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As the launch date approaches, DHS will continue to listen to agency partners on the project, while bringing to a close the development of the revised MnCHOICES application.
Over the last several months, DHS and FEI Systems collected test results, prioritized fixes for future releases and collected change requests for future updates. The MnCHOICES System Governance Group (SGG) and MnCHOICES Input Group (introduced in our eList from May 23, 2022) started to review user impact for future changes that address fixes and new functionality. In December, selected lead agency staff began the next round of user acceptance testing (UAT). In November 2022, mentors re-started their system training, while agency staff will re-start their training in January 2023.
DHS’ vision for MnCHOICES is that the system helps everyone in Minnesota to have access to the full range of integrated, person-centered human services through comprehensive, sustainable technology. The core system from FEI Systems, with specific enhancements, will provide DHS and its community partners with an integrated system of assessment, support planning and evaluation.
The work throughout the last several months was focused on the give and take needed to make changes to a vendor’s system. With the MnCHOICES launch on the horizon, users will learn to use the current functionality and future enhancements document to guide their work. In addition, DHS is aware that the system will need changes in the next year that will improve and enhance its functionality. DHS will continue to collect input from agency mentors using the MnCHOICES Help Desk Contact Form, DHS-6979 and work with the SGG and MnCHOICES Input Group to prioritize competing interests as we plan for future changes.
Legislative update – Remote reassessments
The results of the 2022 legislative session included changes to Minn. Stat. §256B.0911, subd. 3a (r), which outlines requirements for remote reassessments. The statute lays out the following:
- Remote reassessments conducted by interactive video or telephone may substitute for in-person reassessments.
- Remote reassessments may be substituted for two consecutive reassessments if followed by an in-person reassessment for services provided by the Developmental Disabilities (DD) Waiver under Minn. Stat. §256B.092 and the Community Access for Disability Inclusion (CADI), Community Alternative Care (CAC) and Brain Injury (BI) waiver programs under Minn. Stat. §256B.49.
- Remote reassessments may be substituted for one reassessment if followed by an in-person reassessment for services provided by Alternative Care (AC) under Minn. Stat. §256B.0913, Essential Community Supports under Minn. Stat. §256B.0922 and the Elderly Waiver (EW) under Minn. Stat., ch. 256S.
- A remote reassessment is permitted only if the person being reassessed, or the person's legal representative (if applicable), consents to a remote assessment after getting the information they need to make an informed choice from the lead agency. Lead agencies must document that a person was able to make an informed choice, according to the standard.
- The person being reassessed, or the person's legal representative, has the right to refuse a remote reassessment at any time and have an in-person assessment, instead. If the certified assessor determines an in-person reassessment is necessary during a remote reassessment, the lead agency should schedule an in-person reassessment.
- All other requirements of an in-person reassessment shall apply to a remote reassessment, including updates to a person's support plan.
During the federal public health emergency, DHS obtained permission from CMS to allow lead agencies to conduct phone or video visits in place of in-person visits for people who seek or receive home and community-based services (HCBS) and supports or people with developmental disabilities who need an OBRA Level II evaluation. Assessments, reassessments and case management visits can continue to be remote up to six months after the end of the federal public health emergency.
When DHS notifies lead agencies that COVID-19 policy changes will end, lead agencies should follow the post-COVID-19 policy for remote reassessments. DHS will communicate more about this new policy when an end date for the federal public health emergency is set.
Identify opportunities for efficiencies
In 2021, the Minnesota Legislature issued an appropriation to the commissioner of human services to review lead agency (county and tribal nation) policies and business practices to identify opportunities for efficiencies in long-term care consultation services and to make recommendations to lead agencies based on the review.
The MnCHOICES team contracted a vendor to review and analyze the business processes related to eligibility, assessment and support planning in order to recommend efficiencies, improvements and best practices within each agency. The contractor will write unique recommendation reports for each of the lead agencies analyzed, and present these findings to state leadership. The contractor also will develop a professional guide for applicants from diverse backgrounds (and their families) that covers the basic steps of the eligibility, assessment and support planning processes.
By conducting field-based analyses of the policies and business practices of lead agencies, the state expects to:
- Identify ways to improve and streamline the eligibility, assessment and support planning processes for long-term services and supports (LTSS).
- Work to increase capacity at the lead agency level.
- Improve workflows at the lead agency level.
- Identify best practices that can be implemented across the state.
This project is a part of Minnesota’s HCBS spending plan under Section 9817 of the American Rescue Plan Act of 2021.
