*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***
Effective: September 1, 2011 |
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13.05.05 - Institutional Residence |
Archived: June 1, 2016 (Previous Versions) |
This section provides guidance on the federal regulations that apply when MA clients enter institutions.
State Residency for MA Clients Living in an Institution.
Age 18 or Older or Under Age 18 and Emancipated.
Interstate Compact on Mental Health.
State Residency for MA Clients Living in an Institution
Age 18 or older or under age 18 and emancipated
The state of residence for a client in an institution is the state where the institution is located, in which the client is living indefinitely or intends to remain permanently, unless an exception applies.
Exceptions:
n Unless placed through the Interstate Compact on Mental Health, an applicant placed in an institution by another state is not eligible for MHCP; the placing state remains the state of residence so the applicant does not meet Minnesota state residency requirements.
Note: ”Placed in an institution by another state” means any agency of another state and agencies under contract with the state, including a county agency, that arranges for an individual to be placed in an institution located in another state. Providing information to the individual or the individual’s family does not constitute arranging a placement.
n The state of residence for an institutionalized client who became incapable of indicating intent before age 18 is the state of residence of:
m At application:
q The parent applying on the client’s behalf; or
q The guardian.
m At placement:
q The parent; or
q The guardian.
The state of residence for clients living in an institution who are not emancipated is the state of residence of:
n At application:
m The parent applying on the client’s behalf; or
m The guardian, if parental rights are terminated.
n At placement:
m The parent; or
m The guardian, if parental rights are terminated.
If the client has been abandoned by his or her parents and does not have a guardian, the state of residence is the state where the client lives.
Minnesota and North Dakota have an interstate agreement that governs state residence for people who reside in one state and enter a nursing facility in the other state. The agreement applies only to skilled nursing facilities (nursing homes). It does not apply to any other type of living arrangement such as assisted living, boarding homes, medical hospitals, or receipt of home and community-based waiver services.
l North Dakota to Minnesota.
A North Dakota resident who moves to a Minnesota nursing facility from North Dakota remains North Dakota's financial responsibility and is not eligible for MHCP’s because the client does not meet Minnesota state residency requirements:
n for 24 months following the date of admission if the person has no community spouse living in North Dakota and was not placed in the facility by North Dakota, or until such time as a Minnesota state or county agency assumes responsibility for the person’s care, whichever comes first.
n for at least 24 months following the date of admission and indefinitely after the 24 months as long as the person has a community spouse living in North Dakota, unless a Minnesota state or county agency assumes responsibility for the person’s care.
n for at least 24 months following the date of admission if the person was placed in the facility by North Dakota and indefinitely after the 24 months, unless a Minnesota state or county agency assumes responsibility for the person’s care.
l Minnesota to North Dakota.
A Minnesota resident who moves to a North Dakota nursing facility from Minnesota remains Minnesota's financial responsibility:
n for 24 months following the date of admission if the person has no community spouse living in Minnesota and was not placed in the facility by Minnesota, or until such time as a North Dakota state or county agency assumes responsibility for the person’s care, whichever comes first.
n for at least 24 months following the date of admission and indefinitely after the 24 months as long as the person has a community spouse living in Minnesota, unless a North Dakota state or county agency assumes responsibility for the person’s care.
n for at least 24 months following the date of admission if the person was placed in the facility by Minnesota and indefinitely after the 24 months, unless a North Dakota state or county agency assumes responsibility for the person’s care.
Interstate Compact on Mental Health and State Operated Services (SOS)
The Interstate Compact on Mental Health is an agreement between 46 states, including Minnesota, which allows a state to transfer a patient directly from a state-operated treatment facility to a state-operated treatment facility in another state. The purpose of the Compact is to enable a family member of a patient who meets certain criteria to request that the patient receive treatment closer to the family member. Patients are not transferred under the compact for the purpose of short term hospitalization with the intent that they will be returning to the state they came from. Transfer means the patient wants to transfer to Minnesota for continued treatment and to assume residency in the receiving state.
DHS has a Compact Coordinator who works with the county where the patient’s family member is residing when a request for a transfer is received from another Compact state. Prior to authorizing a transfer under the Compact, the Compact Coordinator obtains agreement from the affected county to accept financial and social service responsibility for the patient.