Presenters: SUD Reform ITV Updates Tuesday October 16, 2018 10:00 am-11:00 am Diane Hulzebos, Leah Fernandez, Vicki Radinzel - Minnesota.gov
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SUD Reform ITV Updates
Tuesday October 16, 2018
10:00 am-11:00 am
Presenters:
Diane Hulzebos, Leah Fernandez, Vicki Radinzel
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 1Reform Updates
Diane Hulzebos, Vicki Radinzel
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 2Parallel Process - Two Portals - Diane
• Rule 25 Portal continues – only through 6/30/2020.
• During that time period, and once
• Systems and forms are updated,
• Provider assurance statements are updated,
• New providers have NPIs and are enrolled as an MHCP provider, and are enrolled in
DAANES, AND
• DHS informs stakeholders that Direct Access is ready,
• Then the Direct Access Portal will become active/available.
• DHS will notify stakeholders by e-memo when these are completed and
provide info re: necessary training.
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 3Parallel Process – Two Portals of Access until 6/30/2020 –
Diane
Rule 25 - 9530.6600-9530.6655 Direct Access (not yet)
• County/Tribal Placing Authority: • Client choice:
• MS, Section 256M • Provider of Comprehensive
Assessment (CA) (245G.07)
• Rule 25 Assessment
• Pre-admission
• MS, Section 256G
• Defines Medical Necessity
• Service Agreement > Enrolled
providers > SA Letter • Treatment Provider
• Comprehensive Assessment occurs • Level of Service – equal to or
after admission (245G.07) less restrictive than CA
Recommendation
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 4Rule 25 ASSESSMENT AND COMPREHENSIVE ASSESSSMENT –
Diane
RULE 25 Direct Access – Will be available
when DHS has provided more
• 9530.6610, 6615 – Provide info and training
assessment to those who
request or for whom it is • Comprehensive Assessment-
requested on a form prescribed Client choice
by the commissioner (DHS)
• Treating Provider – Client
• 9530.7015, 7020 – Determine choice
CCDTF eligibility as of date of
Rule 25 assessment -
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 5Parallel Process - Rule 25 Portal - Vicki • County provides Rule 25 Assessment using form approved by the Commissioner. • County determines CCDTF financial eligibility as of the date of the Rule 25 assessment. Sent out annually on CCDTF eligibility guidelines. • County authorized service by MMIS service agreement. • CCDTF funds per outcome of Rule 25 • Provider receives client specific service agreement letter. • Provider bills accordingly. • CCDTF subsystem processes claims and assigns federal, state, and county share. 10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 6
Annual CCDTF Eligibility Guidelines - Vicki • https://content.govdelivery.com/bulletins/gd/MNDHS- 1f7b49b?wgt_ref=MNDHS_WIDGET_C36 10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 7
Parallel Process – Direct Access Portal (more detail to come) -
Vicki
• Client requests CA at provider of choice
• Provider determines if funding exists –Medicaid, CCDTF, or Managed Care
• IF Yes (Fee for service Medicaid or CCDTF)– Provides CA and assists client with admission or with referral to another provider
• IF Yes (Managed Care)- Provides CA if vendor is credentialed with that plan and assists client with admission or with referral to another
provider
• IF Self pay with or without commercial insurance – provider’s current process
• IF No active Funding – Provider asks client for place of residence – contacts identified CFR
• Identified County determines client’s CCDTF Financial Eligibility/ facilitates Medicaid enrollment. (more detail to come)
• Provider(s) move forward with CA, admission, and tx provision when financial eligibility is confirmed.
• Funding will pay for client choice of service of a lesser intensity than CA recommendation.
• Provider(s) bill for services (No CCDTF Service Agreement is required)
• CCDTF subsystem processes claims and assigns federal, state, and county share.
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 8It’s after 7/1/2018 – we have CMS approval- can providers do
and submit Comprehensive Assessments to counties in place
of Rule 25?
• No.
