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Behavioral Health Update - June 2018

Key Highlights This Month:  

SUD Reform:
DHS is still waiting for CMS approval for 1115 Waiver and other reform requests.  All have been submitted.  If approval soon expect implementation rolling out after July.  It has been determined that CHATS will not be used for Rule 25 eligibility and payment.  Counties will determine eligibility and need to enter time span.  RFP participation with 1115 waiver has been sent out.  It is important that counties encourage and work with residential providers who are impacted by the IMD status change.  The placing cost savings for counties if a provider is participating is significant.  23% of cost share vs 1.5%.  There is a June 25th deadline for participation!!!  Some County concern about state enrollment operations to handle all the SUD provider changes.  Attached, please find a short list of potential action items for counties to consider in preparation for SUD reform.   

 MH Legislation:
As all know many things vetoed by the Governor!    The MH bonding legislation was positive and an RFP should come out soon.

AMHI/ Grants:
State is rolling out new process for AMHI grant applications.  AMHI coordinators have been participating in state meetings.  All changes to take effect by 2020.  State trying to assure the AMHI is treated as initiative, there are outcomes and Governance of the dollars have broad stakeholder authority/participation.

 Competency Restoration: DHS/DCT will be presenting in July to MACSSA

Requested Actions Needed From MACSSA:  NA

New Trends in This Area:  NA

Issues/Concerns Regarding This Topic: NA  

Legislative Impacts:  NA

Supporting Materials:  

Action Items for Counties to Consider in Preparation for SUD Reform.

Contact(s):  
Julie Ellis, Jerry Pederson

Case Management Update - June 2018

Key Highlights This Month:  

The Initial Design Team for Case Management continues to meet with the goal of having some recommended design for all of case management services in the fall. Recent meetings are focused on activities included in the core functions of case management: assessment, planning, referral and monitoring. The meeting this month also focused a bit on the notion of choice in case management services – and this will require ongoing discussion and consideration as we move forward.

 Navigant continues to work with the finance team and Carlton, Dakota and Sibley Counties to develop a tool to capture local/county level finance data.

Requested Actions Needed From MACSSA:  NA

New Trends in This Area:  NA

Issues/Concerns Regarding This Topic:  

Ongoing concerns about the breadth and depth of this topic and how this will impact us financially and as it relates to policy and program.

Legislative Impacts:  None at this time

Supporting Materials:  

See linked document put together related to choice that was discussed at the Initial Design team meeting.

Contact(s):  Michael Herzing, Stacy Hennen

Child Wellbeing Update - June 2018

Key Highlights This Month:  

  • The MN Program Improvement Plan (PIP) was approved.  See attached notice and approved PIP.
  • DHS-Children’s Mental Health is producing a bulletin on changes in the case management role for CMH including completing the functional assessment. In approximately 2012 counties were told this was no longer a requirement.  This apparently changed in 2015 but many counties were not aware of this.  MACSSA has requested additional information and communication.    
  • CMH TCM and Outcome Reporting Training-WebEx Scheduled June 27, 2018 1-2: p.m.  See attached.
  • DHS-Children’s Mental Health will be having regular CMH Supervisor WebEx meetings as a strategy to improve communication with counties.   The first WebEx meeting will be June 21, 2018.  See attached.   
  • IMD:  eleven residential treatment facilities (580 beds) have been determined to be IMD.  See attached list.  State funding is only authorized through April 30, 2019. Effective May 2019 counties will bear 100% of the cost for children placed in these eleven facilities.   See attached “Children’s IMD overview.”
  • The CWB group continues monthly phone meeting with DHS (CSP and MH Division).  See attached notes from May 2018. 

Requested Actions Needed From MACSSA:

  • Potential request from MACSSA to the children’s mental health area of DHS to meet to find ways to address and improve communication and working relationships. 

