MnCHOICES Matters June 17, 2013 8:00 am – 11:00 am Odyssey Duluth, MN

1. MnCHOICES Matters June 17, 2013 8:00 am – 11:00 am Odyssey Duluth, MN

2. Housekeeping • Break about 9:30 am • Restrooms • You “matter” today • Policies • Assessment • Workflow • Staffing • Funding • MnCAT • Launch • Other • Format for today

3. Objectives • Participants will be able to: • Describe the current status of the MnCHOICES launch • Share concerns about implementing and managing MnCHOICES and gain strategies from colleagues • List at least three action steps they will take within two weeks of participating in the Preconference Intensive

4. Update and Review

5. Launch Strategy: Stepped Roll-out • Launch begins November 4, 2013 • Lead agencies grouped in intervals: • 6-8 weeks; • 3-4 weeks; and • 2-3 weeks • All lead agencies using MnCHOICES by June 2014

6. Launch Strategy: New Assessments Only • New Assessments = Used to determine eligibility for people who are not currently on programs or receiving long-term services and supports for which MnCHOICES determines eligibility such as: • Alternative Care • Home and Community-Based Waivers • Personal Care Assistance Services • Consumer Support Grants • Family Support Grants • Case Management for persons with Developmental Disabilities • Semi-independent Living Services

7. Launch Strategy: New Assessments Only • Exception to the “new” only rule • A new assessment is completed for a person in MnCHOICES; and • Person needs reassessment before reassessments are launched

8. Launch Strategy: Reassessments • Reassessment = Used to re-determine eligibility for people currently on programs or receiving long-term services and supports for which MnCHOICES determines eligibility such as: • Alternative Care • Home and Community-Based Waivers • Personal Care Assistance Services • Consumer Support Grants • Family Support Grants • Case Management for persons with Developmental Disabilities • Semi-independent Living Services

9. Launch Strategy: Reassessments • Launched separately • After lead agency is comfortable with MnCHOICES “new” assessments • DHS will work with lead agencies to develop a reassessment transition plan considering: • How and when to begin • County of location vs. county of financial responsibility • Transition of 65+ from fee-for-service to managed care • Continuation of current reassessment process during launch of new assessments

10. Launch Strategy: Who Goes When Dakota Ramsey White Earth Hennepin FI = First Implementer

11. Launch Strategy: Who Goes When • Other considerations • Managed Care Organizations (MCOs) may launch after or together with the lead agencies they serve • County-based purchasing groups may launch together or sequentially • How to handle needed transfers from a lead agency that launched and one that has not

12. Launch Strategy: Who Goes When • Announcements • May 2013 – Initial two launch groups • August 2013 – Anticipated order of all launch groups • February 2014 Confirmed order of all launch groups

13. Launch Strategy: Note…. • Payment • October 1, 2013 time studies for assessment activities begin for counties and tribes • DHS Financial Operations Division will provide communication, training and technical assistance before start • Considerations when MnCHOICES launches • Counties may continue current contracting practicesfor reassessment during launch of new • Contract language must be revised to assure no duplicative payments

14. Launch Strategy: Note…. • Payment • BRASS codes change January 2014 • Payments (allocation) from Nursing Facilities ends 09-30-13

15. Launch Preparation: Beta 3 Testing • First Implementers begin late summer 2013 • Will test: • Workflows • Social Services Information System (SSIS) integration • Person search • Intake • Assignment • Transfer • Assessment

16. Launch Preparation: Beta 3 Testing • Will test: • Help Desk • Application revisions based on beta 2 feedback • Rules revisions • Content revisions • Organization of content

17. Launch: Next Steps • DHS will have discussions with lead agencies around readiness • To develop launch order • In preparation for individual launch groups • DHS will invite lead agencies to identify MnCHOICES Mentors • DHS will provide a description of roles and functions of the MnCHOICES mentors • Lead agencies will identify individual(s) • DHS will provide training and technical assistance

18. Launch: Next Steps • “Some” things we are working on at DHS: • Help Desk • Survey • Roles of MnCHOICES Mentors • Communication • Beta 3 • Tools • Assurances • Payment • Training

19. Topics You Want to Hear About Policies “The” Assessment Workflow Staffing Funding MnCAT Launch Other

20. Policies: How to proceed if…. • MnCHOICES determines person meets eligibility criteria for both NF and ICF/DD • Interface with waiver management system • Screening document(s) to enter in MMIS • Waiver waiting list(s) • Sent to policy staff

21. Policies: Separation of duties…. Evaluating case management services Discretion of counties/tribes in separating duties of case management services from the administrative functions of case management

22. Policies: County of location “interference” What is told to the person about the services and programs for which the person may be eligible?

