• Medica is removed as a participating health plan for program year 2018; and
• In accordance with a change in state law, children are redefined as individuals under age 19 for purposes of eligibility for all Medicaid state plan services (see Minnesota Laws 2017, First Special Session, chapter 6, article 4, section 55).
DHS invites the public to comment on the progress of the Reform 2020 waiver at the annual public forum Dec. 15, 2017.
The Centers for Medicare & Medicaid Services approved Minnesota’s section 1115 demonstration project, titled Reform 2020, in October 2013. The five-year demonstration provides federal support for the Alternative Care program, which provides supports to help seniors at risk of nursing home placement to stay in their homes. The Reform 2020 demonstration waiver will also provide access to expanded self-directed options under the Community First Services and Supports (CFSS) program for people who would not otherwise be eligible for these services.
The 2017 annual forum to discuss the implementation of the waiver will be incorporated into the Dec. 15 Home and Community-Based Services Partners Panel meeting. The forum will include a brief update on the status of the work, followed by time for questions and comments from the public.
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: firstname.lastname@example.org. Or by regular mail to this address:
Minnesota Department of Human Services
Reports and Forecasts Division
PO Box 64996
St. Paul, MN 55164-0996
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.
Many advisory committees provide expertise and input on a regular basis to help DHS create and implement program changes. Most committees are comprised of members from outside DHS. A complete list of DHS advisory committees is online.