Commissioners voice frustrations in meeting

 

Counties across the state, including Freeborn County, were notified Monday of a series of payment problems in the Minnesota Department of Human Services that will have a trickle-down effect to the county level. 

In a letter to county officials, Minnesota Department of Human Services Commissioner Jodi Harpstead said counties are being asked to pay a share of the state’s use of federal Medicaid funds to pay for substance use disorder treatment for patients in institutes of mental disease settings from January 2014 through May 2019.

“Federal law requires us to reimburse the federal government for their share of those payments,” Harpstead said in the letter. “As a result, DHS underestimated the county share for these payments, and state law requires us to collect the additional share of the cost from counties.”

For Freeborn County, this share equates to about $78,000. For Mower County, the total is also about $78,000; in Faribault County it is about $32,000; in Waseca County it is about $17,000; and in Steele County it is about $128,000.

“We understand the significance of this issue and the frustration it’s likely to cause,” she said, noting she wants to work closely with county representatives to figure out how the funds can be recouped in a timeframe that best allows counties to plan for and mitigate the impacts.

Freeborn County commissioners were notified of the letter at the regular board meeting on Tuesday and briefly discussed the impacts it would have on the county.

Commissioners Mike Lee and Jim Nelson expressed frustration at the request.

“It seems like when the state screws up, it goes on our back,” Nelson said. He questioned who the state answers to when it makes mistakes.

Freeborn County Administrator Tom Jensen said ultimately the issue would force the county to have to raise its levy to be able to make the payment to the state.

In addition to the payments for substance use disorder services, Harpstead listed two other issues in the letter that would affect counties.

She said the state is not able to reimburse claims for Title IV-E funding for congregate care settings that do not have enhanced background checks, which include fingerprint-based criminal records checks, on every adult working in the settings as required by law effective July 1. This includes group homes, residential treatment centers and shelters.

The letter stated there are not any child care institution facilities in the state that are in compliance.

“We know that counties rely on guidance from DHS to implement changes in law, and we did not issue our guidance on this issue in a timely manner,” Harpstead wrote. “We are committed to working with you to help providers come into compliance with the background study requirements.”

Lastly, she said a law took that took effect in 2016 released participants in the cash assistance program from responsibility for repaying overpayments caused by county, tribal or state errors. DHS guidance to counties results in some people having to repay overpayments caused by administrative error.

She said the department is committed to repaying the amounts collected in error to these participants and will be gathering a group of counties, tribes and legal aid to determine the process for suspending claims and refunding money when necessary. She anticipated an impact on county staff time.

“Thank you for your patience as we address areas of concern by implementing continuous improvement processes and preventative measures,” she said. “We are committed to learning from these issues and want to work with you to improve our processes.”

In other action, the board:

• Approved a grant contract amendment with the Department of Human Services effective for 2020 to encourage families on medical assistance to get their well-child checkups. The funding amount is about $113,600.

• Approved a grant contract with the Minnesota Department of Human Services for about $15,500 for 2020 that will be used to perform mental health screenings and to make referrals for assessment and treatment of mental health needs in children and youth.

• Approved a final payment of almost $8,000 to Freeborn County Co-op Oil of Albert Lea for furnishing and applying magnesium chloride to the county. The total project cost was about $158,000.

• Approved a contract with River Valley Forensic Services for medical examiner services for 2020 through 2022.

Jensen said the previous doctor, Michael McGee, is retiring and handing off the business to Dr. Kelly Mills.

• Accepted a $1,000 donation from the Moose Lake Restorative Justice Program to the Freeborn County Crime Victims Crisis Center to be used for the 2020 Paint the Town Purple campaign or sexual assault awareness events.

• Approved various repairs to the drainage system.

• Went into closed session to consider allegations or charges against an individual subject to its authority. No other details were provided.