Brain injury waiver & services for person with BI

Services for persons with brain injury



The brain injury waiver provides funding for home and community-based services for certified disabled individuals with an acquired brain injury, on Medical Assistance, and who require community support in order to avoid or delay nursing facility or neurobehavioral hospital placement. This is a federal Medicaid program.

Brain injury waiver program information
BI Brochure

Personal care assistance program


This program provides services to people who need help with day-to-day activities to allow them be more independent in their own homes. A personal care assistant is trained to help with basic daily routines. A PCA may be able to help you if you have a physical, emotional, or mental disability, a chronic illness or an injury.

Personal Care Assistance (PCA) Program information
PCA consumer information

Community Access for Disability Inclusion waiver


The Community Access for Disability Inclusion (CADI) waiver program provides support for people younger than 65 who are certified disabled, eligible for Medical Assistance, and need support to avoid or delay institutional living. 

Community access for disability inclusion information 
Community access for disability inclusion brochure 
  
Some programs require a person be certified disabled; this disability status can be obtained through Social Security or the State Medical Review Team (SMRT) 

Social Security Disability Determinations  
FAQs about the State Medical Review Team  
 
  

Consumer Directed Options



These programs allow people to write their own plans and hire and direct their own staff. Programs include consumer-directed community support, consumer support grant, and family support grant.

Consumer-directed community supports

 
Consumer directed community supports (CDCS) is a service option for people with disabilities that gives the flexibility and responsibility to tailor services and supports to their unique needs.

With this program, you:  
  • Decide how to spend your budget allowance based on your assessed needs
  • Have the option to hire people you know, such as family, friends and neighbors 
  • Choose as much responsibility as you want to hire, train and manage your workers
Eligibility:
CDCS is an option for people who qualify for Medical Assistance and are enrolled in at least one of the following programs: 
  • Alternative Care (AC)
  • Brain Injury (BI) Waiver 
  • Community Alternative Care (CAC) Waiver 
  • Community Access for Disability Inclusion (CADI) Waiver 
  • Developmental Disabilities (DD) Waiver
  • Elderly Waiver (EW)

How it works

A. Budget
Your budget is determined using information from your most recent assessment and screening documents. You must be assessed by your county case manager, tribal entity or health plan representative every year to remain in the program. If your needs stay the same, you should expect that your budget will remain about the same from year to year. 

B. Write a community support plan
The community support plan is your roadmap for care. It addresses your assessed needs within your budget, and it may contain a mix of paid and unpaid services, and formal and informal supports. Your plan should include:

  • Supports and services you need and plan to use
  • Costs of each support or service – all funds must focus on the assessed needs of the disabled person, meet health and safety standards, and be fiscally responsible
  • Qualifications of the people that will provide your services or supports
  • Training you want your staff to have
  • Plans to monitor your services or supports
  • Goals and outcomes you hope to achieve

If you need help writing your plan or managing any element of your plan, you can hire a state-certified support planner. Ask you case manager for a current list.
 
C. Hire and supervise staff
You can choose to hire staff from a formal provider or hire people you know, like family, friends or neighbors. If you are already receiving services from an agency, you can choose to continue those services and pay for them out of your CDCS budget.

D. Hire a fiscal support entity 
Your fiscal support entity bills the state for waiver services, provides payroll assistance and helps you develop the financial part of your community support plan to ensure it is within your budget amount. You may choose to have this person: 

  • Review time cards and expenditures
  • Produce exception reports when you have overspent, underspent or when you have unapproved overtime
  • Pay staff, reimburse families for expenses
       List of fiscal support entities  

E. Monitor your plan
You must keep a record of all services and supports provided to you. Keep all receipts and time sheets so that you can accurately bill for services and supports.

You should also make sure that the people you hire are doing what they have been hired to do, and you should monitor whether the plan and supports are working for you.

MNPrairie’s role

MNPrairie will review your support plan to ensure it complies with waiver requirements, and annually review progress on outcomes identified in your support plan. MNPrairie will also authorize services listed in your plan in the state Medicaid Management Information System (MMIS).

Resources

 
CDCS consumer handbook
CDCS lead agency manual 
CDCS support planner 
Fiscal support entities (FSE) provider information
CDCS person-centered planning 
MnCHOICES  
Olmstead plan 
Appeal information