Minnesota Minnesota

Community-Based Services Manual (CBSM)

Community-Based Services Manual (CBSM)


Market rate services (BI, CAC, CADI and DD)

Page posted: 2/6/19

Page reviewed: 1/5/24

Page updated: 1/5/24

Legal authority

Federally approved BI, CAC, CADI and DD waiver plans

Definition

Disability Waiver Rate System (DWRS): An initiative that determines individualized payment rates for certain Brain Injury (BI), Community Access for Disability Inclusion (CADI), Community Alternative Care (CAC) and Developmental Disabilities (DD) waiver services. The DWRS divides disability waiver services into three categories:

  • · Framework.
  • · Market rate.
  • · Pre-determined rate.

    • For more information, refer to CBSM – DWRS.

    Background

    Market rates allow lead agencies and providers to determine rates that:

  • · Meet the person’s assessed needs.
  • · Are appropriate according to identifiable service costs.
  • · Are allowable Medical Assistance (MA) expenses.

    • Covered services

    The following service rates are market rate services:

  • · 24-hour emergency assistance
  • · Assistive technology
  • · Caregiver living expenses
  • · Chore services
  • · Crisis respite
  • · Environmental accessibility adaptations
  • · Family training and counseling
  • · Respite
  • · Specialist services
  • · Specialized equipment and supplies
  • · Transitional services (BI, CAC, CADI, DD)
  • · Transportation (waiver transportation)

    • Rate-setting methods

    Lead agencies should use specific components of the person’s service and support needs to work with the provider to determine an appropriate service rate.

    The following items may be appropriate components to consider when setting a market rate:

  • · Wage and expertise of the person providing the service.
  • · Number of people sharing the service.
  • · Administrative and indirect costs associated with providing the service.
  • · Program or facility costs.
  • · Local rates for comparable services not provided through MA.

    • The following are not appropriate methods of setting a market rate:

  • · Setting a rate (by a lead agency or provider) that does not reflect the person’s assessed needs or costs of providing the service.
  • · Incorporating costs into a rate that are not allowable through MA.

    • Additional resources

    CBSM – DWRS
    CBSM – Rate Management System (RMS)
    CBSM – Financial management overview
    CBSM – Waiver/AC service provider overview

    Report this page