DHS Systems and IT Updates SSIS resources Mentor Program Meeting Minutes

MPAC Meeting Minutes

June 19, 2012

Attending: Peggy Vizenor (Polk), Kathy Melvin (Hubbard), Diane Eastman (Aitkin), Staci Stoner (Morrison), Becky Diebel (Morrison), Carol Clausen (Meeker), Laurie Plessel (Pine), Cathy Higgins-West (SWHHS), Joy Beebe (Nicollet), Wanda Kane (Scott), Terri Berg (Hennepin), Michelle Bennett (Ramsey), Lisa Wefelmeyer (Carlton), Mary Klinghagen (SSIS)

Not Attending: Emelie Rivera (Leech Lake), Chris Worth (Itasca), Teresa Schmidt (Douglas), Rita Berg (Renville), Leigh Jagusch (LeSueur), Mary Gagnon (White Earth), Sue Cleveland (Dakota)

1. Welcome and attendance
2. Feedback from May agenda and notes
   1. Discussed IV-E Eligibility Determination Trainer (EDT) availability, contact info, how one can tell if the information provided to the MAXIS workers has been updated
   2. Send path to EDT assignment list. LISA NOTE: EDT Assignment List and EDT Map sent to MPAC members and posted on the Mentor web page under Resources.
   3. Michele Bennett requested that Laurie from Pine send her info on equipment and process for electronic signature info they are using.
   4. Correct the May minutes: Kathy from Hubbard did attend. Region 11 meeting is scheduled for June 29th. Both changes were made to the Meeting Minutes which were reposted on CountyLink.
3. Version 12.3 release
   1. Continued questions about what is the difference between the Prime West CMH
      plan and the SSIS CMH plan. Meeker is putting a Prime West CMH template in SSIS so that the plan displays in SSIS as a workgroup service plan.
   2. Meeker does not have remote access and can’t take SSIS into the field on a laptop. They are not using a plan on Prime West laptops.
   3. Reviewed the V12.3 big ticket items
   4. Ramsey may be interested in piloting.
   5. Please contact Lisa if you are interested in piloting.
4. Region meeting update – discussed current schedule
5. MPAC open topic
   1. CP workers do not like the Family Strengths and Needs tool. Polk has a lot of concerns. Apparently there was technical trouble on both days for the webinars. Their workers gave up. Workers want to be able to make a selection to not complete the Strengths and Needs tool if they are not referring to ongoing case management. When the risk is not high and they are not referring to on-going services, they would like a check box to override the need to do the Family Strengths and Needs tool. Terri from Hennepin reported that workers say they don’t want to do this either. Nan, Dave Thompson and Hennepin representatives are having a conference call
      on this. Ramsey is questioning why stepchildren display.

LISA NOTE: Regarding the issue of workers wanting to opt out of the FSN if their assessment is to close the case: per the Minnesota Department of Human Services policy and procedure manual (page 38), the FSN Assessment serves several purposes within the assessment phase:

It ensures that all caseworkers consistently consider each family’s strengths and needs in an objective format when assessing need for services.

· It provides an important case planning reference for workers and supervisors.

· The initial strengths and needs assessment, when followed by periodic reassessments, permits caseworkers and their supervisors to easily assess changes in family functioning and thus assess the impact of services on the case.

· In the aggregate, strengths and needs assessment data provide information on the issues facing families served by the department. These profiles can then be used to develop resources to meet client needs.

/main/groups/agencywide/documents/pub/dhs16_169048.pdf

The requirement to complete the Family Strengths and Needs tool in an FA Assessment workgroup to close the workgroup is not new. Per the SDM training documentation:

The Strengths and Needs Assessment is required in all Family Assessment track – Child Protection workgroups. It is recommended for all Family Investigation track – Child Protection workgroups and required if the investigation will be opened for ongoing services.

In Family Assessments, the Strengths and Needs Assessment should be completed with the 45-day assessment period. In Family Investigations, the Strengths and Needs Assessment should be completed within the 45-day investigation period, or within 30 days of opening for ongoing services, prior to development of the initial service plan.

After initial assessment, a Strengths and Needs Assessment should be completed again
30 days prior to the required service plan updates.

Regarding question about why a stepchild is included in the list of child tabs: Depending on the worker’s assessment, it may be appropriate to assess all family members in the household(s). Workers may deselect a child’s name if it is determined that the assessment is not appropriate on the tool and a tab does not display.

2. 2. CW-TCM service plan. Peggy sent materials on CW-TCM to webinar attendees. Very concerned about whether they can back claim for services they are providing before they get a service plan signed. Hennepin says they are able to back claim for CMH. Ramsey reported that Sue Krinkie met with them and said they could go to court if a parent does not sign the service plan that includes CW-TCM information. Hennepin asks: Is it ok to back date a plan with the parent so they can claim CW-TCM? What is the CW-TCM review period? They need confirmation that workers must still do CP plans, etc. Ramsey inferred from Sue Krinkie that workers don’t need to do any other plan.

