CM Update - February 2018

Key Highlights This Month:  

Financial analysis

• The contract for the case management redesign financial analysis has been signed with Navigant Consulting.  Navigant has worked with DHS on projects in the past including HCBS Rate Development and Implementation and the Inpatient Hospital Prospective Payment Reimbursement System. They have worked with multiple states to assess case management service delivery and payment systems.
• Navigant will start working soon with the 3 counties that are participating in the “current state” phase of the financial analysis (Carlton, Sibley, and Dakota) to gather financial data.  

Policy

• The policy team continues to have conversations about trying to understand what is happening. i.e state level folks talking about outcomes and how each area looks at outcomes. They may want to survey counties as to what they do to look at outcomes.  

SSTS and CMS Letter

• During a forum in August of 2017 on the Case Management Redesign Project, we had a discussion with MACSSA members about the SSTS (Social Service Time Study) and taking the opportunity of turnover in DHS to get more feedback data from DHS regarding the SSTS process, how to help counties look at budgeting more proactively and getting enough information to make meaningful policy and personnel decisions.  Additionally, another issue that we know is important is appropriate training for staff regarding SSTS time study.  It was recommended that a group from MACSSA meet with DHS finance to discuss. MACSSA has had that discussion with DHS and would like to follow up with the group and pass along some of the questions DHS had about process and whom to contact, and have a discussion on how to move forward from here. 
• There have also been new developments in the Case Management Redesign Project, including the receipt of a letter from federal CMS on Minnesota’s case management rate-setting practices, restating previous federal concerns that targeted case management rates for private providers are set locally without statewide consistency. The result of this letter will be an amped up the timeline for when we thought something would be implemented. DHS will be proposing back to CMS something ready to implement by 2021 which means legislative language will be needed by 2020.
• Also, as a result of the CMS letter, DHS is looking to pull another team together to assemble a more specific proposal in the next 6-8months.  DHS envisions this more specific, comprehensive proposal will address both the CMS letter and comprehensive Case Management Redesign.  This comprehensive proposal would then be looked at by the financial vendor and many other stakeholders so we want to be engaged early in this process.

Requested Actions Needed From MACSSA:  
We are proposing a topic forum for our March meeting to address the SSTS issue and the CMS letter.

New Trends in This Area:  
The CMS letter will drive the system to a quicker solution to rate setting issues and will impact the redesign effort.

Issues/Concerns Regarding This Topic:  
These are outlined in the highlights above. 

Legislative Impacts:  NA

Supporting Materials:  NA

Contact(s): Stacy Hennen, Michael Herzing