Wadena County Board of Commissioners AGENDA Call To Order

Transcription

1.
9:00
A.M.
Wadena County Board of Commissioners
AGENDA
Call To Order/Pledge Of Allegiance
2. Amend/Approve Day's Agenda
3. Minutes July 14th
Documents:
7-14-15 BOARD MEETING.PDF
4. Board Warrants
Documents:
WARRANTREGISTER07_30_2015_15_16_32.PDF
5. US Bank
Documents:
US BANK.PDF
6.
9:15
A.M.
Rhonda Bot - Court Administration Staffing Announcements
7.
9:25
A.M.
Ryan Odden - Safe Room Request
Documents:
20150804 BAF SAFE ROOM.PDF
8. Ryan Odden - Transit Title VI Resolution
Documents:
20150804 BAF TRANSIT TITLE VI RESOULTION.PDF
9. Ryan Odden - Final Payment Traffic Marker
Documents:
INC..PDF
10.
9:45
A.M.
20150804 BAF FINAL PAYMENT TRAFFIC MARKING SERVICE,
Tanya Leskey - West Central Juvenile Center Contract
Documents:
WADENA- ANNUAL PURCHASE AGREEMENT - 16.PDF
11. Tanya Leskey - South Country Health Alliance Discussion/Motion
Documents: 256B.692.PDF, 256B..69V2.PDF, MOTION TO OBJECT TO MINNESOTA
DEPARTMENT OF HUMAN SERVICES.PDF, RFP MCO COUNTIES PROTECTED WEB
VERSION JUNE 1 2015_01262015.PDF, WADENA PROCUREMENT IMPACT.PDF,
KANABEC_SCHA RESOLUTION.PDF
12.
9:50
A.M.
Curt Kreklau - Sebeka TIF Annual Disclosure
Documents: LTR - DISCLOSURE TO COUNTY BOARD.PDF, ANNUAL
DISCLOSURE.PDF
13.
9:55
A.M.
Closed Meeting - Labor Negotiations
Documents:
14.
10:30
A.M.
CLOSED MEETING FOR LABOR NEGOTIATIONS STRATEGY.PDF
Deana Malone - Conditional Use Permit
Documents:
BOARD ACTION FORM - WIESELER CUP 8-4-15.PDF, MEETING
13.
9:55
A.M.
Closed Meeting - Labor Negotiations
Documents:
14.
10:30
A.M.
CLOSED MEETING FOR LABOR NEGOTIATIONS STRATEGY.PDF
Deana Malone - Conditional Use Permit
Documents: BOARD ACTION FORM - WIESELER CUP 8-4-15.PDF, MEETING
MINUTES JULY 16, 2015.PDF, CUP RESOLUTION.WIESELER.PDF
15.
10:40
A.M.
Closed Meeting - County Coordinator Evaluation
Documents:
CLOSED MEETING FOR EMPLOYEE PERFORMANCE REVIEWS.PDF
WADENA COUNTY BOARD OF COMMISSIONERS' MEETING
JULY 14, 2015
Wadena County Courthouse, Commissioners' Room
415 South Jefferson Street, Wadena, Minnesota
1
Call to Order and Pledge of Allegiance
Chairperson Bounds called the meeting to order at 9:00 a.m. and all present recited the Pledge of
Allegiance.
Present:
District 1
District 2
District 3
District 4
District 5
Sheldon Monson
Jim Hofer
Bill Stearns
Rodney Bounds
Dave Hillukka
Also present: County Coordinator Curt Kreklau, Jr., Wadena County Attorney Kyra Ladd, Wadena
County Auditor/Treasurer Judy Taves, Auditor's Office Tax Specialist Missy Lund, Wadena County
Assessor Lee Brekke, Wadena County Human Services Director Tanya Leskey, Transit Director Ryan
Damlo, Sue Siemers, Beverly Herfindahl, Highway Engineer Ryan Odden, Planning and Zoning
Director Deana Malone, County Recorder Soledad Henriksen, Emergency Management Services
(EMS) Director Luke Manderschied, Mike Willie and Sebeka Review Messenger/Verndale Sun
Reporter Matthew B. Johnson and Staples World Reporter Laurinda Porter.
2
Review and Approve 7-14-15 Regular County Board Meeting Agenda
Moved by Commissioner Monson seconded by Commissioner Stearns to approve the agenda of the
July 14, 2015 regular County Board Meeting as amended to include item #3 - approval of $5,000 in
postage, include item #13 – Disaster Declaration and delay item #11 - Data Breach Policy until July 21,
2015, motion carried unanimously.
3
$5,000 Postage
Moved by Commissioner Hillukka seconded by Commissioner Monson for approval to increase the
postage $5,000.00, motion carried unanimously.
4
Deana Malone – LISSTS Grant Request
Moved by Commissioner Stearns seconded by Commissioner Monson for approval to provide $3,718
in grant funding from Low Income SSTS Grant to install replacement septic system for property owner
in Section 26 of Red Eye Township, motion carried unanimously.
7/14/2015 – Page 1
5
Ryan Damlo – Transit Merger Update
Mr. Damlo gave an update on the Transit Merger and his activities over the past several months. He
presented a proposed Becker Wadena Transit Joint Powers Agreement for the Board to review and will
be submitting the Resolution for the Board's signature in August. Commissioners Bounds and Stearns
have been working with them throughout their merger committees.
Some of the activities he has been working on to attract new ridership include the Open House at the
Wadena County Fair, adding the Summer Rec program, getting a bike rack for one of the busses,
comment cards and weekly drawing contest, expanding hours and offering late rides one night a week,
and Commuter Challenge. Also, he talked to Rising Phoenix and they are stopping their local in-town
service and will suggest using Friendly Rider instead.
10
Judy Taves – Information Regarding PILT
Because of the tax forfeit sale last year, they started with 2,425 acres of PILT (Payments in Lieu of
Taxes) last year and now have 700 acres because the remaining 1,725 acres are back on the tax rolls.
Missy Lund gave a breakdown on why the 700 acres are left. 105.44 acres is conservation (completely
under water), 71.68 acres is still available left over from the last land sale, 474.94 is under timber
contract with the DNR, 2.91 acres is eligible for adjacent landowner sales, 5 acres will go on the next
tax forfeit sale, and 40 acres is being transferred to Anderson's Crossing
9
Judy Taves – Donated Leave Bank
Ms. Taves met with the County Coordinator and the County Attorney and are recommending making a
change to the vacation and compensatory time policy, which is Article 40 of the personnel policy.
Currently, you can name who you want to give the hours to, but the County Attorney felt that legally
they shouldn't be doing that and it should be changed to a donated time bank. The suggested annual
amount will be 80 hours and there will be a lifetime maximum suggested amount of 160 hours. The
Board was asked to consider this change.
Moved by Commissioner Monson seconded by Commissioner Hofer to (1) approve the amended
language, as presented, to the Wadena County Personnel Policy Article 40, Donation of
Vacation/Compensatory Time into Donated Time Bank, (2) to approve, as presented, Criteria
Regarding Eligibility to Receive Donation of Vacation/Compensatory Time from Donated Leave Bank,
and (3) to approve, as presented, the Accept/Deny/Notification form for use by the Auditor/Treasurer
with regard to Donated Time Bank, all effective July 14, 2015, motion carried unanimously.
6
Tanya Leskey – Child Protection Positions
Mike Willie gave an overview of the legislative action taken on child protection. Child population is
the biggest variable in county staffing/services allocation. The total allocation that was provided at the
end of the last legislation for Wadena County is $75,000. Wadena County comes in at 1.0 for estimated
FTE. It is based primarily on child population. The County staffing allocation is based on four figures:
50% is based on the child population in the county, 25% is based on the number of screened in child
protection investigations and assessments and 25% is based on the number of child protection case
management. The 2013 child welfare report indicates Wadena County has child population of 3,372
7/14/2015 – Page 2
(makes up 50% of the allocation). Mike reported that even though we have a small child population,
we have quite a bit of need in our county based on the number of unique children that were served.
With that allocation received from the Legislature, they are requesting to fill that one FTE person with
a Lead Social Worker Position which would be accounted for in that one FTE allotment. He noted that
the money the State has given us is only available if they hire a person and needs to be hired after July
1, 2015.
Ms. Leskey stated they had already been approved an additional FTE for a Child Protection Worker,
but it was anticipated they would be receiving two FTE's. They have an open Child Protection position
right now. She talked with the Personnel Committee and she would like to move that FTE from Child
Protection into Children's Mental Health because they are understaffed and use the allocated dollars
that have to be for a new position for Children and Family Services Team Lead position
Moved by Commissioner Stearns seconded by Commissioner Hillukka for approval to create a Lead
Social Worker Position, motion carried unanimously.
The Board recessed at 9:48 a.m. and reconvened at 9:56 a.m.
7
Stephen Halonen – Vercon Space Needs Analysis
A Wadena County Space Needs-Solutions Analysis that was prepared by Vercon was provided to
supply the County with the information necessary to choose a direction towards accommodating
current and future space needs. The first option is an addition to the existing courthouse building
which indicates an overall square footage cost of $232 to add and complete the interior shell and
interior build-out. The second option is to update and renovate the Wensman Building which includes
updating the exterior shell and complete the interior build-out for a cost of $163 per square foot. The
third option would be to look at other properties. The summary indicates that of these three options
compared in the cost/value analysis table, the Wensman Building option will provide the greatest
amount of additional finished square footage for a sample budget of $1,000,000.
Commissioner Stearns noted if they did the Wensman Building, there is considerable work that could
be done by Sentence to Serve crews. That is not taken into consideration in Vercon's analysis because
of the difficulty of knowing what their availability is going to be and what their skill of level will be,
but there definitely could be room for savings.
Justin stated that in order to get a dollar amount for Sentence to Serve labor, they will try to break out
what work Sentence to Serve could do, estimate the range of hours for each area before bid time, get
together with Ryan and see what is realistic on what can be expected from the Sentenced to Service
crew (STS.)
Vercon will refine their cost analysis to include more accurate figures using STS.
8
Stephen Halonen – Vercon Master CM Agreement
Mr. Kreklau presented the AIA (The American Institute of Architects) Document C132 – 2009 Standard
Form of Agreement between Owner and Construction Manager and stated it needed to be taken care of
as work is proceeding under that Agreement. The Space Needs-Solutions Analysis falls under this
Agreement, but no Agreement has been signed with them yet. The Board made a motion to go ahead
7/14/2015 – Page 3
with the analysis, but we don't have an actual contract yet with Vercon for this work. Right now,
Vercon is under contract with Solid Waste, but this will convert it to an overall umbrella CM services as
the Board directs. There was question about Article 11.1.1 (The Construction Manager will charge the
Owner a fee of 10%, calculated on Reimbursable expenses and Direct Personnel expenses) and 11.1.2
(The Construction Manager will charge the Owner a fee of 10%, calculated on Cost of the Work,
Reimbursable expenses and Direct Personnel expenses). Justin explained the 10% is their overhead
profit, it is fairly standard verbiage and it is willing to be negotiated. A larger project fee would be less
whereas a smaller project fee tends to be a little more. The unit rates per hour are negotiable, as well,
on a job by job basis. The fees would be agreed upon before they moved forward. Wadena County
Attorney Kyra Ladd asked if Reimbursable Expense, Direct Personnel Expense or Cost of Work is
defined anywhere. Justin stated there should be an addition and deletion supplement, but it was not
attached, however, that does define the terms. Reimbursable expenses were listed in the Agreement.
He will get definitions for Direct Personnel Expense and Cost of Work and bring back to the Board
next week.
12
Curt Kreklau – Courtroom Remodel Inspector
Moved by Commissioner Stearns seconded by Commissioner Hofer to allow Curt Kreklau and Ryan
Odden to engage Vercon when they feel necessary for consultation on the court remodeling project and
upon engaging them to notify the two commissioners on the Building Services Committee that they
have engaged them, motion carried unanimously.
13
Disaster Declaration
The State has come up with a Disaster Fund maintained by the State and, in order to get money from
that fund, a state of emergency needs to be declared. At this point, the county departments, as a whole,
have not met the threshold as required by the State, which is $24,000, but as of July 1st, the electrical
coops can be included and can get money from that fund. Right now, between Todd and Wadena
Counties, the estimate of Todd-Wadena Electric is $200,000 that they will have into the repair. At least
$100,000 of that is in Wadena County. Ryan Odden estimates his department at $3,000 and the
Sheriff's department is estimated at $3,000.
Moved by Commissioner Hofer seconded by Commissioner Hillukka to approve Resolution # _______
as presented Declaring Wadena County in a State of Emergency for conditions resulting from the
severe thunderstorm event of July 12, 2015, motion carried unanimously.
Moved by Commissioner Stearns seconded by Commissioner Monson to approve Resolution # ______
as presented requesting State public disaster assistance in accordance with Minnesota Statute 12B.30,
motion carried unanimously.
Motion by Hillukka second by Monson to adjourn the Board of Commissioner's Meeting at 10:53 a.m.
__________________________________
Curt Kreklau
Wadena County Coordinator
__________________________________
Rodney Bounds, Chairperson
7/14/2015 – Page 4
JSKTAX
07/30/2015
*** W A D E N A C O U N T Y ***
3:16PM
Warrant Form CHEK
Commissioner's Warrants
Vendor # Vendor Name
WARRANT REGISTER
Commissioner Warrants
Amount
Description
OBO#
Approved 08/04/2015
Pay Date 08/07/2015
Account Number
On-Behalf-of-Name
Invoice #
From Date
Page 1
PO # Tx
To Date
Mileage.Zoning
01-103-000-0000-6334
7162015
N
OIL RACK 072015
13-330-000-0000-6562
59541
N
Mat Rental
Mats
01-111-000-0000-6410
17-403-100-0000-6210
1601047229
1601058612
N
N
Total...
64.78
44.15
108.93
102617 ARVIG COMMUNICATION SYSTEMS*
102617
Warrant #
Total...
31741
155.00
155.00
310.00
Phone Line Repair-Shrf
Phone Line Repair-Shrf
01-201-000-0000-6401
01-201-000-0000-6401
234419
234653
N
N
100519 ATOM
Warrant #
475.00
475.00
Training-Shrf
01-201-000-0000-6241
83767256
N
Total...
100226 AUTO VALUE WADENA-FISKUMS*
100226
Warrant #
Total...
31743
16.08
64.36
80.44
Contract Cleaner
Hand Wipes-Jail
01-111-000-0000-6560
01-251-000-0000-6450
65119389
65117621
N
N
Gun Permit Fees-Shrf
Gun Permit Fees-Shrf
CDJN Connect Fees-E911
01-209-000-0000-6803
01-209-000-0000-6803
01-284-000-0000-6803
80000045
85000045
00000230332
N
N
N
Total...
175.00
115.00
270.00
560.00
100959 BOB BARKER COMPANY*
100959
Warrant #
31745
Jail Supplies-Shrf
Jail Supplies-Shrf
01-251-000-0000-6450
01-251-000-0000-6450
WEB000379507
WEB000379291
N
N
Total...
188.29
91.77
280.06
104614 BOUNDS/RODNEY
Warrant #
31746
19.55
19.55
Mileage.Zoning
01-103-000-0000-6334
7162015
N
Total...
101413 CANON FINANCIAL SERVICES, INC
101413
Warrant #
Total...
31747
48.32
96.64
144.96
CoprLease.Coordinator
CoprLease.Zoning
01-032-000-0000-6241
01-103-000-0000-6401
15087824
15087824
N
N
100987 CENTURYLINK
100987
Warrant #
261.00
4.54
265.54
Circuit Account-Shrf
Circuit Account-Tax-Shrf
01-062-000-0000-6202
01-062-000-0000-6202
218D310032
218D310032
N
N
731.40
YIELD AEROSOL 072015
13-330-000-0000-6569
1972518
N
100335 AAGARD/CHARLES
Warrant #
31738
Total...
3.60
3.60
102196 ALDRICH TRACTOR INC*
Warrant #
31739
Total...
71.50
71.50
101859 AMERI PRIDE*
101859
Warrant #
31740
31742
100576 BCA-CJIS SECTION
100576
100576
Warrant #
31744
101252 CHEMSEARCH*
31748
Total...
Copyright 2010 Integrated Financial Systems
JSKTAX
07/30/2015
*** W A D E N A C O U N T Y ***
3:16PM
Warrant Form CHEK
Warrant #
Amount
31749
Total...
102421 CHRISTIAN MISSIONARY ALLIANCE CHURCH
Warrant #
Total...
31750
101780 CITRIX SYSTEMS, INC
Warrant #
31751
101806 COBURN'S INC
101806
101806
101806
Warrant #
WARRANT REGISTER
65.00
480.78
102060 CONTACT RADIO COMMUNICATIONS
102060
102060
102060
102060
Warrant #
Total...
31753
38.00
14.00
38.00
42.50
115.50
Total...
3,718.00
101752 DACOTAH PAPER CO*
Warrant #
31755
Total...
422.38
3,718.00
422.38
100461 DEAN/BRYAN
Warrant #
183.33
118.23
09-481-000-0000-6340
August
N
Citrix Systems
01-061-000-0000-6409
20132474
N
Inmate
Inmate
Inmate
Inmate
01-251-000-0000-6430
01-251-000-0000-6430
01-251-000-0000-6430
01-251-000-0000-6430
05012015
05022015
06092015
06092015
N
N
N
N
Removal of Equipment-Shrf
Monitor Repair-Visitation-Shrf
Monitor Repair-Visitation-Shrf
Door Access Cards-Shrf
Headset Adapter-Dispatch-Shrf
01-201-000-0000-6301
01-251-000-0000-6310
01-251-000-0000-6312
01-281-000-0000-6399
01-284-000-0000-6803
3593
3585
3602
3569
3560
N
N
N
N
N
GrantRatcliff.Zoning
01-103-000-0000-6356
646
N
Paper
01-062-000-0000-6403
54497
N
Cartidges
postage supplies
01-062-000-0000-6803
09-481-000-0000-6401
44495
44655
N
N
Capet and Tile--TFF
17-403-100-0000-6957
6/19/15
N
Law Lib
01-020-000-0000-6260
July 2015
N
Meds-Jail
Meds-Jail
Meds-Jail
Meds-Jail
301.56
1,679.86
Total...
Clinic Rent
248.00
101791 CUSTOM SEPTIC INC
Warrant #
31754
100014 DAVE'S FLOOR COVERING
Warrant #
31757
PO # Tx
To Date
2,240.00
Total...
103139 DAKOTA MAILING AND SHIPPING EQUIP, INC*
103139
Warrant #
Total...
31756
Invoice #
From Date
65.00
72.92
13.81
37.26
356.79
31752
Account Number
On-Behalf-of-Name
Page 2
731.40
2,240.00
Total...
Description
OBO#
Approved 08/04/2015
Pay Date 08/07/2015
1,679.86
50.00
Total...
50.00
103562 DEPARTMENT OF HUMAN SERVICES
Warrant #
Total...
31759
63.42
63.42
Postage
01-064-000-0000-6401
14434100
N
101416 DITTBERNER/RHONDA
10.93
Mileage - Rhonda
01-061-000-0000-6334
20133580
N
31758
JSKTAX
07/30/2015
*** W A D E N A C O U N T Y ***
3:16PM
Warrant Form CHEK
WARRANT REGISTER
Amount
31760
Total...
10.93
101782 DOUG'S PLUMBING
Warrant #
31761
Total...
75.00
75.00
101943 ELECTION SYSTEMS & SOFTWARE,INC.*
Warrant #
Total...
31762
11,000.00
11,000.00
Warrant #
Description
OBO#
Approved 08/04/2015
Pay Date 08/07/2015
Account Number
On-Behalf-of-Name
Invoice #
From Date
Page 3
PO # Tx
To Date
Repair Men's Restroom sink
17-403-100-0000-6340
559665
N
Equipment
01-065-000-0000-6480
934399
N
103040 EMERGENCY AUTOMOTIVE TECHNOLOGY, INC
Warrant #
Total...
31763
771.55
771.55
Equipment for Squad-Shrf
01-201-000-0000-6660
AW0616158A
N
101510 ERICKSON ENGINEERING CO.
Warrant #
31764
765.00
765.00
ENGINEERING SERVICES-BR 070915
13-324-000-0000-6260
11330
N
Total...
101800 FIRE SAFETY USA
Warrant #
31765
2,605.00
2,605.00
LED Lights-Shrf
01-201-000-0000-6803
80426
N
Total...
100286 FIRST ENGLISH LUTHERN CHURCH
Warrant #
Total...
31766
65.00
65.00
Clinic Rent
09-481-000-0000-6340
August
N
101125 FUNK/CHARLES
Warrant #
34.50
34.50
Mileage.Zoning
01-103-000-0000-6334
7162015
N
Total...
McGvnCottnghm.Parks
WhiteDog.Parks
01-521-000-0000-6803
01-521-000-0000-6803
1388
1387
N
N
Total...
1,510.00
220.00
1,730.00
103183 GREATAMERICA FINANCIAL SVCS*
Warrant #
Total...
31769
390.00
390.00
FP Jetmail
01-062-000-0000-6340
17248728
N
Mileage from Staples--Safety T
17-403-100-0000-6330
7/7/15
N
31767
103484 GILSTER EXCAVATING
103484
Warrant #
31768
104078 GROTBERG/ROBIN
Warrant #
31770
Total...
10.35
10.35
102974 HEARTLAND TIRE SERVICE*
Warrant #
31771
120.73
120.73
New Tire for Squad-Shrf
01-201-000-0000-6560
0000031427
N
Total...
Training-Shrf
Training-Shrf
01-201-000-0000-6241
01-201-000-0000-6241
09172015
09182015
N
N
Total...
300.00
300.00
600.00
598.77
598.77
Jail Supplies-Shrf
01-251-000-0000-6450
601684477
N
101331 Hennepin County
101331
Warrant #
31772
102092 HILLYARD FLOOR CARE SUPPLY-HUTCHINSON*
Warrant #
Total...
31773
JSKTAX
07/30/2015
*** W A D E N A C O U N T Y ***
3:16PM
Warrant Form CHEK
Amount
100068 HOCKERT'S CLEANERS*
Warrant #
31774
100259 HOFER/JIM
100259
100259
100259
100259
100259
100259
Warrant #
WARRANT REGISTER
30.60
Total...
Total...
144.90
100632 HYTEC CONSTRUCTION OF BRAINERD
Warrant #
Total...
31776
9,500.00
101313 INDEPENDENT EMERGENCY SERVICES
Warrant #
Total...
31777
100.00
102536 JOHN'S CAR CARE CENTER*
102536
102536
102536
102536
Warrant #
31778
9,500.00
100.00
110.65
75.00
609.38
52.07
15.75
Total...
Invoice #
From Date
PO # Tx
To Date
N
Mat Rental-Dispatch
01-251-000-0000-6312
06302015
Mileage-brd mtg
Mileage-ACA
Mileage-Fairboard
Mileage-Brd mtg
Mileage-Hist Soc
Mileage-Transit
Mileage-Brd mtg
01-002-000-0000-6334
01-002-000-0000-6334
01-002-000-0000-6334
01-002-000-0000-6334
01-002-000-0000-6334
01-002-000-0000-6334
01-002-000-0000-6334
7/7/2015
7/9/2015
7/9/2015
7/14/2015
7/14/2015
7/15/2015
7/21/2015
N
N
N
N
N
N
N
Grandstand Roof
01-801-000-0000-6179
7864
N
Monthly Service-E911
01-284-000-0000-6803
2000280
N
Gas for Vets Van
Tow-Shrf
Rear wheel brake job
Oil change and lift inspection
Tire repair
01-121-000-0000-6566
01-201-000-0000-6803
17-403-100-0000-6310
17-403-100-0000-6310
17-403-100-0000-6310
june 2015
1510190
99434
99370
99336
N
N
N
N
N
Rotors-Squad-Shrf
Tow-Forfeiture-Shrf
Tow-Forfeiture-Shrf
01-201-000-0000-6560
01-210-000-0000-6803
01-210-000-0000-6803
06302015
20158189
20159107
N
N
N
Mileage.Zoning
01-103-000-0000-6334
7162015
N
Uniform
Uniform
Uniform
Uniform
Uniform
Uniform
01-201-000-0000-6182
01-201-000-0000-6182
01-201-000-0000-6182
01-201-000-0000-6182
01-201-000-0000-6182
01-201-000-0000-6182
279746
279872
279337
279867
27879701
280137
N
N
N
N
N
N
862.85
102975 K&K TRUCK & AUTO REPAIR
102975
102975
Warrant #
31779
Total...
747.88
100336 KANGAS/JONATHAN
Warrant #
31780
Total...
28.29
Total...
91.97
249.12
101.98
37.99
237.59
166.54
885.19
101955 KEEPRS,INC/CY'S UNIFORMS
101955
101955
101955
101955
101955
Warrant #
31781
Account Number
On-Behalf-of-Name
Page 4
30.60
20.70
20.70
20.70
20.70
20.70
20.70
20.70
31775
Description
OBO#
Approved 08/04/2015
Pay Date 08/07/2015
472.88
125.00
150.00
28.29
Allowance-Shrf
Allowance-Shrf
Allowance-Shrf
Allowance-Shrf
Allowance-Shrf
Allowance-Shrf
JSKTAX
07/30/2015
*** W A D E N A C O U N T Y ***
3:16PM
Warrant Form CHEK
WARRANT REGISTER
Amount
101789 KERN/FRED
Warrant #
31782
Total...
100.00
101807 KREMEER/ALAN
Warrant #
31783
Total...
350.00
101213 LADD/KYRA
Warrant #
31784
Total...
600.00
100303 LAMBERTY, MD/LEONARD
Warrant #
31785
Total...
150.00
100136 LEAF RIVER AG SERVICE*-WADENA
100136
100136
100136
100136
100136
100136
100136
100136
Warrant #
Total...
31786
396.79
1,251.26
1,023.93
1,260.06
647.97
431.75
1,244.64
446.72
409.24
100.00
350.00
600.00
150.00
Total...
112.50
101989 LORENTZ/STEPHEN
Warrant #
31788
Total...
217.32
112.50
217.32
1,738.00
777.40
772.10
480.00
Total...
3,767.50
101445 MARCO, INC. (SUPPLIES & SALES)
101445
Warrant #
Total...
31790
3,769.88
18,513.97
22,283.85
102505 MCIT
Warrant #
31791
Total...
Account Number
On-Behalf-of-Name
Invoice #
From Date
Page 5
PO # Tx
To Date
N
DRIVEWAY PERMIT REFUND 071415
13-310-000-0000-6501
Transport-Coroner
01-204-000-0000-6260
3 Desk/2Chair
01-091-000-0000-6660
Consultating Services
09-481-000-0000-6260
August
N
DIESEL
DIESEL
DIESEL
DIESEL
DIESEL
DIESEL
DIESEL
DIESEL
DIESEL
13-314-000-0000-6564
13-314-000-0000-6564
13-314-000-0000-6564
13-314-000-0000-6564
13-314-000-0000-6564
13-314-000-0000-6564
13-314-000-0000-6564
13-314-000-0000-6564
13-314-000-0000-6564
128520
128521
128522
128544
128552
128572
128600
128604
128616
N
N
N
N
N
N
N
N
N
Transcription-Shrf
01-201-000-0000-6401
201503
N
Tire and oil change
01-102-000-0000-6560
POSTS 070815
911 HOUSE BLANKS 070815
911 HOUSE BLANKS 070815
BARRICADES 070815
13-314-000-0000-6511
13-314-000-0000-6512
13-314-000-0000-6512
13-330-000-0000-6569
186849
186738
186739
186850
N
N
N
N
Marco, INC - VMWARE Vshere
Marco, INC - EMC SAN
01-061-000-0000-6409
01-061-000-0000-6661
3266910379
3266397840
N
N
Training.Zoning
01-103-000-0000-6241
7212015
N
072215
072215
072215
072215
072215
072215
072215
072215
072215
06192015
N
N
7,112.36
101110 LOCKHART/CARMEN
Warrant #
31787
100246 M-R SIGN COMPANY, INC.
100246
100246
100246
Warrant #
31789
Description
OBO#
Approved 08/04/2015
Pay Date 08/07/2015
60.00
60.00
N
JSKTAX
07/30/2015
*** W A D E N A C O U N T Y ***
3:16PM
Warrant Form CHEK
101314 MILLER/TOM
Warrant #
WARRANT REGISTER
Amount
18.10
31792
Total...
Account Number
On-Behalf-of-Name
15.00
101106 MINNESOTA ASSOCIATION OF ASSESS MEMBERSH
Warrant #
Total...
31794
190.00
102788 MINNESOTA SHERIFFS ASSOCIATION
Warrant #
Total...
31795
165.00
15.00
190.00
165.00
101762 MONIQUE SOBANIA-COURT
Warrant #
31796
Total...
24.50
100346 MORRIS ELECTRONICS*
Warrant #
31797
Total...
34.98
101766 MUNICIPAL EMERGENCY SERVICES
Warrant #
Total...
31798
16.00
103998 NORTH CENTRAL TRUCK EQUIPMENT
Warrant #
Total...
31799
1,810.80
7162015
PO # Tx
To Date
N
Mileage.Zoning
01-103-000-0000-6334
MEMBERSHIP DUES-JEFF AD 071615
13-324-000-0000-6241
N
MAAP Workshop
01-102-000-0000-6241
N
Conference-Jail Admin-Shrf
01-251-000-0000-6241
24.50
Transcript Dunbar
01-091-000-0000-6285
34.98
MEI - Board RM Cables
01-061-000-0000-6369
3267696542
N
16.00
Uniform Allowance-Shrf
01-201-000-0000-6182
00646939SNV
N
1,810.80
Bike rack and mounting bracket
17-403-100-0000-6310
11.92
88.28
160.47
31.48
14.78
Copies-Treas
Office Supplies-Shrf
Office Supplies-Gun Permit-Shr
Office Supplies-Jail
Office Supplies-EMS
01-041-000-0000-6340
01-201-000-0000-6401
01-209-000-0000-6803
01-251-000-0000-6450
01-281-000-0000-6401
cnin135119
ARIN258269
ARIN258269
ARIN258269
ARIN258269
N
N
N
N
N
Index Tabs-aud
01-041-000-0000-6401
8579030
N
Oil Change-Shrf
01-201-000-0000-6560
192444
N
908969
N
0088960
N
N
N
306.93
103397 NORTHERN BUSINESS PRODUCTS,INC*
Warrant #
Total...
31801
18.61
104700 NYHUS CHEVROLET BUICK
Warrant #
31802
Total...
44.09
100015 ROBINSON/CHRIS
Warrant #
31803
700.00
700.00
Carpet Install--TFF
17-403-100-0000-6957
Total...
98.00
Transcript-Dunbar
01-091-000-0000-6285
101601 ROCHEFORD/MARTHA
Invoice #
From Date
Page 6
18.10
101073 MINN ASSC OF ASPHALT PAVING TECHNOLOGIES
Warrant #
Total...
31793
100135 NORTH COUNTRY BUSINESS PRODUCTS*
100135
100135
100135
100135
Warrant #
Total...
31800
Description
OBO#
Approved 08/04/2015
Pay Date 08/07/2015
18.61
44.09
N
JSKTAX
07/30/2015
*** W A D E N A C O U N T Y ***
3:16PM
Warrant Form CHEK
WARRANT REGISTER
Amount
31804
Total...
98.00
31805
Total...
457.97
457.97
101812 SEIP DRUG LLC WADENA
Warrant #
31806
Total...
70.69
70.69
Warrant #
103321 ROYAL TIRE INC
Warrant #
101942 STAPLES ADVANTAGE*
101942
101942
Warrant #
31807
102864 STAR SQUADS LLC
102864
102864
102864
102864
Warrant #
31808
102353 STEIN'S, INC*
102353
102353
102353
Warrant #
31809
100798 STELLHER HUMAN SERVICES
Warrant #
31810
101986 STEVE'S ALIGNMENT & REPAIR
101986
101986
101986
101986
Warrant #
31811
100753 THOMSON WEST*
Warrant #
31812
102465 THRIFTY WHITE PHARMACY
Warrant #
31813
Description
OBO#
Approved 08/04/2015
Pay Date 08/07/2015
Account Number
On-Behalf-of-Name
Invoice #
From Date
Page 7
PO # Tx
To Date
Set of 4 Tires-Shrf
01-201-000-0000-6560
31718771
N
Prescription-Inmate-Jail
01-251-000-0000-6430
411962
N
Staples Advantage
Staples Advantage - Hardware (
HP Laserjet
01-061-000-0000-6402
01-061-000-0000-6661
01-061-000-0000-6661
3266910378
3266397836
3269532065
N
N
N
Total...
576.05
7,436.97
1,199.96
9,212.98
Installation of Siren/Controll
Removal of Equipment-Shrf
Install New Squad Equipment-Sh
Install New Squad Equipment-Sh
Install Equipment-Shrf
01-201-000-0000-6560
01-201-000-0000-6560
01-201-000-0000-6560
01-201-000-0000-6560
01-201-000-0000-6560
734
735
736
740
741
N
N
N
N
N
Total...
290.00
230.00
1,598.00
350.00
1,138.00
3,606.00
Janitorial Supplies
Janitorial Supplies
Jail Supplies-Shrf
Jail Supplies-Shrf
01-111-000-0000-6410
01-111-000-0000-6410
01-251-000-0000-6450
01-251-000-0000-6450
731941
731527
729816
729654
N
N
N
N
Total...
182.69
314.73
153.47
130.69
781.58
272.00
272.00
Consultating Services
09-481-000-0000-6260
7891
N
Total...
Oil Change, Tire Rotate-Shrf
Oil Change, Repair Seal-Shrf
Oil Change, Tire Rotate-Shrf
Seal Repair-Shrf
Repair Tire & Sensor-Shrf
01-201-000-0000-6560
01-201-000-0000-6560
01-201-000-0000-6560
01-201-000-0000-6560
01-201-000-0000-6560
22845
22871
22946
22959
22998
N
N
N
N
N
Total...
81.30
64.93
45.15
138.84
64.25
394.47
Information charges
01-091-000-0000-6260
832101053
N
Total...
261.63
261.63
Medical Supplies-Jail
01-251-000-0000-6430
786203
N
Total...
17.41
17.41
JSKTAX
07/30/2015
*** W A D E N A C O U N T Y ***
3:16PM
Warrant Form CHEK
WARRANT REGISTER
Amount
102258 TODD COUNTY AUDITORS OFFICE
Warrant #
Total...
31814
3,360.00
100362 TREASURER CITY OF MENAHGA
Warrant #
Total...
31815
747.96
100365 TREASURER CITY OF STAPLES
100365
Warrant #
31816
3,360.00
747.96
1,003.76
441.76
Total...
1,445.52
100342 TREASURER INDEPENDENT 818
Warrant #
Total...
31817
50.00
50.00
101813 U.S. BANK
Warrant #
31818
Total...
800.00
101808 UPS
Warrant #
31819
Total...
37.70
101588 WADENA COUNTY GIS DEPARTMENT
Warrant #
Total...
31820
153.06
800.00
37.70
102146 WADENA COUNTY HEALTH DEPT
102146
Warrant #
Total...
31821
102795 WADENA COUNTY HISTORICAL SOCIETY
Warrant #
Total...
31822
101735 WADENA COUNTY HUMANE SOCIETY
Warrant #
Total...
31823
153.06
36.38
1,935.45
Account Number
On-Behalf-of-Name
Invoice #
From Date
Page 8
PO # Tx
To Date
N
Out of County Boarding-Jail
01-251-000-0000-6288
06302015
TZD Grant-Shrf
01-212-000-0000-6455
52428
N
TZD Grant-Shrf
TZD Grant-Shrf
01-212-000-0000-6455
01-212-000-0000-6455
6115
6121
N
N
School Reimbursement
09-481-000-0000-6369
Acceptance/Agent Fee
37-391-000-0000-6715
4032973
N
Postage-Shrf
01-281-000-0000-6204
07182015
N
New Address-E911
01-284-000-0000-6803
07132015
N
Postage
Correctional Health-Jail
01-062-000-0000-6204
01-251-000-0000-6430
7/24/2015
271
N
N
2015 1st Half
01-801-000-0000-6921
N
2015 2nd Qtr Appropriation
01-801-000-0000-6918
N
CUP-Minnerath.Zoning
VAREtzler.Zoning
01-103-000-0000-6264
01-103-000-0000-6264
201500000055
201500000056
N
N
Dental-Jail
01-251-000-0000-6430
10405
N
Screws-cust
Paint-cust
Screws-cust
01-111-000-0000-6302
01-111-000-0000-6302
01-111-000-0000-6302
307812
307762
307789
N
N
N
N
1,971.83
3,000.00
3,000.00
1,125.00
1,125.00
101659 WADENA COUNTY RECORDER
101659
Warrant #
31824
Total...
92.00
101192 WADENA FAMILY DENTAL
Warrant #
31825
Total...
422.00
422.00
46.00
46.00
100201 WADENA HARDWARE CO - WEBERS*
100201
100201
Description
OBO#
Approved 08/04/2015
Pay Date 08/07/2015
7.17
12.86
9.98
JSKTAX
07/30/2015
*** W A D E N A C O U N T Y ***
3:16PM
Warrant Form CHEK
Amount
100201 WADENA HARDWARE CO - WEBERS*
100201
100201
100201
100201
100201
Warrant #
Total...
31826
100890 WADENA MOTOR VEHICLES*
Warrant #
31827
WARRANT REGISTER
4.49
3.21
25.76
1.92
2.98
5.97
74.34
Description
OBO#
Approved 08/04/2015
Pay Date 08/07/2015
Account Number
On-Behalf-of-Name
Thermometer-cust
Seals-cust
Drop Cloth-cust
Insulation-cust
Sponges-cust
Keys-Shrf
01-111-000-0000-6302
01-111-000-0000-6302
01-111-000-0000-6302
01-111-000-0000-6302
01-111-000-0000-6302
01-201-000-0000-6401
Invoice #
From Date
307964
307982
310613
310650
310795
309177
Page 9
PO # Tx
To Date
N
N
N
N
N
N
N
174.00
174.00
License Tabs
01-102-000-0000-6560
Total...