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 9Rule 25 ASSESSMENT AND COMPREHENSIVE ASSESSSMENT –
Diane
RULE 25 – Current until 6/30/2020 DIRECT ACCESS – Will be available
when DHS has provided more info
• 9530.6610, 6615 – Provide and training
assessment to those who request or
for whom it is requested on a form • Comprehensive Assessment- Client
prescribed by the commissioner choice
(DHS)
• Treating Provider – Client choice
• 9530.7015, 7020 – Determine CCDTF
eligibility as of date of Rule 25 Paid by funding available to client
assessment. Providers and counties coordinate client
eligibility/enrollment for CCDTF and
• MMIS SA Medical Assistance
• Providers bill against SA Providers bill (no MMIS SA)
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 10Regulations directing Rule 25/Rule 24 process (Diane) • For 30 years providers have been trained to refer clients who are CCDTF eligible to the CFR for funding, or risk non-payment for services. Rule 25 assessment is currently required of all placing authorities in order to utilize public funding. • https://www.revisor.mn.gov/rules/pdf/9530.6610/2014-01-18%2010:22:14+00:00 • https://www.revisor.mn.gov/rules/pdf/9530.6615/2014-01-18%2010:22:19+00:00 • https://www.revisor.mn.gov/rules/pdf/9530.7005/2014-01-18%2010:22:56+00:00 • https:www.revisor.mn.gov/rules/pdf/9530.6600/2014-01-18%2010:22:08+00:00// • https://www.revisor.mn.gov/statutes/cite/254B.06 10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 11
What about clients who “churn” from managed care
placement to CCDTF - Vicki
MCOs are considered a placing authority under Rule 25 – and must
comply –
Managed Care clients will have had a Rule 25 assessment – with that
requirement being met, the client’s funding then transitions with the
client’s eligibility. (There will be more discussion about this and the Direct Access Portal at a later date.)
https://www.revisor.mn.gov/rules/pdf/9530.7015/2014-01-
18%2010:23:04+00:00
https://www.revisor.mn.gov/rules/pdf/9530.7020/2014-01-
18%2010:23:06+00:00
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 12What about clients who enter treatment and then apply for
and transition to Medicaid?
• Technically, in most cases, these clients would have been eligible for
the CCDTF.
• Providers should refer clients who likely meet public funding criteria
to the CFR for Rue 25 assessment and determination of CCDTF
eligibility as of the date of that assessment.
• CCDTF clients who are subsequently enrolled in Medicaid will either
pay under CCDTF or Medicaid
• Retro MA is possible
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 13County and Provider Collaboration from September ITV
Greg Anderson
andersong@StLouisCountyMN.gov
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 14St. Louis County – Greg Anderson
• 23 licensed SUD programs in St. Louis County
• 7 residential
• Started with separate provider meetings North & South in
early 2018
• After 2 N/S meetings we followed up with 2 joint
meeting.
• Last meeting was 6/22
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 15St. Louis County – Greg Anderson
• Important to bring involved/impacted entities together
• Our SUD Reform Group now includes but not limited to:
• Providers;
• Court/Judicial System;
• Corrections
• Law Enforcement
• Medical/Hospital Community
• Mental Health Community
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 16St. Louis County – Greg Anderson
• Following the last meeting:
• Group decided to slow things down;
• Time was needed to see how things were to play out
with Fed approval;
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 17St. Louis County – Greg Anderson
• Comprehensive Assessment (CA):
• SLC PHHS & the SLC Provider group are supportive of SLC PHHS
pursuing opportunity to do CAs
• SLC completed roughly 870 Rule 25 assessments in 2017
• Workforce issues/shortage raises concerns regarding licensed
SUD providers being able to address assessment demands on
7/1/2020
• We do not see ourselves meeting the current level of
assessments, but PHHS is wanting to be a collaborative
partner in addressing that need
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 18St. Louis County – Greg Anderson
• Explore development of a universal comprehensive
assessment tool for qualified SLC CA assessors to use
• Concerns discussed regarding multiple instruments &
SUD providers ability to interpret & qualify individuals
for treatment with different instruments;
• Understood that this challenge will be faced when
accepting individuals outside of SLC;
• Draft instrument has been recently submitted for
review;
• No recommendation for direct yet determined
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 19St. Louis County – Greg Anderson
• Treatment Coordination (TC)
• SLC PHHS will seek to become an enrolled TC provider;
• 30 hour training session is set up with a private training agency to be
