ARRM's Daily Dispatch

ARRM is addressing your concerns about the survey on behavior management issues

ARRM has recently received a number of calls from members regarding the residential services provider data request on the use of restrictive, aversive and deprivation procedures. There have been concerns about the length of the survey, the amount of time it will take to complete, the survey deadline and its general lack of clarity.

We are currently working with DHS to address these issues and seek some relief for those completing the survey. We will continue to provide updated information to you in a timely manner, and if you have specific concerns you would like to share with ARRM, please send them to Barb Turner bturner@arrm.org.

--Barb Turner, COO

Medicaid Reform Waiver released

During the 2011 legislative session, the Department of Human Services (DHS) was directed in the final budget agreement to apply for a waiver from the federal government to reform Minnesota’s Medicaid program.

The goals of reform were as follows:

• to increase community integration and independence;
• improve health;
• reduce reliance on institutional care;
• obtain or maintain employment and housing;
• provide long-term sustainability of needed services through better alignment of available services that most effectively meet people's needs.

Often referred to as the “global waiver,” this is an effort to restructure Medicaid services to reduce spending and deliver the most appropriate and cost-effective services.

DHS submitted its waiver application to the state register -- the first step in the process -- for public comment on June 18. That notice can be found here on page 1580 of the document. Submission triggers a 30-day public comment period that will end on July 17. A copy of the waiver request is available on DHS’s website here. DHS has also set up a website for the entire Reform 2020 project with additional information here.

ARRM staff have begun reviewing the contents of this waiver and analyzing the impact the changes would have on our members and the services you provide. We plan to submit comments on behalf of all members before the public comment period ends. At the same time, we encourage you to review the waiver request and provide any comments you have directly to the department. Written comments may be submitted to DHS via this email address: Reform2020Comments@state.mn.us.

There was a public comment hearing last week, and another scheduled for yesterday (Monday, June 25).

As always, ARRM will continue to monitor this and other issues important to our members, and will provide the most updated information via this blog.

If you have questions or concerns, please contact Craig Wieber at cwieber@arrm.org or by phone at (651) 291-1086 ext. 9; or Barb Turner at bturner@arrm.org or by phone at (651) 291-1086 ext. 3.

--Craig Wieber, Chief Fiscal Analyst

Contact ARRM if you're experiencing a crisis due to flooding

Due to the recent flooding in the Duluth area, we'd like to hear from you if your agency is experiencing a crisis. If you have any updates on your situation, or know of another ARRM member who needs assistance, please contact ARRM at 651-291-1086, ext. 0 or info@arrm.org.

We are in contact with members in the Duluth area who said they can be of assistance, and we can connect you with them.

Also, we’d like to make members aware of DHS’ policy in an emergency:

• In an emergency, do what is necessary to protect vulnerable clients and staff.
• DHS will manage reimbursement (within legal limits) afterwards.

Minn. Stat. §12A.01 and Minn. Stat. §12A.03 provide authority for state agencies to assist communities to recover from a natural disaster for areas of Minnesota that are included in a presidential declaration of major disaster. Minn. Stat. §12A.10 provides DHS with specific statutory authority to reimburse providers that incur additional costs assuring the health and safety of Medical Assistance (MA) recipients.

This assistance is only for costs not covered by other disaster assistance, private insurance or federal human services funding. This assistance is not for flood damage to buildings or property. Please read these statutes.

DHS will contact county directors in disaster areas to gather what information you have on affected providers and clients. See additional information about state reimbursement for flood damage and other resources related to flood recovery.

Again, please let ARRM know if you need our help.

Correction on background study requirements

In previous blogs and training provided by ARRM, we told you there was a change in the background study requirements for employees who are currently employed but who have not worked for more than 45 consecutive days. 

There were two bills passed during the 2012 legislative session that addressed this issue. One bill said that a license holder must initiate a background study when an employee has not worked for 180 or more consecutive days; the other bill said the background study must be done when the employee has not worked for 90 or more consecutive days.

Because the Legislature adopted the bill with the most recent language, the number of days that is currently in statute is 90, not 180. Here’s the specific language from that statute:

“Effective July 1, 2012 a license holder must initiate a new background study through the commissioner's online background study system when an individual returns to a position requiring a background study following an absence of 90 or more consecutive days.”

We apologize for the confusion and any problems this may have caused you.

If you have questions, please contact Barb Turner at bturner@arrm.org or 651-291-1086 ext 3.

--Barb Turner, COO

Check your MN-ITS mailbox for DHS payment methodology survey

The Department of Human Services had an announcement on the Disability Services Division mailing list about a new survey it is conducting, connected to the payment methodology project and DHS’s Waiver Rate Management System. This survey is being sent to specific type of providers: adult day service, prevocational service and structured day program providers. Because some ARRM members provide these services, we wanted to pass along the department’s notice.

DHS is collecting data on weekly staffing ratios. Eventually, providers and lead agencies will need to work together to identify an average staffing ratio over the course of a typical week for each recipient of day services.

If you have been selected to participate, you would have received notice via your MN-ITS mailbox. The announcement contains specifics on the type of information the department is looking to collect. It is available here.

Providers are supposed to complete several worksheets, and discuss the data for their services with county case managers between now and August 15, 2012. After consultation between county and provider staff, the final agreed-upon values will be entered into DHS’s Waiver Rate Management System. DHS will then use the data entered into the system to refine its payment methodology for day services, which will eventually be introduced as legislation during the upcoming legislative session. Because these data are the foundation of what the department uses to complete its recommendation, we strongly encourage providers to participate.

As always, if you have any questions feel free to contact me via email at cwieber@arrm.org or by phone at (651) 291-1086 ext. 9.

--Craig Wieber, Chief Fiscal Analyst

MPR story on group homes in very beginning stages

ARRM staff Bruce Nelson, Barb Turner, and Barb Brynstad sat down with Minnesota Public Radio reporter Madeleine Baran Wednesday, May 30 to offer the private provider perspective on an upcoming MPR story about group homes.

We learned that at this point, the story is still in its very beginning stages with no angle or focus. Baran is gathering information from a variety of sources to see where it will lead her. So far, she’s talked to ARRM, DHS, mental health providers, and family members of people with disabilities. With over 100 responses to MPR’s May 11 Public Insight Network query, Baran has received loads of insights about group homes -- both pro and con.

During our 90 minute conversation with Baran, we discussed the following topics:

• The history of disability services in Minnesota;
• The range of needs adult foster care fills;
• ARRM’s response to an unsustainable model and our Blueprint for Reform wins from the legislative session;
• Why ARRM’s approach is better than de-licensing, cuts, and a moratorium.

We also touched on licensing issues, monitoring technology, and ARRM’s vision for the future: providing services based on outcomes and quality rather than compliance. We emphasized that by offering people a range of choices rather than a “one size fits all” model, individuals can live up to their full potential.

Baran will let us know when she’s getting ready to publish a story, and we’ll pass that information on to you. Meanwhile, if you have any questions about the piece or media relations in general, please contact Barb Brynstad at bbrynstad@arrm.org or 651-291-1086, ext. 4.

-- Barb Brynstad, Communications Director