Human Services - The Arc Minnesota https://arcminnesota.org/topic/human-services/ The Arc Minnesota promotes and protects the human rights of people with intellectual and developmental disabilities. Mon, 05 Apr 2021 18:05:14 +0000 en-US hourly 1 https://wordpress.org/?v=6.3.2 https://arcminnesota.org/wp-content/uploads/2019/03/cropped-arc-swoosh-favicon-32x32.png Human Services - The Arc Minnesota https://arcminnesota.org/topic/human-services/ 32 32 Community Organizations and Resources https://arcminnesota.org/resource/community-organizations-and-resources/ Thu, 30 May 2019 15:24:44 +0000 https://arcminnesota.org/?post_type=resource&p=22112 Organizations Affiliated With The Arc Minnesota The Arc (National Organization) The Arc Northland Greater Twin Cities United Way Healthy Legacy

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Organizations Affiliated With The Arc Minnesota

 

Community Resources

 

Government Resources – County

 

Government Resources – State

 

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Medical Assistance and Social Security at Age 18 Pre-recorded Webinar https://arcminnesota.org/resource/medical-assistance-and-social-security-at-age-18-pre-recorded-webinar/ Tue, 02 Apr 2019 02:36:31 +0000 https://arcminnesota.org/?post_type=resource&p=21627 Webinar recorded December, 2019:  

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Webinar recorded December, 2019:

 

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Position Statement — Government as a Direct Service Provider for Persons With Intellectual and Other Developmental Disabilities https://arcminnesota.org/resource/position-statement-government-as-a-direct-service-provider/ Wed, 06 Mar 2019 05:25:09 +0000 https://arcminnesota.org/?post_type=resource&p=19821 The Arc Minnesota believes that government should not provide residential and day programs to individuals with intellectual and other developmental

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The Arc Minnesota believes that government should not provide residential and day programs to individuals with intellectual and other developmental disabilities. When government does act as the provider of these services, it must ensure that the conflicts of interest inherent in that role are minimized and that the rights of individuals with disabilities are protected.

Position Statement

The Arc Minnesota believes that government should not provide direct care services to individuals with developmental and intellectual disabilities. The Arc Minnesota believes in inclusion in the community as envisioned by the U.S. Supreme Court’s Olmstead decision and the Americans with Disabilities Act. The Minnesota Olmstead Plan seeks to provide full supports for full inclusion so that people with intellectual and developmental disabilities receive community-based supports, not government run supports.

Until government no longer provides direct services, it must ensure that the conflicts of interest inherent in that role are minimized and that the rights of individuals with intellectual and developmental disabilities are protected. It should also meet operational requirements commensurate with community-based licensing requirements.

Outside monitoring by a non-governmental entity is an essential check and balance to maintain appropriate services and asset allocation, as well as to protect the rights of the individual and evaluate the ongoing quality of services provided.

The Arc Minnesota supports the creation of a new statewide quality assurance program to provide this monitoring, as well as general monitoring of all statewide services and supports provided by private entities.

Private case managers or service coordinators should be appointed when a person needs assistance to advocate for his/her preferences and to ensure that his/her individual needs are being met.

Public guardianship should be replaced with a system that uses family members, relatives, friends, and private guardians, with appropriate monitoring.

Direct services provided by the government must comply with all laws and regulations that apply to non-governmental entities providing the same or similar services, including limitations on aversive and deprivation procedures and funding rules. The same entity should not provide services for any individual for twenty-four hours per day. (See The Arc Minnesota’s Position Statement on the Provision of Twenty-Four Hour Services to Persons With Intellectual and Other Developmental Disabilities.)

 

Issue

In the past, the State of Minnesota cared for the majority of individuals with intellectual and other developmental disabilities in government-operated state hospitals. Today, most individuals are living in the community, and the State of Minnesota allocates and provides the funding for the care but generally does not provide direct care services.

However, some individuals with intellectual and other developmental disabilities live in the community in state-operated, community-based programs funded by state and federal Medicaid dollars and staffed by state employees. As with the state hospitals, there are inherent conflicts of interest when the same entity pays for and provides the care. The government role in ensuring that the needs of individuals with disabilities are met is in conflict with the government’s interest in containing costs and with the government’s role as the entity that allocates the resources available to provide the care. These conflicts loom larger when the government is also the guardian of the person using the services. It is these conflicting roles affecting the quality of care provided to individuals with intellectual and other developmental disabilities that are of concern to The Arc Minnesota.

Approved by The Arc Minnesota Position Statements Task Force on July 29, 2014.

Approved by The Arc Minnesota Public Policy Committee on August 20, 2014.