New Trends in This Area:  

  • Continued concerns regarding availability of placement options for children with high needs.  The first PRTF through Northwood’s has been delayed (possibly for another 3 months) while they meet federal and state licensing requirements.  This PRTF will be located in a part of Northwood’s which previously provided 60 residential treatment beds.  It will now have 48 PRTF beds. 

Issues/Concerns Regarding This Topic:  

  • Beginning July 1, CMH-TCM will require the areas of housing and employment to be addressed for any youth age 14 or older receiving children’s mental health case management services.  This needs to be reflected in SSIS and in the functional assessment.  DHS will not be providing specific training regarding this requirement.  Handouts were provided at the SSIS Mentor Meeting regarding the changes. (See attached). 

Legislative Impacts:  

  • Funding to cover loss of federal payments for children’s residential mental health treatment was a provision in the Supplemental Budget Bill which was vetoed by Gov. Dayton.  This means the “bridge” funding ends April 30, 2019 and counties will be responsible for the total cost of placement (board and lodging plus treatment costs).  It is believed the portion covered by MCOs will also end in 2019. 
  • MACSSA priority to eliminate Child Protection withholds and funding for a child welfare training academy did not pass.
  • The Sibling Bill of Rights for children in foster care passed and will need to be provided to youth by the social worker. 
  • MACSSA and MCAA will be meeting in June to discuss legislative issues and strategies in preparation for 2019 legislative session. 

Supporting Materials:  
Notice of PIP Approval
External Children's Mental Health Targets
MN CFSR PIP
Children's Mental Health IMD Facilities
CMH Outcomes FAQ
May 2018 Minutes

Contact(s):  
Brenda Mahoney
Suzanne Arntson

Healthcare Update - June 2018

Key Highlights This Month:  

A PDM Field Test is still under consideration to begin at the end of July.  The effort is being led by the AMC METS Workgroup and the field test assessment criteria is currently under development.  Details will be shared once it if finalized.

 There is a Security, Organization and Location Structure project that is focused on updating security and the METS framework.  It also includes a security role analysis to ensure all roles meet business and security requirements.  Clean-up analysis has started

 Medicare recipients will start getting their new cards with their new Medicare ID number this month.

 DHS is seeking public feedback on 2016 Medicaid Managed Care Comprehensive Quality Strategy.  The document is currently posted for a public review period and can be found here:  https://mn.gov/dhs/partners-and-providers/news-initiatives-reports-workgroups/minnesota-health-care-programs/managed-care-reporting/quality.jsp

 In order to contain managed care mailing costs and improve the enrollees’ experience, DHS is proposing a change for the enrollment packets sent out by the counties for PMAP and the Elderly.  Beginning July 1, you will not be required to send out the Primary Care Network Lists (PCNLs) in the packets sent to potential enrollees for the health plans in your county.  DHS is currently modifying the cover letter that is inserted with the packets and will send it out to counties once it is final.

 Requested Actions Needed From MACSSA:  None.

New Trends in This Area:  

Issues/Concerns Regarding This Topic:   Several counties have discussed/reported billing issues and impacts to revenue due to duplicate PMIs.  DHS recently released some guidance on Duplicate PMI numbers that includes information on how to report duplicates, urgent requests, how the duplicate PMI merge process works, what happens after they are merged, and who to contact for questions.  See link below.

Legislative Impacts:  

Supporting Materials:  
Duplicate PMI Numbers Guidance Doc

Contact(s):  Kari Ouimette

Modernization Update - June 2018

Key Highlights This Month:  

Update on Governance and Communication Planning for MACSSA; Modernization Steering Committee

-          There is a small team finalizing the charter and scope of the Steering Committee. Meetings will begin in the coming month or so with members from all of the various governance groups. One role clarification we are grappling with is when we need to speak for “MACSSA” representing multiple counties and when we speak from our specific county perspective.

-          Meanwhile the state is working on getting the next APD finalized; there will be a special MACSSA Steering Committee to allow time for conversations and feedback amongst county members of the various teams.

