Minn. Stat. §256B.501, subd. 3m, Minn. Stat. §256B.5015, subd. 2

Services during the day: An option for people who live in an intermediate care facility for persons with developmental disabilities (ICF/DD) to receive services other than day training and habilitation (DT&H). Services or supports provided using this option help the person fully integrate into the community. Services during the day may include a variety of supports to allow the person to exercise choices for community integration and inclusion activities. Services during the day may include, but are not limited to:

Note: DT&H is a separate service option and is not a part of services during the day.

Services during the day provide people who live in an ICF/DD with flexibility and choices of day program options that best meet their needs, as identified in their support plan.

The following are current options for services during the day:

A person is eligible to receive services during the day if the person and their support team determine the person’s needs can be best met through either:

Services during the day can be provided by any of the following:

The person can receive services during the day from a provider other than the ICF/DD when the person or their legally authorized representative chooses to do so.

If the ICF/DD where the person lives will provide the services during the day, the person or their legally authorized representative must both:

All providers who deliver services during the day must provide active treatment, as described on ICF/DD Manual – Active treatment, and meet all of the federal regulations, as defined under CFR 42, 483.440, for serving a person who lives in an ICF/DD.

The ICF/DD where the person lives is responsible to arrange, oversee and bill for the services provided. The ICF/DD will pay the service provider at a rate that does not exceed the rate approved by DHS.

To request services during the day, the lead agency case manager submits ICF/DD Services During the Day Option, DHS-4677F to DHS.

Once DHS receives DHS-4677F, DHS determines the rate. After DHS approves DHS-4677F, the lead agency case manager and services during the day provider sign ICF/DD Services During the Day Option Agreement, DHS-4677G (PDF). DHS notifies the case manager of the approval and the daily rate in writing.

The person may receive services during the day for up to five days per week.

If the person’s needs change, they can make the following changes to their schedule with prior approval:

To make a change, the person should have a discussion with their care team, including the ICF/DD, lead agency case manager and services during the day provider.

If the person chooses the services during the day option, the lead agency case manager must update their support plan to:

Regardless of the provider, services during the day are funded as a pass-through payment to the ICF/DD where the person lives.

DHS pays the pass-through payments for services during the day separately to the ICF/DD. These payments are not included in the ICF/DD’s total payment rate.

Rates for services during the day cannot exceed 100% of a person’s DT&H rate prior to the service change. The rate is determined by DHS and is not negotiable by the lead agency, ICF/DD or services during the day provider.

The ICF/DD that signed ICF/DD Services During the Day Option Agreement, DHS-4677G (PDF) bills for services during the day by submitting the HCFA-1500 form to DHS. The ICF/DD may bill DHS for the approved amount of services identified in the person’s service agreement under procedure code H2016.

Contact the MHCP Provider Resource Center with questions about completing the HCFA-1500 form.

A person cannot receive both DT&H and services during the day on the same day. Only one of these services may be billed per day. For example, a person can choose to have services during the day on Monday, Tuesday and Wednesday provided by the ICF/DD residential provider and attend DT&H Thursday and Friday.