Home and Community Based Services (“HCBS) (“Waiver”) (“245D License”) Provider Enrollment

 
 

Home and Community Based Services (“HCBS”) “Waiver” 245D License

 

 

Who Can Become a 245D provider

 
Anyone can be an owner of 245D company in Minnesota, so long as they have the appropriate Designated Manager or Designated Coordinator (see below.) The owner(s) do not have to be the designated coordinator(s) or designated manager(s).

 

 

What is it?

The Home and Community Based Services (“HCBS”) “Waiver” 245D License is issued by DHS under the Medicaid program (“Medical Assistance” in Minnesota). Minnesota residents with disabilities or chronic illnesses who need certain levels of care may qualify for the Minnesota HCBS waiver programs. These programs are available to persons who choose to reside in the community and meet the eligibility criteria – listed below. Home and Community Based Services (“HCBS”) “Waiver” 245D Providers provide staff to provide basic or intensive services to the individuals.

 

 

What do I need to start?

The 245D license requires, at a minimum, a designated coordinator and a designated manager.

The designated coordinator must have one of the following: (1) a baccalaureate degree in a field related to human services, and one year of full-time work experience providing direct care services to persons with disabilities or persons age 65 and older; (2) associate degree in a field related to human services, and two years of full-time work experience providing direct care services to persons with disabilities or persons age 65 and older; (3) a diploma in a field related to human services from an accredited postsecondary institution and three years of full-time work experience providing direct care services to persons with disabilities or persons age 65 and older; or (4) minimum of 50 hours of education and training related to human services and disabilities; and four years of full-time work experience providing direct care services to persons with disabilities or persons age 65 and older under the supervision of a staff person who meets the qualifications identified in clauses (1) to (3). 

The designated manager must qualify as a designated coordinator (although it does not need to be the same person) AND they must have a minimum of three years of supervisory level experience in a program providing direct support services to persons with disabilities or persons age 65 or older.

In addition, the owner or managerial official for your organization must complete the required HCBS Waiver and AC Provider Training 101 and competency test and also pass a NETstudy Background check.

Certain services require additional qualifications which are specific to the service provided (such as a residential setting) and are not included.

 

Staff Requirements

 

Minimum staff required for application:

*Note that one person could fulfill both positions

 

Additional Staff (not required for application):

 

Positive support services:

Employment Specialists (click here to download job description)

 

 

What is the process and how long does it take to start?

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Onboarding (1-2 days)

We send onboarding documents to you 1-2 business days after your initial consultation. Onboarding documents include a Proposal, Rep Agreement, and Invoice.
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Questionnaire (1-2 days)

After the onboarding documents are received back, we will send you an 245D questionnaire. The questionnaire generally takes clients 1-2 days to complete. We're available for questions as you navigate through the questions.
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245D application is prepared (2 weeks)

After we receive your completed Questionnaire, we'll work on your application documents! This can take us approximately 2 weeks. This timeline depends on timely communication from you and receiving documents we may need for your application in a timely manner.
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Application submitted to Portal

After we complete your application documents and receive any necessary information/documents from you, we'll submit your 245D Application to the DHS portal.
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NetStudy 2.0 Background Studies (2-3 weeks)

Next, you'll complete all required background studies via NetStudy 2.0. This process can take between 2 and 3 weeks.
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Pending Licensor (12+ months from date of portal submission)

After submission to the portal, DHS will assign you a licensor. While DHS doesn't give hard timelines, we see providers waiting over a year for a licensor to be assigned.
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Licensor Assigned (3-4 weeks for final review and approval)

Once a licensor is assigned, they usually take 3-4 weeks to review your application and issue an approval.
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MPSE Submitted (30-45 days)

Once we have gathered your Provider Enrollment items and you have paid the DHS provider enrollment fee, we will submit to MPSE. This process takes between 30-45 days, but we keep an eye on things to make sure it's moving along.
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MPSE Approved

Congrats! You are now an approved and enrolled Integrated Community Supports setting.
 
 

How much does it cost?

The legal investment is $4450, which includes getting the license, or your money back. It includes $500 filing fee, all policies and procedures, and legal forms, and education on how to use them properly for services. It does not include $709 (DHS provider enrollment).
 
