Minnesota Administrative Rules

9525.1250 REIMBURSABLE SERVICES.

Subpart 1.

Types of services.

Day training and habilitation services are reimbursable under the medical assistance program when the services are provided for the development and maintenance of life skills. Reimbursable services include transportation to and from the service site and supervision, assistance, and training in one or more of the following when they are provided to promote age appropriate outcomes and community integration:

A.

prevocational services, if the services meet all of the following requirements:

(1)

the documented goals of the service do not include placement within one year in either a sheltered workshop's transitional employment program or unsupervised competitive employment in the general work force. In this subitem, "unsupervised" means not directly supervised by a provider or a vocational service agency; and

(2)

the client receives ongoing supervision from the provider while participating in the training activities;

B.

community orientation, including proper use of traffic signals, identification of police, firefighters, and bus drivers, use of pedestrian pathways and public transportation to and from stores, restaurants, meeting places, and other familiar settings;

C.

communication skills, including expressive and receptive language skill development;

D.

self-care, including grooming, eating, toileting, dressing, medication monitoring, skin care, and oral hygiene;

E.

cognitive skills, including functional reading, writing, and number skills;

F.

motor development, including gross and fine motor activities, and range of motion exercises;

G.

emotional development, including behavioral programming, to develop situationally acceptable affective expression; and

H.

socialization, including social interaction skills, development of relationships, initiation or participation in leisure activities, and phone use.

Subp. 2.

Service requirements.

Day training and habilitation services are reimbursable under the medical assistance program if the services provided are in compliance with subpart 1 and the conditions listed in items A to F are met.

A.

Day training and habilitation services must be authorized in writing by the county of financial responsibility and must include subitems (1) to (3):

(1)

the amount and type of day training and habilitation services to be provided;

(2)

the service costs; and

(3)

the expected client outcome or results of providing day training and habilitation services.

B.

Day training and habilitation services must not be included in the approved rate of the ICF/DD.

C.

Medical assistance money for day training and habilitation services must not replace the Minnesota Division of Vocational Rehabilitation money for sheltered work or work activity services.

D.

Medical assistance reimbursable day training and habilitation services must not exceed the number of days per calendar year as provided by Minnesota Statutes, section 256B.501, subdivision 5, paragraph (e).

E.

Day training and habilitation services needed by the person eligible under part 9525.1220 and identified in the client's individual service plan must be available to the client in amount, duration, and scope equal to day training and habilitation services made available to other persons served by the same day service provider.

F.

Day training and habilitation services must not include:

(1)

special education and related services as defined in the Individuals with Disabilities Education Act, United States Code, title 20, chapter 33, section 1401, clauses (6) and (17), as amended through October 8, 1986, which otherwise are available through a local educational agency; or

(2)

vocational services funded under section 110 of the Rehabilitation Act of 1973, United States Code, title 29, section 720, as amended through October 21, 1986, which otherwise are available from a local vocational rehabilitation agency.

Statutory Authority:

MS s 256B.501

History:

10 SR 68; 12 SR 2044; 17 SR 1279; L 2005 c 56 s 2

Published Electronically:

October 16, 2013