2)  Housing Transition

Services that assist a person to plan for, find, and move to a home in the community.

Covered Services:

Activities with an asterisk (*) can be provided directly (in person or remotely working directly with the person) or indirectly on behalf of the person. The expectation is that services are primarily provided as a direct service. Documentation must indicate whether the service was provided as a direct (in person or remotely working directly with the person) or an indirect service. Refer to the Housing Stabilization Direct, Indirect, and Remote Services Chart for more guidance.

• Developing a housing transition plan*
• Supporting the person in applying for benefits to afford their housing, including helping the person determine which benefits they may be eligible for*
• Assisting the person with the housing search and application process*
• Assisting the person with tenant screening and housing assessments*
• Providing transportation with the person receiving services present and discussing housing related issues
• Helping the person understand and develop a budget
• Helping the person understand and negotiate a lease
• Helping the person meet and build a relationship with a prospective landlord
• Promoting/supporting cultural practice needs and understandings with prospective landlords, property managers*
• Helping the person find funding for deposits*
• Helping the person organize their move*
• Researching possible housing options for the person*
• Contacting possible housing options for the person*
• Identifying resources to pay for deposits or home goods *
• Identifying resources to cover moving expenses*
• Completing housing applications on behalf of the service recipient*
• Working to expunge records or access reasonable accommodations*
• Identifying services and benefits that will support the person with housing instability*
• Ensuring the new living arrangement is safe for the person and ready for move-in*
• Arranging for adaptive house related accommodations required by the person*
• Arranging for assistive technology required by the person*

Not Covered Services:

• Room and Board (including moving expenses)
• Deposits
• Food
• Furnishings
• Rent
• Utilities
• No-show appointments
• Staff travel time with a person not in the vehicle or the person is in the vehicle but Housing Stabilization Services is not discussed
• Direct or indirect services provision in a group setting
• Transition services from institutions if a person dies before discharge or transition services exceed 180 days
• Physically touring housing located outside of Minnesota

Housing transition services cannot duplicate other services or assistance available to the person.

Housing Transition Service Limitations:

• All housing transition services must be provided through a Medical Assistance enrolled provider.
• Housing transition is limited to 150 hours per transition. An additional 150 hours may be authorized by the Department for people who meet the exception requirements outlined in the Housing Stabilizations Eligibility Request Form (DHS-7948).
• A person must be planning to transition to somewhere that meets home and community-based setting requirements (excluding community residential settings or foster care licensed under 245D). These services may be provided in any community setting if the person is moving into a setting meeting home and community-based setting requirements (excluding community residential settings or foster care licensed under 245D) when the person moves in.
• This service can only be provided to a person transitioning to a less-restrictive setting. For a person transitioning from provider-controlled settings, the service is only provided to those transitioning to a private residence where the individual will be directly responsible for their own living expense.
• For a person living in an institutional setting, services may be furnished no more than 180 consecutive days prior to discharge and providers may not bill for services until the person has transitioned to a home and community-based setting (excluding community residential setting or foster care licensed under 245D). “Institution” is defined under Minn. Stat. 256B.0621, Subd. 2(3).
• Providers may only bill for housing transition services provided during the time the person was in an institution after the date the person is discharged from the institutional setting and enrolled in housing transition services. For example, services are case noted on the actual date of service, and then collectively billed the date the person is back in the community and enrolled in Housing Stabilization Services.
• A provider cannot provide housing transition services to the same person with whom the person-centered plan was created (Coordinated Services and Support Plan, Housing Focused Person-Centered Plan, MSHO/MSC+ Coordinated [Collaborative] Care Plan) without a DHS-approved provider shortage exception.
• A person cannot receive housing transition and Medical Assistance-funded Relocation Service Coordination (RSC) in the same calendar month.
• Housing transition services are not covered when a person is concurrently receiving housing sustaining services.
• A person receiving Moving Home Minnesota- transition services cannot also receive housing transition services.
• A person receiving Assertive Community Treatment (ACT) services cannot also receive housing transition services.

Important Definitions:

• Less restrictive setting: Where a person can move using Housing Stabilization transition services is based on whether the planned housing setting is less restrictive for that person. “Less restrictive” means the setting will allow the person more freedom, independence, and control over their daily lives than their current living situation. “Less restrictive” can also mean the setting will provide a safer living environment for the person, or will allow the person to increase or maintain community connections, or engage in more community activities.
  • The determination that a specific setting is less restrictive is based on the person’s unique situation, wants, and needs. For instance, an older person who has safety concerns while living independently can move to an assisted living building, if having the support allows them more freedom and independence. However, a young person moving out of their family home into an assisted living building controlled by the service provider is moving to a more restrictive setting.
  • A person cannot use housing transition services to move to a provider-controlled setting where 24-hour customized living BI or CADI waiver funded services will support the person once they move in unless the person is moving out of homelessness and also meets the definition of long-term homeless.
• Provider-controlled setting: A provider-controlled setting is a setting where the provider of MA-funded services also has direct or indirect financial interest or gain in the physical housing the person will live in.
• Directly responsible for their own living expenses: According to the MA state plan, a person moving from a provider-controlled setting can only use housing transition services to help the person move to a private residence where the person will be directly responsible (with or without income supports) for his/her/their own living expense. In Minnesota, outside of an institution, MA service payments are always separate from room and board costs and a person is always responsible for paying their living expenses (with or without income supports).

Other Service Information:

• A provider cannot require a person to have an identified or authorized housing funding source in order to receive services. Similarly, a provider cannot deny a person services because the person doesn’t have a housing funding source. Finding funding for housing is one of the key activities of transition services.
• A housing transition provider should share the service plan with the waiver case manager/care coordinator/targeted case manager/housing consultant who developed the person-centered plan covering Housing Stabilization Services within three months of service start.
• A person may change their housing transition service provider at any time. This change of provider must be updated and reflected in their person-centered plan developed by a waiver case manager/care coordinator/targeted case manager/housing consultant and uploaded into the eligibility review system as a provider change request by the new provider. The new provider will be paid for services starting with the new effective date.
• Providers in identified home and community-based settings, excluding foster care and assisted living (housing with services registration with comprehensive homecare license), can provide housing transition services to people living in housing owned and/or managed by a company associated with the provider delivering the service.
• Providers in foster care, assisted living (housing with services registration with comprehensive homecare license) or a setting not yet determined to meet home and community-based services settings rule cannot be reimbursed for housing transition services for people living in housing owned and/or managed by a company associated with the provider delivering the service except when the setting is specifically designed to be temporary such as a residential treatment facility, sober living house, halfway house, shelter, or time-limited supportive housing.
  • Note: If a person is in a setting that excludes the same provider from providing housing transition, a person must be able to access housing transition services by a provider not associated with the housing provider to move into a more integrated setting.