Case management redesign

The Minnesota Legislature directed DHS to partner with counties, tribes and other stakeholders to redesign case management to achieve the following:

  1. Increase opportunities for choice of case management service provider.
  2. Define the service of case management to include the identification of roles and activities of a case manager to avoid duplication of services.
  3. Provide guidance on caseload size to reduce variation across the state.
  4. Develop a statewide system to standardize case management provider standards, which may include establishing a licensure or certification process.
  5. Develop reporting measures to determine outcomes for case management services to increase continuous quality improvement.
  6. Establish rates for the service of case management that are transparent and consistent for all Medical Assistance-paid case management.
  7. Develop information for case management recipients to make an informed choice of case management service provider.
  8. Provide waiver case management recipients with an itemized list of case management services provided on a monthly basis.

Overview and Reports

Implementation information for the statewide fee-for-service county-subcontracted targeted case management rate methodology

The statewide fee-for-service county-subcontracted targeted case management (TCM) rate methodology will go into effect on July 1, 2022. This statewide, mandated TCM rate methodology is for providers that are subcontracted by the county to provide Medicaid-funded TCM services on a fee-for-service basis for:

  • Adult Mental Health (AMH-TCM)
  • Children’s Mental Health (CMH-TCM)
  • Child Welfare (CW-TCM)
  • Vulnerable Adult/Developmental Disability (VA/DD-TCM)

All counties negotiating a contract with private providers for these Medicaid-funded TCM services will need to use rates determined by the new rate methodology. The Implementation Standards: Fee-for-Service Subcontracted Targeted Case Management Rate Methodology (PDF) provides comprehensive information for counties as they implement the statewide rate methodology, including standard contract clauses to accurately reflect the rate methodology and information about how counties can request rate exceptions. Counties may submit rate exception requests using the Rate Exception Request: Fee-for-Service Subcontracted Targeted Case Management (PDF). The rate schedules will also be posted on the DHS Fiscal Reporting and Accounting webpage.

Summary of initial public comments for the draft state plan amendment

The 2021 Minnesota Legislature approved a statewide rate methodology for county subcontracted Targeted Case Management (TCM) services. This rate methodology is intended to address Centers for Medicare and Medicaid Services (CMS) concerns about county-negotiated TCM rates, as well as create transparency and consistency in setting these rates. DHS and the Minnesota Association of County Social Service Administrators (MACSSA) leadership have encouraged counties and providers to be involved in the development of this rate methodology by providing data and feedback throughout the process.

In June 2021, DHS opened an initial 30-day public comment period regarding the draft state plan amendment for the proposed rate methodology. This public commend period was held in addition to CMS' required public comment period that will open in March 2022. See the summary document with initial public comments and responses (PDF) for the state plan amendment on the targeted case management subcontracted rate methodology. DHS will use the comments to update the state plan amendment.

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We want to hear from you

Email your ideas, feedback and questions to dhs.cmredesign@state.mn.us.

Draft service design for case management services

DHS convened an initial design team to draft a definition for the service of case management and create a foundational set of standards for the delivery of the service so people know what they can expect and what they can rely on if they are receiving case management services. To learn more about the work of the design team, see the following:

Stakeholder vision