DWRS implementation of Waiver Reimagine

Lead agency workers will be able to select from the new service menu and calculate rates once they receive an “all clear” message after the Dec. 19, 2020, update to the Rate Management System (RMS) within MnSP. 

After the RMS update, lead agencies will be able to calculate rates for streamline services that have a start date of Jan. 1, 2021, or later. If lead agencies attempt to calculate rates in MnSP prior to the RMS update for services with a start date before Jan. 1, 2021, they will receive an error message and will not be allowed to calculate the rate.

For the correct service name, procedure code and rate framework to populate MnSP, all technical changes must be in place and operational.

New component values will be implemented on a rolling basis throughout 2022, pending federal approval. This means new frameworks will not be used until a person’s 2022 annual renewal or if they have a service change that starts on, or after, Jan. 1, 2022.

Yes, DHS will update Rate management worksheets, DHS-6790 (PDF) to reflect streamline service changes. We will post the updated worksheets in December 2020.

DHS published CBSM – Waiver Reimagine streamlined service crosswalk to provide details about service name, HCPC and framework changes.

See CBSM – Resource: Waiver Reimagine streamlined service crosswalk for a complete list of frameworks used for each streamlined service.

No, frameworks will not change, with the exception of integrated community supports. Integrated community supports is a new service, so DHS developed a new framework for it.

The other streamline services will use frameworks that already exist. DHS will update the names of the frameworks to reflect the streamline service name. For the complete list of the frameworks used for each streamline service, see CBSM – Waiver Reimagine streamline service crosswalk.

There are no changes to the input fields used to calculate the rate because existing RMS frameworks are used for the streamline services, except integrated community supports. The only change will be to service names, so they reflect the new streamlined services.

If a previous service had a rate worksheet, the Rate management worksheets, DHS-6790 (PDF) will look the same.

Yes. Effective January 1, 2022, lead agencies may authorize remote services in MnSP and MMIS. DHS updated MnSP to support authorization of these remote services. Lead agencies should review Remote support in the CBSM to learn more. Some remote services have a different HCPC modifier combination. The Long-Term Services and Supports (LTSS) Service Rate Limits, DHS-3945(PDF) document contains the service, HCPC and modifier combination to use for remote services.

A person who receives SLS in an unlicensed setting (e.g., their own apartment) must select a different service that meets their individual needs and goals.

At the person’s 2021 renewal or a service change in 2021 prior to renewal, review CBSM – Waiver Reimagine streamline service crosswalk. Select the correct service to meet the person’s needs based on the Waiver Reimagine service definitions, in cooperation with support planning.

No. Day support services are only available in a 15-minute unit. There is not a daily unit for day support services.

No. Adult day services are not an option for people younger than age 55 who are new to the services and who would not begin receiving the service until on or after Jan. 1, 2021. For more information, see CBSM – Adult day services.

A person in this situation could receive day support services.

Integrated community supports are services that provide support and training in community living service categories to adults ages 18 and older who reside in a living unit of a provider-controlled, integrated community supports setting (e.g., apartment in a multifamily housing building). Integrated community supports can be delivered up to 24 hours a day in the person’s living unit or in the community. For more information, see CBSM – Integrated community supports.

Integrated community supports are only available through the Brain Injury (BI) and Community Access for Disability Inclusion (CADI) waivers during the 2021 Waiver Reimagine implementation. A future waiver amendment will add this service to the Community Alternative Care (CAC) and Developmental Disabilities (DD) waivers in 2023.

Following federal approval, we posted the integrated community supports framework on DHS – Disability waiver rate system, under the frameworks tab.

For the input fields used to calculate the rate for this service, see RMS User Manual – Residential fields for integrated community supports. For additional information about the framework, see the integrated community supports framework on DHS – Disability waiver rate system, under the frameworks tab.

Yes. It is available through Rate management worksheets, DHS-6790 (PDF).

No. The base shared staffing hours is not an input field and cannot be adjusted. The base shared staffing value of 8 hours is set in Minn. Stat. §256B.4914, subd. 6(e)(1).

No. The hours a person needs should be provided on an individual basis and entered in the 1:1 hours input area in the RMS tool. The base shared staffing number of 8 hours is for the general oversight of the program. Integrated community supports is designed to meet the individual needs of a person and not a setting.

DHS has published guidance to confirm the number of DHS-approved provider-controlled units.

Use one-way waiver transportation (T2003 UC), which is a market rate service. For more information, see CBSM – Briefcase resource document: Transportation and day and employment services.

No. DTH transportation (T2002) cannot be used if the service start date is Jan. 1, 2021, or later. Instead, authorize one-way waiver transportation (T2003 UC) for day support services.

For more information, see CBSM – Briefcase resource document: Transportation and day and employment services.

No. Providers and lead agencies will continue to follow the guidance provided on DHS – Disability waiver rate system, under the exceptions tab.

DHS will update the service drop-down on DWRS Exception Request Application, DHS-5820 to align with the Waiver Reimagine service streamlining for services with effective dates of Jan. 1, 2021, or later.

In this situation, the lead agency would select community residential services on DHS-5820.

It depends.

If the person has an existing DWRS rate exception and is moving to the corresponding streamline service, the lead agency should mark the application as a renewal. If there is a change in rate requested from the previous year, the lead agency must provide all appropriate cost driver documentation. For more information, see DHS – Disability waiver rate system, under the exceptions tab.

If the person has never had exception for the service prior to the 2021 Waiver Reimagine changes, the lead agency should mark the application as new. The lead agency must provide all appropriate cost driver information. For more information, see DHS – Disability waiver rate system, under the exceptions tab.