Elderly Waiver Rate Caps Increase January 1

Posted on November 18, 2020 by Jeff Bostic

The customized living and overall case mix caps in the Elderly Waiver (EW) program increase effective January 1 because they are tied to the increase in care center rates. The customized living caps increase by 3.64%, which is the amount of the 2020 care center increase, and the overall EW caps are going up by 3.60% due to some minor rate changes in a couple of EW services. Members should be aware that, particularly for any clients who are near one or both of those caps, the higher cap will allow the case manager to authorize additional services that they have not been able to authorize previously.

Unfortunately, the service rates for customized living and most other services have not increased. The Legislature has not authorized any increases despite our advocacy and a DHS study showing that the current rates are far short of the cost of providing these vital community services even prior to the impact of the pandemic. LeadingAge Minnesota and our LTC Imperative partner have approved a legislative agenda for 2021 that prioritizes further implementation of the new EW rate system, and we are hopeful that despite the state’s pandemic-related budget challenges that progress can be made in the next session.