clay county commissioners

Dan Haglund 

An annual Clay County Social Services: Home and Community-based Licensing and Disability Division annual department update was presented by three supervisors on Tuesday to the Clay County Board of Commissioners in Moorhead.

Rhonda Porter, director of Social Services; Jessica Mickelson, supervisor for Child Care licensing; and Hollie Wanner, Social Service supervisor, gave an overview of how different sectors of the department have been evolving based on needs and funding.

The first division presented was the Adult Foster Care (AFC) portion, which consists of 188 total available beds, 68 of which are licensed as AFC and 11 as corporate foster care for children, and 109 are corporate foster care for adults. There is one licensor assigned to this division.

Three new AFC licenses were opened in 2022, but 14 closed either due to inactivity, non-compliance issues or the license holder moved out of the county.

The Child Foster Care (CFC) part includes 17 relative homes with eight in the application process. There are 36 non-relative CFC homes with 14 in application. In 2021, there were 60 CFC homes, but two non-relative and five relative homes were closed. There are two licensors assigned to this division. A further update will be given at the May 9 board meeting.

In Family Child Care (FCC), there are currently 139 homes with 10 in application, up from 123 FCC homes in 2021.

The FCC has partnered with Creating Community Consulting through the Childcare Grant received through a partnership with Clay County and West Central Initiative to promote childcare. They are currently working on the development of a new childcare center in Moorhead, which will have 128 slots, along with several other childcare-based initiatives. The two licensees assigned to this division have been promoting the new option to provide childcare outside of the homes.

The FCC American Rescue Plan Act (ARPA) Initiatives also include a wide marketing swath through Off The Wall Advertising, new brochures, digital marketing, social media campaign, community events, SPUDS TV, MAPS KidSource, and a collaborative mailing sent to Barnesville, Sabin, Baker, Comstock, Wolverton and Hawley.

This initiative also compensates current providers who hold spots for foster care children in their childcare, with three providers participating.

A mentor program has also been developed for licensed providers, with five mentors being identified. They participate in an orientation process, and are available to new and current providers.

There is also a referral bonus for current providers who refer a new applicant who obtains licensure and maintains active enrollment for at least one year.

The ARPA initiative also waives all childcare licensing fees, and provides up to 16 hours of free training for two years. So far, two trainings have been offered with another set for this month.

There is also a $1,000 incentive offered for providers who hold a B1 (infant and toddler) license. As of yet, no provider has applied for it.

Another incentive is offered to providers who offer non-traditional childcare hours, of which there are currently two with evening hours.

ARPA funding was allotted in May 2022, and there have been increases in orientation participation as well as new applicants over the past few years.

Under the Adult and Disability division, there are 1.5 intake workers. A half-time position was added in May 2022 to eliminate a backup rotation previously used, and to improve response times to inquiries. 

In 2022, there were 1,300 intakes, up from 1,097 in 2021.

Under Special Needs Basic Care (SNBC), there is one care coordinator. Clay contracts with UCARE to provide care coordination for their members. UCARE is currently the only health plan in Clay County providing SNBC, resulting in a drastic increase in caseloads. Current caseload for Social Services is 361 members, with an expectation of more. There were just 132 members per month in 2022, and 112 in 2021.

The main reason for the increase has been that Health Partners is no longer providing services within the county this year, leaving UCARE as the sole provider.

UCARE is also in the process of implementing Care Coordination Redesign, which will impact how care coordination with be provided and increase outreach efforts.

A variable hour social worker has been hired to assist in this area, but a more permanent solution is being sought.

A web-based tool called MnChoices is used for creating person-centered assessments and support plans. It helps people with long-term or chronic care needs to make decisions about their care, and assists with determining services eligibility. The McChoices Assessors are still operating under the Federal Peacetime Emergency, which allows assessments to be conducted virtually. The FPTE is scheduled to end on May 11, but there will be a six-month transitioning period to phase into conducting all assessments face-to-face.

The Department of Human Services is launching MnChoices Revision this month, which is an online tool assessors will use to complete assessments and support plans. At present, there are 42 known technical issues with Revision, and the state is anticipating each assessment conducted in Revision will take an additional 50 to 100 minutes to complete.

There were 521 assessments in 2021 and 583 in 2022. Of these, 177 were referred by mental health, 44 for chemical health, 88 for developmental disabilities, 11 for COVID-19-related issues, and 48 required the use of an interpreter.

There were 540 reassessments in 2021 and 571 in 2022. 

In Home and Community Based Services (HCBS) and Rule 185 Division, there are 14 case managers who provide case management services to individuals and families focused on person-centered planning, referrals, support plan monitoring, coordination and advocacy-related to waiver services or other community resources.

These managers serve people of all ages who have a disability and are eligible for a Medicaid waiver or Rule 185 (Developmental Disability Case Management). Additional case managers were added in November and January to help manage the caseload increase.

There are also two case aides who assist the case managers with administrative duties related to waiver and Rule 185 services.

Regarding state disability waivers, an applicant must be a Minnesota resident, be on Minnesota Medicaid, be certified disabled or have a disability, have a need for services as an alternative to living in an institution, or meet additional individual waiver requirements including level of care.