DISABILITY SERVICES QUARTERLY UPDATES WEBEX SPRING 2021
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Disability Services Quarterly Updates WebEx
Spring 2021
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Welcome
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3
Agenda
• DHS Announcements
• COVID-19 Updates
• Upcoming Training Sessions/Webinars
• Tech 4 Home
• Resources
4
DHS Announcements
Disability Services Division
Fall 2020 5
2021 DSD Initiatives Outline
Community First
Services & Supports
Waiver Reimagine (CFSS)
Service Streamlining
MnCHOICES Revision
Employment First MN Project
E1MN
Electronic Visit
Verification (EVV)
Quarter 1 Quarter 2 Quarter 3 Quarter 4
6
MnCHOICES Revision Updates
• On track for a November 2021 statewide launch.
• Launch webinars for supervisors and mentors see the CountyLink
page; MnCHOICES Revision Project-launch webinar schedule.
• Updated the Revised MnCHOICES workstation technical
specifications document
7
Waiver Reimagine Phase 1 updates
January:
• Streamlined service Menu for all disability waivers.
February:
• Updated CBSM – Waiver Reimagine streamlined service crosswalk
• New Resource CBSM Service options for individualized home
supports.
8
Waiver Reimagine Phase 1 updates continued
March:
• Updated CBSM- Individualized home supports billing section
April:
• New guidance about overnight staffing options under the DD Waiver
CBSM-Service plan options for people living in their own home when
transitioning from daily SLS.
• Updated numerous CBSM pages to outline information about authorizing
services when a single provider leases or owns more than one setting
located on the same or adjoining property. (Residential and Non-
Residential services)
9
Waiver Reimagine Phase 2 updates
Individual Budgets:
• Continued stakeholder engagement in 2021
• Development of budget exception process
10Reshaping waiver updates
Consolidate the four disability waiver programs into two waivers.
• The Individual Supports waiver would serve people living independently or
at home with family.
• The Residential Supports waiver would serve people living in paid
residential settings, such as community residential settings or housing with
services settings.
• With these changes, services and supports will align with a person’s living
situation, not their diagnosis.
• Both waivers will support all levels of need and retain existing eligibility
criteria.
11Waiver Reimagine FAQ
• Why 2 waivers and not 1 waiver?
• The 2-waiver approach by living setting incents people to live in their own
home/family home as there are more service options that promote/support
independent living, including a variety of self-directed service options
• Provider-controlled residential services are bundled including many functions such
as assistance with activities of daily living, behavioral support, and independent
activities of daily living. These are also all separate/distinct unit based services that
a person living independently could receive. If these services were available to
everyone on one waiver, there would be greater risk of service duplication.
• We need to differentiate between people living in provider controlled settings and
own home/family home to monitor compliance with HCBS settings requirements at
an individual level
12Waiver Reimagine FAQ continued
How will people move between the 2-waiver system?
• Movement will be driven by the support planning process and where
a person chooses to live.
• DHS is developing a process to monitor demand for movement
between waivers.
13Waiver Reimagine Feedback survey
In May, we plan to launch a survey to receive feedback from lead
agencies on the transition from a 4-waiver system to a 2-waiver
system. We need your input on the following topics to inform policy
moving forward:
• Criteria for accessing the Residential Supports Waiver
• Removing habilitation requirement in a 2-waiver system
• Services available on Individual Supports waiver and Residential Supports
waiver
• Lead agency roles in a 2-waiver system
14Waiver Reimagine Office Hours
Office hours will be held from 9-10 am on:
• May 28, 2021
• June 25, 2021
• July 23, 2021
15Waiver Reimagine Resources
Waiver Reimagine FAQs
2021 Waiver Reimagine Legislative Report (PDF)
2020 Waiver Reimagine Communications and Engagement Summary Report (PDF): This report provides detailed
information about our 2020 virtual stakeholder engagement and communication.
