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Disability waivers rate system

The Disability Waivers Rate System moved to a more centralized mode of operation on Jan. 1, 2014. Please see Rates Management System in the Community-Based Services Manual for current information. DHS will continue to update this page in addition to the policy manual.

News and updates

  • Non-wage component value study

    To ensure rates accurately reflect true costs, DHS commissioned an independent research firm, Truven Health Analytics, to examine non-wage costs within the DWRS frameworks. Researchers will survey home and community-based providers in Minnesota in order to collect cost information.

    DWRS rate frameworks reflect the costs to deliver services in Minnesota. Frameworks factor in things such as staff wages and program and business expenses. The purpose of the non-wage component value study is to examine non-wage costs within the DWRS frameworks.

    For more information on survey participation, see Truven's webinar on Non-Wage Provider Costs in Home and Community Based Disability Waiver Services.

  • Regional variance factors

    The legislature required DHS (Minn. Stat. §256B.4914, subd. 10c)  to study the difference in waiver service costs across the state. It required DHS to include a calculation in the Disability Waiver Rate System frameworks that accounts for regional cost differences. That difference is called a “regional variance factor.”

    DHS commissioned a study on cost differences across the state. The study found staff wages, which are the predominant cost in providing HCBS services, did vary significantly across the state. DHS developed regional variance factors from this data. For additional information, see the Regional Variance Factors study report (PDF).

    Beginning Jan. 1, 2016, the Rates Management System will apply the regional variance factor to service frameworks automatically. DHS will integrate changes in the Rate Management System. Lead agencies will not have to change their processes. Implementation will occur on a rolling basis as service authorizations either renew or change.

  • Day training and habilitation transportation

    The legislature also required DHS (Minn. Stat. §256B.4914, subd. 7) to implement a transportation payment framework for full-day day training and habilitation services. The full-day day training and habilitation framework in Rates Management System includes these values, as defined by statute. See the Disability Waiver Rate System frameworks page for more information on frameworks.

    Beginning Jan. 1, 2016, the Rates Management System will apply the legislate transportation values to full-day day training and habilitation frameworks. DHS will integrate changes in the Rate Management System. Lead agencies will not have to change their processes. Implementation will occur on a rolling basis as service authorizations either renew or change.

  • Disability Waiver Rate System exceptions research

    DHS is conducting research on disability waiver rate-setting exceptions requests. This study will look at the impact of rate exceptions within the Disability Waiver Rate System.

    This analysis is a requirement of Minn. Stat. §256B.4914. Results of this analysis will be available in a legislative report in January 2016.

    For more information, see Disability Waiver Rate System exceptions research.

Background

In 2007, the Centers for Medicare and Medicaid Services informed Minnesota that its four disability waivers were out of compliance with federal requirements for uniform rate determination methods and standards. The disability waivers are the Brain Injury (BI), Community Alternative Care (CAC), Community Alternative for Disabled Individuals (CADI) and Developmental Disabilities (DD) waivers.

In January 2014, DHS established what is now known as the Disability Waivers Rate System.

What the system accomplishes

Implementation of the system:

  • Transfers the responsibility of setting service rates from counties and tribes to the state.
  • Restores compliance with federal requirements. Allows federal renewal of the Minnesota disability waivers.

Failure to comply with the federal requirements jeopardizes the services to 37,000 people who rely on disability waiver services.

What are goals of the system?

Goals of the system are to create statewide rate setting methodologies that:

  • Are transparent, fair and consistent across the state Comply with federal requirements for administration of waiver programs
  • Establish rates based on a uniform process of structuring component values for service Promote quality and participant choice
  • Recognize a person’s assessed need for particular components within each service.

How do I benefit from the system?

People benefit from increased choice of provider(s) and geographic areas where they receive services.

Lead agencies benefit from use of a Web-based rate-setting calculator and are no longer required to negotiate rates with waiver providers.

Waiver providers benefit from more predictability of rates when the needs of people who receive services increase or people live in different areas of the state and require the same services.

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