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Existing Supports and Services to Help Your Young Adult Live Independently

A wide variety of services and supports exist to enable a person with disabilities to live independently. The philosophy of supported living is that no matter where an individual lives, services and supports can be matched to their needs. They can vary in amount, frequency, and duration. In order to access these services, you must apply for case management through your county social services department. Case management is defined as “identifying the need for, seeking out, acquiring, authorizing, coordinating, and monitoring the delivery of services to, and protecting the rights of, persons with disabilities by an individual designated by the county board.” Case managers are sometimes called county social workers. Not everyone is eligible for case management and certain services do not require case management

In order to start the process, you must ask for a MnCHOICES assessment by a certified assessor. MnCHOICES is a single comprehensive assessment tool that uses the person-centered planning approach to help make decisions about services and supports. It includes a person-centered assessment of the health, psychological, functional, environmental, and social needs of the individual based on their needs, strengths and preferences.

If outside assessments by licensed practitioners are necessary, the case manager will arrange for them with your approval, or that of your young adult if he or she is 18 or older and not under guardianship. When you request an assessment or reassessment on behalf of your young adult for a Home and Community- Based Waiver, personal care services, or home care nursing, you must be visited by a long-term consultation team within 20 calendar days after the date following your request. The long-term care consultation team members will include a certified assessor, social worker, or a public health nurse. It is important to remember that the timelines stated in law are associated with the screening process. Services are generally provided to individuals with developmental disabilities or mental health who meet the county’s eligibility criteria.

After the county assesses your young adult’s individual needs,  a service plan is developed with your input. Depending on what services he or she qualifies for, the plan name will differ. Common plan names are the Coordinated Services and Supports Plan and the Addendum (CSSP & CSSP Addendum), Personal Care Service Plan, and Individual Family Community Support Plan  (IFCSP). The plan is developed with your young adult’s or your  input.

It may be easier to apply during the high school years because counties usually provide case management and other services to ensure an uninterrupted and successful movement from school to the community. A case manager can help the family understand timelines for various funding sources. Formal supports like Respite, Personal Care Assistance (PCA) services, Private Duty Nursing services, Home Health Care services, Home and Community- Based Waiver programs, Homemaker services, In-Home Family Support Services, Housing Access Coordination, and 24-hour Emergency Assistance require you to apply for case management through your county social services division. Following the application process, disability related eligibility will determine the services you can access. The county looks at an individual’s income level, assets, age, and if he or she is blind or has another disability.

Most providers must be licensed by a state’s Department of Health or Department of Human Services. Programs have specific criteria, rules, and regulations that must be followed.

Home Care Services

Home care services provide medical- and health-related services and assistance with day-to-day activities to people in their home. It can be used to provide short-term care for people moving from a hospital or nursing home back to their home, or to provide continuing care to people with ongoing needs. Home care services may also be provided outside the person’s residence when normal life activities take them into the community. Medical Assistance covers the following home care services: Equipment and supplies, such as wheelchairs and diabetic supplies and services; Personal Care Assistance; Home Health Aide, Home Care Nursing, Skilled Nurse Visit, Home Care Therapies (occupational, physical, respiratory, and speech).

Personal Care Assistance (PCA)

Personal Care Assistance (PCA) services help a person with day- to-day activities in their home and community. PCAs help people with activities of daily living, health-related procedures and tasks, observation and redirection of behaviors, and instrumental activities of daily living for adults. It is available to eligible people enrolled in a Minnesota Health Care Program.

Respite

Respite services offer relief to a family member or primary caregiver that are either absent or who needs relief. Respite is available to individuals with disabilities living in a person’s own home or family home. Your young adult may stay at home (In-home respite) or go to another home (Out-of-home respite) to receive services. A county social worker is required to screen and determine eligibility for services.

Individualized Home Supports

Individualized Home Supports: Services for people who live in their own home or family home that provide support and/or training in four community living service categories: Community Participation, Health, Safety and Wellness, Household Management, Adaptive Skills.

There are three types of individualized home supports:

• Without Training - This service option is provided to adults or children when they need support in at least one of the community living service categories.
• With Training - This service option is provided to adults when they need support and training in at least one of the community living service categories.
• With Family Training - This service option is designed for people who live with their family to provide training to the person and their family members. The training increases their capabilities to care for and maintain the person’s ability to live in the home.

All types of individualized home supports can be provided in the person’s own home, family’s home or in community spaces used by the general public, and either in person or remotely.

Integrated Community Supports

Integrated community supports (ICS): Services that provide support and training in community living service categories to adults ages 18 and older who reside in a living unit of a provider-controlled ICS setting (e.g., apartment in a multi-family housing building). ICS can be delivered up to 24 hours per day in the person’s living unit or in the community.

Consumer Directed Community Supports

Consumer Directed Community Supports (CDCS) is a service option available to people on the home and community-based services (HCBS) waivers and Alternative Care (AC) program. CDCS gives a person flexibility in service planning and responsibility for self-directing his or her services, including hiring and managing support workers. CDCS may include traditional services and goods, and self-designed services.

For additional technical information go to the CDCS Policy Manual.

Consumer First Supports and Services

Community First Services and Supports (CFSS) is a Minnesota health care program that allows for a higher federal match of dollars for the state home care budget for services and offers flexible options to meet the unique needs of people. CFSS allows people greater independence in their homes and communities. CFSS will replace personal care assistance (PCA) and the Consumer Support Grant (CSG). Parent or spouse pay is an option, as well as being able to purchase services that decrease human assistance (for example, building a ramp so a person with a physical disability does not need to be carried or using assistive/monitoring technology to enable a person to complete tasks more independently without the use of staff). Implementation is set for late 2022.

