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Case Management Update - August 2018

Key Highlights This Month:  

The State Initial Design team is now discussing the issue of case management competencies, and eligibility elements in case management services. The documents used to discuss these are attached. The discussion around competencies included discussion related to challenges that our more rural counties might have in recruitment if the requirements are drawn up too narrowly.

 Also attached is an update draft service components sheet outlining the components of case management included in the redesign discussion.

 There remains one more meeting of the group in August, to be followed by an all-day session in September.

 Navigant continues to work with the three pilot counties on the rate setting tool, with that work hopefully wrapping up in October. Community stakeholder meeting continue throughout the State.

Requested Actions Needed From MACSSA:  NONE AT THIS TIME

New Trends in This Area:  

Issues/Concerns Regarding This Topic:  

Legislative Impacts:  NA AT THIS TIME

Supporting Materials:  
CM Eligibility service and Tiers
CM.Eligibility.elements_2018
CMcompetenciesdiscussion
Draft Service Components 8.18

Contact(s):  Stacy Hennen and Mike Herzing

Child Wellbeing Update - August 2018

Key Highlights This Month:  

  • DHS Bulletin 18-68-14--MN Proof of Foster Care:   According to the Family First Prevention Services Act, (Public Law 115-123) as of February 9, 2018, a Title IV-E agency responsible for placement must provide a youth in foster care with any official documentation necessary to prove that they were previously in foster care. This must be done before a youth ages out of care.  The bulletin includes a form to be used for this purpose.  MACSSA CWB has requested this be added to eDocs and/or SSIS.  (See below for link to bulletin).
  • Foster Care Sibling Bill of Right:  The Bill of Rights was passed by the legislature.  Social Workers are to provide to children in foster care effective 8-1-18.  DHS is working on a bulletin with sample documents, to be released by the end of August.  MACSSA CWB has requested the forms be added to eDocs and/or SSIS. 
  • Systems of Care Grant:  DHS is reviewing the grant proposals from counties/tribes on 8-13 and expect to award the grants in September.  Requests surpassed available Grant and additional DHS funding.  DHS and county members attended the SOC national conference in July.  There was substantial information on residential treatment, PRTFs, impact of Families First Act, etc.  MACSSA may wish to consider asking DHS to request specific technical assistance to assist counties with planning.  
  • Wilder Center has been awarded the contract to work on the CMH Intensive Needs Study.  MACSSA is asking this include data on expenditures from counties.  (See below for link to overview of the study).
  • QPI event/training held in July.  Training focused on ABC Visitation (Attachment Bio behavioral Catch Up) and how foster parents can provide critical support during supervised visits.  ABC visitation is an evidenced-based intervention.  Current efforts to explore how implementation of ABC Visitation could be implemented in MN.  QPI forum being developed for fall 2018. 

Requested Actions Needed From MACSSA:  Based on recommendations from the Governor’s Task Force on CP, DHS is making changes on how services are tracked in SSIS.  The first step is to have a more comprehensive list of services.  DHS is developing a new list of recommended services for review.  DHS will send to the CWB topic leads for distribution to the CWB email list (contact Brenda or Suzanne if you want to be added to the list).  After feedback is received the next step will be to develop a process for documenting and tracking services across program areas.  DHS wants to develop a process that auto-fills into case plans so not duplicate entry.  

New Trends in This Area:  

Families First Act continues to be a concern at the county and state level as we work through the potential impacts and opportunities.  Most states are waiting for the release from the feds of the list of services that will be included for potential funding under prevention services before determining whether to ask for the two year extension for compliance with the act.  There are many variables.  For instance, to qualify for IV-E, congregate care facilities must qualify as QRTPs.  To do so would require a licensing body to complete the accreditation and states feel this may overload current licensing bodies.  In addition, QRTPs must meet other requirements such as 24 hour nursing staff availability.  DHS wants to create a forum/process to regularly meet with and collaborate with counties on the Act.  MACSSA is working on a forum for September related to the Families First Act to assure all counties have information and for discussion of potential direction. 

Issues/Concerns Regarding This Topic:  Families First Act:  The Act requires background checks on ALL employees in congregate care institutes, including those not having direct child contact (janitor, cook).  This required legislative changes in the next session after the Act passed on Feb. 1. MN Legislative Session started later in Feb and this did not occur.  DHS is asking for a PIP to allow time to have legislative action in the 2019 session.  If the PIP is not approved, IV-E funding for any facility other than foster care would end 10/1/18.  DHS estimates a $7 million impact.  

Legislative Impacts:  Developing legislative priorities related to CWB and CMH.  This will a topic at the August MACSSA meetings so please bring your ideas!  Also, we will be seeking assistance in writing any legislative proposals.  Thank you!