Subscription.Zoning
Subscription
01-103-000-0000-6240
09-481-000-0000-6240
177997751
July
N
N
Total...
47.00
74.00
121.00
101936 WADENA STATE BANK-GREIMAN
Warrant #
Total...
31829
5.48
5.48
Office Supplies-EM
01-281-000-0000-6401
130027
N
Postage-Shrf
01-201-000-0000-6401
MA79SGER6T0YE
N
Office Supplies-Shrf
Dog Food-K9
Headlight-Shrf
Jail Supplies-Shrf
Finance Charge-Jail
Fan/Cord-EOC-Shrf
01-201-000-0000-6401
01-201-000-0000-6454
01-201-000-0000-6560
01-251-000-0000-6430
01-251-000-0000-6450
01-251-000-0000-6450
01-251-000-0000-6450
01-281-000-0000-6401
010051
003851
020990
015703
016443
007836
07162015
025438
N
N
N
N
N
N
N
N
Service Call for photo eyes
17-403-100-0000-6310
100203 WADENA PIONEER JOURNAL*
100203
Warrant #
31828
100450 WADENA STATE BANK-SHERIFF PETTY CASH
Warrant #
Total...
31830
101201 WALMART COMMUNITY - GECRB
101201
101201
101201
101201
101201
101201
101201
Warrant #
Total...
31831
102067 WARNER GARAGE DOOR*
Warrant #
31832
17.17
17.17
5.34
31.10
9.63
81.93
19.26
33.82
0.70
26.04
207.82
N
Total...
62.00
62.00
100266 WEST CENTRAL TELEPHONE INC*
100266
Warrant #
Total...
31833
75.00
153.06
228.06
WCTA
Courtroom-Camera's
01-062-000-0000-6306
01-115-000-0000-6260
3267696541
1360100
N
N
100209 WEST PAYMENT CENTER
Warrant #
31834
788.61
788.61
Monthly Charge
01-020-000-0000-6452
832081193
N
Total...
JSKTAX
07/30/2015
*** W A D E N A C O U N T Y ***
3:16PM
Warrant Form CHEK
101518 WHITE/STACIE
101518
Warrant #
WARRANT REGISTER
Amount
Description
OBO#
Approved 08/04/2015
Pay Date 08/07/2015
Account Number
On-Behalf-of-Name
Invoice #
From Date
Page 10
PO # Tx
To Date
N
N
Room/Meals - Stacie
mileage - Stacie
01-061-000-0000-6330
01-061-000-0000-6334
20133393
20133526
Total...
238.44
288.26
526.70
500.00
500.00
Custody
01-092-000-0000-6275
81
N
Total...
102128 WIDSETH SMITH NOLTING & ASSOC*
102128
Warrant #
Total...
31837
4,906.00
5,104.28
10,010.28
ENGINEERING SERVICES-CS 061915
ENGINEERING SERVICES-CS 061915
13-324-000-0000-6260
13-324-000-0000-6604
104303
101413
N
N
Chips
01-092-000-0000-6275
80jv15370
N
31835
100378 WHYNOTT LAW OFFICE, PLLC
Warrant #
31836
100872 ZIEMKE LAW OFFICE
Warrant #
31838
Warrant Form
CHEK
Total...
500.00
500.00
Total...
123,087.32
187 Transactions
JSKTAX
07/30/2015
*** W A D E N A C O U N T Y ***
3:16PM
Warrant Form CHEK-ACH
WARRANT REGISTER
Amount
Description
OBO#
Approved 08/04/2015
Pay Date 08/07/2015
Account Number
On-Behalf-of-Name
Invoice #
From Date
Page 11
PO # Tx
To Date
Breakfast Bus Roadeo
Mileage to St. Cloud--Bus Road
17-403-100-0000-6330
17-403-100-0000-6330
7/18/15
N
N
Total...
8.00
103.50
111.50
01-201-000-0000-6182
4533
N
Total...
189.99
189.99
5061
103466 BREKKE/LEE
Warrant #
01-102-000-0000-6334
Total...
447.35
447.35
Mileage
5062
101450 LAUGHLIN/LAURE
Warrant #
09-481-000-0000-6330
July
N
Total...
379.33
379.33
Conference
5063
102081 ODDEN/RYAN
Warrant #
13-310-000-0000-6401
WALMART
N
Total...
14.14
14.14
PLEDGE/KLEENEX 063015
5064
BINDING MACHINE 072215
PLOTTER PRINTER INK 072215
13-310-000-0000-6401
13-324-000-0000-6509
AMAZON
AMAZON
N
N
01-201-000-0000-6182
AGH1516000709
N
104813 BEHL/GEORGE
104813
Warrant #
5060
101564 BERGQUIST/AMIE
Warrant #
100980 OLSON/HEATHER
100980
Warrant #
5065
Total...
286.41
435.73
722.14
101793 PEARSON/JAMIE
Warrant #
5066
Total...
52.21
52.21
Total...
1,916.66
9 Transactions
Final Total...
125,003.98
196 Transactions
Warrant Form
CHEK-ACH
N
*** W A D E N A C O U N T Y ***
JSKTAX
07/30/2015
3:16PM
WARRANT RUN
INFORMATION
101
7
WARRANT
FORM
123,087.32
1,916.66
125,003.98
CHEK
CHEK-ACH
WARRANT REGISTER
STARTING
WARRANT NO.
ENDING
WARRANT NO.
Approved 08/04/2015
Pay Date 08/07/2015
DATE OF
PAYMENT
DATE OF
APPROVAL
31738
31838
08/07/2015
08/04/2015
5060
5066
08/07/2015
08/04/2015
TOTAL
Page 12
PPD
CTX
COUNT
AMOUNT
COUNT
AMOUNT
6
1,726.67
1
189.99
JSKTAX
07/30/2015
RECAP BY FUND
*** W A D E N A C O U N T Y ***
3:16PM
FUND
AMOUNT
1
94,550.24
9
1,173.56
13
23,309.32
17
5,170.86
37
800.00
125,003.98
WARRANT REGISTER
NAME
General Revenue Fund
Public Health Fund
Road And Bridge Fund
Friendly Rider's Transit
Capital Projects Fund
TOTAL
Approved 08/04/2015
Pay Date 08/07/2015
Page 13
Wadena County
Report Date; OAlO3l2O'15
Full Transaction and Order Detail - Summary
Matching Transaction Posting
Data
Date
Status
Merchant
Transactlon Sales
Nam6
Amount
Tax
Trans
Transaction
Status
Oisputed Oetail
Status lnd
Allocation
Dotall
lndicator
Name: AMIE GENDRON
Account Number; "61'10
Unmatched OGl25l2O15 0O126120'15 WM SUPERCENTER #4246
Reference Number: 24445005177400090497075 Authorization Numb€r:
Name: Al\,1|E GENDRON
Account Number: '*6110
t.,nmalched O7lO1l2O15 0710212015 WAL-MART #4246
Reference Numbert 24226385182360577382451 Authorization
10.71 0.00 Not Reviewed
No
Number:030421
Nam6: AMIE GENDRON
Account Number: *.6110
Unmalched 0710712015 0710812015 WAL-|\IART #4246
Reference Number:24226385188360646379730
Number:042020
Nam6: MISSY PETERSON
Account Number: *'6243
lJnmalched 0711012015 0711312015 AMMON MKTPLACE PMTS
R€ference Numbar: 24692165191000725594777 Authorization t'lumber:
Name: MISSY PETERSON
Account Number: 't6243
Unmatched 0711012015 07l'1312015 AMMON MKTPLACE PN,ITS
Reference Number: 24692165191000731109248 Authorization Number:
Name: MISSY PETERSON
llnmatched 07l2Ol2O'15 0712212015 EMERGENCY MEDICAL
Reference Number: 24081625202700080474973 Authorization Number:
$
33.07 $ 2.21
49.18 0.00
639.89
Nam6: RYAN PDAMLO
Unmatched 0711912015 0712012015 BEST WESTERN HOTELS
-
Name: RYAN PDAMLO
Unmatched 0711912015 0712012015 BEST WESTERN HOTELS
-
Not
O.OO Not
71.97 0.00
PRODUC
Not
486.25 33.40
Not
Not
Reviewed
Reviewed
Reviewed
Reviewed
Reviewed
No
Authorization
No
No
No
No
Reference Number: 247554252o11220109348a8 Authorization
ST.
ST.
200.02 0.00
Not
Reviewed
No
N
N
N
y
y
y
N
Not
Reviewed
No
N
Name: DEBBIE BELCH
Account Number: '*0652
Unmatched 0710812015 0710912015 WAL-I\,IART #4246
Reference Number: 24226385'18936065873'1330 Authorization Number:
Name: LEE BREKKE
Unmatched 06/30/2015 O7lO1l2O15 AMMON.COM
Reference Number: 24692165'181000051898588 Authorization Number:
Full Transaction and Order Detail - Summary I jane|liiem I 0810312015 12:40.41
297.69 0.00
21.61 1.48
Not
Not
Reviewed
Reviewed
No
No
N
y
purchase lD:
Derait
purchase lD: s773,l24s
Detait
purchase lD;64637973
Detait
063619
purchase lD: 102-111OO78-liO42
Derait
042509
purchase lD: 1064292944-36450
Derait
OO395O
purchase lD: 1732g6
Detait
Number:053457
Referenco Numbert 24755425201122010934904 Authorization Number:
200.02 0.00
01560.l
purchase lD:527791A
Detaii
og5og5
purchase lD:5277894
Detait
033't04
purchase tD: 65873i33
Detait
042600
purchase lD: 129
Detait
Page
'l
Wadena County
Reporl Date: 08/03/20'15
Matching Transaction Posting
Date
Status
Date
Transactlon Sales
Merchant
Amount
Name
Tax
Trans
Transaction
Status
Disputed Dotail
Status lnd
Reference Number 24226385205360845653504 Authorization Number:
178.97 $ 0.00 Not Reviewed
$
No
N
Name: MICHAEL D CARR
Account Number: **3059
unmatched 0710612015 07108t20't5 vALVoLtNE |NSTANT
44.31 1.33
OtL CHA
Name; KYRA L LADD
unmarched 0710612015 071o8t2015 suPREt\,4E cT LAWYER
Not Reviewed
No
Detall
lndicator
Name: LEE BREKKE
unmatched 0712412015 0712712015 WAL-MART#4246
Authorization
Allocation
063605
Detail
Number:027689
N
076222
Name: KYRA L LADD
Account Number: "0862
Unmatched 0712412015 0712712015 TARGEI 00006593
27.90 .1.92 Not Reviewed
y
No
08547s
Name: CYNTHIA M PEDERSON Account Number:'*0182
Ljnmatched o7lo2l2o'15 o7lool2o15 UPS (800) 811-1648
Reference Number 2469216518400039190108'1 Authorization Number:
O1S85S
Name: CYNTHIA l\,1 PEDERSON Account Number: "0182
Unmatched 07114120'15 0711512015 WAL-I\,IART #4246
Reference Numbet: 24226385196400002528023 Authorization
168.00 O.OO Not Reviewed
No
Name: CAROL TABERY
Unmatched 0612512015 0612612015 E.REPUBLIC, lNC.
Name: SEAN USELMAN
Accouni Number:'*9568
Unmatched 0710112015 o7lo2l2o15 wM SUPERCENTER #4246
Referonce Number: 24445005183400093633553 Authorization Number:
Name: SEAN USELI\.4AN
Account Number; "9568
0712212015
0712312015
PAYPAL -DIGITALDESI
Unmatched
Reference Number: 24492'155203894237288699 Authorization Numb€r:
Name: LINDAYOUNGBAUER Account Number: -'9'138
Unmatched 07logl2o'15 O7l'lOl2O15 USI ED GOV
rull Transaction and Order Detail - Summary lianelkem I 0810312015 12:40:41
53..15
8.97
0.00
25.00 0.00
24.20 1.66
61.00 3.92
50.80
Not
Not
Not
Not
O.0O Not
Reviewed
Reviewed
Reviewed
Reviewed
Reviewed
No
No
No
No
Authorization
No
N
N
N
N
purchase lD: 46201o7o2341o12
purchaso tD:
000OOOOOOOOOOOOOO
Detait
purchase lD;015g55
Detait
purchase tD: 0714154246
Detait
0g5965
purchase tD: 72gS2,lS27O
Derait
047548
purchase tD:
Delait
095649
purchase lD; A32HWSHD53GSL
Detait
Number:086432
N
P48OO42O6
Detait
Number:071439
N
purchase lD;
Detail
Reference Numbe,:. 2471705518815'1888434076 Authorization Numbe.:
0.00 Not Reviewed
No
N
REGTSTR
purchase lD: 84565350
purchase lD: WO102697000.l
Detait
Page
2
Wadena County
Report Oate: 08/03/201 s
Matchlng Trans.ctlon
Status
Dat3
Postlng
Morchant
Drt
Namo
Name: LINDA YOUNGBAUER
Account Number: "9138
Unmatched O7l15l2O'15 07l'1612015 GREIMAN SILK SCREEN AND S
Transactlon Salss
Amount
Tar
Tran3acdon
Sletus
Reieronce Number: 24632695'l 96300380648197
$
13.9S $ O.OO
Not Reviewed
Name: LINDA YOUNGBAUER
AccountNumber:'*9138 RoferoncoNumber:24639235204900012500126
unmatched 0712212015 0712412015 NORTHERN BUSINESS PRoDUcr
i6.99 o.oo Nor Reviewed
fotal Number ol
Records:
Tlans
Dbpded D.tall
Stat s
lnd
Allocaflon
Dotall
lndlcaior
AuthorlzstionNumbor:003252 purchaselD:
No
N
Detail
Authorlzaiion umb€r:065702 puichaselD:856987
No
N
Dotail
22
fotal:
2,683.68
End of Report
Full Transac{on and Order Oetrall - Summary
/ianetkem / 08/03/20'15 12:40:41
51o-.14
Page
3
Wadena County, MN Board Action Form
Action Requested
Action/Motion
Discussion
Information Item
Report
Resolution
Other
Board Action Tracking Number (Admin use):
Title: Event Center / Safe Room at Fairgrounds
Date of Meeting: August 4, 2015
Total time requested:15 Minutes
Department Requesting Action: Highway Department
Presenting Board Action/Discussion at Meeting: Ryan Odden, County Engineer and Kyle Davis
Background
Supporting Documentation enclosed
Options
Supporting Documentation enclosed
Recommendation
The Wadena County Board of Commissioners approves the following by Motion:
County Engineer is requested by the County Board to write a letter of interest to the Office of Homeland
Security and Emergency Management. To determine if there is a funding available for a safe room/event
center
Financial Implications: $
Comments:
Funding Source:
Budgeted:
Action
Motion:
Second:
Passed
Failed
Tabled
Signatures
Yes
No
Voting in Favor
Hillukka
Stearns
Bounds
Monson
Hofer
Voting Against
Hillukka
Stearns
Bounds
Monson
Hofer
STATE OF MINNESOTA}
COUNTY OF Wadena}
I, Curtis Kreklau, Jr., County Coordinator, Wadena County, Minnesota hereby certify that I have compared the foregoing copy of the proceedings of the County Board
of said County with the original record thereof on file in the Administration Office of Wadena County in Wadena, Minnesota as stated in the minutes of the
proceedings of said board and that the same is a true and correct copy of said original record and of the whole thereof, and that said motion was duly passed by said
board at said meeting. Witness my hand and seal:
Seal
ANNUAL PURCHASE AGREEMENT
The undersigned County, being a Member County in the West Central Regional Juvenile
Center Cooperative Agreement, hereby elects the following billing structure for the calendar
year 2016 for use of the juvenile detention facility at the West Central Regional Juvenile Center.
A. _____ We elect to purchase annually by the bed. The number of beds that will
meet our needs for the year 2016 are___.75___ beds. This number is reasonably
related to our prior four years usage. The flat fee amount per bed for the year 2016
is $_79,500.00____ multiplied by the number of beds purchased herein is
$__59,625.00_____ per year, payable 1/12 per month. We understand we will pay
$__4,968.75 ____ per month and we are committing to pay that amount for the
entire year, regardless of our usage. Further we understand we may utilize the
center as needed without an additional charge, even if that use exceeds the total
beds purchased herein, if room is available. The guidelines for determining who has
priority for use of limited space will be developed by the Facility Administrator and
approved by the Advisory Board. We understand that any annual purchase by the
bed must be approved by the facility administrator and if there is a disagreement
between our County and the facility administrator, the number of beds we would
need to purchase would be resolved by the Advisory Board. We also understand we
need to elect our billing structure for the year 2016 on or before August 1, 2015.
Dated:
____WADENA_______ COUNTY
By ________________________________________
(print name)________________
, Chairperson
ATTESTED BY:
Sign___________________________________________
(print) Name:
Title:________________
Approved by Facility Administrator:
Dated:______________
________________________________________________
1
MINNESOTA STATUTES 2014
256B.692
256B.692 COUNTY-BASED PURCHASING.
Subdivision 1. In general. County boards or groups of county boards may elect to purchase or provide
health care services on behalf of persons eligible for medical assistance who would otherwise be required to
or may elect to participate in the prepaid medical assistance program according to section 256B.69. Counties
that elect to purchase or provide health care under this section must provide all services included in prepaid
managed care programs according to section 256B.69, subdivisions 1 to 22. County-based purchasing under
this section is governed by section 256B.69, unless otherwise provided for under this section.
Subd. 2. Duties of commissioner of health. (a) Notwithstanding chapters 62D and 62N, a county that
elects to purchase medical assistance in return for a fixed sum without regard to the frequency or extent
of services furnished to any particular enrollee is not required to obtain a certificate of authority under
chapter 62D or 62N. The county board of commissioners is the governing body of a county-based purchasing
program. In a multicounty arrangement, the governing body is a joint powers board established under section
471.59.
(b) A county that elects to purchase medical assistance services under this section must satisfy the
commissioner of health that the requirements for assurance of consumer protection, provider protection,
and fiscal solvency of chapter 62D, applicable to health maintenance organizations will be met according
to the following schedule:
(1) for a county-based purchasing plan approved on or before June 30, 2008, the plan must have in
reserve:
(i) at least 50 percent of the minimum amount required under chapter 62D as of January 1, 2010;
(ii) at least 75 percent of the minimum amount required under chapter 62D as of January 1, 2011;
(iii) at least 87.5 percent of the minimum amount required under chapter 62D as of January 1, 2012; and
(iv) at least 100 percent of the minimum amount required under chapter 62D as of January 1, 2013; and
(2) for a county-based purchasing plan first approved after June 30, 2008, the plan must have in reserve:
(i) at least 50 percent of the minimum amount required under chapter 62D at the time the plan begins
enrolling enrollees;
(ii) at least 75 percent of the minimum amount required under chapter 62D after the first full calendar
year;
(iii) at least 87.5 percent of the minimum amount required under chapter 62D after the second full
calendar year; and
(iv) at least 100 percent of the minimum amount required under chapter 62D after the third full calendar
year.
(c) Until a plan is required to have reserves equaling at least 100 percent of the minimum amount
required under chapter 62D, the plan may demonstrate its ability to cover any losses by satisfying the requirements of chapter 62N. A county-based purchasing plan must also assure the commissioner of health that
the requirements of sections 62J.041; 62J.48; 62J.71 to 62J.73; 62M.01 to 62M.16; all applicable provisions
Copyright © 2014 by the Revisor of Statutes, State of Minnesota. All Rights Reserved.
256B.692
2
of chapter 62Q, including sections 62Q.075; 62Q.1055; 62Q.106; 62Q.12; 62Q.135; 62Q.14; 62Q.145;
62Q.19; 62Q.23, paragraph (c); 62Q.43; 62Q.47; 62Q.50; 62Q.52 to 62Q.56; 62Q.58; 62Q.68 to 62Q.72;
and 72A.201 will be met.
(d) All enforcement and rulemaking powers available under chapters 62D, 62J, 62M, 62N, and 62Q
are hereby granted to the commissioner of health with respect to counties that purchase medical assistance
services under this section.
(e) The commissioner, in consultation with county government, shall develop administrative and
financial reporting requirements for county-based purchasing programs relating to sections 62D.041,
62D.042, 62D.045, 62D.08, 62N.28, 62N.29, and 62N.31, and other sections as necessary, that are specific
to county administrative, accounting, and reporting systems and consistent with other statutory requirements
of counties.
(f) The commissioner shall collect from a county-based purchasing plan under this section the following
fees:
(1) fees attributable to the costs of audits and other examinations of plan financial operations. These
fees are subject to the provisions of Minnesota Rules, part 4685.2800, subpart 1, item F; and
(2) an annual fee of $21,500, to be paid by June 15 of each calendar year.
All fees collected under this paragraph shall be deposited in the state government special revenue fund.
Subd. 3. Requirements of the county board. A county board that intends to purchase or provide health
care under this section, which may include purchasing all or part of these services from health plans or
individual providers on a fee-for-service basis, or providing these services directly, must demonstrate the
ability to follow and agree to the following requirements:
(1) purchase all covered services for a fixed payment from the state that does not exceed the estimated
state and federal cost that would have occurred under the prepaid medical assistance program;
(2) ensure that covered services are accessible to all enrollees and that enrollees have a reasonable
choice of providers, health plans, or networks when possible. If the county is also a provider of service,
the county board shall develop a process to ensure that providers employed by the county are not the sole
referral source and are not the sole provider of health care services if other providers, which meet the same
quality and cost requirements are available;
(3) issue payments to participating vendors or networks in a timely manner;
(4) establish a process to ensure and improve the quality of care provided;
(5) provide appropriate quality and other required data in a format required by the state;
(6) provide a system for advocacy, enrollee protection, and complaints and appeals that is independent
of care providers or other risk bearers and complies with section 256B.69;
(7) ensure that the implementation and operation of the Minnesota senior health options demonstration
project and the Minnesota disability health options demonstration project, authorized under section 256B.69,
subdivision 23, will not be impeded;
3
256B.692
(8) ensure that all recipients that are enrolled in the prepaid medical assistance program will be
transferred to county-based purchasing without utilizing the department's fee-for-service claims payment
system;
(9) ensure that all recipients who are required to participate in county-based purchasing are given
sufficient information prior to enrollment in order to make informed decisions; and
(10) ensure that the state and the medical assistance recipients will be held harmless for the payment
of obligations incurred by the county if the county, or a health plan providing services on behalf of the
county, or a provider participating in county-based purchasing becomes insolvent, and the state has made
the payments due to the county under this section.
Subd. 4. Payments to counties. The commissioner shall pay counties that are purchasing or providing
health care under this section a per capita payment for all enrolled recipients. Payments shall not exceed
payments that otherwise would have been paid to health plans under medical assistance for that county or
region. This payment is in addition to any administrative allocation to counties for education, enrollment,
and advocacy. The state of Minnesota and the United States Department of Health and Human Services
are not liable for any costs incurred by a county that exceed the payments to the county made under this
subdivision. A county whose costs exceed the payments made by the state, or any affected enrollees or
creditors of that county, shall have no rights under chapter 61B or section 62D.181. A county may assign
risk for the cost of care to a third party.
Subd. 4a. Expenditure of revenues. (a) A county that has elected to participate in a county-based
purchasing plan under this section shall use any excess revenues over expenses that are received by the
county and are not needed (1) for capital reserves under subdivision 2, (2) to increase payments to providers,
or (3) to repay county investments or contributions to the county-based purchasing plan, for prevention,
early intervention, and health care programs, services, or activities.
(b) A county-based purchasing plan under this section is subject to the unreasonable expense provisions
of section 62D.19.
Subd. 5. County proposals. (a) A county board that wishes to purchase or provide health care under
this section must submit a preliminary proposal that substantially demonstrates the county's ability to meet
all the requirements of this section in response to criteria for proposals issued by the department. Counties
submitting preliminary proposals must establish a local planning process that involves input from medical
assistance recipients, recipient advocates, providers and representatives of local school districts, labor, and
tribal government to advise on the development of a final proposal and its implementation.
(b) The county board must submit a final proposal that demonstrates the ability to meet all the requirements of this section.
(c) For a county in which the prepaid medical assistance program is in existence, the county board must
submit a preliminary proposal at least 15 months prior to termination of health plan contracts in that county
and a final proposal six months prior to the health plan contract termination date in order to begin enrollment
after the termination. Nothing in this section shall impede or delay implementation or continuation of the
prepaid medical assistance program in counties for which the board does not submit a proposal, or submits
a proposal that is not in compliance with this section.
Subd. 6. Commissioner's authority. The commissioner may:
(1) reject any preliminary or final proposal that:
256B.692
4
(a) substantially fails to meet the requirements of this section, or
(b) that the commissioner determines would substantially impair the state's ability to purchase health
care services in other areas of the state, or
(c) would substantially impair an enrollee's choice of care systems when reasonable choice is possible, or
(d) would substantially impair the implementation and operation of the Minnesota senior health options
demonstration project authorized under section 256B.69, subdivision 23; and
(2) assume operation of a county's purchasing of health care for enrollees in medical assistance in the
event that the contract with the county is terminated.
Subd. 7. Dispute resolution. In the event the commissioner rejects a proposal under subdivision 6, the
county board may request the recommendation of a three-person mediation panel. The commissioner shall
resolve all disputes after taking into account the recommendations of the mediation panel. The panel shall
be composed of one designee of the president of the Association of Minnesota Counties, one designee of
the commissioner of human services, and one person selected jointly by the designee of the commissioner
of human services and the designee of the Association of Minnesota Counties. Within a reasonable period
of time before the hearing, the panelists must be provided all documents and information relevant to the
mediation. The parties to the mediation must be given 30 days' notice of a hearing before the mediation panel.
Subd. 8. Appeals. A county that conducts county-based purchasing shall be considered to be a prepaid
health plan for purposes of section 256.045.
Subd. 9. Federal approval. The commissioner shall request any federal waivers and federal approval
required to implement this section. County-based purchasing shall not be implemented without obtaining
all federal approval required to maintain federal matching funds in the medical assistance program.
Subd. 10. [Repealed, 2014 c 262 art 2 s 18]
History: 1997 c 203 art 4 s 56; 1998 c 407 art 4 s 49,50; 1999 c 239 s 42; 1999 c 245 art 4 s 76; 2001
c 170 s 8; 2002 c 277 s 25; 2005 c 77 s 6; 2006 c 264 s 12; 2008 c 326 art 1 s 39; 2008 c 364 s 7,8; 2010
c 200 art 1 s 20; 1Sp2010 c 1 art 16 s 24; 2014 c 262 art 2 s 16,17
256B.69 PREPAID HEALTH PLANS.
Subdivision 1.Purpose.
The commissioner of human services shall establish a medical assistance demonstration
project to determine whether prepayment combined with better management of health care
services is an effective mechanism to ensure that all eligible individuals receive necessary
health care in a coordinated fashion while containing costs. For the purposes of this project,
waiver of certain statutory provisions is necessary in accordance with this section.
Subd. 2.Definitions.
For the purposes of this section, the following terms have the meanings given.
(a) "Commissioner" means the commissioner of human services. For the remainder of
this section, the commissioner's responsibilities for methods and policies for implementing
the project will be proposed by the project advisory committees and approved by the
commissioner.
(b) "Demonstration provider" means a health maintenance organization, community
integrated service network, or accountable provider network authorized and operating under
chapter 62D, 62N, or 62T that participates in the demonstration project according to criteria,
standards, methods, and other requirements established for the project and approved by the
commissioner. For purposes of this section, a county board, or group of county boards
operating under a joint powers agreement, is considered a demonstration provider if the
county or group of county boards meets the requirements of section 256B.692.
(c) "Eligible individuals" means those persons eligible for medical assistance benefits as
defined in sections 256B.055, 256B.056, and 256B.06.
(d) "Limitation of choice" means suspending freedom of choice while allowing eligible
individuals to choose among the demonstration providers.
Subd. 3.Geographic area.
The commissioner shall designate the geographic areas in which eligible individuals
may be included in the medical assistance prepayment programs.
Subd. 3a.County authority.
(a) The commissioner, when implementing the medical assistance prepayment program
within a county, must include the county board in the process of development, approval, and
issuance of the request for proposals to provide services to eligible individuals within the
proposed county. County boards must be given reasonable opportunity to make
recommendations regarding the development, issuance, review of responses, and changes
needed in the request for proposals. The commissioner must provide county boards the
opportunity to review each proposal based on the identification of community needs under
chapters 145A and 256E and county advocacy activities. If a county board finds that a
proposal does not address certain community needs, the county board and commissioner
shall continue efforts for improving the proposal and network prior to the approval of the
contract. The county board shall make recommendations regarding the approval of local
networks and their operations to ensure adequate availability and access to covered services.
The provider or health plan must respond directly to county advocates and the state prepaid
medical assistance ombudsperson regarding service delivery and must be accountable to the
state regarding contracts with medical assistance funds. The county board may recommend a
maximum number of participating health plans after considering the size of the enrolling
population; ensuring adequate access and capacity; considering the client and county
administrative complexity; and considering the need to promote the viability of locally
developed health plans. The county board or a single entity representing a group of county
boards and the commissioner shall mutually select health plans for participation at the time
of initial implementation of the prepaid medical assistance program in that county or group
of counties and at the time of contract renewal. The commissioner shall also seek input for
contract requirements from the county or single entity representing a group of county boards
at each contract renewal and incorporate those recommendations into the contract negotiation
process.
(b) At the option of the county board, the board may develop contract requirements
related to the achievement of local public health goals to meet the health needs of medical
assistance enrollees. These requirements must be reasonably related to the performance of
health plan functions and within the scope of the medical assistance benefit set. If the county
board and the commissioner mutually agree to such requirements, the department shall
include such requirements in all health plan contracts governing the prepaid medical
assistance program in that county at initial implementation of the program in that county and
at the time of contract renewal. The county board may participate in the enforcement of the
contract provisions related to local public health goals.
(c) For counties in which a prepaid medical assistance program has not been established,
the commissioner shall not implement that program if a county board submits an acceptable
and timely preliminary and final proposal under section 256B.692, until county-based
purchasing is no longer operational in that county. For counties in which a prepaid medical
assistance program is in existence on or after September 1, 1997, the commissioner must
terminate contracts with health plans according to section 256B.692, subdivision 5, if the
county board submits and the commissioner accepts a preliminary and final proposal
according to that subdivision. The commissioner is not required to terminate contracts that
begin on or after September 1, 1997, according to section 256B.692 until two years have
elapsed from the date of initial enrollment.
(d) In the event that a county board or a single entity representing a group of county
boards and the commissioner cannot reach agreement regarding: (i) the selection of
participating health plans in that county; (ii) contract requirements; or (iii) implementation
and enforcement of county requirements including provisions regarding local public health
goals, the commissioner shall resolve all disputes after taking into account the
recommendations of a three-person mediation panel. The panel shall be composed of one
designee of the president of the association of Minnesota counties, one designee of the
commissioner of human services, and one person selected jointly by the designee of the
commissioner of human services and the designee of the Association of Minnesota Counties.
Within a reasonable period of time before the hearing, the panelists must be provided all
documents and information relevant to the mediation. The parties to the mediation must be
given 30 days' notice of a hearing before the mediation panel.
(e) If a county which elects to implement county-based purchasing ceases to implement
county-based purchasing, it is prohibited from assuming the responsibility of county-based
purchasing for a period of five years from the date it discontinues purchasing.
(f) The commissioner shall not require that contractual disputes between county-based
purchasing entities and the commissioner be mediated by a panel that includes a
representative of the Minnesota Council of Health Plans.
(g) At the request of a county-purchasing entity, the commissioner shall adopt a contract
reprocurement or renewal schedule under which all counties included in the entity's service
area are reprocured or renewed at the same time.
(h) The commissioner shall provide a written report under section 3.195 to the chairs of
the legislative committees having jurisdiction over human services in the senate and the
house of representatives describing in detail the activities undertaken by the commissioner to
ensure full compliance with this section. The report must also provide an explanation for any
decisions of the commissioner not to accept the recommendations of a county or group of
counties required to be consulted under this section. The report must be provided at least 30
days prior to the effective date of a new or renewed prepaid or managed care contract in a
county.
Subd. 3b.Provision of data to county boards.
The commissioner, in consultation with representatives of county boards of
commissioners shall identify program information and data necessary on an ongoing basis
for county boards to: (1) make recommendations to the commissioner related to state
purchasing under the prepaid medical assistance program; and (2) effectively administer
county-based purchasing. This information and data must include, but is not limited to,
county-specific, individual-level fee-for-service and prepaid health plan claims information.
Motion to object to Minnesota Department of Human Services’ selection of participating
health plans for _________County and, specifically, the Department’s decision to reject South
County Health Alliance’s proposal to provide healthcare through the Prepaid Medical
Assistance and MinnesotaCare programs. ___________ County hereby authorizes the
submission of a request for mediation with the Department pursuant to Minn. Stat. § 256B,
both on behalf of __________County individually and through South Country Health Alliance.
Minnesota Department of Human
Services Purchasing and Service Delivery
Division
Request for Proposals for a Qualified
Grantee to
Provide Health Care Services to Medical Assistance (MA) and MinnesotaCare in Aitkin, Anoka,
Becker, Beltrami, Benton, Big Stone, Blue Earth, Brown, Carlton, Carver, Cass, Chippewa, Chisago,
Clay, Clearwater, Cook, Cottonwood, Crow Wing, Dakota, Dodge, Douglas, Faribault, Fillmore,
Freeborn, Goodhue, Grant, Hennepin, Houston, Hubbard, Isanti, Itasca, Jackson, Kanabec, Kandiyohi,
Kittson, Koochiching, Lac Qui Parle, Lake, Lake Of The Woods, Le Sueur, Lincoln, Lyon, Mahnomen,
Marshall, Martin, McLeod, Meeker, Mille Lacs, Morrison, Mower, Murray, Nicollet, Nobles, Norman,
Olmsted, Otter Tail, Pennington, Pine, Pipestone, Polk, Pope, Ramsey, Red Lake, Redwood, Renville,
Rice, Rock, Roseau, St. Louis, Scott, Sherburne, Sibley, Stearns, Steele, Stevens, Swift, Todd, Traverse,
Wabasha, Wadena, Waseca, Washington, Watonwan, Wilkin, Winona, Wright and Yellow Medicine
Counties.
Date of Publication: January 26, 2015
Americans with Disabilities Act (ADA) Statement: This information is available in
accessible formats for people with disabilities by calling 651-431-2670 or by
using your preferred relay service. For other information on disability rights and
protections, contact the agency’s Americans with Disabilities Act (ADA)
coordinator.
This Request for Proposal (RFP) template is in an accessible format. However, some
appendices and attachments incorporated in the RFP may not be in an accessible format. If
you require an accessible document send an email to the procurement staff in the Department
of Human Services (DHS) Purchasing and Service Delivery (PSD) Division at
[email protected].