Waiver Reimagine: Simplifying the service menu: This new page provides service planning information and scenarios for
each streamlined service.
Disability Hub MN Waiver Reimagine: Overview This new page provides information about Waiver Reimagine to people and
families, including tools and resources for planning services and supports.
Changes to simplify and expand disability services (PDF): We sent this letter to people who access services and their
families to explain the Waiver Reimagine changes and our next steps.
Questions: Waiver.Reimagine@state.mn.us
16Assisted Living Licensure
Assisted Living Licensure law passed
August 1, 2021: Assisted Living
June 1, 2021: Licensure goes into effect
May 1, 2021: Assisted Living settings Conversion
can begin applying for licensure applications must
be completed
May 31, 2021: 60 Day
Provider Notice due
May 2019 May 2021 June 2021 August 2021
17What an assisted living facility WAS vs. WILL BE
• What it WAS
• Housing with Services
• Home Care
• What it WILL BE
• Under the new law, all will be licensed as Assisted Living facilities
• Some settings are exempt
5/7/2021 Optional Tagline Goes Here | mn.gov/websiteurl 18Notice of and Planning for Changing Providers, Discharge or Closures
Provider must give notice of their decision to close or terminate services.
• This notice must be provided to people and their case manager at least 60
days before the expiration of the provider’s license or by May 31, 2021,
whichever one occurs earlier.
• This is to provide people enough time to locate a different service provider
that can meet their needs.
19Assisted Living Licensure Webinar for Waiver Case Managers
Wednesday, May 19, 2021 2:00 p.m. to 3:30 p.m.
Join the Webinar with this link:
https://minnesota.webex.com/minnesota/j.php?MTID=m9eede8f10d9863778a79050b41
f89a51
After attending the webinar Waiver Case Managers will be able to:
• Describe the resources and tools available in the Assistive Living Lead Agency Toolkit
• Recognize the role and responsibilities of waiver case managers
• Understand common scenarios of licensure transition and frequently asked questions
• Ask additional questions they may have regarding ALL
20Assisted Living Licensure resources
• MDH Assisted Living Licensure webpage
• Assisted Living Fact Sheets
• Contact health.assistedliving@state.mn.us for questions about the
assisted living licensure requirement
• Contact dhs.aasd.hcbs@state.mn.us for questions about new
provider standards for customized living providers
21ICF/DD Local Systems Needs Plans
Lead agencies must submit their Local System Needs Plans (LSNP) to
DHS before July 1, 2021.
Submit plans or questions about plans to dhs.icf.dd@state.mn.us or
by fax to 651-431-7589.
22Disability Waivers public comment period
• DHS requests public comments on amendments to the disability waiver plans
• DHS requests public comments on spring 2021 waiver plan amendments before we
submit them to the federal Centers for Medicare & Medicaid Services (CMS) for approval. These
amendments apply to the following home and community-based services (HCBS) waivers:
• Brain Injury (BI)
• Community Access for Disability Inclusion (CADI)
• Community Alternative Care (CAC)
• Developmental Disabilities (DD).
To view the amendments and submit comments, visit the full announcement: DHS requests public
comments on amendments to the disability waiver plans.
23IMD admissions & Waiver programs during the
Public Health Emergency Period
Disability Services Division
Aging and Adult Services Division
24Requirement outlined in DHS Bulletin 20-56-06 The requirement to continue eligibility for people receiving LTSS programs was effective March 18, 2020, and continues until the end of the COVID-19 Public Health Emergency (PHE) period. The requirement applies to these LTSS programs: • Alternative Care (AC) • Brain Injury (BI-NB and BI-NF) Waiver • Community Alternative Care (CAC) Waiver • Community Access for Disability Inclusion (CADI) Waiver • Developmental Disabilities (DD) Waiver • Elderly Waiver (EW).
