Ramsey County approves pilot placing county eligibility specialists in Monarch long‑term care sites

The Ramsey County Board of Commissioners approved on Oct. 21 a one‑year pilot agreement with Monarch Healthcare Management 4 LLC to place county eligibility specialists inside seven of Monarch’s long‑term care facilities in the county.

County staff said the arrangement mirrors long‑standing contracts the county has with other providers and with Regions Hospital, and that the eligibility specialists will remain Ramsey County employees whose work is prioritized for the agency while still supporting broader county caseloads. The county expects federal random‑moment reimbursement to cover approximately half of the specialists’ salaries; Monarch will fund the remainder.

Staff described the pilot as limited and evaluative: after a workload review the county proposed assigning two eligibility specialists to the contract rather than one; an internal evaluator will track outcomes, including turnover in residents’ medical‑assistance cases, speed of processing, and reimbursement rates. If Monarch or the county declines to renew the arrangement after one year the county said the work could be reabsorbed into existing staffing.

Commissioners asked how Monarch was selected and whether the pilot could disadvantage other providers. Staff said Monarch approached the county after similar agreements in other counties and that other providers have not asked for identical arrangements in Ramsey County. To avoid service disruptions county staff requested two additional FTEs to offset potential queue impacts.

The board voted by roll call to approve the agreement. Moran was excused.