Minnesota Minnesota

Community-Based Services Manual (CBSM)

Community-Based Services Manual (CBSM)


Family adult day services

Page posted: 11/14/16

Page reviewed: 2/6/24

Page updated: 2/6/24

Legal authority

Federally approved BI, CAC, CADI, DD and EW waiver plans, Minn. Stat. §256B.0913, Minn. Stat. §245A.143, Minn. Stat. Ch. 245A, Minn. R. 9555.5105 to 9555.6265, Minn. R. 9555.9600 to 9555.9730

Definitions

Family adult day services (FADS): Adult day services provided in a family foster care license holder’s primary residence. The license holder must be the primary FADS provider.

Adult day services: Refer to CBSM – Adult day services.

Institution: For the purposes of this page, “institution” means:

  • · Nursing facility.
  • · Hospital.
  • · Intermediate care facility for persons with developmental disabilities (ICF/DD).
  • · Institution for mental disease (IMD).

    • Eligibility

    A person is eligible to receive FADS if they meet both of the following criteria:

    1. Eligible for services through one of the following options:

  • · Alternative Care (AC).
  • · Brain Injury (BI) Waiver.
  • · Community Access for Disability Inclusion (CADI) Waiver.
  • · Community Alternative Care (CAC) Waiver.
  • · Developmental Disabilities (DD) Waiver.
  • · Elderly Waiver (EW).

    • 2. Have FADS as an assessed need in their support plan.

    Covered services

    FADS are services available under adult day services. FADS must provide the supports necessary either to maintain or improve a person’s ability to care for themselves. FADS cover:

  • · Activities.
  • · Assistance.
  • · Care.
  • · Supervision.
  • · Training.

    • Activities

    Activities must:

  • · Provide a variety of meaningful and age-appropriate tasks and materials that are responsive to a person’s goals, interests and needs.
  • · Provide community integration opportunities to enhance a person’s social and physical interaction with people in their community who do not have disabilities and who are not paid caregivers or staff members. For example, under the supervision of a FADS provider, a person may participate in community activities at senior citizen centers, clubs, service organizations or community education centers.
  • · Offer flexibility in scheduling to accommodate a person’s work schedule.

    • Meals and snacks

    A FADS provider must meet snack and meal provisions according to Minn. Stat. §245A.143, subd. 3 and subd. 8.

    Non-covered services

    Not covered within the service

    FADS do not cover:

  • · Therapies.
  • · Transportation costs.
  • · Remote delivery of services.

    • Services that cannot be authorized with FADS

    A person cannot receive FADS and adult foster care or family residential services from the same provider.

    The following services are not covered during the same period of the day (i.e., provided simultaneously) when the person receives FADS:

  • · Community residential services.
  • · Day support services.
  • · Family residential services.
  • · Homemaker (ADL assistance and home management).
  • · Individualized home supports (with training and with family training).
  • · Integrated community supports.
  • · Prevocational services.
  • · Respite.

    • Setting size

    The license holder may not serve more than eight adults at one time, including residents of the foster home.

    New authorizations and location requirements (BI, CAC, CADI and DD only)

    The authorizations policy in this section is effective Jan. 11, 2021, for people on BI, CAC, CADI and DD waivers. DHS sent an eList announcement on Jan. 22, 2021, to announce this policy. For background information about this policy change, refer to DHS – Home and community-based services (HCBS) settings transition plan.

    The limitations for new authorizations and setting location do not apply to FADS funded by AC or EW.

    Authorizations

    New authorizations

    A new authorization refers to an authorization for a person who has not received FADS prior to Jan. 11, 2021.

    New authorizations for FADS for a person on BI, CAC, CADI or DD on or after Jan. 11, 2021, may only occur when all of the following criteria are met:

  • · The person is age 55 or older.
  • · The person chooses to receive FADS.
  • · The person does not choose day support services or employment services.
  • · FADS meet outcomes identified by the person, within the scope of covered services.

    • Existing authorizations

    People who received FADS prior to Jan. 11, 2021, regardless of age, may continue to use FADS if all of the following criteria are met:

  • · The person is assessed to need the service.
  • · The person chooses to receive FADS from other service options.

