AASD and DSD eList announcement
Date: Oct. 22, 2024
To: Lead agency staff, contracted case management providers, case managers and other interested parties
From: DHS Aging and Adult Services and Disability Services divisions
Purpose: To clarify policy guidance for waiver exits to align with the wind-down of COVID-19 long-term services and supports (LTSS) continuous coverage requirements for Alternative Care (AC), Brain Injury (BI), Community Alternative Care (CAC), Community Access for Disability Inclusion (CADI), Developmental Disabilities (DD) and Elderly Waiver (EW)
Effective: Immediately
Contact: For policy questions related to BI, CAC, CADI and DD waivers, use the DSD Contact Form. For policy questions related to AC and EW, contact dhs.aasd.hcbs@state.mn.us.
COVID-19 wind-down policy clarifications
DHS identified multiple AC, BI, CAC, CADI, DD and EW service agreements that do not align with the COVID-19 wind-down policy. These service agreements have an improperly forced exception code 951 after the wind-down period expired on July 1, 2023.
All lead agencies must follow existing eligibility and enrollment policies.
This eList includes information about:
DHS is developing a remediation plan for affected MMIS service agreements and will share more information soon.
Existing eligibility and enrollment policy
Case management for AC, BI, CAC, CADI, DD and EW
People on AC, BI, CAC, CADI, DD and EW must receive another waiver service in addition to waiver/AC case management.
The lead agency may authorize waiver/AC case management without another waiver service for a maximum of 60 calendar days. During this timeframe, the case manager/care coordinator must check in with the person at least monthly (e.g., phone calls or in-person visits).
If the lead agency does not authorize an additional waiver service during the 60-day timeframe, the person must exit the waiver or AC until the person becomes eligible and the lead agency can authorize additional waiver services.
For information about the exception to extend the waiver for an additional 60 days, refer to CBSM – Waiver, AC and ECS case management.
Case management and habilitation for DD
People on the DD Waiver must receive waiver case management and habilitation within certain timelines of starting a waiver or continuing on a waiver. For more information about DD Waiver requirements, refer to CBSM –Waiver, AC and ECS case management and CBSM – Habilitation.
Starting DD Waiver
When a person starts the DD Waiver, the lead agency may authorize a support plan that does not include habilitation for a maximum of 90 calendar days. The case manager must:
If the lead agency does not authorize habilitation during the 90-day timeframe, the person must exit the waiver until the person becomes eligible and the lead agency can authorize additional waiver services.
Loss of habilitation while currently on DD Waiver
People currently on the DD Waiver must receive waiver case management and habilitation.
The lead agency may authorize waiver case management without habilitation for a maximum of 60 calendar days. During this timeframe, the case manager must check in with the person at least monthly (e.g., phone calls or in-person visits).
If the lead agency does not authorize habilitation during the 60-day timeframe, the person must exit the waiver until the person becomes eligible and the lead agency can authorize habilitation.
Exception code 951
Exception code 951 posts to MMIS service agreements when the requirements have not been met for people on AC, BI, CAC, CADI, DD and EW programs to receive another waiver service in addition to waiver/AC case management within required timelines. It also posts in conjunction with exception code 632 for people on the DD Waiver when the requirements have not been met to receive waiver case management and habilitation within required timelines.
As of July 1, 2024, lead agencies can no longer force exception code 951. Lead agencies must close the program if the person does not maintain eligibility and enrollment requirements.
Notice of action and appeal requirements
If additional waiver services other than case management or the required habilitation service on DD cannot be authorized in the required time period, the lead agency must provide the person a notice of action to inform them of the action taken. For instructions, refer to CBSM – Notice of action.
If a person appeals this action, the lead agency has a responsibility to continue services at the previous level pending the outcome of the appeal. For more information, refer to CBSM – Appeals process.
If the lead agency did not meet notice of action and appeal requirements, they should use the contact information in this eList for guidance and next steps.
Wind-down instructions
In the wind-down instructions, DHS directed lead agencies to complete annual reassessments when due according to waiver/AC policies on CBSM – Assessment applicability and timelines. All people will have their reassessment completed based on the date of their last assessment or reassessment.
For any annual reassessment completed beginning in May 2023 that had an effective date of July 1, 2023, or later, the person must have met all waiver/AC eligibility criteria to continue on the program. If the person no longer met all waiver/AC eligibility criteria at reassessment, the lead agency should have closed the waiver/AC program no earlier than the first day after the end of their current waiver/AC span. For additional information, refer to CBSM – Temporary waiver exits and restarts: MMIS actions. Lead agencies had to provide advanced notice, as described on CBSM – Notice of action, and follow all other requirements.
Previous instructions during the federal public health emergency
To comply with federal continuous coverage requirements, DHS waived certain policies to allow people access to continuous coverage during the federal public health emergency.
Federal public health emergency instructions for AC, BI, CAC, CADI and EW
To comply with federal continuous coverage requirements, DHS was required to allow AC, BI, CAC, CADI and EW to remain open, even in situations when case management was the person’s only authorized service.
When case management was the only service for longer than 120 days, exception code 951 posted in MMIS on the AC, BI, CAC, CADI or EW service agreement. However, during the peacetime emergency and wind-down period, lead agencies could force exception code 951.
Federal public health emergency instructions for DD waiver
To comply with federal continuous coverage requirements, DHS was required to allow the DD Waiver to remain open, even in situations when case management was the person’s only authorized service and/or a habilitative service was not authorized.
During the federal public health emergency and wind-down period, DHS allowed lead agencies to force exception codes 951 and 632 to comply with continuous coverage requirements and maintain the person’s program eligibility. Lead agencies can still force exception code 632 when the lack of an approved habilitative service is within the allowed timelines.
Previous communications
In an April 11, 2023, eList announcement, DHS notified lead agencies that:
In a May 21, 2024, eList announcement, DHS notified lead agencies that DHS will no longer allow lead agencies to bypass MMIS exception code 951.
Previous eList announcements
AASD LEAD AGENCY ARCHIVE | DSD LEAD AGENCY ARCHIVE | DSD STAKEHOLDER ARCHIVE
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