TABLE OF CONTENTS
REQUEST FOR PROPOSAL - SUMMARY OF IMPORTANT DATES .............................................................................. 4
I. INTRODUCTION .................................................................................................................................................. 5
A. PURPOSE OF REQUEST .................................................................................................................................................5
B. OBJECTIVE OF THIS RFP ...............................................................................................................................................5
C. BACKGROUND ............................................................................................................................................................6
II. SCOPE OF WORK .............................................................................................................................................. 11
A. OVERVIEW ..............................................................................................................................................................11
B. TASKS/DELIVERABLES ................................................................................................................................................12
III. PROPOSAL FORMAT ........................................................................................................................................ 12
A. REQUIRED PROPOSAL CONTENTS .................................................................................................................................12
B. TECHNICAL PROPOSAL REQUIREMENTS .........................................................................................................................13
C. REQUIRED STATEMENTS .............................................................................................................................................15
IV. RFP PROCESS .................................................................................................................................................. 19
A. TIMELINE ................................................................................................................................................................19
B. ACCESS TO THE RFP ..................................................................................................................................................20
C. RESPONDERS’ CONFERENCES.......................................................................................................................................20
D. RESPONDERS’ QUESTIONS ..........................................................................................................................................20
E. PROPOSAL SUBMISSION .............................................................................................................................................21
V. PROPOSAL EVALUATION AND SELECTION ........................................................................................................ 22
A. OVERVIEW OF EVALUATION METHODOLOGY ..................................................................................................................22
B. EVALUATION TEAM ...................................................................................................................................................22
C. EVALUATION PROCESS ...............................................................................................................................................23
D. EVALUATION PHASES.................................................................................................................................................23
E. CONTRACT NEGOTIATIONS AND UNSUCCESSFUL RESPONDER NOTICE ..................................................................................25
VI. REQUIRED CONTRACT TERMS AND CONDITIONS ............................................................................................ 25
VII. STATE’S RIGHTS RESERVED ............................................................................................................................ 30
VIII. APPENDICES (A-S) ......................................................................................................................................... 31
APPENDIX A - RESPONDER INFORMATION/DECLARATIONS................................................................................. 32
APPENDIX B - EXCEPTIONS TO TERMS AND CONDITIONS..................................................................................... 37
APPENDIX C - AFFIDAVIT OF NONCOLLUSION ...................................................................................................... 38
APPENDIX D - TRADE SECRET/CONFIDENTIAL DATA NOTICE ................................................................................ 39
APPENDIX E – AFFIRMATIVE ACTION DATA PAGE ................................................................................................ 40
APPENDIX F - CERTIFICATION REGARDING LOBBYING .......................................................................................... 41
APPENDIX G – DISCLOSURE OF OWNERSHIP ........................................................................................................ 42
APPENDIX H - PROFESSIONAL RESPONSIBILITY .................................................................................................... 43
APPENDIX I - SUBMISSION OF CERTIFIED FINANCIAL AUDIT, IRS FORM 990 OR MOST RECENT BOARD-REVIEWED
FINANCIAL STATEMENTS ..................................................................................................................................... 44
APPENDIX J - ENROLLMENT LIMIT DECLARATION ................................................................................................ 45
APPENDIX K – DISCLOSURE OF FUNDING ............................................................................................................. 48
APPENDIX L – COUNTY-SPECIFIC INFORMATION .................................................................................................. 49
APPENDIX M - COUNTY ASSURANCES ................................................................................................................ 229
APPENDIX N - COUNTY EXHIBITS ....................................................................................................................... 231
DHS Template - Revised 11/2014
2
APPENDIX O - STATE EXHIBITS ........................................................................................................................... 241
APPENDIX P – QUALITY OF CARE AND SERVICES EVALUATION .......................................................................... 243
APPENDIX Q - HEALTH CARE REFORM INITIATIVES ............................................................................................ 245
APPENDIX R - SPECIFICATIONS FOR PROVIDER NETWORK LISTING .................................................................... 246
APPENDIX S – REQUIRED PROPOSAL CONTENTS CHECKLIST .............................................................................. 249
3
Request for Proposal - Summary of Important Dates
State Register Notice – January 26, 2015
RFP Published on DHS Website – January 26, 2015
RFP Technical and Price Bid Responders’ Conference Registration Deadline – February 13, 2015
RFP Technical and Price Bid Responders’ Conference – February 17, 2015
All RFP Technical Questions due – February 24, 2015
All RFP Technical Questions answered – February 27, 2015
Technical Proposals due – April 6, 2015
Provide Data Book to MCOs – April 30, 2015
All RFP Price Bid Questions due – May 6, 2015
All RFP Price Bid Questions answered – May 11, 2015
Price Bid Proposals due – June 1, 2015
Selection of Successful Responder(s) – July 14, 2015
Start of Contract – January 1, 2016
State Contacts: Beryl Palmer and Pam Olson
4
I. Introduction
A. Purpose of Request
The Minnesota Department of Human Services (DHS), through its Purchasing and Service Delivery Division, is
seeking Proposals from qualified responders including demonstration providers as defined in Minnesota Statute,
section 256B.69, subd. 1 and participating entities as defined in Minnesota Statute, section 256L.01, subd. 7,
definitions included below:
Demonstration Provider – means a health maintenance organization, community integrated service network, or
accountable provider network authorized and operating under Minnesota Statutes, chapter 62D, 62N, or 62T that
participates in the demonstration project according to criteria, standards, methods, and other requirements
established for the project and approved by the commissioner. For purposes of this section, a county board, or
group of county boards operating under a joint powers agreement, is considered a demonstration provider if the
county or group of county boards meets the requirements of Minnesota Statute, section 256B.692.
Participating Entities – means a health carrier as defined in Minnesota Statutes, section 62A.01, subd. 2; a countybased purchasing plan established under Minnesota Statute, section 256B.692; an accountable care organization
or other entity operating a health care delivery systems demonstration project authorized under Minnesota
Statute, section 256B.0755; an entity operating a county integrated health care delivery network pilot project
authorized under Minnesota Statute, section 256B.0756; or a network of health care providers established to offer
services under MinnesotaCare.
This RFP is being issued to provide prepaid health care to eligible Medical Assistance (MA) and MinnesotaCare
recipients in Aitkin, Anoka, Becker, Beltrami, Benton, Big Stone, Blue Earth, Brown, Carlton, Carver, Cass,
Chippewa, Chisago, Clay, Clearwater, Cook, Cottonwood, Crow Wing, Dakota, Dodge, Douglas, Faribault, Fillmore,
Freeborn, Goodhue, Grant, Hennepin, Houston, Hubbard, Isanti, Itasca, Jackson, Kanabec, Kandiyohi, Kittson,
Koochiching, Lac Qui Parle, Lake, Lake Of The Woods, Le Sueur, Lincoln, Lyon, Mahnomen, Marshall, Martin,
McLeod, Meeker, Mille Lacs, Morrison, Mower, Murray, Nicollet, Nobles, Norman, Olmsted, Otter Tail, Pennington,
Pine, Pipestone, Polk, Pope, Ramsey, Red Lake, Redwood, Renville, Rice, Rock, Roseau, St. Louis, Scott, Sherburne,
Sibley, Stearns, Steele, Stevens, Swift, Todd, Traverse, Wabasha, Wadena, Waseca, Washington, Watonwan,
Wilkin, Winona, Wright and Yellow Medicine Counties. This is a statewide procurement in the 87 counties in
Minnesota and these counties will be referred to as the “87 counties” in this RFP.
B. Objective of this Request for Proposal (RFP)
The objective of this RFP is to contract with a qualified responder(s) to perform the tasks and services set forth in
this RFP. The term of any resulting contract is anticipated to be from January 1, 2016 until December 31, 2016
with the option to renew annually, not to exceed the five-year limit for procurement. DHS reserves the right to do
procurement whenever it becomes necessary.
For the Prepaid Medical Assistance Program (PMAP) if a county is identified as a Metropolitan Statistical Area
(MSA), the State will require that at least two managed care organizations (MCOs) be selected to provide health
care services in that county. The following counties are identified as MSAs: Anoka, Benton, Blue Earth, Carlton,
Carver, Chisago, Clay, Dakota, Dodge, Fillmore, Hennepin, Houston, Isanti, LeSueur, Mille Lacs, Nicollet, Olmsted,
Polk, Ramsey, Scott, Sherburne, Sibley, St. Louis, Stearns, Wabasha, Washington and Wright. The remaining
counties are currently identified as rural areas and therefore are not required to have more than a single MCO in
these counties.
For MinnesotaCare, a minimum of two MCOs will be selected in all 87 counties. Pursuant to Minnesota Statute
section 256L.121, subd. 1, a minimum of two participating entities are required to provide services. Demonstration
providers may submit a single proposal for both PMAP and MinnesotaCare. Participating entities may submit a
proposal for MinnesotaCare only.
This procurement includes two components, one which is for Technical requirements and one which is for Price
Bid requirements. See Section IV.E for the proposal submission requirements.
5
Technical Proposals must be submitted by 4:00 p.m. Central Time on April 6, 2015.
Price Bid Proposals must be submitted by 4:00 p.m. Central Time on June 1, 2015.
This RFP does not obligate the State to award a contract or complete the project, and the State reserves the right
to cancel the solicitation if it is considered to be in the State’s best interest. All costs incurred in responding to this
RFP will be borne by the responder.
C. Background
1.
General
Under the authority of Minnesota Statutes, sections 256B.69, 256B.692 and 256L.12, the State is soliciting
proposals for health care services in the 87 counties. Recipients in these counties are currently enrolled in the
Prepaid Medical Assistance Program (PMAP) and MinnesotaCare.
To serve the above populations in these counties, responders must successfully submit proposals in response to
this RFP.
Pursuant to Minnesota Statutes, section 256B.69, subd. 3a, County Boards are included in the development,
approval, and issuance of this RFP as it pertains to the PMAP and MinnesotaCare populations.
2.
Managed Care Education and Enrollment Process
The ability for current managed care enrollees to enroll in a managed care organization (MCO) will be offered as
an open enrollment option for PMAP and MinnesotaCare in September/October 2015, with an effective
enrollment date of January 1, 2016. For Managed Care enrollment after January 1, 2016, new recipients will
receive the current MCOs options at the time their eligibility is established.
3.
Eligible Populations
The following eligible persons who are recipients of Medical Assistance and MinnesotaCare and reside within the
counties identified in this RFP are eligible for managed care enrollment:
a)
Medical Assistance/Pregnant Woman - Women who are pregnant and meet Medical Assistance
eligibility requirements.
b) Medical Assistance/Children Under 21 - Children who meet Medical Assistance eligibility
requirements.
c)
Medical Assistance/Adults with Children – Parents and relative caretakers of children who meet
Medical Assistance eligibility requirements.
d) Medical Assistance/Adults without Children – Adults 21- 64 who meet Medical Assistance eligibility
requirements.
e)
MinnesotaCare Enrollees – Individuals must belong to an eligible group under Minnesota Statutes,
Chapter 256L, meet income criteria and satisfy all other eligibility requirements. Most MinnesotaCare
enrollees are required to pay a premium to the State. (Children under age 21 do not pay a
premium). All MinnesotaCare eligible recipients are required to participate in managed care and
there is no basis for exclusion for this population. Additional requirements include:
• Must be a U.S. citizen or a lawfully present noncitizen and meet program guidelines.
• Individuals are eligible if they do not qualify for Medical Assistance and their annual
income is at or below 200% Federal Poverty Guidelines (FPG).
• There are no asset limits.
• Cannot have Medicare or be enrolled in other minimum essential coverage as defined
by the Affordable Care Act. Coverage through a Qualified Health Plan is not a barrier to
MinnesotaCare.
6
•
4.
Cannot have current access to employer-subsidized insurance that meets the Affordable
Care Act minimum value requirements and is considered affordable.
Excluded Populations
A. The following Medical Assistance eligible recipients are excluded from enrollment in managed care:
1.
Recipients receiving Medical Assistance due to blindness or disability as determined by the
U.S. Social Security Administration or the State Medical Review Team, except if age 65 years
or older. Disabled recipients under 65 may enroll on a voluntary basis.
2.
Recipients receiving Medical Assistance under the Refugee Assistance Program pursuant to 8
U.S.C. 1522(e).
3.
Medical Assistance recipients who are residents of state institutions, unless the placement
has been approved by the MCO or is a court-ordered placement.
4.
Medical Assistance recipients who are terminally ill as defined in Minnesota Rules, part
9505.0297, subpart 2; item N and who, at the time of enrollment in PMAP, have an
established relationship with a primary physician who is not is not a participating provider in
the MCO.
5.
Individuals who are Qualified Medicare Beneficiaries (QMB), as defined in Section 1905(p) of
the Social Security Act, 42 U.S.C. 1396d (p), who are not otherwise receiving Medical
Assistance.
6.
Individuals who are Service Limited Medicare Beneficiaries (SLMB), as defined in Section
1905(p) of the Social Security Act, 42 U.S.C. 1396a(a)(10)(E)(iii) and 1396d(p), and who are
not otherwise receiving Medical Assistance.
7.
Non-citizen recipients who only receive emergency Medical Assistance under Minnesota
Statutes, section 256B.06, subd. 4.
8.
Recipients receiving Medical Assistance on a medical spend-down basis.
9.
Recipients, who at the time of notification of mandatory enrollment in PMAP have a
communicable disease whose prognosis is terminal and whose primary physician is not a
participating provider in the MCO, and that physician certifies that disruption of the existing
physician-patient relationship is likely to result in the patient becoming noncompliant with
medication or other health services.
10. Medical Assistance recipients with cost-effective employer-sponsored private health care
coverage, or who are enrolled in a non-Medicare individual health plan determined to be
cost-effective according to Minnesota Statutes, section 256B.69, subd. 4(b)(9).
11. Medical Assistance recipients who are eligible while receiving care and services from a nonprofit center established to serve victims of torture.
12. Women receiving Medical Assistance through the Breast and Cervical Cancer Control
Program.
B.
The following Medical Assistance populations are excluded from mandatory enrollment, but may
elect to enroll in PMAP on a voluntary basis:
1.
Medical Assistance recipients with private health care coverage through an HMO licensed
under Minnesota Statutes, Chapter 62D. Such recipients may enroll in PMAP on a voluntary
basis if the private HMO is the same as the MCO the person will select under PMAP.
7
C.
5.
2.
Adults who are determined to be seriously and persistently mentally ill (SPMI) and eligible to
receive Medical Assistance covered targeted case management services pursuant to
Minnesota Statutes, section 245.4711.
3.
Children who are determined to be severely emotionally disturbed (SED) and eligible to
receive Medical Assistance covered targeted case management services pursuant to
Minnesota Statutes, section 245.4881.
4.
Children receiving Medical Assistance through adoption assistance according to Minnesota
Statutes, section 256B.69, subd. 4(b)(1).
There are no exclusions from managed care enrollment for recipients eligible for MinnesotaCare.
Financial Considerations
Responders will be paid a fixed monthly payment per enrolled member for the provision of all services covered by
the contract. Such responders will be at full risk for provision of the covered services. Responders will be expected
to have access to sufficient reserves and/or reinsurance to bear the risk of unexpected medical claims which may
occur. Furthermore, the capitation (rates) proposed by the responder must be certified on behalf of the responder
by a qualified actuary who is a member of the American Academy of Actuaries. The State’s contracted actuaries
will develop actuarially sound rate ranges, within which the capitation paid to the responder will fall. This is a
requirement of the Centers for Medicare and Medicaid (CMS).
Responders to this RFP who have current contracts with the State are required to provide a recent 5-year history
of their medical loss ratio (MLR) (2010-2014) on PMAP and MinnesotaCare programs. Those responders, who do
not have a prior contracting history with the State, shall provide recent MLR history on other business (commercial
or individual) to meet this medical loss requirement. As part of the Price Bid, responders are required to exclude
from the PMPM (per member per month) administrative rate any charitable contributions or donations, indirect
marketing, fines or penalties, lobbying and any cost allocation for any portion of an MCO salary and compensation
in excess of $200,000. The administrative rate must reflect what an efficient MCO needs to appropriately
administer the programs. Specifications and a template for this requirement will be provided along with the Data
Book. In the absence of public program experience, the administrative costs on commercial or individual business
may be used.
Responders must submit a Price Bid for contracting in calendar year 2016. Specifications, instructions, information
about rate regions and a bid development template for this requirement will be provided prior to the responders’
Conference. The State will establish a confidential rate range for each region prior to submission of the bids. Bids
outside the rate range will be adjusted to fall within an actuarially sound range. The State may, at its option, trend
responder bids for up to four additional years, develop rates independent of responder bids or may subsequently
require a new bid for those years. A price proposal template and instructions will be available on the DHS public
website prior to the Responders’ Conference. The State will evaluate the bids for sufficiency in the individual rate
cells.
The State will employ a health-based risk assessment mechanism to adjust the final payments to selected
responders. The risk-adjustment mechanism will utilize the CDPS+Rx model on a prospective basis. Riskadjustment will be budget-neutral for the State for each rate cell and region, with revenue only shifting between
responders. Additional detail on the risk adjustment mechanism will be provided along with the data book. To
assist responders in bid development, a data book will be provided with calendar year 2014 historical cost and
enrollment history in each of the counties. The data book will include factors to transform one responder bid for
each region into rate cell base capitation rates. This data book will be available on the DHS public website on April
30, 2015.
The State may, at its option, request that any or all responders submit a best and final offer (BAFO). The State at its
discretion may choose not to request a BAFO. Responders are therefore advised to submit their most competitive
offer at the outset. Each proposal must be certified as a viable bid by a qualified actuary. The certification must
accompany the Price Bid.
8
The State anticipates that if bids are competitive we may reduce the number of MCOs in a county to take
advantage of additional value. For PMAP, the State may select one MCO for each county except in MSA counties
where at least two MCOs are required to be selected. For MinnesotaCare, the State will select at least two MCOs
for each county. The selection of the MCOs will be based on the evaluation criteria found in Section V.D.2.c.
Since final legislative changes are not available adjustments to the bid may be made for significant changes from
the most recent session. Final rates paid for 2016 will be made incorporating any legislative changes in benefits
and payments coming out of the 2015 session. At the State’s discretion, 2016 rates may be adjusted for any other
issues that materially affect benefits and payments not included in the base data or legislative changes. In
addition, the State will revise the data book factors that convert single regional bids to rate cell capitation rates to
account for the differential impact of trend and legislative changes between 2014 and 2016 across rate cells. These
adjustments will be applied by the State to the rates agreed upon by the State and the successful responders.
For specific programs rates contact Jeff Provance at 651-431-2349.
Feasibility Study
For each responder submitting a proposal that does not have an existing managed care contract for state public
programs (i.e. insurance carriers, HMOs, a network of health care providers, accountable care organizations, etc.)
should include a feasibility study demonstrating the due diligence conducted before considering submitting a
proposal. Often these studies are prepared by an actuarial firm, with perhaps the assistance of a public accounting
firm, to advise the applicant as to the amount of capital needed to support the intended business. Internal
financial resources available to the applicant may also be sufficient to produce the study. The feasibility study
prepared for this RFP would be customized to fit your considerations and needs. There is no template for these
reports. Feasibility studies are supposed to accomplish the following objectives:
a. Offer an informed opinion as to the initial capitalization that the responder should have and what, if any,
access the applicant may have to additional funds to support its operations.
b. Offer an informed opinion on the initial reimbursement structure (projected enrollment, reimbursement
rates, etc.) that is necessary to support the medical needs of the population you expect to serve.
c. Identify inherent risks with the program you are proposing that are unique to the service areas you intend
to serve.
d. What steps the applicant has taken to mitigate financial risk related to liquidity needs and/or adverse
operating results outside forecasts (reinsurance, etc.).
e. Prepare two-year projections of the balance sheet, income statement, and cash flow statement with a full
description of underlying assumptions, which are consistent with reimbursement assumptions and advice
on initial capitalization.
f. What consumer protections have you included to insulate/protect enrollees of your services (e.g. holdharmless provisions).
g. Identification and summary of any service arrangements with outside parties (both affiliated and
unaffiliated) to administer the business for the applicant and/or identification of the internal resources
expected to administer the program.
The quality of a feasibility study depends in large part on the quality and accuracy of the information that you
would supply to your preparers (internal or external). Certainly a balance needs to be struck between “optimistic”
and “pessimistic” case scenarios. It will be important for the applicants to understand the possible range of likely
outcomes with regards to member enrollment expectations and consider potential remedies or features that
address other outcomes. The feasibility study and financial forecasts included should be based on the applicants
“reasonable and realistic” expectations.
9
6.
Evidence of Coverage (EOC)
MCO(s) must develop an EOC for the populations they serve under Minnesota Health Care Programs (MHCP).
The EOCs are based on models available from the State and must contain the following elements: specific
information on benefits, including any limitations and exclusions, cost-sharing (or co-pays), what services
require authorization or approval, American Indian access to Indian Health Services, enrollee rights and
protections, information on prescription drug coverage, and information on how grievances and appeals are
resolved. Model EOCs are on the DHS public website and can be accessed by the following link: Evidence of
Coverage.
7.
Primary Care Network Listing (PCNL)
MCO(s) must develop PCNLs twice a year for the populations they serve under Minnesota Health Care
Programs (MHCP). The PCNL is used for distribution to enrollees/potential enrollees during the managed care
enrollment process, including the Open Enrollment period. The PCNL is a list of participating providers
including clinics, primary care physicians and hospitals. The PCNL also includes a description of access to the
following services which include but are not limited to chemical dependency, dental, mental health, durable
medical, interpreter services, home care and open access services. The PCNL for Open Enrollment for 2016 will
be due to the State by July 20, 2015. The PCNL model/guidelines are on the DHS public website and can be
accessed by the following link: Primary Care Network Listing.
8.
Other Information
•
Minnesota Health Care Programs 2015 Families and
Children Model Contra
•
Medically Underserved Listing - By State & County
Medically Underserved Areas/Populations
•
Local Health Department/Community Health Boards Local Health Dept & CHB
•
Community Health Clinics Listing Community Health Clinics
•
Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHC) 2014 FQHC Listing and 2014 RHC Listing for RFP
FQHC Listing Jan
2015_For Dec 2014 R
RHC Listing Jan
2015_For Dec Report
f) Model Contract -
2015 Families and
Children Model Contra
10
II. Scope of Work
A. Overview
A responder is required to submit a proposal in good faith that meets the requirements of the RFP provided that
the requirements can be reasonably met by the responder to serve individuals eligible for the programs in a
geographic region of the state. To be eligible as a successful responder, a demonstration provider or participating
entity must meet all of the following criteria and fulfill all of the following requirements.
1.
Managed Care Organization Definition
To be considered a qualified MCO for purposes of responding to this RFP, a successful Responder must meet the
definition of an MCO. Under the managed care regulation, MCO means an entity that has, or is seeking to qualify
for, a comprehensive risk contract, and that is:
a) A Federally Qualified HMO that meets the advance directives requirements of 42 CFR 489.100-104;
or
b) Any public or private entity that meets the advance directives requirements and is determined to also
meet the following conditions: a) makes the services it provides to its Medicaid Enrollees as
accessible (in terms of timeliness, amount, duration, and scope) as those services are to other
Medicaid Recipients within the area served by the entity, and b) meets the solvency standards of 42
CFR 438.116.
In determining whether an entity meets the definition of a qualified MCO, the Commissioner has discretion to
explore various provider options that will be most advantageous to the population eligible for enrollment in the
managed care programs. Providing the above requirements are met, the Commissioner may contract with any
demonstration provider or participating entity under Minnesota Statutes 256B.69 subd. 1 and 256L.01 subd. 7.
2.
Participation Requirements
Pursuant to Minnesota Statutes, section 256B.0644, health maintenance organizations (HMOs) and vendors of
medical care as defined in 256B.02, subd. 7 must participate as providers or contractors in the Medical Assistance
and MinnesotaCare programs as a condition of participating in state and local government employee health
insurance programs, the workers’ compensation system, and insurance plans provided through the Minnesota
Comprehensive Health Association (MCHA).
Minnesota Statute, section 256L.12, subd. 5, requires qualified managed care organizations to participate in the
MinnesotaCare program in service areas where it participates in the Medical Assistance program. The responder
must qualify as a demonstration provider to serve both PMAP and MinnesotaCare.
In addition, Health Maintenance Organizations (HMOs), Community Integrated Service Networks (CISNs), countybased purchasing (CBP) entities, and other qualified provider types must participate in Minnesota Health Care
Programs, including Medical Assistance and MinnesotaCare as a condition of licensure/certification by the
Minnesota Department of Health pursuant to Minnesota Statutes, Chapters 62D.04, subd. 5 and 62N.25, subd. 2.
In accordance with Minnesota Statute, 62D.04, subd. 5, HMOs shall as a condition of receiving and retaining a
certificate of authority, participate in the Medical Assistance and MinnesotaCare programs. The HMOs shall
submit a proposal for all counties in which they are licensed for the entire county.
3.
Conflict of Interest Safeguards
The Balanced Budget Act of 1997 extends federal conflict of interest regulations to contractors and requires them
to have safeguards in place regarding conflict of interest for purchases involving Medicaid funds. These safeguards
shall be as effective as those in federal purchasing statutes, in accordance with 41 U.S.C. 423, and 18 U.S.C. 207
and 208. Minnesota Statutes, section 256B.0914 also requires responders to have conflict of interest safeguards.
11
4.
Administrative Simplification, Security and Privacy Requirements
The MCO must comply with the Administrative Simplification, Security and Privacy requirements of the Health
Insurance Portability and Accountability Act of 1996 (HIPAA), any rules promulgated thereunder, the Minnesota
Health Care Simplification Act of 1994, Minnesota Statutes, section 62J.50 et.seq., including but not limited to,
compliance with 45 CFR, Parts 160 and 162. Health Insurance Reforms: Electronic Transaction Standards and Part
164 Security and Privacy requirements. The MCO shall be in compliance with these requirements consistent with
the applicable effective dates contained in state or federal law.
5.
Financial Solvency
All MCOs must meet the solvency standards established by the State for health maintenance organizations (HMOs)
or be licensed or certified by the State as a risk bearing entity.
B. Tasks/Deliverables
Persons eligible for MA under the age of 65 and all eligible persons in MinnesotaCare are covered under the
Families and Children contract. This contract provides enrollees with access to cost-effective health care.
The contract includes comprehensive, preventive, diagnostic, therapeutic and rehabilitative health care services as
specified in Article 6 of the contract. The contract includes requirements for enrollment, MCO and enrollee
communications, marketing and enrollee education, reporting requirements, access standards, transition services,
service authorization, quality assessment and performance improvement, denials, terminations and reductions
(DTRs), grievances, appeals, and state fair hearings, and other required provisions including compliance with
various state and federal laws and regulations. The MCOs must comply with the program contract requirements
specified in the model contract which is attached. Responder should carefully review the model contract on page
10 in this document. Note: Changes that have been made since the negotiated 2015 contract have been tracked
in the document.
III. Proposal Format
Proposals must conform to all instructions, conditions, and requirements included in the RFP. Responders are
expected to examine all documentation and other requirements. Failure to observe the terms and conditions in
completion of the proposal are at the responder’s risk and may, at the discretion of the State, result in
disqualification of the proposal for nonresponsiveness. Acceptable proposals must offer all services identified in
Section II - Scope of Work and agree to the contract conditions specified throughout the RFP.
A. Required Proposal Contents
Responses to this RFP must consist of all of the following components (see following sections for more detail on
each component). Each of these components must be separate from the others and uniquely identified with
labeled tabs and bookmarked in the electronic version.
1. Table of Contents
2. Technical Proposal Requirements
a. Executive Summary
b. Description of the Applicant Organization
c. Service Delivery Plan
d. Professional Responsibility
e. Feasibility Study (applies to responders who are submitting a proposal for the first time)
12
3. Appendices
a. Responder Information and Declarations (Appendix A)
b. Exceptions to Terms and Conditions (Appendix B)
c. Affidavit of Noncollusion (Appendix C)
d. Trade Secret/Confidential Data Notification (Appendix D)
e. Affirmative Action Data Page (Appendix E)
f. Certification and Restriction on Lobbying (Appendix F)
g. Disclosure of Ownership (Appendix G)
h. Professional Responsibility Disclosure (Appendix H)
i. Submission of Certified Financial Audit, IRS Form 990, or Most Recent Board-Reviewed Financial Statements
(Appendix I)
j. MCO Enrollment Limit Declaration (Appendix J)
k. Disclosure of Funding Form (Appendix K)
l. County Specific Information (Appendix L) – No information needs to be submitted by a responder for this
appendix.
m. County Assurances (Appendix M)
n. County Exhibits (Appendix N)
o. State Exhibits (Appendix O)
p. Quality of Care and Services Evaluation (Appendix P)
q. HealthCare Reform Initiatives (Appendix Q)
r. Specifications for Provider Network Listing (Appendix R)
s. Required Proposal Contents Checklist
4. Price Bid Requirements
a. Specifications, instructions, information about rate regions and a bid development template for this
requirement will be provided prior to the Responders Conference scheduled February 17, 2015.
b. Data Book and Templates available April 30, 2015.
B. Technical Proposal Requirements
The following components will be considered minimum requirements of the proposal. Each component (1-4)
below should be separately identified with individual tabs for each subcomponent. Emphasis should be on
completeness and clarity of content. All proposals submitted under this RFP must address, in sufficient detail, how
the responder will fulfill the expected outcomes outlined in this RFP. Simply repeating the outcomes and asserting
that they will be performed is not an acceptable response.
1. Executive Summary: This component of the proposal should demonstrate the responder's understanding of the
services requested in this RFP and any problems anticipated in accomplishing the work. The Executive Summary
should also show the responder’s overall design of the project in response to achieving the deliverables as defined
in this RFP. Specifically, the proposal should demonstrate the responder's familiarity with the project elements, its
solutions to the problems presented and knowledge of the requested services.
2. Description of the Applicant Organization: This component must include the following information:
a.
b.
c.
d.
e.
f.
g.
a brief history of the organization;
the programs and activities of the organization;
strengths considered to be an asset to your programs;
the number of people served;
geographic area served;
staff experience, and
program accomplishments.
Responder should also demonstrate:
h. the length, depth, and applicability of all prior experience in providing the requested services; including
i. the skills and experience of staff.
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3. Service Delivery Plan: This component shall describe the structure for delivery of health care services to the
Medical Assistance and MinnesotaCare populations. The plan shall include, but is not limited to:
a. an organizational statement that includes its mission, philosophy, goals and objectives, quality of care and
service program and overall structure of the organization;
b. a description of staffing resources for administrative and clinical services;
c. a description of the organization’s information systems used for data collection, statistics, quality
improvement activities and reporting, including how the organization uses the data in its delivery of
health care services;
d. a description of the organization’s claims payment systems;
e. a description of the organization’s utilization management program and how it is utilized to deliver
appropriate care;
f. a description of the processes for ongoing monitoring, evaluation and improvement of the quality of
health care services;
g. a description of the organization’s grievance system which includes the handling of appeals and
grievances;
h. identification of delegates and major subcontractors for delegated activities, and a description of each of
the delegated activities;
i. a description of the organization’s service authorization and referral requirements and what services are
required to be prior authorized, including requests for second opinions, out-of-network referrals and
procedures for continuity of care;
j. a description of the organization’s outreach efforts to individuals and minority populations to improve the
quality of their health care;
k. a description of the process for identifying individuals for case management/care coordination, identifying
individuals with special health care needs or chronic conditions;
l. a description of how the organization supports and works with local public health agencies and counties
on health care initiatives;
m. a description of the provider network and the process for how providers are included to ensure capacity
in terms of number, type , geographic distribution and adequacy in the areas of preventive, primary care,
and specialty care for the anticipated population. The plan should also address how the organization
provides for culturally appropriate services rendered by providers with special expertise in the delivery of
health care services to various cultural and racial minority groups;
n. a description of how the selection of network providers will be conducted and ensure network adequacy
will be achieved;
o. a description of any other processes the organization utilizes in the delivery of health care services; and
p. a description of how provider and enrollee satisfaction with care services and care delivery will be
assessed.
4. Professional Responsibility: It is crucial that the State locate reliable responders to serve our clients. The
successful responder must be professionally responsible. Therefore, responders must include a component that
provides satisfactory information regarding their professional responsibility.
Professional responsibility information includes providing information concerning any complaints filed with or by
professional and/or state or federal licensing/regulatory organizations within the past six years against your
organization or its employees relating to the provision of services. If such complaints exist, please include the date
of the complaint(s), the nature of the complaint(s), and the resolution/status of the complaint(s), including any
disciplinary actions taken.
This component must also include information about pending litigation and/or litigation resolved within the past
two years that relates to the provision of services by your organization and/or its employees. If such litigation
exists, please include the date of the lawsuit, nature of the lawsuit, and the dollar amount being requested as
damages, and if resolved, what the resolution was (e.g. settled, dismissed, withdrawn by plaintiff, verdict for
plaintiff with $x damages awarded, verdict for responder, etc.).
Responder should also submit information which demonstrates recognition of their professional responsibility.
This may include awards, certifications, and/or professional memberships.
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The information collected from these inquiries will be used in the State’s determination of the award of the
contract. It may be shared with other persons within the Minnesota Department of Human Services who may be
involved in the decision-making process, and/or with other persons as authorized by law. You are not required to
provide any of the above information. However, if you choose not to provide the requested information, your
organization’s proposal may be found nonresponsive and given no further consideration. The State reserves the
right to request any additional information to assure itself of a responder's professional status.
C. Required Statements
The responder may use the correlating forms or the identified link to complete the required statements in Section
C. However, for Appendices A, B, G, H, I and J you must use the templates/forms included in this RFP. The
correlating can be found in the DHS electronic documents (eDocs) library. To complete the fillable forms, right click
on the links below (in blue) and select “Copy Hyperlink” and paste into your web browser and click Enter.
Complete the form online and save the completed form. Submit the saved completed forms in the “Required
Statements” section of your proposal. You must use the current forms found in eDocs. Failure to use the most
current forms found in eDocs in the completion of the proposal are at the responder’s risk and may, at the
discretion of the State, result in disqualification of the proposal for “nonresponsiveness.”
1. Responder Information and Declarations – Appendix A: Complete and submit the attached “Responder
Information and Declarations” form. If you are required to submit additional information as a result of the
declarations, include the additional information as part of this form.
2. Exceptions to RFP Terms – Appendix B: The contents of this RFP, the model contract and the proposal(s) of the
successful responder(s) may be part of the final award. Each responder's proposal must include a statement of
acceptance of all terms and conditions stated within this RFP and model contract or provide a detailed statement
of exception for each item excepted by the responder. Responders who object to any condition of this RFP or
model contract must note the objection on Appendix B “Exceptions to RFP Terms” form. If a responder has no
objections to any terms or conditions, the responder should write “None” on the form.
Responder should carefully review the State’s model contract in which new provisions have been added since the
most recent negotiated contract. Much of the language reflected in the contract is required by statute. If you take
exception to any of the terms, conditions or language in the contract, you must indicate those exceptions in the
Appendix.
Responders are cautioned that any exceptions to the terms of the model contract which give the responder a
material advantage over other responders may result in the responder’s proposal being declared nonresponsive or
result in the reduction of points from the overall score. If there are exceptions noted below, the State will
determine if the exception(s) results in a rejection of the proposal or a reduction of five (5) points from the
overall Technical and Price Bid score., Proposals that take blanket exception to all or substantially all boilerplate
contract provisions will be considered nonresponsive proposals and rejected from further consideration for
contract award.
3. Affidavit of Noncollusion – Appendix C (Affidavit of Noncollusion Form- DHS-7021) : Each responder must
complete and submit the attached “Affidavit of Noncollusion” form.
4. Trade Secret/Confidential Data Notification – Appendix D (Trade Secret/Confidential Data Notice Form- DHS7015-ENG): All materials submitted in response to this RFP will become property of the State and will become
public record in accordance with Minnesota Statutes, section 13.591, after the evaluation process is completed.
Pursuant to the statute, completion of the evaluation process occurs when the government entity has completed
negotiating the contract with the successful responder. If a contract is awarded to the responder, the State must
have the right to use or disclose the trade secret data to the extent otherwise provided in the grant contract or by
law.
If the responder submits information in response to this RFP that it believes to be trade secret/confidential
materials, as defined by the Minnesota Government Data Practices Act, Minnesota Statutes, section 13.37, and the
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responder does not want such data used or disclosed for any purpose other than the evaluation of this proposal,
the responder must:
a. clearly mark every page of trade secret materials in its proposal at the time the proposal is submitted with the
words “TRADE SECRET” or “CONFIDENTIAL” in capitalized, underlined and bolded type that is at least 20 pt.; the
State does not assume liability for the use or disclosure of unmarked or unclearly marked trade secret/confidential
data;
b. fill out and submit the attached “Trade Secret/Confidential Information Notification Form,” specifying the
pages of the proposal which are to be restricted and justifying the trade secret designation for each item. If no
material is being designated as protected, a statement of “None” should be listed on the form;
c. satisfy the burden to justify any claim of trade secret/confidential information. In order for a trade secret claim
to be considered by the State, detailed justification that satisfies the statutory elements of Minnesota Statutes,
section and the factors discussed in Prairie Island Indian Community v. Minnesota Dept. of Public Safety, 658
N.W.2d 876, 884-89 (Minn.App.2003) must be provided. Use of generic trade secret language encompassing
substantial portions of the proposal or simple assertions of trade secret interest without substantive explanation
of the basis therefore will be regarded as nonresponsive requests for trade secret exception and will not be
considered by the State in the event of a data request is received for proposal information; and
d. defend any action seeking release of the materials it believes to be trade secret and/or confidential, and
indemnify and hold harmless the State, its agents and employees, from any judgments awarded against the State
in favor of the party requesting the materials, and any and all costs connected with that defense. This
indemnification survives the State’s award of a contract. In submitting a response to this RFP, the responder
agrees that this indemnification survives as long as the trade secret materials are in the possession of the State.
The State is required to keep all the basic documents related to its contracts, including selected responses to RFPs,
for a minimum of six years after the end of the contract. Non-selected RFP proposals will be kept by the State for a
minimum of one year after the award of a contract, and could potentially be kept for much longer.
The State reserves the right to reject a claim if it determines responder has not met the burden of establishing that
the information constitutes a trade secret or is confidential. The State will not consider prices or costs submitted
by the responder to be trade secret materials. Any decision by the State to disclose information designated by the
responder as trade secret/confidential will be made consistent with the Minnesota Government Data Practices Act
and other relevant laws and regulations. If certain information is found to constitute a trade secret/confidential,
the remainder of the Proposal will become public; only the trade secret/confidential information will be removed
and remain nonpublic.
The State also retains the right to use any or all system ideas presented in any proposal received in response to this
RFP unless the responder presents a positive statement of objection in the proposal. Exceptions to such responder
objections include: (1) public data, (2) ideas which were known to the State before submission of such proposal, or
(3) ideas which properly became known to the State thereafter through other sources or through acceptance of
the responder's proposal.
5. Human Rights Compliance– Appendix E (Affirmative Action Data Page- DHS-7016-ENG): For all contracts
estimated to be in excess of $100,000, Responders are required to complete and submit the attached “Affirmative
Action Data” page. As required by Minnesota Rules, part 5000.3600, “It is hereby agreed between the parties that
Minnesota Statutes, section 363A.36 and Minnesota Rules, parts 5000.3400 - 5000.3600 are incorporated into any
contract between these parties based upon this specification or any modification of it. A copy of Minnesota
Statutes, section 363A.36 and Minnesota Rules, parts 5000.3400 - 5000.3600 are available upon request from the
contracting agency.”
6. Certification Regarding Lobbying – Appendix F (Certificate Regarding Lobbying Form- DHS-7017-ENG): Federal
money will be used or may potentially be used to pay for all or part of the work under the contract, therefore the
responder must complete and submit the attached “Certification Regarding Lobbying” form.
7. Disclosure of Ownership – Appendix G – Federal law (42 CFR § 455.104) requires Managed Care Organizations
to submit disclosure information as indicated in Appendix G. The MCO should not have a director, officer, partner,
16
agents, managing employees or other Persons with a 5% or more Ownership or Control Interest in their business
entity, either directly or indirectly, if they are excluded from participation in Medicaid under §§ 1128 or 1128A of
the Social Security Act or have been convicted of a criminal offense related to that person's involvement in any
program under Medicare, Medicaid, or the Title XX services program.