IHSM (Integrated Human Services Modernization) ESC (Executive Steering Committee)

-          The primary task right now is to review projects from MMIS, METS, and ISDS in order to provide a recommendation for priorities of the APD. Presentations and prioritization from the various Program Management Teams have occured – costs are going to be a huge a factor.

EAB (Enterprise Architecture Board)

-          Will soon be reviewing recommendations for the APD proposals.

Legacy systems conversations

-          A meeting was held to discuss the pros/cons of using leveraging legacy systems to create incremental changes that move us in a positive direction towards modernization. This does not negate the work being done in Curam (for example), but rather how do use what works well.

-          One conversation point is the narrative to this point that legacy systems need to be replaced because they are outdated, people don’t know them anymore, etc.. These statements may be true; but it’s also true leveraging aspects of what those systems do well may help get us to a new modern system more effectively.

ISBM (Integrated Services Business Model)

-          An ISBM webcast is publically available. In light of other conversations happening around potential of legacy systems, narrative may need to be revisited and possibly re-worked.

-          Working on a plan for how to engage effectively with AMC commissioners – clarity of alignment and endorsement. Submitted a proposal for the AMC conference in the fall.

METS

-          PDM is being delayed – Counties are working with the state to articulate field or validation testing. Also working with AMC to ensure coordination and communication around this issue.

DIGT (New data team replacing DADT)

-          new tool to work with the data warehouse is being explored;

-          a county survey was completed describing how counties are using EDMS

-          Pilot projects to work in the Office of Inspector General; entering into APD process as well.

-          Nice work has been done on some mock-ups for new business intelligence portal available to state and counties.

 MNChoices

-          EDMS –Some print issues have been occuring with MNChoices – originally counties were told it’s a local problem. MN.IT now believes it is a MNChoices issue; they are working on a resolution. They want to resolve now to avoid carrying over into MNChoices 2.0.

-          There was a survey on MNChoices 2.0 to assess how people were feeling about new version and identify gaps.  Won’t necessarily be able to apply all feedback but they want to get a sense of concerns to try to address. More communication coming on 2.0.

-          State is recognizing reports out of MNChoices is too canned and counties should have the ability to pull data they find helpful and design reports. It came up because of re-assessments and a need for a current list that may change daily.

-          A known issue - there is a long pause people are experiencing where system doesn’t move – MN.IT reports it’s a technical issue, they are aware and working on it.

Prism

-          The planning APD – feasibility study is in the Feds hands. DHS is working on a response to some questions from the feds. They are looking at the feasibility of what they can and cannot do for child support – financial vetting and case management mechanisms as well as client portals.

-          Technology change they need to make decisions on SSIS server centralization is on hold – think it’s temporary hold

SSIS –

-          They haven’t yet settled on a new platform; question of centralization is on hold.

-          Unanimous vote on cost allocation – that was approved.

-          Question about purging cases came up. If there was a glitch on SSIS the direction is not to destroy until purged from the system.

IT Alignment meeting – no report, meeting was cancelled.

Requested Actions Needed From MACSSA:  

Nothing right now          

New Trends in This Area:  

APD is driving a lot of questions and efforts at this time. 

Issues/Concerns Regarding This Topic:  

In the new IT governance structure, the Integrated Human Services Modernization Executive Steering Committee (IHSM ESC), in consultation with the Business Architecture Domain Team (BADT), is responsible to determine the new function-based Program Management Team (PMT) structure for modernization work. The original governance transition timeline had targeted having the new PMTs in place by June 1, and to sunset existing PMTs at that time. The IHSM ESC has been meeting frequently. Recognizing the need to allow enough time to first determine the new PMT structure and sort through the details of the transition, the governance transition sponsors, Chuck Johnson and Greg Poehling, have approved an extension. This conversation will be picked back up once APD process is complete.

Legislative Impacts:  There are some financial limitations that may inform future legislative needs. 

