MnCHOICES Assessment and Support Plan

Transcription

1 MnCHOICES Assessment and Support Plan 11/01/2017 Minnesota Department of Human Services mn.gov/dhs 1 Beyond Assessment: Integration of assessment and support plan application State and federal requirements for person centered planning Disability Waiver Rates calculations based on person s needs and support plan Outcome data to improve quality and inform policy decisions Support state policy to provide the right service at the right time Two examples are the Foster Care Moratorium and goals of Reform /31/2017 Minnesota Department of Human Services mn.gov/dhs 2 1

2 Beyond assessment: Person Centered Planning and Informed Choice Person centered planning and informed choice Certified assessor and case manager develop the person s Support Plan using person centered information that is carried over from the MnCHOICES Assessment into the MnCHOICES Support Plan. Integration of assessment and support planning results in time savings Agencies report electronic support plan is saving 30 to 90 minutes Data sharing between computer applications reduces time spent writing and transferring information from assessment to support plan Data from the previous year s documents, copy over for use and revision during next year s assessment or service plan 11/01/2017 Minnesota Department of Human Services mn.gov/dhs 3 Beyond Assessment: Support Plan Includes Rate Calculation Calculating Rates in the MnCHOICES Support Plan application The manual process for calculating rates, which includes use of spreadsheets and printing copies, is being discontinued. The calculation of rates is now integrated into the support plan application, which creates additional efficiencies. Providers as well as people who use services receive information about their rates with the support plan Integration of these systems and separate activities saves time and increases transparency. 11/01/2017 Minnesota Department of Human Services mn.gov/dhs 4 2

3 Beyond Assessment: Measuring Outcomes and informing policy decisions Measuring outcomes MnCHOICES contains outcome and quality data Based on assessment information, the case manager asks questions at the mid year visit to capture the person s experience with his/her Support Plan and provider. Creates a feedback loop for quality assurance and improvement. Serves as an important data source for program reporting as well as continuous quality improvement and program redesign State Policy Reform Federal Reporting 11/01/2017 Minnesota Department of Human Services mn.gov/dhs 5 Original Goals of MnCHOICES Increase consistency and transparency in access to long term services and supports Provide access to the right service at the right time Make person centered assessment and decision making the foundation for delivery of services Provide accountability and improve quality Foster a shared vision and a culture of innovation Strengthen partnerships and collaboration 11/1/2017 3

4 Finding the balance Efficiencies Policy Goals 11/1/2017 Minnesota Department of Human Services mn.gov/dhs 7 MnCHOICES Efficiencies Completed Completed 9items completed since March 2017 Examples include 11/01/2017 Launch of electronic support plan for more efficient support planning; information gathered from the assessment is automatically transferred into the support plan, where service rates are also calculated. Staggered statewide launch began June Lead agencies report a time savings of minutes per support plan. Reduced the number of questions in MnCHOICES that are required before running eligibility (exact number is age dependent). In addition, there are questions where the requirement was removed but are still recommended to be completed at some point before closing the assessment. Effective September 8, DHS Quality Assurance staff report during testing an average time savings of 1/3 of typical assessment time. Assessment timeline change for Nursing Facility (NF) assessments following an admission for persons under the age of 65. The assessment timeline has changed from 40 days to within 80 days after admission. Effective 5/25/2017. This change results in a decrease of assessments needed statewide by approximately 14% (CY 2016 data.) 4

5 MnCHOICES Efficiencies in Progress In Progress: 10 items currently in progress Examples include Policy change to allow a phone based assessment interview for updating eligibility status when starting someone on the DD waiver. Easily update service plan for certain changes without having an assessor meet with the person. Training to emphasize the effective use of MnCHOICES for capturing what is important to, and what is important for the person Goal to reduce the perception the assessor needs to fill everything out and answer every question (which they do not!) 11/01/2017 MnCHOICES Efficiencies: Priority Topic Areas Collaboration with the County State Work Group comprised of members from the Local Public Health Association and Minnesota Association of County Social Service Administrators to identify additional efficiencies. Goal is to use professionals where they add the most value, and to fully implement MnCHOICES within current resources Three workgroups were developed: MnCHOICES Process workgroup Lead Agency Workflow workgroup Developmental Disabilities (DD) Reform workgroup 11/01/2017 Minnesota Department of Human Services mn.gov/dhs 10 5