 $9,500 for the Premium* Package which is all of the elements of the Standard Package and includes DC/DM Staffing until approval.
*We connect you separately with DC/DM staff for you to speak to them about a business relationship after approval
 
 
 
 

Rates/Reimbursement for Services:

  • Adult Companion Services / S5135 / 15 mins / $2.92
  • Homemaker, Assistance with personal cares, Cleaning, Home Management / S5130 / 15 mins / $5.04
  • Individual Community Living Support / H2015 / 15 mins / $6.18
 
View this link for more info.
 
 
 
 

Resources

245D Frequently used Forms in practice – download here.

245D Waiver Providers must complete Cost Reporting – more information here.

Forms for Long Term services and supports LTSS – here.

Disability Services Division (DHS) Training Archive

 

 

FAQs

What are the requirements for the Designated Coordinator?

In order to qualify as the Designated Coordinator as defined in Minnesota Statute Chapter 245D.081, you must meet one of the below requirements:

  1. A baccalaureate degree in a field related to human services, and one year of full-time work experience providing direct care services to persons with disabilities or persons age 65 and older.
  2. An associate degree in a field related to human services, and two years of full-time work experience providing direct care services to persons with disabilities or persons age 65 and older.
  3. A diploma in a field related to human services, and three years of full-time work experience providing direct care services to persons with disabilities or persons age 65 and older.
  4. A minimum of 50 hours of education and training related to human services and disabilities; and four years of full-time work experience providing direct care services to persons with disabilities or persons age 65 and older under the supervision of a staff person who meets the requirements identified in (1) to (3) above.
What are the requirements for Designated Manager?

 In order to qualify, you must meet one of the below requirements:

  1. A baccalaureate degree in a field related to human services, and one year of full-time work experience providing direct care services to persons with disabilities or persons age 65 and older.
  2. An associate degree in a field related to human services, and two years of full-time work experience providing direct care services to persons with disabilities or persons age 65 and older.
  3. A diploma in a field related to human services, and three years of full-time work experience providing direct care services to persons with disabilities or persons age 65 and older.
  4. A minimum of 50 hours of education and training related to human services and disabilities; and four years of full-time work experience providing direct care services to persons with disabilities or persons age 65 and older under the supervision of a staff person who meets the requirements identified in (1) to (3) above.

AND you must also have a minimum of three years of supervisory level work experience in a program providing director support services to persons with disabilities or persons age 65 or older.

Can one person be both the Designated Coordinator and Designated Manager?

Yes, one person can in fact be both.

Do I need a Designated Coordinator and Designated Manager to submit the application?

Technically no, not required to submit. However, we recommend finding staff to fulfill these roles ASAP. Once a licensor is assigned (within 12+ months) they will be requesting the DC/DM’s resume with addresses, dates, responsibilities, and individuals to call who can verify their experience. This process can be time consuming, we like to be prepared in advance to avoid any possible further delays. 

Does STAR Services training make me qualified to serve as a Designated Manager?

No. 3 years of supervisory experience in a program providing direct support services to persons with disabilities or aged 65+  is still required. 

What counts as 50 hours of education and training?

This can be considered on-the-job training with relevant employment experience. If you have no formal training or education, the minimum 4 years of on-the-job experience can satisfy this requirement. 

How long is the 245D licensing process?

The majority of the wait time is due to DHS. This process is currently taking about 12+ months for DHS to review their 245D applications.

Does anything hurry up the 245D licensing process?

No, DHS reviews applications in the order that they are received.

Can I apply for ICS with my initial license application?
Do I need an office?

Home office is acceptable, (as long as there is no other medicaid-disclosing entities in the same location) 

Do I have to have the NETstudy 2.0 background studies complete before I submit?

No. DHS will provide access to your 245D-specific NETstudy 2.0 account only after the application is submitted. 

What services under my 245D license can I apply for?

The ONLY services the law firm assists with are: basic support services + employment services + IHS (individualized home supports)

Community Residential Services, can we add this?

No. Many services such as CRS require a 245D license as a prerequisite. Cannot be applied for with your initial license application. Only basic support services + employment services + IHS

In the premium package, when does the 6 months of Fractional Legal Counsel begin?

The 6 months of Fractional Legal Counsel included in the premium package will begin upon the day the application is officially reviewed and returned to us from DHS. 

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