CBSM - Integrated community supports (ICS)

Page posted: 12/28/20

Page reviewed:

Page updated: 6/12/23

Definitions

Integrated community supports (ICS): Services that provide support and training/habilitation in community living service categories to adults age 18 and older who reside in a living unit of a provider-controlled ICS setting (e.g., apartment in a multi-family housing building). ICS can be delivered up to 24 hours per day in the person&#;s living unit or in the community.

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Note: For information about community living service categories, refer to the covered services section on this page.

Support in community living service categories: Cueing, skill maintenance, guidance, instruction, assistance with activities of daily living, assistance with coordination of community living activities or direct supervision within an allowable community living service category.

Training in community living service categories: Skill-building and instructional services to acquire, retain and improve the person&#;s experience living in the community within an allowable community living service category. Training must meet the person&#;s identified needs.

ICS setting: A setting in which a provider has an approved setting capacity report and has direct/indirect control over a person&#;s living unit. A provider has direct or indirect control over a person&#;s living unit when the provider either:

ICS settings have a minimum capacity of three or more living units for the delivery of ICS services.

An ICS setting does not meet the requirements for a person&#;s own home, community residential program or family residential program.

Living unit: A self-contained living unit (e.g., apartment) with living, sleeping, eating, cooking and bathroom areas.

Covered services

ICS covers training/habilitation and support to meet the person&#;s individualized assessed needs and goals in at least one of the community living service categories:

Community participation

This category may include:

Health, safety and wellness

This category may include:

Household management

This category may include:

1. Cueing, guidance, supervision, training or instructional support to complete routine household care and maintenance.

2. Household safety knowledge and skills.

3. Tenancy support and advocacy.

4. Training, assistance, support and/or guidance with:

Adaptive skills

This category may include:

Remote support

ICS can be delivered through remote support. Services delivered through remote support must meet all the requirements listed on CBSM &#; Remote support.

Secondary information

Choice in provider

A person who lives in an ICS setting is not required to receive ICS. However, when a person lives in an ICS setting, ICS can only be delivered by the provider who controls the setting. The provider who controls the ICS setting cannot deliver other HCBS services in the setting (except transportation and extended home care nursing).

When a person who lives in an ICS setting chooses not to receive ICS, they may choose to receive other services from another provider who does not control the setting.

A person who receives ICS may also receive the following services from a different provider (i.e., not the ICS provider):

The case manager must clearly define in the person&#;s support plan how ICS and the above services do not duplicate one another.

Roommates

If more than one person resides in a single living unit of an ICS setting, the ICS provider must:

Documentation

The lead agency must clearly document the person&#;s service needs and identify outcomes in the person&#;s support plan.

The ICS provider is responsible to provide written reports to the lead agency and the person at a minimum of once per year or the frequency established in the person&#;s support plan.

Transition plans

CBSM &#; ICS transition plans provide instructions and scenarios for lead agencies and providers to:

Setting requirements

ICS settings are considered home and community-based services (HCBS) provider-controlled settings. ICS settings have a minimum capacity of three or more living units for the delivery of ICS services.

For a list of approved ICS settings, refer to CBSM &#; Resource: ICS settings. The provider must comply with all requirements for HCBS settings in 42 C.F.R. 441.301(c). For more information about the HCBS settings rule, refer to DHS &#; HCBS settings transition plan.

If a person lives in an ICS setting and receives ICS from the provider who controls the setting, it is not considered a residential program (as defined on CBSM &#; Requirements for a person&#;s own home). Other units in the building might be considered:

Setting capacity report

Before an ICS provider can deliver services, they must submit a Setting Capacity Report, DHS- to DHS for each ICS setting, as required by Minn. Stat. Ch. 245D. An ICS provider&#;s license must be in good standing to receive approval for a new ICS setting. Only one HCBS provider may deliver ICS in the approved setting.

To submit a setting capacity report, the completed DHS- form to .

Capacity limit

ICS may be provided in:

Setting connected to an institution

The lead agency cannot authorize ICS for people who reside in a living setting that is adjoined to or on the same property as an institution (i.e., nursing facility, hospital, intermediate care facility for persons with developmental disabilities [ICF/DD], institution for mental disease [IMD]), or if the institution has any financial interest in the living setting.

Collocated settings

When a single provider leases or owns more than one service setting located on the same or adjoining property, the lead agency can only authorize services in one of the settings. A service setting includes a setting used to deliver any of the following services:

Exceptions to the collocated ICS settings policy

A provider may request an exception to the collocated settings policy to deliver ICS in two or more multi-family housing buildings that are part of the same multi-family housing apartment complex that are either:

The exception to the collocated settings policy requires:

When the ICS provider subleases a living unit

If the ICS provider rents a living unit from the property manager, the ICS provider must be able to demonstrate the authority granted by the property manager/owner to sublease that unit to people who receive ICS services. To comply with the HCBS settings rule, a person receiving services must have a lease that complies with the Minn. Stat. Ch. 504B landlord and tenant law.

Additional information

The ICS provider and their delegated staff members may not live in or otherwise occupy space in a person&#;s individual living unit for business-related purposes (e.g., office space, break room).

Site-specific review process

A site-specific review is required for:

The site-specific review is required to ensure the setting does not isolate or create a stigma for people living there.

Required information

Information the provider submits to DHS for the site-specific review must include, but is not limited to:

DHS will not approve the site-specific review if the information submitted does not:

Instructions

If a site-specific review is required for a setting based on the setting capacity report, DHS will contact the provider to obtain the required information. Technical assistance about the site-specific review criteria is available to lead agencies or providers upon request by submitting information using the DSD Contact Form.

Authorization, rates and billing

ICS is a framework service. The lead agency uses the Rate Management System (RMS) to determine rates. For more information, refer to CBSM &#; RMS and Long-Term Services and Supports Service Rate Limits, DHS- (PDF).

Excerpt of Transcript

The following is an excerpt from the transcript of the interview with the owner of the landscaping company: 

[Supervisor]: Thank you for meeting with me today. My assistant told me that your company had a landscaping contract with a homeowner who is refusing to pay for the work. Did you bring the contract with you?

[Owner]: Actually, we had two contracts with this homeowner. I didn&#;t bring them with me, but I can drop them off at your office tomorrow.

[Supervisor]: That&#;s great. Let&#;s start at the beginning. What is the problem you&#;re having with the homeowner on the first contract?

[Owner]: This homeowner recently built a new house and wanted the backyard to be landscaped as a large entertainment space. There is a historic oak tree in the backyard, and she wanted it to be featured in the landscaping design. I visited the property and sketched a plan for the project that featured the oak tree, and then I drew up a contract and attached the landscaping plan as an exhibit. The homeowner signed the contract and paid $70,000 of the $140,000 contract price as a deposit before we started the work.

[Supervisor]: Did you complete the project as it was described in the plan?

[Owner]: Yes. I did everything the homeowner requested, but now she&#;s refusing to pay the remaining $70,000 because she thinks we did something to damage the oak tree. She says the tree looks sick and that it might be dying. I guess the workers could have damaged its roots, but then again, it&#;s a very old tree.  

[Supervisor]: Okay, that gives me a good start on the issues concerning the first contract. Now tell me about the second contract.  

[Owner]: After we started work on the project, the homeowner asked if we could add a large fishpond to the backyard. I said we could do it for $20,000. She agreed to that and I drew up another contract, which she signed. I billed her when we finished the work, but now she&#;s refusing to pay the $20,000 for the fishpond until we do something about the oak tree. 
 
End of excerpt 

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