See the Disclosure of Ownership in Appendix G.
8. Professional Responsibility Disclosure – Appendix H: The Successful Responder must be professionally
responsible. Therefore, Responders must include in their Proposals satisfactory information regarding their
professional responsibility.
9. Submission of Certified Financial Audit, IRS Form 990, or Most Recent Board-Reviewed Financial Statements –
Appendix I: The successful responder must be fiscally responsible. Therefore, responders must include in their
proposals sufficient financial documentation to establish their financial stability.
Depending on the responder’s annual income or how long the responder has been in business, a responder is
required to submit either a certified financial audit, IRS Form 990, or most recent board-reviewed financial
statements. A certified financial audit is a review of an organization’s financial statements, fiscal policies and
control procedures by an independent third party to determine if the statements fairly represent the
organization’s financial position and if organizational procedures are in accordance with Generally Accepted
Accounting Principles (GAAP). Minnesota nonprofit organizations are required to have a certified financial audit
completed for any fiscal year in which they have total revenue of more than $750,000. An IRS Form 990 is a federal
tax return for nonprofit organizations. Nonprofit organizations that are recognized as exempt from federal income
tax must file a Form 990 or Form 990 EZ if it has averaged more than $25,000 in annual gross receipts over the past
three tax years.
Responders must submit financial information as outlined below with their proposal:
a. Responders with an annual income of under $25,000 or who have not been in existence long enough to have an
audit or completed IRS Form 990 should submit their most recent board-reviewed financial statements.
b. Responders with total annual revenue of under $750,000 should submit their most recent IRS Form 990.
c. Grant applicants with total annual revenue of over $750,000 should submit their most recent certified financial
audit.
Responders may also include documentations of cash reserves to carry you through shortages or delays in receipt
of revenue, and/or other documents sufficient to substantiate responsible fiscal management. In the event a
responder is either substantially or wholly owned by another corporate entity, the proposal must also include the
most recent detailed financial report of the parent organization, and a written guarantee by the parent
organization that it will unconditionally guarantee performance by the responder in each and every term,
covenant, and condition of such contract as may be executed by the parties. Please also include information about
any pending major accusations that could affect your financial stability.
If the responder is a county government or a multi-county human services agency that has 1) had an audit in the
last year by the State Auditor or an outside auditing firm or 2) meets the requirements of the Single Audit Act, the
responder is not required to submit financial statements. However, the State reserves the right to request any
financial information to assure itself of a county’s financial status.
The information collected from these inquiries will be used in the State’s determination of the award of the
contract. It may be shared with other persons within the Minnesota Department of Human Services who may be
involved in the decision-making process, and/or with other persons as authorized by law. If you choose not to
provide the requested information, your organization’s proposal will found nonresponsive and given no further
consideration. The State reserves the right to request any additional information to assure itself of a responder's
financial reliability.
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10. MCO Enrollment Limit Declaration – Appendix J
Any limits placed on enrollment by the MCO should be indicated on the checklist in Appendix J.
11. Disclosure of Funding Form – Appendix K (Disclosure of Funding Form- DHS-7018-ENG)
Per the Federal Funding Accountability and Transparency Act of 2006 “Transparency Act” or “FFATA” (Public Law
109-282), all entities and organizations receiving federal funds are required to report full disclosure of funding
(United States Code, title 31, chapter 61, section 6101). The purpose of FFATA is to provide every American with
the ability to hold the government accountable for each spending decision. The end result is to reduce wasteful
spending in the government. The FFATA legislation requires information on federal awards to be made available to
the public through a single, searchable website. Federal awards include grants, sub-grants, loans, awards, and
delivery orders.
In order to comply with the federal statute, the Minnesota Department of Human Services is required to obtain
and report by the grantee’s Data Universal Numbering System (DUNS) number and determine if the grantee meets
specific requirement which would require additional reporting items and to collect additional information on
executive compensation if required. In order to comply with federal law and to collect this information,
responders are required to fill out the Disclosure of Funding Form and submit it with their response. The form
requires responders to provide their Data Universal Numbering System (DUNS) number. The Data Universal
Numbering System (DUNS) number is the nine-digit number established and assigned by Dun and Bradstreet, Inc.
(D&B) to uniquely identify business entities. If a responder does not already have a DUNS number, a number may
be obtained from the D&B by telephone (currently 866-705-5711) or the Internet (currently at
http://fedgov.dnb.com/webform). The responder must have a DUNS number before their response is submitted.
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IV. RFP Process
A. Timeline
ACTIVITY
State Register Notice – RFP Publication
Technical and Price Bid Responder’s
Conference Questions Received
RFP Technical and Price Bid
Responders’ Conference Registration
Deadline
Technical and Price Bid Responder’s
Conferences
All Technical RFP Questions Received
All Technical RFP Questions Answered
and Posted on DHS Website
Technical Proposals Due
Provide Data Book to MCOs
All Price Bid RFP Questions Received
Technical RFP Review Completed
All Price Bid RFP Questions Answered
and Posted on DHS Website
Resolutions from County Boards Due
Price Bid Proposal Due
Notice of Intent to Contract
PCNLs Due to Contract Manager for
Review
Contract Managers Review and
Approval
PCNL Supply Delivery Deadline
Open Enrollment
Access to Services
RFP COUNTIES
(Aitkin, Anoka, Becker, Beltrami, Benton, Big Stone, Blue
Earth, Brown, Carlton, Carver, Cass, Chippewa, Chisago, Clay,
Clearwater, Cook, Cottonwood, Crow Wing, Dakota, Dodge,
Douglas, Faribault, Fillmore, Freeborn, Goodhue, Grant,
Hennepin, Houston, Hubbard, Isanti, Itasca, Jackson, Kanabec,
Kandiyohi, Kittson, Koochiching, Lac Qui Parle, Lake, Lake Of The
Woods, Le Sueur, Lincoln, Lyon, Mahnomen, Marshall, Martin,
McLeod, Meeker, Mille Lacs, Morrison, Mower, Murray,
Nicollet, Nobles, Norman, Olmsted, Otter Tail, Pennington, Pine,
Pipestone, Polk, Pope, Ramsey, Red Lake, Redwood, Renville,
Rice, Rock, Roseau, St. Louis, Scott, Sherburne, Sibley, Stearns,
Steele, Stevens, Swift, Todd, Traverse, Wabasha, Wadena,
Waseca, Washington, Watonwan, Wilkin, Winona, Wright and
Yellow Medicine Counties)
Technical Bid
January 26, 2015
February 10, 2015
Price Bid
February 10, 2015
February 13, 2015
February 13, 2015
February 17, 2015
February 17, 2015
February 24, 2015
February 27, 2015
April 6, 2015
April 30, 2015
May 6, 2015
May 8, 2015
May 11, 2015
May 29, 2015
July 14, 2015
July 20, 2015
August 11, 2015
September 9, 2015
September 2015
January 1, 2016
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June 1, 2015
July 14, 2015
B. Access to the RFP
To access the RFP, click on the link below and go to the DHS public website on or after 12:00 noon (Central
Daylight Time) on January 26, 2015.
http://www.dhs.state.mn.us/id_000102
To obtain a paper copy of the RFP, use the above link. You may also access a copy of the RFP in a Microsoft
Word format from the link.
C. Responders’ Conferences
Responders’ Conference – Technical Proposal Requirements
The Responders’ Conference for technical requirements will be held on February 17, 2015 at 10 a.m., Room
2380, at the Elmer L. Andersen Human Services Building, 540 Cedar Street, St. Paul, MN. The conference will
serve as an opportunity for responders to ask specific questions of State staff concerning the RFP. Attendance
at the Responders’ Conference is mandatory. Registration is also mandatory. Please contact Jolayne Lange at
(651) 431-2502 or e-mail her at [email protected] by February 13, 2015 to register. Responders may
attend via conference call. Request the conference call information when you contact Jolayne to register.
Although you may attend by conference call, we cannot guarantee that you will be able to hear all of the
conversation. Therefore, we suggest that you attend the meeting in person. All written answers to questions
asked at the conference will be posted on the DHS Public website. Oral answers given at the conference are
non-binding.
Responders’ Conference – Price Bid Requirements
The Responders’ Conference for the Price Bid will be held on February 17, 2015 at 1:00 p.m., Room 2380, at
the Elmer L. Andersen Human Services Building, 540 Cedar Street, St. Paul, MN. The conference will serve as
an opportunity for responders to ask specific questions of State staff concerning the RFP. Attendance at the
Responders’ Conference is mandatory. Registration is mandatory. Please contact Jolayne Lange at (651)
431-2502 or e-mail her at [email protected] by February 13, 2015 to register. Responders may
attend via conference call. Request the conference call information when you contact Jolayne to register.
Although you may attend by conference call, we cannot guarantee that you will be able to hear all of the
conversation. Therefore, we suggest that you attend the meeting in person. All written answers to questions
asked at the conference will be posted on the DHS Public website. Oral answers given at the conference are
non-binding.
D. Responders’ Questions
All responders’ questions regarding the Technical Requirements for the RFP must be submitted by email prior
to 4:00 p.m. Central Daylight Time by February 24, 2015. All questions must be emailed to:
[email protected]. All written answers to questions will be posted on the DHS Public
website by February 27, 2015.
All responders’ questions regarding the Price Bid Requirements for the RFP must be submitted by email prior
to 4:00 p.m. Central Daylight Time by May 6, 2015. All questions must be emailed to:
[email protected]. All written answers to questions will be posted on the DHS Public
website by May 11, 2015.
Personnel other than the designated representatives are NOT authorized to discuss this RFP with responders
before the proposal submission deadlines for both the technical proposal and price bid. The designated
representatives for the technical proposal are Beryl Palmer and Pam Olson, and for the price bid, Jeff
Provance. You may contact them using the respective e-mail addresses above. Contact regarding this RFP
with any State personnel other than the designated representatives could result in disqualification.
20
The State will not be held responsible for oral responses to responders. Written answers to all Technical
Requirement questions will be posted on the DHS Public website no later than February 27, 2015. Written
answers to all Price Bid Requirement questions will be posted on the DHS Public website no later than May 11,
2015.
E. Proposal Submission
Submit one (1) original paper copy of the Technical Proposal along with a CD. The CD must contain a copy of
the Proposal in a PDF version with the capability to select and copy specific text from the PDF document. In
addition, a CD (or CDs) containing a complete proposal must be included for each county that the MCO is
including in the proposal. Technical Proposals must be physically received (not postmarked) by 4:00 p.m.
Central Daylight Time on April 6, 2015 to be considered.
Clearly label the “Proposal – Original” and CD(s) with the RFP name and submission due date for this RFP. If
there is more than one CD, please indicate that by marking the CDs as 1 of 2. The Proposal, including the
required electronic copies, must be submitted in a single sealed package or container. The original proposal
should be submitted in a three-ring binder or spiral bound binder with each section indexed with tabs. The
main body of the Proposal pages must be numbered and submitted in 12-point font on 8 ½ X 11 inch paper,
single spaced. The size and/or style of graphics, tabs, attachments, margin notes/highlights, etc. are not
restricted by this RFP and their use and style are at the responder’s discretion. The proposals submitted on
CD(s) must be bookmarked to indicate RFP sections.
Technical Proposals must be addressed to:
Request for Proposal Response
Attention: Beryl Palmer/Pam Olson
Purchasing and Service Delivery Division
Department of Human Services
444 Lafayette Road N.
St. Paul, MN 55101
Submit one (1) original paper copy of the Price Bid Proposal along with a CD with the Price Bid Proposal in
Excel with the capability to select and copy specific text from the PDF document. Price Bid Instructions and
template will include instructions and specifications and any additional information regarding submission of
the Price Bid Proposal. Price Bids must be physically received (not postmarked) by 4:00 p.m. Central Daylight
Time on June 1, 2015 to be considered.
Price Bid Proposal must be addressed to:
Request for Proposal Price Bid Response
Attention: Jeff Provance
Purchasing and Service Delivery Division
Department of Human Services
444 Lafayette Road N.
St. Paul, MN 55101
Late Technical or Price Bid Proposals will not be considered and will be returned unopened to the submitting
party. Faxed or e-mailed Proposals will not be accepted.
The above-referenced packages and all correspondence related to this RFP must be delivered in accordance
with the instructions above.
It is solely the responsibility of each responder to assure that their proposal is delivered at the specific place,
in the specific format, and prior to the deadline for submission. Failure to abide by these instructions for
submitting proposals may result in the disqualification of any non-complying proposal.
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V. Proposal Evaluation and Selection
A. Overview of Evaluation Methodology
1. All responsive proposals received by the deadline will be evaluated by the State. Proposals will be
evaluated on “best value” as specified below, using a 100 point scale. The evaluation will be conducted in
three phases:
a. Phase I Required Statements Review
b. Phase II Evaluation of Proposal Requirements
c. Phase III Selection of the Successful Responder(s)
2. During the evaluation process, all information concerning the proposals submitted, except identity and
address, will remain non-public and will not be disclosed to anyone whose official duties do not require such
knowledge.
3. Nonselection of any proposals will mean that either another proposal(s) was determined to be more
advantageous to the State or that the State exercised the right to reject any or all Proposals.
B. Evaluation Team
State staff will select evaluators for the evaluation team to review and evaluate RFP responses. Each county
will also select a representative(s) that will participate on the evaluation team. State and professional staff,
other than the evaluation team, may also assist in the State’s evaluation process. The State reserves the right
to alter the composition of the evaluation team and their specific responsibilities.
The State as a participant in the federal Medicaid program must safeguard against conflicts of interest in the
Medicaid procurement process. See U.S. Code, title 42, sections 1396a(a)(4) and 1396u-2(d)(3); Minnesota
Statutes, section 256B.0914. The State must ensure that a person who participates in the evaluation of the
RFP responses does not have a conflict of interest. Therefore, all evaluators and other staff will be required to
sign a conflict of interest statement and confidentiality agreement in order to participate as a member of the
evaluation team.
County representatives who participate on the RFP evaluation team may not:
• be or have been involved in discussions regarding becoming a member of a county-based
purchasing entity;
• be or have been involved in direct or indirect negotiations with an MCO;
• disclose contractor bid or proposal information, or source selection information, as defined in
Minnesota Statutes, section 256B.0914, before the award decision has been made by the
State. (This prohibition against disclosure does not apply to discussions between evaluation team
members as part of the deliberative process, or as otherwise permitted by law.)
• disclose proprietary, aka “trade secret” information (see Minnesota Statutes, section 13.37), even
after the award decision, unless permitted by law.
• extend an offer or accept employment by procurement responders and bid evaluators,
respectively.
Pursuant to Minnesota Statutes, section 256B.0914: Failure to abide by the above restrictions could result in
criminal prosecutions or a fine of $50,000, or both, for each violation.
The county in seeking MCO(s) to provide services to eligible individuals within the county plays an important role in
the development, approval and issuance of the RFP. The county also has the opportunity to review each proposal
based on the identification of community needs and county advocacy activities, and can advise the State on the
approval of local networks and their operations to ensure adequate availability and access to covered services.
22
Counties are delegated the duty of developing the county sections of the RFP including identification of service
delivery and access issues as described in Appendix N: County Exhibits. Please note that county information will
need to be addressed as part of the RFP response.
C. Evaluation Process
Evaluation of RFP responses include, but are not limited to, the following:
1) Assessment of the proposal requirements.
2) Assessment of responder’s provider network.
3) Assessment of responses to county and state sections, quality measures, and health care reform initiatives.
4) Evaluation of Price Bids.
Any dispute between the State and the counties about the MCO selection process will be reviewed by a three
person mediation panel as provided in Minnesota Statutes, section 256B.69, subd. 3a(d). The Commissioner of the
Minnesota Department of Human Services will resolve any disputes taking into account the recommendations of
this panel.
D. Evaluation Phases
At any time during the evaluation phases, the State may, at the State’s discretion, contact a responder to (1)
provide further or missing information or clarification of their proposal, (2) provide an oral presentation of their
proposal, or (3) obtain the opportunity to interview the proposed key personnel. Reference checks may also be
made at this time. However, there is no guarantee that the State will look for information or clarification outside
of the submitted written proposal. Therefore, it is important that the responder ensure that all sections of the
proposal have been completed to avoid the possibility of failing an evaluation phase or having their score reduced
for lack of information.
1. Phase I: Required Statements Review (Appendices A-K)
The Required Statements will be evaluated on a pass or fail basis. Responders must "pass" each of the
requirements identified in these sections to move to Phase II.
2. Phase II: Evaluation of Technical Requirements
a. Points have been assigned to components of the technical proposal. The total possible points for these
components are as follows:
Component
i. Executive Summary
ii. Description of the Applicant
Organization
iii. Service Delivery Plan
iv. Appendix M: Assurances
v. Appendix N: County Exhibits
vi. Appendix O: State Exhibits
vii. Appendix P: Quality of Care
and Services Evaluation
viii. Appendix Q: Health Care
Reform Initiatives
ix. Appendix R: Provider Network
MDH Review
County Limited Review
x. Price Bid
Total:
Total Possible Points
P/F
P/F
P/F
P/F
15
10
5
10
10
5
45
100
23
b. Technical Evaluation: The evaluation team will review the components of each responsive Technical Proposal
submitted. Each component will be evaluated on the responder's understanding, and the quality and
completeness of the responder's approach and solution to the problems or issues presented.
After reviewing the Proposals, the members of the evaluation team will rate each Proposal component using the
following formula:
Each Proposal component will receive one of the following ratings based on how well the component met the RFP
requirements. Upon determining which of the following ratings best describes the component being rated, the
total possible points available for the component will be multiplied by the corresponding point factor.
Component Rating
Excellent
Very Good
Good
Fair
Poor
Point Factor to be Applied to Total
Possible Points
1
.75
.50
.25
0
Other factors upon which the proposals will be evaluated by the State include, but are not limited to, the
following:
•
•
•
•
•
•
•
•
Whether the organization meets the State Plan definition of an MCO.
Qualifications of the organization and its personnel.
Can serve most or all of the counties in the geographic area.
Ability to accept all enrollment for the county.
Demonstrate the ability to integrate health services with community, public health, and social services.
Completeness of the response and ability to meet all requirements contained in this RFP, which includes
providing all services and tasks required in the model contract.
MCO’s ability to provide accessible, quality, and timely medical care to MA and MinnesotaCare recipients.
Number of potential responders(s) and availability of providers in the responder’s service areas.
c. Evaluation of Price Bid Proposals
i. The Price Bid Proposals will be examined to determine if they are complete, in compliance with the
requirements of this RFP, accurate in their calculation, and consistent with their technical counterpart. Any
Price Proposal that does not meet these criteria may be considered nonresponsive and rejected.
ii. Evaluation criteria for the Price Bid component will be made available prior to the Price Bid Responders’
Conference and will be included in the Price Bid template. Points for the Price Bid Proposal will be awarded
as follows:
Price Bid Component
Price Bid
Total Possible Points
45 points
iii. The evaluation team reserves the right to reject unreasonable costs proposed by Responders. Specifically,
the evaluation team will not consider any proposed costs that are, at the sole discretion of the State, not
rational or are not competitively priced. Such Proposals will be regarded as nonresponsive and receive no
further consideration.
d. Evaluation of Responder’s Exception to Terms of the RFP or Model Contract
i. A responder’s exception to the State’s terms and conditions (including those found in the attached model
contract) is subject to evaluation and a reduction in the final score of the RFP proposal.
24
ii. RESPONDERS ARE CAUTIONED THAT BY TAKING ANY EXCEPTION THEY MAY BE MATERIALLY DEVIATING
FROM THE RFP SPECIFICATIONS. IF A RESPONDER MATERIALLY DEVIATES FROM A RFP SPECIFICATION,
THE PROPOSAL MAY BE REJECTED.
iii. Any material deviation to a specification by a responder which 1) affords the responder taking the exception
a competitive advantage over other responders, or 2) gives the State something significantly different than
the State requested will affect the responder’s overall total score.
iv. A deduction of five (5) points will be deducted from the overall Technical and Price Bid score for any
exception to the State’s terms and conditions (including those found in the attached model contract on
page 10) that is listed by the responder in Appendix B: Exceptions to Terms and Conditions.
3. Phase III: Selection of the Successful Responder(s)
a. Only the proposals found to be responsive under Phases I and II will be considered in Phase III.
b. The evaluation team will review the scoring in making its recommendations of the successful responder(s).
c. The State may submit a list of detailed comments, questions, and concerns to one or more responders after the
initial evaluation. The State may require said response to be written, oral, or both. The State will only use written
responses for evaluation purposes. The total scores for those responders selected to submit additional
information may be revised as a result of the new information.
d. The evaluation team will make its recommendation based on the above-described evaluation process. A notice
of intent to contract will be issued no later than July 14, 2015.
E. Contract Negotiations and Unsuccessful Responder Notice
If a responder(s) is selected, the State will notify the successful responder(s) in writing of their selection and the
State’s desire to enter into contract negotiations. Until the State successfully completes negotiations with the
selected responder(s), all submitted proposals remain eligible for selection by the State.
In the event contract negotiations are unsuccessful with the selected responder(s), the evaluation team may
recommend another responder(s.
After the State and chosen responder(s) have successfully negotiated a contract, the State will notify the
unsuccessful responders in writing that their proposals have not been accepted. All public information within
proposals will then be available for responders to review, upon request.
VI. Required Contract Terms and Conditions
A. Requirements. All responders must be willing to comply with all state and federal legal requirements regarding
the performance of the grant contract. The requirements are set forth throughout this RFP and are contained in
the attached grant contract in the Appendix.
B. Governing Law/Venue. This RFP and any subsequent contract must be governed by the laws of the State of
Minnesota. Any and all legal proceedings arising from this RFP or any resulting contract in which the State is made
a party must be brought in the State of Minnesota, District Court of Ramsey County. The venue of any federal
action or proceeding arising here from in which the State is a party must be the United States District Court for the
State of Minnesota.
C. Travel. Reimbursement for travel and subsistence expenses actually and necessarily incurred by the grantee as a
result of the grant contract will be in no greater amount than provided in the current "Commissioner’s Plan”
promulgated by the commissioner of Minnesota Management and Budget. Reimbursements will not be made for
travel and subsistence expenses incurred outside Minnesota unless it has received the State’s prior written
approval for out of state travel. Minnesota will be considered the home state for determining whether travel is
out-of-state.
25
D. Preparation Costs. The State is not liable for any cost incurred by Responders in the preparation and production
of a proposal. Any work performed prior to the issuance of a fully executed grant contact will be done only to the
extent the responder voluntarily assumes risk of non-payment.
E. Contingency Fees Prohibited. Pursuant to Minnesota Statutes, section 10A.06, no person may act as or employ
a lobbyist for compensation that is dependent upon the result or outcome of any legislation or administrative
action.
F. Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion. Federal money will be
used or may potentially be used to pay for all or part of the work under the contract, therefore the responder must
certify the following, as required by the regulations implementing Executive Order 12549.
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -- Lower Tier Covered
Transactions
Instructions for Certification
1. By signing and submitting this proposal, the prospective lower tier participant is providing the certification set
out below.
2. The certification in this clause is a material representation of fact upon which reliance was placed when this
transaction was entered into. If it is later determined that the prospective lower tier participant knowingly
rendered an erroneous certification, in addition to other remedies available to the federal government, the
department or agency with which this transaction originated may pursue available remedies, including suspension
and/or debarment.
3. The prospective lower tier participant shall provide immediate written notice to the person to which this
proposal is submitted if at any time the prospective lower tier participant learns that its certification was
erroneous when submitted or had become erroneous by reason of changed circumstances.
4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant,
person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the
meaning set out in the Definitions and Coverages sections of rules implementing Executive Order 12549. You may
contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations.
5. The prospective lower tier participant agrees by submitting this response that, should the proposed covered
transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who
is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, or
voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency
with which this transaction originated.
6. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause
titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Lower Tier Covered
Transaction,” without modification, in all lower tier covered transactions and in all solicitations for lower tier
covered transactions.
7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier
covered transaction that it is not proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred,
suspended, ineligible, or voluntarily excluded from covered transactions, unless it knows that the certification is
erroneous. A participant may decide the method and frequency by which it determines the eligibility of its
principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal
Procurement and Nonprocurement Programs.
8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order
to render in good faith the certification required by this clause. The knowledge and information of a participant is
26
not required to exceed that which is normally possessed by a prudent person in the ordinary course of business
dealings.
9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered
transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment
under 48 C.F.R. 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this
transaction, in addition to other remedies available to the federal government, the department or agency with
which this transaction originated may pursue available remedies, including suspension and/or debarment.
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered
Transactions
1. The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is
presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
participation in this transaction by any Federal department or agency.
2. Where the prospective lower tier participant is unable to certify to any of the statements in this certification,
such prospective participant shall attach an explanation to this proposal.
G. Insurance Requirements
1. Responder shall not commence work under the grant contract until they have obtained all the insurance
described below and the State of Minnesota has approved such insurance. All policies and certificates shall
provide that the policies shall remain in force and effect throughout the term of the grant contract.
2. Responder is required to maintain and furnish satisfactory evidence of the following insurance policies:
a. Workers’ Compensation Insurance: Except as provided below, responder must provide Workers’ Compensation
insurance for all its employees and, in case any work is subcontracted, responder will require the subcontractor to
provide Workers’ Compensation insurance in accordance with the statutory requirements of the State of
Minnesota, including Coverage B, Employer’s Liability. Insurance minimum amounts are as follows:
$100,000 – Bodily Injury by Disease per employee
$500,000 – Bodily Injury by Disease aggregate
$100,000 – Bodily Injury by Accident
If Minnesota Statute, section 176.041 exempts responder from Workers’ Compensation insurance or if the
responder has no employees in the State of Minnesota, responder must provide a written statement, signed by an
authorized representative, indicating the qualifying exemption that excludes responder from the Minnesota
Workers’ Compensation requirements.
If during the course of the grant contract the responder becomes eligible for Workers’ Compensation, the
responder must comply with the Workers’ Compensation Insurance requirements herein and provide the State of
Minnesota with a certificate of insurance
b. Commercial General Liability: Responder is required to maintain insurance protecting it from claims for
damages for bodily injury, including sickness or disease, death, and for care and loss of services as well as from
claims for property damage, including loss of use which may arise from operations under the grant contract
whether the operations are by the responder or by a subcontractor or by anyone directly or indirectly employed by
the responder under the grant contract. Insurance minimum amounts are as follows:
$2,000,000 – per occurrence
$2,000,000 – annual aggregate
$2,000,000 – annual aggregate – Products/Completed Operations
The following coverages shall be included:
27
Premises and Operations Bodily Injury and Property Damage
Personal and Advertising Injury
Blanket Contractual Liability
Products and Completed Operations Liability
Other; if applicable, please list______________________.
State of Minnesota named as an Additional Insured, to the extent permitted by law.
c. Commercial Automobile Liability: Responder is required to maintain insurance protecting the responder from
claims for damages for bodily injury as well as from claims for property damage resulting from ownership,
operation, maintenance or use of all owned, hired, and non-owned autos which may arise from operations under
this grant contract, and in case any work is subcontracted the responder will require the subcontractor to provide
Commercial Automobile Liability. Insurance minimum amounts are as follows:
$2,000,000 – per occurrence Combined Single limit for Bodily Injury and Property Damage
In addition, the following coverages should be included:
Owned, Hired, and Non-owned Automobile
d. Professional/Technical, Errors and Omissions, and/or Miscellaneous Liability Insurance (if applicable)
This policy will provide coverage for all claims the responder may become legally obligated to pay resulting from
any actual or alleged negligent act, error, or omission related to responder’s professional services required under
the grant contract.
Responder is required to carry the following minimum amounts:
$2,000,000 – per claim or event
$2,000,000 – annual aggregate
Any deductible will be the sole responsibility of the responder and may not exceed $50,000 without the written
approval of the State. If the responder desires authority from the State to have a deductible in a higher amount,
the responder shall so request in writing, specifying the amount of the desired deductible and providing financial
documentation by submitting the most current audited financial statements so that the State can ascertain the
ability of the responder to cover the deductible from its own resources.
The retroactive or prior acts date of such coverage shall not be after the effective date of this grant contract and
responder shall maintain such insurance for a period of at least three (3) years, following completion of the work.
If responder discontinues such insurance, then extended reporting period coverage must be purchased to fulfill
this requirement.
e. Blanket Employee Theft/Employee Dishonesty Insurance
Responder is required to obtain a blanket employee theft/employee dishonesty policy in at least the total amount
of the first year’s grant award as either an addendum on its property insurance policy, or if it is not feasible to
include it as an addendum to a property insurance policy, as a stand-alone employee theft/employee dishonesty
policy. The State will be named as both a joint payee and a certificate holder on the property insurance policy
addendum or on the stand-alone employee theft/employee dishonesty policy, whichever is applicable. Only in
cases in which the first year’s grant award exceeds the available employee theft/employee dishonesty coverage
may responders provide blanket employee theft/employee dishonesty insurance in an amount equal to either 25%
of the yearly grant amount, or the first quarterly advance amount, whichever is greater. Upon execution of a grant
contract, the responder must furnish the State with a certificate of employee theft/employee dishonesty
insurance. This requirement does not apply to grant contracts with the University of Minnesota, counties, school
districts or reservations.
28
3. Additional Insurance Conditions:
• Responder’s policy(ies) shall be primary insurance to any other valid and collectible insurance available to the
State of Minnesota with respect to any claim arising out of responder’s performance under this grant contract;
• If responder receives a cancellation notice from an insurance carrier affording coverage herein, responder agrees
to notify the State of Minnesota within five (5) business days with a copy of the cancellation notice, unless
responder’s policy(ies) contain a provision that coverage afforded under the policy(ies) will not be cancelled
without at least thirty (30) days advance written notice to the State of Minnesota;
• Responder is responsible for payment of grant contract related insurance premiums and deductibles;
• If Responder is self-insured, a Certificate of Self-Insurance must be attached;
• Include legal defense fees in addition to its liability policy limits, with the exception of V.G.2.d. above; and
• Obtain insurance policies from an insurance company having an “AM BEST” rating of A- (minus); Financial Size
Category (FSC) VII or better and must be authorized to do business in the State of Minnesota; and
• An Umbrella or Excess Liability insurance policy may be used to supplement the responder’s policy limits to
satisfy the full policy limits required by the grant contract.
4. The State reserves the right to immediately terminate the grant contract if the responder is not in compliance
with the insurance requirements and retains all rights to pursue any legal remedies against the responder. All
insurance policies must be open to inspection by the State, and copies of policies must be submitted to the State’s
authorized representative upon written request.
5. The successful responder is required to submit Certificates of Insurance acceptable to the State of Minnesota as
evidence of insurance coverage requirements prior to commencing work under the grant contract. This
information will be required from the responder when the Intent to Contract letter is issued.
H. Contingency of Operations Planning Requirement
Functions identified under this request for proposal have been designated as Priority 1 or Priority 2 services under
the Minnesota Department of Human Service’s Continuity of Operations Plan. Due to this designation, the
successful responder will be required to develop a contingency of operations plan to be implemented in the event
of a gubernatorial or commissioner of the Minnesota Department of Health declared health emergency. The
successful responder will be expected to have a contingency of operations plan available for inspection by the
State upon request. The contingency of operations plan shall do the following:
(a) ensure fulfillment of Priority 1 or Priority 2 obligations under the contract;
(b) outline procedures for the activation of the contingency plan upon the occurrence of a governor or
commissioner of the Minnesota Department of Health declared health emergency;
(c) identify an individual as its Emergency Preparedness Response Coordinator (EPRC), the EPRC shall serve as the
contact for the State with regard to emergency preparedness and response issues, the EPRC shall provide updates
to the State as the health emergency unfolds;
(d) outline roles, command structure, decision making processes, and emergency action procedures that will be
implemented upon the occurrence of a health emergency;
(e) provide alternative operating plans for Priority 1 or Priority 2 functions;
(f) include a procedure for returning to normal operations; and
(g) be available for inspection upon request.
29
I. Accessibility Standards
Any information systems, tools, information content, and/or work products, including the response to this
solicitation/contract, applications, web sites, video, learning modules, webinars, presentations, etc., whether
commercial, off-the-shelf (COTS) or custom, purchased or developed, must comply with the Minnesota IT
Accessibility Standards effective September 1, 2010, as updated on October 3, 2013. This standard requires in part,
compliance with the Web Content Accessibility Guidelines (WCAG) 2.0 (Level AA) and Section 508 Subparts A-D.
Information technology deliverables and services offered must comply with the MN.IT Services Accessibility
Standards. The relevant requirements are contained under the “Standards” tab. Information technology
deliverables or services that do not meet the required number of standards or the specific standards required may
be rejected and may not receive further consideration.
VII. State’s Rights Reserved
Notwithstanding anything to the contrary, the State reserves the right to:
A. Reject any and all proposals received in response to this RFP;
B. Disqualify any responder whose conduct or proposal fails to conform to the requirements of this RFP;
C. Have unlimited rights to duplicate all materials submitted for purposes of RFP evaluation, and duplicate all
public information in response to data requests regarding the proposal;
D. Select for contract or for negotiations a proposal other than that with the lowest cost or the highest evaluation
score;
E. Consider a late modification of a proposal if the proposal itself was submitted on time and if the modifications
were requested by the State and the modifications make the terms of the proposal more favorable to the State,
and accept such proposal as modified;
F. At its sole discretion, reserve the right to waive any non-material deviations from the requirements and
procedures of this RFP;
G. Negotiate as to any aspect of the proposal with any responder and negotiate with more than one responder at
the same time, including asking for responders’ “Best and Final” offers;
H. Extend the grant contract, in increments determined by the State, not to exceed a total contract term of five
years; and
I. Cancel the RFP at any time and for any reason with no cost or penalty to the State.
J. Correct or amend the RFP at any time with no cost or penalty to the State. If the State should correct or amend
any segment of the RFP after submission of proposals and prior to announcement of the successful responder, all
responders will be afforded ample opportunity to revise their proposal to accommodate the RFP amendment and
the dates for submission of revised proposals announced at that time. The State will not be liable for any errors in
the RFP or other responses related to the RFP.
30
VIII. APPENDICES (A-S)
Remainder of the page intentionally left blank. (Appendices to follow)
31
APPENDIX A - Responder Information/Declarations
REQUEST FOR PROPOSALS
STATE OF MINNESOTA
PREPAID HEALTH CARE
Face Sheet: Required Information
Name of Responder:
_______________________________________________
Principal Place of Business:
Address: ________________________________________________________________________
City: _________________________________State ______________Zip Code: ______________
Name of Contact Person:
Title: _____________________________
Telephone Number: ______________
Name of Contact Person for Contract Selection Notification (If different from above):
Title: ______________________________
Telephone Number: ______________
Address: _________________________________________________________________________
Federal Employer's I.D. Number:
Check the applicable boxes for the license held by your MCO:
 HMO
CISN
Other(Explain) _________________________________________
TECHNICAL PROPOSAL DEADLINE: April 6, 2015 at 4:00 p.m. Central Time
PRICE BID PROPOSAL DEADLINE: June 1, 2015 at 4:00 p.m. Central Time
We hereby agree to furnish services in accordance with the specifications contained in this Request
for Proposals.
Company Name: ________________________________________________________________
Authorized Signature: ____________________________________________________________
Title: ___________________________________________________________________________
Telephone Number (Including Area Code): ___________________________________________
32
REQUEST FOR PROPOSALS
STATE OF MINNESOTA
PREPAID HEALTH CARE
Face Sheet: Required Information
Name of Responder Organization: ___________________________________________________
Check the applicable boxes for the counties within the responder’s current service areas, and the
counties the responder is proposing to serve in this proposal.
Licensed
Proposing
County
Aitkin
Anoka
Becker
Beltrami
Benton
Big Stone
Blue Earth
Brown
Carlton
Carver
Cass
Chippewa
Chisago
Clay
Clearwater
Cook
Cottonwood
Crow Wing
Dakota
Dodge
Douglas
Faribault
Fillmore
Freeborn
Goodhue
Grant
Hennepin
Houston
Hubbard
Isanti
Itasca
Jackson
Kanabec
Kandiyohi
Kittson
Koochiching
Lac qui Parle
Lake
Lake Of The Woods
33
Licensed
Proposing
County
Le Sueur
Lincoln
Lyon
Mahnomen
Marshall
Martin
McLeod
Meeker
Mille Lacs
Morrison
Mower
Murray
Nicollet
Nobles
Norman
Olmsted
Otter Tail
Pennington
Pine
Pipestone
Polk
Pope
Ramsey
Red Lake
Redwood
Renville
Rice
Rock
Roseau
St. Louis
Scott
Sherburne
Sibley
Stearns
Steele
Stevens
Swift
Todd
Traverse
Wabasha
Wadena
Waseca
Washington
34
Licensed
Proposing
County
Watonwan
Wilkin
Winona
Wright
Yellow Medicine
Name(s) of individuals involved with the preparation of this Proposal:
By submission of this Proposal, the responder warrants that:
1. The information provided is true, correct and reliable for purposes of evaluation for potential contract
award. Responder understands that the submission of inaccurate or misleading information may be
grounds for disqualification from the award as well as subject the responder to suspension or
debarment proceedings as well as other remedies available by law.
2. It is competent to provide all the services set forth in its Proposal.
3. Each person signing a section of this Proposal is authorized to make decisions as to the prices quoted
and/or duties proposed and is legally authorized to bind the company to those decisions.
4. If it has relationships that create, or appear to create, a conflict of interest with the work that is
contemplated in this request for proposals, responder will provide, along with this form, a list containing
the names of the entities, the relationship, and a discussion of the conflict.