Approved by The Arc Minnesota Board of Directors on September 13, 2014.

Approved by delegates at The Arc Minnesota Annual Business Meeting, November 14, 2014.

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Arc Guide to Olmstead Plan https://arcminnesota.org/resource/the-arc-guide-to-olmstead-plan/ Sat, 16 Feb 2019 16:16:06 +0000 https://arcminnesota.org/?post_type=resource&p=17408 In 1999, the Supreme Court ruled in a case known as Olmstead vs. L.C. The lawsuit was brought against Commissioner

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In 1999, the Supreme Court ruled in a case known as Olmstead vs. L.C. The lawsuit was brought against Commissioner Tommy Olmstead of the Georgia Department of Human Services by two women living in a nursing home. The women wanted to move out of the nursing home and receive the supports they needed to live more independently. The Supreme Court ruled that under the Americans with Disabilities Act (ADA), individuals with disabilities must have opportunities to live in community-based, inclusive settings. The state of Georgia was ordered to create an Olmstead Plan outlining how it will comply with the ruling of the court.

In 2012, the State of Minnesota agreed to establish an Olmstead Plan as part of the settlement of a lawsuit known as Jensen vs Minnesota Department of Human Services (DHS). The Minnesota Olmstead Plan was approved in September 2015 by the federal court. The vision of the plan is that people with disabilities are living, learning, working, and enjoying life in the most inclusive setting. The Olmstead Plan does not only apply to services offered through the Minnesota Department of Human Services; rather, it is a comprehensive plan that applies to all Minnesota government agencies and the services they provide.

Minnesota has developed 13 topic areas in the Olmstead Plan with measureable goals. The goals are reviewed and updated annually. Each year, the Olmstead Implementation Office seeks public input on changes made to goals within the plan. These goals outline what the Olmstead Plan hopes to achieve:

  • Person-Centered Planning: Ensuring that all plans to provide supports that are created by a county or agency place the needs and desires of the individual with the disability at the center of the services that are received
  • Transition Services: Focusing on supporting people to move from less inclusive to more inclusive homes or settings
  • Housing and Services: Providing an informed choice and appropriate funding/services so people can choose where they live, with whom and in what type of housing situation
  • Employment: Increasing the number of people with disabilities working in competitive, meaningful and sustained employment in the most inclusive setting by providing appropriate supports to those interested in competitive, integrated jobs
  • Lifelong Learning and Education: Increasing the inclusion of students with disabilities in classrooms and increasing the number of students with disabilities who enroll in an inclusive post-secondary education setting after graduation
  • Waiting Lists: Moving toward having no wait lists for Medical Assistance disability waivers
  • Transportation: Improving accessibility for pedestrians and increasing transit access and ridership throughout the state
  • Healthcare and Healthy Living: Reducing health care inequalities among people with disabilities by increasing access to preventive care, mental health services, dental care and other services
  • Positive Supports: Reducing the use of restrictive procedures involving restraining during an emergency situation in schools and in adult settings (including residential and vocational)
  • Crisis Services: Reducing the need for crisis services that take an individual away from their home and work and increasing access to crisis services that are brief and effective so that the individual can stay in their home or return to their home as soon as possible
  • Preventing Abuse and Neglect: Goals focus on reducing the number of people with disabilities who experience abuse and/or neglect
  • Community Engagement: Goals include increasing the number of people with disabilities involved in self-advocacy and increasing the number involved with Governor-appointed boards and commissions and with public planning projects

One topic area, Assistive Technology, does not have measurable goals. Rather, goals related to assistive technology are integrated throughout the plan. The overall vision for this area is to expand the availability and use of technology to assist a person with a disability to live and work in the most inclusive settings.

For more detailed information on the Minnesota Olmstead Plan you can click on the link below:

The Minnesota Olmstead Plan

Olmstead Plan Implementation Office

Video  on  the  Olmstead  Plan  from  The  Arc  Minnesota The Olmstead Plan and Employment First: Myths and Realities


For further information or advocacy services, contact The Arc Minnesota at 952-920-0855 or toll-free at 833.450.1494 or visit www.arcminnesota.org. (Please note: This document is not legal advice, and should not be construed as such. Thus, no information herein should replace the sound advice of an attorney.)

