Human Services

Operations

Statewide Outcome(s):

Operations supports the following statewide outcome(s).

Efficient and accountable government services.

People in Minnesota are safe.

Context:

The Operations administration within the Minnesota Department of Human Services (DHS) provides the agencywide support and infrastructure needed for the effective and efficient delivery of human services. The work done in Operations ensures that federal and state compliance measures are in place and that proper fiscal accounting procedures are used in handling federal and state funds. The department’s fraud prevention and detection efforts, which help ensure that public resources go to support those who need them by reducing fraud and abuse, are housed within Operations.

Operations works to ensure the necessary tools and capacity exist for the department’s administrative work. Operations staff accomplish this by providing a wide variety of support services that include information and technology, human resource management, financial operations, facilities management and compliance services, as well as facilitating our work with our county and tribal partners. Primary customers for the Operations activities include human services staff, counties, tribes and community service providers.

Operations also provides direct program services that protect children and vulnerable adults as well as ensure fair and equal access to human services programs. Families, children and vulnerable adults need to be assured that the licensed facilities in which they receive care are safe and that people responsible for taking care of these family members, children and vulnerable adults meet service expectations. Operations staff license child and adult care programs, conduct fraud investigations related to human services program payments, and provide appeals processes for those who feel access to public services was wrongly reduced or ended. Primary customers include more than 289,000 individuals receiving care from a licensed service provider, individuals or providers receiving assistance or payments from human service programs and taxpayers.

Most Operations activities are funded through state general, health care access and special revenue funds and federal funds. Licensing activities are funded largely through special revenue fund proceeds from licenses and background study fees.

Strategies:

Operations functions fall generally into two categories: those efforts that support the effective and efficient delivery of human services and those efforts that contribute to keeping Minnesotans safe.

Effective and efficient delivery of human services – Operations provides the agencywide support and infrastructure required for the efficient and accountable delivery of human services. These activities include:

·         Reducing fraud, waste and abuse. DHS created the Office of Inspector General (OIG) in August 2011. The OIG works to ensure government resources are going to those who need them by reducing fraud and abuse in the use and distribution of state and federal funds. The office is also using new tools to stop individuals and providers from receiving benefits and funds inappropriately.

·         Providing an appeals process that helps ensure accountability and fairness for human services programs. Upon request, fair hearings are conducted for individuals or providers whose services, benefits or payments have been changed.

·         Information and technology services, which includes day-to-day network maintenance and support and management of more than 300 system applications and several major statewide computer systems. The major systems, used by 87 counties and thousands of providers, are: (1) “Medicaid Management Information System” (MMIS), which processes Medical Assistance and MinnesotaCare claims; (2) MAXIS, which is used by state and county workers to determine eligibility for public assistance and health care programs and to make public assistance payments; (3) “Providing Resources to Improve Support in Minnesota” (PRISM), which supports Minnesota’s Child Support Enforcement program; and (4) “Social Service Information System” (SSIS), which is a county case management and data collection system for foster care, out-of-home placement, children’s mental health, and adoption information.

·         Financial operations. Staff develop agency budgets based on sound fiscal policy, provide accounting payment processes that ensure health care providers, child care providers or assistance recipients receive accurate and timely payments, and forecast program enrollment and expenditures to provide federal and state decision makers with sound fiscal estimates.

·         Compliance services. Staff conduct operational and program evaluations, county audits, and reviews of grantees and contractors to ensure fiscal and compliance requirements are met.

Keeping people safe – Licensing activities help to ensure individuals receive services that meet accepted standards in safe, healthy environments. Staff conduct background studies to ensure that individuals providing direct care do not have disqualifying characteristics and conduct licensing reviews to ensure applicants and license holders comply with statutes and regulations. Operations licenses more than 23,000 service providers and conducts 252,000 background studies annually. Licensing activities also include conducting maltreatment investigations, removing individuals responsible for maltreatment from providing care services, and applying licensing sanctions when warranted to protect the health and safety of individuals. Licensing staff conduct approximately 950 maltreatment investigation each year.

A new Licensing Information Lookup website enables individuals to learn more about their care providers. In the first half of 2012, there was a 26 percent increase in the monthly number of visits to this website. This resource will continue to provide valuable information to Minnesotans as DHS strives to provide more relevant information about service providers on this website.

Operations supports several strategies in the agency’s “Framework for the Future: 2012.”

(https://edocs.dhs.state.mn.us/lfserver/Public/DHS-6464-ENG):

·         Establish Office of Inspector General to improve fraud prevention and lead to increased prosecutions and collections of overpayments

·         Expand field investigations through Medicaid Recovery Audit Contracts

·         Create new enforcement tools including background study expansion, data analytics and financial integrity standards in licensing

·         Use technology to increase our outreach through online applications, a new website and e-licensing initiatives

·         Create a new partnership model for our work with counties and tribes

·         Enhance capacity of our tribal partners to assume more direct service delivery

·        

Results:

Operations monitors and reports on key measures to tell us how well our strategies are working. DHS tracks the amount of funds recovered as a key measure of the effectiveness of OIG efforts. The Appeals Office tracks the timeliness with which appeals are heard and completed. This is important because there has been significant growth in the number of appeals that must be processed. (In FY 2008, the office closed out 6,482 appeals and in FY 2012, the office closed out 9,730 appeals.) Operations has added a performance measure to track usage of the Licensing Information Lookup website. We also track the number of licensing sanctions; these have remained relatively stable over the past four years. Our Minnesota IT Services (MN.IT) staff track the volume of information that is processed by one of the largest of the Department’s major systems.

Performance Measures Notes:

1.             Compares FY2008 (Previous) to FY2011 (Current). Source: DHS Dashboard data on Program Integrity – recovered funds: http://dashboard.dhs.state.mn.us/measure04.aspx

2.             Compares the percentage closed within statutory timelines for FY 2008 (Previous) to FY 2012 (Current). Source: DHS monthly Appeals reports

3.             Reports the number of unique visits that separate individuals made to the DHS Licensing Information Lookup website per month. Compares January 2012 (Previous) to July 2012 (Current). Source: DHS Licensing Information Lookup website: http://licensinglookup.dhs.state.mn.us

4.             Compares 2008 (Previous) to 2011 (Current). Source: License Information System (LIS). The Licensing sanctions reported here include license revocations, suspensions, fines, conditional licenses and order of temporary immediate suspensions.

5.             Compares July 2011 (Previous) to July 2012 (Current). Source: MN.ITS @ DHS MMIS reporting