A person with a developmental disability means an individual who has been diagnosed as having significant limitations in present function, manifested as significantly sub average intellectual funding (an IQ of 70 or below) existing concurrently with demonstrated deficits in adaptive behavior and who manifests these conditions before their 22nd birthday.
A related condition is one that is found to be closely related to developmental disability including, but not limited to cerebral palsy, epilepsy, autism and Prader-Willi syndrome and that meets all of the following criteria:
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Is severe and chronic
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Results in impairment of general intellectual functioning or adaptive behavior similar to that of a person with developmental disabilities
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Is manifested before the person reaches 22 years of age
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Is likely to continue indefinitely
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Results in substantial functional limitation in 3 or more of the following areas of major life activity:
- Self-care
- Understanding and use of language
- Learning
- Mobility
- Self-direction
- Capacity for independent living
- Is not attributable to a mental illness or an emotional disturbance.
Referral Process for Rule 185
(DD Case Management)
Parents or professionals can refer a consumer for Rule 185 ( DD case management) services by calling SWHHS’ centralized intake at 1-800-810-8816 and requesting a Mn Choices Assessment. The assessment alone does not determine eligibility for services. Other eligibility information needs to be submitted and reviewed.
Eligibility Assessment
Following the referral, a certified assessor will be assigned and make contact to determine a time for the assessment. It will be helpful to have copies of the most recent diagnostic report. If there is not a current diagnostic, the case manager will assist the family or consumer with scheduling one. If it is determined that the person is not eligible for services based on the information gathered and the eligibility requirements as stated in Minnesota Statue 256B.092, the case manager will notify the family or consumer in writing.
Group Residential Housing (GRH)
This funding source is for room and board in a facility licensed under GRH rules. These facilities may include adult foster home, room and board, and assisted living.
Home and Community Based Waivers
Must be on MA and eligible for the waiver based on information gathered at an assessment performed by a case manager. Waiver allocations must be available at the county level to receive one for use.
Medical Assistance
A Federal program that pays for medical care and some support services for low income families and individuals eight years or older.
Private Health Insurance
May pay for assessments, adaptive equipment, therapy, counseling, and support services.
Supplemental Security Income(SSI) and Retirement and Survivors Disability Insurance (RSDI)
Cash benefits payable to children with qualifying disabilities whose families have a very limited income. At age eighteen, the family income is no longer considered for eligibility.
Tax Equity and Financial Responsibility Act (TEFRA) of 1982
A program that provides MA for children with qualifying disabilities who live with their families and do not qualify for MA because the family’s income is above eligibility criteria. There is a parental fee based on family income and family size.
Personal Care Assistant Services are provided to assist and support persons with disabilities living independently in the community. This includes the elderly and others with special health care needs. PCA services are provided in the recipient’s home or in the community when normal life activities take him/her outside the home.
Eligibility for PCA
- Medically necessary
- Prior authorized
- A PCA assessment establishes the need for PCA Services
- A physician has signed the “Physician Statement of Need”
- Approved in the recipient’s PCA care plan
- Documented in the recipient’s PCA care plan
- Provided by a PCA under the direction of a qualified professional, the recipient, or their responsible party
For individuals who have been assessed by a Public Health Nurse and are determined in need of PCA services and are eligible, the Consumer Support Grant may be a way to allow the family to use those authorized PCA services to arrange for and direct the care of the child.
This would mean the family decides what services or goods they need to assist the child with daily living skills, respite, or other needs. There needs to be someone in the family who can direct the cares for the child.
The Family Support Grant (FSG) is an effective resource for children with disabilities who live or will live in their family home. Many families with children with disabilities living at home incur higher than average expenses that are directly related to the child's disability.
The Family Support Grant provides cash grants to families to offset some of these expenses and gives the families the flexibility to purchase an array of supports and services to meet the child's needs. The amount of and number of grants varies by county. Families wishing to access the program need to complete an application form and provide information to certify the child has been certified disabled, a description of the family's need, and other information as needed to determine grant eligibility.
Eligibility
- Under 21 years of age AND
- Certified disabled by the Social Security Administration(SSA), State Medical Review Team(SMRT), or the lead agency Rule 185 DD case manager.
- Living in their biological or adoptive family home; OR
- Residing in a treatment center, ICF/DD, or other licensed residential service or nursing facility and would return to their family home if the grant were awarded.
- People who are receiving services through a Home and Community Based Waiver including CAC/CADI/TBI. People receiving the DD waiver are not eligible for Family Support Grant dollars.
Family income limits are determined annually by DHS. Considerations may include size of the family, presence of a disability in other family members and substantial debt due to the child's disability. Agency must have funds available for use in order to receive the grant.