The commissioner suspended or modified specific routine enforcements by DHS Licensing so that clients can continue receiving services during the COVID-19 pandemic:
The Licensing Division will continue to respond to critical incidents involving high risk of harm to clients or allegations of abuse or neglect and will prioritize on-site visits as needed on a case-by-case basis. Inspections for pre-licensure and change of premises will continue on a case-by-case basis.
The commissioner also took actions to increase flexibility for providers:
These waivers will be in effect until May 1, 2020.
The commissioner waived certain requirements for economic assistance and housing programs, affecting procedures for applications and interviews, verification, changes to existing applications and reporting. The affected programs include General Assistance, Housing Support, Minnesota Supplemental Aid, the Minnesota Family Investment Program and the Diversionary Work Program. The changes also reduce barriers for families applying for cash assistance, relieve eligibility workers of after-the-fact verifications, and ensure that participants do not have to repay cash assistance overpayments caused by state, local agency or system errors. These changes will reduce the number of face-to-face contacts in county and tribal offices while making it easier for Minnesotans in sudden financial crisis to receive assistance.
The commissioner temporarily waived a requirement for MFIP participants experiencing family violence to meet with both an employment counselor and a family violence specialist if the family violence specialist cannot be reached. The commissioner also directed employment counselors to avoid requiring activities that participants indicate would be dangerous in their situation, such as face to face meetings. The Minnesota Family Investment Program requires employment plans for participants experiencing family violence to make safety the primary concern, and those plans normally must involve both an employment counselor and a family violence specialist.
Affects Minnesota Statutes, section 256J.521, subdivision 3
The commissioner temporarily waived certain requirements for the Child Care Assistance Program. The department is modifying rules for payment for absent days, both to allow flexibility for medical documentation and to allow programs that close because of the pandemic to continue billing child care assistance. Another waiver automatically extends CCAP registration for any provider who was due to renew registration in the next three months.
Affects Minnesota Statutes, Chapter 119B
The commissioner waived state requirements for foster care caseworkers to permit video conferencing or any similar technology to serve as the monthly visit between a child and their foster care caseworker, which aligns with federal guidance issued March 18, 2020. State and federal law have prohibited video conferencing and normally require that monthly caseworker visits be held face-to-face.
Affects Minnesota Statutes, section 260C.212, subdivision 4a
The commissioner suspended new actions for child support remedies during the public health emergency. Parents who fall into arrears on child support may have driver’s licenses and occupational licenses suspended and may be reported to credit bureaus. Due to pandemic closures, these parents currently have no access to the courts to challenge such actions.
The commissioner has modified certain requirements in order to simultaneously pay two providers in the Child Care Assistance Program (CCAP) when a child’s regular provider is temporarily closed and the child is attending a new program, waiving the normal 15-day notice period. The commissioner’s action also allows CCAP to pay for more than the usual maximum of 120 hours of care per child.
Providers whose child care programs are temporarily closed due to COVID-19 will continue to receive CCAP funds for up to one month while they are closed to assist in paying basic operating costs, such as rent, and may enable them to re-open. DHS will review this policy on an ongoing basis and consider extending the policy if necessary.
The commissioner has extended redetermination due dates for families’ eligibility for the Child Care Assistance Program by three months on cases with redeterminations due on or before June 30, 2020. This will allow families to continue to receive care until their new redetermination date and allow time to gather verifications.
The commissioner temporarily waived requirements for reporting, documentation and signatures for Minnesota Family Investment Program (MFIP), Diversionary Work Program, General Assistance, Minnesota Supplemental Aid and housing support; and directed that no overpayments caused by agency or system errors should be charged to participants, because no reasonable person could be expected to recognize errors as emergency program policies are implemented. The commissioner also waived the requirement for counties and tribes to conduct program recertifications.
In addition, because implementing the following MFIP policies requires face-to-face meetings and/or documentation from third parties, requirements for the following will be suspended during the public health emergency for:
The commissioner has temporarily suspended the six-month and annual recertification processes for Minnesota’s HIV/AIDS program, Program HH, for the duration of the COVID-19 pandemic. Enrollees will not be removed from services unless providers or the recipients themselves report ineligibility, such as income or residency requirements. Program HH includes the AIDS Drug Assistance Program as well as insurance, dental, mental health, nutrition, and medication therapy management programs.
Affects Minnesota Statutes, section 256.9365.