Independent Living Skills (ILS) Therapies

Independent living skills (ILS) therapies: Art, music or recreational therapies with specific therapeutic goals and outcomes. A person is eligible to receive ILS therapies when the services are directed toward acquiring, maintaining or improving the person’s community living skills, are not diversionary, meet specific therapeutic goals and outcomes.

Community Residential Services, Family Residential Services, Life Sharing

• Community Residential Services
  Services that provide training and/or habilitation, ongoing residential care and supportive services to adults and/or children in a licensed setting. These services are individualized and based on the needs of the person, as identified in the support plan.

• Family Residential Services
  Family residential services are provided in a licensed family foster care setting where the license holder resides in the home.

• Life Sharing
  In a life-sharing living arrangement, the lead agency authorizes family residential services to ensure the person receives support from the life-sharing agency and the individual/family sharing their home. The individual/family’s home must comply with the family residential services setting requirements listed above. The life-sharing agency holds the 245D family residential services license and is enrolled as the family residential services provider. The individual/family is required to use a life-sharing agency. A life-sharing arrangement can include up to two adults who use disability waiver services and choose to live together with an unrelated individual/family. The life-sharing arrangement cannot include more than two adults living in the same home.

Semi-Independent Living Services (SILS)

Semi-Independent Living Services (SILS) are services that provide activities, recreation, training, and support. Individuals who qualify for SILS require less than a 24-hour care plan. For example, some individuals may need assistance in one area, such as money management. Other services provided by SILS may include training and assistance in preparing meals, shopping, personal appearance and hygiene, and other activities to maintain and improve a person’s capacity to live in the community. A goal of SILS is to support people so they can achieve personally-desired outcomes and lead self-directed lives. To qualify for services, your young adult must have a county developmental disabilities social worker. The county in which your child lives will pay for the service if there is money available. Each county has limited funds, so you may need to wait for services even if your child is eligible. Some families choose to pay for this service themselves.

Consumer Support Grant (CSG)

The Consumer Support Grant (CSG) program is a state-funded alternative to Medicaid home care services of home health aide, personal care assistance, and/or private duty nursing.

The CSG program provides consumers with greater flexibility and freedom of choice in service selection, payment rates, service delivery specifications, and employment of service providers. Parents, spouses, family members, trusted neighbors, or friends can be paid for service, along with employees of home care provider agencies.

Family Support Grant (FSG)

The Family Support Grant (FSG) program provides a limited number of state cash grants to a certain number of families of children with certified disabilities. The goal of the program is to prevent or delay out-of-home placement of children with disabilities, and promote family health and social well-being by facilitating access to family- centered services and supports.

Adult Rehabilitative Health Services (ARMHS)

Adult Rehabilitative Mental Health Services (ARMHS) are adult mental health services designed to maintain psychiatric stability enabling the person to develop social competencies, enhance personal and emotional adjustment, and improve independent living and community skills, when these abilities are impaired by the symptoms of mental illness. Services offered under ARHMS include skill development in interpersonal communication, relapse prevention, budgeting and shopping, cooking and nutrition, mental health awareness, medication monitoring, transportation, employment, and transition to community living. An eligible recipient is a Medical Assistance-eligible individual who is age 18 or older; is diagnosed with a medical condition, such as mental illness or traumatic brain injury, for which adult rehabilitative mental health services are needed; has substantial disability and functional impairment in three or more areas, so that self-sufficiency is markedly reduced; and has had a recent diagnostic assessment by a qualified professional that documents adult rehabilitative mental health services are medically necessary to address identified disability and functional impairments and individual recipient goals.

Housing Stabilization Services

Housing Stabilization Services is a new Minnesota Medical Assistance benefit to help people 18 years or older with disabilities, including mental illness and substance use disorder, and seniors find and keep housing. The purpose of these services is to support an individual's transition into housing, increase long-term stability in housing in the community and avoid future periods of homelessness or institutionalization.

Eligible individuals are: aged blind, or disabled as describe under Title II of the Social Security Act (SSI/SSDI) and people determined by a medical professional to have any of the following conditions: long-term injury or illness, mental illness, developmental disability, learning disability, substance use disorder.

Housing Stabilization Services consists of three main categories:

• Housing Consultation are services that assist a person, who does not have Medicaid funded case management services, in developing a housing-focused person-centered plan , to assist the person to access needed state plan services that support housing stability and provide referrals or information about to other needed services.* Some services include: identifying a person’s strengths, needs and wants in housing including cultural requirements and/or preferences, supporting them to make an informed choice in their housing transition/sustaining provider, coordinating with other service providers currently working with the person, offering resource information including understanding their rights around privacy and appeals information.
  * This service shall not duplicate other services or assistance
• Housing Transition are services that assist a person to plan for, find, and move to a home in the community. Some services include, developing a housing transition plan, applying for benefits to afford their housing including developing a budget, assist with the housing search and application process, tenant screening, negotiating the lease and building a relationship with prospective landlords, identifying resources to pay for deposits, moving expenses and home goods as well as arranging for adaptive house related accommodations required by the person and arranging for assistive technology.
• Housing Sustaining are services that supports a person to maintain living in their home in the community. Some services include, developing, updating and modifying the housing support and crisis/safety plan on a regular basis, Preventing and early identification of behaviors that may jeopardize continued housing including advocating with community resources to prevent eviction when housing is at risk and maintain person’s safety, coaching to develop and maintain key relationships with property managers and neighbors, including landlords to promote and support cultural practice needs and understandings and supporting the person to apply for benefits to retain housing.

See the Housing Stabilization Process Chart for the steps toward eligibility and to secure services.

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