5. To the best of its knowledge and belief, and except as otherwise disclosed, there are no relevant facts or
circumstances which could give rise to organizational conflicts of interest. An organizational conflict of
interest exists when, because of existing or planned activities or because of relationships with other
persons, a vendor is unable or potentially unable to render impartial assistance or advice to the State, or
the vendor’s objectivity in performing the contract work is or might be otherwise impaired, or the
vendor has an unfair competitive advantage. Responder agrees that, if after award, an organizational
conflict of interest is discovered, an immediate and full disclosure in writing will be made to the
Assistant Director of the Department of Administration’s Materials Management Division (“MMD”)
which will include a description of the action which responder has taken or proposes to take to avoid or
mitigate such conflicts. If an organization conflict of interest is determined to exist, the State may, at its
discretion, cancel the contract. In the event the responder was aware of an organizational conflict of
interest prior to the award of the contract and did not disclose the conflict to MMD, the State may
terminate the contract for default. The provisions of this clause must be included in all subcontracts for
35
work to be performed similar to the service provided by the prime contractor, and the terms “contract,”
“contractor,” and “contracting officer” modified appropriately to preserve the State’s rights.
6. No attempt has been made or will be made by responder to induce any other person or firm to submit
or not to submit a Proposal.
6. If there is a reasonable expectation that the responder is or would be associated with any parent,
affiliate, or subsidiary organization in order to supply any service, supplies or equipment to comply with
the performance requirements under the resulting contract of the RFP, responder must include with this
form written authorization from the parent, affiliate, or subsidiary organization granting the right to
examine directly, pertinent books, documents, papers, and records involving such transactions that are
related to the resulting contract. This right will be given to the Minnesota Department of Human
Services, U.S. Department of Health and Human Services, and Comptroller General of the United States.
7. If, at any time after a Proposal is submitted and a contract has been awarded, such an association arises
as described in the paragraph above, responder will obtain a similar certification and authorization from
the parent, affiliate, or subsidiary organization within ten (10) working days after forming the
relationship.
By signing this statement, you certify that the information provided is accurate and that you are authorized to sign
on behalf of, and legally bind, the responder.
Authorized Signature: ____________________________________________________________________
Printed Name:
_____________________________________________________________________
Title:
_____________________________________________________________________
Date:__________________________ Telephone Number:________________________________________
36
APPENDIX B - EXCEPTIONS TO TERMS AND CONDITIONS
A responder shall be presumed to be in agreement with the terms and conditions of the RFP and the
attached model contract unless the responder takes specific exception to one or more of the conditions
on this form.
RESPONDERS ARE CAUTIONED THAT BY TAKING ANY EXCEPTION THEY MAY BE MATERIALLY
DEVIATING FROM THE RFP SPECIFICATIONS OR CONTRACT TERMS. IF A RESPONDER MATERIALLY
DEVIATES FROM A RFP SPECIFICATION OR CONTRACT TERM, ITS PROPOSAL MAY BE REJECTED OR
POINTS REDUCED FROM THE RESPONDER’S OVERALL SCORE IF THERE ARE EXCEPTIONS NOTED
BELOW, THE STATE WILL DETERMINE IF THE EXCEPTION(S) RESULT IN A REJECTION OF THE PROPOSAL
OR A REDUCTION OF FIVE (5) POINTS FROM THE OVERALL TECHNICAL AND PRICE BID SCORE.
A material deviation is an exception to a specification or term which 1) affords the responder taking the
exception a competitive advantage over other responders, or 2) gives the State something significantly
different than the State requested.
INSTRUCTIONS: Responders must explicitly list all exceptions to State terms and conditions (including
those found in the attached model contract on page 10), if any. Reference the actual number of the
State's term and condition and page number for which an exception(s) is being taken. If no exceptions
exist, state "NONE" specifically on the form below. Whether or not exceptions are taken, the responder
must sign and date this form and submit it as part of their Proposal. (Add additional pages if necessary.)
Responder Name:
Term & Condition
Number/Provision
Explanation of Exception
By signing this form, I acknowledge that the above named responder accepts, without qualification, all
terms and conditions stated in this RFP including the sample contract except those clearly outlined as
exceptions above.
________________________________
Signature
________________________________
Printed Name
______________________
Title
37
_________________
Date
APPENDIX C - AFFIDAVIT OF NONCOLLUSION
I swear (or affirm) under the penalty of perjury:
1.
That I am the responder (if the responder is an individual), a partner in the company (if the
responder is a partnership), or an officer or employee of the responding corporation having
authority to sign on its behalf (if the responder is a corporation);
2.
That the attached Proposal submitted in response to the ______________________ _____
Request for Proposals has been arrived at by the responder independently and has been
submitted without collusion with and without any agreement, understanding or planned
common course of action with, any other responder of materials, supplies, equipment or
services described in the Request for Proposal, designed to limit fair and open competition;
3.
That the contents of the Proposal have not been communicated by the responder or its
employees or agents to any person not an employee or agent of the responder and will not be
communicated to any such persons prior to the official opening of the Proposals; and
4.
That I am fully informed regarding the accuracy of the statements made in this affidavit.
Responder’s Firm Name: ___________________________________________
Authorized Signature: _____________________________________________
Date: __________________
Subscribed and sworn to me this ________ day of ___________
____________________________________________
Notary Public
My commission expires: ______________
38
APPENDIX D - Trade Secret/Confidential Data Notice
Responder/Company Name: _____________________________________________________________
It is the position of the above-named responder that certain data contained in the following page(s) of
the attached Proposal have been submitted in confidence and contain trade secrets and/or privileged or
confidential information (list pages -- If no protected information has been submitted, state “NONE”):
____________________________________________________________________________________
The justification for the Trade Secret/Confidential data designation is (be specific, do not make general
statements of confidentiality. Include reference to specific facts, licenses, trademarks, etc., and any
relevant statutes or other law, such as how the data meets the requirements of Minn. Stat. §13.37, subd.
1(b). Add additional pages if necessary):
_____________________________________________________________________________________
_____________________________________________________________________________________
The responder acknowledges that, in accordance with Minn. Stat. §§ 13.591 and 16C.06, Subd. 3, upon
completion of contract negotiations, all materials submitted in response to this RFP will become the
property of the STATE and will become public record, with the exception of any portion(s) of an RFP or
supporting data that are determined to be nonpublic “trade secret information.”
The responder asserts that it has clearly marked every page of trade secret or confidential materials in
the attached Proposal at the time the Proposal was submitted with the words “TRADE SECRET” or
“CONFIDENTIAL” in capitalized, underlined and bolded type that is at least 20 pt. Responder
acknowledges that the State is not liable for the use or disclosure of trade secret data or confidential
data that Responder has failed to clearly mark as such.
Responder agrees to defend any action seeking release of the materials it believes to be trade secret or
confidential, and indemnify and hold harmless the STATE, its agents and employees, from any
judgments awarded against the STATE in favor of the party requesting the materials, and any and all
reasonable costs connected with that defense. This indemnification survives the STATE’s award of a
contract and remains as long as the trade secret and/or confidential materials are in the possession of
the STATE.
Responder acknowledges that the STATE is required to keep all the basic documents related to its
contracts, including selected responses to RFPs, for a minimum of six years after the end of the contract.
Non-selected RFP Proposals will be kept by the STATE for a minimum of one year after the award of a
contract, and may be kept for much longer. Responder acknowledges that prices submitted by the
responder will not be considered trade secret materials.
The responder acknowledges that the STATE reserves the right to reject responder’s claim of trade
secret/confidential data if the STATE determines that the responder has not met the legal burden of
establishing that the information constitutes a trade secret or is confidential. The responder also
acknowledges that if certain information is found to constitute a trade secret or is confidential, the
remainder of the Proposal will become public; only the protected information will be removed and
remain nonpublic.
_______________________________
_____________________
_________________
Signature
Title
Date
* Whether or not protected information is provided, the responder must sign and date this form and
submit it with the “Required Statements”.
39
APPENDIX E – AFFIRMATIVE ACTION DATA PAGE
If your response to this solicitation is in excess of $100,000, complete the information requested below
to determine whether you are subject to the Minnesota Human Rights Act (Minnesota Statutes
363A.36) certification requirement, and to provide documentation of compliance if necessary. It is your
sole responsibility to provide this information and—if required—to apply for Human Rights
certification prior to execution of the contract. The State of Minnesota is under no obligation to delay
proceeding with a contract until a company receives Human Rights certification.
BOX A – For companies which have employed more than 40 full-time employees within Minnesota on any single
working day during the previous 12 months. All other companies proceed to Box B.
Your response will be rejected unless your business:
has a current Certificate of Compliance issued by the Minnesota Department of Human Rights (MDHR)
-orhas submitted an affirmative action plan to the MDHR, which the Department received prior to
the date and time the responses are due.
Check one of the following statements if you have employed more than 40 full-time employees in Minnesota on
any single working day during the previous 12 months:
□ We have a current Certificate of Compliance issued by the MDHR. Proceed to Box C. Include a copy of your
certificate with your response.
□ We do not have a current Certificate of Compliance. However, we submitted an Affirmative Action Plan to the
MDHR for approval, which the Department received on __________________ (date). [If the date is the same as
the response due date, indicate the time your plan was received: _________ (time)]. Proceed to Box C.
□ We do not have a Certificate of Compliance, nor has the MDHR received an Affirmative Action Plan from our
company. We acknowledge that our response will be rejected. Proceed to Box C.
Contact the Minnesota Department of Human Rights for assistance. (See below for contact information.)
Please note: Certificates of Compliance must be issued by the Minnesota Department of Human Rights.
Affirmative Action Plans approved by the Federal government, a county, or a municipality must still be received,
reviewed, and approved by the Minnesota Department of Human Rights before a certificate can be issued.
BOX B – For those companies not described in BOX A
Check below.
 We have not employed more than 40 full-time employees on any single working day in Minnesota within the
previous 12 months. Proceed to BOX C.
BOX C – For all companies
By signing this statement, you certify that the information provided is accurate and that you are authorized to sign
on behalf of the responder. You also certify that you are in compliance with federal affirmative action
requirements that may apply to your company. (These requirements are generally triggered only by participating
as a prime or subcontractor on federal projects or contract. Contractors are alerted to these requirements by the
federal government.)
Name of Company: _______________________________________________________________________
Date:_______________________________________
Authorized Signature: ______________________________ Telephone number: ____________________________
Printed Name: _________________________________________ Title: _______________________________
For assistance with this form, contact
Minnesota Department of Human Rights, Compliance Services
Mail:
The Freeman Building 625 Robert Street N,
Saint Paul, MN 55155
Web: www.humanrights.state.mn.us
Email: [email protected]
TC Metro:
(651) 296-5663
Toll Free: 800-657-3704
Fax:
(651) 296-9042
TTY:
40
(651) 296-1283
APPENDIX F - CERTIFICATION REGARDING LOBBYING
For State of Minnesota Contracts and Grants over $100,000
The undersigned certifies, to the best of his or her knowledge and belief that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or employee of
any agency, a member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with the awarding of any Federal contract, the making of
any Federal grant, the making of any Federal loan, the entering into of any cooperative
agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any
person for influencing or attempting to influence an officer or employee of any agency, A
Member of Congress, an officer or employee of Congress, or an employee of a Member of
Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the
undersigned shall complete and submit Standard Form-LLL, Disclosure Form to Report Lobbying
in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award
documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under
grants, loans and cooperative agreements) and that all subrecipients shall certify and disclose
accordingly.
This certification is a material representation of fact upon which reliance was placed when this
transaction was made or entered into. Submission of this certification is a prerequisite for
making or entering into this transaction imposed by 31 U.S.C. 1352. Any person who fails to file
the required certification shall be subject to a civil penalty of not less than $10,000 and not
more than $100,000 for each such failure.
__________________________________________
Organization Name
__________________________________________
Name and Title of Official Signing for Organization
By: _______________________________________
Signature of Official
__________________________________________
Date
41
APPENDIX G – DISCLOSURE OF OWNERSHIP

NOT APPLICABLE

APPLICABLE (IF APPLICABLE, PLEASE COMPLETE THE FOLLOWING)
1. The name, address, date of birth, social security number (in the case of an individual), and tax
identification number (in the case of a corporation) of each person (individual or corporation), including
managing employees of the responder, with an Ownership or Control Interest in the responder or in any
subcontractor in which the responder has direct or indirect ownership of five percent (5%) or more. The
address for corporate entities must include primary business address, every business location and P.O.
Box address;
2. A statement as to whether any Person (individual or corporation) with an Ownership or Control
Interest in the responder or in any subcontractor as identified in Section 1 above is related
(if an individual) to any other Person with an Ownership or Control interest as a spouse, parent,
child, or sibling; and
3. The name of any other disclosing entity in which a Person with an Ownership or Control
Interest in the responder also has an ownership or control interest in the other disclosing entity and
4. The name, address, date of birth, and social security number of any managing employee of the
responder.
By signing this statement, you certify that the information provided is accurate and that you
are authorized to sign on behalf of, and legally bind, the responder.
Authorized Signature: _________________________________________________________
Printed Name:________________________________________________________________
Title:
____________________________________________________________
Date:__________________________
Telephone Number:______________________________________
42
APPENDIX H - PROFESSIONAL RESPONSIBILITY
It is crucial that the State locate reliable grantees to serve our clients. The successful responder must be
professionally responsible. Please address the following information in your response:
1. Provide information concerning any complaints filed with or by professional and/or state or federal
licensing/regulatory organizations within the past six years against your organization or its employees
relating to the provision of services. If such complaints exist, please include the date of the
complaint(s), the nature of the complaint(s), and the resolution/status of the complaint(s), including any
disciplinary actions taken.
2. Provide information about pending litigation and/or litigation resolved within the past two years that
relates to the provision of services by your organization and/or its employees. If such litigation exists,
please include the date of the lawsuit, nature of the lawsuit, and the dollar amount being requested as
damages, and if resolved, what the resolution was (e.g. settled, dismissed, withdrawn by plaintiff,
verdict for plaintiff with amount of damages awarded, verdict for responder, etc.).
3. Submit information which demonstrates recognition of their professional responsibility. This may
include awards, certifications, and/or professional memberships.
4. The State reserves the right to request any additional information to assure itself of a responder's
professional status.
43
APPENDIX I - SUBMISSION OF CERTIFIED FINANCIAL AUDIT, IRS FORM
990 or MOST RECENT BOARD-REVIEWED FINANCIAL STATEMENTS
The successful responder must be fiscally responsible. Therefore, responders must include in their
proposals sufficient financial documentation to establish their financial stability.
1. Depending on the responder’s annual income or how long the grantee has been in business, a responder
is required to submit either a certified financial audit, IRS Form 990, or most recent board-reviewed
financial statements.
2. Responders must submit financial information as outlined below with their proposal:

Responders with an annual income of under $25,000 or who have not been in existence long enough to
have an audit or completed IRS Form 990 should submit their most recent board-reviewed financial
statements.

Responders with total annual revenue of under $750,000 should submit their most recent IRS Form 990.

Grant applicants with total annual revenue of over $750,000 should submit their most recent certified
financial audit.
3. Responders may also include documentations of cash reserves to carry you through shortages or delays
in receipt of revenue, and/or other documents sufficient to substantiate responsible fiscal
management. If the responder is a county government or a multi-county human services agency that
has 1.) had an audit in the last year by the State Auditor or an outside auditing firm or 2.) meets the
requirements of the Single Audit Act, the responder is not required to submit
financial statements. However, the State reserves the right to request any financial information to
assure itself of a county’s financial status.
4. The information collected from these inquiries will be used in the State’s determination of the award of
the contract. It may be shared with other persons within DHS who may be involved in the decisionmaking process, and/or with other persons as authorized by law. If you choose not to provide the
requested information, your organization’s proposal will be found nonresponsive and given no further
consideration. The State reserves the right to request any additional information to assure itself of a
responder's financial reliability.
44
APPENDIX J - ENROLLMENT LIMIT DECLARATION
•
Any limits on enrollment by the responder must be indicated in this Appendix.
Check the box below if the responder agrees to accept all enrollment for all Counties for which the
responder is proposing to serve in this RFP.
Responder agrees to accept all enrollment for the Counties for which the responder has included in
this proposal.
If the responder is limiting enrollment, check each applicable county and enter the limited number of enrollees
that the responder is willing to accept in a county. For each county that the responder has placed a limit on
enrollment, the responder must provide an explanation for the limitation. Any limits placed on enrollment will
be one of many factors that will be considered in the selection process.
County
Number of
enrollees the
responder is
willing to accept.
Aitkin
Anoka
Becker
Beltrami
Benton
Big Stone
Blue Earth
Brown
Carlton
. Carver
. Cass
. Chippewa
. Chisago
. Clay
. Clearwater
. Cook
. Cottonwood
. Crow Wing
. Dakota
. Dodge
. Douglas
. Faribault
. Fillmore
. Freeborn
. Goodhue
. Grant
. Hennepin
45
Explanation
If the responder is limiting enrollment, check each applicable county and enter the limited number of
enrollees that the responder is willing to accept in a county. For each county that the responder has
placed a limit on enrollment, the responder must provide an explanation for the limitation. Any limits
placed on enrollment will be one of many factors that will be considered in the selection process.
County
Number of
enrollees the
responder is
willing to accept.
. Houston
. Hubbard
. Isanti
. Itasca
. Jackson
. Kanabec
. Kandiyohi
. Kittson
. Koochiching
. Lac qui Parle
. Lake
. Lake Of The Woods
. Le Sueur
. Lincoln
. Lyon
. Mahnomen
. Marshall
. Martin
. McLeod
. Meeker
. Mille Lacs
. Morrison
. Mower
. Murray
. Nicollet
. Nobles
. Norman
. Olmsted
. Otter Tail
. Pennington
. Pine
. Pipestone
46
Explanation
If the responder is limiting enrollment, check each applicable county and enter the limited number of
enrollees that the responder is willing to accept in a county. For each county that the responder has
placed a limit on enrollment, the responder must provide an explanation for the limitation. Any limits
placed on enrollment will be one of many factors that will be considered in the selection process.
County
. Polk
Number of
enrollees the
responder is
willing to accept.
. Pope
. Ramsey
. Red Lake
. Redwood
. Renville
. Rice
. Rock
. Roseau
. St. Louis
. Scott
. Sherburne
. Sibley
. Stearns
. Steele
. Stevens
. Swift
. Todd
. Traverse
. Wabasha
. Wadena
. Waseca
. Washington
. Watonwan
. Wilkin
. Winona
. Wright
. Yellow Medicine
47
Explanation
APPENDIX K – DISCLOSURE OF FUNDING
Per the Federal Funding Accountability and Transparency Act of 2006 “Transparency Act” or “FFATA” (Public Law
109-282), all entities and organizations receiving federal funds are required to report full disclosure of funding
(United States Code, title 31, chapter 61, section 6101). The purpose of FFATA is to provide every American with
the ability to hold the government accountable for each spending decision. The end result is to reduce wasteful
spending in the government. The FFATA legislation requires information on federal awards to be made available to
the public through a single, searchable website. Federal awards include grants, sub-grants, loans, awards, and
delivery orders.
In order to comply with the federal statute, the Minnesota Department of Human Services is required to obtain
and report by the grantee’s Data Universal Numbering System (DUNS) number and determine if the grantee meets
specific requirement which would require additional reporting items and to collect additional information on
executive compensation if required. In order to comply with federal law and to collect this information,
responders are required to fill out the Disclosure of Funding Form and submit it with their response. The form is
located on the link at the bottom of this page. The form requires responders to provide their Data Universal
Numbering System (DUNS) number. The Data Universal Numbering System (DUNS) number is the nine-digit
number established and assigned by Dun and Bradstreet, Inc. (D&B) to uniquely identify business entities. If a
responder does not already have a DUNS number, a number may be obtained from the D&B by telephone
(currently 866-705-5711) or the Internet (currently at http://fedgov.dnb.com/webform). The responder must have
a DUNS number before their response is submitted.
Disclosure of Funding Form- DHS-7018-ENG
48
APPENDIX L – COUNTY-SPECIFIC INFORMATION
The county specific and demographic information for each of the 87 counties is attached below.
Current enrollment information and projected enrollment information is included below.
Demographic information and county-specific information by county is also included this
Appendix.
The county information included in this Appendix:
1. Enrollment Information
2. Projected Managed Care Enrollment
3. Minnesota Demographic Data by County
4. County Specific Information sections by County
1. Number of Enrollees as of December 2014
The following table contains the current enrollment number of Medical Assistance and MinnesotaCare in the 87
counties.
*Indicates MSA counties
County
Aitkin
Anoka
Becker
Beltrami
Benton*
Big Stone
Blue Earth*
Brown
Carlton*
Carver*
Cass
Chippewa
Chisago*
Clay*
Clearwater
Cook
Cottonwood
Crow Wing
Dakota*
Dodge*
Douglas
Faribault
Fillmore*
Freeborn
Goodhue
Grant
Hennepin*
Houston*
MA<65
(including
Non-citizens)
2,529
39,128
5,168
7,348
5,273
549
6,708
2,433
4,224
5,843
5,215
1,861
5,443
7,085
1,292
851
1,708
9,442
38,623
2,152
4,021
1,980
2,439
4,634
4,054
864
163,264
1,730
MinnesotaCare
358
4,978
552
699
540
77
768
285
415
848
657
194
697
637
140
201
158
1,268
5,235
228
605
211
272
504
594
127
19,985
219
49
County Total
2,887
44,106
5,720
8,047
5,813
626
7,476
2,718
4,639
6,691
5,872
2,055
6,140
7,722
1,432
1,052
1,866
10,710
43,858
2,380
4,626
2,191
2,711
5,138
4,648
991
183,249
1,949
Hubbard
Isanti*
Itasca
Jackson
Kanabec
Kandiyohi
Kittson
Koochiching
Lac qui Parle
Lake
Lake of the Woods
Le Sueur
Lincoln
Lyon
Mahnomen
Marshall
Martin
McLeod
Meeker
Mille Lacs*
Morrison
Mower
Murray
Nicollet*
Nobles
Norman
Olmsted*
Otter Tail
Pennington
Pine
Pipestone
Polk*
Pope
Ramsey*
Red Lake
Redwood
Renville
Rice
Rock
Roseau
St. Louis*
Scott*
Sherburne*
Sibley*
Stearns*
Steele
Stevens
Swift
Todd
Traverse
Wabasha*
Wadena
3,390
5,258
7,557
1,072
2,492
6,727
535
1,958
687
1,233
566
2,814
600
3,207
3,603
459
894
2,776
2,617
4,058
4,616
5,553
917
3,168
3,420
1,037
14,898
7,070
1,488
4,458
1,253
4,360
1,426
96,993
422
1,750
2,125
7,368
974
1,325
24,194
11,513
8,959
1,719
17,900
4,594
809
1,302
3,526
454
2,135
2,186
415
660
741
117
300
652
58
262
91
217
83
317
91
347
483
73
117
237
334
507
597
435
118
349
242
77
1,769
949
174
518
112
392
178
9,336
47
251
242
869
101
178
2,991
1,566
1,141
198
1,930
438
106
135
398
30
261
235
50
3,805
5,918
8,298
1,189
2,792
7,379
593
2,220
778
1,450
649
3,131
691
3,554
4,086
532
1,011
3,013
2,951
4,565
5,213
5,988
1,035
3,517
3,662
1,114
16,667
8,019
1,662
4,976
1,365
4,752
1,604
106,329
469
2,001
2,367
8,237
1,075
1,503
27,185
13,079
10,100
1,917
19,830
5,032
915
1,437
3,924
484
2,396
2,421
Waseca
Washington*
Watonwan
Wilkin
Winona
Wright*
Yellow Medicine
TOTAL
2,083
18,426
1,523
985
4,882
12,150
1,185
79,447
271
2,662
144
80
580
1,640
153
673,510
2,354
21,088
1,667
1,065
5,462
13,790
1,338
752,957
(County Exhibits can be found in Appendix M of this RFP.)
2.
3.
November 2014 Forecast – Projected Managed Care Enrollment
MA
MA
Families
Adults
With Kids
No Kids
January 2016
524,237
146,914
117,269
February 2016
525,262
147,045
118,653
March 2016
526,934
147,173
120,038
April 2016
528,250
147,300
121,422
May 2016
528,267
147,426
122,806
June 2016
528,727
147,551
124,191
July 2016
529,198
147,676
125,575
August 2016
529,378
147,800
126,960
September 2016
528,890
147,923
128,344
October 2016
528,061
148,047
129,729
November 2016
526,432
148,170
131,113
December 2016
526,263
148,294
132,493
MinnesotaCare
County Demographics
County
Demographics.xlsx
4.
List of Providers by County
The documents below contain those providers that the counties indicated are most important to access for health
care services. NOTE: Not all counties submitted a list of providers.
County Provider
Listings.xlsx
5.
St Louis Co Provider
List.xlsx
County Provider
Listings.docx
County Specific Information sections by County
(See individual county sections on the following pages)
51
Aitkin County:
County Administration:
Agency Name: Aitkin County Health & Human Services
Director’s Name:
Thomas Burke
Address:
204 – 1st Street NW, Aitkin, MN 56431
Telephone Number:
218-927-7200
FAX Number:
218-927-7210
County Agency Contacts:
Area of Responsibility
Social Services
Name
Title
SS Supvs
Telephone Number
218-927-7200
IM Supvs
218-927-7200
Financial Assistance
Sue Tange
Ann Rivas
Eileen Foss
Public Health
Erin Melz
PH Supvs
218-927-7200
Mental Health – Adults
Ann Rivas
SS Supvs
218-927-7200
Mental Health – Children
Sue Tange
SS Supvs
218-927-7200
Chemical Dependency
Ann Rivas
SS Supvs
218-927-7200
Transportation
Pam Karnowski
Case Aide
218-927-7200
Other – please list
52
General County Service Delivery and Access:
Aitkin County is a large geographical county covering some 1,800 square miles with a year round
population of just over 16,000 residents. During the summer this figure can be 2-3 times as large.
Aitkin County has a hospital in the city of Aitkin with clinics in Aitkin and McGregor. There are numerous
hospitals and clinics in neighboring counties which include Crosby, Brainerd, Onamia, Mora, Moose
Lake, and Grand Rapids.
Accessing health care can be difficult due to distances. Specialty care is available but on a more limited
basis.
Behavioral Health services are offered in the surrounding counties and on an itinerant basis in the
county. We do not have a Mental Health clinic is our county. We have been successful in getting some
services locally. Substance abuse treatment is also difficult to find locally. Our local hospital has not
considered housing such services outside of a Nurse Practitioner.
Dental is also limited for MA recipients. Our local dentists are not taking new MA recipients. The Smile
center in Deerwood has not always been a reliable center.
As a Health and Human Services agency, Public Health is an intricate piece of our continuum of care.
Aitkin County has utilized savings in out of home placement to bring a second Public Health Educator on
staff to assist us in the area of early intervention. We have found this to be very beneficial.
53
Anoka County:
Agency Name: Anoka County Human Services
Director’s Name: Jerry Soma, Division Manager
Address: 2100 Third Avenue
Anoka, MN 55303
Telephone Number: 763-422-7008
FAX Number: 763-422-6987
Social Services
Name
Cindy Cesare
Jerry Vitzthum
Public Health
Laurel Hoff
Cindy Cesare
Cindy Cesare
Chemical Dependency
Cindy Cesare
Transportation
Tim Kirchoff
54
Title
Director - Social
Services & Mental
Health
Director Economic
Assistance and Job
Training Center
DirectorCommunity Health
& Environmental
Services
Director - Social
Services & Mental
Health
Director - Social
Services & Mental
Health
Director - Social
Services & Mental
Health
Supervisor of
Transit &
Operations
Planning
(countywide)
Telephone Number
763-422-7007
763-783-4801
763-422-6918
763-422-7007
763-422-7007
763-422-7007
763-422-7088
Anoka County Community Health and Environmental Services just completed the “Health Issues in Your
Community” Survey-2014. Survey results related to the availability of health services indicated that
over 50% of those responding had concerns about the following: lack of mental health services at low or
no cost, lack of dental services at low or no cost, lack of medical services at low or no cast, long wait
times for access to mental health services, and lack of transportation to and from medical care. The
survey also showed that over 40% of the respondents felt there were language or communication
barriers in accessing services and that there was a lack of culturally appropriate health care services.
(FYI: over 1100 people responded to this survey from throughout Anoka County)
Anoka County has limited dental providers willing to accept new MA/MinnesotaCare recipients for
general dental care. There are very few, if none, Oral Surgeons, Endodontists, or Orthodontists in Anoka
County who accept managed care enrollees. One MCO currently does not have any of these specialists
in Anoka County so clients who need orthodontia or more complex dental services, must travel usually
to Hennepin County for care. Since public transportation is non-existent in the northern half of Anoka
County, clients rely on the transportation from the MCO’s to get to these appointments.
Anoka County provides access to funding for chemical dependency treatment for low-income persons
through the Consolidated Chemical Dependency Treatment Fund (CCDTF). Rule 25 assessments are
provided by county staff for those eligible for the CCDTF; assessments are done in the Social
Services/Behavioral Health Department for those already receiving services through the Department,
while the Community Corrections Department provides Rule 25 assessments for all others, under a
Memorandum of Understanding with Social Services. Referrals are made to the programs under
contract with Anoka County as well as too many other programs both in and beyond the metro area,
depending upon client need and availability of services. Sub-acute detoxification services are provided at
Mission Detox in Plymouth and Ramsey Detox in St. Paul, under contractual relationships with Anoka
County, with overflow services at Dakota County Receiving Center in Hastings. Pre-petition Screening
staff coordinates with the MCOs and other third-party insurers. Anoka County operates a treatment
support program for a small group of methamphetamine users utilizing grant and county funding.
Mental health services in Anoka County are largely provided by private providers in the community.
Anoka County itself provides Mental Health Targeted Case Management for Adults and Children, along
with early intervention and prevention services through our Intake services. Community based services
may be funded through a contract with Anoka County or through health insurance. Anoka County
provides funding for clinic based services though contracts that reimburse on a sliding fee basis. Mercy
Hospital provides inpatient psychiatric services for adults. Anoka County has adult contracted crisis
residential services along with crisis phone and mobile services for children and adults.
Adult Mental Health Intake and Early Intervention, Prepetition Screening and Targeted Case
Management, is accessed by contacting Anoka County at 763-422-3283. Crisis, Outpatient and
community based services can be accessed by recipients and/or primary care providers by directly
contacting the provider. Timely access to a Psychiatrist or Nurse Practitioner continues to be major issue
in Anoka County. The waiting time for the initial outpatient appointment can range from 6 weeks to
three months, depending on the clinic. Housing and Mental Health related support services have varied
access through the county or directly through provider contact. Mental Health services may be accessed
through referrals from primary care providers. In the area of Adult Mental health there is a lack of
specialists/services in the areas of Psychiatrists, Psychiatric Nurse Practitioners, Supervised Living
Settings, Intensive Behavioral Residential Settings and Intensive Behavioral Community Services.
55
Children’s Mental Health Targeted Case Management is accessed by contacting Anoka County at 763712-2722. Outpatient and Community Based services can be accessed by recipients by directly
contacting the provider. Mental Health services may be accessed through a referral from their primary
care provider. Timely access to a Child Psychiatrist or Nurse Practitioner continues to be major issue in
Anoka County. The waiting time for the initial outpatient appointment can range up to 6 months,
depending on the clinic. An initial appointment with an individual therapist can be as soon as two weeks,
depending on the clinic and if the recipient is requesting a particular therapist that is in high demand.
There are no in-patient psychiatric hospital beds for children/adolescents in Anoka County. In the area
of Children’s MH there is a lack of Child Psychiatrists, Psychiatric Nurse Practitioners, Mental Health
Behavioral aides, Licensed In-Home Therapists, In Home Mental Health Supports (PCA),
Neuropsychologists, Culturally specific therapeutic services, Children’s Day Treatment, Functional
Behavioral Analysts and Programming and Crisis Residential Services for Children
Mass transit is nonexistent in northern Anoka County and many times the bus is not an option for
families with children. Managed care enrollees rely on the free transportation provided by the MCO to
get to and from medical appointments with-in and across county lines. A lack of free medical
transportation creates an issue of access and follow-through for many.
56
Becker County:
Agency Name: Becker County Human Service
Director’s Name: vacant
Interim: Jack W. Ingstad, County Administrator
Address: 712 Minnesota Ave, Detroit Lakes, MN 56501
FAX Number: 218-847-6738
Social Services
Name
Donna Richgels
Title
Supervisor
Telephone Number
218-847-5628
Susan Kent
FAS
218-847-5628
Public Health
Ronda Stock
Supervisor
218-847-5628
Jon Iwen
Don Janes
Supervisor
Supervisor
218-847-5628
218-847-5628
Chemical Dependency
Don Janes
Supervisor
218-847-5628
Transportation
Rusty Haskins
Supervisor
218-847-5628
57
Becker County is located in west central Minnesota, 30 miles east of the Fargo/Moorhead MSA.
Established by an act of the legislature, Becker County was approved on March 18, 1858. For 10 years
after the establishment of Becker County there were no white settlers. The Chippewa (Ojibwe) Indians
occupied nearly all the county. The Sioux Indians had about one half of Cormorant Township and a small
part of the corner of Lake Park Township. In 1867, a treaty was signed establishing the White Earth
Reservation, a large tract of land in the northern part of Becker County, to be home for the Chippewa
Indians.
According to figures compiled by the Centers for Disease Control, 971 people died in Becker County in
the years 1999-2001. The county death rate was 11 per thousand people, compared with 8 per
thousand people statewide. During the same period, 221 people died from cancer. The county death
rate from cancer was 2.5 per thousand people, compared with 1.9 per thousand statewide.
A reported 30 people died in motor vehicle accidents. The county death rate from such accidents was
0.3 per thousand people, compared with 0.1 per thousand statewide. The average age of people living
in Becker County at the time of the 2000 census was 38.9, compared with 36.0 statewide and 36.2
nationwide.
The area has several clinics and satellite clinics along with hospitals. Referrals are made out of the area
for specialty services. Like most communities dental care is a critical issue to locate locally.
Community Health is a part of the Human Services department.
Minnesota is considered to be one of the healthiest states in the nation. The United Health Foundation
has ranked states’ overall health status since 1990, and for the first 18 years Minnesota consistently
landed in the top five. In the last three years, however, Minnesota’s rank has slipped to sixth, and
remains there.
According to the 2011 America’s Health Rankings report, Minnesota’s strengths include:
 Low rate of death related to cardiovascular disease (Rank: 1)
 Low rate of uninsured (Rank: 3)
 High rate of high school graduation (Rank: 3
Challenges identified by the report include:
 Low rate of public health funding per capita (Rank: 46)
 High prevalence of binge drinking (Rank: 44)
Both Minnesota and the U.S. have aging populations. From 2000 to 2010, the proportion of
Minnesotans under the age of 45 decreased by 2 percent while the proportion of persons 45 and over
increased by 27 percent; the proportion of the state’s population over 65 will increase as the baby
boomer generation continues to move toward retirement age. The largest increases in Minnesota’s
population from 2000 to 2010 were to age groups 50 years and older
(The health of Minnesota 2012 statewide health assessment report)
http://www.countyhealthrankings.org/app/#!/minnesota/2014/rankings/becker/county/outcomes/over
all/snapshot
58
Beltrami County:
Agency Name: Beltrami County Health and Human Services
Director’s Name: Becky Secore
Address: 616 America Ave. NW, Bemidji MN 56601
Telephone Number: (218)333-4195
FAX Number:
Social Services
Jeff Lind
Janelle Vance
Public Health
Becky Secore, Darice
Dwyer, Lori Jenson
Dan Brouse
Lisa Monsrud, Becky
Secore
Dan Brouse, Darice
Dwyer
Janelle Vance, John
Pugleasa
Chemical Dependency
Transportation
Name
59
Title
Social Service Division
Director
Finance Supervisor
Telephone Number
(218)333-4196
Agency Director, Family
Health, Home and Managed
Care
Social Service Adult Program
Manager
Social Service, Children’s
Program Manager
Social Service, Adult
Program Manager
Finance Supervisor, Division
Director Income
Maintenance
(218)333-4195
(218)333-8151
(218)333-8111
(218)333-8119
(218)333-4197
(218)333-4244
(218)333-8119
(218)333-8151
(218)333-4197
(218)333-4199
Beltrami County has a population of 43,835 people and it is a diverse population both culturally (predominantly
Caucasian and Native American) and economically. Bemidji is the county seat and is a regional hub for north
western Minnesota. Bemidji is host to many major retailers and is a hub for health care with Sanford Health
maintaining a strong presence in our community. There are two Indian reservations within the bounds of Beltrami
County, the Leech Lake Indian Reservation and the Red Lake Reservation which is almost entirely within the
bounds of Beltrami County. The Red Lake Indian Reservation is located in upper north-central Minnesota about
160 miles south of the Canadian border. It is a “closed” reservation, meaning all of its lands are held or owned in
common by all enrolled members. The Red Lake Nation is part of the greater Ojibwe or Anishinabe Nation which is
the second largest in North America after the Navajo Nation. There is still retention of the original language,
ceremonies, customs and beliefs.
Minnesota Health Care Programs (MHCPs) are accessed through our county income maintenance unit. Eligibility is
determined by our eligibility staff and based on income and asset guidelines as established by state statute and
state policy. Beltrami County is also a member of a thirteen county managed care organization (Prime West
Health). Additionally, it is worth noting that all counties in Minnesota have experienced significant program and
eligibility changes due to the implementation of the Affordable Care Act (ACA) and MNSure. Ultimately, these
sweeping changes are yet to be fully implemented. As a result, the overall function of MHCP and the overall access
to these programs s in a time of dynamic change.
