If you provide services to waiver participants, especially those on the Community Alternatives for Disabled Individuals (CADI) or Traumatic Brain Injury (TBI) waivers, the Minnesota Department of Human Services (DHS) wants to hear from you.  DHS has released a survey asking for feedback on information presented at an August 2 videoconference and an August 20 full-day forum.  The ten question survey can be accessed here (click on the "Take the survey" link near the bottom of the page), with a deadline for response of Friday, October 29.  The survey will ask you about information presented at the August 2nd video conference and the August 20th all-day forum.  We reported on these video conferences in the August 20 and August 27 editions of Action.  DHS has now released 12 pages of notes that were collected at the August 20 full-day forum.  Participants spent the day providing responses to the following three questions:

1) What are the distinguishing characteristics of home and community, as compared to institutions (defined as nursing facilities, hospitals, Intermediate Care Facilities for the Mentally Retarded (ICF/MR) or Institutes for Mental Disease (IMD)?

2) What are the pressures that need to be addressed and how can these pressures be addressed?

3) Which criteria are the most important when measuring whether someone lives in their own home, and how would you measure that the criteria have been met?

The responses to these questions are very diverse.  The most pressing issue that needs to be addressed for many members is the set of restrictions on the “size and setting” of providers serving CADI and TBI recipients, which can be found on the DHS website and are repeated below.  The restrictions are:

A) Assisted Living (aka customized living) service may not be authorized for persons residing in a living setting adjoined to or on the same property as a nursing facility, hospital, ICF/MR or IMD.

B) When more than one living setting is located on the same property or adjoining property is leased on owned by a single provider, services may only be authorized for individuals living in one of the settings.

C) For persons under the age of 55, the number of persons residing in a living setting can not exceed four.  This mean four people unrelated to the principal care provider.

Exception – Residence was developed before May 1, 2001 and has continually provided waiver services.

These restrictions seem to unnecessarily limit the provider choices of participants on the CADI and TBI waivers.  Another question that many members will have is:  “If corporate foster care costs twice as much as housing with services (HWS), why can’t more people be living in housing with services?"  This question comes from reviewing the information from slides presented at the August 2 video conference,  specifically slide 18 that showed the following annual cost of Community Alternative Care (CAC), Community Alternatives for Disabled Individuals (CADI) and Traumatic Brain Injury (TBI) waivers.

We did confirm with DHS that the populations in each category are equivalent, taking into account age, acuity and behaviors.  We strongly encourage members to participate in this survey so that DHS can hear directly from members.  We will be discussing this survey at our October 26 Housing and Community-Based Services Cabinet Meeting.

Phil Manz
952.851.2484
pmanz@careproviders.org

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