[{"_1":2,"_88":-5,"_89":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6321288,"mediaKeyId","2350974-4212be483a97e5813d55138cde1a9f73","parentId",2350974,"title","DHS outlines PACE option for Minnesota, highlights implementation, staffing and fiscal questions","audioSeconds",3562,"startMs",61000,"endMs",3623000,"viewUrl","/Search/View?dp=1&key=2350974-4212be483a97e5813d55138cde1a9f73&start=61&end=3623","thumbnailUrl","https://assets.pipeline.soar.com/2350974-4212be483a97e5813d55138cde1a9f73/thumbnail_61000.jpg","articleUrl","/articles/6321288/Minnesota/DHS-outlines-PACE-option-for-Minnesota-highlights-implementation-staffing-and-fiscal-questions","mediaUrl","https://secure.pipeline.soar.com/6321288-cde8002db2e2a509cf12e58d5a50d52a/orig.mp4?Expires=1775646946&Signature=OgNrDmPoGOhR5mWwkrRTuLF-CfNluuzyyyiNnXAXG9siXCCOdVqwT1Uzf28cg7-y2y6h4UPuEKf5dNd49D35bnuvOMT0NaYX4vadvskanYuf7wJ-Y1JmGxGGhLWexCkFMmmM-4nJqrlEhB363JUbBiLuK9lGxWf8eiVS7uTDKIvhS~-uEyr7boxHDu6K3PIYtURx3~uT~XZuiBAjaPMa6IeLenDkldgpaFtvfADVCDGex95q-NLS1vA1QNSIcJerKlAXmp2tZy2RBxssKlm3Rj59fsdrTOoVpUPDU7amAkcpeO6qHerY2oOrHdlhrHtuYPPwk8hFnddhOqrpFPwf0Q__&Key-Pair-Id=KUT5TJCACFTXG","author","MNHouseInfo","date","2025-02-19T00:00:00Z","article","The House Human Services Finance and Policy Committee heard a presentation from the Minnesota Department of Human Services on the Program of All‑Inclusive Care for the Elderly (PACE), a federal Medicare‑Medicaid model the department says would offer a site‑based, fully integrated option for people age 55 and older.

Assistant Commissioner Natasha Merz of DHS said PACE “is a model of delivering home and community based services for people age 55 and older” that combines Medicare, Medicaid and long‑term services and supports through a single capitation payment. She added, “PACE can’t result in more spending than Medicare or Medicaid would otherwise spend on that person were they not enrolled in PACE.”

The report submitted to the committee summarizes two analyses requested by the Legislature: an implementation analysis and an actuarial analysis. DHS contracted with a consulting firm (Barry Dunn) for implementation considerations and with Milliman for the actuarial work. Merz said the implementation analysis and actuarial report look at provider readiness, state‑level program criteria, readiness reviews required by the Centers for Medicare & Medicaid Services (CMS), and practical questions such as enrollment choice and involuntary disenrollment.

Why it matters

DHS told the committee PACE would create a new fully integrated option for people ages 55–64 that is not available now in Minnesota. The department emphasized the program is federally authorized and would require a state plan amendment, federal readiness reviews and state administrative resources to implement. Merz noted Minnesota already operates Minnesota Senior Health Options (MSHO), a fully integrated dual‑eligible product for people 65 and older, and said PACE’s principal distinction is its site‑based adult day center model and availability to people age 55 and older.

Key details presented

- Eligibility and services: PACE enrollment requires meeting a nursing facility level of care and being able to live safely in the community at the time of application. PACE programs include an adult day center that can provide primary care, therapy, meals, personal care and transportation, and they coordinate Medicare, Medicaid and long‑term services and supports.

- Financing: Merz said the PACE model is financed through a monthly capitation payment covering Medicare and Medicaid benefits. She told the committee the standard Medicaid match applies: “It’s the standard FMAP for Medicaid.” The federal requirement is that the PACE capitation payment must be less than the projected spending for the enrollee outside PACE.

