Page posted: 6/22/26

Minn. Stat. §256B.0911, subd. 3a and 5

Assessment summary: A written summary completed for everyone who has an assessment, regardless of whether they are eligible for Minnesota Health Care Programs (MHCP) or choose to receive publicly funded home and community-based services (HCBS). This document provides a summary of what the assessor discovered through the assessment process and identifies next steps based on the person’s needs.

Assessment and program acknowledgement: A document that outlines the person’s rights and responsibilities, assessment program information and other information/resources.

This page guides assessors through the assessment process. It provides assessment expectations and gives direction to assessors on how to conduct person-centered assessments.

This page provides information about:

Lead agencies must provide MnCHOICES assessments to all people, regardless of their eligibility for MHCP. The responsibility to conduct the assessment depends on the person’s situation, as described in the following sections.

People accessing a disability waiver or Rule 185, or people younger than age 65

This section applies to:

For the people listed above, the county where the person is located at the time of the request for assessment is responsible to complete the assessment activities. If eligible, the person may choose to have a Tribal Nation complete their assessment. For more information, refer to CBSM – Tribal administration and management of HCBS programs.

In most situations, the person’s county of residence (COR) completes the assessment activities. However, there are situations when the person may temporarily be located in another county. When the person is in a county other than their COR, the county where the person is located is responsible to complete the assessment activities.

The county/Tribal Nation must follow timelines and procedures on:

People age 65 or older

For people age 65 or older who are not accessing the BI, CAC, CADI or DD waivers, assessment responsibility depends on whether the person is enrolled in Minnesota Senior Health Options (MSHO)/Minnesota Senior Care Plus (MSC+).

Not enrolled in MSHO or MSC+

When the person is not enrolled in MSHO or MSC+, the county where the person is located at the time of the request for assessment is responsible to complete the assessment activities. If eligible, the person may choose to have a Tribal Nation complete their assessment. For more information, refer to CBSM – Tribal administration and management of HCBS programs.

In most situations, the person’s COR completes the assessment activities. However, there are situations when the person may temporarily be located in another county. When the person is located in a county other than their COR, the county where the person is located is responsible to complete the assessment activities.

Enrolled in MSHO or MSC+

When the person is enrolled in MSHO or MSC+, the managed care organization (MCO) is responsible to complete the assessment activities, regardless of the person’s location. If eligible, the person may choose to have a Tribal Nation complete their assessment. For more information, refer to CBSM – Tribal administration and management of HCBS programs.

The MCO should refer the person to the county/Tribal Nation in which the person is located for an assessment if the person requests to:

The assessment interview always involves the following people:

The assessment is always conducted with the person exploring options or receiving services. The people who participate in the assessment must not have a financial interest in the provision of services (except for family members).

Legal representatives

If the person has a legal representative, the legal representative should be present for the assessment. The lead agency must make every effort to accommodate both the person’s and the legal representative’s schedules so both can attend.

If the legal representative cannot participate in person, the lead agency can engage with them using remote technology or telephone to ensure timely access to and continuity in services.

Case managers

In general, the person’s case manager should not attend the assessment. Both the case manager and the assessor have a responsibility to update each other and work cooperatively on the person’s behalf.

If a person specifically requests that their case manager attend the assessment, the assessor should honor the person’s request. However, the assessor must organize the interview to ensure the person has the opportunity to share information privately.

Billing

Attending an assessment is not a billable waiver case management activity. However, the case manager may bill for time engaged in allowable activities, including time engaged with the person in support-planning discussions. For more information, refer to CBSM – Waiver, AC and ECS case management.

Care coordinators

MSHO and MSC+

The care coordinator conducts the assessment for a person enrolled in MSHO and MSC+ who is not currently accessing or requesting to explore/return to the BI, CAC, CADI or DD waiver.

If a person age 65 or older is accessing or requesting to explore/return to the BI, CAC, CADI or DD waiver, the county/Tribal Nation is responsible to conduct the person’s assessment. The person may choose to have their MSHO or MSC+ care coordinator present for the assessment. DHS encourages lead agencies to coordinate the assessment so the certified assessor and care coordinator can conduct the meeting jointly.

