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Date: July 6, 2020
To: Lead agency staff and people who use Alternative Care, Consumer-Directed Community Supports, Elderly Waiver and Essential Community Supports forms and worksheets
From: DHS Aging and Adult Services Division
Purpose of E-Mail: To announce updates to AC, CDCS, EW and ECS forms and worksheets
Effective Date: Immediately
Contact: dhs.aasd.hcbs@state.mn.us
Updated AC, CDCS, EW and ECS forms and eligibility worksheets
DHS updated the following forms and worksheets:
Alternative care (AC):
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DHS-2630-ENG Alternative Care Program Eligibility Worksheet for Unmarried Individuals or Married Couples When Both May Choose the Alternative Care Program or a Married Person Whose Spouse Is an EW Recipient or Is Living in a Nursing Facility
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DHS-2630A-ENG Alternative Care Program Eligibility Worksheet for a Married Person who has a Community Spouse
Consumer-directed community supports (CDCS):
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DHS-6633A-ENG CDCS Community Support Plan Addendum with 2020-21 Budget Increase
Elderly Waiver (EW):
Essential community supports (ECS):
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DHS-6683-ENG Essential Community Supports Program (ECS) Financial Eligibility Worksheet for unmarried individuals, married couples when both are applying for ECS and married couples when spouse is on AC, EW or in a nursing home
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DHS-6683A-ENG Essential Community Supports Program (ECS) Eligibility Worksheet for a Married Individual when only one spouse is requesting services
All forms are posted to eDocs. Please begin using the updated versions immediately.
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