DHS asked the vendor to engage with at least 15 separate agencies. The following counties and tribal nations are currently participating in this project, with the potential to add more: Anoka, Atkin, Beltrami, Chisago, Crow Wing, Des Moines Valley Health and Human Services (DVHHS) (Cottonwood and Jackson), McLeod, MnPrairie County Alliance (Dodge, Steele and Waseca), Morrison, Olmsted, Otter Tail, Polk, Ramsey, Sherburne, Washington and the White Earth Nation.
Culturally responsive system
The MnCHOICES team recently signed a contract with Queen Health Consultants. They will meet with key community members to collect insight and advice during community engagement sessions to optimize our communication about MnCHOICES assessments.
Queen Health Consultants is a Minnesota-based, woman- and minority-owned business that focuses on healthcare consulting and education. The company’s mission is to facilitate the transformation of healthcare systems into equitable institutions for all people. They develop platforms that allow healthcare providers and systems to be responsive to the unique needs of the diverse communities they serve. Queen Health Consultants also create evidence-based programs that address the roots of health inequalities and work directly with communities to help them become confident healthcare consumers.
Recently, an email went out to mentors that asked for assistance to recruit a diverse group of people to share what they know and need to know about a MnCHOICES assessment. Our goal is to attract community engagement session participants from several groups, with a focus on people from the:
- Black (with slave ancestry) community
- Latino/a/x community
- Hmong community
- Somali/Ormo community
- Native/Indigenous community.
The insight from community engagement events will help to:
- Update/redesign content in the MnCHOICES assessment brochure to reflect how different communities talk about health and disabilities.
- Create informational videos about MnCHOICES assessments in the language of the listed communities that is authentically articulated, which provides information needed to have access to a MnCHOICES assessment.
- Develop a resource for MnCHOICES assessors who work with interpreters.
The MnCHOICES team looks forward to our partnership with Queen Health Consultants. MnCHOICES Matters will provide updates and more information about this important work to better address equal access to a MnCHOICES assessment.
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Industry advice
The MnCHOICES team continues to see an increase in multiple TrainLink accounts that are associated with one certified assessor. TrainLink IDs are associated with access data in the revised MnCHOICES application. It is important for a certified assessor to have only one TrainLink record.
Can’t remember your TrainLink ID? Go to the TrainLink sign-in page, and select lookup unique key and sign in.
If the agency you represent or other information has changed since the last time DHS training activities were accessed, update your record with the TrainLink update request form and select “Update information” for the type of request.
Go to the TrainLink homepage for more information.
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Do you have a technical or workflow question that you would like help with? If so, submit your question on the MnCHOICES Help Desk Contact Form, DHS-6979 and choose “Other” under the QUESTION TYPE. We will answer one question per issue.
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You asked, we answered...
Question: When will MnCHOICES mentor meetings return to in-person meetings?
Answer: There are no plans, as of right now, to return to in-person meetings. Past MnCHOICES mentor meetings have been paid with contract funds associated with the MnCHOICES assessments and support plans. The revised MnCHOICES application is a vendor contract. There are not funds available for an on-site meeting. A survey will collect input from mentors about the meeting content and other key areas of interest.
The Lead Agency Review (LAR) team visited Ramsey County in August 2022. During the visit, the LAR team learned Ramsey County is busy implementing a new group of efforts to increase case management capacity and support their internal and contracted case management staff. The LAR report for Ramsey County will include this effort as one of the strengths.
Ramsey County’s approaches include:
- Culturally specific contract vendors.
- Two “vendor liaisons” to specifically support contracted case management agencies.
- Monthly consultation and training meetings for internal and external case management staff to attend and ask questions.
- A SharePoint site that is constantly updated and used for standard operating procedures and case file audits.
- A biweekly newsletter that goes out to all staff and contracted vendors to inform them of any internal changes and policy updates.
With the actions above, Ramsey County aims to better serve people in HCBS programs and make the work as easy and streamlined as possible for all case management staff.
Workforce shortage
DSD has heard from a number of other lead agencies regarding the pressures of the workforce shortage. The following are some of the capacity-building strategies they have shared:
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Expansion of case aide: Benefit by expanding and maximizing the case aide role within an agency to reduce the administrative demands of case managers.
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Integration of contracted case management: Have shared agency and contracted case management provider processes for information systems, communication, emails, phone banks, team meetings or communities of practice to help reduce administrative and duplicated work.
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Balance capacity: Address the needs of assessment and case management workforce, together.
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Development of supervisor training: Create and refine training for case management supervisors to support onboarding and retention for case managers.