- State context: Merz said there are about 180 PACE organizations operating nationally in 33 states and the District of Columbia serving roughly 80,000 people. By comparison, Minnesota has more than 25,000 people enrolled in MSHO. DHS noted that, because Minnesota already has MSHO, net state savings from PACE may be smaller than in states without an integrated product.

- Implementation and timeline: DHS described federal approvals and readiness reviews by CMS as prerequisites, and said states must draft a state plan amendment. Merz said implementation “is not flipping a switch” and will require federal coordination and readiness reviews. The department has issued a request for information (RFI) to gauge provider interest; the RFI was reported to close by the end of the month. Merz said the department will report RFI results to the committee when available.

- Department staffing: Rachel Shands, deputy director of Aging and Adult Services at DHS, told the committee the department will need additional staff to stand up and oversee PACE. When asked for a ballpark estimate, Shands said, “I would ballpark, 5 to 10, you know, somewhere in that range.” She also said the department will include staffing and systems costs in any fiscal note for legislation.

Questions and concerns from legislators

Committee members asked about provider interest, the 2011 procurement that drew no bids, the role of staffing shortages in Greater Minnesota, and how PACE would compare with nursing home costs. Merz said providers in 2011 felt the capitation rate then was too low. On staffing, DHS officials said workforce shortages are a systemwide challenge and that the PACE geographic, site‑based model may help assemble interdisciplinary teams, but they did not assert it would solve workforce constraints.

Several legislators pressed for more detailed fiscal analysis and for estimates comparing PACE costs with nursing home costs and with current integrated products. DHS reiterated that the actuarial report and a fiscal note for any bill would provide more precise numbers.

Votes at a glance

- Motion to adopt minutes for 02/18/2025: adopted by voice vote; individual member tallies were not recorded.

What’s next

DHS said it will share RFI summaries and two reports (implementation analysis and actuarial analysis) with the committee and will provide additional detail in a fiscal note if legislation is introduced. The department did not take a position on whether the Legislature should authorize or fund PACE; the presentation was framed as informational.","mediaType","Video","parentTitle","House Human Services Finance and Policy Committee 2/19/25","oneSentenceSummary","The House Human Services Finance and Policy Committee heard a presentation from the Minnesota Department of Human Services on the Program of All‑Inclusive Care for the Elderly (PACE), a federal Medicare‑Medicaid model the department said would offer a site‑based, fully integrated option for people age 55 and older.","taxTitle","2025 Legislature MN, Minnesota","taxId",77817,"location","Minnesota","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6321282,"Advisory council urges expanded regional capacity and data systems to address patients stuck in hospitals",1882,3657000,5539000,"/Search/View?dp=1&key=2350974-4212be483a97e5813d55138cde1a9f73&start=3657&end=5539","https://assets.pipeline.soar.com/2350974-4212be483a97e5813d55138cde1a9f73/thumbnail_3657000.jpg","/articles/6321282/Minnesota/Advisory-council-urges-expanded-regional-capacity-and-data-systems-to-address-patients-stuck-in-hospitals","https://secure.pipeline.soar.com/6321282-7a50cd8849edde4a9c3f0ea43fc08233/orig.mp4?Expires=1775646946&Signature=gH2u2EHQe8xBHNy3Mfhas4tO9ypfhHV8y3c6VCHyFrYvsL5nxI8djMazrrKaQ4mH1YsQy07Xi-CwtrMGAGNr0otChWfDZrHvi8UocUZdGbnEBTU32xYXJca~yBhuC2ZGxx5frgG25l6eio9-V8LW2rb5aOoEcZ~chLCN8niRYEtoFlGtzfbyyzYU4JthAjPhhWWF29UwHkkiNt9bNvKEIfQIvDjK7SAS2bXLcA-FHblyxnM3Ck~ve6pU7CB0rJERt~oV1Q5JOwjDdrQbA-L3G9x4gcsd~DarSp23wQdY9PsTV5Wvc6m259myWOu9W8noL~Q0sJOmnJwnzASouV2dbA__&Key-Pair-Id=KUT5TJCACFTXG","The House Human Services Finance and Policy Committee received the Acute Care Transitions Advisory Council report and a presentation from the Minnesota Department of Human Services on work to reduce long, avoidable hospital stays for people with complex medical and behavioral needs.

