This section provides information on the following Minnesota state programs for the elderly—Long-Term Care Consultation Services, the Alternative Care program, essential community supports, Group Residential Housing, and programs administered by the Minnesota Board on Aging.

Long-Term Care Consultation Services

Long-term care consultation services provide screening, assessment, and information and education services to help individuals access and decide on the appropriate level of long-term care services that meet their needs and reflect their preferences. Long-term care consultation services are available to any individual with long-term or chronic care needs.

State law requires all applicants to MA-certified nursing facilities to be screened prior to admission to determine if they need a nursing facility level of care. This preadmission screening is a face-to-face assessment conducted by a certified assessor.

Each county has a long-term care consultation team of certified assessors that includes a social worker and a public health nurse or registered nurse.

Counties are also required, as part of preadmission screening, to assess individuals to determine whether alternatives to nursing facility care, such as Alternative Care services and elderly waiver services, are appropriate.

The total annual expenditure for long-term care consultation services in fiscal year 2016 was $103.5 million.

Alternative Care Program

The Alternative Care program (AC) provides home and community-based services to individuals who are not MA enrollees, but who are at risk of nursing facility placement.

In order to qualify for AC services, individuals must:

  • be age 65 or over;
  • screened by a long-term care certified assessor, be determined to need nursing facility level care, and choose community care; and
  • have a gross monthly income that is greater than 120 percent of FPG, or have gross assets greater than the standard MA asset limit, and have combined assets and income no greater than the cost of 135 days of nursing facility care.

In addition, the monthly cost of alternative care services must not exceed 75 percent of the MA payment rate for nursing care for the person’s case-mix classification.

Services available through AC include the following:

  • Adult day care
  • Caregiver training and education
  • Case management
  • Chore, companion, and homemaker services
  • Home care and personal care services
  • Home-delivered meals
  • Environmental modifications and adaptations
  • Nonmedical transportation
  • Nutrition service
  • Respite care
  • Specialized supplies and equipment
  • Telehomecare

Enrollees meeting certain income and asset criteria are required to pay a monthly fee to help offset the cost to the state of providing AC services.

The AC program was a state-funded program until fiscal year 2014 when the state began receiving federal MA funding as well.

AC program statistics for fiscal year 2016:

  • Total expenditures: $27.1 million
  • Monthly average recipients: 2,574
  • Average monthly cost per recipient: $882

Essential Community Supports

The essential community supports (ECS) program provides targeted services to persons age 65 and older who need essential community support, but whose needs do not meet the nursing home level of care.

Services must be available to a person who:

  • is age 65 or older;
  • is not eligible for Medical Assistance (MA);
  • has received a community assessment and does not require the level of care provided in a nursing facility;
  • meets the financial eligibility criteria for the alternative care program;
  • has a community support plan; and
  • has an assessed need for at least one of the support services offered under ECS in order to maintain his or her community residence.

Transitional ECS may be available to a person who:

  • is age 21 or older;
  • lives in his or her own home or apartment;
  • meets the financial eligibility criteria for AC;
  • was receiving nursing facility services or home and community-based long-term services and supports on January 1, 2015;
  • lost eligibility for continuing Medical Assistance payment of nursing facility services or home and community-based long-term services and supports at his or her 2015 annual assessment due to the changes in the nursing home level of care standard;
  • is not eligible for personal care attendant services; and
  • has an assessed need for at least one of the support services offered under ECS in order to maintain his or her community residence.

Services available through ECS include the following:

  • adult day services
  • caregiver support
  • homemaker support
  • chore services
  • a personal emergency response device or system
  • home-delivered meals
  • community living assistance
  • service coordination/case management (not to exceed $600 per person in a 12-month authorization period)

ECS benefits are limited to $424 per person per month.

ECS program statistics for fiscal year 2016:

  • Total expenditures: $624,312
  • Monthly average recipients: 222
  • Average monthly cost per recipient: $234

Group Residential Housing (GRH)

GRH is a state-funded income supplement program that pays for room-and-board costs for low-income adults residing in a licensed or registered setting with which a county human services agency has negotiated a monthly rate.

In order to be eligible for GRH payments, a person must have county approval for residence in a GRH setting and must: (1) be aged, blind, or over 18 years old and disabled, and meet specified income and asset standards; or (2) belong to a category of individuals potentially eligible for General Assistance and meet specified income and asset standards.

