Minnesota · statute · Minn. Stat. ch. 256S · 33 active provisions
Subdivision 1. Authority. The commissioner is authorized to apply for a home and community-based services waiver for the elderly, authorized under section 1915(c) of the Social Security Act, to obtain federal financial participation to expand the availability of services for persons who are eligible for medical assista…
Subdivision 1. Application. For the purposes of this chapter, the terms in this section have the meanings given unless otherwise explicitly provided. Subd. 2. Adjusted base wage. "Adjusted base wage" refers to adjusted base wage described in section 256S.214. Subd. 3. Annual average statewide percentage increase in nur…
Notwithstanding any other state laws or rules, the commissioner may develop a model for tribal management of the elderly waiver and implement this model through a contract between the state and any of the state's federally recognized tribal governments. The model shall include the provision of tribal elderly waiver cas…
The number of elderly waiver participants that a lead agency may serve must be allocated according to the number of elderly waiver cases open on July 1 of each fiscal year. Additional elderly waiver participants may be served with the approval of the commissioner.
Subdivision 1. Elderly waiver plan eligibility requirements. In addition to the requirements of this section, applicants and participants must meet all eligibility requirements in the elderly waiver plan. Subd. 2. Nursing facility level of care determination required. Notwithstanding other assessments identified in sec…
Subdivision 1. Initial assessments. A lead agency shall provide each participant with an initial long-term care consultation assessment of strengths, informal supports, and need for services according to section 256B.0911. Subd. 2. Annual reassessments. At least every 12 months, a lead agency shall provide each partici…
Subdivision 1. Elderly waiver case management provided by counties and tribes. (a) For participants not enrolled in a managed care organization, the county of residence or tribe must provide or arrange to provide elderly waiver case management activities under section 256S.09, subdivisions 2 and 3. (b) If a county agen…
Subdivision 1. Provider requirements. (a) Except as provided in section 256S.07, subdivision 2, elderly waiver case management must be provided by a lead agency or by a private agency that is enrolled as a medical assistance provider. (b) Any private agency that provides case management to a participant must not have a…
Subdivision 1. Choice of case management provider. An eligible participant may choose any qualified provider of elderly waiver case management. Subd. 2. Case management activities. Elderly waiver case management activities provided to or arranged for a participant include: (1) development of the support plan under sect…
Subdivision 1. Written plan required. Each participant's case manager shall provide the participant with a copy of the participant's written support plan. Subd. 2. Plan development timeline. Within the timelines established by the commissioner and section 256B.0911, subdivision 29, the case manager must develop with th…
Medical assistance funding for the following services for a participant must be approved by the case manager and included in the participant's support plan: (1) skilled nursing services; (2) home care nursing; (3) home health aide services; and (4) personal care assistance services.
Subdivision 1. Adult day services authorization limits. Adult day services may be authorized for up to 48 units, or 12 hours, per day based on the needs of the participant and the participant's family caregivers. Subd. 2. Adult day services bath authorization minimum. If a bath is authorized for a participant receiving…
Subdivision 1. Provider requirements. A provider of individual community living supports must not be the landlord of the participant receiving individual community living supports, nor have any interest in the participant's housing. Subd. 2. Licensing standards. Licensing standards for individual community living suppo…
The case manager must give the participant a ten-day written notice of any denial, reduction, or termination of elderly waiver services.
Subdivision 1. Statewide service rates and service rate limits. The commissioner shall establish statewide service rates and service rate limits. The commissioner shall publish updated service rates and service rate limits at least annually. Subd. 2. Foster care limit. The elderly waiver payment for the foster care ser…
A lead agency must use the service rates and service rate limits published by the commissioner to authorize services.
Elderly waiver service rates for foster care and customized living must not include room and board, rent, or raw food costs.
Subdivision 1. Case mix classifications. (a) The elderly waiver case mix classifications A to K shall be the resident classes A to K established under Minnesota Rules, parts 9549.0058 and 9549.0059. (b) A participant assigned to elderly waiver case mix classification A must be reassigned to elderly waiver case mix clas…
Subdivision 1. Requests for elderly waiver monthly conversion budget caps. A participant who is a nursing facility resident when requesting an eligibility determination for elderly waiver services may request an elderly waiver monthly conversion budget cap for the cost of elderly waiver services. Subd. 2. Eligibility f…
Subdivision 1. Eligibility for budget and rate exceptions. A participant is eligible to request an elderly waiver budget and rate exception when: (1) hospitalization of the participant is no longer medically necessary but the participant has not been discharged to the community due to lack of community care options; (2…
Subdivision 1. Customized living services provider requirements. (a) To deliver customized living services or 24-hour customized living services, a provider must: (1) be licensed as an assisted living facility under chapter 144G; or (2) be licensed as a comprehensive home care provider under chapter 144A, be delivering…
Subdivision 1. Authorized customized living service rates. The rates for customized living services and 24-hour customized living services shall be the monthly rates authorized by the lead agency based on the customized living service plan developed within the parameters established by the commissioner and specified in…
Subdivision 1. Customized living monthly service rate limits. (a) Except for a participant assigned to case mix classification L, as described in section 256S.18, subdivision 1, paragraph (b), the customized living monthly service rate limit shall not exceed 50 percent of the monthly case mix budget cap, adjusted at le…
Subdivision 1. Capitation payments. The commissioner must adjust the elderly waiver capitation payment rates for managed care organizations paid to reflect the monthly service rate limits for customized living services and 24-hour customized living services established under section 256S.202 and the rate adjustments fo…
Notwithstanding the customized living monthly service rate limits under section 256S.202, subdivision 1, the 24-hour customized living monthly service rate limits under section 256S.202, subdivision 2, and the component service rates established under section 256S.201, subdivision 4, the commissioner may establish alte…