Home and Community Based Services (“HCBS) (“Waiver”) (“245D License”) Provider Enrollment

 

Home and Community Based Services (“HCBS”) “Waiver” 245D License

What is it?

The Home and Community Based Services (“HCBS”) “Waiver” 245D License is issued by DHS under the Medicaid program (“Medical Assistance” in Minnesota). Minnesota residents with disabilities or chronic illnesses who need certain levels of care may qualify for the Minnesota HCBS waiver programs. These programs are available to persons who choose to reside in the community and meet the eligibility criteria – listed below. Home and Community Based Services (“HCBS”) “Waiver” 245D Providers provide staff to provide basic or intensive services to the individuals.

What do I need to start?

The 245D license requires, at a minimum, a designated coordinator and a designated manager.

The designated coordinator must have one of the following: (1) a baccalaureate degree in a field related to human services, and one year of full-time work experience providing direct care services to persons with disabilities or persons age 65 and older; (2) associate degree in a field related to human services, and two years of full-time work    experience providing direct care services to persons with disabilities or persons age 65 and older; (3) a diploma in a field related to human services from an accredited postsecondary institution and three years of full-time work experience providing direct care services to persons with disabilities or persons age 65 and older; or (4) minimum of 50 hours of education and training related to human services and disabilities; and four years of full-time work experience providing direct care services to persons with disabilities or persons age 65 and older under the supervision of a staff person who meets the qualifications identified in clauses (1) to (3). 

The designated manager must qualify as a designated coordinator (although it does not need to be the same person) AND they must have a minimum of three years of supervisory level experience in a program providing direct support services to persons with disabilities or persons age 65 or older.

In addition, the owner or managerial official for your organization must complete the required HCBS Waiver and AC Provider Training 101 and competency test and also pass a NETstudy Background check.

Certain services require additional qualifications which are specific to the service provided (such as a residential setting).

Who qualifies as your clients – HCBS Eligibility Criteria

Minnesota residents with disabilities or chronic illnesses who need certain levels of care may qualify for the Minnesota HCBS waiver programs.

These programs are available to persons who choose to reside in the community and meet the eligibility criteria.

  1. Alternative Care (AC) for people over age 65 years who are at risk of nursing home placement (DHS Aging and Adult Services Division administers the AC program)
  2. Brain Injury (BI) Waiver for people with a traumatic, acquired or degenerative brain injury who require the level of care provided in a nursing facility that provides specialized services for persons with BI, or who require the level of care provided in a neurobehavioral hospital
  3. Community Alternative Care (CAC) Waiver for chronically ill and medically fragile people who require the level of care provided in a hospital
  4. Community Alternatives for Disabled Individuals (CADI) Waiver for people with disabilities who require the level of care provided in a nursing facility
  5. Developmental Disability (DD) Waiver for persons with developmental disabilities or a related condition who require the level of care provided in an Intermediate Care Facility for Persons with Persons with Developmental Disabilities (ICF/DD).
  6. Elderly Waiver (EW) for people over the age of 65 years who require the level of care provided in a nursing facility and choose to reside in the community (DHS Aging and Adult Services Division administers the EW program)

What is the process and how long does it take to start?

After you have the designated manager and coordinator, we can start the process. The process takes about 5 months from the date we submit the initial license to the date we can start billing for services. Information will be gathered and you will be prompted on what to do along the way.
 

How much does it cost?

The legal investment is $2950, which includes getting the license, or your money back. It includes all policies and procedures, and legal forms, and education on how to use them properly for services. It does not include filing fees of $500 (license fee) and $631 (DHS provider enrollment).
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