Minnesota Minnesota

Community-Based Services Manual (CBSM)

Community-Based Services Manual (CBSM)


Notice of action

Page posted: 11/13/17

Page reviewed: 9/22/25

Page updated: 9/22/25

Legal authority

42 C.F.R. 431.200 to 431.250, Minn. Stat. §256.045, Minn. Stat. §256.0451, Minn. Stat. §256B.0911, subd. 3(a), Minn. R. 9505.0125

Definitions

Notice of action: Document used by the certified assessor or case manager to inform the person that the county/tribal nation has made a decision about their services and will take an action that affects them. The notice of action includes:

  • · The reason (including the legal basis) for the decision and corresponding action.
  • · Timeline associated with the action.
  • · Information about the appeals process, including how to file an appeal if the person disagrees with the decision, timelines and the person’s right to request their services continue during an appeal.

    • Reduction: A situation in which either of the following is true:

  • · The county/tribal nation determines the person will receive less of a service or program they are currently receiving.
  • · The person chooses to receive less of a service or program they are currently receiving.

    • Termination: A situation in which either of the following is true:

  • · The county/tribal nation determines the person is no longer eligible for a service or program they are currently receiving.
  • · The person chooses to discontinue a service or program they are currently receiving.

    • Denial: A situation in which the county/tribal nation determines the person is not eligible for a service or program they are not currently receiving.

    Overview

    This page includes information for counties and tribal nations. Managed care organizations (MCOs) use their own forms and processes for notices of action.

    The county/tribal nation must send a notice of action in the following situations:

  • · When the person receives an assessment or reassessment.
  • · When the county/tribal nation denies, terminates or reduces the person’s services.

    • The following sections explain these situations in more detail.

    Some changes do not require the county/tribal nation to send the person a notice of action. For example, the person needs to know about legislative changes that affect their services, but the county/tribal nation does not need to send a notice of action about those changes. Notices of action include appeal rights, which are not applicable to legislative changes.

    Assessment Summary: Action Taken by the Lead Agency and Your Right to Appeal (formerly DHS-2828A)

    The certified assessor must complete the MnCHOICES assessment summary and give it to the person and their legal representative (as applicable) after every assessment (e.g., initial assessment, reassessment, functional needs update, etc.). The assessment summary includes the notice of action and appeal rights (i.e., Action Taken by the Lead Agency and Your Right to Appeal subsection).

    The notice of action informs the person of the following information as a result of the assessment:

  • · Eligibility for programs, including Alternative Care (AC) and Community First Services and Supports (CFSS).
  • · Resources available based on the outcome of the assessment.
  • · Reduction, termination and/or denial of services or programs.

    • Additionally, the certified assessor must explain any changes and answer any questions the person may have about the changes.

    Instructions

    For instructions to complete the assessment summary, refer to the MnCHOICES Assessment Form Practice Guide in the MnCHOICES Help Center.

    If the person’s assessment is not in MnCHOICES, the assessor may use Long-Term Services and Supports (LTSS) Notice of Action – Assessment or Reassessment Program Eligibility Summary, DHS-2828A. For instructions to use this form, refer to the DHS-2828A and DHS-2828B instructions section below.

    Notice of Action: Explanation of Changes to Your Support Plan (formerly DHS-2828B)

    The case manager must complete the Notice of Action: Explanation of Changes to Your Support Plan form in MnCHOICES and send it to the person and their legal representative (as applicable) in the following situations:

  • · Any time the case manager takes an action in the support plan that denies, terminates or reduces the person’s service(s).
  • · Any time the case manager denies the purchase of a service or item requested by the person. This could include a service or item that is not explicitly documented in the existing support plan.
  • · When the person chooses to discontinue or reduce services.
  • · When the person is no longer eligible for a service, including consumer directed community supports (CDCS).
  • · When there are reductions in services due to reductions in overall budgets.
  • · When a change in the person’s program eliminates their access to a service.
  • · When there is a change in the person’s AC fees.
  • · When the person is offered a service but declines it.
  • · When the person has a reduction or termination of a service due to the results of their assessment (e.g., the person’s needs changed and they no longer have an assessed need for a service they were previously receiving).
  • · When the person receives their CDCS budget, including if there were no changes to the budget.

    • These situations could happen during the support planning process after the person’s assessment or throughout the service plan year. Notice of Action: Explanation of Changes to Your Support Plan helps the person understand when and why their services and/or AC fees are changing. Not all changes to the person’s support plan require a notice of action (e.g., change in schedule, change in provider without change in service amount).

