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Brain Injury (BI)

Elderly Waiver in Roseville, Minnesota

Page posted: 10/1/03		Page reviewed: 4/16/13	Page updated: 11/18/16
Legal authority	Federally approved BI Waiver Plan, Minn. Stat. §256B.093, Minn. Stat §256B.49
Background	Effective with the waiver renewal April 1, 2011, the name of this waiver changed from Traumatic Brain Injury to Brain Injury to accurately reflect the people eligible for this program. Please note you may continue to see references to the TBI Waiver in various forms, documents and CBSM pages as we work on implementing the name change. Thank you for your patience as we continue with these updates.
Definition	Brain Injury (BI) Waiver: Home and community-based services necessary as an alternative to institutionalization that promote the optimal health, independence, safety and integration of a person and who would otherwise require the level of care provided in a specialized nursing facility or neurobehavioral hospital.
Eligibility	To be eligible for the BI Waiver, a person must choose the BI Waiver and meet all of the following criteria: 1. Eligible for Medical Assistance 2. Certified disabled by Social Security or the State Medical Review Team (SMRT) 3. Under age 65 at the time of opening to the waiver 4. Determined by the case manager/service coordinator to meet one of the following level of care criteria : Nursing Facility (BI-NF) Neurobehavioral Hospital (BI-NB) 5. Have a completed BI Waiver Assessment and Eligibility Determination (DHS-3471) (PDF) 6. Diagnosed with one of the following documented diagnoses of brain injury or related neurological condition that resulted in significant cognitive and behavioral impairment: Acquired or traumatic brain injury that is not congenital Degenerative or genetic disease where cognitive impairment is present, becomes symptomatic on or after the person’s 18th birthday and is not congenital 7. Have the potential to benefit from rehabilitative services as determined by a Ranchos Los Amigos score of IV or above 8. Has an assessed need for supports and services over and above those available through the MA State plan 9. Has an assessed need for one or more of the following: Specialized provider with experience or expertise appropriate to meet the person’s cognitive or behavior impairments Higher amount of units or rate for services due to cognitive or behavior impairments Service only available through the BI Waiver, regardless of whether or not those needs are met by formal waiver services.
Covered services	The following services are covered under the BI Waiver. For a service-specific policy page, select a service from the list: 24-hour emergency assistance Adult companion services Adult day services Adult day services bath Behavioral support Caregiver living expenses Case management/service coordination Case management aide Chore services Consumer directed community supports (CDCS) Crisis respite Customized living Customized living 24-hour Environmental accessibility adaptations Extended home care services Family adult day services Family training and counseling Foster care Home-delivered meals Homemaker Housing access coordination Independent living skills (ILS) training ILS therapies Night supervision services Prevocational services Residential care services Respite Specialized supplies and equipment Structured day program Supported employment services Transitional services Transportation.
Local waiver program administration	Local county or tribal administration acting as agents for the state Medicaid agency and DHS have many responsibilities. See the state and county/tribal responsibilities for waiver management section on CBSM – Waiver programs overview.
Waiver forms	For a comparison grid of forms applicable across and/or specific to waiver programs, see CBSM – Required waiver forms .
Process and procedure	Out of state services Access Assessment Service planning Authorization Reassessment 65 years of age Changing waiver programs Termination
Additional resources	Brain Injury (BI) Waiver Program brochure, DHS-3442 (PDF) CBSM – Waiver/AC provider enrollment and standards CBSM – Waiver general process and procedures (BI, CAC, CADI, DD) CBSM – Waiver programs overview CBSM – Waiver rates and billing Comparison of LTCC, RSC and CAC, CADI and BI waivers for people with disabilities (PDF)