held in Duluth in late October/early November of this year;
• Concerns regarding again about workforce & licensed SUD providers
meeting that service demand;
• Concerns regarding consistent communications between treatment
provider(s) & involved parties;
• See TC as a great new tool & resource for getting individuals
connected with community resources when returning to community;
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 20St. Louis County – Greg Anderson
• Peer Recovery Support
• Great addition to the service menu
• Discussions within service community & reform group
regarding development & training needed for establishment
• Two to three possible providers working towards getting
service in place;
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 21St. Louis County – Greg Anderson
• Parallel Process
• Wanting to make sure things are in place to initiate
implementation
• Being able to quickly & appropriately identify & separate processes
& lead individuals in direction that will provide quickest access;
• Access to Services
• Residential services difficult to access
• Having supportive plans in place with necessary resources to
minimize an individual’s risk while awaiting placement
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 22St. Louis County – Greg Anderson
• Placing Authority
• Activities or responsibilities reduced with reform
• Gaining clear understanding of what can & can’t be
done
• Being able to best support individuals & involved
parties with accessing & supporting treatment &
recovery efforts
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 23St. Louis County – Greg Anderson
• Legislation
• Support CA Assessor qualification modifications to
allow established County Rule 25 assessors ability to
do CAs with additional course work & proper sign-off
• Support modifying supervision requirements for TC
from 1 hour weekly to 1 hour monthly by properly
accredited individual
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 24Contact Information
Diane, Leah, Vicki
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 25Who to contact and why - Vicki
Behavioral Health Division: General Line: 651-431-2460
Counties: Diane Hulzebos, diane.Hulzebos@state.mn.us
Children’s Residential facilities: Jeff Hunsberger, Jeffrey.Hunsberger@state.mn.us
Out of State and Free standing: Amelia Fink, amelia.fink@state.mn.us
Recovery Community Organization/Residential withdrawal management: Dana Nelson,
Dana.nelson@state.mn.us
OTPs: Rick Moldenhauer, Richard.Moldenhauer@state.mn.us
Individually enrolled SUD providers: Jeff Hunsberger, Jeffrey.Hunsberger@state.mn.us
Tribal Programs: Shawnee Hunt, Shawnee.hunt@state.mn.us
Managed Care Organization: Lucas Peterson, lucas.Peterson@state.mn.us
DAANES: Angie McNeil-Olson, angela.mcneil-olson@state.mn.us
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 26Who to contact and why - Vicki
Licensing:
When to contact: existing or new 245G programs regarding licensing requirements, and treatment services
Contact: 651-431-6500 (general licensing number)
Provider Enrollment Call Center:
When to contact: To enroll as a new vendor, track the status of their enrollment, or update their provider
record, questions on enrollment documents or how to complete.
Contact: 651-431-2700 , Toll-free line, 800-366-5411
National Plan & Provider Enumeration System:
When to contact: Where to get the NPI Application- see bottom of the page under Resources NPI will be
required for a Recovery Community organization, new SUD Treatment programs and individually enrolled
providers
Contact: https://nppes.cms.hhs.gov/#/
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 27Ways to Stay Informed – Leah
• Visit our website to:
• Subscribe for email updates (e-Memo) to receive updates from the Behavioral
Health Division on SUD
• Learn more about substance use disorder policies and procedures, initiatives,
workgroups, training and conferences, grant announcements, access forms and
more
Look for our “Friday’s Digest” e-Memo!
• We want to hear from you about YOUR substance use disorder system
planning. Send input to: YourOpinionMatters.DHS@state.mn.us
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 28E-MEMO and Website Resources - Diane • Visit our website to sign up for the E-memo to receive updates from the Alcohol and Drug Abuse Division. • SUD Resources are posted on the SUD Reform Page at our website: mn.gov/dhs – sign up for e-memos! • FAQs are at SUD Reform FAQs - Updated May 2018 • We encourage participants to review the SUD Reform e- memos and website resources available on the website prior to attending the WebEx's. These materials provide basic information that is helpful to understand reform and its implications. 10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 29
Thank you for joining us
Behavioral Health Division
10/19/2018 Minnesota Department of Human Services | mn.gov/dhs 30You can also read
