Deficit Reduction Act, 2005 (PL 109), sec. 6071 (PDF), Patient Protection and Affordable Care Act, 2010 §2403 (PDF), Minn. Stat. §256B.04, subd. 20

Comprehensive community support services (CCSS): MHM service a person may choose to receive after moving into the community. This service is designed to promote successful adjustment to living in the community. The service must be:

Transition coordination: MHM service that provides coordination of activities to support a person who resides in a qualified institution to gain access to medical, social, education, financial, housing and other services and supports that are necessary to move to the community. For more information, refer to MHM Manual – Transition coordination.

Transition coordinator: Professional who carries out the transition coordination service and supports a person to move from a qualified institution to the community with MHM.

Lead agency: County, tribal nation or managed care organization (MCO).

Reinstitutionalization: Situation in which a person returns to an institutional setting for short-term or long-term care.

A person is eligible to receive CCSS for up to 365/366 days after their move into the community if they meet all the following criteria:

Waiver interaction

If the person is on a home and community-based services (HCBS) waiver program, they may choose to receive CCSS in addition to their waiver services.

To promote successful adjustment to living in the community, CCSS covers services and supports in the following categories:

Community integration

This category includes the following activities:

1. Connect the person to community resources to help reduce isolation, expand relationships, encourage community interests and increase community involvement. This includes connecting the person to:

2. Support the person to use mobile devices, the internet and other technology.

Risk mitigation

This category includes the following activities:

Supportive housing

This category includes the following activities:

CCSS does not cover:

1. Habilitation support to acquire independent daily living skills (refer to CBSM – Habilitation).

2. Help for a person to find new housing options while they are in the community.

3. Administrative activities such as:

4. Room and board (including moving expenses).

5. Deposits for rent and utilities.

6. Food.

7. Furnishings.

8. Rent.

9. Utilities.

10. No-show appointments.

11. Services that duplicate other waiver or state plan services available to the person.

Note: The CCSS provider is responsible to coordinate the delivery of CCSS with other services.

CCSS is limited to 300 hours during the person’s 365/366-day MHM community service period, after their move from an institution. More than 300 hours requires prior authorization. For more information, refer to the authorization, rates and billing section below.

A provider cannot deliver CCSS to more than one person at the same time.

A person cannot receive CCSS if they also receive housing sustaining services through Housing Stabilization Services, as described on DHS – Housing Stabilization Services.

Reinstitutionalization

When a person is reinstitutionalized, they can receive CCSS for up to 30 calendar days. CCSS will stop after the 30th day of reinstitutionalization and may resume once the person returns to the community. For more information, refer to MHM Manual – Reporting enrollment changes, reinstitutionalization and disenrollment for MHM.

CCSS is a DHS enrollment-required service. For more information, refer to MHCP Provider Manual – MHM.

The CCSS provider must:

License requirements

The provider must be one of the following:

Background studies

Minn. Stat. Ch. 245C requires a licensed program to conduct background studies. Providers who have direct contact with the person must have a completed background study (for a complete list, refer to Minn. Stat. §245D.03). A provider must complete and submit individual background studies using New Electronically Transmitted Study (NETStudy) through DHS licensing.

Service authorization

The transition coordinator, demonstration case manager, waiver case manager or care coordinator authorizes CCSS.

CCSS requires a service authorization. Prior authorization from DHS is required if a person needs and requests additional hours beyond the 300-hour limit. DHS pays the provider as indicated on the service agreement.

For instructions about authorizing MHM community services and how to receive prior authorization, refer to MHM Manual – Services.

Rate

The lead agency authorizes CCSS at a 15-minute unit rate that does not exceed the rate limit in Long-Term Services and Supports (LTSS) Service Rate Limits, DHS-3945 (PDF).

Billing

The CCSS provider must plan and deliver services based on the person's needs, as documented in the person’s TPT. All submitted claims must be based on actual services delivered.

The CCSS provider cannot bill for services based on an average of billable units provided to a person.