One of the primary issues around access to health care services is distance and transportation. Beltrami County is
90 miles from one end to the other and there are several communities in greater Beltrami County that have limited
access to both primary and specialized care. Residents of the two local reservations do have access to Indian
Health Services however some of the specialized care can only be accessed in Bemidji, which in the case of Red
Lake is 40 miles north on Bemidji and at times winter weather can cause further challenges in accessing these
services. Beltrami County is one of the poorest counties per capita in the state and as is often the case with people
in poverty it creates unhealthy lifestyles, and effects people’s needs for services along with their ability to access
these services. Beltrami County has high rates of diabetes, heart disease, as well as some of the highest suicide
rates in the state.
Although Sanford Health has a significant presence here in Beltrami County there are still services that are
unavailable or limited in nature in north western Minnesota. Specialized pediatric care continues to be a
significant challenge. Children in need of specialized care often have to travel to the Twin cities for services.
Currently there are no pediatric psychiatrists in the Beltrami County area and there are very few adult psychiatric
services available in the region either. We have one CBHH however our patients that need this care regularly are
forces to access these services in other communities. Two of the programs that are often accessed for psychiatric
care are Prairie St. John and the Stadter Center both of which are in North Dakota.
With the high poverty rates and the number of people on MA dental care does continue to be an issue however
we do have the Northern Dental Access Clinic which does appear to meet the needs of the residents of the Bemidji
Area. Access to Dental services in many of the communities in greater Beltrami County does continue to be a
challenge.
60
Benton County:
Agency Name: Benton County Human Services
Director’s Name: Robert Cornelius
Address: P O Box 740
531 Dewey St
Foley MN 56329
FAX Number: 320-968-5330
Social Services
Title
Supervisors
Public Health
Name
Bruce DeGrote
Debra Rieland
Sandi Shoberg
Janel Sczublewski
Lisa Holker
Nichole Ruhoff
Supervisor
Telephone Number
320-968-5097
320-968-5098
320-968-5113
320-968-5188
320-968-5122
320-968-3172
Sandi Shoberg
Supervisor
320-968-5113
Sandi Shoberg
Supervisor
320-968-5113
Chemical Dependency
Sandi Shoberg
Supervisor
320-968-5113
Transportation
Bruce DeGrote
Supervisor
320-968-5097
61
Supervisors
Benton County is located in Central Minnesota, approximately one-hour driving distance from the
northern suburbs of Minneapolis. A portion of its western border combines with Sherburne and Stearns
County making up the St. Cloud Metropolitan area. In 2013, the population of Benton County was
estimated at approximately 39,214. Cities located in Benton County are Foley, Gilman, Rice, Sauk Rapids
and parts of Royalton, Sartell and St. Cloud. Most of the counties larger communities are located on its
western edge (St. Cloud, Sauk Rapids, Sartell and Rice). The average median household income in
Benton County 2013 was $53,299 with approximately 13.6% of the population having incomes below
the Poverty Level. Benton County has approximately 10,627 children under age 18 (27.1%) living in
Benton County with many of these children living in households falling well under poverty guidelines.
Labor force trends show an expected 32% expansion from 2005 and in 2020. Benton County currently
has an unemployment rate of approximately 3.2%.
According to Minnesota Department of Health (MDH) Health Tables, Benton County had the lowest ratio
of physicians/population when compared with other Minnesota counties. However, Benton County is
located directly adjacent to Stearns County, which houses a number of major medical service providers
for the Central Minnesota Region. Benton County residents access the St. Cloud Hospital (which serves
as a regional hospital/ 12 county area) and related services system, as well as other smaller hospitals
located in Little Falls, Princeton, Elk River areas. Benton County has three (3) major nursing homes with
a total of 416 beds, and over 600 customized living beds located within its borders.
There are issues accessing:
•
Dental care - Lack of providers accepting state funded healthcare, not enough culturally
appropriate providers
•
Chemical dependency services - difficult time placing chronic users with medical issues, lack of
long term support system providing management of recovery
•
Public Health - Not enough funding for Early Intervention and Education for Dental, Family
Planning, Pregnancy and Mental Health
•
Mental Health (Adult) - Lack of Psychiatrists and Crisis Services
•
Mental Health (Children) - Lack of Psychiatrists, Infant Mental Health Specialists and Crisis
Services
•
Transportation - Benton County needs transportation for additional services to provide a holistic
approach. These services would include pharmacy trips, public health visits, and etc. not just
medical appointments.
There are currently no services are unavailable because of our proximity to both the St Cloud and Twin
Cities Metro areas. There are many services that clients have to travel for so in some cases the distance
limits the availability.
Specialized dental services are limited in their available to the county’s MA and MinnesotaCare
enrollees.
62
Big Stone County
Agency Name: Big Stone County Family Service Center
Director’s Name: Pamela Rud
Address: 340 NW 2nd St PO Box 338, Ortonville, MN 56278
FAX Number: 320-839-3966
Social Services
Name
Amy Weir
Diana Hults
Public Health
Liz Auch
Amy Weir
Amy Weir
Chemical Dependency
Pamela Rud
Transportation
Diana Hults
63
Title
Social Services
Supervisor
Supervisor
Administrator
Telephone Number
320-839-2555
Social Services
Supervisor
Social Services
Supervisor
Director
320-839-2555
Supervisor
320-839-2555
320-839-2555
320-843-4546
320-839-2555
320-839-2555
Big Stone County, with a population of 5,106 is located in the farthest west central region of the State.
Big Stone County continues to experience a decline in population over the past 15 years. 27.2% of the
County Population is over the age of 65.
Big Stone County has no statistically significant minority population with 98.2% of our individuals being
Caucasian. With this population, the primary language is English.
Big Stone County is home to two hospitals, and two nursing homes located in Ortonville and Graceville.
There is one Intermediate Care Facility for Developmental Disabilities, five corporate Adult Foster Care
home and four assisted living facilities. In Big Stone County, there are 9 primary care physicians, 3
physician assistants, 2 chiropractors, 3 pharmacists and one dentist. Big Stone County receives mobile
dental services through Caring Hands dental clinic in Alexandria with the support of Prime West Health.
There are no mental health facilities in Big Stone County. Individuals need to travel a minimum of 50
miles to see a psychologist or psychiatrist face to face. Stevens Community Medical Center provides
tele-med with a psychiatrist two times monthly in Big Stone County with the support of Prime West
Health.
Big Stone County contracts with Prairie 5 RIDES to provide local, regional and volunteer drivers for our
transportation needs. Medical transportation needs are currently being met, but individuals in need of
transportation for non-medical related issues or evening or weekend transports continue to be a need.
64
Blue Earth County
Agency Name: Blue Earth County Human Services
Director’s Name: Phil Claussen
Address: 410 South 5th Street
P.O. Box 3526
Mankato MN 56002-3526
FAX Number: 507-304-4387
Name
Title
Social Services
Anne Broskoff
Social Services
Supervisor
Lanette Ayers
Social Services
Supervisor
Telephone
Number
(507) 3044459
(507) 3044292
(507) 304Supervisor
4358
Public Health
(507) 304Supervisor
4175
Adult Mental Health (507) 304& CD Supervisor
4271
Social Services
(507) 304Supervisor
4459
Adult Mental Health (507) 304& CD Supervisor
4271
DeAnn Boney
Public Health
Kelley Haeder
Mental Health - Adults
Julie Moniz
Anne Broskoff
Chemical Dependency
Julie Moniz
Transportation
DeAnn Boney
Financial Assistance (507) 304Supervisor
4358
Lanette Ayers
Social Services
Supervisor
Angela Youngerberg
Assistant Director
Other
65
(507) 3044292
(507) 3044351
Blue Earth County is a rural, regional hub that supports a population of 65,528 residents (2013 Census).
The main population center is the city of Mankato and is the county seat. Minnesota State University –
Mankato, retail, local government, light industry and agriculture are among our areas major employers.
Ethnic Makeup of the County (2013 data):
White
89.9%
Asian
2.4%
Black
3.2%
Hispanic /Latino 2.9%
American Indian 0.4%
2 or more races
1.5%
The five most common non-English languages represented in Blue Earth County are
Somalian, Sudanese languages of Nuer, Anuyak, and Dinka, Vietnamese, Spanish, and Arabic.
Specialty Care Needs:
•
Culturally competent health services for growing diversity in the county’s population
•
Interpreter services
•
Isolated rural population
•
Isolated elderly population
•
Children with serious emotional disturbance (SED)
•
Persons with disabilities
•
Persons with Serious and Persistent Mental Illness (SPMI)
•
Dental care – lack of local providers
Blue Earth County is committed to ensuring their residents have effective preventative care and
appropriate medical and supportive services so they can achieve greater outcomes of maximum selfsufficiency and satisfying lives. The county looks forward to a close working relationship with the MCOs
to progress towards improved client outcomes. Welfare reform and increased immigration have
changed the nature of client service. Changing approaches to serving populations with specific
challenges (mental health, chemical dependency, out of home placement, etc.) will also require a
willingness to adapt and coordinate care. The county believes services must adapt to meet the need of
the individual client. We believe this can best be accomplished by increased joint planning, data sharing,
and engaging in ongoing communication. Past gaps in coordination may have resulted in additional
costs and inefficiencies for both counties and the MCOs. We recognize issues the health care delivery
system faces are not static. Blue Earth County is looking for MCOs that propose community-based
strategies that will creatively address new issues as they present.
66
Brown County:
Agency Name: Brown County Family Services and Brown County Public Health Nursing
Director’s Name: Tom Henderson and Karen Moritz
Address: 1117 Center Street, New Ulm MN 56073
Telephone Number: 507-359-6500 and 507-233-6820
FAX Number: 507-359-6542
Social Services
Title
Supervisors
Telephone Number
507-359-6500
Name
Barb Dietz and Tom
Sandberg
Theresa Schroeder
Supervisor
507-359-6500
Public Health
Karen Moritz
Director
507-233-6820
Barb Dietz
Supervisor
507-359-6500
Supervisor
507-359-6500
Chemical Dependency
Tom
Sandberg
Tom Sandberg
Supervisor
507-359-6500
Transportation
Bob Aptiz
507-359-6500
Rose Fischer
Transit Services
Supervisor
Accounting
Supervisor
67
507-359-6500
Brown County Public Health provides a variety of personal and community health services to prevent
chronic and infectious disease and promote health. Public Health serves the entire population from
birth through the aging population. Public Health provides services that otherwise would not be
available or accessible to various population groups in the county. Services supplement existing health
resources in the county, to meet unmet health needs and avoid duplication of services and wasted
resources. Public Health partners with local healthcare providers and clinics, education, social services
providers, business, and other non-profit services agencies in the county to expand and improve services
to individuals, families, systems, and population groups.
Public Health programs that specifically target families are: Universal Home Visiting for all families of
newborns in the county, targeted family home visiting for moderate to high risk pregnant and parenting
families, Follow-Along Program, home visits & referrals for children and families with special health and
development needs, immunization Services; for all ages, WIC, school health , Family Planning Special
Project grant services, C&TC outreach, car seat training program, and pregnancy testing.
Brown County has many active initiatives to promote healthy eating and active living in communities.
Brown County Public Health and Family Services would expect an MCO to actively participate and
promote health prevention activities in the community.
• Brown County Public Health has implemented the Statewide Health Improvement Program (SHIP) in
a four county project with Nicollet, Le Sueur, and Waseca counties. Healthcare providers, schools,
community agencies, and worksites are participating throughout the county.
• Brown County Public Health has been an active partner in the nationally known “Heart of New Ulm
Project” – it is a research project aimed at eliminating heart attacks in New Ulm by helping residents
reduce their health risks, by increasing physical activity, improve nutrition, reduce obesity and
tobacco use. The project involves community education, individual and community programming,
medical interventions and policy, system, and environmental changes. Brown County Family
Services has also participated by being on the steering committee.
• The New Ulm District 88 school district currently is working on Safe Routes to School with a grant
from MNDOT.
• The community of Springfield is in its sixth year of an active Wellness Task Force that focuses on
making good nutrition and physical activity choices in schools, homes, and communities to reduce
childhood obesity.
Brown County Public Health and Family Services have active working relationships with the healthcare
systems in Brown County to work towards reducing health care costs, assuring members receive the
best healthcare experience, and improving population health – the “Triple Aim.” The New Ulm Medical
Center has just received a SIMS grant to create an Accountable Community of Health with the MA
population as the identified population for health management. Both Brown County Public Health and
Brown County Family Services are partners in the project.
Out of county referrals for specialty and tertiary care are often made to specialty clinics in Mankato,
Rochester or the Twin Cities.
Home care is provided by Brown County Public Health, Allina Home Care, and Oak Hills Living Center
(Medicare certified agencies) and private companies such as Golden Home Care, MBW Company.
In Brown County managed care enrollees are accustomed to having access to a professional who serves
as a primary local liaison between the member and the MCO. It enables clientele to get their questions
answered about medical access issues and any particular medical vendor problems that they may need
help with. Through Public Health, this position also provides medical Care Coordination for members as
needed. This assures that all members have access to both medical and social care coordination as
68
needed, by a local, familiar person who is available to assist with access and help when needed. This
designated employee works closely with social workers, public health nurses, and health care
practitioners involved with the care of the member. Care coordination services for the MA population
are provided by local county professional nurses and social workers, this is key in providing managed
care to members, who more readily accept and cooperate with a local person whom they know and
trust. MCO(s) need to realize the importance of that relationship and the benefits of knowing the
populations and resources in the local area.
69
Carlton County:
Agency Name: Carlton County
Director’s Name: Dave Lee
Address: 14 N 11th Street, Cloquet, MN 55720
FAX Number: 218-878-4583
Social Services – Family Unit
Social Services – Mental &
Chemical Health
Social Services – Children’s
Mental Health & Family School
Support Workers
Social Services – Disability
Services Unit
Public Health – Long Term Care
Name
Brenda Carlson
Julie Juntti
Karen Tribby,
Karen Milbrath
Title
Supervisor
Supervisor
Clinical Supervisor
Supervisor
Telephone Number
218-878-2588
218-878-2842
218-878-2503
Annie Napoli
Supervisor
Patti Martin
Supervisor
Public Health
Income Maintenance
Terri Allen
Supervisor
218-878-2859
218-878-2858
Patti Hart
Supervisor
218-878-2523
Managed Care Advocate
Patti Hart
Advocate
218-878-2523
70
218-878-2899
Carlton County has two full service clinics and two hospitals. Outlying areas find accessing these
services difficult. The Community Memorial Hospital and Mercy Hospital are both going through
significant building updates and expansions with the idea that the types and amount of services they can
offer their communities will increase significantly.
Part of the Fond du Lac Indian Reservation is in Carlton County. It is important for us to maintain our
excellent working relationship with Indian Public Health and Min No Aya Win Clinic. Indian Public Health
bills both Fee-for-Service (FFS) and the MCOs. Indian Public Health dollars covers what FFS or the
MCO(s) do not cover.
We have several service areas that are difficult to access: dialysis, pediatrics, orthodontics, hospice,
psychiatry, dental, infant mental health and psychiatric care for children. The lack of public
transportation for rural areas is a continuing theme. There is a growing need to leverage the capabilities
of tele-health: tele-mental health, tele-public health – through use of our growing internet telepresence
(ITP) services.
Carlton County has a number of dentists who serve MA recipients, but most have a quota for MA and
have met that quota. They are not taking new clients. Current MCOs have not been able to currently
meet the dental needs of Carlton County recipients. Carlton County needs a better reimbursement rate
to encourage providers to provide services to MA clients. It would be helpful to have a regional mobile
dental clinic. This could help with the lack of preventive care.
The number one issue we are facing is the escalating role that prescription opioids, heroin and
methadone play in our communities. We have a growing number of addicted citizens who present
additional complications to our criminal justice, child protection and healthcare systems. We need a
strong, proactive partnership with our MCOs in helping to reduce this growing addition epidemic.
The MCOs authorize very little time for inpatient treatment. Detox is funded primarily by county dollars.
There is a lack of services for individuals with a dual diagnosis of mental illness and chemical
dependency. Integration with primary care, mental and chemical health services is limited. The length
of treatment is very short.
Carlton County needs better integration between mental health and primary care. We need strong
partners in finding creative reimbursement strategies to allow for the teaming of behavioral health
providers with primary care providers, providing integrated behavioral health services. Without such
advances, there is little chance we will be able to address the large percentage of untreated or
undertreated mental health concerns that make life very difficult for too many of our citizens and are
very costly to the current health care system.
Early intervention and crisis services are limited. There is also lack of preventative care and early
assessments for adults with mental health needs.
There is a shortage of outpatient psychiatric services service and extensive waits for medications and
medication management. There is a considerable shortage of psychiatric beds for youth resulting in
youth being hospitalized hours away or staying in emergency rooms for extended periods of time.
HDC provides Volunteer Driver transportation and volunteer driver services.
Managed care enrollees access transportation through their MCO. In most cases, the MCO
provides/pays for a volunteer driver for this service area which includes Duluth. The client always has
71
the option of driving themselves whether or not they are in managed care and MA will reimburse them
for mileage. For transportation provided by Med A Van, the providers bill MA or the MCO directly. The
MCOs presently have contracts with Volunteer Services. There is no access to handicapped accessible
transportation and transportation in the evening hours. We have no public transportation in the rural
areas. There needs to be coordinated EMS services. Public transportation is very limited in Carlton
County.
Currently Public Health conducts the following:
• Injections and medication set-ups for mental health clients.
• Contracts with Carlton County Public Health for a minimum of three visits to all newborns on
public programs – not to be restricted by unreasonably short pre-authorization timelines.
(Same for) Follow Along Program
Public Health provides medication monitoring and many other programs such as:
• Jail Health.
• Jail Mental Health Assessments
• Universal Home visiting (post- partum and well-baby). This services needs to continue, but it is
increasingly difficult to get full reimbursements for nurses.
• Prenatal home visits.
• High risk parenting home visits.
• Dentist and Dental Hygienist at Public Health through Children’s Dental Services
• ToothSavers Dental Varnish Program
• Clinic Liaison – Public Health connection to physicians and clinics for education and
Assessment/Monitoring of immunization practices, emergency preparedness, infectious disease
reporting, best practices for parent and child health.
• FAS Prevention – Healthy Promise
• Shelter Services – health care screenings for youth by public health nurse.
• Lactation Consultants and Breastfeeding Specialists.
• Car Seat Safety.
• Follow Along Program.
• Immunizations and public clinics, immunization registry.
• Bereavement visits for parents experiencing loss.
• Teen parent home visits and school credits.
• Screenings: Blood pressure, prenatal and post- partum depression, Mantoux, hearing, vision,
alcohol and drug abuse, infant mental health, developmental.
• Toes R Us clinic for seniors.
• WIC nutritional services and education.
• Parenting classes, Young parents, Baby Steps, Infant Massage
• Health fairs
• Personal Care Assessments
• Child and Teen Check-up outreach.
• Child and Teen Check-ups with focus on ages 3-4 and adolescents who are behind schedule.
72
Carver County:
County Administration
Agency Name:
Carver County Community Social Services
Director’s Name:
Gary Bork
Address:
602 East 4th Street
Chaska, MN 55318-2102
Telephone Number:
(952)361-1600
FAX Number:
(952)361-1660
Area of
Responsibility
Name
Title
Telephone
Number
Social Services
Gary Bork
Director
(952) 361-1670
Public Health
Mental Health Adults
Mental Health Children
Rod Franks
Marcee Shaughnessy
Income Support Manager
Public Health Manager
Behavioral Health
Manager
(952) 361-1710
(952) 361-1312
Dan Koziolek
Child & Family Manager
(952) 361-1640
Chemical
Dependency
Transportation
Gary Norman
Behavioral Health
Manager
(952) 442-3093
Rod Franks
Income Support Manager
(952) 361-1710
Gary Norman
73
(952) 442-3093
While there are many minorities, specific services in the adjacent metropolitan area, there are few such
services in Carver County and transportation to services outside of the county frequently becomes a
barrier.
Access to dental services for MA and MinnesotaCare recipients is often a challenge due to limited
providers, long waits to get appointments, and transportation barriers to available providers when they
are some distance away.
Recipients have two local outpatient chemical dependency providers from which to choose. Both
providers have a contract with Carver County. Hazelton in Chaska and Five Stars Recovery Center in
Chaska provide outpatient treatment. Five Stars also provides sober housing and outpatient treatment
services with housing.
Carver County operates a full mental health center at an office in Waconia and with satellite office hours
in Chaska. First Street Center provides Rule 29, Rule 79, and Mobile Crisis services. The center is willing
to continue to contract to provide Targeted Case Management to eligible adults with serious and
persistent mental illness.
Transportation is a frequent barrier to access to mental health services and lack of affordable housing
can create an unstable living environment which can be a barrier to sustained mental health.
Carver County Community Social Services is willing to continue to contract to provide Targeted Case
Management services directly to eligible children at the annual rate established by DHS. Outpatient
mental health services are available through Carver County at First Street Center and from private
practitioners within the county. Day treatment is available through Carver County’s ANICCA Day
Treatment Program in Chanhassen. Partial Hospitalization Services are available at Prairie Care’s location
in Chaska. There are no Residential Programs for mental health within Carver County. Child psychiatry is
available through Carver County at First Street Center. Carver County has a very limited capacity to
provide diagnostic assessments of infants and toddlers.
There is a need for increased local access to child psychiatry, DC:0-3 diagnostic assessments and
evidence-based trauma therapy for children and parents.
SmartLink Transit, operated by Scott County, provides mass transportation in Carver and Scott Counties
from Monday – Friday from 5:30AM to 7:00 PM. SmartLink is integrated with the Dial-A-Ride and ADA
services of the surrounding communities via the regional TransitLink system.
SmartLink Transit provides mileage reimbursement and rides for residents of Scott and Carver Counties
who are eligible for MA transportation benefits. Residents, who receive benefits, may qualify for
reimbursement of transportation costs. Private medical transportation is available in Carver County
through Allina Medical Transportation and Ridgeview Hospital in Waconia.
Carver County Public Health provides a wide array of essential public health services which include
preventing the spread of disease, protecting against environmental hazards, preventing injuries,
promoting and encouraging healthy behaviors, responding to disaster, and assuring the quality and
accessibility of health services. Our mission is to promote and protect health for all in Carver County.
In 2014, Carver County residents and workers participated in a community health assessment to identify
issues that affect them. State and local health data and statistics from a wide array of sources were also
reviewed as part of the assessment process. Through this process, the top three community health
74
priority issues identified for 2015 – 2019 were obesity and chronic disease due to physical inactivity and
unhealthy eating habits, mental health concerns that impact quality of life and health care costs, and
local low-cost dental services. County was awarded the Statewide Health Improvement Program (SHIP)
grant to address obesity and chronic disease, with a focus on those residents who may be experiencing
health inequities.
Carver County belongs to the Metro Alliance for Healthy Families (MAHF), practicing Healthy Families
America home visiting program. Carver County Public Health also provides health education classes, car
seat and CarFit education and clinics, and immunization clinics twice per month for those who are
uninsured or underinsured. Carver County would benefit from extra support of the SHIP grant efforts
and early childhood development services, such as home visiting.
Carver County Public Health partners with River Valley Nursing Center to provide education, resources,
and referrals into the health care system for residents who are uninsured or underinsured. Carver
County residents struggle to find local low-cost dental care, mental health services, and affordable
transportation. Although providers exist, many only accept a certain percentage of their clients as MA
recipients, leaving limited options and/or long waiting lists. Residents needing specialty care must often
travel longer distances.
75
Cass County:
Agency Name: Cass County Health, Human and Veterans Services
Director’s Name: Reno Wells
Address: PO Box 519, Walker MN 56484-0519
FAX Number: 218-547-1448
Social Services
Name
Michele Piprude
Title
Social Services Manager
Telephone Number
218-547-1340 Ext 225
Wanda Reed
Income Maintenance
Supervisor Adult
218-547-1340
Ext 328
Sarah Smythe
Income Maintenance
Supervisor Family
218-547-1340
Ext 327
Public Health
Jamie Richter
Lori Muller
Director of Public Health
Nursing
Cass County Team Leader
218-547-1340
Ext 201
218-547-1340 Ext
Michele Piprude
Social Services Manager
218-547-1340 Ext 225
Chemical Dependency
Tammey Stacey
Cass County Team Leader
218-547-1340
Ext 245
Transportation
Kim Minton
Support Services
Supervisor
218-547-1340
Ext 302
Other –
Business Manager
Melanie Wolfe
Business Manager
218-547-1340 Ext 152
76
Cass County faces unique challenges in meeting the health care needs of MA and MinnesotaCare
recipients based on being extremely rural, large geographical sized, and no large cities hubs of
population which limits health care resources available in Cass County. The majority of the Leech Lake
Band of the Ojibwe Reservation is located in northern Cass County which American Indian/Native
American residents comprise 11.3% of the population of Cass County. Cass County has unique
socioeconomic factors including high rates of uninsured individuals, high poverty rates, and health
inequities demonstrated by poor health care outcomes which impact health care services.
There are limited health care providers within Cass County so a large percentage of recipients seek
medical care in the surrounding counties and key urban cities. There are no community hospitals in Cass
County. The 13-bed Indian Health Service facility located in Cass Lake is no longer functioning as a
hospital offering services. Cass County is designated as a Health Professional Shortage Area and a
Medically Underserved Area. Cass County has 9 small communities not specialized located medical
clinics in which some medical clinics are designated for the Minnesota Federally Qualified Health
Centers and Rural Health Centers. Of these 9 medical clinics located in Cass County, we have 5 separate
medical systems managing services.
The health care access issues are listed below.
1.
Lack of health care services providers for mental health, chemical dependency, and dental
services are limited within Cass County.
2.
In conjunction with lack of specialized health care services in Cass County this leads to extensive
barrier of transportation challenges for recipients in our rural communities. Lack of public
transportation and many county residents reliable transportation.
3.
Timely access to health care services appointments is a barrier in dental, mental health, and
chemical dependency services.
4.
Assuring more streamline approach for services authorization of process for recipients to
received needed services.
5.
Access to home care services are limited based on low reimbursement rates and large
geographical areas.
Mental health access is a huge challenge with only two counseling providers, no psychiatric service
providers in Cass County, and timeliness to access services is a barrier. Children’s Mental Health has
only one in Cass County provider available. There are no infant mental health providers in Cass County.
There are few dental providers that will accept new clients on MA/MinnesotaCare and who are willing
to accept populations on public programs due to low reimbursement and no-show experience.
Timely access and prior authorization process to for acute and longer term chemical dependency
treatment needed by recipients process need to be streamlined to assure recipient needs are met.
Methadone treatment and Half Way houses are unavailable in Cass County.
77
Chippewa County:
Agency Name: Chippewa County Family Services
Director’s Name: Patrick Bruflat
Address: 719 North 7th St. Ste.200
Telephone Number: 320-269-6401 Ext. 1127
FAX Number: 320-269-6405
Social Services
Name
Lisa Schultz /Pam
Modderman
Michelle Trulock
Public Health
Liz Auch
Title
Social Service
Supervisors
Supervisor
PH Supervisor
Lisa Schultz
Same as above
Pam Modderman
Same as above
Chemical Dependency
Lisa Schultz
Transportation
Deb Thompson Prairie
Five Rides
78
Director
Telephone Number
320-269-6401
320-269-6401
320-843-4546
320-269-6578
1.
Chippewa County has a population of approximately 13,000 people; the economy is primarily
based on agriculture.
2.
The available health care services are primarily located in Montevideo, the county seat. The
local hospital/medical clinic is co-owned by Chippewa County and the City of Montevideo with
satellite clinics located in neighboring communities. Other health care services available include
dental, pharmacy, optical, home care, and PCA services. There is also a satellite office of the
Woodlands Mental Health Center located in Montevideo.
3.
Accessing health care can be difficult because of limited transportation and availability of MA
dental providers.
4.
Chippewa County lacks chemical dependency outpatient services for adults and adolescents
within the county and detox can be of short supply as well. In regard to mental health we do not
have any residential services located within the county.
5.
Benefit rates from the MCOs need to increase in order for MA/MinnesotaCare enrollees to
receive better access to services such as dental care and Rule 25 CD Assessments for example.
Refer to our Regional response Appendix M for more details.
79
Chisago County:
Agency Name: Chisago County Health and Human Services
Director’s Name: Nancy Dahlin
Address:
313 North Main Street
Center City, MN 55012
Telephone Number: 651 213 5601
FAX Number: 651 213 5685
Social Services
Name
Liz Dodge
Title
Social Services Director
Telephone Number
651 213 5664
Supervisors
Public Health
Todd McMurray
Ami Helmbrecht
Nancy Dahlin
Director
651 213 5637
651 213 5265
651 213
Angie Kemen
Lead Worker
651 213 5631
Angie Kemen
Lead Worker
651 213 5631
Chemical Dependency
Angie Kemen
Lead Worker
651 213 5631
Transportation
Todd McMurray
Supervisor
651 213 5637
80
Chisago County is located in close proximity to the metropolitan area, which houses a number of major
medical service providers for the East Central Minnesota Region. Chisago County residents access an
area hospital in Wyoming MN, which can also serve as a regional hospital for the five county area and
related services system.
Chisago County has three major nursing homes with a total of 217 beds, and over 500 customized living
beds located within its borders.
Issues that exist in Chisago County around accessing health care services are list below.
•
Dental- lack of providers accepting state funded healthcare
•
Chemical Dependency- hard time placing chronic users with medical issues, lack of long term
support system providing management of recovery
•
Public Health- Not enough funding for Early Intervention and Education for Dental, Family
Planning, Pregnancy and Mental Health
•
Mental Health (Adult)- Lack of Psychiatrists and Crisis Services
•
Mental Health (Children)- Lack of Psychiatrists, Infant Mental Health Specialists and Crisis
Services
•
Transportation- Not enough options. Need transportation for additional services to provide a
holistic approach. These services would include pharmacy trips, public health visits and not just
medical appointments. Lastly, we value a Prepaid Medical Assistance Plan (PMAP) that assures
our Chisago County vendors receive timely payment from the PMAP entity.
Currently there are currently no services unavailable because of our proximity to Twin Cities Metro
areas. Sometimes transportation is an issue because of the distance required to get medical services.
This can limit the availability.
All dental services are limited in their availability to the county’s MA and MinnesotaCare enrollees in
Chisago County.
81
Clay County:
Agency Name: Clay County Social Services
Director’s Name: Rhonda Porter
Address: 715 11th Street North Suite 502, Moorhead, MN. 56560
FAX Number: 218-299-7515
Social Services
Name
Pat Boyer
Hollie Wanner
Scott Madson
Stacey Christensen
Telephone Number
218-299-7136
218-299-7119
218-299-7073
218-299-7113
Kathy McKay
Title
Adult Services Supervisor
Disability Services
Supervisor
Children’s Services
Supervisor
Supervisor
Supervisor
Public Health Director
Larry Young
Public Health
Pat Boyer
218-299-7136
Scott Madson
218-299-7073
Chemical Dependency
Pat Boyer
Supervisor
Transportation
Larry Young
Supervisor
Supervisor
218-299-7111
Scott Madson
82
218-299-7111
218-299-7186
218-299-7136
218-299-7073
General Clay County Service Delivery and Access:
Clay County experiences unique service delivery issues due to the population density, border state
migration, public benefit/service differences and hospital services being located in Fargo, ND.
The inability to access dental care is a significant unmet health care need for low income and special
needs children, adults and elders in Clay County and throughout Minnesota. The barriers that contribute
to this problem include:
o
lack of available dentists that take new MA or MinnesotaCare recipients;
o
lack of dental facilities in our rural areas;
o
transportation challenges; and
o
lack of adequate funding through Medicaid for the majority of residents
Some additional problems recipients have in accessing dental care are waiting for an appointment when
they have more emergent needs, rigid scheduling, and being dropped from the provider for missed
appointments.
Clay County Social Services (CCSS) provides Rule 25 Assessments to voluntary and court ordered
persons. CCSS then determines need/eligibility for chemical dependency treatment as well as funding
via the Consolidated Chemical Dependency Treatment Fund (CCDTF). The assessor may make referrals
for treatment and will maintain involvement with the client and treatment provider throughout the
course of the service and aftercare planning.
Detoxification services are provided at the Clay County Receiving Center located in Moorhead. This is a
10 bed program operated by Clay County Public Health. Residents receive a Rule 25 assessment while at
the detoxification center.
Clay County Social Services is heavily involved in the Clay County Drug Court program. Clay County
would like the MCOs to be involved with client case planning for recipients in the Drug Court program.
Areas needing improvement in the Chemical Health area for Clay County include:
o
Funding for detoxification services in our Detox facility.
o
Increased funding for Intensive case management in the chemical dependency service area.
o
Increased programming for dual diagnosed CD/MI.
o
Increased on-site psychiatric and medication management services in residential programs.
o
Increased support for transportation to treatment on evenings and weekends.
o
Increased support for drug testing.
o
Increased emphasis on parent compliance with court orders when a juvenile is involved.
o
Lack of culturally competent CD providers.
o
Lack of Adolescent Halfway House services locally.
Public Health Nurses coordinate the provision of health and long term care services to members among
different health and social services programs and across settings of care including but not limited to
needs assessment, service authorization, care communication, coordination and risk assessment.
Areas of need/concern identified by Public Health in Clay County include:
o
Lack of senior companion services to the elderly
o
Limited chore service providers that offer snow removal, yard cleanup, window washing etc.
o
Lack of providers that offer assistance with relocations to a facility or another dwelling (includes
heavy lifting and trucks for transporting items)
o
Lack of health care specialists such as neurology
o
Location of the hospital system and specialists for Clay County are in Fargo, North Dakota
o
Lack of Nursing Home and Assisted Living beds for memory care services.
o
Timely and proper medical care and immunizations.
83
o
Increased need for prenatal care and parent education and prevention regarding FAS and
chemical use during pregnancy.
Emergency Mental Health Services are available for adults and children however the Local Advisory
Council would like a crisis bed for adults in the community. The majority of in-patient services are
provided by two local hospitals in Fargo, ND (Prairie St. Johns and Sanford) and the CBHHs in our region.
Clay County has contracts with Sanford and Prairie St. John’s for mental health hold orders.
Access to psychiatric care is difficult in Clay County. Length of time to see a Psychiatrist must be
reduced. Accessing appropriate psychiatric care in the rural areas of Clay County can create challenges
and transportation and telemedicine is needed to address this issue.
It is important that the MCOs work with the court system for court ordered mental health evaluations
and treatment, family, delinquency and criminal court proceedings and pre-petition screening for
commitments and commitment hearings. These situations require prompt response and authorizations
due to the time limits that exist.
Clay County Social Services and Public Health collaborate on a Reintegration Advance Planning Program
for jail inmates. There is a lack of mental health services for individuals who are incarcerated and better
access to clinical services, community supports, case management and housing are necessary. Clay
County would like the MCOs to be involved with client case planning for recipients in the Reintegration
Advanced Planning program.
Additional Issues Identified:
o
Lack of primary care medical staff able to identify mental health issues early on
o
Lack of flexible funding to provide for individualized needs identified by adult or child’s team.
o
Lack of transition services for SED kids fourteen and over.
o
Lack of trained providers to serve children from 0-5 with mental health concerns.
o
lack culturally appropriate MH providers in our community
o
Lack effective treatment options for sexually deviant behaviors of adults and children
o
Inability to managing aggressive behaviors across environments. This is becoming more of an
issue for schools and living environments due to reimbursement levels for intervening services
from available pay sources is decreasing.
o
There is a lack of pediatric providers for mental health services to children in our county.
o
Need to offer expanded coverage for alternative therapies for both adults and children.
Clay County Social Services authorizes transportation services to Minnesota Health Care Program
recipients per the Health Care Access Fund. CCSS has a Volunteer Driver Program which helps with offhour and long distance transportation needs.
Additional Issue Identified:
o
Limited bus services evenings, weekends and rural areas.
o
Lack of available bus tokens, criteria for the bus tokens vary between providers.
o
Lack of attendants to accompany physically fragile or mentally compromised elderly citizens to
health care appointments.
o
Unpredictable bus schedules can cause recipients to be late for health care appointments risking
them being cancelled.
o
Inability for some individuals or families to afford car repairs.
84
Clearwater County:
County Administration
Agency Name: Clearwater County Human Services
Director’s Name: Malotte Backer
Address: Box X, 216 Park Ave. NW, Bagley, Mn. 56621
FAX Number: 218-694-6163
County Agency Contacts
Area of
Responsibility
Name
Title
Social Services
Sandy Comer-Moen
Social Service Supervisor
Telephone
Number
694-6164
Public Health
Mental Health Adults
Mental Health Children
Tammy Kortan
Marissa Hetland
Sandy Comer-Moen
Fiscal Supervisor
Public Health—Director
694-6164
694-6581
694-6164
Sandy Comer-Moen
694-6164
Chemical
Dependency
Transportation
Others (Please List)
Sandy Comer-Moen
694-6164
Jolene Gitz
Transit Coordinator
Fiscal Supervisor
694-6164
694-6164
Tammy Kortan
85
General County Service and Access Issues:
Clearwater County houses one hospital with three clinics that serve the population. Each
reservation has a health care facility. We have two nursing homes in our County located in Bagley
and Clearbrook. There and two Assisted Living facilities in Clearwater County.
Since we have a hospital and clinics in our county we have health care services available. We
access specialty care from referrals to other facilities in our region if needed. We have enough
volunteer drivers to meet the needs of most transportation requests when medical services are
needed beyond our county. In Clearwater County, Sanford has a psychiatrist and a psychologist in
our county twice a month for each service.
Since the Northern Access clinic in Bemidji has been open, Clearwater County does not have an access
problem as they did a few years ago. Our office assists with transportation if there is a need. Our goal is
to maintain and continue the accomplishments that have been achieved with dental access and
maintain the existing network of dental providers willing to accept MHCP recipients.