Special Needs BasicCare (SNBC)

A person enrolled in SNBC might choose to have their care coordinator present for the assessment. DHS encourages lead agencies to coordinate the assessment so the certified assessor and care coordinator can conduct the meeting jointly.

Service providers

The input of providers is an important part of the assessment process. DHS encourages service providers to participate in the assessment process by submitting supporting documentation or speaking with the certified assessor, but they should not attend the assessment. The person needs the opportunity to share information privately. For more information, refer to the section below about information from providers.

The lead agency must ensure staff meet the qualifications on CBSM – MnCHOICES certified assessors.

The assessor must review information from providers to inform the assessment process before they finalize the person's assessment or reassessment. The provider can either:

Information for AC, ECS and EW

With the permission of the person or their legal representative, the customized living or adult day services provider may submit a nursing assessment or written report that outlines the provider’s recommendations about the person's care needs. The assessor must notify the provider of the date by which to submit this information.

Information for BI, CAC, CADI and DD

The person's current service provider may submit a written report that outlines recommendations about the person's care needs. The provider must submit this report at least 60 days before the end of the person's current service agreement.

Before the assessment

Either the assessor or support staff completes the following activities:

The assessor reviews the following items, as applicable:

At the assessment

The assessor completes the following activities during the assessment interview, as applicable:

After the assessment

The assessor completes the following activities, as applicable:

The lead agency must:

County/Tribal Nation timeline

The county/Tribal Nation must send the assessment summary to the person within 60 days of the assessment.

If the person is going to use HCBS services, the county/Tribal Nation also must develop a support plan. It is important that the assessor and case manager work together to ensure the person receives their assessment and support plan within 60 days of the assessment activity date.

MCO timeline

The MCO must send the assessment summary and support plan to the person according to the timelines within the MCOs contract. MCOs must provide the person with their rights and responsibilities, right to appeal and the denial, termination and reduction notice.

Instructions

For instructions to complete the assessment summary and the support plan in MnCHOICES, refer to the MnCHOICES guidance documents in the Help Center.

There are certain circumstances when an assessor is responsible for the support plan, including when:

For information about support planning, refer to CBSM – Support planning for LTSS.

All waivers, AC and ECS

A person does not need a new MnCHOICES assessment when they transfer to a new lead agency mid-way through a waiver/AC/ECS span.

CFSS

When a person disenrolls from an MCO, the county/Tribal Nation can authorize CFSS without a new assessment. The county/Tribal Nation can use the MCO assessment results to continue CFSS.

Additional information

For more information about case transfers, refer to:

When a person experiences a stay in certain settings for 121 or fewer days, they may restart their waiver without receiving a new assessment (refer to CBSM – Temporary waiver exits and restarts: MMIS actions).

A person must receive a new assessment to determine eligibility if they enter a setting and one or more of the following is true:

When a person needs a new assessment, the county/Tribal Nation responsible for case management must notify the county where the person is located or the Tribal Nation in a timely manner about the person’s need for an assessment. If the person is returning to EW and enrolled in MSHO or MSC+, the care coordinator completes the assessment. For more information, refer to CBSM – Assessment applicability and timelines.

If the certified assessor completes a new assessment, they must monitor assessment timelines and use an initial assessment review if the person experiences a delay in discharge from the institutional stay that exceeds 60 days from the initial assessment. For more information, refer to CBSM – Initial assessment review (IAR) for HCBS.

A person has the right to request an appeal (all people) or a conciliation conference (people on the DD Waiver) at any time during the assessment process. The county/Tribal Nation provides the person with a copy of Your Appeal Rights, DHS-1941 (PDF) at the assessment.

The county/Tribal Nation communicates assessment results using the assessment summary after the assessment interview. The assessment summary also includes a notice of action that helps explain the programs for which the person is and is not eligible.

MCOs follow their own processes to provide the person appeal rights and information about denial, termination and reduction.

For more information, refer to CBSM – Appeals.

Additional resources