All rights reserved (c) 2019 The Arc Minnesota

 

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Arc Guide to the Minnesota Department of Education (MDE) Complaint System https://arcminnesota.org/resource/arc-guide-to-the-minnesota-department-of-education-mde-complaint-system/ Sat, 16 Feb 2019 16:14:18 +0000 https://arcminnesota.org/?post_type=resource&p=17407 Students who meet eligibility criteria under Free, Appropriate Public Education (FAPE), have a right to special education and related services

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Students who meet eligibility criteria under Free, Appropriate Public Education (FAPE), have a right to special education and related services to meet their individual needs. The student’s needs and services are documented in the student’s Individualized Education Program (IEP). If a parent or guardian thinks their son or daughter is not receiving appropriate services under FAPE or not receiving services documented in the IEP, they can file a complaint with the Minnesota Department of Education (MDE). This guide will describe when and how to use that process.

 

Before filing a complaint, it is helpful to speak with an educational advocate at The Arc Minnesota. The Arc Minnesota advocate will discuss the complaint process with you. Together, you and The Arc Minnesota advocate will discuss if filing a complaint is the best option to resolve the issue or if other options may be more helpful. The Arc Minnesota advocate may help you fill out the complaint form.

 

You may want to file a complaint if you think the school:

  • Did not provide something that was stated in the IEP
  • Did not meet required timelines, procedures or requirements
  • Violated a special education law or rule
  • Did not provide FAPE to the student

 

A complaint must be in writing. There is a form that can be used to file a complaint. The form has all the necessary information that must be provided. A copy of the complaint must be sent to the school district the complaint is about.

 

When MDE receives the complaint, appropriate staff will decide to investigate or dismiss it.

 

If the complaint is dismissed, this means it will not be investigated by a MDE complaint investigator. A complaint may be dismissed if:

  • It has been more than one year since the issue/violation occurred OR
  • The issue/violation does not involve a special education law or rule

 

If MDE decides to investigate, a MDE staff person who is an investigator will:

  • Contact the person who wrote (filed) the complaint
  • Contact the school district’s special education director to find out if the issue/violation can be resolved without a formal investigation
  • Review documentation and decide what to do
  • The complaint investigator will make a decision within 60 days of receiving the complaint form. (In some cases, it may take more than 60 days. In this situation, the person who made the complaint will be informed.)
    • If the investigator decided there was a violation of a special education law or rule, the investigator will tell the school how to correct the problem. This includes a Corrective Action Plan. MDE will check to see if the school did what it was supposed to do.
    • If the investigator decided there was no violation, the complaint is closed. If the parent/guardian does not agree with the investigator’s decision, the decision can be appealed to the Minnesota Court of Appeals. This must be done within 60 days of receiving the decision from MDE. If the parent/guardian wants to do this, Arc advocates recommend talking to an attorney with knowledge of special education.

 

Please call an advocate at The Arc Minnesota if you have any questions about a special education complaint.

 

Additional resources:

The Arc Minnesota Arc Guides: https://arcminnesota.org/type/arc-guide

 

**State Complaint information is available at:

CFR 34 300.151 – 153 http://www.ecfr.gov/cgi-bin/text- idx?SID=ae317c7552ecea140df7f8583f6a785f&mc=true&node=sg34.2.300_1150.sg12&rgn=div7 Minnesota Statute 125A.44 https://www.revisor.mn.gov/statutes/?id=125A.44

For further information or advocacy services, contact The Arc Minnesota at 952-920-0855 or toll-free at 833.450.1494 or visit www.arcminnesota.org. (Please note: This document is not legal advice, and should not be construed as such. Thus, no information herein should replace the sound advice of an attorney.)

All rights reserved (c) 2019 The Arc Minnesota

 

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Arc Guide to the Community Access for Disability Inclusion (CADI) Waiver https://arcminnesota.org/resource/arc-guide-to-the-community-access-for-disability-inclusion-cadi-waiver/ Sat, 16 Feb 2019 16:12:30 +0000 https://arcminnesota.org/?post_type=resource&p=17406 The Community Access for Disability Inclusion (CADI) waiver is one of several Home and Community-Based Services (HCBS) waivers available through

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The Community Access for Disability Inclusion (CADI) waiver is one of several Home and Community-Based Services (HCBS) waivers available through Minnesota’s Medical Assistance* program.

 

The CADI waiver is for individuals, both children and adults, who need the level of care that would otherwise be provided in a nursing home. Like all waivers, the CADI waiver provides supports to an individual to live where they want in the community.