Supporting Materials:  

Contact(s):  

Marti Fischbach – Modernization Co-Lead; IHSM ESC Co-chair

Brad Vold – Modernization Co – Lead; BADT member

Gary Sprynczynatyk – SSIS

Scott Jara – Data/DIGT

Chris Lancrete – IT Alignment; IHSM ESC member

Deb Huskins – Mets; BADT co-chair

Todd McMurray – PRISM

Julie Ellis – MnChoices

Jane Hardwick, Nicole Names, Denise Moreland - EAB

 

Self-Sufficiency Update - June 2018

Key Highlights This Month:  

Child Care Assistance Program/CCAP

 

  • DHS CCAP is creating Guidance for Redetermination Processing and System Functionality that will be issued in a DHS memo this month. The intent of this guidance is to further assist workers in understanding best practices in processing redeterminations in light of system changes. Guidance will expand on information shared at in-person trainings.
  • County and tribal agencies must report death, maltreatment and serious injury incidents for 1st quarter of 2018. A DHS Memo was issued April 20, 2018. This is the first time DHS has requested information about serious injury incidents. Agencies were asked to submit the report to DHS CCAP by May 18, 2018. Approximately half of the responses have been received. DHS will follow up to achieve a full response rate.
  • DHS CCAP continues to work towards full compliance with the federal law. Some of these changes were included in the House and Senate HHS Omnibus bills, but these bills were vetoed. The department will be assessing changes that can be done without legislation. Changes that require state statute changes may be reintroduced in the 2019 legislative session.
  • DHS CCAP is working with MN Tribes to ensure that Tribally Licensed Child Care Providers are in compliance with Health & Safety Training requirements needed in order to continue to receive CCAP Payments after 9/30/2018. DHS CCAP wants to ensure that Native American children receiving CCAP can continue to be served in culturally responsive settings by tribally licensed providers.
  • DHS drafted Minnesota’s 2019-2021 Federal CCDF plan. Public hearings to discuss Minnesota’s draft plan were held on April 23 (daytime) and April 25 (evening). Public comments will continue to be accepted through June 8. More details is available on the DHS website. People who want to be involved and to receive regular updates can send an email to CCDFReform@state.mn.us and ask to be added to the list serve. The federal office has extended the deadline to submit the plan to August 31, 2018.
  • DHS CCAP is implementing additional changes that passed in the 2017 legislative session:
    • Maximum Rates change for St. Cloud and Sartell is effective July 2, 2018. A bulletin will be published later this month. System changes were installed in MEC² in early June to implement this change.
    • Changes in counting the income for new spouses will be effective December 1, 2018. DHS CCAP is working with MFIP staff to implement this change. A bulletin will be published later this year.
    • Media stories and a Senate hearing have highlighted issues related to fraud and CCAP. There will be an OLA audit conducted, and DHS is meeting with our Fraud Stakeholders group and planning for the next legislative session to continue to address this issue.

SNAP:

The Education and Training Event put on by Midwest Partners for SNAP Program Improvement will be August 1-3 in Battle Creek, MI.  County staff are encouraged to attend. The Registration Deadline is June 28 and is at https://www.surveymonkey.com/r/18Registration.   The registration fee is $100. If you would like more information

Requested Actions Needed From MACSSA:  None

New Trends in This Area:  

Issues/Concerns Regarding This Topic:  

Legislative Impacts:  

See Bulletin # 17-68-19 for changes that took effect September 25, 2017:  Federal and State Changes to the Child Care Assistance Program – Phase 1

 See Bulletin # 17-68-22 for changes that took effect October 23, 2017: Federal and State Changes to the Child Care Assistance Program - Phase 2

 See Bulletin # 17-68-26 for changes that took effect December 18, 2017: Federal and State Changes to the Child Care Assistance Program - Phase 3

 See Bulletin # 18-68-07 for changes that took effect April 23, 2018: Federal and State Changes to the Child Care Assistance Program - Phase 4

Supporting Materials:  
Listed above.