The commissioner temporarily waived certain requirements for School-Linked Mental Health and Intermediate School District Mental Health Innovation programs to allow for services via telemedicine. This action:
The commissioner temporarily modified certain statutory background study requirements for workers who serve vulnerable Minnesotans. Completing studies has become difficult due to closures of public fingerprinting sites and lack of response to requests for records from other states. These changes will assist health and human service providers to quickly respond to their changing workforce needs and continue to serve clients. Modifications are effective beginning April 6, 2020.
These modifications permit the completion of a temporary emergency background study while still applying the same standards that would disqualify someone from passing a background study, including previous disqualification decisions.
The temporary change offers all providers across the state the flexibility that they need to address workforce changes, and affords optimal access to qualified and available direct care workers while still protecting the safety of clients. Providers will be best positioned to maintain the health and safety of clients they serve.
The modified background studies will end after the Governor of Minnesota declares that the peacetime state of emergency is over. After that time, all study subjects who had received a modified background study will need to submit a new background study with fingerprints to ensure full compliance with state and federal background check requirements.
Affects Minnesota Statutes, Chapter 245C.
The commissioner temporarily waived the requirement to hold certain fair hearings in person. Hearings will still proceed by telephone and videoconference. This temporary change aligns with guidance to limit in-person contact as much as possible. Those affected by the temporary waiver may request that an in-person hearing be scheduled for a later date. This became effective upon the commissioner’s signature on April 3, 2020, and will remain in effect until the end of the peacetime emergency.
The commissioner temporarily modified certain requirements for licensed family child care providers, whose services have been designated as essential during the peacetime emergency due to the COVID-19 pandemic. These modifications are necessary to provide additional flexibility to providers, mitigate the spread of the virus and protect the health and safety of children and child care providers.
The modifications relate to guidance from the Minnesota Department of Health and the Centers for Disease Control, age distribution, record-keeping, and outdoor space requirements. These changes are effective April 9, 2020, and will continue until the end of the peacetime emergency.
The commissioner temporarily modified certain requirements for licensed child care centers and certified child care centers, whose services have been designated as essential during the peacetime emergency due to the COVID-19 pandemic. These modifications are necessary to provide additional flexibility to providers, mitigate the spread of the virus, and protect the health and safety of children and child care providers.
The modifications relate to guidance from the Minnesota Department of Health and the Centers for Disease Control, requirements for staffing, age category grouping, staff training, record-keeping, the use of public parks, and overnight care. These changes are effective April 9, 2020, and will remain in effect until the end of the peacetime emergency.
The commissioner waived certain requirements for Housing Support recipients who would be vulnerable to service interruptions due to COVID-19.
Under current law, there is a limit to the number of days Housing Support recipients can be absent from their residence. By continuing Housing Support payments for people in quarantine or hospitalized due to the COVID-19 pandemic, these individuals will not lose their housing.
This extension of payments is authorized for up to three months, effective April 2020.
Affects Minnesota Statutes, section 256I.05, subd. 1c (d).
The commissioner temporarily modified timelines and face-to-face requirements for certain child protection responses to alleged child maltreatment by allowing additional time and alternative means of contact by county or tribal workers under limited circumstances, and where child safety can still be assured. These temporary measures will allow for maximum flexibility to respond to the most urgent needs, and to attend to the safety and health of families and the child welfare workforce during the current peacetime emergency. This is effective April 7, 2020, and will remain in effect until the end of the peacetime emergency.
Affects Minnesota Statutes, section 626.556, subd.10(j).
The commissioner continued enrollment in public health care programs to ensure that no one enrolled in Medical Assistance or MinnesotaCare loses coverage during the pandemic, unless an enrollee requests that their coverage ends or moves out of Minnesota. The department is not sending notices on the need to renew coverage or closure notices to Minnesotans on Medical Assistance and MinnesotaCare.
Affected statutes and rules:
The commissioner waived certain requirements for face-to-face visits for seniors and people with disabilities receiving long-term services and supports. For people receiving home and community-based services under Medical Assistance, this means that assessments for needs can be done by phone or online connection, and that case managers can conduct phone or online visits. The affected programs are Alternative Care (AC), Brain Injury (BI) waiver, Community Alternative Care (CAC) waiver, Community Access for Disability Inclusion (CADI) waiver, Developmental Disabilities (DD) waiver, Elderly Waiver (EW), Essential Community Supports (ECS), and Federal OBRA Level II Evaluations. Personal Care Assistance (PCA) programs include assessments but do not require case management. This change also applies to people served under Rule 185 case management who choose not to waive the annual reassessment. These actions will protect people receiving services and case managers during the pandemic.
