HCBS Strategies - Client Minnesota

To view the most recent version of the full tool and other project management documents, CLICK HERE.

Overview of the Effort

The state of Minnesota is refining its current assessment process to ensure greater consistency across the counties and across all populations with disabilities under age 65. This project developed standards and protocols, a common data collection tool, and recommendations to best utilize these tools to improve the reliability and equity of service provision, with careful regard given to the possible impact on service funding structures. The state's vision was to have a comprehensive assessment process that supports improvements to the quality and efficiency of supports.

This effort resulted in the MNCHOICES Comprehensive Assessment (formerly known as the Universal Assessment, and COMPASS). Development of the tool was completed in August 2007. The state is currently developing a plan for implementing the tool.

The purpose of this website was to facilitate the sharing of information across the stakeholders involved in the development of this effort. This work was overseen by the Comprehensive Assessment Steering Committee . Thus, this site contains documents that have been developed as a part of this effort to make sure that all the stakeholders can be full and active participants.

Factors Driving the Need for a New Assessment Tool

To receive home and community-based service programs an initial screen is required to establish eligibility and determine a person’s need for services. An annual screen is required thereafter to determine continued functional eligibility. The current screening and assessment process is at times challenging and time consuming. First, there are multiple forms to complete, sign, and process. This makes the intake process confusing and cumbersome for families and for some county staff. In addition, individuals and their families or caregivers do not feel that the present data collection instruments capture what their true needs are, yielding a service plan that is often not responsive to the actual needs of the individual and their situation.

Also of concern is the inability of the tools to allow for flexibility of use, and collection of the right information, i.e., enough relevant detail to direct planning and fiscal accountability. For example, the DD screening document currently required does not satisfactorily screen for the level of complexity and intensity of the needs of the individual with a disability. The Long Term Care Consultation (LTCC) Screening Document is focused more on the aged population, and less so on the needs of youth or children. Finally, the current screening tools do not adequately screen for mental health needs to help plan for services.

Stakeholder Input

Based upon input of numerous stakeholder groups, we heard the following as reasons for the need to change the current approach:

Assessments are performed at a period of time and reflect a "snapshot" versus the overall needs of the person. Parents tend to want to base the assessment of their children on their worst days. The new tool will allow for some clarity in how to address this.
People may switch from waiver to waiver, which is hard for staff at the local level. Having a single assessment process will help to determine what services fit a persons' needs best.
One of the greatest concerns of county-level providers is the inability to meet the timeframes, e.g., 10 days for assessment. Factors contributing to this are:
- Obtaining medical necessity approval for primary care provider/medical provider.
- Numerous forms to sign.
- The time it takes to perform the assessments for mental health, especially for the CADI waiver.
- Obtaining all of the necessary eligibility requirements for DD in particular, such as psychological evaluations, and disability certifications .
Services cannot start without a service agreement, which is driven by assessment and service eligibility determination.

Issues with Current Screening Documents

Multiple forms are confusing and cumbersome for families and for some county staff.
Staff at the county level do not want to be forced by the design, to complete all form fields if they are not relevant.
Current tools are not specific enough to capture the Active Treatment requirement of the DD waiver.
Currently the LTCC is too focused on the aged and not on youth or children.
DD does not satisfactorily screen for level of complexity and intensity of the needs of the DD population.
The issue of having two screening tools, one for DD and one for LTC, not only limits the ability to screen true levels of intensity for the DD populations, it also creates a separation at the county level of separate service provision units.
Tools do not adequately screen for mental health needs to help plan for services.
Consumers do not feel that the present design captures what their true needs and therefore staff are not responsive to actual needs.

MNCHOICES Comprehensive Assessment is Designed to Meet the Objectives Outlined Below:

Assure assessment for services and supports to individuals with disabilities are driven less by the funding stream (i.e., waiver or state plan) and more by the needs and preferences of the individual. A key starting point for this reform will be the ability to accurately assess what individuals need and prefer.
Allow intake and assessment staff at the county level to gather additional information on specific populations, such as individuals with greater medical needs or mental health concerns.
Streamline the process to reduce use of duplicative forms across waiver populations.
More accurately reflect the true needs of the individual and family/support system.
Capture more relevant information to address vocation, habilitation, skills adaptation and other needs for which the State currently does not offer tools.
Enhance the ability to conduct initial behavioral health screens for CADI and MR/RC by providing more definitions for screening.
Move toward an automated intake and screening process that is less cumbersome for the consumer and will capture more accurate data about the individual for service planning.

To view the most recent version of the full tool and other project management documents, CLICK HERE.

Requests for information or if a document is inaccesible to you can be sent to Kristy Michael

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