Long-Term Services and Supports (LTSS): Services likely needed by a person on an ongoing and continuous basis. LTSS may be provided as home and community-based services or as institutional services.
Home and Community-Based Services (HCBS): Services provided in a person's home, residence or community under various state and federal waiver programs. These services are not provided in an institutional setting. HCBS includes services provided through the BI, CAC, CADI, DD, EW, and AC programs. It also includes services provided through State Plan Home Care such as, personal care assistance paid through fee for service and managed care, home care nursing, home health agency services, and the Consumer Support Grant.
Institutional Services: Services paid through Medical Assistance provided in an intermediate care facilities for persons with developmental disabilities (ICF/DD), nursing homes, residential treatment facility (Rule 5), neurobehavioral hospitals and state operated residential treatment facilities paid by Medical Assistance. Services provided in state operated residential treatment facilities designated as Institutions for Mental Disease (e.g. Anoka) or nursing home services paid by other payors are not included.
Alternative Care (AC): Home and community-based services for Minnesotans age 65 years and older who require the level of care provided in a nursing home and are not yet financially eligible for Medical Assistance.
Elderly Waiver (EW): Home and community-based services as an alternative to institutionalization that promotes the optimal health, independence, and safety of a person age 65 years or older, who would otherwise require the level of care provided in a nursing facility.
Brain Injury (BI) Waiver: Home and community-based services necessary as an alternative to institutionalization that promote the optimal health, independence, safety and integration of a person and who would otherwise require the level of care provided in a specialized nursing facility or neurobehavioral hospital.
Community Access for Disability Inclusion (CADI) Waiver: Home and community-based services necessary as an alternative to institutionalization that promote the optimal health, independence, safety and integration of a person who would otherwise require the level of care provided in a nursing facility.
Community Alternative Care (CAC) Waiver: Home and community-based services necessary as an alternative to institutionalization that promote the optimal health, independence, safety and integration of a person who is chronically ill or medically fragile and who would otherwise require the level of care provided in a hospital.
Developmental Disabilities (DD) Waiver: Home and community based services necessary as an alternative to institutionalization that promote the optimal health, independence, safety and integration of a person who meets the waiver eligibility criteria and who would require the level of care provided in an Intermediate Care Facility for Persons with Developmental Disabilities.
Disability Waivers (non-DD Waiver): This refers to people on three of the disability waivers, Community Alternatives for Care (CAC), Community Access for Disability Inclusion (CADI) and Brain Injury (BI) waivers only.
County: Represents the county of financial responsibility identified for the program participant.
Fiscal Year: The state fiscal year runs from June 30 to July 1st. For example, state fiscal year 2019 began July 1, 2018 and ended June 30, 2019.
Percent of people receiving HCBS: Number of people who received a home and community-based service in January of each year, rather than institutional services, divided by total number of people receiving LTSS for the same time period.
Percent of LTSS spending in HCBS: Total annual amount spent on HCBS divided by the total annual amount spend on all LTSS.
HCBS Spending: Total annual amount paid in a given state fiscal year for home and community-based services.
LTSS Spending: Total annual amount paid in a given state fiscal year for all publically funded home and community-based services and institutional services.
Average LTSS spending: Total annual spending on LTSS services in a given state fiscal year divided by the annual number of people who receive LTSS services for the same time period.
Percent served at home: Annual number of people on a HCBS waiver program who did not receive a residential service during the given fiscal year divided by the total number of people using that waiver program during the same time period.
Residential service: Family and corporate foster care, supportive living services and customized living. This does not include supported living services paid in 15 minute units.
Percent of people with higher needs: Annual number of people on a HCBS waiver program with higher needs divided by the total number of people on that waiver program during the same fiscal year.
Higher Needs: Indicator of a person requiring more support based on their Case Mix classification or Profile Code. This includes people who do not have case mix A or L through BI, CAC, CADI, EW and AC or Profile Code 4 through the DD waiver.
Case Mix Classification: Classification of a person for the purposes of establishing payment levels that relies on the ability to complete certain activities of daily living (ADL), the need for behavioral interventions, and clinical or nursing care required. Case Mix classification was developed as a payment system for nursing facilities and used for establishing individual community budgets under various programs.
Profile code: Classification based on the DD Screening Document that summarizes a person’s level of independence, medical and behavioral needs.
Percent of people with higher needs served at home: Annual number of people on a HCBS waiver program with higher needs who did not receive a residential service during the given fiscal year divided by the total number of people on that waiver program during the same fiscal year.
Percent of people with earned income: Number of working age people on a disability waivers with earned income divided by number of working age people on the disability waivers. Earned income: Income earned by an individual including income from wages and self-employment.
Working age people: People ages 18 through 64.
Percent of people earnings $600+/month: Number of working age people on a disability waivers with average monthly earnings greater than $600 divided by number of working age people on the disability waivers.
Average monthly earnings: A person’s total income for the fiscal year divided by the number of months worked during that same time period. Average months worked is 10 months a year.
For more information or questions, email dhs.ccareports@state.mn.us.
