ARRM's Daily Dispatch

Updates on Significant DHS Administrative Rollouts

Following the end of the 2019 legislative session, the Minnesota Department of Human Services (DHS) staff have been hard at work implementing some of the statutory changes to policies and procedures, as well as other administrative changes, which impact providers of residential home and community-based services (HCBS).

Provider Cost Reporting vs. Labor Market Reporting

The provider cost reporting requirements for DWRS were enacted prior to 2019 for the purpose of providing DHS with hard data to support research on the cost of providing services, and to make recommendations on component values and inflationary adjustments. This year, the final health and human services omnibus bill signed by the Governor included new requirements for labor market reporting to be used for assessments of workforce and service access. Providers may now be wondering about the similarities and differences between these data sets. Here’s a little chart that may help shed light on what needs to be done.

Cost Reporting	Labor Market Reporting
Collected annually on a 5-year cycle beginning in 2020 (20% sample of providers with rates calculated by DWRS drawn every year)	Collected annually: -DWRS providers beginning Fall 2019 -Other HCBS providers beginning in 2020
Gathers information about specific dollars associated with service provision based on current cost centers	Gathers information about direct care worker salaries, benefits and retention
Data to be submitted online via portal	Data submission method TBD
Measures the cost of providing services	Measures the health of the direct support workforce
§256B.4914, Subd. 10a, para. a	§256B.4914, Subd. 10a, para. g; §256B.4912, Subd. 1a

DHS Announces Implementation of the Account Validation Service (AVS) for Medical Assistance (MA)

Pursuant to §1940 of the federal Social Security Act and MN Statutes, §256.01, subd. 18f, DHS recently announced in a bulletin that it will implement its electronic asset verification program called the Account Validation Service (AVS) beginning September 1, 2019. This service will be used to help identify unreported accounts when determining Medical Assistance (MA) (Minnesota’s Medicaid program) eligibility for people whose MA basis of eligibility is MA-ABD (aged, blind, disabled). Applicants and enrollees must authorize the state to request information from financial institutions as a condition of Medicaid eligibility upon initial application, status change to MA-ABD, or annual renewal. This is of interest to HCBS providers because of the potential for delays in approval of the applications, especially if unreported assets are discovered, which can delay placement and/or reimbursement. For more information, refer to bulletin #19-21-02 found here.

Efficiency updates to assessment process, short-term institutional stays, DD screening document

DHS made several updates to streamline processes and procedures related to the DD screening document. While these changes apply most directly to lead agencies, residential providers should be aware of them.

Eligibility updates – a new page added to the Community-Based Services Manual provides information about eligibility updates, which can be used to extend the time in which lead agencies can determine program eligibility without another in-person assessment

DD assessments – the requirement for an in-person DD assessment has been removed for a change in the county of financial responsibility and guardianship status

Assessment applicability and timelines – policies about who participates in an assessment, and change in condition, have been updated

Short-term institutional stays – this policy has been updated to allow the DD waiver to remain open for people who have short-term (less than 30 days) nursing facility stays

DD screening document and code book – DHS has made changes to sections that include action types, legal representatives, exits and screening scenarios

The full announcement of these updates can be found here.

Reminder: Important HCBS Changes now in Effect

As members are aware, the 2019 Health and Human Service Omnibus bill contained many important changes to Home and Community-Based Service. Initial information that ARRM provided contained an effective date of August 1^st, however because these items were contained in an overall appropriations bill, the effective date is July 1^st. We have since corrected this information in past communications and have been communicating the new date to members.

The Licensing Department recently released further guidance on some of the changes that we wanted to share with you, specifically, what licensing will be looking for in verifying that members have come into compliance with the new requirements.

Annual Conversation on Technology:

During licensing review, licensors will confirm that providers discussed the use of technology during annual meetings and documented the discussions in the coordinated service and support plan addendum. Licensors will also review the documentation for a decision about the use of technology and an indication of whether more information is needed to make a decision.

Annual Training:

There is no longer a requirement for a minimum number of hours of annual training. Orientation and annual training requirements for the Positive Support Rule have not changed. The requirement to document staff training has not changed. Providers must document staff training according to Minnesota Statutes, section 245D.095, subdivision 5, including the date the training was completed, the number of hours per subject area, and the name of the trainer or instructor.

Intensive Support Standards:

Service planning and delivery for in-home family support, in-home supported living services and semi-living services must now be provided following the standards of intensive support services.

For people currently receiving services, at the time of their annual service plan review, providers must follow the intensive support standards.

HCBS Billing and Service Documentation Requirements:

As a reminder, the following documentation standards must be met by providers:

• The date of the documentation
• The day, month and year the service was provided
• The start and stop times with a.m. and p.m. designations (for hourly or minute-based services)
• Service name or description
• The name, signature and title of the person providing the service. If the service is provided by more than one staff, the provider may designate one staff member responsible

Additionally, providers must have documentation that staff have reviewed and attested to the following statement on an annual basis: “It is a federal crime to provide materially false information on service billings for medical assistance or services provided under a federally approved waiver plan as authorized under Minnesota Statures, sections 256B.0913, 256B.0915, 256B.092, and 256B.49.”

ARRM has reached out to the department to get clarification on the expectations of providers to be in compliance with the requirement that all staff reviewed the above statement by the July 1^st date, we have not received a response and will update members as soon as we know more.

You can review the full Implementation Plan for 2019 Legislative Changes from the Licensing Division of the Department of Human Services below.

DHS Licensing changes 2019