Federally approved BI and CADI waiver plans (2021), federally approved CAC and DD waiver plans (2023), Minn. Stat. §245D.03, Minn. Stat. §245D.12, Minn. Stat. §256B.49, subd. 23

Integrated community supports (ICS): Services that provide support and training in community living service categories to adults age 18 and older who reside in a living unit of a provider-controlled ICS setting (e.g., apartment in a multi-family housing building). ICS can be delivered up to 24 hours per day in the person’s living unit or in the community.

Support in community living service categories: Cueing, skill maintenance, guidance, instruction, assistance with activities of daily living, assistance with coordination of community living activities or direct supervision within an allowable community living service category.

Training in community living service categories: Skill-building and instructional services to acquire, retain and improve the person’s experience living in the community within an allowable community living service category. Training must meet the person’s identified needs.

ICS setting: A setting in which a provider has an approved setting capacity report and has direct/indirect control over a person’s living unit. A provider has direct or indirect control over a person’s living unit when the provider either:

An ICS setting does not meet the requirements for a person’s own home, community residential program or family residential program.

Living unit: A self-contained living unit (e.g., apartment) with living, sleeping, eating, cooking and bathroom areas.

ICS is available to adults who live in an ICS setting. For a list of approved ICS settings, see CBSM – Resource: Integrated community supports (ICS) settings. If the provider does not own, operate or lease the living unit(s) or have direct or indirect financial interest in the property or housing where services are delivered, see CBSM – Individualized home supports instead.

Effective Jan. 1, 2021, ICS is available to adults on the following waivers:

Effective Jan. 1, 2023, or upon federal approval, ICS is available to adults on the following waivers:

ICS covers training and support to meet the person’s individualized assessed needs and goals in at least one of the community living service categories:

Community participation

This category may include:

Health, safety and wellness

This category may include:

Household management

This category may include:

1. Cueing, guidance, supervision, training or instructional support to complete routine household care and maintenance

2. Household safety knowledge and skills

3. Tenancy support and advocacy

4. Training, assistance, support and/or guidance with:

Adaptive skills

This category may include:

ICS is not covered if it is delivered in a setting that is:

ICS can be delivered through remote support. Services delivered through remote support must meet all the requirements listed on CBSM – Remote support.

If a person receives ICS, they cannot also receive the following waiver services:

Choice in provider

A person who lives in an ICS setting is not required to receive ICS. However, when a person lives in an ICS setting, ICS can only be delivered by the provider who controls the setting.

When a person who lives in an ICS setting chooses not to receive ICS, they may choose to receive other services from another provider who does not control the setting.

A person who receives ICS may also receive the following services from a different provider (i.e., other than the ICS provider):

The case manager must clearly define in the person’s support plan how ICS and the above services do not duplicate one another.

Roommates

If more than one person resides in a single living unit of an ICS setting, the ICS provider must:

Documentation

The lead agency must clearly document the person’s service needs and identify outcomes in the person’s support plan.

The ICS provider is responsible to provide written reports to the lead agency and the person at a minimum of once per year or the frequency established in the person’s support plan.

Transition plans

CBSM – ICS transition plans provide instructions and scenarios for lead agencies and providers to:

ICS settings are considered home and community-based services (HCBS) provider-controlled settings. For a list of approved ICS settings, see CBSM – Resource: Integrated community supports (ICS) settings. The provider must comply with all requirements for HCBS settings in 42 C.F.R. 441.301(c). For more information about the HCBS settings rule, see DHS – HCBS settings transition plan.

If a person lives in an ICS setting and receives ICS from the provider who controls the setting, it is not considered a residential program (as defined on CBSM – Requirements for a person’s own home). Other units in the building might be considered:

Setting capacity report

Before an ICS provider can deliver services, they must submit a Setting Capacity Report, DHS-8062 to DHS for each ICS setting, as required by Minn. Stat. Chapter 245D. Only one HCBS provider may deliver ICS in the approved setting.

To submit a setting capacity report, email the completed DHS-8062 form to HCBS.Settings@state.mn.us.

Capacity limit

ICS may be provided in:

Setting connected to an institution

The lead agency cannot authorize ICS for people who reside in a living setting that is adjoined to or on the same property as an institution (i.e., nursing facility, hospital, intermediate care facility for persons with developmental disabilities [ICF/DD], institution for mental disease [IMD]), or if the institution has any financial interest in the living setting.

Collocated settings

When a single provider leases or owns more than one living setting located on the same or adjoining property, the lead agency can only authorize services in one of the settings. A living setting includes a setting used to deliver any of the following services:

When the ICS provider subleases a living unit

If the ICS provider rents a living unit from the property manager, the ICS provider must be able to demonstrate the authority granted by the property manager/owner to sublease that unit to people who receive ICS services. To comply with the HCBS settings rule, a person receiving services must have a lease that complies with the Minn. Stat. Ch. 504B landlord and tenant law.

Additional information

The ICS provider and their delegated staff members may not live in or otherwise occupy space in a person’s individual living unit for business-related purposes (e.g., office space, break room).

A site-specific review is required for:

The site-specific review is required to ensure the setting does not isolate or create a stigma for people living there.

Required information

Information the provider submits to DHS for the site-specific review must include, but is not limited to:

DHS will not approve the site-specific review if the information submitted does not:

Instructions

If a site-specific review is required for a setting based on the setting capacity report, DHS will contact the provider to obtain the required information. Technical assistance about the site-specific review criteria is available to lead agencies or providers upon request by submitting information using the DSD Contact Form.

ICS is a DHS enrollment-required service. For more information, see CBSM – Waiver/AC service provider overview.

Licensing requirements

An ICS provider must have a license under Minn. Stat. Chapter 245D as an intensive support services provider.

Each provider-controlled setting where ICS is delivered must complete a Setting Capacity Report, DHS-8062, as required by Minn. Stat. Chapter 245D.

To submit a setting capacity report, email the completed DHS-8062 form to hcbs.settings@state.mn.us.

Reporting

A provider licensed under 245D must report all uses of controlled procedures, emergency use of manual restraint and prohibited procedures according to Minn. Stat. §245D.06, subd. 5 to DHS via the Behavioral Intervention Report Form, DHS-5148.

Background studies

To provide ICS, providers must have a background study. For more information, see CBSM – Waiver/AC service provider overview – Required DHS background studies for direct-contact services.

ICS is a framework service. The lead agency uses the Rate Management System (RMS) to determine rates. For more information, see CBSM – RMS and Long-Term Services and Supports Service Rate Limits, DHS-3945 (PDF).