Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Health And Human Services Waivers topic
No spam. Unsubscribe anytime.
Morrison County Health and Human Services reports growing MnChoices assessments and waiver enrollments
Summary
Morrison County Health and Human Services told the Board of Commissioners on March 20 that MnChoices assessments and disability-waiver enrollments have increased in recent years, and staff described steps taken to manage variable caseloads and pending state and federal rule changes.
Morrison County Health and Human Services reported to the Board of Commissioners on March 20 that the county is completing more MnChoices assessments and serving a growing number of disability-waiver participants, and that the program’s funding and eligibility rules remain tied to state and federal approvals.
Nathan Bertram, the county’s Health and Human Services director, introduced the combined MnChoices-and-waiver update and said the county consolidated two separate reports because “you can't really have one of these services without the other.” Aaron Stein, human services supervisor, described MnChoices as “a person-centered comprehensive assessment to help people with long term or chronic needs to make these care decisions,” and stressed that the assessment is required for anyone seeking waiver services.
Stein said staff completed about 593 MnChoices assessments in 2024. He explained that the county has four full-time assessors (about 13 assessments per month each on average), supplemented by two part-time intermittent assessors added in 2024 to smooth workload peaks and allow time off without overwhelming the full-time team. “The intermittent part time pool … has been very, very helpful,” Stein said, and county leaders said it supports staff retention because MnChoices training is lengthy and proficiency takes time.
Jeff Bowman, adult services supervisor, reviewed waiver categories and trends. He described four disability waivers — community alternative care (CAC), community alternative for persons with chronic illness (CADI), brain-injury (BI) and developmental disability (DD) — and said state changes have made some services available across waiver types. Bowman said the county’s CAC/CADI/BI pool has increased substantially since 2017 while DD caseloads have remained more stable.
Bowman and Bertram told commissioners the increase reflects several factors: fewer informal supports from family or community after the pandemic, greater accessibility to medical assistance for some individuals, and more minors entering waiver services. Bowman estimated about 20% of CADI participants are under age 18 and noted BI participants in the county are few in number but typically adults.
On budgets, staff said waiver funds are managed as pass-throughs to providers rather than kept in county accounts. Historically Morrison County used up to about 95% of its authorized waiver budget; in recent years utilization has varied and staff reported roughly 30% in the last several years, reflecting provider billing, changing eligibility and other dynamics. Bowman described the statewide disability waiver rate system as a standardization meant to replace widely varying, negotiation-based rates used previously.
Commissioners asked about long-term trends and federal-state interplay. Bertram and Bowman said proposed legislative changes could alter reassessment frequency (for example, moving away from an annual MnChoices reassessment), but any change would require both state legislation and federal approval from CMS and would likely take two years to implement if adopted. Bertram said he expects to return with a fuller summary in July after the legislative session.
The presentation closed with commissioners noting concern about the upward trend in waiver enrollments and asking staff to monitor caseloads and budget impacts as the county plans staffing and services.