 

To be eligible for CADI waiver services, an individual must:

  • Be eligible for Medical Assistance (MA)
  • Be certified as disabled by the State Medical Review Team (SMRT) or Social Security
  • Be under the age of 65 when the waiver begins
  • Be determined to need the level of care that would otherwise be provided in a nursing facility
  • Have an assessed need for services and supports more than those available from other funding sources
  • Make an informed choice for services in the community instead of a nursing facility

 

Individuals interested in the CADI waiver should contact their county of residence and ask about an assessment for services.**

 

Through the MnCHOICES assessmenet process, information is gathered to determine if the services:

  • Are necessary for the individual’s health, safety and welfare  Are covered by any other funding source
  • Meet the individual’s needs, wants and preferences  Costs are reasonable and customary

 

Service available through the CADI waiver:

  • 24 – hour customized living: Supportive services provided to a person who lives in a specific housing situation (a registered housing with services establishment)

24 – hour emergency assistance: on-call counseling and problem solving, immediate response for assistance

Adult and child foster care: Services provided in a foster care setting

Adult companion: Care provided to an individual age 18 or older; care that is not medical, includes supervision and socialization

Adult day services: For an individual age 18 or older who needs supervised care outside of the home during the day

  • Adult day services bath: For when a bath is unable to happen in the person’s home

Behavioral support: Assistance to increase positive behavior and decrease/eliminate negative or challenging behavior

Caregiver living expenses: Expenses by a caregiver who resides with the person who also provides a waiver service

Case management: services provided by the case manager (social worker) to assist the person to access and plan services

Case management aide: Assistance provided to the case manager

Chore services: Assistance provided to individual or primary caregiver, for a clean and safe environment

Consumer-directed community support: an option that gives the person more flexibility and responsibility for directing services and staff; the person writes a plan describing how needs will be met

Crisis respite: Intervention and care provided on a short-term basis, for both medical

and behavior needs, support the individual and/or protect others living with the individual

Customized living: Supportive services provided to a person who lives in a specific housing situatin (a registered housing with services establishment)

Environmental accessibility and adaptations: Purchase, install, maintenance and repairs of environmental modifications and equipment, to home or vehicle

Extended home care services: Home care services that exceed those in state plan (traditional) MA services

Family counseling and training: Provided for the individual and/or family members, includes person-centered planning

  • Home delivered meals: Nutritional meals delivered to the individual’s home

Homemaker service: General household cleaning when the person or caregiver is unable to perform the activities

Housing access coordination: Services to assist the individual plan, find and move to a

home of his/her own

  • Independent Living Skills (ILS) training: Focus on developing, maintaining and improving the individual’s skills for living in the community
  • Night supervision services: Overnight awake staff in the individual’s home

Prevocational services: General work skills services that prepare an individual for a job with competitive pay

 

Residential care: Support and health supervision provided to an individual living in a licensed residential setting

  • Respite care: Short-term services provided to the individual due to family member or primary caregiver needing some relief, provided in the person’s home or in a specific out-of-home setting

Specialized supplies and equipment: Devices, controls, supplies that allows an individual to interact with others and/or do daily activities

Supported employment services: Services to assist a person find and keep paid

employment in a situation with people without disabilities; services may involve working directly with the individual or indirectly with employment related tasks

Transitional services: Items, expenses, etc. to assist a person move from a licensed setting into their own home

Transportation: Transportation required to access community activities/services

 

 

*This includes medically necessary hospital care, doctor care, dental services, therapies, counseling, medical transportation, home care, etc. For more information, read The Arc Guide to Medical Assistance.

 

**See Arc Guide to MnCHOICES

 

Minnesota Statute (Law) provides more detailed information on Home and Community-Based Service Waivers for Disabled. It is available at https://www.revisor.mn.gov/statutes/?id=256B.49

 

 

For further information or advocacy services, contact The Arc Minnesota at 952-920-0855 or toll-free at 833.450.1494 or visit www.arcminnesota.org. (Please note: This document is not legal advice, and should not be construed as such. Thus, no information herein should replace the sound advice of an attorney.)

All rights reserved (c) 2019 The Arc Minnesota

 

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Arc Guide to Supplemental Security Income (SSI) https://arcminnesota.org/resource/arc-guide-to-supplemental-security-income-ssi/ Sat, 16 Feb 2019 16:07:27 +0000 https://arcminnesota.org/?post_type=resource&p=17404 Supplemental Security Income (SSI) is a Social Security Administration (SSA) program. It gives cash benefit payments to people who have

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Supplemental Security Income (SSI) is a Social Security Administration (SSA) program. It gives cash benefit payments to people who have a disability, limited income and assets. Financial need and living situation determine the amount received. In 2020, the maximum amount given is $783 for individuals and $1,175 if married.

Eligibility

  • People aged 18-64, with disabilities and limited income and assets under $2,000
  • People who are 65 years old or older with limited income and assets
  • Children under 18 with disabilities and limited parental/guardian income and assets

If you are under 18 and receive SSI, when you turn 18, Social Security will review your eligibility for continued SSI benefits. This is based on disability rules for adults, including non-medical eligibility rules. SSA will generally contact you within a year of turning 18 years old.

