Frequently asked questions about integrated community supports
DHS created this page as a resource for lead agencies as they work with people who use the integrated community supports (ICS) waiver service. For policy information, see CBSM – ICS.
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DHS created this page as a resource for lead agencies as they work with people who use the integrated community supports (ICS) waiver service. For policy information, see CBSM – ICS.
ICS is a new 245D-licensed service that helps fill identified service gaps and supports people who choose to live and receive services in a supported apartment setting. An ICS setting is a multi-family housing building (e.g., apartment building) in which the provider has direct or indirect control over the person’s living unit. This means the provider owns, operates or leases the living units contained in the setting.
ICS provides supports and training in four community living service categories:
All service delivery hours are awake and must provide training or support in at least one of the community living service categories.
Effective Jan. 11, 2021, ICS is available to adults age 18 or older on the following waivers:
Effective Jan. 1, 2023, or upon federal approval, ICS will be available to adults age 18 or older on the following waivers:
For more information, see CBSM – ICS.
No. ICS is a new service for people on the BI and CADI waivers as of January 2021, and it will be available for people on the CAC and DD waivers in 2023, or upon federal approval.
DHS introduced ICS to fill identified gaps in services for certain living settings and further promote independent living. This new service is designed to be similar to a supported apartment setting for adults age 18 and older. For information about the history and creation of ICS, see Minnesota’s Home and Community-Based Services Rule Statewide Transition Plan (PDF).
If a person receives ICS, they cannot receive the following waiver services:
The amount of services authorized depends on the person-centered support plan, developed by the case manager to meet the person’s specific assessed areas of need. ICS can be delivered up to 24 hours per day in the person’s living unit or in the community.
All service delivery hours are awake and must provide training or support in at least one of the community living service categories.
For provider standards and qualifications, see CBSM – ICS.
ICS is provided in an ICS setting. An ICS setting is a multi-family housing building of three or more units (e.g., apartment building) in which the provider has direct or indirect control over the person’s living unit. A provider has direct or indirect control over a person’s living unit when the provider either:
No. A person receiving customized living is not required to transition to ICS if the setting continues to be licensed as an assisted living setting. If the setting transitions to an ICS setting, a person must either transition to ICS or move to an assisted living setting to continue receiving customized living. For information about how to transition from a customized living setting to an ICS setting, see CBSM – ICS transition plans.
ICS adds another option to the continuum of living arrangements available to people. The person’s living space in an ICS setting includes their own sleeping, bathing, cooking and living area (e.g., apartment unit).
The person has autonomy in their living unit. Although the person lives in a provider-controlled setting, the setting requirements ensure the service provided increases the person’s community integration, independence and options to live in their chosen community. For more information, see CBSM – ICS.
No. A single service provider cannot provide both ICS and individualized home supports in a single setting. A provider that controls the ICS setting can only provide ICS in that setting. Other service providers can provide other services (e.g., individualized home supports with training) in the ICS setting.
No. All hours authorized for ICS are provided directly to the person, one to one. For more information about staffing, see the rates section of this page.
No. ICS settings are multi-family housing buildings with three or more living units. Duplexes and single family homes are not included in the ICS policy.
For the definition of a living unit, see CBSM – ICS.
Yes. However, when more than one person lives in a single living unit of an ICS setting, the ICS provider cannot direct or facilitate who will and will not live in the unit. The provider must allow each person to choose who lives with them, as allowed by rental guidelines and choice-of-roommate requirements under the HCBS settings rule. Neither the person nor their roommate is required to receive ICS or any other HCBS service. For more information, see the secondary information – roommates section on CBSM – ICS.
A provider-controlled setting is a setting in which the HCBS provider has direct or indirect control over a person’s living unit. This means the provider either:
ICS settings are provider-controlled settings. They do not meet the requirements for a person’s own home, community residential program or family residential program.
If a person decides to terminate ICS services with the provider who controls the setting, the person has the right to continue living in the unit according to their lease agreement.
The person cannot receive ICS services from another provider who does not control the setting. However, the person can choose to receive other services from a provider who does not control the setting.
No. Only one HCBS provider may deliver ICS in an approved ICS setting.
Yes. ICS uses a residential rate methodology specifically for the service that uses a “base plus” model. For more information, see RMS User Manual – Residential fields for ICS.
The base rate is a standard amount calculated as eight hours of available staffing per day, divided among the number of approved units in the setting, per the setting capacity report.
The base rate allows for the intermittent and unplanned staffing needs of the people who live in the setting. It allows for flexible administration of program operations to have available staffing for all the people who receive ICS in the setting. The base rate is not shared staffing.
The “plus” in the methodology is the number of individual, awake one-to-one hours the person needs per day to support their assessed needs, as allowed within ICS covered services.
Example: A person lives in an ICS setting with five provider-controlled living units. The person’s rate is calculated as the standard amount for the base, divided by five, plus one-to-one hours to meet their assessed needs.
For more information, see RMS Manual – Quick reference guide on staffing hours for ICS.
A staff person is not required to work on site at the ICS setting outside of each person’s one-to-one hours. Each setting may be set up differently using the base rate, depending on the needs of the people who live and receive services there. However, each setting must have a plan in place for a person to access staff on-site to meet unplanned and intermittent support needs.
The base rate allows for the intermittent and unplanned staffing needs of the people who live in the setting. It allows for flexible administration of program operations to have available staffing for all the people who receive ICS in the setting. The base rate is not shared staffing.
Yes. The lead agency manages Housing Support for ICS settings. The ICS provider should work with the local lead agency if they have questions about Housing Support applications. For more information, see DHS – Housing Support.
The staffing planned for an ICS setting must align to the support needs of the people served in the setting. The base rate allows for unplanned, intermittent needs and access to staffing availability in the setting to meet the needs of the people receiving ICS.
Yes. The ICS provider enrolls each ICS setting separately. Each setting has its own NPI number associated with the program’s enrollment record.
Nursing service hours are not calculated as part of the DWRS framework for ICS. ICS is a 245D-licensed service. The ICS provider is responsible to meet a person’s health service needs in the support plan, consistent with the person's health needs.
If a person receiving ICS is assessed to need nursing services, they may receive skilled nursing visits or home care nursing from a qualified home care provider. For policy information about those services, see CBSM – Skilled nursing visit and CBSM – Home care nursing.
The qualified home care provider can be the same provider that delivers ICS, if the person chooses to receive nursing services from them.
Yes. ICS is an intensive service licensed under 245D, so the licensed provider is required to have a safe medication assistance and administration policy, per Minn. Stat. §245D.11, subd 2, par. 3.
Unlicensed staff working for a 245D-licensed provider can administer medications with the appropriate training. The medication administration training curriculum must be developed by a registered nurse or appropriate licensed health care professional. Providers must follow their internal safe medication assistance and administration policy. Minn. Stat. §245D.09, subd. 4a lists the training requirements for medication administration (paragraph d).
For questions about medication administration and medical equipment requirements under 245D, contact the 245D help desk at 651-431-6624.