Supporting Materials:  
Bulletin 18-68-14 Proof of Foster Care
Intensive MH Study

Contact(s):  Brenda Mahoney, Suzanne Arntson

Healthcare Update - August 2018

Key Highlights This Month:  

Periodic Data Matching

  • The Periodic Data Matching process has begun with the first batches running at the end of July
  • There are two PDM reports available:
    • MNCM_228 PDM Post-Case Selection Report – this report is available via DHS Web Reports and  lists the cases selected for the September PDM month by county, but will not indicate whether or not they have a discrepancy
    • PDM Projected Eligibility Report – this report was sent to your County’s health care liaison on Friday 8/10/18 and lists the individuals that were identified as having discrepancies for the September PDM month
    • PDM videoconference recording from 8/2/18 is available on SIR under the Meeting Videos Archive section
    • The Field Test Assessment Group, comprised of 8 counties, DHS and MNIT staff, has been meeting regularly with Anoka County serving as the point of contact

 

The METS system will be unavailable Friday, August 17th beginning at 10:00pm through Monday, August 20th at 4:00am in order to migrate the database to its new hardware platform.

 Open enrollment has been extended to January 13, 2019

Requested Actions Needed From MACSSA:  None

New Trends in This Area:  On 6/27/18 an email came out from MN_DHS_HCEO_Administration titled “County Contacts for Project Requests.”  In an effort to streamline the process for recruiting County representatives for project teams, this request went out for County contacts to help find appropriate and available staff as project needs arise.  Please respond if you haven’t already.

Issues/Concerns Regarding This Topic:  

Legislative Impacts:  

Supporting Materials:  

Contact(s):  Kari Ouimette

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

Modernization Update - August 2018

Key Highlights This Month:  

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

We had our first meeting on Tuesday, August 7th. The minutes are below.

Present: Tiffany Miller, Eric Ratzmann, Marti Fischbach, Emily Babcock, Bill Calmbacher, Chris Lancrete, Denise Moreland, Deborah Huskins, Brad Vold, Rachel Grimes, Stephanie Radke, Kari Ouimette, Corinne Dahl, Bina Nikrin, facilitating.

Not available: Jane Hardwick, Erik Erikson, Nicole Names, Andrea Zuber, Mike Oanes, and Scott Jara

Highlights are action items.

  • Discussion:
    • ESC and EAB APD Process: Marti Fischbach
      • MACSSA EAB members will consult on issues raised at this meeting and best way to move them forward for EAB, e.g. is it a process or a structure question?
  • Core Planning Teams Key Initiatives informing EAB 1,3, and 5-year goals and ESC creation of workgroup to propose roadmap and timelines - Janet Goligowski
    • Request for county reps on this work will be coming soon
  • Process for Stopping Defunded APD Projects: Chris Lancrete
    • See attached “blue line” docs
  • Revamping PMT Structure and county participation – Chris Lancrete
    • More to come later.
  • MACSSA reps & co-chair on Mod Strategic Communication and Information Team (SCIT) – Bina
    • Eric will serve on this group and he and Bina will meet with Matt Woods to clarify other county roles needed.
  • Program simplification MACSSA reps: This request from DHS Jeff Hendrix is going through normal MACSSA process to find county reps.
  • Review/edit/agree on Charter: Members will review the charter off line and send any requests for clarification or changes to Bina to take up at a future meeting.
    • Will Modernization Topic Area “call-in” meeting remain once steering committee begins? These meetings have been cancelled.  Brad and Marti will monitor to determine if this new group fills the need.
    • Will ISDS Regional MACSSA Network continue? TBD
    • How to communicate between meetings? Call or email directly. Revised list of participants with phone numbers will be send soon.
    • Possible topics for next meeting:
      • Consider whether ESC and EAB levels of authority are appropriate, along with PMT.
      • Should there be embedded county people with DHS for Modernization?
      • What kind of topics are appropriate to get input from MACSSA Forums?

Business Architecture Domain Team (BADT): BADT heard a presentation on Collaborative Lifecycle Management (CLM) Licenses from MNIT representatives. The CLM includes several development lifecycle tools that will be used by MNIT, and the discussion included whether or not business would want to procure licenses for these products.

BADT received an update from Sarah Small about next steps for the roadmaps requested by the EAB. Volunteers are needed for a workgroup tasked with the development of a Modernization roadmap and Integrated Services Business Model (ISBM) timeline. A joint I-ESC/BADT meeting is scheduled for August 8th to establish the workgroup.

Michelle Doheny gave an update around the PMT Structure I-ESC/BADT sub-workgroup. The sub-workgroup is continuing to work on a recommendation for the new PMT Structure. The goal for the group is to provide I-ESC/BADT a recommendation by 8/13/18. 

Data and Information Governance Team (DIGT): DIGT did not meet this week. Next meeting is scheduled for August 28, 2018

Enterprise Architecture Board (EAB): EAB did not meet this week. EAB will have a day-long goal-setting retreat on Friday, August 10th.

Financial Architecture Domain Team (FADT): FADT did not meet this week. Next meeting is scheduled for August 10, 2018

Integrated Human Services Executive Steering Committee (I-ESC): The I-ESC added a new member. DHS Management Operations Director Roger Ehresmann will be representing the DHS Operations area.

