Introduction
MnCHOICES is a person centered face-to-face assessment – similar to an interview – with a certifed assessor. The assessment assists to determine whether an individual with a disability needs services and supports to live and work in their communities. The assessment helps decide the types of support that someone might be able to access, as well as how much support they need, and next steps to take to begin accessing services.
Intent of MnCHOICES
The goal of MnCHOICES is:
• To have one assessment for services and supports available by individuals with disabilities
• A consistent assessment tool across the state
• One annual re-assessment instead of multiple re-assessments that happen during different times throughout the year
• Person-centered emphasis, and an emphasis on the individual with a disability
The MnCHOICES process involves three steps:
• Intake of information about the person by the certified county accessor
• Assessment of the individual’s needs
• Support planning to address assessed needs
What happens during the MnCHOICES assessment?
A certified assessor from the county where an individual lives will schedule a time to come to meet the person in their home, and ask a series of questions that may include areas include:
• Personal Information – Name, age date of birth, family and emergency contacts, guardianship status
• The person’s preferences and choices, routines, relationships, strengths, traditions, dreams and goals for the future
• ADLs (Activities of Daily Living) – support the person may need to eat, bathe, get dressed,etc.
• IADLS (Instrumental Activities of Daily Living) – support the person may need with organizing and taking their medications, making or cooking food, household chores, etc.
• Health – what medication the person takes health risks, treatments and therapies
• Psychosocial – information or concerns about the person’s behaviors, addictions, or situations that might lead to a change in the person’s response to their environment, etc.
• Memory and Understanding – issues related to how the person receives information and is able to recall that information, or use to communicate needs
• Sensory and Communication – the person’s vision and hearing, ability to communicate, awareness and action when the person is in a dangerous situation
• Employment, Volunteering and Learning – what resources or support the person needs and identifying any problems
• Housing and Environment – current housing needs and support with specific adaptations needed for ramps, widening of doorways, accessible bathrooms, fencing, and vehicle modifications
• Self-Direction – the person’s interest in using and directing services to best meet his/her needs
• Assessor conclusions – a recap of what the certified assessor learned about the person and a list of the person’s next steps
The first assessment typically takes about 2-3 hours, but reassessments – which happen every year – should take less time as the certified assessor reads and reviews the individual’s past assessment(s) before meeting.
How does the MnCHOICES assessment impact services?
The MnCHOICES assessment helps decide if someone with a disability is eligible for the following long term services and supports:
Consumer Support Grant (CSG): The CSG uses the state dollars available under the PCA, home health aide and private-duty nursing program for a self-directed option that allows the person to hire spouses, family, friends or others to be caregivers. The purchase of goods and services that benefit the person with a disability are also allowed.
Home and Community Based Services
Homes and Community Based Services include many different supports that help an individual with a disability to live and work at home and stay in their community, instead of in a facility, hospital or nursing home. HCBS are offered to individuals with “waivers”, a technical term for certain services and supports that Minnesota may offer to people with disabilities. Waivers are funded through Medical Assistance – a source of money that helps an individual with a disability to live at home and stay in the community.
Some examples include the Developmental Disabilities (DD), Community Alternatives for Disability Inclusion (CADI), Community Alternative Waiver (CAC) and Brain Injury (BI) waiver. The type of waiver an individual may get depends on their type of disability and individual support needs as identified during their MnCHOICES assessment.
Moving Home Minnesota: A service that moves people from facilities like nursing homes or hospitals to the community. To qualify, a person must be a resident of a facility for at least 90 days and be on Medical Assistance. Services related to their transition needs are funded, like moving expenses, accessibility modifications to homes or vehicles, employment supports, and community services. Assistance will continue for up to one year after the move.
Personal Care Assistance (PCA) Services
Personal Care Assistance is a type of support that can help an individual with a disability at home or in their community with activities of daily living (ADLs). In general, activities of daily living are those activities that need to take place each day like dressing, bathing, grooming, eating, mobility and other essential tasks.
