This is a brief summary of the primary activities I am involved in with DHS. There are miscellaneous things that occur on an ongoing basis, but these are the groups/issues that are fairly standard.
245D/Licensing-Currently there are no regularly scheduled meetings on this topic, but we get together as needed to discuss issues that arise or to coordinate potential revisions to 245D. The most recent issues involve concerns over things that we revised last year, discussion on things that still need revision, and ongoing interpretation of the statute. This includes frequent contact to clarify the county role in oversight of 245D.
DWRS- There are ongoing stakeholder meetings that I am not involved in, but I have been invited to attend some of these meetings- depending on the topic. Outside of the regularly scheduled meetings there are meetings scheduled to deal with current implementation problems- including inconsistency or errors in county implementation, issues around nursing hours, pro-rated leave days, inaccurate or not timely service authorizations and numerous other problems.
HCBS Experts/Partners Panel- This group is made up of representatives from most of the major long term care stakeholders. We normally meet every other month, although meetings are added if things are really jumping. The time at these meetings is spent bringing people up to speed on DHS initiatives as well as getting input from the group on issues as DHS moves forward. These are normally half day meetings, but dependent on the agenda have also been full day meetings, as the one this month will be.
Monitoring Technology- DHS has been working on developing policy regarding the use of technology. They have invited stakeholders to be a part of the process, a bit after the fact actually. ARRM was really the only residential provider representative initially invited, thus we then requested to add some of our members to the group. These meetings have not been on a regularly scheduled basis, but have been fairly frequent the last few months. In addition to the meetings called by DHS, the stakeholders have been meeting separately, and ARRM members have also held separate meetings as ARRM’s Service Innovations Committee determined that rather than reacting to the proposal from DHS we should draft our own proposal/recommendations to DHS.
HCBS Report Card- There is a requirement for DHS to develop a report card to be used to help individuals make decisions regarding service providers. We have been involved in some initial stakeholder meetings as they begin the process for a limited number of waivers. Initially they will develop a report card for the ILS, customized living, and supported employment services. The intent is to eventually have report cards for all waiver services.
Electronic Medical Records- This group initial met as needed, only a few times. They are now developing a regular stakeholder group with routine meetings. The impact on our members is probably farther down the road, but it is necessary to have a seat at the table now. Hopefully, an ARRM member can be found to fill this role.
Positive Behavior Supports- This is a part of the changes required due to the METO lawsuit. There are meetings as needed and webinars approximately twice per month for three hours each. The intent for meetings is to gather information as well as provide information on the changes in behavior management standards. We have also had several meetings at our request. The webinars provide information and training and also have a component to allow questions to be asked of licensing staff. One of the primary reasons to participate is to hear first- hand what DHS is telling providers.
Rule 40 changes- This is the second part of changes required by the lawsuit. Although a draft of the rule was to be written by August of 2014 – DHS has now pushed the date to the end of the year. There were some preliminary meetings early on, but we are now waiting for the final draft in order to provide comment, etc. Steve Anderson (Mount Olivet Rolling Acres) spent two full days per month attending stakeholder meetings to provide input on the new rule. My involvement has been focused on the results of those meetings and big picture implementation issues.
State Quality Council (SQC)- This is a group with members who are appointed by the governor. This group meets once per month, occasionally additional meetings are added. Members are also expected to participate in one of the sub-groups and these meet one-two times per month. The primary focus of this group is to look at overall quality issues in the HCBS services. Their main recommendations are to establish regional quality councils and a system modeled after Region 10- VOICE Reviews. No funding has been allocated for any of the group’s recommendations, and the Council was also not funded for the current biennium. The Council has been supported by funds from the DHS budget the past two years.
SQC Risk Group- ARRM’s issue of looking at risk was assigned to the SQC. There is a sub-group that has been working on this and we currently meet twice per month. We submitted a report to the Legislature last year. It contained the issues we identified. We are now working on the second part of the report that will identify possible solutions and make recommendations on how to advance them.
MNChoices- This group provides input into the new assessment process. This group normally meets once per month, but at times meetings are not consistent, depending on what phase the project is in.
CMS Transition Plan- This is a limited group of stakeholders who are advising DHS on how to gather information as they work to develop their transition plan to meet the new CMS Final Rule. This group is scheduled to meet twice per month and I am sharing this with Devin Nelson (Habilitative Services, Inc.). In addition to the meetings are a number of webinars or other meetings that require attendance as DHS works on this issue. It is anticipated that this will end, or the group will transform, once the bulk of the work is done by the end of 2014.
Background Studies- There is not an ongoing workgroup, but as DHS continues to move forward with the changes they pull together stakeholders to meet and get input/feedback. There are also other meetings scheduled to share information as the project progresses.
Money Follows the Person (also called “Moving Home Minnesota”)- This stakeholder group is tasked with proving input on how to move this grant project, intended to assist people in moving out of institutions, forward. Initially meetings were held monthly, they are now held on an “as needed” basis.
ARRM staff and members are deeply involved in other DHS initiatives, including a plethora of Disability Waiver Rate Setting (DWRS) groups and issues and quality improvement projects.
-- Barb Turner, ARRM COO