New Directors School


LTSS Update - April 2018

Key Highlights This Month:  

Announcements – Kay Dickison, Dakota County, retiring mid to late June.

 MnCHOICES – Change in Reassessment Responsibility – Rita Chamberlin and Jill Schweisthal, DHS

Based on statute language 256.0911, Subd. 3(b)

Beginning in 2018 – the county of location or County of Residence (COR) is responsible for completing all reassessments for people receiving LTSS.

Timeline – slide 7 of the PPT – in the timeline, the CM notifies the COR of the needed reassessment. If the COR hasn’t heard from the COR – they should reach out to the CM/CFR related to what is going on that notice hasn’t been received.  This guidance is for reassessments that are planned annually, understanding that there are situations that will not fit into the timeframes listed.


  • A person shows up on the COR report but no notification.  COR has reached out to CFR without response.  What should be done?  Answer – utilize the “chain of command” at the county. Utilize MMIS, Eligibility Workers, other data base, contact service provider, etc.
  • ICF-DD or non-waiver: There is no Service Agreement these individuals are not on the report/list as their current living arrangement is institutional. DHS is addressing how to pull this data.

Timeline guideline (CBSM):

Reassessment Communication form (DHS-6791E) – CM submits to the COR.

MnCHOICES interagency contact point list (County Link) -

 If a situation occurs that the reassessment is not completed timely through no fault of the COR – DHS will provide technical assistance/problem solve to resolve this issue.

 HCBS Settings Rule Update – Stephan Horn and Rachel Shands, DHS

Word Document – Phase 1 attestation updates and Phase 2 plan

Phase 1 provider attestation.  12 providers that did not provide attestation had their payments suspended and 18 opted out via a transition plan

Phase 2 – 222 settings expected to complete a Phase 2 attestation

Desk audit/follow up plan – desk audits reviews and follow up activities with providers through June 2018.

Word Document – HCBS Rights Modification Support Plan Attachment:

Standards for settings that are residential settings provider owned or controlled and day service settings Rights modification (exception)– what if a person has a need that a person cannot have a requirement within the settings rule.  This can be allowed with appropriate documentation and has a significant impact on health and safety. The documentation cannot be solely from the provider of service.

Template to guide the work – DHS-7176H (not yet finalized or available as an e-Doc) – finalize the form early to mid-April and an online training to be provided with launch to utilize in July.


LTSS Improvement Tool – Ashley Reisenauer and Rosh Dahal, DHS

LTSS Improvement Tool Update – document dated March 27, 2018

51 lead agencies have used the tool with 621 people

Currently looking primarily at the volume vs. the information provided.  Ensuring that the information is coming in from all areas in the state for all types of providers being reviewed, etc.

Continued questions related to data provided to counties – plan to come back to the HCBS CSWG for continued feedback on what information would be most beneficial to counties and in what format, such as an interactive dashboard.


Legislative Update – Kari Benson and Alex Bartolic

MnCHOICES – there have been three different bills introduced and one has moved forward to the floor incorporating language from the three bills (ARRM policy bill) through amendments to the language. The bill is now cost neutral.  One was from an advocacy organization – one item wanted was a mechanism for providers to provide information.  DHS has committed to include some language regarding such a mechanism. 

DHS will send a chart of the three bills and what is going forward to the HCBS CSWG members

Rate Legislation has been introduced as well.

Numerous bills related to adult protection.

Bill related to homes that meet requirements to be licensed – to extend the timeframe for getting a license.

 County Role Discussion – Kari Benson and Alex Bartolic, DHS

Would like to have a process to work on this in April and May.  Initial recommendations from the Waiver Reimagine project will be provided and a workgroup could review this and address what roles should be at the county level, what roles at the state level, quality assurance, operational aspects, etc.  Framework development and stakeholder engagement by the end of May.

 Employment Update

New Employment Services - Lead Agency employment mentors:

 DHS has put out a request for each lead agency to appoint an employment mentor who will serve as the main point of contact between DHS and the lead agency during implementation of the new employment services.

Employment mentors will be a conduit for critical information and will learn the most up-to-date information and policy about the implementation of the employment services. Lead agencies must identify at least one employment mentor, but may identify more than one employment mentor if they choose.  If you choose to fill out applications for more than one mentor you should notify as to who you would like to be the ‘primary’ mentor.   The deadline for applications is Friday, April 13.   

 Mentor responsibilities include:

  • Serve as the point of contact between DHS Disability Services Division and the lead agency during the implementation of the new employment services
  • Serve as local area expert in employment services, including answering questions from other lead agency staff, service providers and bringing questions to DHS Disability Services Division when appropriate
  • Attend regular webinars and teleconferences to learn the most up-to-date information and policy about the implementation of the employment services. DHS will hold these webinars at least once a month during summer 2018. It is likely we will hold webinars every other week initially. 
  • Share information on employment services implementation across the mentor’s lead agency
  • Ensure all relevant lead agency staff are trained properly to implement the employment services starting July 1, 2018


Guidance and instructions for how to identify mentors:

 Selecting skilled and qualified staff members as employment mentors is essential. Effective mentors need a variety of skills and abilities to provide support and knowledge to case managers as they learn about the new employment services.  To help lead agencies select one or more mentors, DHS provides a list of selection criteria below:

  • Availability to users: Mentors should be readily available to case managers and other staff from the lead agency throughout the work day. Consider selecting multiple mentors to assure availability.
  • Employment First: Mentors should have a basic understanding of the principles in Employment First and competitive, integrated employment.
  • Lead agency internal operations: Mentors should understand the operations and needs of lead agencies to represent lead agency needs and requests appropriately during the implementation of the employment services. Mentors should also be able to ensure that necessary information provided by DHS is shared across the lead agency. 
  • Computer skills: Mentors should be able to access webinars, training modules and other online training materials.
  • Other skills: Skilled at problem-solving, communication and decision-making

 Day Training and Habilitation/Prevocational Services Update:

The DHS stakeholder group working to help re-define the DTH/PreVoc services will re-convene later this month.  More updates should be available after this meeting.   

Requested Actions Needed From MACSSA:  

New Trends in This Area:  

Issues/Concerns Regarding This Topic:  

Legislative Impacts:  

Watching the MnCHOICES Legislation

Supporting Materials:  

MnCHOICES – PDF Change in Reassessment Roles

Word Document – Phase 1 attestation updates and Phase 2 plan

LTSS Improvement Tool Update – PDF document dated March 27, 2018


Deb Sjostrom/Paul Bukovich

Louella Kauffer, Andrea Zuber, Beth Price

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