Rule 185 Case Management
Case managers work with other professionals and service providers to best help the individual with the disability access the right services and supports they need in their community. Some examples of what case managers do include:
• Coordinate services
• Help the person learn about other services that could help and how to apply for them
• Evaluate and monitor services identified in the service plan and see how they are or are not working for the person
• Help identify possible service providers
Semi-Independent Living Services (SILS): Supports related to cooking, cleaning, budgeting and other services to help someone live in the community
What happens after the MnCHOICES assessment?
From the assessment, the county staff creates a summary, which they use to:
• Review what was discussed with the person during the assessment
• Develop a Community Support Plan (CSP)
• Give information to the individual’s case manager, who will then create a Coordinated Services and Supports (CSSP)
The CSP must include:
• A summary of the person’s needs that were discussed during the assessment
• Options and choices to meet the person’s identified needs:
Self-directed services
Case management services
Provider services
The person’s health and safety risks and how they will be addressed
Information about other organizations or places that could help the person
Natural supports like family or friends (if applicable )
Information about the amount of funding that might be available for the individual’s services
If the person is eligible for case management services and a case manager is assigned, the case manager will write a Coordinated Services and Support Plan (CSSP). The CSSP is based on the Community Support Plan but must also include:
• Results of the MnCHOICES assessment, like the person’s need for services and how his/her needs will be met in a way that ensures health and safety
• The person’s long and short-term goals
• Specific services the person wants to use and the amount, frequency, duration, and cost of those services
• A place for the person or representative to sign if they agree to the plan
• Information about the person’s right to appeal – or argue against/change – any decisions about their services and supports made based on the MnCHOICES assessment
Both the CSP and the CSSP must be completed by the MnCHOICES assessor and the individual’s case manager (if they have one) within 60 days of the assessment. DHS Form 6791-B-ENG is used. You can find a link to that form from the DHS E-Docs website, but you will need the Internet Explorer browser to open up documents:
https://mn.gov/dhs/general-public/publications-forms-resources/edocs/
How do I request a MnCHOICES assessment?
In order to get a MnCHOICES assessment, an individual, their parent, or guardian should contact the county health care office in the county where the individual lives. You can find that information through this link: Minnesota County & Tribal Directory
When making the call, be specific about that you are requesting a MnCHOICES assessment so they direct you to the proper person to get the assessment scheduled. The county has 20 calendar days after the request is made to complete the assessment.
The individual with the disability does not need to have Medical Assistance (MA) before they request an assessment from the county, or be on MA for the certified assessor to do the assessment. A MnCHOICES assessment is valid for 60 days, and the county can update it to add an extra 30 days. When the individual applies for MA, if it takes more than 90 days then the county may need to do a new MnCHOICES assessment before they can set up services.
Preparing for the MnCHOICES Assessement
It is important to be as prepared as possible for the MnCHOICES assessment to have the best results. Gather important existing documents like psychological assessments, any determinations by Social Security of disability status or the State Medical Review Team (SMRT). Other preparation includes thinking about answering questions concerning where the person might want to live, how they spend their time, and if there are obstacles to getting things that are needed to live in the community like housing, transportation and employment. Be prepared to speak about how a caregiver provides assistance to the person having the assessment. Caregivers may be asked about the person’s memory and ability to retain information, plus assistance that is needed on a daily basis.
Think about the needs of the individual on a very challenging day. What would be needed to support them with basic necessities and successful in accomplishing their goals? This is important because services should address situations that may not happen every day, but are a real possibility. It will be important to communicate the full range of an individual’s needs to the assessor so they have a complete picture of the individual’s needs.
If a school-aged child is being assessed, it will be important to gather information like their Individualized Education Program (IEP), 504 plan, and any other school based documentation of disabilities. These can be used to document intelligence or other assessment information.
If it is not possible for the individual to communicate their own needs – in any capacity – it may be possible for you to communicate about sensitive personal matters in private. You may ask the assessor for time to discuss these types of needs as necessary, but the individual should be involved in as much of their own assessment – and communicate on their own behalf – as much as possible.
Where can I get more information?
Minnesota Department of Human Services’ MnCHOICES website.
For further information or advocacy services, contact The Arc Minnesota at 952-920-0855 or toll-free at 833.450.1494 or visit www.arcminnesota.org. (Please note: This document is not legal advice, and should not be construed as such. Thus, no information herein should replace the sound advice of an attorney.)
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