CurrentUCarePolicy N/A

Housing supports and transitional services comparison for UCare products

This document compares housing support and transitional service programs (Elderly Waiver Transitional Services, Disability Waiver Transitional Services, Housing Access Services, Moving Home Minnesota, and Relocation Service Coordination/TCM) across UCare products (Connect, Connect + Medicare, MSC+, MSHO) and describes eligibility, payors, products, limitations, and referral processes for members and care coordinators.

Policy Summary

PayerUCare

PolicyHousing supports and transitional services comparison for UCare products

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateN/A

Next Review DateN/A

Key ActionCare coordinators must complete or initiate MnCHOICES assessments and refer eligible members to the appropriate transitional services or county for waiver enrollment.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

5distinct program types

4product lines referenced

180 dayscommon timeframe

180 daysRSC-TCM limit

Coverage and Eligibility for Transitional & Housing Programs

Elderly Waiver Transitional Services

Covered when ALL of the following are met:

Member is open to Elderly Waiver (EW) or expected to open to EW within 180 days.

Member is moving from an eligible licensed setting to independent or semi-independent community-based housing.

Member is moving from a setting where the items/supports were provided to a setting where those items are not normally furnished.

Member cannot access the items or supports from other funding sources.

Transitional Services - BI/CAC/CADI/DD

Covered when ALL of the following are met:

Policy Summary

PayerUCare

PolicyHousing supports and transitional services comparison for UCare products

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateN/A

Next Review DateN/A

Key ActionCare coordinators must complete or initiate MnCHOICES assessments and refer eligible members to the appropriate transitional services or county for waiver enrollment.

SourceLink

On This Page

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Referrals, Assessments, and Care Coordinator Responsibilities

Prior Authorization

Elderly Waiver referral requirement

Elderly Waiver (EW) Transitional Services: MSC+/MSHO care coordinator must complete a MnCHOICES assessment that documents the member is eligible for EW (or expected to be opened to EW within 180 days). Once MnCHOICES indicates EW eligibility, the care coordinator must refer the member to a DHS-enrolled transitional services provider to support the move from a licensed setting to independent or semi-independent community-based housing.

Eligibility includes: open to EW or expected to open to EW within 180 days; moving from an eligible licensed setting to independent or semi-independent community-based housing; moving from a setting where items were provided to a setting where these items are not normally furnished; unable to access items/support from other funding sources.

Note

Relocation / Moving Home Minnesota referral processes

Relocation Service Coordination (RSC) / Moving Home Minnesota (MHM) referral processes: Members may begin MHM enrollment during their institutional stay by having anyone complete and submit the online MHM Intake Form (DHS-5032) (mail or fax accepted). For Relocation Service Coordination (Targeted Case Management), members can be referred by their care coordinator or a nursing facility social worker to a relocation service coordination provider. Care coordinators and facility staff should follow program-specific intake/referral pathways and confirm any required MnCHOICES or waiver enrollment steps prior to discharge.

MHM: anyone can complete the DHS-5032 intake form to start the process; MHM requires MA paying for at least one day of the institutional stay and enrollment in MA during service eligibility; must enroll in Elderly Waiver (or other eligible waiver) upon discharge and use waiver supports first.
RSC-TCM: referral sources include the member's care coordinator or the nursing facility social worker; RSC-TCM is limited to 180 days and members receiving certain other TCM/behavioral health services are not eligible.

Program Definitions and Scope

Elderly Waiver Transitional Services — definition

DefinitionFunding for items and supports necessary for an MSC+ or MSHO member opened to Elderly Waiver to move from a licensed setting to independent or semi-independent community-based housing.

Eligibility timeframeOpen to EW or expected to open to EW within 180 days

Referral requirementMSC+/MSHO care coordinator must complete a MnCHOICES Assessment indicating EW eligibility and refer to a DHS-enrolled transitional services provider.

PayorMSC+/MSHO: Elderly Waiver

Disability Waiver Transitional Services — definition

DefinitionProvides funding for items and expenses necessary and reasonable for a person to transition from an eligible setting to their own home or an integrated community supports setting (BI, CAC, CADI, DD).

Eligibility timeframeOpen to BI, CAC, CADI, or DD waiver or expected to be open within 180 days

Referral processCare coordinators will make a referral to the county to complete a MnCHOICES assessment.

PayorDisability Waiver: BI, CAC, CADI, or DD waiver

Housing Access Services — definition

DefinitionSupport or funding to help plan, find, and move into independent accessible housing; may cover security deposit, mover cost, or basic furniture/household goods.

EligibilityNon-waiver individuals who are not at risk of homelessness, not currently living in a congregate or institutional setting, have their own home and can afford to stay there, want to move to their own home and can decide on services.

PayorState & Federal Grants

ProductsConnect, Connect + Medicare, MSC+, and MSHO

Moving Home Minnesota (MHM) — definition

DefinitionProvides a transition coordinator to support members moving from institutions to their own home in the community (Moving Home Minnesota).

EligibilityMA paying for at least one day of the institutional stay and maintains enrollment in MA during eligibility; desires to transition to a qualified community residence and must enroll in EW or other eligible waiver upon discharge.

Referral processAnyone may begin enrollment during institutional stay by completing the online MHM Intake Form (DHS-5032); form can be mailed or faxed.

LimitationsMay not use MHM, Housing Support Services, and RSC-TCM at the same time.

Relocation Service Coordination / TCM — definition

DefinitionRelocation Service Coordination (Targeted Case Management - RSC-TCM) is case management to help members move out of qualifying facilities into the community.

EligibilityResides in an institution that qualifies for services at time of service delivery; chooses to move into the community and to receive services; TCM benefit must not be exhausted.

Benefit limit180 days

ExclusionsMembers receiving Mental Health TCM, VA/DD TCM, or Behavioral Health Home services are not eligible for RSC-TCM.

OpenPayer

Housing supports and transitional services comparison for UCare products

Coverage and Eligibility for Transitional & Housing Programs

Billing, Codes, and Duration Limits

Referrals, Assessments, and Care Coordinator Responsibilities

Program Definitions and Scope