Beginning July 1, 2015, the GRH basic room and board rate is $891 per month. Recipients in certain GRH settings may also qualify for a supplemental payment that is in addition to the GRH basic room and board rate. GRH pays for room and board in a number of licensed or registered settings, including:

  • adult foster care;
  • board and lodging establishments;
  • supervised living facilities;
  • noncertified boarding care homes; and
  • various forms of assisted living settings registered under the Housing with Services Act.

Persons residing in a setting with a GRH rate are usually considered to be living in the community in their own home. As such, these persons can receive services from most community sources, such as home care and home and community-based waiver programs.

GRH program statistics for fiscal year 2016:

  • Total expenditures: $149.5 million (general fund)
  • Average monthly recipients: 19,627
  • Average monthly payment per recipient: $635

Programs Administered by the Board of Aging

The Minnesota Board on Aging is a 25-member board whose members are appointed by the governor. Board staff is provided by DHS and the board is housed within that agency. One of the duties of the board is to administer programs funded through the federal Older Americans Act (OAA). The board is the agency designated by the state to receive OAA funds for distribution to Area Agencies on Aging.

In fiscal year 2016, the board received about $25.9 million in federal funds and $18.3 million in state funds for programs that it administers. Some of these programs are described below.

  • Senior LinkAge Line and related information and assistance services. A free telephone service that provides elderly persons with information on and assistance in accessing a range of community services, such as transportation, housing, home care, chore help, caregiver support, meal delivery and nutrition, access to prescription drugs (through RxConnect), and health insurance counseling. The Senior LinkAge Line phone number is1-800-333-2433.
  • MinnesotaHelp. Provides individuals with information and guidance on long-term care planning, decision-making, and resources. Individuals can access a directory of long-term care, health care, housing, disability, and human services providers and organizations at www.MinnesotaHelp.info. The information provided can be tailored to the location and needs of the individual.
  • Senior Nutrition Services. Senior dining services (also referred to as congregate meals)provide nutritionally balanced meals to individuals age 60 and over, and their spouses, at various sites in the community. Home-delivered meals provide meals to homebound individuals age 60 and over in their place of residence. There is no charge for these services, but donations are requested to pay for the cost. Each year about 47,000individuals are served congregate meals, 13,000 are served home-delivered meals, and grocery delivery is provided to 600 individuals.
  • Caregiver Grants. Grants provided to Area Agencies on Aging and service providers to fund respite care, education and training in caregiving, and support groups for family caregivers. In fiscal year 2015, $479,000 was appropriated from the state general fund for caregiver grants.
  • Dementia Grants. These grants are state-funded competitive grants for regional and local projects and initiatives to increase awareness of Alzheimer’s disease and other dementias, increase the rate of cognitive testing in the population at risk for dementias, promote the benefits of early diagnosis of dementias, or connect caregivers of persons with dementia to education and resources. Eligible applicants include, but are not limited to, community health boards, school districts, colleges and universities, community clinics, tribal communities, nonprofit organizations, and other healthcare organizations. For fiscal year 2017, $750,000 was appropriated from the state general fund for dementia grants.
  • Minnesota Senior Corps. A network of programs that provide elderly persons with volunteer opportunities. The Retired and Senior Volunteer Program (RSVP) assists persons age 55 and over in volunteering at hospitals, youth recreation centers, and other community organizations. The Senior Companion Program (SCP) allows seniors age 55and over to assist at-risk, frail elderly in daily living tasks. The Foster Grandparent Program (FPG) allows seniors age 55 and over to serve as mentors, tutors, and caregivers for children and youth with special needs. Each year more than 20,000 volunteers provide services through these programs. In fiscal year 2015, $1.988 million was appropriated from the state general fund for Minnesota Senior Corps.
  • Ombudsman for Long-Term Care. This office serves as an advocate for and investigates and resolves complaints concerning health, safety, welfare, and rights for people receiving long-term care services. This office is primarily state funded, but also receives some OAA funding.

For more information about public assistance programs, visit the health and human services area of our website, www.house.mn/hrd/.

The content of this and any related posts has been copied or adopted from the Minnesota House of Representatives Research Department’s Information Brief, Long-Term Care Services for the Elderly, written by legislative analyst Danyell Punelli.