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Disability waivers rate system

The Disability Waivers Rate System moved to a more centralized mode of operation on Jan. 1, 2014. Please see Rates Management System in the Community-Based Services Manual for current information. DHS will continue to update this page in addition to the policy manual.

Disability waiver rate system comments sought

DHS is looking for comments on two proposed regional adjustment factor options (PDF) detailed in the Minnesota Regional Variation Analysis Final Report Jan. 30, 2015 (PDF). We would apply regional adjustment factors to the framework rates in the Disability Waiver Rate System.

Implementation depends on the comments we receive, more stakeholder input and so on. Find more information below under Regional variance study.

This analysis and the opportunity for public comment are requirements of Minn. Stat. §256B.4914.

The comment period begins at 8 a.m. Wednesday, July 1, 2015, and ends at 4 p.m. Friday, July 31, 2015. Email comments to DSD.PublicComments@state.mn.us.

Background

In 2007, the Centers for Medicare and Medicaid Services informed Minnesota that its four disability waivers were out of compliance with federal requirements for uniform rate determination methods and standards. The disability waivers are the Brain Injury (BI), Community Alternative Care (CAC), Community Alternative for Disabled Individuals (CADI) and Developmental Disabilities (DD) waivers.

In January 2014, DHS established what is now known as the Disability Waivers Rate System.

What the system accomplishes

Implementation of the system:

  1. Transfers the responsibility of setting service rates from counties and tribes to the state.
  2. Restores compliance with federal requirements.
  3. Allows federal renewal of the Minnesota disability waivers.

Failure to comply with the federal requirements jeopardizes the services to  37,000 people who rely on disability waiver services.

What are goals of the system?

Goals of the system are to create statewide rate setting methodologies that:

  • Are transparent, fair and consistent across the state
  • Comply with federal requirements for administration of waiver programs
  • Establish rates based on a uniform process of structuring component values for service
  • Promote quality and participant choice
  • Recognize a person’s assessed need for particular components within each service

How do I benefit from the system?

People benefit from increased choice of provider(s) and geographic areas where they receive services.

Lead agencies benefit from use of a Web-based rate-setting calculator and are no longer required to negotiate rates with waiver providers.

Waiver providers benefit from more predictability of rates when the needs of people who receive services increase or people live in different areas of the state and require the same services.

Regional variance study

  • Requirements

    Under Minn. Stat. §256B.4914, we are required to:

    1. Study the regional differences in the cost of providing home and community-based services across the state.
    2. Implement a regional adjustment factor to all rate calculations in the Disability Waiver Rate System.

    DHS contracted with Truven Health Analytics, an independent research firm, to conduct this study.

  • Research findings

    This study concluded that the primary driver in provider costs, staff wages, does have a statistically significant variation throughout regions of the state. Regions used in this study are the Metropolitan Statistical Areas, identified in Section 2: Core Analysis of the Minnesota Regional Variation Analysis Final Report Jan. 30, 2015 (PDF).

    As a product of these research findings, two separate options of regional variance factors have been generated.

    Option 1: Uncapped version of regional variance factor

    Values reflect research findings without placing limits on the final Regional Variance Factor that would be implemented.

    Option 2:Capped version of regional variance factor

    We place a three percent limit on the research findings. This means that no regional variance factor will increase or decrease a calculation by more than three percent.

  • Application of the regional variance factors

    We will:

    • Implement the regional adjustment factors according to the recipient’s county of residence
    • Program the regional variance factors to all frameworks at the end of each calculation. as required by statute.

    The tentative implementation date is Jan. 1, 2016. We will communicate a formal public notice of the framework changes before Oct. 1, 2015. After Jan. 1, the new frameworks will take effect as service agreements renew.


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