Elderly Waiver providers that provide a DHS Enrollment Required Service, such as Adult Day Care, must be enrolled with the Minnesota Department of Human Services (DHS). Please go to the DHS link below to begin the enrollment process:

Provider Enrollment

What is an Elderly Waiver Provider?

The Elderly Waiver (EW) program is a federal Medicaid waiver program that funds home and community-based services for people age 65 years and older who are eligible for Medical Assistance (MA) and require the level of care provided in a nursing home and choose to reside in the community. Eligible EW recipients can receive waiver services and MA services funded through HealthPartners Minnesota Senior Care Plus (MSC+) or Minnesota Senior Health Options (MSHO).

• The cost of care for a member must be lower than the cost of care to have the member stay in a nursing home.
• Additional information can be found on the DHS EW Services website.
• Please note that HealthPartners does not have a contract for DHS Enrollment Required (formerly Tier 1) services. HealthPartners uses the DHS Open Network.

Providers who are considered eligible to provider DHS Enrollment Required EW Services will be listed on the MinnesotaHelp.Info website. You may access the website via the link MinnesotaHelp.Info.

What services are covered under EW?

As defined by DHS, services include, but not limited to, the following:

DHS Enrollment Required (formerly Tier 1)

• Adult Day Care
• Companion Services
• Home Delivered Meals (e.g, Meals on Wheels)
• Homemaker Home Management
• Homemaker ADL Assistance
• Respite Care

Approval-Option Direct Delivery (formerly Tier 2)

• Chore Services
• Home and Vehicle Modifications Installation
• Homemaker-Cleaning Only
• Transition Services/EW related supports

Approval-Option Purchased Items (formerly Tier 3)

• Family Caregiver Training & Education
• Home & Vehicle Modification Expenses
• Transitional Service Items & Expenses

How do I become a contracted EW Provider for Approval-Option Direct Delivery or Approval-Option Purchased Items Services?

In order to be considered for a contract for Approval-Option Direct Delivery or Approval-Option Purchased Items EW Services, the provider/vendor must:

• Must be licensed with DHS for applicable service types
• Be able to meet HealthPartners quality standards
• Have completed criminal background checks for all employees

Interested providers/vendors may complete a Provider Contract Inquiry for consideration.

DHS Enrollment Required providers must be enrolled with DHS and once enrolled are considered in network. Direct contracting is not required

I'd like to provide EW services to a HealthPartners Member:

Please contact HealthPartners Member Services to obtain benefit information and for direction on providing care at:

Local: (952) 883-7979
Toll Free: 1-800-233-9645

 

What is Personal Care Assistance?

Personal Care Assistance (PCA) services provide assistance and support for the elderly (age 65 and older) to help them live independently in the community. HealthPartners covers PCA services for members on MSHO and MSC+. (Note that individuals in Medical Assistance, MinnesotaCare, and Special Needs BasicCare who are eligible for PCA should work with their county to receive services.

• Additional information can be found at DHS PCA Services.

The Personal Care Assistant (PCA) is the person who provides assistance and support to the recipient who needs help with their activities of daily living through hands on assistance, supervision, redirection/intervention of behaviors including observation and monitoring. A PCA is limited to providing and being paid for up to 275 hours per month of PCA regardless of the number of recipients being served or the number of PCA provider agencies the PCA is enrolled with.

PCA agencies must enroll individual PCAs with MHCP and affiliate individual PCAs with their agencies.

• Additional information about enrollment/affiliation criteria of the individual PCA can be found at Individual PCA Enrollment Criteria.

What Services are considered to be PCA Services?

As defined by DHS, there are four categories of Personal Care Assistance service eligible for Medicaid Payment:

• Activities of daily living (ADLs): Bathing, dressing, toileting, grooming assistance, eating, etc.
• Health-related procedures and tasks
• Observation and redirection of behaviors
• Instrumental activities of daily living (IADLs): Assist with paying bills, plan and prepare meals, etc.

Providing PCA services to a HealthPartners Member:

Please contact HealthPartners Member Services to obtain benefit information and for direction on providing care at:

Local: (952) 883-7979
Toll Free: 1-800-233-9645

HealthPartners PCA Network:

The HealthPartners PCA network is currently closed. Contract requests will be reviewed on the needed basis. Providers located in our 12 county service area that are able to meet unique needs or have PCAs with specialized training are encouraged to submit applications to be part of our network. PCA providers that can guarantee availability of PCAs willing to take new cases will be given priority status to be added to our network.