Allowable Reasons to Terminate Waiver or AC Eligibility
A lead agency cannot terminate a person’s enrollment from an LTSS
program during the COVID-PHE except for the following reasons:
• The person chooses to exit the waiver or AC program
• The person moves out of state
• The person has died
• The person has been admitted to an institution for more than 30 days.
• Institutions included here are limited to nursing facilities, certified boarding care facilities,
ICF/DD settings, and hospitals.
• The definition of institutions here does NOT include treatment settings that are IMDs.Institute for Mental Disease (IMD) What is an IMD? Institute for Mental Disease (IMD) are settings that have 16 or more beds where people receive mental health, chemical/substance use disorder (CD/SUD) treatment, as well as additional medical and/or nursing care services.
Waiver and IMD admissions during the PHE
When a person on a waiver is admitted to an IMD:
• Do not exit the person from their LTSS program.
• Do close the Service Agreement
• Do communicate with the financial worker
• Do contact DHS right away for technical assistance.
282 of 2 - DHS IMD Technical Assistance outreach Lead agencies should contact dhs.aasd.hcbs@state.mn.us and include the following information: • PMI • A timeline of the person’s recent changes in living arrangement • Completed or needed assessment activity and effective dates • Troubleshooting that has already been completed.
DHS IMD Technical Assistance support
DHS staff will support the lead agency by providing guidance on:
• Resolving any MMIS edits and required MMIS actions during the
person’s IMD admission.
• Reassessment guidance if applicable
• Steps that need to be taken once the person has a plan to return to
the community.
301 of 2 - DHS IMD technical assistance expectations Due to the complex nature of the MMIS system and current COVID-19 guidance lead agencies should expect: • Assistance may come in multiple forms from DHS (email, phone and/or WebEx with screen sharing). • Partnership between the Lead agency and DHS to troubleshoot possible solutions. • Technical assistance to be ongoing until it is resolved
IMD COVID-19 Resource References • DHS Bulletin #20-56-06 for information specifically related to continuation of waiver and AC eligibility throughout the national public health emergency period. • COVID-19 Frequently Asked Questions Webpage DHS will provide specific information and timelines to lead agencies related to all COVID-19 policy modifications as they are discontinued and/or replaced.
Contact DHS greatly appreciates lead agency ongoing partnership in maintaining waiver eligibility during the peacetime emergency. Please contact dhs.aasd.hcbs@state.mn.us for additional questions or clarification.
COVID-19 Updates/Resources
Disability Services Division
Fall 2020 34COVID-19 waivers and modifications
Waivers and modifications webpage provides:
• All of the waivers and modifications put into place during the
peacetime emergency.
• Date it went into effect
• Expiration date/projected expiration date
Send questions related to specific waivers and modifications to the
dsd.responsecenter@state.mn.us
35COVID-19 Vaccinations
• Make a plan for your vaccine and plan to help others who may need
help eList
• HUB resource regarding vaccine planning
• Host a COVID-19 vaccination pop-up clinic
• Vaccination coordination for people who are homebound contact
the MDH helpline 833-431-2053
36New guidance for Alternative Adult Day services
requirements
Effective March 29th, 2021, Alternative adult day services providers
may implement the following modifications:
1. Increase the max daily service duration (remote and/or in person)
to one person at a time from 4 hours per day to 6 hours per day.
2. Increase the max number of people attending online events:
• For people on disability waivers does not include a cap for the number of
people participating in online events. The authorized staffing ratio is based
on the average staffing ration for delivering the service.
