County health unit to transition 157 Blue Cross case management clients to Lutheran Social Services; staff outline legislative changes to waiver payments

County Health and Human Services staff briefed commissioners that Blue Cross Blue Shield (BCBS) has scheduled a transition of care‑coordination services and that Lutheran Social Services will take over case management for people covered by BCBS starting Oct. 1, 2025. Officials said 157 Pine County residents currently receive care coordination under the BCBS contract and will be reassigned to Lutheran Social Services.

At the meeting a Health and Human Services staff member described staff cross‑training already underway to support a smooth handoff and reported that a July BCBS desk audit of 30 randomly selected cases found 100% compliance for the county’s contracted files. That audit and the county’s seven‑year compliance record were presented to reassure commissioners that the transition reflects contract and administrative decisions, not a problem with the county’s service quality.

Staff also summarized recent state legislative changes that affect MinChoices assessments and waiver payment methodology. Key changes flagged for commissioners included expanded remote assessment options, an individual waiver option to attest that no reassessment is needed for a year, and a direction to move toward a flat reimbursement model for waiver services starting in 2027. Staff emphasized two fiscal risks: (1) legislation includes a statewide target of approximately $18 million in savings from payment methodology changes, with the potential for county‑level funding shifts if savings are not realized; and (2) a larger package of cost‑savings measures in the biennial budget assumed $143.5 million in savings and built in a potential $72.5 million cost shift to counties beginning July 1, 2027, if the savings do not materialize.

Commissioners asked whether clients would lose coverage or services; staff said clients would not lose coverage and that BCBS and Lutheran Social Services are coordinating to avoid service disruption. Commissioners also asked where Lutheran Social Services would be located; staff said the agency’s office is based out of Mankato and that case managers typically travel from their regional office to meet clients in the community.

Staff recommended, and the board acknowledged, monitoring the transition closely and tracking any client or provider contacts that indicate problems. The county also applied to participate on an advisory working group convened by the Association of Minnesota Counties and national partners to represent Greater Minnesota perspectives on the implementation and cost‑shift work.

Health and Human Services staff flagged several other legislative changes that could affect county service delivery and budgets, including capped provider inflation tied to CPI, reductions in day/unit‑based services on disability waivers (including cuts to high‑hour in‑home supports), a new nursing‑home surcharge, and other payment changes across waiver programs. Commissioners asked for regular updates and for staff to model budget impacts as legislation and implementation rules are clarified.