LTSS Update - January 2018

Key Highlights This Month:  

(information provided at the HCBS CSWG)

Licensing Exception – Dawn Bramel and Christala Culhane, Licensing Division

Licensing moratorium exception  handout with status update

Addition for exception – an exception for new foster care licenses or CRS for people receiving services under chapter 245D and residing in an unlicensed setting before May 1, 2017 and for which a license is required.  There is a presumption that a license is required when services are provided to three or more people in a dwelling unit when the setting is controlled by the provider.  There is a process for reconsideration process if the license holder subject to the exception rebuts the presumption.

Data indicates that there are up to or over 500

  • 3 or more at same address and all receiving supported living services or FC services funded by a disability waiver.
  • There may be more that have fewer than 3 people – if the setting meets the definition of residential setting – will need to be licensed. If a county has a setting (such as a one person development that “looks like” FC) contact Deb Amman for discussion on this type of site.
  • Expecting there will be a significant number of applications for licensure.
  • The exception is available until June 30, 2018.

County licensors role:

  • Assist providers to initiate the application process
  • Provide the following information to Deb Amman (Deborah.g.amman@state.mn.us)
    • Name of provider
    • Location of the setting
    • Single or multi-site unit
    • Number of individuals receiving services in each unit.

Exception goal is for people to be able to remain where they are living.  However, if a license is required, the facility/provider will need to meet licensing requirements.

CBSM provides guidance when making determinations of a setting being a person’s own home.


Duplicate PMI – Curtis Buhman, DHS

DSD will have a liaison – Carry Matson, to connect with Economic Assistance – Tammy Smith, DHS. Counties should continue to work with Tammy. 

Information regarding merging PMIs is being sent out.

System solutions – desire to pull together a group of counties to review potential solutions and testing of assumptions.  

Case Management Redesign – Lisa Cariveau

Rebecca    -  lead for case management redesign

Redesign is ALL Medicaid funded CM. 

To date:

  • review of past work, strengthen relationships and engage stakeholders and partners, align vision within the department. 
  • Identified barriers to success in the past.
  • Determination of points of agreement.

Planning framework 2017-2019:

  • Create a planning infrastructure
  • Document the financial infrastructure
  • Solidify a universal definition and core set of activities
  • Ensure community and civic engagement in development of policies.

Case Management Redesign Infrastructure (see Document)


Communication plan in process to determine that best way to communicate with counties at various levels: director, supervisor, staff.


Financial State:  Entering into a contract with a vendor regarding financial state

  • Phase 1: To document the current state.  Will work with three counties to do this documentation: Dakota, Sibley and Carlton Counties – counties that both provide CM and contract for CM.
  • Phase 2: develop models for potential universal base rate.


Universal definition and core set of activities:

  • Purpose is to build upon past work to solidity the definition and core activities of CM.
    • Progress : analysis of past engagement efforts to identify where we need more input and analyzing existing policies
    • Next steps: finalize documentation of current polities, community engagement and inform finance work.


Policy Work:

  • Catalog the following information for CM:
    • Definitions
    • Authority
    • Financing
    • Activities
    • Intersection between the services

 Community and civic engagement:

  • Ensure people we serve, families and caregivers, providers, and other stakeholders are engaged throughout the CM redesign process.
    • Progress: worked with MN Dept. of Human Rights to develop community engagement plan
    • Engage stakeholders
    • Hired a full-time community engagement coordinator
    • Next steps:
      • Finalize engagement plan
      • Identify key questions/touchpoints to inform decision making.

Lead Agency Reviews – Stacy Twite

Monitoring of Person Centered Plans (see Document)

Effective January 2018 – DHS will require lead agencies to meet the requirements of the monitoring measures of the person-centered plan.

Look back for review is 12 months from the date the reviewers are on site.  For EW – only look at fee for service EW.


MnCHOICES 2.0 – Rita Chamberlian, Jill Schweitsthal – DHS, Jane Davison, Mary Ruth Harsha – MN-IT

MnCHOICES 2.0 User experience

MnCHOICES 2.0 redesign principles and plan (see Document for numbered sections below)


2.0 Content redesign principles – Start was with items 15 and 16 and grew to the 16 items listed in the handout.

  • 1-3: tool and the assessors
  • 4-8: need for policy alignment
  • 9-11: focus of the tool statements, response choice pattern and language using capabilities vs. inabilities.
  • 13-14: areas that pay attention to professional conclusions and manage the process, tone, customization of the interview to the person and not the tool in charge.
  • 15-16: initial drivers of the process


2.0 Master Outline (working outline)

  • First 3 make up the face to face interview
  • Risk and Planning – where the information the assessor learns is synthesized and professional conclusions are made.
  • Programmatic Requirements – confirming criteria and documenting external authorities
  • Administrative Activities

View of the Domains working document for 2.0

  • Sections lead with a document box then sections of statements for interview and selection of capabilities.
  • Sections includes consolidation response pattern for 2.0

Volunteers opportunities to review and “test” – contact Rita and Jill.


Mary Ruth Harsha– work is going forward understanding the issues with 1.0.  One way to address this is using prototypes with groups testing to react and update based on feedback. 

Collaboration – team developers, business analysts, user experience design team, and Rita and Jill as business/project owners. Weekly project team meetings.

Jane Davison – User Experience Design Team (Handout of PPT: MnCHOICES 2.0 and Person-Centered Design)

 “[Person-centered design] is a process that starts with the people you’re designing for and ends with new solutions that are tailor made to suit their needs.”

 Timelines – proposal for timelines at steering committee – overall timelines for 2019

Will be on the agenda for January HCBS – CSWG


Efficiencies Document for all three workgroups (see Document)

Membership discussion


National Core Indicators – Suite of assessments being completed.  These will start in January – more information will be sent out regarding this.  

Requested Actions Needed From MACSSA:  None at this time

New Trends in This Area:  Continued focus on MnCHOICES

Issues/Concerns Regarding This Topic:  

Legislative Impacts:  

Supporting Materials:  

HCBS 2017 Licensing Moratorium Exception

Case Management Redesign Infrastructure Document

Monitoring of Person Centered Plans Document

2.0 Content Redesign Principles Document

2.0 Master Outline Sections (high level overview) Document

MnCHOICES 2.0 and Person-Centered Design PPT

Efficiencies Document


Topic Owner:  Deb Sjostrom
Content Experts: TBD

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