Affected statutes and rules:
The commissioner eased certain limits on receiving care and services through telephone and video visits that can instead be provided safely and effectively without a face-to-face visit by:
These measures help enrollees and providers follow social distancing best practices.
DHS is also considering how best to provide flexibility for greater use of communications technology in specific settings and for certain types of treatment, including group therapy and residential treatment settings.
Affected statutes and rules:
The commissioner increased the prescription drug limits on maintenance medications from 34 days to 90 days for all Medical Assistance and MinnesotaCare enrollees for certain therapeutic drug classes. DHS will work with managed care organizations to further extend the benefits of these flexibilities.
Affects Minnesota Statutes, section 256B.0625, subdivision 13.
The commissioner allowed health care providers currently authorized to serve public health care program enrollees to continue doing so without requiring them to re-enroll with DHS. The commissioner postponed the requirement to re-enroll health care providers every five years and personal care attendants every three years to avoid unnecessarily terminating enrolled providers over paperwork, enabling them to continue providing necessary services to enrollees during the COVID-19 peacetime emergency. DHS will make adjustments to accommodate the same activities within managed care.
To ease administrative burdens, the commissioner also postponed setting up new managed care-only providers in the Medicaid Management Information System for the purpose of getting encounter claims data. DHS will make adjustments to accommodate the same activities within managed care.
The commissioner eliminated any cost-sharing, including co-pays and deductibles, for the diagnosis, testing and treatment of COVID-19 for all Medical Assistance and MinnesotaCare enrollees. This applies to enrollees in both fee for service and managed care. This helps ensure that financial concerns don’t prevent someone from seeking testing, treatment or appropriate care, increasing public health risks. This change was effective as of March 19, 2020, but may apply to testing and treatment that occurred prior to that date. Further details about retroactive coverage will be announced later. The change will end when the national public health emergency is declared over.
Affects Minnesota Statutes, sections 256B.0631; 256L.03, subd. 5.
The commissioner waived requirements temporarily for face-to-face visits for Minnesotans on Medical Assistance who receive certain targeted case management services. This means case managers can conduct targeted case management visits by phone or the internet with adults receiving services or their legal guardians and with children receiving services and their parents or legal guardians. The affected programs include:
The commissioner temporarily expanded access to telemedicine for Minnesotans enrolled in Medical Assistance and MinnesotaCare who receive health care, mental health treatment, or substance use disorder treatment. Specifically, the commissioner expanded the providers who are permitted to provide services through telephone and video visits to include the following providers and their tribal provider equivalents:
The commissioner also temporarily expanded telemedicine (including telephone and video visits) to Rule 25 assessments, comprehensive assessments, and group therapy.
These measures help enrollees and providers follow social distancing best practices. DHS is seeking federal approval for these changes and will provide specific guidance once approval is obtained.
Affects Minnesota Statutes sections 256B.0625, subd. 3b(e); 256B.0625, subd. 46; 254B.05, subd. 5,(f); and Minnesota Rules, part 9530.6615, subp. 3, item A
The commissioner waived work requirements for able-bodied adults without children who receive Supplemental Nutrition Assistance Program benefits.
The commissioner used existing authority under federal law to make this change during the public health emergency. Able-bodied adults without children are normally required to meet work requirements unless they give good cause, defined as circumstances beyond their control, such as illness, household emergency or unavailable transportation. States determine what qualifies as good cause, and the department considers the COVID-19 pandemic to be an emergency facing all Minnesota households.
Authority provided in 7 C.F.R. § 273.7 (i)
The commissioner temporarily ordered that participants in the Minnesota Family Investment Program and Diversionary Work Program will not be sanctioned or disqualified for failing to attend meetings, submit paperwork or comply with other specific requirements. This will be in effect for the duration of the public health emergency.
The commissioner used existing authority under state law, which recognizes emergencies as good cause for failing to meet certain program requirements.
Authority provided in Minnesota Statutes, section 256J.57
The commissioner used existing authority under state law related to disasters and emergencies to provide immediate, expedited reimbursement to Minnesota’s 365 skilled nursing facilities for costs related to COVID-19 incurred on or after March 13, 2020. This is primarily a change in timing of payments so facilities can cover costs they are incurring during the pandemic.
DHS will authorize expedited, emergency payments to nursing facilities for costs such as:
Authority provided in Minnesota Statutes 12A.10.