Medical Definition of Disability

  • SSA focuses on functional limitation. The SSA Blue Book lists qualifying impairments for adults and for children.
  • You must be able to show medical reports that confirm you have a disability. If no reports are available, Social Security will send you to a doctor to confirm your disability.
  • Your disability must have lasted or expected to last at least a year.
  • If you are blind, there are special SSA rules to consider you blind. Learn more about those rules.

How to Apply
Fill out all needed documents to help your chances of approval.

  1. Get the child or adult Disability Starter Kit, which includes the application and more information.
  2. Call SSA at 1-800-772-1213 to request an interview. This will be over the phone or in-person at your local Social Security office. The Arc Minnesota recommends an in-person meeting if possible.
  3. For adults, fill out the Adult Disability Report and Adult Function Report and bring it to your interview.
  4. For children, fill out the online Children’s Disability Report and bring it to your interview.

After applying, SSA will review your information and make a determination. If they have more questions, they will contact you.

Decision

The determination process can generally take up to 5 months. After SSA has made a decision, they will mail an approval or denial letter and the reason why.

Appeals

If denied SSI, you can appeal. There are four appeal levels:

  1. Reconsideration

You have 60 days to return reconsideration documents after receiving a denial
notice. You can provide more medical documentation and further explain your
situation.

  1. Hearing

If you disagree with the reconsideration decision, you may ask for a hearing. The hearing is with a law judge who had no part in the original decision or the reconsideration of your case.

  1. Appeals Council

If you disagree with the hearing decision, you may ask for a review by Social Security’s Appeals Council. If reviewed, it will either decide your case, or return it to a law judge for further review.

  1. Federal Court

The Appeal Council will send you a letter with their decision. If you disagree with their decision, you may file a lawsuit. The letter will explain how to do it.

Check out the SSA disability appeals website to learn more about the appeals process.

Managing the SSI Benefit – Representative Payee

A representative payee is a person or an organization. Social Security appoints a payee to receive the disability benefit for anyone who needs support managing their benefit. Their role is to pay for the needs of the person, and save any benefits not currently needed. A payee must also keep records of expenses. Learn more at ssa.gov/payee.

What Can Affect Benefit Amount

The amount of earned and unearned income counted reduces your SSI benefit. Generally, you must make less than $1,600 per month to be eligible for a benefit. Check out DB 101 to estimate your payments, or call your local Social Security office for help. 

  • Living Arrangement and Value of One-Third Reduction Rule

If you live in someone else’s household and do not pay your share of food and shelter costs, the benefit payment is less. The typical reduction is one-third of the maximum amount.

  • Presumed Maximum Value Rule

If somebody you do not live with helps you with food and/or shelter costs, the benefit payment will most likely drop by one-third.

  • SSI and Work

You can work and still collect SSI. Most people on SSI who work have more money. Even though the SSI benefit goes down, the total income will almost always be higher. To find out how work affects SSI payments, please use the DB101 SSI and work calculator.

  • Student Earned-Income Exclusion (SEIE)

Students under age 22 regularly attending school can make up to $7,670 a year without any effect on their SSI benefit. They can exclude up to$1,900 a month, until they have reached $7,670 for the year. The SSI benefits are reduced if a student makes over $1,900 a month. Find details at ssa.gov/oact/cola/studentEIE.html.

  • Plan to Achieve Self Support (PASS)
    A PASS plan is an SSA work program. It lets a person who gets SSI or Social Security Disability Income (SSDI) save work earnings for training or other expenses to reach a work goal. Resources set aside will not count as assets.

For more information or to apply contact your local SSA office or get the PASS form online. You can also get help from a Social Security PASS Cadre or a vocational counselor

  • Ticket to Work (TTW)
    Social Security’s TTW helps adults, ages 18 to 64, who receive SSI or SSDI, and want to work. It connects people with disabilities with services and supports they need for success in the workforce. Find help at ssa.gov/findhelp.

Services offered may include:

  • job coaching
  • job counseling
  • training
  • benefits counseling
  • job placement

Resources

Arc Guide to Social Security Disability Income (SSDI) PDF

Arc Guide to Supplemental Security Income (SSI)

Social Security Administration

Social Security Office Locator

Disability Benefits 101: tools and information on employment, health coverage, and benefits

Social Security Advocacy and SOAR: free assistance in applying for SSI or for appeals.