Clearwater County uses Lakes Region Chemical Dependency for chemical dependency assessment and
outpatient treatment. There is also access to the White Earth Chemical Dependency treatment for
youth and adults. Clearwater County jail has access to outpatient chemical dependency services. There
are multiple sites for AA and similar services such as “Most Excellent Way” which is at the Clearwater
Life Center in Clearbrook.
Recipients receive outpatient chemical dependency services in Bagley and there are also services
available in neighboring counties. In-patient and detox services are provided outside of Clearwater
County as needed. Clearwater County lacks funding assistance for transportation to get clients to their
outpatient chemical dependency services. The same problem exists with inpatient facilities but some
providers do provide transportation to their programs.
The adult mental health system in Clearwater County provides an array of services including community
education and prevention, emergency services, community support program, outpatient treatment,
community residential treatment, screening and inpatient treatment.
Thief River Medical Center provides our Community Support Program. They work very closely with case
managers and other staff at our department to meet the needs of consumers. Some of the services
provided by our Community Support Program include medication monitoring, assistance in developing
independent living skills, client outreach, crisis assistance, and emergency assistance. We also have an
emergency 24-hour crisis phone line.
Clearwater County is involved with the Region II Adult Mental Health Initiative, which has developed
services for SPMI individuals. The Consumer/Survivor Network works closely with the Initiative and the
counties to supply educational and public awareness on mental health topics.
Clearwater County has a psychiatrist in our county twice a month and also a psychologist twice a month.
Our recipients have to travel for 72 hour and commitment holds and have found that the Bemidji CBHH
is full most the time and we are unable to access services within our Region. When we do access the
CBHH, the admission process has improved but still takes a long time to authorize a client’s stay at the
facility.
Currently in Clearwater County children’s mental health services consist of in-home counseling,
individual and group therapy, school base services, residential treatment, and medication management.
Case Managers work closely with Clearwater County Nursing Services and the schools for referrals.
86
Individuals are usually served with these programs within two weeks of referrals. The Tribes also have
their own mental health services for children including in-home counseling. It can be difficulties to find
child psychiatrists and therapists because of our rural setting.
Our goals for adult and children mental health services would be to increase access to crisis and
emergency MH services, provide a clear prior authorization process for MH services, have county-bycounty joint planning with plans for behavioral health services and work with county/regional MH or
children’s collaborative to improve service access and delivery.
Clearwater County coordinates transportation for access medical assistance appointments. Individuals
that do not have their own means of transportation, call Clearwater County Human Services for services
to their appointments. There is also a volunteer driver program through Clearwater County Human
Services, Veteran’s Services and the Reservations. We also contract with Tri Valley for bus service within
the County. At this time these three service entities communicate well with their program coordination.
Clients receive their transportation services by using the Tri Valley Transit bus program, assistance from
friends or family and volunteer drivers. The clients may call or come directly to the office for
services. In order to supply quality services, Clearwater County follows their Health Care Access Plan to
supply clients with cost effective transportation.
Since the Sheriff’s Office is no longer transporting patients to 72 hour holds and ambulance service can
be very expensive our Region 2 Adult Mental Health Initiative supports a program to transport
individuals in crisis situations in a reasonable and appropriate manner.
Clearwater County provides Public Health services in the following areas;
* Healthy Communities/Healthy Behaviors
* Assure Quality & Accessibility of Health Services Programs
* Prevent the Spread of Infectious Disease Programs
* Protect Against Environmental Health Hazards Programs
* Prepare For & Respond to Disasters & Assist Community in Recovery Programs
* Assure an Adequate Local Public Health Infrastructure Programs
87
Cook County:
Agency Name: Cook County Public Health and Human Services
Director’s Name: Sue Futterer
Address: 411 West 2nd Street, Grand Marais, MN 55604
FAX Number: 218-387-3020
Social Services
Name
Grace Bushard
Telephone Number
218-387-3624
Alison McIntyre
Title
Social Services
Supervisor
Eligibility Specialist
Public Health
Joni Kristenson
Public Health Nurse
218-387-3605
Grace Bushard
218-387-3624
Grace Bushard
Chemical Dependency
Grace Bushard
Transportation
Alison McIntyre
Social Services
Supervisor
Social Services
Supervisor
Social Services
Supervisor
Eligibility Specialist
Barb Rasmussen
Lead Adult Services
Social Worker
218-387-3609
Adult Services
88
218-387-3623
218-387-3624
218-387-3624
218-387-3623
Cook County is located at the tip of the Arrowhead in Northeastern Minnesota. The county is
geographically large in comparison to other counties and sparsely populated. The county borders
Canada, Lake Superior and Lake County. The majority of the county is public land and the county also
includes the Grand Portage Band of Ojibwa. Dental services, access to psychiatry and transportation
issues are primary concerns in Cook County as in most rural Minnesota counties.
Persons with limited incomes tend to be relatively isolated from health care services due to the
availability of providers and the distance required to travel to receive specialized care. People need to
travel to Duluth (approximately 265 miles round trip for those who live on the US/Canadian border) in
order to consult specialists and/or receive any type of surgical procedure. Pregnant moms travel long
distances to have their babies delivered. Any follow up for specialty pediatric care for infants and
children with special needs requires travel to Duluth and beyond. Most recently an increased number of
persons have been referred for cancer treatments to the Twin Cities area and Mayo clinic which
increased the need for alternate means of transportation.
There is limited public transportation through the Arrowhead Economic Opportunity Agency (AEOA)
bus. This bus provides service primarily within the city of Grand Marais during daytime hours. The bus
also makes two trips a month to Duluth. This transportation option provides limited benefit since
residents needing to use public transportation to Duluth for medical services are often too ill or require
special assistance to take the bus safely. It is also difficult to schedule appointments on the days
designated by the AEOA bus service for travel to Duluth. People who use their own automobiles are
also challenged by operating vehicles in poor working condition and low gas mileage. The
reimbursements from the Health Care Access fund do not begin to cover the costs.
In the past year the volunteer driver program operated under the Cook County PHHS In Home Support
Program has expanded. Having contracts with health plans who also pay a higher per mile
reimbursement rate to cover unloaded miles has been an advantage.
Cook County Public Health and Human Services (PHHS) offers Chemical Dependency (CD) case
management, CD assessments and outpatient treatment. All clients needing inpatient CD services are
referred to Duluth, or other regions of the state. (up to 400 mi away) Inpatient adolescent treatment
requires families to seek services outside of the Arrowhead Region, which causes great stress on the
family and children. Without family support and involvement in treatment, it is likely that youth will
need to re-enter treatment. Recovery coaching, aftercare programs and halfway houses are a very
necessary component of the recovery process and should be considered as part of a benefit set. These
resources do not exist in Cook County and without these services individuals are likely to relapse. There
is an increase in babies born affected by Neonatal Abstinence Syndrome (NAS). NAS, with its potential
for serious negative health outcomes could be decreased with a focus on greater support after the
completion of treatment.
89
Cottonwood County:
Agency Name: Des Moines Valley Health and Human Services
Director’s Name: Craig Myers
Address: 11 Fourth Street, PO Box 9, Windom MN 56101
FAX Number: 507-831-0126
Area of
Responsibility
Social Services
Name
Title
Telephone Number
Rebecca Wiens
[email protected]
507-831-1891
Angela Holmen
[email protected]
Supervisor
507-831-1891
Public Health
Pat Stewart
[email protected]
Public Health
Administrator/Director
507-847-2366
Mental Health –
Adults
Shelley Stevermer
[email protected]
rg
507-847-4000
Mental Health –
Children
Susan Miller
[email protected]
507-831-1891
Chemical
Dependency
Susan Miller
[email protected]
507-831-1891
Transportation
Angela Holmen
[email protected]
Supervisor
507-831-1891
Other – please list –
alternate contact for
Director – all areas
Kay Steffen
[email protected]
Director of Agency
Operations
507-847-4000
90
Cottonwood County is a small, rural community in Southwest Minnesota. The population for
Cottonwood County is 11,687. Windom, the county seat, is the largest city in the county with a
population of 4,646. Cottonwood County has a strong agricultural focus. The county has a lower
economic level with median income at $43,223 compared to the state average of $59,126. Cottonwood
County’s poverty level is 12.7% compared to the state average of 11.2%. The county also has a higher
than average rate of disabled individuals.
Cottonwood County has two small hospitals, Windom Area Hospital and Sanford Westbrook Medical
Center. Access issues are one of the major challenges to health care in Cottonwood County.
Transportation presents a significant barrier to residents of Cottonwood County. Cottonwood County’s
public transportation is limited by hours and range. Because of this, Cottonwood County relies heavily
on volunteer driver services to try to meet the needs.
Another significant issue is the lack of or very limited access of some services in the county. Dental
services for MA and Minnesota Care recipients are hard to obtain and frequently requires long distance
travel outside the county. One to two hours of travel time one-way is common. Dentists within the
county are reluctant to take MA clients due to the low rate of payment. Chemical dependency services
are another service that is limited within the county, with only one provider and no treatment options
for adolescents. Mental health services are partially met, but we see long waits for appointments.
There is also limited types of mental health services available and a disconnect between local physicians
who are prescribing medications and the mental health service providers.
Cottonwood County also sees the need for a stronger relationship with MCOs in communication and
partnership around case management with social services and public health with emphasis on
appropriate rates and investment in local development of services.
There is also a need for greater work with Public Health around looking at and funding prevention
oriented activities across the range of our county population.
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Crow Wing County:
Agency Name: Crow Wing County Community Services
Director’s Name: Kara Terry
Address: 204 Laurel St., Brainerd, MN 56401
Telephone Number: (218) 824-1205
FAX Number: (218) 824-1305
Social Services
Name
Gwen Anderson
Kara Griffin
Public Health
Gwen Anderson
Tami Lueck
Lynda Erickson
Chemical Dependency
Tami Lueck
Transportation
Kara Griffin
92
Title
Health and Social
Services Division
Manager
Operations
Supervisor
Health and Social
Services Division
Manager
Adult Services
Supervisor
Family Services
Supervisor
Adult Services
Supervisor
Operations
Supervisor
Telephone Number
(218) 824-1077
(218) 824-1159
(218) 824-1077
(218) 824-1186
(218) 824-1187
(218) 824-1186
(218) 824-1159
In Crow Wing County health care services are accessed via personal vehicles, by foot, county transit bus,
friends or relatives, MediVan, ambulance, health plan transportation programs, taxi, volunteer drivers
and air transport.
The issues that exist around accessing health care are primarily health care coverage, lack of local
specialists, lack of comprehensive bus system and lack of funding for gas (per individual, lack of
treatment/placement options around specific populations such as juvenile sex offenders and juvenile
sex offenders who are SPMI (severe and persistent mental illness). There are transportation issues
related to chemical dependency treatment. There are only two treatment programs who offer
transportation which sometimes limits what programs will work for some clients. Detoxification services
that are not covered by insurance coverage continue to burden the community and the tax payer.
Currently the health care services that are unavailable for Crow Wing County enrollees are pediatric
intensive care services, psychiatric services especially for children which Crow Wing currently has none,
neurology, dermatology and although dental providers are available, that service remains unmet for the
level of demand in Crow Wing County for the MA/MinnesotaCare population. Dual Diagnosis programs There are two outpatient programs in Brainerd and a third program working on certification. Most of
those struggling with substance abuse have co-occurring disorders and treating these concurrently is the
most beneficial to the client. The county could benefit for an inpatient treatment program that works
with dual diagnosed individuals. There is a need for long term supportive groups and housing to support
chemical dependent persons coming out of treatment.
Dental, specialized medical services and higher level of acuity/intensive care services for the pediatric
population are limited in their availability to the county’s MA and Minnesota Care enrollees.
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Dakota County:
Agency Name: Community Services Administration
Director’s Name: Kelly Harder
Address: 1 Mendota Rd W, Suite 500, West St. Paul, MN 55118
FAX Number: (651) 554-5948
Social Services
Andrea Zuber
Marti Fischbach
Public Health
Bonnie Brueshoff
Emily Schug
Joan Granger-Kopesky
Chemical Dependency
Emily Schug
Transportation
Emily Schug
Community Corrections
Barbara Illsley
Workforce Services
Mark Jacobs
Name
94
Title
Social Services
Director
Director
Public Health
Director
Social Services,
Deputy Director
Social Services,
Deputy Director
Social Services,
Deputy Director
Social Services,
Deputy Director
Community
Corrections
Director
Workforce
Services Director
Telephone Number
651-554-6344
651-554-5618
651-554-6103
651-554-6316
952-891-7458
651-554-6316
651-554-6316
651-438-8290
651-554-5622
Dakota County is located in the southeastern section of the 7-county Twin Cities Metropolitan area. As
of 2013 Census, the county had 408,000 residents, maintaining its third largest county status in
Minnesota. Majority of county residents live in cities and suburban residential areas, with more sparse
populations living in rural areas in the south and south east sections of Dakota County.
Dakota County has two hospitals - Fairview Ridges in Burnsville and Regina Medical Center in Hastings,
as well as one border hospital to the south in Northfield, and several hospital options in St. Paul, MN on
the northern border. Apart from acute hospital care, Dakota County has 8 Urgent Care Clinics, 10
Convenience Center locations, and 9 Nursing Home facilities. With well over 3 dozen Primary Care
clinics and a variety of specialty care providers, Dakota residents have many options to choose from for
their health care needs.
With metro sprawl and convenience, residents will use providers in neighboring metro counties,
including providers located in Ramsey, Scott, Hennepin and Rice County.
Some resources are limited in Dakota County, for Public Program recipients, including mental health
professionals, substance abuse providers, oral surgeons and a steadily increasing lack of dental
providers accepting Medical Assistance. In addition, specific service providers lack services such as
injectable medication provided at a clinic level.
The lack of specialty services county-wide limit clients’ ability to access these services, while placing a
strain on remaining providers. As a result, DC clients have longer wait times due to the demand and
availability of the respective services.
Specifically, access to care in the eastern most part of the county (like Hastings, MN) is limited to the
mainly Allina Clinic system, allowing little clinic choice options for nearby residents. Limited access,
occasionally prevent clients from on-time arrivals for appointments, which sometimes results in them
being dropped from that provider. This can create undue hardship for the client with limited or no
options for alternative service offerings.
Eligible clients can obtain transportation via MNET who receive regular Medical Assistance and via each
of the MCO’s ride programs for any client enrolled in a prepaid MCO/MA health plan. (Note: Common
carrier transportation is not available to MinnesotaCare enrollees). Volunteer programs also exist for
those not on a public program, via county-specific contracts. Despite having these transportation
options, they still do not adequately cover the rural regions of the county.
Finally, based on Dakota County’s demographic projections, the county’s cultural diversity is changing.
Consequently, there is a greater need to identify and address the cultural and language barriers that
prevent certain populations from accessing the county services.
95
Minnesota Prairie County Alliance (Dodge, Steele and Waseca Counties):
Administration:
Agency Name: Minnesota Prairie County Alliance
Director’s Name: Jane Hardwick
Address: 22 East 6th Street, Dept. 401, Mantorville, MN 55955
FAX Number: (507) 635-6186
Agency Contacts:
Name
Title
Telephone Number
Social Services -Adults
Julie Holgate
Tara Watson
Hanna Marzinske
Rosalie Grams
Supervisor
Supervisor
Supervisor
Supervisor
507.635.6182
507.444.7533
507.444.7561
507.835.0577
Social Services -Children
Stephanie Burton
Wendy Morton
Dean Schneck
Supervisor
Supervisor
Supervisor
507.635.6126
507.835.0585
507.444.7560
Income Maintenance
Cathy Skogen
Linda Johnson
Valerie Elzen
Supervisor
Supervisor
Supervisor
507.635.6172
507.835.0574
507.444.7535
Public Health
Peggy Espey
Stan Groff
Amy Roggenbuck
Director
Director
Director
507.635.6150
507. 444.7665
507.835.0656
Julie Holgate
Hanna Marzinske
Rosalie Grams
Supervisor
Supervisor
Supervisor
507.635.6182
507.444.7561
507.835.0577
Mental Health - Children
Stephanie Burton
Wendy Morton
Dean Schneck
Supervisor
Supervisor
Supervisor
507.635.6126
507.835.0585
507.444.7560
Chemical Dependency
Julie Holgate
Hanna Marzinske
Supervisor
Supervisor
507.635.6170
507.444.7561
Transportation
Cathy Skogen
Valerie Elzen
Linda Johnson
Supervisor
Supervisor
Supervisor
507.635.6170
507.444.7535
507.835.0574
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General Service Delivery and Access Issues:
Minnesota Prairie County Alliance (MNPrairie) is a Service Delivery Authority (SDA) organized under
Minnesota Statutes 471.59 and 402A. It is comprised of the Human Service Departments of three
counties: Dodge, Steele and Waseca, located in Region Ten in the southeast portion of Minnesota. The
three-county area is largely rural in nature. The largest town, Owatonna, is centrally located in the
MNPrairie area. MNPrairie is located between two major population centers; Rochester and Mankato.
The Public Health Departments of Dodge, Steele, and Waseca are not members of the SDA; but they
continue in their commitment to protect and promote the health of the residents of the three counties
Dodge County is classified as a Metropolitan Statistical Area (MSA) as a significant portion of its
residents commute to the adjacent city of Rochester for employment purposes. While Dodge County is
classified as a MSA, the health care service capacity physically located within the county is limited.
MNPrairie residents primarily access medical services within the MNPrairie area and the surrounding
communities of Mankato and Rochester.
The key service delivery and access issue in MNPrairie is transportation. MNPrairie will continue to
utilize their State Health Care Access Plan to provide transportation services. Within the city of
Owatonna there is a well-developed public transit system. However, outside of the city of Owatonna,
transportation to medical providers depends largely on volunteer driver programs such as SEMCAC,
Faith in Action, Minnesota Valley Action Council and Aging Services Volunteers. Specialized nonemergency transportation options are limited. Only two companies provide specialized non-emergency
transportation services: AmeriCare Mobility Van (AMV) and R&S; both headquartered outside of
MNPrairie boundaries. The MCO coordinate transportation needs with available providers and to
actively pursue development of new transportation resources. Expanded options in transportation will
provide increased access to providers and promote client choice.
Other issues are:

Assuring enrollee access to the following services for which access is of particular concern:
o
Dental Services
o
Timely Psychiatric access

Coordination with county public health, detailing how gaps and duplication of service will be
avoided.

Using the expertise of Public Health in serving specialized populations such as families with
newborns, families at risk for abuse or neglect, families with special needs children, children at
risk for developmental delays, teen parents, single parents, children under the age of five who
are at nutritional risk, pregnant or breastfeeding women, post-partum women, infants, children
and young adults in need of routine health checks, Refugee and Migrant families.
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Douglas County:
Agency Name: Douglas County
Director’s Name: Mike Woods
Address: 809 Elm St., Suite 1186
Telephone Number: 320 -762-2302
FAX Number: 320-762-3833
Social Services
Name
Mike Woods
Director
Dawn Cooper
Supervisor
Public Health
Sandy Tubbs
Director
Sandy Olson
Supervisor
Laurie Bonds
Supervisor
Chemical Dependency
Sandy Olson
Supervisor
Transportation
Mike Woods
Director
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Title
Telephone Number
320-762- 2302
Faribault & Martin Counties:
Agency Name: Human Services of Faribault & Martin Counties
Director’s Name: Kathy Werner
Address: 115 W 1st St, Fairmont, MN 56031
FAX Number: 507-238-1574
Social Services
Name
Vickie Savick
Rhonda Hines/
Nicole Worlds
Public Health
Carmen Reckard
Liz Odom
Liz Odom
Chemical Dependency
Vickie Savick
Transportation
Rhonda Hines/
Nicole Worlds
Michele Miller
Business Office
99
Title
Social Services
Manager
Financial
Assistance
Supervisor
Community
Health Service
Manager
Social Services
Supervisor
Social Services
Supervisor
Social Services
Manager
Financial
Assistance
Supervisor
Director of
Business
Management
Telephone Number
507-526-3265
507-526-3265
507-238-4757
507-238-4757
507-238-4757
507-526-3265
507-526-3265
507-238-4757
We are a two-county Human Services Agency. We are a rural area and timely specialty care is often
limited and often requires travel of a distance of 100 miles or more. We expect all responders to service
the health care needs of both Faribault and Martin Counties. In order to facilitate client choice, we
expect that the network of providers will include Human Services of Faribault & Martin Counties for
services that are currently being provided. The services include: Targeted case management,
community support program, Child & Teen checkups, immunizations, lead screening, public health nurse
clinics, public health home visits, transportation and Rule 25 assessments.
People report to the clinic or emergency room of their choice; however, the transportation rule of using
a primary care provider within 30 miles limits choice. Providers may also refuse a patient making this
impossible in our area. Transportation can be an issue with the required 24 hour notice needed prior to
obtaining a ride.
There is a significant shortage of primary dental providers in both counties. Six out of ten are not taking
new MA patients. Our clients often have to travel a distance of 50 miles or beyond to access basic
dental services.
Timely access to specialty providers is also limited. These specialty providers include: psychiatry,
neurology, orthodontia, and very specific specialists like pediatric urology, etc.
Several issues have come up for clients who are covered by MCO’s. History shows that some clients
need to participate in treatment several times before they can successfully maintain their sobriety. We
have had clients who have had services denied because this is a pre-existing condition. Clients are poor
historians making it hard to gather accurate duration/pattern of use resulting in possible denials.
Transportation to medical appointments is covered but not rides to treatment. Billing issues can cause
difficulties for treatment providers. Limiting the length of stay in a program can be detrimental to the
client who is trying to retain sobriety. Decisions on entry into treatment need to be made quickly.
There are many mental health providers that work with us regionally and we want to make sure the
provider network includes all of them as this would best serve our consumers. An issue continues to be
the ability under managed care to provide adequate transportation services to ensure service access
beyond 60 miles or for specialty care.
Health behavioral aides would be a better service for the children with mental health behaviors who are
currently being serviced by Personal Care Assistance Services. Lack of providers of play therapy also
creates a gap.
Child & Teen Checkups are not available from our largest provider. This adversely affects our C & TC
participation rates.
We have a robust and diverse Statewide Health Improvement Program (SHIP). We would like assurance
that the Health Plan will support and promote primary prevention for chronic diseases. Specifically, the
Plan will work with provider network to support and enhance SHIP (Statewide Health Improvement
Program) activities.
Many of the providers are delaying initial prenatal visits until the 2nd trimester and this concerns us and
we would hope that the MCO’s would work to address this issue.
100
Fillmore County:
Agency Name:
Agency Name:
Social Services
Public Health
Director’s Name
Beth Wilms- Community Services Director
Neva Beier-Social Services Manager
Address
902 Houston St NW Suite 1
Preston, MN. 55965
Telephone Number
507-765-2175
FAX Number
507-765-3895
Lantha Stevens
Director’s Name
Address
902 Houston St NW Suite2
Preston, MN. 55965
Telephone Number
507-765-3898
FAX Number
507-765-2139
Name
Title
Telephone Number
Community Services
Social Services
Public Health
Beth Wilms
Neva Beier
Lantha Stevens
Director
Manager
Director
765-2175
765-2175
765-3898
Wendy Ebner
765-2175
Wendy Ebner
Chemical Dependency
Wendy Ebner
Transportation
Neva Beier
Social Services
Supervisor
Social Services
Supervisor
Social Services
Supervisor
Manager
Neva Beier
Supervisor
765-2175
101
765-2175
765-2175
765-2175
1)
There are no hospitals in Fillmore County
2)
There are 6 clinics in Fillmore County that are affiliated with larger clinics in 3 different states: 3
affiliated with Olmsted Medical Clinics in Rochester, MN; 1 affiliated with Gundersen Lutheran in
La Crosse, WI; 1 affililated with Winona Clinic in Winona, MN and 1 affiliated with Mayo Clinic out
of Decorah, IA
3)
Fillmore County residents generally travel to medical services in Rochester, Winona and Austin in
Minnesota, LaCrosse, Wisconsin and Decorah and Cresco providers in Iowa. This creates service
coordination and transportation issues.
4)
The rural make up and relatively small population of Fillmore County inhibits cost effective
program development.
5)
Specialized care and chronic care management are often not available in the county.
6)
There is a need for detailed provider education as to billing procedures, service eligibility and a
user friendly provider help desk.
7)
Providers of dental services adhere closely to the rule that their client base only has to include a
minimum of 10% MA participants.
8)
There is a lack of participating providers that accept new MA clients if their base is at 10% due to
low MA reimbursement issues and large percentage of “No Shows” in the MA population.
9)
Enrollees have to travel great distances to find available dental care. Clients are referred to in
county providers and find-a-dentist services. Clients are also referred to Community Dental Care
in Rochester for preventative and restorative dental services.
10)
A MCO(s) could help increase the number of participating providers by offering higher
reimbursements to dentists and case management services to participants to help them keep
their dental appointments.
As there is just one out –patient CD teatment provider located within the county, current enrollees may
have to travel out of the county to obtain services
Lack of transportation is an issue. A number of clients don’t have valid driver’s licenses so they rely on
others for transportation. That solution is often unreliable, expensive and inconvenient for those
helping out.
Fillmore County currently contracts with the following chemical dependency treatment providers: Inpatient: Fountain Centers, Community Addiction Recovery Enterprise Program, Unity House, Laar
House. Outpatient: Wenden Recovery Services, Fountain Centers, Common Grounds, Zumbro Valley
Mental Health Center (ZVMHC), Halfway house, Pathway House, Unity House, Laar House, House of
Hope, West Hills Lodge. Rule 25 is completed by Fillmore County Social Services and other outpatient
CD providers. Hiawatha Valley Mental Health Center (HVMHC) also provides mental health services to
our adults living in the eastern part of the county. Residents are also traveling to La Crosse, WI as well
as Decorah, IA for services.
Psychiatric services are hard to access. Transportation is difficult for individuals, there is no mass transit
in the county and MCOs are having difficulty as well finding providers to take enrollees to their
appointments outside the community in which they live. Independent supported housing services are
difficult to find as well as crisis services.
Fillmore County contracts with ZVMHC and HVMHC. Fillmore County is also a member of the CREST
Regional Adult Mental Health Initiative and a continuum of services are available in the region.
102
Currently clients can access care for their mental health needs at their primary care clinic. If that clinic
does not have a provider, they can be referred and most, if not all service costs, will be covered by their
plan. They are able to get ongoing care, therapy and medication management as part of the services
provided. They are also able to get their medication under their plan at a minimal cost to them. If
hospitalization is needed, that is also available to them. Fillmore County also recently began contracting
with Hiawatha Valley Mental Health Center, of Winona, to provide Children’s Mental Health Targeted
Case Management services to our MA clients as well as those not on a health care plan. The service will
include outreach, independent living skills, crisis assistance, respite care, medication monitoring. They
will also administer the CTSS component which includes psychotherapy, skills training and crisis
assistance. We also have the Root River school program. This is a setting IV mental health site that
provides programming for students with severe emotional or behavioral issues. This is currently
available for students in grades 7 – 12.
There is a profound need for reliable and affordable transportation. There is a need for a local hospital
with a mental health specialist on staff. Few services are available in Fillmore County. Many of our
residents travel to larger surrounding cities to access care for their mental health needs. The MCO(s)
allow for this and there is also programming to reimburse clients for transportation costs for approved
medical and therapy appointments. Residents also are transported to out of county hospitals for
emergency crisis services. Their MCO(s) cover these costs for the client.
One of the areas where current programs are not meeting the needs of clients is in the area of accessing
services over state borders. Fillmore County residents live close to both the Iowa and Wisconsin
borders. Many use medical providers in those states, they may find that their care plan covers their
standard medical care but then find that their plan does not cover their mental health care.
Fillmore County Public Health employs professionals in the areas of home care, health education, and
maternal and child health. The mission of Fillmore County Public Health is “Supporting healthy lifestyles
among Fillmore County residents through performance, prevention, promotion, and protection.”
Typically, local public health services are targeted toward: families with multiple needs (e.g. frail elderly,
the disabled), families with newborns; at-risk antepartum women; young single first-time parents; lowincome children under age five who are at nutritional risk; low-income pregnant women or breastfeeding women; families with special needs children; children in need of immunizations; and
communities.
Fillmore County Public Health interventions are applied at the community, systems, and
individual/family levels to a given population and a problem.
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Freeborn County:
Agency Name: Freeborn County Department of Human Services and Freeborn County Public Health
Director’s Names: Brian Buhmann and Sue Yost
Address:
203 West Clark
Albert Lea, MN 56007
411 S. Broadway
Albert Lea, MN 56007
507-377-5100
FAX Number:
507-377-5272
507-377-5498
Name
Title
Telephone Number
Social Services
Lisa Appelhof
Supervisor
507-377-5485
Jill Westney
Supervisor
507-377-5435
Public Health
Sue Yost
Director
507-377-5100
Mark Kossman
Supervisor
507-377-5442
Maureen Williams-
Supervisor
507-377-5453
Lisa Appelhof
Supervisor
507-377-5467
Chris Davis
Supervisor
507-377-5459
Zelenak
Chemical Dependency
Transportation
104
There is a single clinic and hospital-Albert Lea Medical Center-Mayo Health System with several satellite
clinics in the smaller nearby towns in Minnesota and Iowa. It includes detox and inpatient/outpatient
chemical dependency treatment for both adults and juveniles. There are three large nursing facilities
with assisted living and independent living facilities. There are two ICF/MR facilities, numerous group
homes for persons with developmental disabilities.
Our current MCO provides us with a county staff position funded to act as a liaison to the clients served,
the county and the current MCO. This position receives and answers/triages incoming calls from
members, Primary Care Providers and community providers regarding services currently being offered.
A call to new enrollee is made through this position welcoming them to our plan. They make referrals to
a Care Coordinator, Clinical Consultant or Nurse Facilitator if a Care Plan needs to be developed and
implemented. They assist members in making medical appointments, many times providing the
transportation and staying with members for their medical visit. The CRMT assures that all the data,
reports, information, plan tools, programs and plan explanations are communicated to appropriate
county staff as provided by the MCO.
Freeborn County entered into an agreement with the current MCO who has delegated certain care
coordination and other services to our agency. The MCO has delegated the Rule 25 assessment services
and placing authority responsibilities with our agency. Freeborn County is responsible to maintain our
current contracts with providers who assess Rule 25 assessments and follow the recommend treatment
plans. Locally clients are served by two providers-Fountain Centers-inpatient/outpatient, Detox services
and the Chemical Dependency Center-Rule 25 assessments.
About 20-25% of the Rule 25 assessments are completed by county staff. Counseling services plus the
majority of the Rule 25 assessments are completed by the Chemical Dependency Center of Freeborn
County by way of a county contract.
One of our providers is planning on expanding their services to be modeled on the Project Turn-about
program based out of Granite Falls, MN. Client placements for treatment services will cross the county
lines to other providers within our region and potentially in Greater Minnesota through the use of
county host contracts.
Freeborn County Mental health Center consists of a program manager, three therapists (Licensed
Independent Clinical Social Workers), one psychologist (Psy.D., contracted for 16 hours per week), one
psychiatrist (M.D., contracted for 16 hours per week), two registered nurses (county employees funded
by SCCBI), three social workers/case managers (three county employees), two case aides (one state
employee, one county employee funded by SCCBI). A pediatrician provides medication services for
children one day per week.
Three social workers provide case management, and they have a total case load of 125 people. The case
load limit mandated by statute is 40 clients per case manager. The case managers are assisted in
providing these services by the case aides and the registered nurses.
All three of these agencies provide services under Adult Rehabilitative Mental Health Services (ARMHS)
for client with public health insurance. The county sometimes pays for similar services for clients not
covered by such insurance using money from our state grant for CSP services. Our case aides and case
managers also provide these services to some clients.
105
Cedar House can bill public and private health insurers to pay for day treatment. The county also pays
for day treatment for uninsured clients using funds from our CSP grant.
Freeborn County Children’s Mental Health Unit employs nine social workers, one mental health
professional, and one social services supervisor (who by Statute is a mental health professional). We
have three programs: Children’s Mental Health Case Management, Family Based Counseling, and
Children’s Day Treatment. Public Health provides health screenings to identify a broad range of health
needs including mental health-these may be through maternal child health clinics, “Healthy Families”
assessments and nursing home pre-admission screenings. Caseloads are dictated by Rule 79 and in the
case of Day Treatment by Chapter 16 of the Minnesota Health Care Programs.
The county provides Targeted Case Management for the children who are opened for CMH case
management services. We also participate in several collaborative efforts which ultimately bring in
funding. We are part of a five county Family Group Decision Making network through a state grant. This
pays for the salaries of 1.5 social workers and the costs of the family meetings, which are in many cases
court ordered. We also have been participating in an 11 county Children’s Mental Health Initiative
which was granted $500,000 by the state legislature. These funds are to be spent on services for the
children with open CMH cases in our individual counties. Our Day Treatment Programs (Options) are
run at Southwest Middle School and the Albert Lea High School and offer services to all county
residents. This is a joint venture between Freeborn County DHS and the Albert Lea Area (district 241)
Schools. It is one of a number of ventures to provide community based services as an alternative to outof home placements.
The current MCO has done a good job of coordinating between Freeborn County’s Local Access Plan and
the needs of our enrollees which includes out of county travel. It has included non-emergency medical
transportation providers for persons with wheelchairs or having other mobility impairments. The
Sheriff’s Department provides transportation for clients under Court or 72 hour holds. Public
transportation in Albert Lea is provided through the Senior Resources, a non-profit agency which
manages a fixed bus route and provides Title III transportation services for senior citizens.
Freeborn County is involved in several local collaboratives:
•
Family Based Services- (including Family group decision making). These are in home services
counseling for families dealing with conflict because of emotional or mental health disorders,
delinquency behaviors and family relational conflicts.
•
Project to end homelessness- regional approach to address the services to transition homeless
participants back into being productive citizens in our communities.
•
Crime Victim’s Crisis Center-assist persons seeking orders for protection provides informational
and service to victims of any crime including domestic abuse.
Freeborn County Public Health coordinates or participates in a number of community initiatives which
have developed as a result of local planning efforts. These include such things as
• Freeborn County Family Services Collaborative
• THRIVE Initiative (focused on children’s mental health issues)
• Freeborn County Mental Health Collaborative
• Interagency Early Intervention Committee (IEIC)
• HUGS (the local child abuse prevention council)
• Community Initiative related to preventing drug and alcohol use among youth and young adults
• Toward Zero Death initiative
• ZAP(Zero Adult Providers) initiative
• Obesity prevention coalition
106
Goodhue County:
Agency Name: Goodhue County Health and Human Services
Director’s Name: Nina Arneson
Address: 426 West Avenue, Red Wing, MN 55066
FAX Number:
651-385-3191
Social Services
Name
Kris Johnson &
Villaran
Sheila Gadient
Public Health
Mary Heckman
Deputy Director
651-385-6154
Abby Villaran
Supervisor
651-385-6185
Kris Johnson
Supervisor
651-385-2022
Chemical Dependency
Abby Villaran
Supervisor
651-385-6185
Transportation
Mary Heckman
Deputy Director
651-385-6154
Finances & IT
Mike Zorn
Deputy Director
651-385-2029
Abby
107
Title
Supervisor
Telephone Number
651-385-2022 & 6185
Supervisor
651-385-3203
Goodhue County covers 764 square miles of rural farmland and small towns. The most populous city is
the county seat, Red Wing, with 16,452 people. Cannon Falls, Zumbrota, and Pine Island are located on
the Highway 52 corridor connecting the Twin Cities and Rochester. Other smaller communities include
Kenyon, Wanamingo, Goodhue, and part of Lake City. Nearly all of Prairie Island Indian Community is
within the county. The total population is 46,464 (2010 Census). The 2011 Goodhue County poverty
rate was 9.2%, slightly below Minnesota’s rate of 11.8% (Census Bureau estimate). The percent of
children on free and reduced lunch is 29.4%, compared to a state average of 38.5%, although both Red
Wing and Kenyon-Wanamingo districts are above 30%, and the rate for the 2012-13 Red Wing
kindergarten class was 48% (Minnesota Department of Education).
www.co.goodhue.mn.us
According to Healthy People 2020, access to health services means the timely use of personal health
services to achieve the best health outcomes. Access to health care impacts the overall physical, social
and mental health of a community. Access also impacts the prevention of disease and disability, detection
and treatment of health conditions, quality of life, preventable death, and life expectancy. Limited access
to health care impacts people's ability to reach their full potential, negatively affecting their quality of life.
According the County Health Rankings, 10% of Goodhue County residents are uninsured.
http://www.countyhealthrankings.org/
http://www.healthypeople.gov
For additional information about the health and access please review the Goodhue County Community
Health Assessment 2012:
http://www.co.goodhue.mn.us/DocumentCenter/View/146
Goodhue County Community Health Improvement Plan:
http://www.co.goodhue.mn.us/982/Community-Health-Improvement-Plan
Mayo Clinic Community Health Needs Assessment 2013:
https://www.mnhospitals.org/Portals/0/Documents/datareporting/CHNA/Mayo%20Clinic%20Health%20System%20-%20Lake%20City%20CHNA.pdf
108
Grant County:
Agency Name: Grant County Social Services
Director’s Name: Stacy Hennen
Address: 28 Central Ave. Elbow Lake, MN 56531
FAX Number: 218-685-4978
Social Services
Name
Kari Metcalf
Title
Supervisor
Telephone Number
218-685-8200
Kim Gullickson
Supervisor
218-685-8200
Public Health
218-685-6714
Kari Metcalf
Supervisor
218-685-8200
Kari Metcalf
Supervisor
218-685-8200
Chemical Dependency
Ben Schultz
Social Worker
218-685-8200
Transportation
Jill Frisell
Supervisor
218-685-8200
109
Grant County is a small county of about 5500 people located in West Central Minnesota. The county
includes eight small towns with Elbow Lake being the county seat and the largest in population with
around 1900 people.
