Public participation

DHS invites client, stakeholder and citizen involvement in its initiatives and proposed program changes. The following are current opportunities for participation.

Public comment period open for an amendment to the Elderly Waiver plan
The Minnesota Department of Human Services (DHS) requests public comments on a Proposed amendment to Minnesota’s Elderly Waiver Plan (PDF) before submitting the amendment to the Centers for Medicare & Medicaid Services (CMS) for approval. The comment period is from 8 a.m. July 3, 2018, to 4 p.m. August 2, 2018.

For information on how to access the full versions of Minnesota’s approved waiver plans, see Community Based Services Manual (CBSM) — How to get a copy of a federally approved waiver plan.

What this amendment does

This amendment to the Elderly waiver plan seeks federal approval to:

Add an exception to the consumer directed community supports (CDCS) budget methodology to provide up to a five percent budget enhancement for increased wages/benefits for workers if the:
- CDCS participant is eligible for 12 or more hours of PCA per day
- Worker has completed qualifying training (For more information, see training requirement section on the DHS — Enhanced rates and training stipends for support workers page.)
How to submit a public comment

Please submit comments to AASD.Publiccomments@state.mn.us by 4 p.m., August 2, 2018. We also will accept comments by U.S. mail. Mail written comments to:

ATTN: Elderly Waiver comments
Minnesota Department of Human Services
Aging and Adult Services Division
P.O. Box 64976
St. Paul, MN 55164-0967
Public forum on Prepaid Medical Assistance Project Plus (PMAP+) Waiver

On Feb. 11, 2016, the Centers for Medicare & Medicaid Services (CMS) approved Minnesota’s request to renew the PMAP+ section 1115 waiver through Dec. 31, 2020.

PMAP+ waiver approval, expenditure and waiver authorities, and special terms and conditions (PDF)

The Department of Human Services holds an annual forum to provide the public with an opportunity to comment on the progress of the PMAP+ waiver. The next public forum will be held:

Date: June 27, 2018

Time: 1-2 p.m.

Location: Department of Human Services, Elmer L. Andersen Human Services Building, Room 2380

540 Cedar Street

St Paul, MN 55164

All interested members of the public are invited to attend. Questions regarding the upcoming public forum may be directed to dhs.waiver.comments@state.mn.us.
Child Care and Development Fund Plan 2019-2021 public hearings planned

The Minnesota Department of Human Services invites input and feedback on the proposed 2019–2021 Child Care and Development Fund Plan. The Child Care and Development Fund Plan describes how state and federal funds will be used to improve the quality of child care and development, and help low-income families access care for their children. There are several ways to learn more about Minnesota's proposed Child Care and Development Fund Plan and provide feedback.

On April 23 and 25, 2018, the Minnesota Department of Human Services is holding public hearings on the Child Care and Development Fund Plan. This event will take place in St. Paul, Minnesota and is open to the public. The department has worked to ensure the widest accessibility possible for all Minnesotans to view the public hearings in person, via live broadcast or video recording.

The livestream of the Child Care and Development Fund Plan public hearings is accessible from almost any device with an internet connection (at home, work or library). For those unable to view the hearing live, the recording of the hearings will be available by April 26, 2018. It will remain available online for 60 consecutive days.

The department will accept feedback on the proposed Child Care and Development Fund Plan any time during the comment period.

For more information about the public hearings, including location and directions, visit Minnesota’s Child Care and Development Fund webpage. Scroll down and expand the heading “Child Care and Development Fund Plan 2019-2021.” The page includes links to the livestream, and after April 26, it will include links to recordings of the public hearing.
Comment period open for substance use disorder system reform waiver application

On March 15, 2018, DHS submitted a substance use disorder (SUD) demonstration waiver application for CMS review and approval. This demonstration is an important component of the state’s larger effort to address the opioid crisis as well as transform the health care delivery system for Medicaid recipients who need substance used disorder treatment and services.

DHS held an initial 30-day public comment period and two public hearings on the waiver request in late February and early March 2018. All written comments received during the public comment period were included in the March 15, 2018 waiver submission.

On March 28, 2018, CMS requested that DHS publish a new request for public comment to clarify certain elements of the proposal. The waiver application itself remains unchanged.

A copy of the SUD waiver application and information on the public input process is available at Health Care Federal Waivers.
Comment period open for CCDTF waiver request

DHS is holding a 30-day comment period on its Consolidated Chemical Dependency Treatment Fund (CCDTF) section 1915(b) waiver renewal request. People seeking chemical dependency rehabilitation services under the CCDTF must go to the locality or placing authority for evaluation and referral to a provider. Minnesota is obliged to maintain a waiver to allow counties and tribes to direct Medicaid fee-for-service recipients to the most appropriate service provider.