Contact(s):  
Brad Theil, Barb Dahl, Topic Owners
Katheryn Heffernan, Casey White, Trish Skophammer, Julie Herbst, Joan Scholljegerder, Content Experts

Race Equity Priority Update

In early 2017, members voted to approve three systemic priorities for the Association:  Equity, Integrated Services and Human Services Fiscal Framework.  Over the last year, through discussions with membership and at the Executive Committee, a statement of purpose for the Equity priority evolved that recognizes the significant disparities in outcomes and disproportionality for people of color across Minnesota’s health and human services and makes a compelling case for MACSSA to target this systemic priority to focus on Race Equity. 

Drafts of the race equity statement of purpose were reviewed at MACSSA membership meetings on several occasions, along with input and feedback sought both at meetings and via email.  The MACSSA Executive Committee reviewed that feedback and made adjustments to the paper to reflect the themes that emerged.  The document sets forth a goal to “Promote racial equity and eliminate racial disparities in the human services system for all people across the state” while providing supporting data and rationale for the focus and goal. In late May 2018, the Executive Committee  sought and received endorsement of the statement of purpose and the direction to focus the priority on race equity through a membership vote.  

 Over the coming months, a small work group has begun work on action steps that the Executive Committee identified for the priority.  This group will be reporting back and engaging the membership as the work moves forward.  Additionally, the group welcomes and encourages engagement from members that are interested in participating.

ISBM Update - June 2018

News: 

  • A 20-minute ISBM webinar is now available to learn about the current Minnesota model. Check it out through this link Integrated Services Business Model Overview Webinar!  Be sure to download new narrative Guide which includes the details covered in the webinar. No password is needed. A live webinar was conducted June 30 with 65 people attending from across the state and DHS.  This was part of onboarding IT Governance members to their role in the context of ISBM. Share with your staff.
  • ISBM Implementation: Integrated Services Business Model/ISBM has moved to the implementation phase, where it will be multiple efforts, not just one project. Two efforts are under way to resource these efforts. 
    • Bina Nikrin, Hennepin, has been assigned as the MACSSA ISBM Implementation Coordinator. She is working closely with the State Implementation Coordinator Kate Kunitz, DHS Business Solutions Office/BSO. Both positions are reimbursable from modernization funding.
    • Bina and Kate have developed a proposed staffing plan for consideration in modernization funding for 2018-19, which includes county and state perspectives and expertise in communication/stakeholder engagement, data analytics, and business readiness. Other county representation is also included in the overall business readiness staffing proposal. Let Bina know if you have people that would be a good fit.
  • MACSSA Spring Conference: Activities provided insights into what parts of ISBM are most understood and least, and what are most of interest. Following a fun, challenging game of Family Feud, input included: What your county does that is unique; Multi-county groups and their contacts; and Rank your knowledge of ISBM guiding principles.
  • BADT/Business Architecture Domain Team: This Modernization governance group oversees ISBM work and heard an update at their June 6 meeting.  MACSSA BADT members include Deborah Huskins, co-chair, Brad Vold, Corinne Dahl, and Rachel Grimes.

Upcoming activities:

  • June 29: Some MACSSA and DHS Business Solutions Office staff will retreat with American Public Human Service Association/ APHSA to plan the MACSSA Fall Conference, focused on implementing ISBM.  This is a very exciting opportunity to benefit from APHSA experience working with other jurisdictions and their knowledge of national research. Let Bina know if you are interested in participating in the June 29 planning retreat. 
  • July 12: MN Integrated Services Business Model/ISBM and UMN Humphrey School Future Services Institute/FSI.  FSI is very involved with DHS and other MN counties in a variety of cutting edge work.  The purpose of this meeting is to explore how MACSSA and DHS could strategically use FSI to advance ISBM implementation work plans statewide.

 

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