Social Security Advocacy Directory: The Minnesota Department of Human Services contracts with agencies throughout the state to assist individuals with applying for federal disability benefits

SSDI Family Benefits

 

For more information or advocacy services, contact The Arc Minnesota at 833.450.1494 or visit www.arcminnesota.org. (Please note: This document is not legal advice. No information should replace the advice of an attorney.)

All rights reserved (c) 2020 The Arc Minnesota. Document updated June 2020.

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Arc Guide to State Medical Review Team (SMRT) https://arcminnesota.org/resource/arc-guide-to-state-medical-review-team-smrt/ Sat, 16 Feb 2019 16:00:54 +0000 https://arcminnesota.org/?post_type=resource&p=17401 The State Medical Review Team (SMRT) is a group of medical professionals and staff at the Minnesota Department of Human

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The State Medical Review Team (SMRT) is a group of medical professionals and staff at the Minnesota Department of Human Services (DHS) who complete disability determinations for healthcare eligibility for Medical Assistance (MA). The SMRT uses the Social Security Administration’s disability criteria to certify disabilities. These certifications last from one to seven years, based on an individual’s age and diagnosis. There are three disability categories that SMRT certifies: developmental disabilities, physical disabilities and mental health.

 

A SMRT disability certification is required when:

  • applicants are seeking specific county services and programs that require disability certification, or;
  • applicants are applying for disability-based MA (MA-TEFRA) for a child under age 19, or;
  • applicants are applying for MA for Employed Persons with Disabilities (MA-EPD), or;
  • applicants are applying to be excluded from Managed Care MA

 

How Social Security and the SMRT process impact each other

  • While SMRT uses the same disability certification criteria as the Social Security Administration (SSA), SMRT disability certifications do not establish eligibility for federal Social Security benefits.
  • If applicants have already been certified disabled by SSA, they do not need to go through the SMRT process. These individuals apply for MA using the DHS 3876 “Application for Certain Populations” and provide a copy of their Social Security award letter.
  • Applicants who go through the SMRT process may be required to apply for Social Security benefits if they appear to be eligible for them.

 

SMRT Determination Process

  1. Applicants submit initial MA applications to their county indicating that they have a disability.
  2. The county financial unit processes the application, reviews initial eligibility for a MA healthcare program and completes the “Referral for Disability Determination” form before submitting it to SMRT
  3. Applicants receive a SMRT “welcome letter” in the mail acknowledging the referral. The mailing also consists of:
  4. The Children’s or Adult Disability Worksheet
  5. Release of information form to allow SMRT to collect medical and educational records on behalf of the applicant
  6. The applicant’s unique Person Master Index (PMI) number, which is also called an MA number.
  7. Applicants complete and return both forms to SMRT with the PMI number written on each.
  8. An assigned SMRT case manager contacts the applicant by letter or phone and requests any required documentation (see list below). SMRT case manager may request documents directly from medical providers or a school district. They may also work with applicants to schedule assessments or evaluations as needed for the disability certification.
  9. Applicants receive a disability certification letter in the mail with SMRT’s decision and length of certification. The county also receives notification of the decision.
  10. If certified disabled:
  11. Applicants should follow up with county financial worker or team to confirm. County opens MA case.
  12. Applicants receive a Minnesota Health Care Programs Member ID card and county approval notice in the mail within a few weeks.
  13. If not certified disabled:
  14. Applicants may appeal the decision following the information listed on the SMRT denial notice. Applicants may contact The Arc Minnesota for more information about their rights, important timelines and the appeal process.

 

Please note: the SMRT process can take at least 3 months from the date the SMRT receives the county referral.

 

SMRT documentation required for Developmental Disabilities based on age

  • Completed & signed Children’s or Adult Disability Worksheet
  • Completed & signed Authorization to Release Protected Health Information form
  • Most recent Individualized Education Plan (IEP) or Individual Family Service Plan (IFSP) if in school
  • Most recent Evaluation Summary Report from the school district if in school
  • Results of a physical exam no more than 3 months old performed by a medical doctor
  • Reports, assessments or evaluations from any consulting medical specialists, therapists or psychologists
  • For children enrolled in a full time Applied Behavior Analysis (ABA) therapy program: current Individual Treatment Plan (ITP) and any updated progress notes

Recertification

SMRT disability recertification is required for ongoing disability-based MA healthcare eligibility. About a month before the disability certification is set to expire, the county completes the “Referral for Disability Determination” form and sends it to the SMRT. Applicants follow the process listed above (starting with step 3). If the SMRT recertifies the disability, the individual continues eligibility for the MA program through the end of the new certification period. If SMRT does not recertify, the county is required to check for other possible bases of eligibility for MA before closing coverage.

