., minimum daily rate).
  • · New eligibility requirements, including a semiannual attestation and changes to compensation.
  • Eligible facilities

    Existing requirements

    To be eligible to apply for payments in 2026, the facility must meet all the following requirements as of Sept. 1, 2025:

  • · The facility was determined eligible for the disproportionate share rate adjustment in application year 2023 and is receiving payments in rate year 2024.
  • · At least 83.5% of the facility’s residents are customized living residents who use EW, Brain Injury (BI) or Community Access for Disability Inclusion (CADI) waivers.
  • · At least 70% of those customized living residents use EW.
  • As of Oct. 1, 2023, DHS cannot process any new applications for disproportionate share facilities after the Sept. 1 through Sept. 30, 2023, application period.

    New requirements

    The Legislature added the following requirements:

    1. Coercion prohibited: A facility must not pressure, coerce, entice or otherwise unduly influence a resident to use EW, as described in Minn. Stat. §256S.205, subd. 8, added by Laws 2025, First Special Session, chapter 9, article 1, section 29.
    Note: DHS is working to develop an attestation form for this requirement that providers must complete every six months after approval. We will provide instructions when the form is available.

    2. Compensation requirements: A provider designated as a disproportionate share facility must use a minimum of 66% of the increase in revenue generated by the rate floor for direct care staff compensation, as described in Minn. Stat. §256S.205, subd. 9, added by Laws 2025, First Special Session, chapter 9, article 1, section 30.

    Providers must acknowledge they understand these requirements when they apply.

    How to apply

    Eligible facilities may use the following information to apply to become a disproportionate share facility:

  • · Application link: Disproportionate Share Facility Application, DHS-8157 (PDF).
  • · Application period: Sept. 1 to Sept. 30, 2025
  • · More information: Billing section of Minnesota Health Care Programs Provider Manual – EW and AC program.
  • After DHS receives each application, we will ask the applicant to submit a list of waiver participants in a secure format to verify their resident numbers.

    Adjustment amount and applicability

    The Legislature approved a rate floor adjustment of $141 for calendar year 2026.

    Qualified facilities will get adjustments up to the rate floor on claims for people who use EW and receive 24-hour customized living services from Jan. 1 to Dec. 31, 2026. The payment does not apply to claims for residents who use the BI and CADI waivers.

    Lead agency guidance

    EW rate floor adjustments do not affect lead agency:

  • · Support planning and rate setting processes.
  • · Daily rates.
  • · Case mix budgets.
  • Managed care organizations that serve as lead agencies must apply the rate floor adjustment when eligible providers submit payment claims.

    For more information on lead agency billing, refer to the authorization, rates and billing section of CBSM Customized living (including 24-hour customized living).

    Previous eList announcements

    AASD LEAD AGENCY ARCHIVE

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