37Upcoming Training sessions/Webinars
38Technology Resource Training Series
Session 1: The What, Why and How of Support Technology in MN
• Thursday May 20th 9:30 am -12 pm or 2-4:30 pm
• Wednesday June 16th 9:30 am-12 pm or 2-4:30 pm
• Thursday July 8th 9:30 am-12 pm or 2-4:30 pm
Session 2: Tech 101
• 5 online modules available at www.assistivetechnologyresources.org
Session 3: Sample case studies for participants to practice technology
conversations. Date TBD
39Employment First MN Training
Employment First MN: Engage – SPPLC presentation 3/31/21
• An encore playback is available until June 30, 2021, call 1-855-859-
2056 and enter conference ID 9561488
Employment First MN: Plan Phase- SPPLC presentation 4/28/21
• An encore playback is available until July 28, 2021, call 1-855-859-
2056 and enter conference ID 3463387
Employment First MN: Find Phase- May 26th
Employment First MN: Keep Phase- June 30th
40Waiver Reimagine Workgroup Discussion – Phase 2
The Waiver Reimagine fiscal team will be joining the County-Fiscal
meetings to provide updates and to hold discussions with lead agency
staff regarding Phase 2 of Waiver Reimagine.
Upcoming meeting dates:
• 06/08 from 12-2 pm
If interested in joining these meetings, email waiver.reimagine@state.mn.us
412021 Odyssey Webinar Series
Registration for the second 2021 Odyssey webinar is now open.
Registration Page: https://mn.gov/dhs/odyssey/attend/2021-odyssey-
series/
• Cultural and linguistic competence: June 9, 2021, 12 – 3 p.m.
• 2021 Legislative Session updates: July 20, 2021, 11 a.m. - 12:30 p.m.
• Reinvention: September or October 2021
42DSD Training News and Information
DSD training news and
information
• Upcoming trainings
• New online self-paced
trainings
• Link to training archive page
• Additional training
opportunities
43Sue Redepenning Assistive Technology Services
LiveLife Therapy Solutions Services Technology for HOME-grant funded DHS Disability Services Tech for Healthy Aging-funded by the LiveWell Grant partnered with Lighthouse Center for Vital Living LiveLife Therapy Solutions options for billing/services
Technology for HOME (T4H): • Partnership with DHS Disability Services and LiveLife Therapy Solutions. • Contracted until June 30, 2023. • All ages, home of their own or family, on MA have a county service and need AT. • T4H completes complex advanced practice AT assessments and training-the type of things you cannot be traditional billable AT. • Within this program, AT expertise is provided to DHS and insight to things that maybe are missed within practice in counties/tribes in MN. This is done for learning/teaching and outreach for RRS and Lead Agencies. • Advisory time from the program to DHS as needed and directed each year. • Time to develop resources in AT to share and develop partnerships to help in the area of AT. • Train the trainer time in AT for MN. • Submit a referral for service (technologyforhome.org)
• T4H has funding to see 300 people
T4H a year.
We are starting year 4 of a 5-year contract. It
started Feb 28, 2021.
• T4H completes approximately 900
training sessions per year.
• With remote technology the
numbers of people we can see will
be more. Last year we did see 429
people.AT areas of practice T4H AAC • Needs to be done in home, needs a team approach. EADL’s and ECU/Sensory • Needs are complex, team approach DME, Simple Home Mod, Safety and Power Mobility • There is not a home health option, team approach needed in home.
T4H follows DHS guidelines: • Person lives in a home of their own, or with family; they have AT needs, and they have a county service. • Provide expertise Team assessment and training. • Matching the features of the technology with the person, their environment, their technology support needs and training abilities. • Outcome is continued use. Abandonment happens often when assessments and equipment match does not happen. • Assist with bid. • Advise to DHS from Tech for HOME Program Manager.