 

Additional information

Expedited SMRT reviews may only be requested by the county in the following situations:

  • For disabilities included on SSA’s “Compassionate Allowance List”. This list includes disabilities so severe that SSA will quickly certify the disability
  • For someone who is awaiting discharge from a facility (like a nursing home or hospital)
  • For potentially life threatening situations (where lack of treatment/medication could result in harm or death)

 

Tips

  • Provide detailed information when completing the Children’s or Adult Disability Worksheet. Remember that SMRT does not get to meet the person with the disability and makes their decision from the paperwork submitted to them.
  • Provide additional information in a separate letter and attach to the worksheet. Consider writing about a tough day and highlighting how the person’s disability/needs impact them and family members.
  • Notify the SMRT case manager about any scheduled appointments or upcoming testing related to the applicant’s disability or diagnosis.
  • Start gathering documentation from within the past year. Sending the most recent information is preferred by the SMRT.
  • Waiting periods can be reduced by providing the SMRT with all required documents (listed above) within a few weeks of receiving the welcome letter. If the SMRT case manager has to request disability documentation or arrange for evaluations, the wait time will increase.
  • Write the applicant’s PMI number on the front page of each document sent to the SMRT. Do not send originals to the SMRT, only send copies.

 

SMRT Contact Information Phone: (651) 431-2493

Fax: (651) 431-7457

Mailing Address:

Minnesota Department of Human Services State Medical Review Team

P.O. Box 64248

Saint Paul, MN 55164-0248

 

 

For further information or advocacy services, contact The Arc Minnesota at 952-920-0855 or toll-free at 833.450.1494 or visit www.arcminnesota.org. (Please note: This document is not legal advice, and should not be construed as such. Thus, no information herein should replace the sound advice of an attorney.)

All rights reserved (c) 2019 The Arc Minnesota

 

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Arc Guide to Personal Supports https://arcminnesota.org/resource/the-arc-guide-to-personal-supports/ Sat, 16 Feb 2019 15:23:22 +0000 https://arcminnesota.org/?post_type=resource&p=17386 What are Home and Community-Based Services? Home and community-based waiver services (HCBS) provide flexibility to allow states to develop and

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What are Home and Community-Based Services?

Home and community-based waiver services (HCBS) provide flexibility to allow states to develop and implement community-based services for individuals instead of placing individuals in hospitals, nursing facilities or Intermediate Care Facilities for Persons with Developmental Disabilities (ICF/DD). HCBS allows individuals to be supported in the most integrated (inclusionary) setting possible providing additional services beyond the services provided by state-plan (typical) Medical Assistance (MA) services.

 

Disability waiver programs must help an individual avoid institutionalization and help the individual act with greater independence in the community. In determining if a person is eligible for HCBS services, a county assessment will determine (among other things), if the services:

  • Are necessary to meet the health and safety needs of the individual
  • Are an alternative to institutional services
  • Meet the individual desires, preferences and needs of the person
  • Costs reasonable and customary
  • Are covered by other funding sources?

 

What are Personal Supports?

Personal supports are currently available through the Developmental Disabilities (DD) waiver. (In the near future, it will be available to people on the Brain Injury (BI), Community Access for Disability Inclusion (CADI) and Community Alternative Care (CAC) waivers.) Personal supports can provide supervision and assistance in the home or community that help an individual attain greater independence and inclusion in the community by learning new skills or having new experiences. Personal supports must be combined with at least one other service under the DD waiver only in order to satisfy a habilitation requirement. Personal supports can’t duplicate another service offered under the waiver.

 

Personal support requirements

Personal supports requires an “anchor” service and a habilitation service. Below are options to meet these requirements.

  • Paid caregiver: when one parent is paid to provide personal supports, the recipient of services must have:
    • In-home family support
  • Unpaid caregiver: when the other parent is not paid through personal supports, the recipient of services must have one of the following:
      • Respite: short-term care services provided due to the absence or need for relief of the family member(s) or primary caregiver normally providing the care
      • Homemaker: services ranging from light household cleaning to household cleaning with incidental assistance with home management and/or activities of daily living
      • In-home family support: skill development and training of the person and their family to increase their capabilities to care for and maintain the person in the home
      • Supported living services (SLS): services that support the person to remain independent by helping them avoid behavioral issues, address medical conditions and support for any physical limitations*

 

When someone chooses personal supports, they must use a licensed agency authorized to provide the service. All staff must be employed by the licensed agency. For the requirements of Personal Supports, an agency licensed under Minnesota Statutes 245D must provide licensed services under the DD waiver like In-Home Family Support, Supportive Living Services and Respite. When a family member or friend of the person receiving services provides personal supports, that personal supports staff must become an employee of the licensed agency. Each licensed agency will have orientation and training requirements for personal supports staff.

