Lead agencies must complete all applicable rate calculations during the COVID-19 national public health emergency period.
For the Disability Waiver Rate System (DWRS) and rate calculations with an effective date of Jan. 1, 2020, or later, lead agencies must continue to use the Rate Management System (RMS) tool to calculate payment rates for specific authorized services and enter them into MMIS. The RMS User Manual provides lead agencies with guidance to use this tool effectively. Please note:
Yes, the person’s eligibility must continue. The case manager/care coordinator cannot renew or reauthorize services other than case management until they make contact with the person.
To maintain a person’s waiver or AC eligibility when a reassessment cannot been completed for this reason, the assessor/care coordinator must:
"This notice is to let you know that the [insert name of program] you were on has been reopened to provide support during the COVID-19 emergency period. Please contact your care coordinator or case manager to review and renew your support plan and services."
The lead agency must:
Maintaining HCBS eligibility means there are no interruptions or gaps in a person’s waiver eligibility or AC span (i.e., eligibility is continuous). DHS expects that lead agencies continue to track and meet reassessment due dates in all circumstances.
Yes, the person must maintain eligibility for their program. The assessor/care coordinator enters the actual reassessment information, including the correct level-of-care determination, into MMIS. If a person no longer meets an institutional level of care, the assessor/care coordinator uses the following process for the screening document, service authorization and notice of action.
For the screening document, the assessor/care coordinator must:
When authorizing services for a person who no longer meets level-of-care requirements, the lead agency must:
The case manager/care coordinator can continue to authorize case management for the person, including when the person does not need other services based on the reassessment.
DHS strongly recommends that the lead agency talks directly with the person to explain the changes they might see, explain the effects on their services and ensure they understand how to contact the lead agency if their situation changes.
After the reassessment, the case manager/care coordinator must complete a Notice of Action (Assessments and Reassessments), DHS-2828A (PDF) as usual and:
If there is a reduction or termination to the person’s services, the lead agency must send a Notice of Action (Service Plan), DHS-2828B (PDF) to the person and clearly outline which services will continue or be added, as well as the reasons for the reduction/termination of services from their previous plan.
For waivers, the person must maintain waiver eligibility as long as they maintain their MA financial eligibility. Financial workers must follow usual policies to determine if a person is a resident of Minnesota. For more information, see MHCP Eligibility Policy Manual – 1.4 state residency and MHCP Eligibility Policy Manual – 1.4.4 temporary absence.
For AC, follow MA policy to determine if a person is a resident of Minnesota and should remain on AC.
If the assessor/care coordinator cannot complete a reassessment (e.g., cannot contact the person), the person must maintain waiver or AC eligibility as described in scenario one. The case manager/care coordinator cannot reauthorize services (other than case management) until they have contact with the person.
If the assessor/care coordinator completes a reassessment remotely, they must follow the instructions in DHS Bulletin #20-56-06 (PDF) for policy amendments related to the COVID-19 peacetime emergency.
If the person will receive services while they are out of state, the assessor/care coordinator must review the section about out-of-state services on CBSM – BI, CAC, CADI and DD waiver general process and procedure for information about how to authorize and provide services.
If the person will not receive any services while out of state, the assessor/care coordinator must send the person a Notice of Action (Assessments and Reassessments), DHS-2828A (PDF) and include this explanation in the “programs available to you” section:
"This notice is to let you know that the [insert name of program] you were on has been reopened to provide support during the COVID-19 emergency period. Please contact your care coordinator or case manager upon your return to Minnesota to review and renew your support plan and services. Please also contact your care coordinator or case manager if you decide your move out of state is permanent."
If the person communicates that they do not intend to return to Minnesota, the case manager/care coordinator must send Lead Agency Assessor/Care Manager/Worker LTC Communication Form, DHS-5181 (PDF) to the financial worker to inform the financial worker of this information. For waivers, the person cannot be exited from their waiver until MA eligibility is terminated. For AC, the case manager must exit the person from the AC program using the date they received this communication from the person.
To enter this information into MMIS, the case manager/care coordinator must:
If the person is available for reassessment and refuses, the assessor/care coordinator must explain the following information:
In MMIS, the assessor/care coordinator must:
Note: The effective date for both LTC and DD screenings should be the date the person’s current service authorization ends. However, this date must be at least 10 days from the date the person refused the reassessment. If the person refused the reassessment within the last 10 days of the current service authorization period, the lead agency must allow a 10-day period before ending services. For help, contact email@example.com.
Yes. The case manager/care coordinator must end service agreement lines using the date of incarceration and keep the person’s waiver or AC program open.
If the person remains incarcerated when a reassessment is due, the assessor/care coordinator must do either of the following:
The assessor/care coordinator will determine whether a reassessment is needed upon the person’s return to the community. For AC and EW, the assessor/care coordinator can also use activity type 10. The case manager/care coordinator cannot authorize services until they make contact with the person.
The policy related to termination of HCBS program participation based on a facility admission of 30 days, as described in DHS Bulletin #20-56-06 (PDF), applies to:
The policy does not apply to any other setting, such as a treatment setting for behavioral health or substance use disorders. People admitted to other settings must maintain their waiver or AC eligibility.
If the person is admitted to any of the above facilities for more than 30 days, the case manager/care coordinator must:
No. To be eligible for PCA services, the person must have an annual reassessment. If the assessor/care coordinator cannot locate the person, the person’s PCA services cannot continue until a reassessment is completed.