Medical Assistance

2.1.2.3 County Residency

Medical Assistance (MA) has rules about county residence. County residency policy determines the:

  • County of service

  • County of financial responsibility

County of Service

County of service (also known as Servicing Agency) refers to the county agency that is responsible for ongoing case management after an application has been processed and eligibility has been determined, including, but not limited to:

  • Accepting and acting on changes in circumstances

  • Processing renewals

  • Gathering proofs and documentation

  • Issuing manual notices

  • Recording actions and information in case notes

  • Processing subsequent applications for new household members

The county of service is determined based on where an enrollee lives.

 

For applications submitted through METS, the servicing agency is assigned by METS when eligibility is pending or approved.

County of Financial Responsibility

The county of financial responsibility is responsible for paying the county share of MA services. The county of financial responsibility is the county where the person lives on the day the county receives a written request for assistance, except in the following circumstances:

  • When an enrollee moves to a different county, the new county becomes the county of financial responsibility after two full calendar months following the month of the move.

  • When an applicant moves to a new county during the application processing period the county in which the client resided at the time the application was submitted is financially responsible, whether or not the county that received the application  has acted on the application. The new county becomes the county of financial responsibility after two full calendar months following the month of the move.

    • Example: John applied for MA in County A on October 4th. On October 20th, he submits all required information to County A and reports that he moved to County B on October 15. County A finishes processing the application and determines John is eligible for MA. County B becomes the county of financial responsibility beginning January 1. November and December are the two full calendar months after the month John moved.

  • When a person lives in an excluded time facility or receives excluded time services, the county of financial responsibility is the county in which the person lived immediately before the excluded time started.

  • When a person leaves an excluded time facility or no longer receives excluded time services, and lives in a county other than the one in which the person lived immediately before the excluded time started, the new county becomes the county of financial responsibility after two full calendar months following the month the excluded time ends.

Excluded Time

Excluded time facilities and situations include:

  • Hospitals

  • Long-Term Care Facilities (LTCF)

  • Shelters (other than emergency shelters)

  • Halfway houses

  • Foster homes for children receiving Title IV-E and Non-Title IV-E Foster Care

  • Adult foster care

  • Board and lodging facilities

  • Maternity homes

  • Battered women's shelters

  • Correctional facilities

  • Regional treatment centers (RTC)

  • Placement in a facility based on an emergency hold

  • Placements in day training and habilitation programs

  • Assisted living services

  • Placements with an indeterminate commitment, including independent living

A person may receive excluded time services while living at home or in a group living situation. Excluded time services include:

  • Participation in a rehabilitation facility which meets the definition of a long-term sheltered workshop

  • Receiving services from a Semi-Independent Living Services (SILS) Program

  • Receiving integrated community supports or day support services

  • Participation in day training and habilitation programs

Safe at Home

When a person is a Safe at Home (SAH) program participant, they use a PO Box address assigned to them. SAH provides a mail forwarding service. The county of financial responsibility and county of residence are the county in which the person lives. More information about SAH Address Confidentiality Program is available from the Minnesota Secretary of State.

Legal Citations

Minnesota Statutes, section 5B, subdivision 1 to 13

Minnesota Statutes, section 256G.02, subdivision 4

Minnesota Statutes, section 256G.02, subdivision 6

Minnesota Statutes, section 256G.07, subdivision 1

Minnesota Statutes, section 256J.75, subdivision 2

Published:  November 1, 2024

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