 

County role and responsibilities

It will be necessary for the county to approve a plan for the provision of personal supports services called a Coordinated Service and Support Plan (CSSP). This plan is sometimes called a “map” that identifies the needed services, supports, goals, and outcomes for services provided to an individual through personal supports. The CSSP will list the licensed agency providing services, the types of services that will be provided, the number of hours that are authorized to be billed for the services and any other licensing requirements. It is up to the provider to follow the map and implement the plan.

*Definitions are from Department of Human Services documents

 

Resources

Arc Guide to Developmental Disabilities Waiver

Arc Guide to Community Access for Disability Inclusion

 

 

For further information or advocacy services, contact The Arc Minnesota at 952-920-0855 or toll-free at 833.450.1494 or visit www.arcminnesota.org. (Please note: This document is not legal advice, and should not be construed as such. Thus, no information herein should replace the sound advice of an attorney.)

All rights reserved (c) 2019 The Arc Minnesota

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Arc Guide to PCA (Personal Care Assistance) Services Funded by Medical Assistance https://arcminnesota.org/resource/arc-guide-to-pca-personal-care-assistance-services-funded-by-medical-assistance/ Sat, 16 Feb 2019 15:21:44 +0000 https://arcminnesota.org/?post_type=resource&p=17385 PCA (Personal Care Assistance) services provide assistance to an individual with a disability who needs help with activities of daily

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PCA (Personal Care Assistance) services provide assistance to an individual with a disability who needs help with activities of daily living (ADLs). In general, activities of daily living are those activities which need to be performed in order for a person to take care of oneself. This guide will provide general information on requirements for Medical Assistance (MA, Medicaid) to pay for PCA services.

Eligibility – Based on an assessment, the person is determined to be dependent in at least one ADL or demonstrate a Level 1 behavior.

Assessment – An assessment must be completed by the county public health nurse or a certified public health nurse under contract with the county. The initial assessment is a review of the need for PCA services completed in person with the intended recipient. The assessment includes:

  • Documentation of the person’s health status
  • Determination of the need for PCA services
  • Evaluation of the effectiveness of PCA services
  • Identification of appropriate services
  • Development of a service plan
  • Coordination of services, referrals to others and follow-up to appropriate payers and community resources
  • Completion of required reports
  • Recommendations for service authorization
  • Consumer education

 

Additional information related to assessment – limitations

In order for a person to be determined as dependent in an ADL, the person must need:

  • Cuing and constant supervision to complete the task, OR
  • Hands-on assistance to complete the task

A child cannot be determined to be dependent in an ADL if an adult would typically perform the activity or assist the child due to the child’s age. A copy of the assessment is available at: http://bit.ly/RocSZO.

 

Activities of daily living include:

  • Dressing, including assistance with choosing, applying and changing clothing and application of special appliances, wraps and/or clothing
  • Grooming, including assistance with basic hair care, oral care, shaving, applying cosmetics and deodorant, and care of eyeglasses and hearing aids. Nail care is included except for recipients who are diabetic or have poor circulation.
  • Bathing, including assistance with basic personal hygiene and skin care
  • Eating, including assistance with hand washing and application of orthotics required for eating, transfers and feeding
  • Transfers, including assistance with transferring the recipient from one seating or reclining area to another
  • Mobility, including assistance with ambulation, including use of a wheelchair. Mobility does not include providing transportation
  • Positioning, including assistance with positioning or turning a recipient for necessary care and comfort
  • Toileting, including assistance with helping recipient with bowel and bladder elimination and care including transfers, mobility, positioning, feminine hygiene, use of toileting equipment or supplies, cleansing the area, inspection of the skin and adjusting clothing

 

Level 1 behaviors – Defined as physical aggression towards self, others, or destruction of property that requires an immediate response from another. More information on PCA services, including information on health-related tasks and procedures, is available

at: http://bit.ly/VC3jbF

 

 

For further information or advocacy services, contact The Arc Minnesota at 952-920-0855 or toll-free at 833.450.1494 or visit www.arcminnesota.org. (Please note: This document is not legal advice, and should not be construed as such. Thus, no information herein should replace the sound advice of an attorney.)

All rights reserved (c) 2019 The Arc Minnesota

The post Arc Guide to PCA (Personal Care Assistance) Services Funded by Medical Assistance first appeared on The Arc Minnesota.

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