6 Timeline to finalize legislative recommendations Low Hanging Fruit addressed in first set of efficiencies Legislative recommendations by December 20, 2017 Development of recommendations includes: Analysis of authority and interactions between statute and federal requirements Analysis of available data to determine impact Business process review to identify unintended consequences Collaboration between counties and DHS 10/31/2017 Minnesota Department of Human Services mn.gov/dhs 11 Workgroup: Process/Modification Workgroup purpose: Re examine policy and technical aspects of completing MnCHOICES assessments/reassessments to create further proficiencies within the process Intended outcome: Short term: Identification of actions to enable more assessments to be completed within the current staffing capacity Longer Term: Determine strategies for improving efficiencies within the broader long term services and supports business workflow; Improve the tool itself (MnCHOICES 2.0) 11/01/2017 Minnesota Department of Human Services mn.gov/dhs 12 6

7 Workgroup: Lead Agency Workflow Workgroup purpose: To validate core functions of assessors and case managers, and identify effective lead agency workflow/process. Intended outcome: To support lead agencies by adjusting policies and procedures, as necessary, in order to create proficiencies within the lead agency workflow. 11/01/2017 Minnesota Department of Human Services mn.gov/dhs 13 Workgroup: DD Reform Workgroup purpose: To re examine policy and procedures related to state programs for people with developmental disabilities and where MnCHOICES offers the most value. Intended outcome: To identify current challenges for lead agencies and strategize potential solutions to eliminate systematic barriers. 11/01/2017 Minnesota Department of Human Services mn.gov/dhs 14 7

8 Required Change Administrative Legislative Waiver Plans 11/01/2017 Minnesota Department of Human Services mn.gov/dhs 15 Administrative Changes Reduce time for reassessments Short term: Individualizing the assessment. Develop training to assist the assessor individualize the assessment, including what questions asked. Longer term: MnCHOICES Assessment 2.0 will reduce the number of questions and allow for a more customized interview. Streamline disability determination process Work with the State Medical Review Team (SMRT) to identify strategies to expedite disability determinations in certain scenarios. 11/01/2017 Minnesota Department of Human Services mn.gov/dhs 16 8

9 Legislative Changes Allow the guardian to participate in the assessment via use of technology (i.e. Skype) Minnesota Statue 256B.0911, Subd. 3a, para. (d) states that the assessment must be conducted in a face to face interview with the person being assessed and the person s legal representative. Modify timelines for support plan development Minnesota Statue 256B.0911 Subd. 3a (e) has a 40 calendar day Community Support Plan requirement (high level plan by the assessor) Minnesota Statue 256B.092 Subd. 1b has a 10 business day Coordinated Service and Support Plan) requirement (more detailed plan by the case manager that goes to providers) 11/01/2017 Minnesota Department of Human Services mn.gov/dhs 17 Waiver Plan Changes Create efficiencies for an annual assessment when situation(s) are stable. Lead agency workgroups will assist in defining stable Create option to use the phone (as an interview) when the situation is stable. Verification of stability Minimize the number of assessment questions 11/01/2017 Minnesota Department of Human Services mn.gov/dhs 18 9

10 MnCHOICES Feedback from Assessors and Parents 11/1/2017 Minnesota Department of Human Services mn.gov/dhs Time Assessor: The assessment can be long. However, I have never walked away from an assessment being told by a family that it was a waste of time. Parent: I wish the assessor had more time to make sure we got everything. Cate was present during the assessment which meant sometimes I had to stop and care for her. Sometimes the questions then were hurried so we could complete the assessment. Minnesota Department of Human Services mn.gov/dhs 20 10