23. Policies: Assurances • Perform administrative functions and activities • Provide access to assessment process • Assure an adequate number of certified assessors • Develop certified assessor multidisciplinary team • Provide resources for technology • Conduct quality assurance and monitoring activities

24. Discussion Time…. Policies

25. Assessment: Assortment Is it possible to have a cheat sheet for trouble shooting or not safe to bring into a home? How to attach forms and get electronic signatures? How have consumers responded?

26. Assessment: Assortment How is information about self-directed service options incorporated in MnCHOICES? What is time frame for including PDN? Does MnCHOICES produce waiver span effective dates?

27. Assessment: Assortment Community Support Plan (CSP) Social services vs. public health: How to work together on screenings Tell us about SNBC and MnCHOICES How will PCA hours be determined by MnCHOICES?

28. Discussion Time….. Assessment

29. Start Workflow

30. Workflow

31. Workflow

32. Workflow End

33. Workflow

34. Discussion Time…… Workflow

35. Staffing • Review existing data • How much time is spent now? • Analyze Volume Reports • Beta 2 findings • Average face-to-face <2.75 hours • Face-to-face range 1-5 hours

36. Staffing • Considerations • Travel time may be reduced with using COL • Intake operations can impact • Same functions, just separated • After several assessments process will get quicker • Intakes, HRAs and Assessments/Reassessments can all be copied • Intakes, HRAs and Assessments/Reassessments can all be transferred

37. Staffing: $64,000 Question…… Should staff do assessments “100%” of time

38. Staffing • Multidisciplinary teams • Social workers; public health nurses; closely related fields • Two or more counties may collaborate to establish a joint local consultation team or teams • The commissioner shall allow arrangements and make recommendations that encourage counties and tribes to collaborate [MN Statutes 256B.0911, Subd.3]

39. Discussion Time…… Staffing

40. Show Me the Money! October 1, 2013 lead agencies begin random moment time study for all assessment activities

41. Show Me the Money! • No changes in payment for MCOs • Screening and assessment HCPCs edit for counties/tribes (PCA, DD and LTCC) • Non-federal share paid by DHS 

42. Show Me the Money! • Counties and tribes that contract with other agencies for case management services must: • Revise contracts • Ensure no double payments • Code administrative activities in RMTS • Enter service agreements including not more than one (1) provider of case management

43. Discussion Time…… Payment

44. MnCAT • Training is available in TrainLink • Communication sent to lead agencies 05-30-13 • Step #1 Overview – watch and learn • Step #1 Foundations – 9 tests • Step #2 • Course 1 • Course 2 - Test • Course 3 - Test • Course 4 – Test • Course 5 – Test • Course 6 – Test • Course 7 • Step #3

45. MnCAT • Step #3 • First Part: Access, Navigation and Function • Initial set-up and login • Creating documents • Basic navigation • Orientation to content • Functionality • On-line/offline use • Post training quiz to demonstrate understanding

46. MnCAT • Step #3 • Second Part – Skills Building • Familiarity with content • Must review and become familiar with “required” domains • Short quizzes to determine comprehension • May review content on optional domains • Domain practice guides • Using MnCHOICES • Enter minimum number (1-3) of assessments into MnCHOICES • Not real – use scenarios provided or current knowledge of client-types

47. MnCAT Based on articles in Gallup Business Journal 02-2013 and GBJ Workplace 01-2013 • Supporting staff: • Choose staff who are passionate about this part of their work • Plan for what ifs and expect some bumps • Start early and “chunk-it-up”

48. MnCAT Based on articles in Gallup Business Journal 02-2013 and GBJ Workplace 01-2013 • Supporting staff • Determine how each person may want/need to approach • Encourage individuals to lead learning activities • Training is not a one-time event keep it active • Ultimate goal is to transform culture, not get through training

49. MnCAT: Suggestions and Strategies Adapted from The Energy Project, 11-16-2010 Do the hardest part(s) first Practice, practice, practice…… Take a break Ritualize their “MnCAT” learnings in pre-MnCHOICES practice Set priorities

50. Discussion Time…. MnCAT