Long-Term Services & Supports Update - May 2018

Key Highlights This Month:  

Waiver Reimaging Project – Elyse Baily and Curtis Buhman, DSD DHS (Fiscal Policy) PPT – Waiver Reimaging Project


  • Required by legislature
  • Recommend structural changes that simplify and improve the programs
  • Waiver Reimagine project includes two leg studies
    • Disability Wavier Reconfiguration
    • Individual Budgeting Model


  • Equity and access
  • Responsiveness
  • Alignment – across waivers
  • Simplification – for people served and lead agencies
  • Smooth transition


Partnering with Human Services Research Institute (HSRI), NASDDDS, the U of M (focus groups) and Burns & Associates (data analysis).

Reports and recommendations due 12/2018 and 1/2019


Study 1 – Disability Waiver reconfiguration:

Examples of reconfiguration

  • Combining waivers into a single 1915© waiver
    • Would need to continue to provide cost effectiveness across populations
  • Adding new
  • Implementing a 1915(i) – HCBS as a state plan option
  • Implementing a 1915(k) – Community First Option


Study 2 – Individual Budget Model

Intent – develop an individual budgeting model for all disability wavier recipients and examine changes to CDCS budget methodology.

Recommended model may include:

  • Individuals’ support needs, MnCHOICES assessment information, living circumstances, and other potential factors

Objective – enhance personal authority people have over choosing the type and amount of HCBS they receive

Would include an exception process.


Public Engagement:


These studies are aligning with the case management redesign project in order to provide understanding of how/if these impact/affect each other.


County – State Roles related to HCBS – Alex Bartolic, DHS

Discussion for planning to the 2019 legislative session. Need for a small workgroup to bring potential model/information back to the CSWG in June for further discussion.

  • Eligibility financial and service
  • Resource management
  • Resource development
  • Quality management
  • What fits with CM whether it is county or other agencies

Approach –  as part of the studies/projects (CM Redesign) that are in process – taking CM out of the waivers and considering TCM as a payment methodology.  Thus, defining the county role.

Right authority (legislation) and how to fund.



Human Services Performance Management – Carol Becker and Gary Mortensen, DHS

Adults live with dignity, autonomy and choice measure

  • Bring together stakeholders from DHS, Counties and community to develop shared outcomes
  • Successful systems integrate the use of data into all facets of the organization
  • Meet our partners where they are on their performance management journey
  • Leverage our partners expertise throughout the process of developing performance measures

Five areas addressed in the development process:

Operations, Quality, Equity, Financial and Customer Service


Steering Committee participants needed – one day retreat

4 staff from Counties and 4 staff from DHS

Then the larger workgroup for a retreat day.


PCA – Jeanine Wilson, Lori Miller and Raukiya Smith, DHS

PCA and Home Care Nursing moving out of the managed care benefit – handout Unique Families and Children Enrollees Receiving PCA Services – this list includes individuals that may be known to the lead agency/county.

Report will be sent out early June for service agreements beginning January, February and March 2019.

1200 people have assessments done by counties via agreements with MCO.

4000 people will need to transition to counties.  DHS is working with MCO to transition and determine how to get data into MMIS.

This is for children and families.

This does not impact seniors enrolled in MSHO/MSC+



Enhanced rate PCA – (complex PCA) financial incentives to increase workers wage or benefits.  PCA, CDCS, CSG – beginning 7/2018 for those:

  • Recipients eligible for 12 or more PCA hours/day
  • Worker – meets specific training requirements
    • Three groupings of training (additional training over the required PCA training) – specific information related to the training will be sent out in early May.

Enhanced rate is 5% higher rate for PCA.  The entire 5% is required to be added to wages or benefits of the PCA staff person.

For CDCS, CSG – may be eligible for a $500 stipend. This will be outside of the CDCS, CSG budget.

At this time – 582 people identified as potentially eligible.

 Employment and DTH

Please see this link for the Employment and DTH Report and the following attachments: DD and LTC Employment Service Codes, Omnibus summary Community Supports, Provided EES Request Email, Reassessor Training, 7% pdf.

Requested Actions Needed From MACSSA:  

None at this time

 New Trends in This Area:  

Issues/Concerns Regarding This Topic:  

Legislative Impacts:  

Supporting Materials:  

WR Project Presentation PPT

Disability Services HSPM PPT

Family+Children PCA services by County

Transition Plan for 2019 - PCA

Deb Sjostrom, Paul Bukovich  

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