    The case manager does not have to include program eligibility results for the home and community-based services (HCBS) waivers, AC or ECS that the certified assessor included in the assessment summary after the assessment.

    The case manager must send a copy of the language block found in the MnCHOICES Help Center along with Notice of Action: Explanation of Changes to Your Support Plan to the person and their legal representative (as applicable).

    Instructions

    For instructions to complete Notice of Action: Explanation of Changes to Your Support Plan, refer to the practice guide(s) in the MnCHOICES Help Center.

    If the person’s assessment and support plan is not in MnCHOICES, the case manager may use LTSS Notice of Action – Explanation of Changes to Your Support Plan, DHS-2828B. For instructions to use this form, refer to the DHS-2828A and DHS-2828B instructions section below.

    Timelines

    The county/tribal nation must send the notice of action to the person and their legal representative (as applicable) within the following timelines:

  • · When there is a restriction of free choice of provider or reduction, termination or denial of services, the county/tribal nation must send the notice no later than 10 days before the effective date of the restriction or reduction.
  • · When there is a denial, reduction or termination of eligibility/level of care, the county/tribal nation must send the notice no later than 10 days before the effective date of the action.

    • Changes in nursing facility level of care

    When the person no longer meets nursing facility level of care criteria, the county/tribal nation must send a notice of action to the person at least 30 days before the level of care change takes effect.

    Residential services

    If possible, the county/tribal nation should provide more than 10 days of notice for residential services as a best practice. This advanced notice can help with transition time and tenancy requirements.

    Instructions for DHS-2828A and DHS-2828B eDocs

    If the person’s assessment and support plan are not in MnCHOICES, the certified assessor or case manager uses LTSS Notice of Action – Assessment or Reassessment Program Eligibility Summary, DHS-2828A or LTSS Notice of Action – Explanation of Changes to Your Support Plan, DHS-2828B. The following sections explain the information the certified assessor or case manager includes on those forms.

    Date

    Indicate the date the county/tribal nation mails the notice to the person.

    You and your representative

    Include the person’s personal information and their legal representative’s information (as applicable).

    Your lead agency

    Include the contact information for the county/tribal nation where the person can ask questions about the notice.

    Programs and services available to you (DHS-2828A only)

    The certified assessor includes information about all the programs and services for which the person is eligible and the person’s informed choice about their options.

    If there are no changes to the person’s current program or services, the certified assessor can select the “no change to your current program or services” box. When selecting this box, the certified assessor must describe the program and services that are continuing in the text box.

    For the purposes of DHS-2828A:

  • · “Services” refer to CFSS.
  • · “Programs” refer to AC, ECS and waiver programs (not the specific services available under the programs).

    • Your informed choice about services (DHS-2828B only)

    The case manager summarizes their conversation with the person about the person’s assessed needs, the services offered to the person and the services the person declined to receive.

    For the purposes of the DHS-2828B, “services” refer to services available through the person’s waiver or program.

    Denial, termination or reduction of services or programs

    The county/tribal nation uses these subsections to provide specific information about the denials, terminations and/or reductions. The county/tribal nation also can identify that there are no changes in the person’s current programs or services.

    Each denial, termination and reduction subsection includes the following fields:

  • · Effective date: Indicate the date the changes specified in the notice of action will take effect (refer to the timelines section for more information).
  • · Reason: Select the reason for each denial, termination or reduction.
  • · Explanation: Each denial, termination and reduction requires an explanation written in plain language with clear details about why the county/tribal nation took the action and what the person should expect as a result of the action (including budgetary implications).
  • · Legal citation: The legal citations automatically populate based on the program selected. The county/tribal nation can select additional legal citation(s) relevant to each denial, termination or reduction. The options in each of these legal citation fields are the statutory sections that govern a program. The county/tribal nation may provide a more specific citation (e.g., paragraph, clause) in the "other" field or the explanation field.
  • · Appeal rights: This section informs the person of their right to appeal and how to request an appeal if they disagree with the county/tribal nation’s action(s).

    • Additional resources

    CBSM – Appeals
    CBSM – Appeals process
    CBSM – Residential support service criteria (RSSC)
    Notice of Action (Assessments and Reassessments), DHS-2828A (PDF)
    Notice of Action (Service Plan), DHS-2828B (PDF)

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