The waiver renewal request also includes a description of the Continuum of Care Pilot Project in Red Lake and White Earth Nations. Under the continuum of care pilot project all fee-for-service clients in participating localities may directly access services at participating providers rather than relying on counties and tribes to make placement referrals.

Finally, the waiver informs the Centers for Medicare & Medicaid Services (CMS) of state law directing DHS to transition its care model for substance use disorder (SUD) services to a model in which individuals can directly access care from a SUD provider without a county or tribe acting as an intermediary. While the state is in the process of developing a transition plan to move toward a direct-access model, it is expected that the implementation of direct access for SUD treatment will require a phased-in approach. Therefore, the state intends to continue its 1915(b) waiver for an additional two-year period to ensure that it has the appropriate authority to transition the system, including providers, enrollees, and counties or tribes, to a model that ensures enrollees have direct access to SUD treatment.

The current CCDTF waiver expires June 30, 2018. This is a request to continue the current waiver for another two-year period, through June 30, 2020.

A copy of the CCDTF waiver renewal request and information on the public input process is available at Federal Health Care Waivers.
Public comment sought on caseload reduction credit calculation method
Federal law requires states to monitor and report trends in the numbers of people who receive cash assistance through the Temporary Assistance to Needy Families (TANF) program. Minnesota uses TANF money to fund the Minnesota Family Investment Program (MFIP).

Federal law requires states’ TANF and related federal programs to meet a 50 percent work participation rate. The "work participation rate" (WPR) measures the proportion of recipients who take part in federally defined work activities for a sufficient number of hours each week. The 50 percent rate may be adjusted by historic reductions in caseload for reasons other than eligibility changes. This is called a caseload reduction credit.

To determine the caseload reduction credit, a state must calculate the percentage change in the number of families served in the most recent Federal Fiscal Year compared to a historical base year of 2005. This percentage change must then be adjusted to take into account any policy changes implemented after 2005.

Minnesota’s caseload reduction credit calculations based on 2016 data are as follows:
- The average monthly number of families receiving TANF and related federal program assistance was 19,296 in 2016. This is a 40 percent decrease from the historical base year of 2005.
- Most of this decrease (31.4 percent) can be explained by funding changes that made families designated to receive Family Stabilization Services and families with two parents ineligible to receive TANF funding. Instead, these families must be funded with state funds.
- Other policy changes that increased the number of families eligible to receive TANF and related benefits in 2016 include changes in how Supplemental Security Income affects a family’s cash assistance, higher asset limit and higher exemption levels for vehicles counted in determining a family’s eligibility for cash assistance, changes in rules around child support assignment and child support disregard, changes in earned income disregard, and implementation of MFIP Housing Assistance Grant. Together these changes are estimated to result in 13.3 percent more families receiving TANF and related federal program assistance relative to the base year of 2005.
- The Northstar Care for Children program implemented in January 2015 consolidates Foster Care (FC), Adoption Assistance (AA), and Relative Custody Assistance (RCA) into one program. Children who would have been in RCA and are now in the kinship assistance component of Northstar are no longer eligible for TANF and related federal benefits. This change is estimated to result in 1.6 percent less families eligible to receive TANF and related federal program assistance relative to the base year of 2005.
Taking these policy changes into account, the estimated caseload reduction credit is 40.2 percent - (31.4 percent -13.3 percent + 1.6 percent) = 20.5 percent. This credit will be used to reduce the “target” work participation rate for Minnesota next year (federal fiscal year 2017).

Federal rule also allows a state to further reduce the target work participation rate by claiming more than the minimum required state funds for the TANF program. These funds are referred to as "excess Maintenance of Effort (MOE)." The working family tax credit and other qualified expenditures have the capacity to provide excess MOE for this purpose. The number of cases that can be served with Excess MOE, as determined by average annual spending on TANF assistance cases, can be claimed as further caseload reduction. Minnesota will claim excess MOE in order to increase the caseload reduction credit.

Citizens are invited to submit any comments on the above methodology to the DHS Office of Management and Budget by email to: dhs.reportsandforecasts@state.mn.us. Or by regular mail to this address:

Minnesota Department of Human Services
Reports and Forecasts Division
PO Box 64996
St. Paul, MN 55164-0996
Input sought on health care waivers and state plan amendments

Under federal law, a state can make changes to its Medicaid program through certain waiver authorities to test new ways of delivering and paying for health services. A state can also amend its Medicaid state plan. The plan is an agreement between the state and federal government about how the state will administer the Medicaid program.

Read more about opportunities for public input on Minnesota’s Medicaid waiver requests and Medicaid state plan amendments.
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