Long-Term Services & Supports Update - August 2018

Key Highlights This Month:  

Information from the HSBS CSWG  7/27/2018 meeting

 Discussion regarding Charter and membership roles and responsibilities: LPHA, MACSSA and DHS.

 Legislative updates – Mark Schulz and Lori Miller

Adult Protection – Chapter 161 “safe seniors”  PDF – 2018 Laws of MN  - concepts that passed into law

2018 – Legislative Session Overview – DSD document          

 2019 Legislative session tentative Ideas

• HCBS – Program Simplification for Providers
• Serve Older Adults with Complex Needs – Behavioral Health – this would allow enhanced EW budgets for persons leaving state hospitals and for those with low ADLs but high behavioral needs to access a higher EW/AC budget
• Strengthen Assisted Living Regulations
• Develop an HCBS Report Card – initial focus on assisted living
• Vulnerable Adult Act and APS
  • Updating definitions with the VAA
  • Allow VA Data Sharing
  • Maltreatment Reconsideration Review Panel Recommendations
  • Technical Corrections
  • Law Enforcement Notification Updates
  • VCAA grants

 MnCHOICES Update – Lori Miller

Change in condition to allow for a phone update – have run into technical issues – radio button for change in condition and second radio button for update – cannot be done in 1.0. The time needed to program this change would be 12 weeks.  This will move out to 2.0.   MnCHOICES 2.0 continues with a targeted implementation 7/2019.

MnCHOICES proposals for Legislation 2019.

• Language cleanup (handout via email) many of the legislative proposals are those that were presented in 2018 session but were not passed due to the Veto of the omnibus bill.
• Timely access language – 20 days upon request – looking at 20 days from the date the person accepts the assessment
• Guardian participation via technology or phone
• Provider information (direct service staff) to be provided upon approval of the person.
• Simplifying timelines – at 56 total days for CSP/CSSP (not to exceed 56 days) – 96% of plans were completed within this timeframe in a data pull from 2017.
• DD eligibility
• Choice to decline an annual reassessments up to 3 years – but service plan is required
• Assistive technology discussion requirement – will include provider conversation

 Policy and guidance will be provided regarding NF level of care definition and when a person shows CADI or DD eligibility – this is being built into 2.0

Discussion regarding ‘Efficiency’ language – will there be language or is it in the context of the above?

 There is an auto save being built into the narrative sections in MnCHOICES and the service plan so that documentation isn’t being lost.

 PCA Rate – DHS is working on a rate framework to assist legislators and others to understand what is involved/included in the rate.

DWRS – how are dollars invested into the system – customization of rates to manage/reduce exception requests.

Services –

• Removal of CL for those under 55 – and adding a new service to meet the needs currently serviced by CL
• 245D – foster care – family foster care rate and utilization of 245D to provide service and supervision.  Life Sharing will be in this area.  Rates and Licensing. 

 New Employment Services - Ryan Merz, DHS

Implementation Update

• “live” as of July 1
• Employment First webpage is updated with resources/tools
• CBSM up
• Ongoing training and information
• 9/1/2018 – the rolling transition at annual renewals begins

 August Regional Meetings – joint lead agency and service provider working sessions hosted and facilitated by DHS – in person sessions focused on practical application of transitioning to the services.

 Vocational Rehabilitation Service and Waiver Employment Services

• Interim guidance – how to authorize HCBS waiver employment services in relationship with Vocational Rehabilitation Services (VRS) and Individual with Disabilities Act (IDEA) services.

(Document link coming soon): View page 10 – slides 19 and 20 of PPT PDF

 County State Role Discussion

Quality Continuum document

1. Developing System Capacity:

• Can the state facilitate this across regions
• There will be a need for funding – regional planning and service development
• State will likely pursue an appropriation
• Gaps analysis will continue in the format of 2017 – regional basis.  Wilder has been contracted.

1. Responding to issues:

• Work with licensing regarding delegated authority – determine the scope of this authority:  What are those issues that the County would want to have authority to respond.

1. Grievances

• Establish processes, communication and training. 
• Better utilize 245D grievance procedures
• Would not require legislation

1. Crisis Response

• Types (disaster, licensing revocation, provider closes/quits)
• Clarify/define host county coordination role

 August HCBS CSWG meeting– DHS to review what DSD is working on for legislation

Requested Actions Needed From MACSSA:  Legislative proposals related to LTSS

New Trends in This Area:  

Issues/Concerns Regarding This Topic:  

Legislative Impacts:  

Supporting Materials:  To be added soon.

Contact(s):  Deb Sjostrom, Paul Bukovich