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Get the free Home and Community-Based Services (HCBS) Waiver Assurances - dhs state mn

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This document outlines the requirements and assurances associated with Home and Community-Based Services (HCBS) waivers under Medicaid, detailing state responsibilities and necessary assurances to
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How to fill out home and community-based services

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How to fill out Home and Community-Based Services (HCBS) Waiver Assurances

01
Gather necessary documents and information required for the HCBS Waiver Assurances.
02
Review the specific requirements outlined by your state’s Medicaid program for HCBS Waiver Assurances.
03
Complete the application form, ensuring that all sections are filled out accurately.
04
Provide detailed descriptions of services that will be offered to the individual receiving services.
05
Include any necessary supporting documentation, such as medical records or service plans.
06
Submit the application to the appropriate reviewing authority for approval.
07
Follow up with the authority if no response is received within the expected timeframe.

Who needs Home and Community-Based Services (HCBS) Waiver Assurances?

01
Individuals who have disabilities and require assistance with daily living activities.
02
Elderly individuals needing support to remain in their homes and communities.
03
People with chronic illnesses who need assistance but prefer not to live in institutional settings.
04
Caregivers and family members looking for additional support through state-funded services.
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This includes controlling personal resources; being treated with privacy, dignity, respect, and freedom from coercion and restraint; deciding what and when to eat; having visitors; being able to lock doors; and having the protections of a lease or other legally enforceable agreement.
Types of HCBS Care Home health care, such as: Skilled nursing care. Durable medical equipment. Case management. Personal care. Caregiver and client training. Health promotion and disease prevention. Hospice care (comfort care for patients likely to die from their medical conditions)
The HCBA Waiver provides care management services to persons at risk of nursing home or institutional placement. The care management services are provided by a multidisciplinary Care Management Team (CMT) comprised of a nurse and social worker.
There are two financial eligibility requirements for Home and Community Based Services (HCBS) Waivers – an asset limit and an income limit. In most states in 2025, the individual asset limit for HCBS Waivers is $2,000 and the individual income limit is $2,901/month.
You may qualify for a fee waiver if your household income is at or below 150% percent of the Federal Poverty Guidelines when you file.
There are two financial eligibility requirements for Home and Community Based Services (HCBS) Waivers – an asset limit and an income limit. In most states in 2025, the individual asset limit for HCBS Waivers is $2,000 and the individual income limit is $2,901/month.

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Home and Community-Based Services (HCBS) Waiver Assurances are commitments made by states to provide services to individuals with disabilities or elderly individuals in their homes and communities rather than in institutions, ensuring that funding and care meet established quality and accessibility standards.
States operating HCBS waivers are required to file HCBS Waiver Assurances as part of their submission to the Centers for Medicare & Medicaid Services (CMS) to demonstrate compliance with federal requirements and to access federal funding.
To fill out HCBS Waiver Assurances, states must provide detailed information on the waiver's design, including eligibility criteria, the services provided, the providers involved, and the quality assurance measures in place. This includes completing required forms and ensuring that all criteria outlined by CMS are met.
The purpose of HCBS Waiver Assurances is to ensure that individuals receiving services in community settings are offered the same level of care and support they would receive in institutional settings while promoting independence, choice, and inclusion in the community.
The information that must be reported on HCBS Waiver Assurances includes details about service provisions, the population served, provider qualifications, quality assurance measures, outcome tracking, and compliance with federal and state regulations to ensure the effective implementation of services.
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