Tech for Healthy Aging Project : • 65 and older • Living in their own home or assisted living • AT assessment/training • 65 and older • Living in their own home or assisted living • AT assessment/training • Funded until June 30,2022 then to become a billable service
Targeting residents in 37 Greater Minnesota counties But any Minnesota resident age 65+ with a disabling condition is eligible People of any income level can be served. Cost sharing may be asked
Why this
Program is
So Important
Crucial need to help more seniors age
safely in their own homes
Technology has great potential to help,
but often misses the mark for older adultsLack of Proper Training May discourage many older adults permanently from technology use
Poor Technology Design Technology often not designed for older adults. People trying to help may not know best options for seniors
Lack of Professional Understanding May not adequately respond to cultural differences
Geographic and Economic Barriers Lack of affordable internet, especially in parts of Greater Minnesota
Outreach, continued Area Agencies on Aging MN Help, Senior Linkage Lines Aging organizations Letters, fliers, press releases, success stories, social media MN Occupational Therapy Association DHS county workers
• 245D license
• Applying to bill waiver
LLTS AT services::
• Contract for services
• Private PayWaiver billable services: There are more billing options available to the waiver then 8 years ago when Tech for HOME started. Goal will be to direct billable options to billable resources. If a referral comes into T4H or T4HA but are billable AT assessment or training, then referral options will be provided with choices. LiveLife Therapy Solutions and our programs and projects focus on AT delivery. We do not sell AT equipment.
Assistive Technology
Switch access or app to allow on/off for things in the person’s environment:
Low Tech:Memory aides/Reminders
Medication Reminders
Voice Recorders Simple Smart PhonesAlerts
Low Vision Aides
AAC High Tech Options:
Tobi Dynavox: Eye Gaze
Prentke Romich Accent
Ablenet
Freestyle Control Bionics Talk to Me
TechnologiesAAC Mounting options:
Modular hose mounts
Rigid Mounts
Floor mounts
Blue Sky versatile mountsFunding Assessment Training Equipment
Medical funding:
Clinical doctor ordered services: Equipment:
• Clinic based • AAC communication devices
• Home care but there are less • Mobility Devices
options in the medical model
• Hospital Bed
• Provided by professionals such
as Speech, Occupational • Safety Bed
Therapist, Physical Therapist. • Durable Medical Equipment:
Rehab shower chair, walkersWaiver Funding
• Social model services • AT equipment
• ATP, therapist, MN-AS, or certifies • Equipment not considered
or professionally educated Durable Medical equipment or
professionals in AT. that is denied.
• Might occur in school, home, • The next step after checking
community or clinical setting. medical funding.
• Needs a bid or bids/approval
• Needs correct code for itemCommunity funding • This is last resort all other funding explored/exhausted. • Go Fund Me • Fund raising events • Arc Microgrant • Community organizations: • Lions Club, Rotary Club, VFW, churches
Thank You • Sue Redepenning • LiveLife Therapy Solutions, Inc. • Technology for HOME • sue@livelifetherapysolutions.com • 612-968-0832
Resources
72DHS COVID-19 Resources
• DSD COVID-19 website: COVID-19 Updates from Disability Services
Division / Minnesota Department of Human Services (mn.gov)
• DSD COVID-19 FAQ: DSD COVID-19 frequently asked questions /
Minnesota Department of Human Services (mn.gov)
• DHS waivers and modifications: https://mn.gov/dhs/waivers-and-
modifications/
2/26/20
73MN Dept. of Admin COVID-19 Resources
Critical Care Supplies: mn.gov/ppe website
Find Testing Locations: https://mn.gov/covid19/for-
minnesotans/if-sick/testing-locations/index.jsp
Vaccination Information: COVID-19 Vaccine Information for
Health Professionals - Minnesota Dept. of Health
(state.mn.us)
2/26/20
74Resources
Communications from DHS
Official policy communications to inform DHS business partners, about program changes and
Bulletins required actions
Official policy communications to inform Disability Services Division business partners, about
E-List Announcements program changes and required actions
Policy and general reference
Community-Based
Online manual and reference tool for lead agencies who administer HCBS.
Services Manual
A website designed for counties administering all DHS programs that includes manuals,
CountyLink performance measurement data, training resources, and I.T. systems (including SSIS and
MnCHOICES, including MnCHOICES Matters).
75Thank you! Email: DSD.RRS@state.mn.us or DSD.ResponseCenter@state.mn.us Phone: 651-431-4300 or 866-267-7655 (toll free)
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