The joint I-ESC and BADT subgroup working on PMT structure has held meetings to review the Human Services Functional Model (HSFM) and discuss the types of activities that will be expected of the new PMTs. The subgroup is reviewing three options for this work and is on track to present recommendations at the August 15 I-ESC meeting. The full I-ESC will evaluate their recommendations and present an approved plan at the August 23 EAB meeting.

Co-chairs Marti Fischbach and Jeff Jorgenson sent an email on Aug. 1 to ISDS and MMIS PMT members and Program Managers with information and deliverables related to the Process for Stopping Defunded APD Projects. This process is expected to wrap up by August 29, and information will be shared with EAB.

Security Architecture Domain Team (SADT): SADT did not meet this week. Next meeting is scheduled for August 27, 2018

Technical Architecture Domain Team (TADT): TADT did not meet this week. Next meeting is scheduled for August 21, 2018

ISDS Program Management Team (ISDS PMT):  The federal Office of Child Support Enforcement (OCSE) within the Administration for Children & Families (ACF) has approved the Planning Advance Planning Document (PAPD) for Child Support for FFY19. This PAPD has a reimbursement rate of 66%. Project management services have been requested to begin October 1, 2018, to initiate the project. Jovan Knutson will act as a business champion. Shaneen Moore will be the business sponsor. Tony Bokhorst will be the MNIT sponsor.

METS Program Management Team (METS PMT): METS PMT approved a project change request for 18.3 to fix a defect in which about 15 percent of ROP termination notices fail in production and must be manually generated. Without this fix, MNIT must manually generate the ROP termination notices that fail with each monthly run, as well as perform the mail merge and stuff envelopes.

By deploying the fix in 18.3 versus 18.4, the need to manually generate the notices will end after the August or September run. If not deployed until 18.4, MNIT would have to manually generate the ROP termination notices monthly through January 2019.

In addition, the METS PMT:

  • Considered a new project proposal related to an IBM service credit.
  • Reviewed new deployment date options for 18.4.1, which has to be moved because it conflicts with the recently announced end date for open enrollment.
  • Requested a “lessons learned” analysis of the conditions that led to implementation of a change request that had been denied.

MMIS Program Management Team (MMIS PMT): PMT heard the business sponsors’ business value case for the change request to include pharmacy claims as a separate module with its own timeline within the PA/SA APD project.

  • Technical will discuss recommended sequencing of the pharmacy project at the next meeting.

 The group discussed that programs are being tasked to conduct project reviews as it relates to stopping defunded APD projects.

  • PMT requested to include the project business sponsors to work with technical team to develop the recommendation for ESC. 

PMT requested to review the documentation that is developed for the recommendation.

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:  

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

Jane Hardwick, Nicole Names, Denise Moreland - EAB

ISBM Update - August 2018

Key Highlights This Month:  

ISBM Presentations Coming Up

  • MAFAS/Minnesota Association of Financial Assistance Supervisors – August  23 meeting
  • MFWCAA/MN Financial Worker Case Aid Association  - October 24 – 26 Conference
  • Presenters will be MACSSA: Marti Fischbach and Rachel Grimes with DHS: Donna Biederman and Kristen Shouman. See attached PowerPoint
  • Key discussion questions are.
    • How can we help people understand their options, as opposed to telling them what they should do?
    • What opportunities come with considering their whole family or household?  (For example, if a family includes a preschooler, adult child with a disability, or a senior?)
    • Where are these “integration” conversations already happening?
    • What are the challenges/opportunities to these approaches?

MACSSA 8/22/18 Forum Presentation on “How ISBM is changing the approach to Modernization projects and that counties can be paid for their staff’s involvement with the Interchange Agreement” Look for handouts.

  • Hiring stakeholder engagement specialist with a county perspective: Connect with county staff across the state to promote innovation and align efforts on integrated services.  We need 2 half-time or 1 full-time staff that is ready for a new challenge, from a county that wants to influence the direction. Costs for current county staff will be reimbursed to the home county through Modernization funds with a DHS interchange agreement.  Look for more details soon.  Can’t wait? email bina.nikrin@hennepin.us.

MACSSA Fall Conference Planning is underway: Working with MACSSA Fall Conference Committee, Janet Goligowski, Chair, and with a larger group that includes key county and DHS staff along with APHSA consultants.  Planned presentations include the following, with an emphasis on counties sharing their unique experiences working on these already and how these all fit together in the integrated model. Watch for conference registration

  • 2Gen/multi-generation
  • Social Determinants of Health
  • Person-centered thinking
  • Data Analytics
  • Value Curve
  • Equity

Requested Actions Needed From MACSSA:  None

New Trends in This Area:  Less emphasis on the “process model” and more focus on the six guiding principles listed above, as foundational to integrated services

Issues/Concerns Regarding This Topic: NA  

Legislative Impacts:  NA

Supporting Materials:  NA

Contact(s):  Bina Nikrin, 612-596-7921  

Supporting Materials:  

Contact(s):  

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