DSD’s Support Planning and Informed Choice team continues to gather information and data to identify and understand the current need for the case management workforce. In June of 2022, the team shared a list of questions to gather initial information on the case management workforce from a select number of counties. This information has helped policy staff identify initial needs in the current case management workforce. If a lead agency or case management organization is interested in sharing case management workforce data with DSD, please use the DSD contact form to reach out and share information.
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From the MnCHOICES Help Desk: For a person with multiple PMIs
The MnCHOICES Help Desk often receives requests to merge PMIs, but that is not something we are able to do. However, we can help populate and add a new PMI to a MnCHOICES person record if that record does not have a current PMI. Mentors should use the help desk form to send us the new PMI and old PMI (if you have it). DHS will check and populate the new PMI if it is available.
Is there anything a user or mentor can try before requesting the help desk to populate the PMI?
Yes.
1. If there is no Social Security number (SSN) and no PMI, or there is no SSN and an old PMI in the MnCHOICES person record: Add the SSN and click “Update Person.” Then, go back to the person search page and search the person by SSN. Get back into the person page and check if the PMI populated. If not, send a request to the help desk.
2. If there is an SSN and no PMI, or there is a SSN and an old PMI in the MnCHOICES person record: Delete the SSN from the MnCHOICES person record and click “Update Person.” Add the SSN back and click the “Update Person.” Go back to the person search page and search for the person by SSN. Go back into the person page and check if the desired PMI populated. If not, send a request to the help desk.
Again, we can’t merge PMIs, but we can populate the correct PMI in MnCHOICES.
To have the PMIs merged: Submit a merge request through the MAXIS PF11 “TRBL-Problem Reporting” or email DHS.TSS.PMI@state.mn.us.
Rate and budget changes
Effective Jan. 1, 2023, DHS will implement increases to select service rates and monthly budgets. Additional information and resources about these changes now is on the Long-term services and supports rates changes webpage. For more information, go to our eList from Oct. 18, 2022.
The deployment of these rate changes to the MnCHOICES Support Plan Prod and MTZ platforms will occur Wednesday, Dec. 14, 2022. The change to rates will not require an outage. Outage messages will provide further instructions.
ISDS read-only access for county and tribal nation staff
The State Medical Review Team (SMRT) will provide view-only access to the Integrated Service Delivery System (ISDS) for some direct county/tribal nation employees who work as social workers, MnCHOICES assessors, case aides and other county workers who routinely request submissions of SMRT referrals. Access to the system allows these workers to monitor the status of SMRT referrals. This access is available only for direct county and tribal nation employees. Contracted county employees and community partners are not eligible for ISDS view-only access.
The State Medical Review Team (SMRT) will be hosting monthly ISDS User Meetings for county and tribal nation staff on the third Thursday of each month from 9 to 10:30 a.m. During the first half of the meeting, SMRT staff will answer questions and discuss SIR announcements posted that month. The second half will be dedicated to ISDS user training for people who seek view-only access.
Feel free to submit any questions in advance that you would like to discuss during the monthly meeting.
If immediate ISDS access for a county or tribal nation staff member is needed, please call or email SMRT and we will coordinate individual training with them as soon as possible.
Registration is required for upcoming SMRT ISDS training sessions:
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“The capacity to learn is a gift; the ability to learn is a skill; the willingness to learn is a choice.” ― Brian Herbert, author.
Visit the Disability Services Division training archive for ongoing educational courses and other training opportunities. Navigate to TrainLink to find additional training courses offered by DHS.
Cultural humility training
Blue Cross Blue Shield’s Center for Prevention offers a YouTube documentary series on cultural humility.
Cultural humility includes:
- A commitment to lifelong learning and critical self-reflection.
- Respectful partnerships with the people we serve by the identification and disassembly of power imbalances.
- Institutional accountability and a mutual respectful partnerships based on trust.
This series explores what brings us together as Minnesotans and celebrates the ways in which our distinct cultures lay the foundation for healthy living.
Cultural humility series: Anishinaabe
Cultural humility series: Black/African American
Cultural humility series: Dakota
Cultural humility series: Hmong
The Center for Prevention works to advance racial equity through health to help transform communities to be part of a healthier Minnesota. To learn more about the difference between the concepts of cultural competency and cultural humility watch “What is cultural humility.” (Video from the Psych Hub, a YouTube channel about mental health education)
Are there trainings you have found valuable and would like to share?
Ask your MnCHOICES mentor to submit suggestion(s) with the DHS-6979 Help Desk Contact Form and choose other for the question type.
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Visit the Community-Based Services Manual (CBSM) often for a list of policies and pages we've recently updated. For a list of changes, visit the What’s New page.
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