Programs You Think You Know
This Minnesota program serves adults 65+ who meet nursing facility level of care but are not Medicaid eligible.
What is the Alternative Care (AC) program?
This term refers to the delay between when a service is delivered and when it appears in claims data.
What is claims lag?
This acronym refers to Home and Community-Based Services.
What is HCBS?
This federal-state program is the largest payer of LTSS in the United States.
What is Medicaid?
This program is designed to delay or prevent nursing home placement for older adults not yet Medicaid eligible.
What is the Alternative Care (AC) program?
This waiver primarily serves older adults who would otherwise require nursing facility care.
What is the Elderly Waiver (EW)?
This measure reflects how many eligible individuals are actually receiving services.
What is utilization (or participation rate)?
This system is Minnesota’s primary source for Medicaid claims and payment data.
What is MMIS?
This requirement ensures that individuals receiving HCBS can choose among service options and providers.
What is person-centered planning (or choice of services/providers)?
These entities administer LTSS programs at the local level, including assessments and service planning.
What are lead agencies (counties and tribal nations)?
This service model allows participants to hire, train, and manage their own staff using an individualized budget.
What is CDCS (Consumer Directed Community Supports)?
This metric tracks the time between eligibility determination and the start of services.
What is time to service initiation (or access measure)?
This assessment tool is used in Minnesota to determine LTSS eligibility and service needs.
What is MnCHOICES?
This federal rule requires that HCBS be delivered in settings that are integrated and support full access to the broader community.
What is the HCBS Settings Rule?
This DHS division supports fiscal analysis, evaluation, and reporting for LTSS programs and policy decisions.
What is FARM (Fiscal Analysis & Results Management)?
This federal authority allows states to provide HCBS instead of institutional care by waiving certain Medicaid rules.
What is a 1915(c) waiver?
This distinction matters in LTSS data because one reflects when services occurred and the other when payment was issued.
What is service date vs. warrant date?
This review process evaluates whether lead agencies are meeting waiver and program requirements.
What is LAR (Lead Agency Review)?
This process refers to reassessing eligibility after the end of COVID-era continuous coverage policies.
What is unwinding?
This data source captures assessment results, including ADLs, level of care, and service recommendations.
What is the MnCHOICES LTC Screening Document?
This is the key eligibility threshold used to determine access to LTSS programs like EW and AC.
What is nursing facility level of care (LOC)?
This type of analysis attempts to estimate program impact by comparing similar groups with and without the program.
What is a matched comparison (or quasi-experimental design)?
These CMS-defined requirements outline evaluation and reporting expectations for Section 1115 demonstrations.
What are Special Terms and Conditions (STCs)?
This requirement ensures that services provided under a 1915(c) waiver do not cost more than institutional care.
What is cost neutrality?
This is the most common comparison group used in evaluating outcomes for the Alternative Care program.
What are Elderly Waiver (EW) participants?