Monitoring Technology Policy and Form Review Page


Below we have provided links to a Proposed Policy Document, which is a new document for stakeholder review, and revised forms for the Monitoring Technology (MT) Review Panel process.  A number of changes have been made to the earlier versions of the forms including:
  • Reduced instances in which the use of MT must go through the State review process
  • Reductions in text fields requiring the case manager to provide written explanations
  • Elimination of non-essential or non-critical information for State level review
  • Elimination of most items that duplicate information contained in the Community Support and Services Plan
  • Improvements to make the process more person-centered

Please provide your feedback about these documents in the comments section of this page or email Andrew@hcbs.info

Proposed Policy Document (New)

This document provides the proposed MT policy language. The State will collect feedback through the blog about this language until October 17, 2014.  After that date, the Department will be using the feedback to develop proposed language for amendments to the waivers.  The content of this document includes:
  1. A definition of monitoring technology falling within the scope of the policy, and a clarification regarding other types of technology not included in the scope of the policy.
  2. Conditions related to the use of Monitoring Technology Services.
  3. A description of the authorization process, including a description of when a State level review is required and timelines for State level review determinations.
  4. Health and welfare assurances required for Monitoring Technology Services.
  5. Requirements for evaluating the effectiveness of Monitoring Technology Services.
  6. An explanation of the proposed scope of coverage under the MN HCBS waivers once federal approval is received.
To access this document, click here

Monitoring Technology Review Forms

Below are links to each of the forms that are currently proposed to be used for the MT Review Process. Although the forms contained here are the final forms for use in piloting the new review process, stakeholders may continue to offer feedback about any portion of the forms.  Feedback offered during the pilot period will be reviewed and considered for making further changes.
The State is particularly interested in hearing from Lead Agencies regarding whether there should be separate forms based on housing status (e.g., person lives in own home, provider-owned) to help in assuring that attention is paid to meeting the new federal HCBS settings regulations that affect residences owned or controlled by provider agencies.  


      1. Participant Consent – Covers information necessary for obtaining informed consent of
the individual or legal representative during the development of the CSSP.
     2. Consent for Affected Individuals – Covers information necessary for obtaining informed
   consent of individuals affected by but not using MT.
     3. Lead Agency Assurances – Provides documentation that the Lead Agency has reviewed and
   is in agreement with the plan for using MT.
     4. Approval Request Coversheet – Provides the State MT Review Panel with additional critical
   information about the plan for using MT
a.      Initial Application – Used for new MT requests
b.      Reauthorization – Used for reauthorizations in which there has been a significant change (defined in proposed policies)

If you have any questions about these documents, please email Andrew@hcbs.info



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