    • Setting connected to an institution

    The lead agency cannot authorize FADS when the FADS setting is adjoined to or on the same property as an institution (as described in the definition section) if that institution has any financial interest in the setting or services provided in the setting.

    Collocated settings

    When a single provider leases or owns more than one service setting located on the same or adjoining property, the lead agency can only authorize services in one of the settings. A service setting includes a setting used to deliver any of the following services:

  • · Adult and child foster care.
  • · Adult day services, including adult day bath and family adult day services.
  • · Community residential services.
  • · Customized living or 24-hour customized living.
  • · Day support services.
  • · Day training and habilitation.
  • · Family residential services.
  • · Integrated community supports.
  • · Prevocational services.

    • Collocated setting exceptions

    Setting status: The provider maintains ownership/control of the setting, and the 2017/2018 HCBS attestation/validation process determined HCBS setting compliance. In this situation:

  • · The provider may continue to deliver services in collocated settings if waiver services have been continuously provided by the same provider that maintained ownership/control of the setting.
  • · The provider can confirm if 2017/2018 attestations were completed for collocated settings by using the DSD Contact Form to submit the provider’s name, setting address and provider identification number.

    • Setting status: There was a sale or transfer of ownership to a new provider, and the 2017/2018 HCBS attestation/validation process determined HCBS setting compliance. In this situation:

  • · The new provider/owner must complete an HCBS site-specific review to ensure the people living in these settings are not isolated from the community. The provider must use the DSD Contact Form to complete the site-specific review process.
  • · The provider can confirm if 2017/2018 attestations were completed for previously owned collocated settings by using the DSD Contact Form to submit the provider’s name, setting address and provider identification number.

    • Secondary information

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

    Service amount

    A person must receive FADS for two or more hours per day, for one or more days per week, on a regularly scheduled basis.

    A person cannot receive FADS for more than 12 hours in one 24-hour period.

    Provider standards and qualifications

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

    License requirements

    A FADS provider must meet one of the following requirements:

  • · Have a foster care license under Minn. R. 9555.5050 to 9555.6265 and comply with Minn. Stat. §245A.143.
  • · Have a FADS license under Minn. Stat. §245A.143.

    • Additional provider requirements

    A FADS provider must:

  • · Assess the compatibility of all people served in the home to ensure each person’s health and safety needs are met. The provider must conduct this assessment before the person’s admission and on an ongoing basis.
  • · Obtain written and signed informed consent from each person who lives in the foster care home or their legal representative before providing FADS in a licensed adult foster care home. The consent must document each person’s informed choice to live in a home that provides FADS and include a statement that the person’s refusal to consent will not result in service termination.

    • BI, CAC, CADI and DD only

    Under the BI, CAC, CADI and DD waivers, a FADS provider also must:

  • · Have demonstrated knowledge of the person’s specific disability and/or chronic medical condition(s), or have previous experience working with people with disabilities.
  • · Have any additional qualifications necessary to meet the person’s unique needs and preferences, as documented in the support plan.

    • Authorization, rates and billing

    This section includes program-specific information about authorization, rates and billing for FADS. For additional information, refer to Long-Term Services and Supports (LTSS) Service Rate Limits, DHS-3945 (PDF).

    AC and EW

    Under AC and EW, the lead agency authorizes FADS at the state-established, 15-minute rate.

    BI, CAC, CADI and DD

    Under BI, CAC, CADI and DD, FADS are framework services. The lead agency uses the Rate Management System (RMS) to determine rates. For more information, refer to CBSM – RMS.

    The lead agency may authorize FADS at a daily or 15-minute rate.

    Exception for BI, CADI and DD

    On a day when the person receives an adult day services bath, the lead agency must authorize FADS using the 15-minute rate.

    Find a FADS provider

    For a list of licensed FADS providers in Minnesota, refer to DHS licensing information lookup or MinnesotaHelp.info.

    Additional resources

    CBSM – Adult day services
    CBSM – Adult day services bath
    CBSM – Waiver, AC and ECS general process and procedures
    CBSM – Waiver and AC programs overview
    CBSM – Waiver/AC service provider overview
    CBSM – Rate methodologies for AC, ECS and EW service authorization
    DHS – HCBS settings transition plan
    LTSS Service Rate Limits, DHS-3945 (PDF)
    RMS User Manual

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