Much of the May 7 County Board meeting was devoted to Health and Human Services issues. Chisago County HHS had some good marks from a state audit of Medicaid programs, and the programming for Developmentally Delayed persons is coming in at a cost that’s lower than comparable caseload counties; however, there’s a waiting list for the Community Alternatives waiver benefit which is not desireable.
In the audit summary Chisago County is cited as one that the state Dept. of Human Services would refer other counties to for assistance in establishing best practices. “We hope that you will serve as a resource to other counties looking to improve their HCBS (Home & Community Based Services) programs,” the report stated. A few recent overhauls for shifting medical assistance recipients onto new health care options, and the long term care consultation rule changes, have created lots of new work and the county department is attempting to staff up to meet demands. “The county is on track to come in line with MNChoices (long term care) changes in June 2014, according to Nancy Dahlin, the county HHS Director.
She said commissioners can expect significant impacts to the county’s “congregate” settings for federally-funded clients. New limits on use of Medicaid funds for services to clients in group homes or day training and habilitation settings are being implemented. In any given year Chisago County will administer about $20 million in federally funded human services programs. Regarding a recent Sunday Star Tribune article about the high incidence of counties screening out reports of child protection cases-- Dahlin noted that the statistics based article did not note that Minnesota “...is doing approximately the same number of assessments per year from 1996 to 2010...in spite of the fact our child population is decreasing.”
Objective decisions on whether to charge out a child protection crime are made consistent with state law, she added. The county utilizes options rather than protective services and a screened out report doesn’t mean no action was taken to assist the family. To only compare screen-out numbers amongst counties doesn’t consider each agency’s perception of risk to the child. Dahlin continued, “We often explain (to mandated reporters) that reports may be screened out but that shouldn’t prohibit them from continuing to report and remain engaged...(and) 98 percent of mandated reporters indicated a positive relationship with counties, so we are obviously relaying that message,” Dahlin concluded. On Mnsure Todd McMurray, County Income Maintenance Supervisor, said he couldn’t give hard numbers on the level of Mnsure enrollment here, because data isn’t available from the state yet. The open enrollment period ended March 31.
The only consumers who can still enroll in health insurance-- either through Mnsure or outside of the program-- must experience a qualifying life event, be eligible for Medical Assistance or MinnesotaCare, be part of a tribe that is federally recognized or participate in Small Business Health Options Program. (A qualifying life event includes birth of a child, job change that impacts insurance or a change in marital status.) The next open enrollment is November 15, 2014. McMurray said the county staff are still taking anywhere from eight to 15 calls daily related to healthcare issues. Lighthouse, in Milaca, has stepped up to supply some mental health services in the wake of the closing of Riverwood Centers, a multi-county program. The Board unanimously adopted a contract. Lighthouse will provide “support services” which are designed to enable individuals with serious mental illness and co-ocurring conditions to intergrate successfully into activities in a community.
Housing, medication monitoring and independent living skills are some of the services. Crisis “Hotline” mental health calls have been shifted to Canvas Health, based in Oakdale. (See story below.) And, the relatively new relationship contracting for medical examiner services out of the Midwest Medical Examiner’s Office in Ramsey, is going very well. Chisago County left its previous Hastings-based medical examiner group. Dr. A. Quinn Strobl is now the county’s chief medical examiner. She said no deaths in Chisago County were classified as a homicide in 2013. Six suicides were determined by her office in Chisago County. Use of oxycodone and meth caused the death of three victims. The office performed 24 autopsies in 2013 compared to 21 for 2012. Death investigations, brief and extensive, numbered 312. This includes authorizing cremations and hospice deaths as well as looking into suspicious or accidental deaths. ~ The Board unanimously awarded a bid for reflective pavement markings for $92,713 to AAA of St. Michael. ~ The new boiler project for the government center went to Corval Group at $253,000.