Assistant Commissioner Natasha Merz said the department’s “vision” is that people move through care levels based on clinical need and receive timely, safe transitions back to the community when hospital‑level care is no longer required. She described a DHS complex transitions team that is currently operating in three regions and handling referrals from hospitals and lead agencies.

Josh Berg, co‑chair of the advisory council, summarized the council’s recommendations and stressed the need to continue the council’s work. “The long term vision of this is to be even more proactive and preventative in all of this so that we can keep people where they need to be with the services and supports that meet their needs,” Berg told the committee.

Why it matters

DHS said people with complex medical and behavioral needs sometimes remain in hospitals long after clinical treatment goals are met because the community lacks providers or placement options capable of safely supporting them. Long unnecessary hospital stays can worsen outcomes and drive system costs; the advisory council recommended building regional capacity and a statewide measurement system to identify and address gaps.

Key recommendations and current DHS work

- Continue the advisory body or establish a standing entity to oversee and support further work; the council recommended ongoing stakeholder engagement and greater representation of people with lived experience.

- Expand regional capacity for care navigation: DHS currently operates a complex transitions team in three regions and the council recommended learning from those pilots and scaling a regional model that reflects local needs and resource availability.

- Build statewide infrastructure for communication and data sharing: council members recommended a measurement and evaluation framework to track outcomes, regional disparities and effective interventions.

- Short‑term administrative and grant measures: the council suggested targeted administrative changes, flexible grant funding for regional capacity building and options to reduce barriers (for example, expedited training, funding to support provider readiness and to pay for transition activities while Medicaid billings or authorizations are processed).

DHS overview of current activity

Merz described an operational complex transitions effort. DHS accepts referrals for people who are already on, or likely to be eligible for, Medical Assistance and asks hospitals to wait at least a week before referring the department to allow for routine discharge planning. DHS records and triages referrals and can provide clinical consultation, training for receiving provider staff, person‑centered planning support and limited flexible grant funds to help bridge gaps while billing and authorizations are arranged.

Preliminary data presented

DHS reported that, between Nov. 23 and Jan. 27, the department received roughly 210 referrals for adults (18 and older) and about 108 referrals for children, with aggression or service‑capacity gaps commonly cited as drivers of prolonged hospitalization. DHS emphasized that its current dataset is incomplete statewide and recommended investment in a more comprehensive data infrastructure.

Questions from legislators

Committee members asked about funding for children vs. adults, how existing grant funds are being used, and the extent to which regional higher‑education institutions and local workforce pipelines could help build capacity in Greater Minnesota. DHS said it contracted with the University of Minnesota Institute on Community Integration for targeted capacity building and recommended exploring regional postsecondary partnerships as the program is scaled.

What’s next

The council recommended continued work, additional state and regional resources and establishing a measurement system to identify regional disparities and outcomes. DHS said it will share summaries of RFI‑style outreach and regional pilot results and recommended legislative consideration of modest, flexible regional grant funding to build capacity.","The Acute Care Transitions Advisory Council recommended continued council work, regional care‑navigation expansion and a statewide data and measurement framework to reduce long hospital stays for people with complex needs. DHS said it has a three‑region pilot complex transitions team and has accepted over 300 referrals since November.","actionData","errors"]

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DHS outlines PACE option for Minnesota, highlights implementation, staffing and fiscal questions

Advisory council urges expanded regional capacity and data systems to address patients stuck in hospitals