11 Consistent Assessment Practice Assessor: The tool has taken much of the guess of how to rate needs. The tool removes the subjectivity of the assessment We are able to fairly assess what the needs and wants are based off of the person s reflection and response. It is beneficial to use the same screening process across all programs. Previous assessment format did not ensure any consistency in rating and results Minnesota Department of Human Services mn.gov/dhs 21 Discovery of Person Assessor: The assessment offers us the ability to get a full picture of what the child s strengths [and provides] reassurance to the family that support is available related to what the child needs help with at that moment in time Parent: This was the first time I really felt like someone heard. They listened to all I had to say in what my daughter needed. Minnesota Department of Human Services mn.gov/dhs 22 11

12 Person Centered Assessor: They are able to have the control to initiate the assessment and identify goals and likes. It also identifies informal supports and how people like to be interacted with. Minnesota Department of Human Services mn.gov/dhs 23 Resources: Information Assessor: The MnCHOICES Assessment tool gathers essential information to help educate and recommend programs and services in relation to how a person wants to live their life. Parent: The assessor is full of knowledge and knows what the resources are. They give us direction. Every assessment gave me place to go, to start. Minnesota Department of Human Services mn.gov/dhs 24 12

13 Opportunities Assessor: I have had several participants discover during the reassessment that work could be an option for them. It opens a door to see what the individual may need to encourage them to look into the possibility of work if they choose to. Minnesota Department of Human Services mn.gov/dhs 25 Person Centered Assessor: On more than one occasion, I have had people say that they have never been asked these about their likes, needs, and wants. Parent: I was able to express Cate s strengths and issues she struggles with, with the assessor because she was in our home and was able to see them. I see what you are talking about. The assessor was able to see the struggles we deal with everyday. Minnesota Department of Human Services mn.gov/dhs 26 13

14 Informed Choice Assessor: Every person deserves a thorough assessment that is person centered, which looks at all aspects of their life, what is going well, and also what is not going well Parent: It s important to do an assessment in my home, because it helped me address the challenges and what to do for my daughter Minnesota Department of Human Services mn.gov/dhs 27 Informed Choice Assessor: This assessment is able to look at all aspects of what mom/dad is doing well and hear what mom/dad wants for her life. The areas that are not going well are naturally captured throughout the tool to help determine what services will best meet their needs. Minnesota Department of Human Services mn.gov/dhs 28 14

15 Informed Choice Assessor: I can think of one individual in particular that thanked me for such a thorough assessment. They stated that they felt like they were able to discuss all of the things they wanted to say. They also stated that it made them think more about how things could be different and that they had the opportunity for change. Parent: Anybody who needs it should get an assessment done. Without an assessment I had no idea what to do. It helped me figure out resources to make things better for the girls. Minnesota Department of Human Services mn.gov/dhs 29 Resources: Education Parent: We got connected to a provider. They will get a school experience [that will] help them with learning. My daughter is non verbal so she will get speech and occupational therapy. Minnesota Department of Human Services mn.gov/dhs 30 15

16 Time Assessor: There have been some comments about the speed of the assessment. However, MnCHOICES is a guide for the assessment; it is intended to assist with conversations and achieving goals for participants. Minnesota Department of Human Services mn.gov/dhs 31 Time MnCHOICES Assessment Assessor: While it can be lengthy, I believe the assessor can guide the interview to cover what is most important for the person. MnCHOICES Support Plan Assessor: MnCHOICES Support Plan has increased the speed of completing the reassessment 10/31/2017 Minnesota Department of Human Services mn.gov/dhs 32 16

17 Assessor: DHS has formed workgroups with counties throughout the implementation of MnCHOICES [Assessment] and listened to feedback to address the length of time spent on assessment determining how much of the assessment is really about the tool, and how much of the full assessment is about medical assistance eligibility and other work processes across teams needed to provide outcome. Collaboration with DHS 33 Thank you! 11/01/2017 Minnesota Department of Human Services mn.gov/dhs 34 17