LISA NOTE: Per the June 2011 webinar by Sue Krinkie and Medicaid speaker Meredith Martinez, CW-TCM case management is defined as activities which assist
a child under age 21 and the child’s family to: gain access to needed services, coordinate the delivery of needed services, assure continuity of care of services, and assess the delivery, appropriateness and effectiveness of services on a regular basis. What a worker enters on the CW-TCM Supplemental Health Care Eligibility screen includes the date child meets one of the CW-TCM Eligibility Factors, the service plan used to describe the CW-TCM services, and in the CW-TCM finding text entry field: identify eligibility criteria that the child meets, a written description of the child’s family situation, and the reason CW-TCM services are needed. A CW-TCM case finding is a statement that identifies why case management services are necessary and that they will be provided to the child. Any plan in SSIS can be used as a child’s CW-TCM case plan, but it must be clearly identified for the specific child. For most plans in SSIS, it is not likely that workers would add sufficient child-specific information to address the requirements of CW-TCM. The OHPP and the IFCSP both already contain the necessary requirements for documenting child needs and services without having to add additional information.

CW-TCM eligibility is reviewed annually and entered on the Annual Review Date tab of the current CW-TCM Eligibility screen.

Per CW-TCM webinar:

Claimable CW-TCM activities:

1. Assessment of needs after eligibility, case finding and case plan are completed
2. Development, completion, and review of written service plan
3. Face-to-face contact with child and family
4. Coordinating referrals
5. Coordinating service delivery
6. Monitoring and evaluating service delivery
7. Completing and maintaining documentation.

Non-claimable CW-TCM Activities:

1. Maltreatment assessments
2. Therapy and treatment services
3. Transportation services
4. Outreach services
5. Foster care placement activities
6. Legal services
7. Services that duplicate the same service provided from another case manager
8. Services to child in MA funded facility except 30 days prior to discharge for planning. Limited to two 30-days-per-year.

CW-TCM can be back claimed for one year. This is different than seeking to claim CW-TCM dollars prior to an eligibility determination, case finding, and signed service plan requirements. These requirements have been in place since 1993. To clarify, per Sue Krinkie, CW-TCM dollars are for case management, not for direct services to clients. When a worker is in the process of doing a maltreatment assessment, she/he is in the process of doing a direct service. Assisting with Foster Care arrangements is a direct service. This is not case management. There is a difference between assessing whether a child is eligible for a program area service, and assessing what services a child needs during case management. It is an exception, not the rule, to claim CW-TCM during an assessment phase for any program area. Further, if a client is not enrolled in MA or eligible for MA, CW-TCM claims at this point are not valid claims.

Sue noted that CW-TCM services are voluntary for parents (unless the local agency has a court order for case management services). This is why it is important to have a parent sign the service plan agreeing to the services. For families that are not MA eligible, e.g., a typical DD or CMH client family, there could be financial ramifications to accepting CW-TCM services. Sue questioned how a worker knows if a family is agreeing to a service until they sign the plan?

Additional resources for CW-TCM:

Link to CW-TCM Quick Reference Guide for Case Managers:

/main/groups/agencywide/documents/pub/dhs16_150085.pdf

Per the Minnesota Health Care Provider Manual for CW-TCM: This determination must be made by the county agency responsible for child welfare services. The activities involved in the determination of eligibility are not claimable as CW-TCM. A CW-TCM claim may be submitted only after the determination of eligibility for CW-TCM services, the case finding (including a brief description of the circumstances that support the finding) and case plan are recorded in the case file.

Link to MHCP Provider Manual for CW-TCM:

Minn. Health Care Provider (MHCP) manual for CW-TCM

3. Topics for upcoming MPAC – None noted.
4. Mentor Meeting August 21st - Reviewed potential Mentor Meeting Agenda items:
   OHPP Trial Home Visit Plan, Combined Documents, Reminders & Alerts, CMH Assessments, IFCSP service plan, and Tableviewer, and SSIS plan to implement legislative changes to adoptions.
5. Questions for SSIS Management. None noted
6. Other:
   1. Lisa will contact Michele from Ramsey County about region meeting concerns.
   2. What is the best way to add something to an old contact?
      1. Add more detailed information in a case note and put connective information to the original note in the Description field.
      2. Add the extra information as an Activity with the Service of Documentation. Mary reminded MPAC that it is important to not record amounts of time previously entered. Only the time involved in recording the additional detail should be reported.
7. Close - Confirm July 17th from 10 – 11a.m. for next MPAC meeting.