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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, refer to CBSM – ICS.
ICS is a 245D-licensed service that helps fill identified service gaps for adults on the Brain Injury (BI), Community Alternative Care (CAC), Community Access for Disability Inclusion (CADI) and Developmental Disabilities (DD) waivers. ICS 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 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.
For more information, refer to CBSM – ICS.
No. ICS is a new service for people on the BI and CADI waivers as of January 2021 and for people on the CAC and DD waivers as of January 2023.
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 program setting for adults age 18 and older. For information about the history and creation of ICS, refer to Minnesota’s Home and Community-Based Services Rule Statewide Transition Plan (PDF).
If a person receives ICS, they cannot receive the following waiver services:
There is no minimum amount of support hours a person must receive to live in an ICS setting. The type and amount of services authorized depends on the person’s specific assessed areas of need, as documented by the case manager in the person-centered support plan.
ICS can be delivered up to 24 hours per day in the person’s living unit or in the community. The type and amount of services authorized depends on the person’s specific assessed areas of need, as documented by the case manager in the person-centered support plan.
All service delivery hours are awake and must provide training or support in at least one of the community living service categories.
ICS is an intensive 245D-licensed service. For more information, refer to the provider standards and qualifications section on CBSM – ICS.
ICS is provided in an ICS setting and in the community. 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, choose other services from a different provider that doesn’t control the setting 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, refer to 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, refer to CBSM – ICS.
No. A single service provider cannot provide both ICS and individualized home supports, or other services delivered to people who live in their own home, 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, refer to 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.
No. ICS settings must have a minimum capacity of three or more living units to deliver ICS. DHS amended the federally approved waiver plans to clarify this requirement, effective June 12, 2023. Refer to the Provider control section for additional information about leases and requirements to demonstrate provider control.
For the definition of a living unit, refer to 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, refer to the secondary information – roommates section on CBSM – ICS.
The provider must complete a Setting Capacity Report, DHS-8062 and submit it to hcbs.settings@state.mn.us with all required documentation described on the form. DHS will not accept or review incomplete setting capacity reports.
The documentation the provider must submit with the setting capacity report depends on how they set up provider control at the multi-family housing building (e.g., apartment building). Setting Capacity Report, DHS-8062 includes a list of required documentation.
The provider must submit an update to their setting capacity report when they have long-term or permanent changes. The setting’s capacity does not change each time a person moves in or out. To submit an update, the provider must complete a Setting Capacity Report, DHS-8062 and use request type: “This is an update to an existing integrated community support setting.” The provider must submit the Setting Capacity Report, DHS-8062 to hcbs.settings@state.mn.us with all the required documentation described on the form. When DHS completes and approves the updates, the provider must update the RMS Worksheet – ICS, DHS-6790O (PDF) for every person in the ICS setting.
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.
Yes. If the provider rents the living unit(s) for the purpose of delivering ICS, the provider must be able to demonstrate through documentation that they have control of all the units requested for the capacity and the authority granted by the property management/owner to sublease the units to people who will receive ICS from the provider. This means the person will hold a lease with the provider, and the provider will continue to hold a lease with the property management/owner.
To comply with the HCBS settings rule, a person receiving services must have a lease that complies with Minn. Stat. Ch. 504B (landlord and tenant law). The lease of a person living in an ICS setting cannot be any more restrictive than a lease of any other person living in that building, including the master lease between the HCBS provider and the property management/owner.
Subleasing does not refer to situations when the HCBS provider co-signs a lease with the person. For more information, refer to the secondary information – sublease section on CBSM – ICS.
People who live in ICS settings are responsible to pay costs associated with rent and utilities with any public assistance for which they may be eligible (e.g., Housing Support, Section 8, energy assistance, etc.) and their personal funds.
If the ICS provider has a master lease and subleases units, the provider is responsible to ensure the rent is paid. The master lease agreement must clearly define responsibilities for rent payments to the property manager at the time the ICS provider develops the ICS setting.
No. Waiver funds cannot pay for or supplement room and board costs.
ICS is an intensive service licensed under Minn. Stat. Ch. 245D. A licensed HCBS provider must follow all applicable licensing standards, including the requirement to provide a 60-day notice before they terminate services. ICS settings are provider-controlled HCBS settings. The ICS provider is responsible to understand the applicable licensing and policy requirements and coordinate with the property owner/manager to ensure compliance.
If a person receiving ICS is evicted from the ICS setting, everyone must follow an eviction process that complies with the legally enforceable, signed lease and follow all requirements of Minn. Stat. Ch. 504B. When the lease allows for less than a 60-day notice of eviction, the provider still must provide a 60-day notice of service termination, as required by Minn. Stat. §245D.10. The provider must follow all 245D requirements, regardless of which entity initiates the eviction process (i.e., the provider or the property manager).
For additional information on the steps the provider must take before they start an eviction, rights of the tenant during the eviction process and the required legal process, review Minnesota Office of Attorney General – Tenants and Landlords: Rights and Responsibilities . If you have additional questions about the termination policy and procedures, contact your DHS licensor.
ICS is an intensive service licensed under Minn. Stat. Ch. 245D. A licensed HCBS provider must follow all applicable licensing standards, including the requirement to provide a 60-day notice before they terminate services. ICS settings are provider-controlled HCBS settings. The ICS provider is responsible to understand the applicable licensing and policy requirements and coordinate with the property owner/manager to ensure compliance.
If a person receiving ICS does not have their lease renewed due to a decision by either the provider or the property manager, everyone must follow a non-renewal process that complies with the legally enforceable, signed lease and follow all requirements of Minn. Stat. Ch. 504B. When the lease allows for less than a 60-day notice of non-renewal of the lease, the provider still must provide a 60-day notice of service termination, as required by Minn. Stat. §245D.10. The provider must follow all 245D requirements, regardless of which entity initiates the non-renewal process (i.e., the provider or the property manager).
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, refer to 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 the one-to-one hours specific to meet the person’s individual assessed needs.
For more information, refer to 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. The provider must ensure the staffing planned for an ICS setting aligns with the support needs of the people who live in the setting. 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, refer to DHS – Housing Support.
The ICS provider is responsible for the health and welfare of people who live in the ICS setting and must be available 24 hours per day, except when a separate provider delivers other services (e.g., day support services).
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 must enroll each ICS setting separately. This means each setting has its own enrollment record. The provider must only bill for services under the enrollment record where the person lives.
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, refer to 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.
