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HCBS provider enrollment and provider standards initiative

Review and approval of providers eligible to deliver HCBS waiver/AC services moved to a more centralized mode of operation on Jan. 1, 2014. Please see HCBS Waiver/AC provider enrollment and standards in the Community-Based Services Manual for current information.

Information on this page will be available through June 2014. However, DHS will no longer update this page.

Background

DHS is introducing changes to Minnesota’s long-term care services system. Many of these changes are required by the federal Center for Medicare and Medicaid (CMS). As a result, waiver services and systems will be more consistent throughout the state. The evaluation of home and community-based waiver service providers will be centralized, achieving consistency in compliance with person-centered service quality standards.

What is happening now?

Jan 1-March 30, 2014: Lead agencies update service agreements to reflect new procedure codes and modifiers

October 15, 2013: DHS will begin sending reports to lead agencies with providers’ current enrollment status

Sept. 30, 2013: Deadline for Waiver/AC Provider Record Review (Providers should continue to enroll with DHS as soon as possible)

August 19, 2013: Providers already licensed with DHS can begin application for (or to covert to) the 245D HCBS license

July 25, 2013: DHS offers lead agency video conference (training registration) on Waiver Provider Record Review process and the impacts to lead agencies

July 22, 2013: DHS offers information session on 245D HCBS and Foster Care: County and Provider Change; Register through the DHS iLinc Public Page

July 10, 2013: Providers new to DHS licensing can begin applying for the 245D HCBS license

July 8, 2013: DHS begins offering webinar trainings for providers on both provider record reviews and obtaining the 245D license

July 1, 2013: DHS begins 245D license reviews for providers of HCBS services identified in 2013 Laws of Minnesota, chapter 108, article 8; (Licenses are effective Jan. 1, 2014)

May 15, 2013: DHS no longer accepts applications for 245B DD services license (See July 5, 2013, announcement)

April 2013: DHS introduces new online Waiver Provider 101 training (First course now available; DHS hopes to complete all modules in September 2013; DHS requires completion of all modules for new HCBS providers enrolling with DHS on or after Jan. 1, 2014)

December 2012: DHS begins Waiver/AC provider record reviews for enrolled MHCP waiver/AC service providers

Provider resources

College of Direct Supports online modules 
MHCP Manual – Waiver and Alternative Care
Waiver / AC provider Record Review and 245D License webinar trainings

  • Completing Record Review and Obtaining the 245D License
  • 245D license training for new license holders
  • 245D license training for 245B, Adult foster care and other DHS licensed providers

Waiver/AC Billing Labs (Effective Jan. 1, 2014, required within 6 months of enrollment for new waiver/AC service providers)  

How will implementation occur?

Jan. 1, 2014:

  • County and tribal waiver provider contract-based system is eliminated
  • Compliance monitoring, licensing inspections and licensing complaint investigations begin for services licensed under 245D
  • Licensing compliance technical assistance is available to help providers new to regulations understand how to achieve and maintain compliance with licensing requirements

Fall 2013: DHS provides training to lead agencies and providers in anticipation of the elimination of waiver provider contracts and movement to state centralized operations

July 2013: Providers of services identified in chapter 245D apply for DHS licensure in accordance with 245D requirements

December 2012-September 2013: All currently enrolled waiver service providers undergo enrollment review with DHS

Mar. 2012 – Jan. 2013:  DHS works with representatives from more than 20 counties and tribes to explore and define local agency administrative functions following the elimination of waiver provider contracts; See Changing County and Tribal Roles Home and Community-Based Services Waiver Provider Oversight February 2013 (PDF) submitted to the 2013 legislature. 

What is the HCBS Waiver Provider Standards?

The project combines the following three related Continuing Care Administration initiatives:

  1. Provider Enrollment and Provider Standards Initiative – CMS reviewed Minnesota’s HCBS Waivers, directing several changes to bring Minnesota in line with federal requirements. In response, CCA launched the Provider Enrollment and Provider Standards Initiative to strengthen state provider standards and approval processes.
  2. Quality Outcome Standards Initiative – In 2009, the Minnesota Legislature directed DHS to develop a single set of provider standards for HCBS waiver services for people with disabilities.
  3. Community Residential Setting / Residential Support Services Initiative (combined with Quality Outcome Standards) – In 2009, the Legislature additionally mandated that DHS create a single set of licensure standards, integrating corporate foster care setting and waiver service delivery. The new Residential Support Service requires a single Community Residential Setting license.

What are the goals of standards?

The project seeks to accomplish three key goals.

  • Expansion of consistent standards for those delivering HCBS waiver services to people age 65 and older and persons with disabilities in Minnesota
  • Improvement of HCBS provider enrollment, licensure and monitoring statewide
  • Re-definition of county and tribe administrative function following centralization of waiver provider contracts

What is the scope of the project?

The project consolidates initiatives with unlicensed and licensed providers of HCBS waiver services in Minnesota. Minnesota Statute Chapter 245D establishes licensing standards effective 2014. New standards are applicable regardless of the funding source(s) for the service (state, private pay and any other funding sources). New standards ensure and protect the health, safety and rights of persons receiving home and community-based services governed by chapter 245D.

  • New 245D licensure standards require providers of 12 currently unlicensed HCBS to obtain a 245D license prior to delivering services on or after Jan. 1, 2014
  • DHS introduces a second tier of 245D service requirements for residential, in-home support, day programs and employment services. These will replace 245B standards for the provision of services to persons with developmental disabilities
  • 245D licensure will apply to the following CAC, CADI and BI Waiver Services: foster care, independent living skills, prevocational, structured day and supported employment services
  • 245D licensure will apply only to three Elderly Waiver and Alternative Care Grant services; homemaker services not licensed by MDH or provide cleaning only; companion services when the provider is not operating under the Corporation for National and Community Services Senior Companion Program and in-home and out-of-home respite care service

The new Residential Support Service – Community Residential Site license will collapse corporate foster care waiver services and facility standards into a single license.

Re-enrollment of all HCBS Waiver providers will strengthen provider eligibility requirements and the DHS provider agreement.

The 2012 legislature, with the provision of 245D licensing requirements, directed the elimination of county and tribe waiver provider contracts on Jan. 1, 2014.

DHS is working with county and tribal representatives to determine the changes needed at the local level to support provider contract elimination and assure quality service delivery.

Who is part of the HCBS Waiver Provider Standards project?

DHS consults with several external work groups on the various aspects of the project. The work groups include representatives from counties, tribes, health plans, provider organizations, advocacy organizations, program participants and family members. Some work groups have completed their work; others continue to assist in the project development and implementation.


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