Home and Community Based Services for People with Brain Injury
Authored By: Minneapolis - Mid-Minnesota Legal Aid, MN Disability Law Center
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Home and Community-Based Services for People with Brain Injury
What is "brain injury?" +
There are several legal and medical definitions for “brain injury” (BI) or “traumatic brain injury” (TBI). For most social service programs in Minnesota, TBI includes any “sudden insult or damage to the brain or its coverings” as long as it happens after birth.
BI is a broader term and also includes “acquired” brain injuries, like those caused by seizures, infectious diseases, or strokes. BI can also include degenerative diseases that cause cognitive damage like multiple sclerosis (MS). Recently, Minnesota has begun to use BI to describe the services available for persons with any brain injury sustained after birth.
What services can I get from Medical Assistance (MA)? +
There are many programs that provide home and community-based services and supports for eligible people with BI disabilities. People with BI who qualify for Medical Assistance, may be able to get:
- cognitive rehabilitation therapy
- adult rehabilitative mental health services
- home health aide and nursing services
- various home health therapies
- personal care assistant services
- medical supplies and equipment, and
- medical transportation services
Are there other support services available? +
Minnesota has a “Family Support Grant” (FSG) program that provides state cash grants of up to $3,113.99 per year to families of children with certified disabilities. The goal of the FSG program is to prevent or delay out-of-home placement of children with disabilities and promote family health and social well-being by providing access to family-centered services and supports.
- Click on People We Serve
- Click on People with Disabilities
- Click on Services
- Click on Home and Community Services
- Click on Programs and Services
- Click on Family Support Grant
Apply at your local county agency.
- Counties offer some home and community-based services through their “Vulnerable Children and Adults Act” programs. Check with your local county to see if it has programs or services specific to BI.
- The Minnesota Department of Employment and Economic Development, Rehabilitation Services branch, also offers vocational services and supports. See our fact sheet D-5 Assistive Technology and Supported Employment.
- You might also be able to get services through the “Essential Community Supports” program if you need help to live in the community. You have to meet certain eligibility rules. It is designed for people who don’t need the level of care provided in a nursing home. You may qualify for up to $424 a month for services and supports.
What is the BI Waiver? +
The BI Waiver is the main program providing home- and community-based services for persons with BI. The BI Waiver is part of the Medical Assistance program. The Disability Services Division of the Minnesota Department of Human Services administers the waiver with help from county social service agencies.
The Waiver gives services and support so people can live in the community and be more independent instead of in hospitals or nursing facilities.
The Waiver covers services and support that you might not be able to get under regular Medical Assistance. Both children and adults can use the waiver.
With the Waiver you can live in your own home or:
- in a biological or adoptive family’s home
- in a relative’s home
- in a family foster care home
- in a corporate foster care home
- in a board and lodging facility
- in an assisted living facility.
If you are married, you can get BI Waiver services while living at home with your spouse.
What services can I get with a BI Waiver? +
It depends on your abilities and needs. The following services and supports are available with a BI Waiver:
- 24-hour emergency assistance
- Adult companion services
- Adult day care services/Adult day care bath
- Assisted living services
- Behavioral support
- Caregiver living expenses
- Case management and case aide services
- Chore services
- Consumer-Directed Community Supports (a self-directed option for managing services)
- Customized living services
- Environmental accessibility adaptations
- Extended home care services (including nursing)
- Family counseling and training
- Foster care
- Home-delivered meals
- Homemaker services
- Housing access coordination
- Independent living skills training and therapies
- Night supervision services
- Personal emergency responses systems (PERS)
- Prevocational services
- Residential care services
- Respite care
- Specialist services
- Specialized equipment and supplies
- Structured day program services
- Supported employment services
- Transitional services
Who is eligible for the BI Waiver? +
Eligibility depends on a screening process. To be eligible for the BI waiver, you must meet all these criteria:
- Be on Medical Assistance (MA) or be eligible for MA
- Have a documented diagnosis of:
- traumatic or acquired brain injury, or
- an acquired or degenerative disease where cognitive damage is present. But it cannot be “congenital” (present at birth)
- Have significant/severe behavioral and cognitive problems because of the injury
- Be under the age of 65 when you apply
- Be certified as disabled by the State Medical Review Team or by the Social Security Administration
- Need the kind of care you get in a nursing facility (NF) or neuro-behavioral (NB) hospital
- Choose services in the community instead of services in a nursing facility or neuro-behavioral hospital
- Be assessed at Level IV or above on the Rancho Los Amigos Levels of Cognitive Functioning Scale (this measures how a person functions after experiencing a BI).
How do I apply for the BI Waiver? +
You can apply through your local county social service agency. The county will arrange for a comprehensive assessment of your eligibility and service needs and can help you get any necessary health evaluations completed. To find your local office, go to www.mn.gov/dhsand click on Contact Us for a link to a list of county agencies.
Will I automatically get BI Waiver services if I am found eligible for the Waiver? +
Usually, yes. The county will ask the following questions to be sure that you need waiver services:
- Are the services necessary to ensure your health, welfare and safety?
- Have all options been reviewed and does this option meet your needs and preferences?
- Is the cost of the service considered reasonable and customary?
- Is the service covered by any other funding source, like Medical Assistance state plan services, private health care coverage, Medicare, education or Vocational Rehabilitation Service funding?
What can I do if the county decides I am not eligible for the BI Waiver? +
If your county refuses to assess you for the BI Waiver or says you are not eligible, and you disagree with them, you can ask for an administrative appeal with the Department of Human Services.
Ask for your appeal from the county or from the Appeals and Regulations Division of the Department of Human Services. You have to ask in writing and you have to ask within 30 days of getting the notice from the county that you were denied. You have 90 days if you have a good reason why.
You can fill out a form and submit your appeal online.
- Click on Government Benefits
- Click on Appeal a Decision for Denied, Reduced or Cut-Off Benefits
Read it carefully, fill it out completely and click "Submit" on the bottom right. It is a good idea to print a copy for yourself.
You can also print the blank form if you want to fill it out by hand or write a simple letter stating what service you were asking for, what the county did, and why you want to appeal.
Mail or fax your letter to:
Minnesota Department of Human Services
P.O. Box 64941
St. Paul, MN 55164-0941
fax number 651-431-7523.
How can the Minnesota Disability Law Center help? +
The Minnesota Disability Law Center (MDLC) is the state’s protection and advocacy system for persons with disabilities. MDLC gets federal funds for that purpose.
If you have a BI, MDLC staff can help you find the right services. MDLC can also help you with other civil legal issues like abuse, neglect and rights violations.
The Minnesota Disability Law Center provides free legal help and advice to people with disabilities in Minnesota. Contact us at:
Metro: (612) 334-5970
TDD: (612) 332-4668
Toll Free: 1-800-292-4150
Minnesota Disability Law Center
430 First Avenue North, Suite 300
Minneapolis, MN 55401-1780