Grant County has a hospital/clinic located in Elbow Lake and affiliated clinics in Ashby and Hoffman.
There is also a clinic in Herman. Within a 50 mile radius, there are other larger hospitals and clinics Alexandria, Fergus Falls, and Morris.
Within a 50 mile radius, there are numerous Mental Health Centers/Services - Alexandria, Fergus Falls,
Glenwood, and Morris. Grant County is also a member of a 24 hour mobile county wide mental health
crisis team for both adults and children.
Clients also access specialists in Fargo, ND and St. Cloud MN.
Within a 50 mile radius, there is a MA dental clinic. This area still lacks local dental clinics which are
willing to accept MA patients.
Transportation to these services relies heavily on volunteer drivers, friends and limited availability on a
five (5) county-wide bus system.
110
Hennepin County:
Agency Name: Hennepin County Human Services and Public Health Department
Director’s Name: Rex Holzemer and Jennifer DeCubellis
Address: 300 South 6th Street, MC 233, Minneapolis, MN 55487
FAX Number: 612-348-8228
Social Services
Name
Todd Monson
Title
Area Director
Telephone Number
612-348-4464
Deborah Huskins
Area Director
612-596-9563
Public Health
Susan Palchick
Area Director
612-348-3045
Michael Herzing
Area Manager
612-596-1371
Cynthia Slowiak
612-348-4580
Chemical Dependency
Leah Kaiser
Program
Manager
Area Manager
Transportation
Catherine Dick or Tammy
Manovich
Jernell Walker
Long-term Waiver and
Supports
111
Program
Manager
612-596-1779
612-348-8361 or 612348-2173
612-490-8877
Hennepin County is the most populous county with almost a fourth of Minnesota’s residents within its
borders. It’s almost 1.2 million residents live in communities that range from inner city neighborhoods
to suburbs and rural areas. It has tremendous diversity in the make-up of its population. Per the 2010
census its racial and cultural diversity has been increasing significantly and 13% were foreign born.
Poverty levels have also increased as 9% of Hennepin families were in poverty in 2010 as opposed to 5%
in 1999.
Of significant concern is the large variation in this measure among racial/ethnic groups with a range of
4% for white families to 36% for Black families and 38 percent for American Indian families. Given well
documented health disparities in Minnesota as a whole, the health needs and services for these families
are a concern.
The lack of affordable rental housing for our public program enrollees affects their health – housing
instability, ability to afford good nutrition, adequate heat in winter, and participation of children in
health promoting activities. Half of all renters pay more than 30% of their income on rent; one in four
pays more than 50%. For those in the bottom 30% of income (many enrollees in MA and
MinnesotaCare), 81% pay more than a third of their income for rent.
Hennepin County has an extensive array of health care services. Health care services may be accessed
through Hennepin County Human Services, health plans, or direct contact with private providers. Issues
that exist regarding access to health services are adequate transportation, confusion over which entity
to contact for access, continuity of health care coverage, high co-pays and or deductibles, shortage of
prescribing professionals for mental health, language and cultural barriers and disparities in health
outcomes.
Hennepin County residents have almost all health care services available to them, but some services are
very restricted. Dental services and access to psychiatric care are issues that continue to need to be
addressed in the county, as they are in the entire state of Minnesota. Also, mental health crisis teams
are inadequately staffed due to a lack of funding resources. Families with members with acute mental
health and chemical dependency problems face disruptive residential placements when community
supports are inadequate. This often results in issues in meeting family needs for visitation and support
while members are in placement.
Health care services that are limited in availability to the MA and MinnesotaCare enrollees are dental
care; psychiatric care; culturally specific mental health and chemical health services; community based
intensive mental health treatment for children and adults; and transportation supports that meet
individual needs.
112
Houston County:
Agency Name: Houston County Human Services and Houston County Public Health Nursing
Director’s Name: Linda Bahr and Mary Marchel
Address: 304 S. Marshall, Room 104, Caledonia, MN 55921; and
611 Vista Drive, Caledonia, MN 55921
Telephone Number: 507-725-5886 and 507-725-5810
FAX Number: 507-725-3990 and 507-725-2150
Social Services
Name
Tim Hunter
Title
Supervisor
Telephone Number
507-725-5811 x1220
Karen Kohlmeyer
Supervisor
507-725-5811 x1305
Public Health
Mary Marchel
Director
507-725-5810 x2324
Tim Hunter
Supervisor
507-725-5811 x1220
Tim Hunter
Supervisor
507-725-5811 x1220
Chemical Dependency
Tim Hunter
Supervisor
507-725-5811 x1220
Transportation
Karen Kohlmeyer
Supervisor
507-725-5811 x1305
113
Houston County is located in the southeast corner of the State of Minnesota. We are contiguous with
Wisconsin and Iowa. We do not have a hospital in our county, but rely on hospitals and clinics mainly in
La Crosse, Wisconsin. Mayo Health System (part of Rochester, MN Mayo) and Gundersen Health System
are the two providers in La Crosse both having hospitals and clinics. Additionally, a few of our clients
access the Winona, Minnesota hospital and clinic which is located in Winona County. A few clients
travel to Gundersen Clinic in Decorah, Iowa. There are also satellite clinics with Mayo and Gundersen in
LaCrescent, Houston, Spring Grove and Caledonia, the four communities in Houston County. Each
community does have ambulance and fire dept. services in place.
Being rural along with the issues that surround out-of state providers are areas that need addressing.
Including:
• Lack of public transportation.
• Lack of reliable personal transportation.
• Lack of volunteer drivers.
• Client choice of providers.
• Lack of sufficient mental health professionals & facilities.
• Prevention and intervention services.
• Lack of adequate dental care.
There is reluctance among local dentists to serve public program patients because of a higher rate of
missed appointments, treatment non-compliance, extra paperwork, and low reimbursement rates. In
turn, dental access is a big problem in the county.
114
Hubbard County:
Agency Name: Hubbard County Social Services
Director’s Name: Daryl Bessler
Address: 205 Court Avenue, Park Rapids, MN 56470
FAX Number: 218-732-3231
Social Services
Name
Michelle Fischer
Renee Weeks
Public Health
RaeAnn Mayer
Michelle Fischer
Michelle Fischer
Chemical Dependency
Michelle Fischer
Transportation
Linda Bair
115
Title
Social Service
Supervisor
Financial
Assistance
Supervisor
Community
Health Director
Social Service
Supervisor
Social Service
Supervisor
Social Service
Supervisor
Transit
Coordinator
Telephone Number
218-732-2306
218-732-2425
218-237-5474
218-732-2306
218-732-2306
218-732-2306
218-732-2421
GENERAL COUNTY SERVICE DELIVERY AND ACCESS:
Hubbard County is a rural county located in north central Minnesota. Our population is estimated to be
about 20,500. Park Rapids, the largest city in the county is the county seat and has a population of
around 3000.
There are essentially two market areas in the county. The northern half of the county tends to do
business in Bemidji, which is a regional medical and shopping center, while the southern portion
gravitates to Park Rapids for shopping and medical services. Both Bemidji and Park Rapids have hospital
and clinic facilities, Sanford and Essentia respectively.
Hubbard County does have a portion of the Leech Lake Indian Reservation in its most northeast portion
of the county. Additionally, Hubbard County borders Becker County on the west which has a portion of
the White Earth Indian Reservation within its borders. Park Rapids Public Schools includes a portion of
the White Earth Reservation; consequently Park Rapids is a point of contact for some White Earth
residents.
The incidence of poverty within the county is higher than the state average and is particularly a concern
on and near the reservations.
Hubbard County has a significant elderly population. The large number of recreational lakes in the
county has attracted many retirees to the area. The median age of the county population is 41.8 years.
Basic health care services are generally available within or close to the county. Medical specialists are
not readily available and one may need to go to Fargo to obtain services. Sanford Health of Bemidji is
becoming a major health care provider for all of northern Minnesota, offering more and more health
care services which will help address the need for more specialist services. Nevertheless, there are
specialty medical services that are not locally available and people will need to travel significant
distances (Fargo most likely) to obtain the appropriate specialized care.
Psychiatric services continue to be an area of need, specifically child psychiatry in our region. This is a
problem statewide in rural areas and is not confined to our area. Resource availability of those able to
prescribe psychotropic medications continues to be a problem and a concern. Clients often need to
travel out of the county for medication management services which do create access concerns.
Due to the rural nature of Hubbard County and distance from large population centers, transportation
can be a problem in accessing health care services particularly in our cold weather winter months.
Clients may lack dependable vehicles and financial resources to pay for the operating costs to travel to
medical facilities.
116
Isanti County:
Agency Name: Isanti County Family Services
Director’s Name: Penny Messer
Address: 1700 East Rum River Drive South, Suite A; Cambridge MN 55008
FAX Number: 763-689-9877
Social Services
Name
Penny Messer
Karrie Kolb
Public Health
Director
Title
Telephone Number
763-689-8152
763-689-8119
Tony Buttacavoli
Income Maintenance
Supervisor
Director
Karyn Hansen
763-689-8116
Karyn Hansen
763-689-8116
Chemical Dependency
Karyn Hansen
763-689-8116
Transportation
Karrie Kolb
Income Maintenance
Supervisor
Transit Director
763-689-8116
Craig Rempp
N/A
117
763-689-8284
763-689-8130
Isanti County is located in east central Minnesota. It is adjacent to Anoka, Chisago, Pine, Kanabec, Mille
Lacs, and Sherburne Counties. The count is approximately 20 minutes west of Highway 35 and 30 – 40
minutes north of the Twin Cities. It has become a “regional hub” for many services. Over the past seven
years or so, the population of Isanti County has remained fairly consistent. It was recorded at 38,204 in
2013.
Isanti County’s unemployment rate is 3.70 currently.
Isanti County is not very ethnically diverse as it’s’ population is 95% Caucasian.
The primary language spoken is English. The county family and public health departments have had to
obtain interpreter services for the languages of Spanish, Russian and Hmong.
Generally speaking individuals in Isanti County are able to obtain needed care to meet their overall
health needs.
Isanti County has reasonable availability of dental providers but certainly does not in those that accept
MA. PMAP clients encounter copays for initial visits/x-rays which can result in delayed treatment if the
individual cannot afford this.
Individuals obtain Rule 25 assessments and/or treatment through the health plans, private insurance or
through the CCDTF fund. There is a lack of providers skilled in MI/CD services. Distance can be a barrier
for outpatient MI/CD treatment. Transportation to and from treatment is sometimes difficult for
persons with limited social supports.
Isanti County Family Services provides mental health services to both adults and children who meet
criteria. There is a contract in place with Cambridge Medical Center for inpatient psychiatric services for
adults. This includes emergency holds and commitments. For children, there is an integrated
collaborative that provides services to truant and chemically dependent youth. There is a contract in
place with Therapeutic Services Agency to provide intensive treatment for those children/youth needing
placement that is provided in the Isanti County area.
Heartland Express is a rural public transportation system in Isanti County. It lacks evening hours and
weekend transportation.
This agency provides services to individuals of all ages in their home, clinic or community. The 2015
community health assessment is in the process of being completed.
118
Itasca County:
Agency Name: Itasca County Health & Human Services
Director’s Name:
Address:
Eric Villeneuve
1209 SE 2nd Ave, Grand Rapids MN 55744
Telephone Number:
218-327-2941
FAX Number:
218-327-5547
Social Services
Name
Becky Lauer
Terri Friesen
Public Health
Kelly Chandler
Becky Lauer
Becky Lauer
Chemical Dependency
Becky Lauer
Transportation
Terri Friesen
Title
Family & Child
Services Division
Manager
Financial
Assistance
Supervisor
Public Health
Division Manager
Family & Child
Services Division
Manager
Family & Child
Services Division
Manager
Family & Child
Services Division
Manager
Financial
Assistance
Supervisor
119
Telephone Number
218-327-6191
218-327-6136
218-327-6144
218-327-6191
218-327-6191
218-327-6191
218-327-6136
Itasca County Health & Human Services (ICHHS) provides Health Care Access services to all MA clients
(both fee-for-service and PMAP) who are in need of transportation for medical purposes. We currently
contract with an agency, Rapids Transit, to provide all aspects of HC Access services, including the
administration of the program and recruiting and maintaining volunteer drivers. Itasca County staff is
responsible for the accounting/billing portion of all transportation services.
County recipients who use the Arrowhead Economic Opportunity Agency (AEOA) mass transit bus are
required to purchase tickets directly from AEOA (these can be purchased from the bus driver) and when
they provide medical proof of transportation usage and they are reimbursed by ICHHS.
County recipients who are in need of mileage reimbursement or need a volunteer driver work through
Rapids Transit. They work with clients to ensure that the Itasca County Health Care Access Plan is
complied with and that clients are receiving the most cost efficient, safe transport available in our
county. All MA clients are provided with information about Health Care Access services at application
and renewal.
Itasca County is a rural county and the county seat is at its most southern edge. Many people in the
outlining areas utilize providers from outside Itasca County. Also, because volunteer drivers are not
reimbursed for no-load miles, it is very difficult to recruit and maintain a significant pool of volunteer
drivers. High gas prices have also impeded the establishment of a strong volunteer driver network. In
many areas of the county, volunteer drivers will need to travel 60 no load miles to take a MA client to a
medical appointment that is just a few miles from the client’s home.
Health care services that are limited or unavailable: Dental coverage has been a service that has
historically been difficult to obtain for MA clients. Most local dentists are willing to see our PMAP
clients, but it can be very difficult to locate a local dentist who will accept a MA patient. Psychiatric care
for children and adults is also limited. Many families have to travel outside of Itasca County due to
limited providers. There is no inpatient hospital based psychiatric care in Itasca County.
120
Jackson County:
Agency Name: Des Moines Valley Health and Human Services
Director’s Name: Craig Myers
Address: 11 Fourth Street, PO Box 9, Windom MN 56101
FAX Number: 507-831-0126
Name
Title
Telephone Number
Social Services
Rebecca Wiens
Rebecca.wiens@dv
hhs.org
507-831-1891
Angela Holmen
Angela.holmen@dv
hhs.org
Supervisor
507-831-1891
Public Health
Pat Stewart
Pat.stewart@dvhhs.
org
Public Health
Administrator/Director
507-847-2366
Shelley Stevermer
Shelley.stevermer@
dvhhs.org
507-847-4000
Susan Miller
Susan.miller@dvhhs
.org
507-831-1891
Chemical Dependency
Susan Miller
Susan.miller@dvhhs
.org
507-831-1891
Transportation
Angela Holmen
Angela.holmen@dv
hhs.org
Supervisor
507-831-1891
Other – please list –
alternate contact for
Director – all areas
Kay Steffen
Kay.steffen@dvhhs.
org
Director of Agency
Operations
507-847-4000
121
General County Service Delivery and Access
Jackson County is a small rural county in Southwest Minnesota with a population of 10,260. The county
seat is the city of Jackson which is the largest city in the county with a population of 3,299. Jackson
County has a mix of agriculture and manufacturing as its economic base. The median income for
Jackson County is $49,886 as compared to the Minnesota state average of $59,126. The poverty rate is
the same as the state average of 11.2%.
Jackson County has one small hospital, Sanford Jackson Medical Center. Access issues are one of the
major challenges to health care in Jackson County. Transportation presents a significant barrier to the
residents of Jackson County. Jackson County’s public transportation is limited by hours and range.
Because of this, Jackson County relies heavily on volunteer driver services to try to meet the needs.
A second significant issue is lack of or very limited access of some services in the county. Dental services
for MA and Minnesota Care recipients are hard to obtain and frequently requires long distance travel
outside the county. One to two hours of travel time one-way is common. Dentists within the county are
reluctant to take MA clients due to the low rate of payment. CD services are another service that is
limited within the county, with only one provider (who is looking to close the office in Jackson County)
and no treatment for adolescents. Mental health services are partially met, but we see long waits for
appointments. There is also limited types of mental health services available and a disconnect between
local physicians who are prescribing medications and the mental health service providers.
Jackson County also sees the need for a stronger relationship with MCOs in communication and
partnership around case management with social services and public health with emphasis on
appropriate rates and investment in local development or services.
There is also a need for greater work with Public Health around looking at and funding prevention
oriented activities across the range of our county population.
122
Kanabec County:
Agency Name: Kanabec County Health and Human Services
Director’s Name: Wendy Thompson
Address: 905 East Forest Avenue, Suite 127 Mora, MN 55051
FAX Number: (320) 679-6333
Social Services
Name
Chuck Hurd
Telephone Number
(320) 679-6357
Wendy Thompson
Title
Social Services Supervisor
(Adult)
(Children)
Eligibility/Child Support
Supervisor
Director
Social Services
Kristen Struss
Rose Linder
Public Health
Chuck Hurd
(320) 679-6357
Kristen Struss
(320) 679-6365
Chemical Dependency
Chuck Hurd
(320) 679-6357
Transportation
Rose Linder
Eligibility/Child Support
Supervisor
(320) 679-6381
123
(320) 679-6365
(320) 679-6381
(320) 679-6322
According to the 2014 County Health Rankings, Kanabec County ranks 81 out of 87 Minnesota counties
in Health Factors. The health factors that are considered in the County Health Rankings include health
behaviors (tobacco use, obesity, drinking, sexual activity), clinical care (access to care, quality of care),
social and economic factors (education, employment, income, family /social supports), and physical
environment (air quality, housing and transportation).
Kanabec County The table below provides statistics regarding two of the health factors, health behaviors
and clinical care, as well as quality of life indicators:
Health Factors/Quality of Life Table
Factor
Kanabec County
Health Behaviors
Adult Smoking
21%
Adult obesity
26%
Physical inactivity
24%
Access to exercise opportunities
22%
Excessive drinking
20%
Clinical Care
Uninsured
11%
Primary care physicians – ratio of patients to
1,155:1
physicians
Dentists – rate of patients to dentists
2,001:1
Mental health providers
3,201:1
Preventable hospital stays
70
Quality of Life
Poor or fair health
14 %
Poor physical health days
3.0
Poor mental health days
4.0
Source: 2014 County Health Rankings
MN
16%
26%
20%
80%
19%
10%
1,116:1
1,562:1
748:1
49
11 %
2.8
2.6
As shown above, Kanabec County residents have less access to clinical care, particularly dentists and
mental health providers. In the description of the preventable hospital stays in the County Health
Rankings – Reason for Ranking, it states “Hospitalization for diagnoses treatable in outpatient services
suggests that the quality of care provided in the outpatient setting was less than ideal. The measure may
also represent a tendency to overuse hospitals as a main source of care.” Because the local health
system is not able to keep up with the demand, many residents travel 30 miles (1-way) or more to
obtain care. Specialty care is not readily available in the area and residents often travel 70 miles (1-way)
or more to obtain care. Unfortunately, there are many individuals who do not have reliable, affordable
transportation. This is one critical component that must be considered by any potential responders.
In the past two months, there have been concerns reported to this agency regarding the lack of options
available to MA and MinnesotaCare enrollees as it pertains to dental and eye care. These concerns
should also be considered by any potential responders. Child and adult psychiatry is difficult to access in
Kanabec County. Again, traveling a far distance would be a requirement and providers rarely have
timely opening for new clients.
124
Kandiyohi County:
Agency Name: Kandiyohi County Health and Human Services
Director’s Name: Ann Stehn
Address: 2200 23rd Street NE, Ste. 1020, Willmar MN 56201
FAX Number: 320-231-7888
Name
Title
Telephone Number
Social Services
Charlotte Hand
Supervisor
320-231-7800 x2457
Barb Kavanagh
Supervisor
320-231-7800 x2331
Public Health
Chery Johnson
Supervisor
320-231-7800 x2581
Corinne Torkelson
Supervisor
320-231-7800 x2459
Corinne Torkelson
Supervisor
320-231-7800 x2459
Chemical Dependency
Corinne Torkelson
Supervisor
320-231-7800 x2459
Transportation
Sue Leal
Supervisor
320-231-7800 x2361
125
Kandiyohi County medical facilities include 4 primary care clinics and a hospital which is city owned.
Other industry and county assets include a large turkey growing and processing industry, Ridgewater
Community College, MN West technologies campus which houses industry leading bio-technology
companies.
Known health inequities in our counties include our citizens who live in poverty. Over 30% of the
population lives under 200% of poverty level and the number living in poverty has been steadily
increasing over the last 4 years. There is also growing diversity in the populations. Thirty percent of
Kandiyohi County’s school population is of minority race/ethnicity. Seven percent of our children are
refugees. Our aging population is above the state average. Forecasts for our rural areas show that
number increasing over the next years as the baby boomers age and retire.
The majority of medical services accessed in our county are in the largest community, Willmar, which is
centrally located and has a population of approximately 19,680. Our hospital, 3 primary care clinics (one
which is a regional multi-specialty clinic, one a family practice clinic and one which is a community
health clinic) and all located in Willmar. We also have one primary care clinic in the northern part of the
county in New London. Our residents are fortunate as our community is considered a regional medical
center. Even with generally good access to primary care, barriers exist. Transportation is often a
concern for Minnesota Health Care enrollees. We access local transit and volunteer drivers to assist
with these needs. Interpreting services are also critical. Our Somali population in particular has been
increasing and there is a great deal of need for Somali interpreting. We have seen decreasing demand
for Spanish interpreting over time, however this need continues as our second most frequent language.
Recently, we have started seeing more need for Karen interpreting. This is often performed via
telephonic language interpreting as there are few local interpreters. We have found other language
needs to be best met with local interpreters.
There continue to be concerns about access to dental services. When talking to providers they state
their primary reason for not accepting more patients is due to the rates. We have also recently lost
access to a State Operated Services provider locally who provided treatment for our disabled
population. Access to appropriate dental care for our large disabled community is a serious challenge.
Rice Regional Dental Clinic has been an important resource for our region for dental care, but low rates
continue to make financing this clinic a challenge and they are not able to meet all of the needs in the
community.
Our community medical centers also have some difficulty recruiting for some specialties. Access to
mental health services particularly for children and psychiatry is difficult. Mental Health Centers are
working to utilize mid-level practitioners in these fields to try to fill the gap. We are also currently
lacking adult mobile crisis, Intensive Residential Treatments Services (IRTS-one in Atwater recently
closed due to provider rates and staffing), adolescent CD treatment, long term care coordination for
chemically dependent people, programming for people with mental health and chemical dependency
needs (dual diagnosis) and placement options in the community for highly behavioral mental health
clients. While many medical services are provided within our county, it is often necessary to refer highly
specialized medical services out of our community. Frequent referral patterns include St. Cloud, Twin
City metro area and Rochester.
126
Kittson County:
Agency Name: Kittson County Social Services
Director’s Name:
Kathleen Johnson
Address:
Hallock MN 56728
410 S 5th St, Suite 100
Telephone Number:
218-843-2689
FAX Number:
218-843-2607
Social Services
Public Health
Chemical Dependency
Transportation
Name
Kathleen Johnson
Kathleen Johnson
Cindy Urbaniak
Kathleen Johnson
Kathleen Johnson
Kathleen Johnson
Kathleen Johnson
Title
Director
Director
Director
Director
Director
Director
Director
127
Telephone Number
218-843-2689
218-843-2689
218-843-3662
218-843-2689
218-843-2689
218-843-2689
218-843-2689
Kittson County has within its borders one hospital (Hallock); two clinics (Hallock and Karlstad); two
nursing homes (Hallock, 70 beds and Karlstad, 48 beds); two Assisted Living facilities (Hallock, 8
apartments and Karlstad, 24 apartments); two 4-bed SLS homes (Karlstad); and two volunteer
ambulance crews (Hallock and Karlstad).
The rural nature and size of our county presents many transportation challenges. There are no public
forms of transportation available in Kittson County which includes no providers of specialized medical
transportation. Kittson County Social Services has facilitated a volunteer driver program for its citizens
60 years old and over. Because the medical doctors at our clinics are general practitioners, many of our
residents often find themselves traveling over 80 miles (one way) to attain their required level of
medical care.
The workforce of Kittson County (ages 18-65) is near full capacity; meaning that everyone who wants to
work is working. There are times when our nursing facilities have to deny access to their facility not
because of bed unavailability, but because they do not have the staff to cover the additional workload.
Listed are some of the health care concerns:
•
Lack of public transportation
•
Meeting the needs of the aging population
•
Prevention and intervention services
•
Lack of providers in many areas of health service delivery
•
Client choice of providers
•
Timely non-emergency access to providers
•
Access to specialized medical services
•
Access to specialized medical transportation services
Kittson County has two privately owned dental clinics (Hallock,1 dentist and Karlstad, two dentists)
Currently the Karlstad providers are no longer accepting any new PMAP/MA clients. The Hallock dentist
is working on contracting with the county’s MCOs. Having a dentist who would take MHCP clients would
greatly relieve our dental access issues. Currently our clients are required to drive 3 to 6 hours to attain
their dental needs.
Kittson County Social Services offers Rule 25 Assessments for our residents. There are no CD counselors
located in Kittson County. There one regional provider with three satellite offices who serve the
residents of our region. For Kittson County residents, this means round-trip travel mileage from
between 60 to 200 miles, depending on which provider is chosen. Region 1 has one non-medical detox
provider located in Crookston, MN, seventy-five miles from Hallock.
Kittson County Social Services contracts with the Northwestern Mental Health Center (NWMHC) for the
majority of our outpatient and in-home mental health services. These services include: psychiatric
services, in- home therapy, CSP, ARMHS, outpatient counseling, mental health assessments, apartments
with ARMHS services, and high needs adult foster care. The NWMHC does provide two psychologists in
Kittson County (Hallock) four days per month.
Kittson County also uses Sanford Medical Center- Thief River Falls, for in-patient hospitalization and 72hour holds, 24-hour crisis-line services, IRTS, and board and lodge services.
Kittson County is a member of the NW8 Mental Health Initiative which seeks to coordinate services in
our region. The NW8 Initiative has been able to expand services through hiring additional workers to
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provide in-county services to its 8-county partners; the development of 24-hour crisis services; flex fund
dollars to meet clients’ needs; and to support other necessary services.
Some issues for adult mental health are:
•
The ability to access services when needed
•
Distance from providers
•
Ability to maintain “in-patient” services in our region
•
Mental Health Stigma
Kittson County is a member of the Kittson County Children’s Mental Health Collaborative organized to
provide early intervention and support services for children and families through school based mental
health services. We are also a member of the Northwest Council of Collaboratives which has secured
several federal SAMHSA grant for the provision and redesigning of children’s mental health services in
our region. Kittson County Social Services and local law enforcement entities work to investigate all
reports of child maltreatment. Foster homes and shelters are used for emergency out-of-home
placements when necessary. Children’s probation services are contracted from the Minnesota
Department of Correction. Historically, we have not had close working relationships with our probation
officers. Kittson County is a participating member of the Roseau-Kittson CJI team.
Children’s mental health targeted case management (CMHTCM) services are available upon request to
all eligible children.
Some issues for children’s mental health are:
•
Remote rural area
•
Lack of Child Psychiatric Practitioners
•
Lack of crisis services skilled in children’s mental health issues
•
Mental Health Stigma
•
Lack of in-patient services
•
Child Protection issues
•
Corrections availability of Mental Health Services
There is no public transportation available in Kittson County. A volunteer driver program is maintained
by Kittson County Social Services for residents over 60 years old. Emergency transportation is run by
two volunteer ambulance programs, one serving the west side of the county and the other one serving
the east side of the county.
Some issues for transportation:
• No public transportation available
• Limited number of volunteer drivers
• Limited funding to provide and develop volunteer driver program
• No Special Transportation providers or common carriers
Special Programs:
•
Kittson County Children’s Mental Health Collaborative
•
The Norwest 7 Council of Collaboratives
•
The NW8 Mental Health Initiative
•
Regional LAC
Kittson County contracts with Kittson Memorial Healthcare Center for its Public Health Services.
Services are provided in client homes, KMHC offices, community sites, businesses, schools and special
community events.
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Koochiching County:
Agency Name:
Koochiching County Public Health & Human Services
Director’s Name: Terry Murray
Address:
1000 Fifth Street, International Falls, MN 56649
Telephone Number:
218 283-7000
FAX Number:
218 283-7013
Social Services
Name
Kathy LaFrance
Title
Valerie Long
Public Health
Chemical Dependency
Transportation
Nancy Lee
Kathy LaFrance
Kathy LaFrance
Kathy LaFrance
Valerie Long
Jane Besch
Supervisor
Public Health Supervisor
Supervisor
Administrative
Secretary/Office Services
Supervisor
130
Telephone Number
218 283-7000
218 283-7000
218 283-7070
218 283-7000
218 283-7000
218 283-7000
218 283-7000
218 283-7000
Koochiching County is the second largest geographical county in the State of Minnesota at 3,127 square
miles. With that we also have a very small population of 13,311 and deal with a declining population.
The population will continue to decline due to the downsizing of our paper mill and the complete
shutdown of the paper mill across the river in Fort Francis, Ontario, all of which has taken place over the
past couple years. With this population decline, an added concern is the increase of our elderly
population in the remaining population in Koochiching County.
Koochiching County has struggled for years with the lack of public transportation from any of our cities.
Adding to that, almost all specialty medical services is provided from 100-160 miles from our largest city
of International Falls, which makes it hard to provide medical transportation for clients that are served
by our county. At this time our only out of county transportation is provided by a contracted provider
that provides volunteer drivers.
Mental health holds at our Local Community Hospital have strained our system because of the lack of
facilities close to our area. It is not uncommon for us to transport mental health clients to the far
western part of the state due to lack of closer facilities.
There are several medical services that are difficult for county residents to access, including: dialysis,
pediatrics, orthodontics, mental health, children’s mental health and there is an extremely long wait for
clients to get psychiatric care. Some of these services can be provided if a specialist comes into the
county, but there can be a lengthy wait to access those services.
There is no inpatient or after care services for adolescents.
There is a lack of services for individuals with dual diagnosis of mental illness and chemical dependency.
Integration with primary care, mental and chemical health services is limited.
Koochiching County’s Public Health Department struggles to keep up with providing mandated services
do to the lack of qualified Public Health Nurses in our area. This is largely due to the wage differential
between the wages paid a public health nurse vs what is paid in our local hospital and clinics.
Any outreach services that are provided by either our Human Service or Public Health departments is a
struggle for us for two reasons. One is the distance traveled which can range from 10 to 70 miles.
Second is the reimbursement we receive for providing these services do not take into account the
excessive travel costs to the county.
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Lac qui Parle County:
Agency Name: Lac qui Parle County Family Service Center
Director’s Name: Joel Churness
Address: P.O. Box 7, 930 First Avenue, Madison, MN 56256
FAX Number: 320-598-7597
Social Services
Name
Kirsten Gloege
Telephone Number
320-598-7594
Liz Auch
Title
Social Work Team
Leader
Supervisor
Donna Hermanson
Public Health
Laura Fischer
Social Worker
320-598-7594
Deborah Hoffmann
Social Worker
320-598-7594
Chemical Dependency
Kristi Kvaal
Social Worker
320-598-7594
Transportation
Tami Stensrud
Office Support
Specialist
320-598-7594
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320-598-7594
320-843-4546
Lac qui Parle County currently has 952 individuals eligible for either Medical Assistance or
MinnesotaCare and enrolled in managed care. The county has developed a wide network of providers
and services to meet client needs in these programs.
Additional services available to managed care enrollees from Lac qui Parle County include outpatient
services from Woodland Centers (Willmar), community MH support program services from Prairie
Community Services (Morris), children’s day treatment services from Greater MN Family Services
(Willmar), inpatient MH services from Avera Behavioral Health (Marshall), inpatient MH services from
Avera McKennan (Sioux Falls, SD), public health services from Countryside Public Health (Benson),
personal care assistant services from CountryCare (Madison), Avenues for Care (Montevideo) and Divine
Home Care (Willmar), transportation services from Prairie Five CAC, Inc. (Montevideo).
Dental services are available but limited with three dentists in county. Referrals are made to the Smile
Center (Big Lake), 1st Family Dental Care (Rogers), Rice Regional Dental Clinic (Willmar), and MN Dept. of
Human Services State Operated Services Dental Clinics (Willmar).
In Lac qui Parle County, health care services are primarily provided by two health systems located in
Madison and Dawson, MN. Services are described as follows:
•
Madison Hospital, Madison Lutheran Home, Lac qui Parle Clinic, and Hilltop Residence is a
healthcare complex located at 900 Second Avenue in Madison offering a wide variety of services
for people of all ages. Our healthcare campus includes an 80-bed skilled nursing facility, a 12bed critical access hospital, home care services, fully staffed medical clinic, secure 36-unit
independent living apartment building, and therapy services provided by Big Stone Therapies.
Together with the nursing staff, Lac qui Parle Clinic coordinates and provides quality care to its
patients. The clinic is conveniently open six days a week and attached directly to the Madison
Hospital allowing easy access to medical services such as lab, x-ray, pharmacy, and other
diagnostic services.
•
Johnson Memorial Health Services (JMHS) is a hospital district located at 1282 Walnut in
Dawson offering a wide variety of high quality services to our community members and visitors.
Our services include: Clinic, Hospital, Care Center, Assisted Living, Emergency Room, Home Care,
Ambulance Service, Boyd Community Health Center and a wide variety of outreach and
consulting services. The Dawson Clinic is staffed by a board certified Family Practice Physician,
three Family Nurse Practitioners and several nurses and technicians.
No services are available to persons with high medical needs and severe behavioral disorders.
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Lake County:
Agency Name:
Lake County Health and Human Services (LCHHS)
Director’s Name:
Vickie L. Thompson
Address:
616 Third Avenue, Two Harbors, MN 55616
Telephone Number:
218-834-8400
FAX Number:
218-834-8412
Social Services
Public Health
Chemical Dependency
Transportation
Name
Amy Stark
Maria VanSanten
Courtney Anderson
Michelle BackesFogelberg
Amy Stark
Maria VanSanten
Maria VanSanten
Courtney Anderson
134
Title
Social Services
Supervisor(s)
Income Maintenance
Supervisor
Public Health and Safety
Supervisor
Income Maintenance
Supervisor
Telephone Number
218-834-8426
218-834-8549
218-834-8423
218-834-8406
218-834-8426
218-834-8549
218-834-8549
218-834-8423
Lake County covers a wide area with several towns and villages with sparse populations. It is a rural
county with sizeable distances between most towns and villages. A portion of the population is low
income and many of the residents living in outlying areas of the county, as well as those living in towns
and villages receive public assistance, and don’t have or can’t afford their own transportation. We also
have those residents who are aged and/or disabled and unable to drive. All of these factors create
transportation issues within Lake County. Lake County contracts with the Arrowhead Economics
Opportunity Agency (AEOA) to provide volunteer drivers and the AEOA bus to provide transportation in
certain areas of the county.
For clients who are enrollees of a MCO, the MCO provides transportation as part of their client services
through their own Care Coordinator and resources and collaborating with our contract providers.
MCO(s) have access to the Lake County provider network and they are encouraged to use those
providers as needed such as volunteer drivers and the AEOA bus. Not all MCO(s) are providing costeffective transportation for clients.
Other access concerns include the following:
• The need for MCO(s) to assist with making the billing process more user-friendly and
standardized.
• The lack of available mental health professionals (psychiatrists, advanced practice nurses and
psychologists). MA recipients should have unlimited access to mental health sessions.
• The lack of children’s mental health services - including in-home therapeutic support or
parenting training, lack of Children’s Therapeutic Services and Supports (CTSS) due to low
reimbursement rates and lack of availability, and lack of Therapeutic Behavior Management
Aides.
• The lack of available childcare to ensure that families are able to keep appointments and take
advantage of the health care system. There is only one child care provider who covers evening
and weekend hours.
• The need for case management service for the purpose of making appointments (medical and
dental) and following up with clients after appointments to be sure clients understand directives
from the health care provider and that they are following through appropriately.
• The lack of client education on how and when to access medical services to reduce the number
of emergency room visits.
• Improving the immunization rate.
• Improving the Child and Teen Checkup rate.
• The high incidence of alcohol and drug abuse including CD treatment for as long as it’s needed
for methamphetamine users, adolescent CD treatment, after-care for all age groups and a
methadone maintenance program.
• The lack of easy access to local services for all clients under “hold” and “commitment” orders.
• The lack of easy access to full dental care (regular, emergency and orthodontia treatments)
• The need to arrange for recipients to access specialists out-of-area when necessary for more
complex care needs.
• The need for open selection of providers.
• The need for MCO(s) to incorporate schools into their networks to allow reimbursement for
billable services provided in school districts.
Some of the dental providers are at a great distance. We continue to be told that (1) MA rates for
dental services are not sufficient for dentists to want to service this population and (2) many MA clients
fail to keep their appointments, which poses a problem for the dental providers who can’t readily fill a
chair for a no-show.
135
Chemical Dependency Rule 25 assessments are available within our county to meet the needs of clients.
We have someone trained at LCHHS as a back-up to the two providers we contract with to provide Rule
25's. We currently have one outpatient CD treatment provider and Rule 25 assessor in Two Harbors,
which does not meet local demand. The Center for Alcohol & Drug Treatment in Duluth provides
detoxification services, Rule 25 assessments, inpatient treatment, and outpatient treatment.
Services such as halfway houses after primary CD treatment are not available in Lake County. St. Louis
County is the closest and most accessible area for Lake County residents. Depending on availability of
space, it is sometimes necessary to send clients to areas more distant than St. Louis County.
One issue we are having in Lake County is the access to CD Treatment. There has been a gap in service,
so most clients are heading to Duluth or other cities to get the needed treatment; thus bringing in the
issue of transportation for our clients to get to and from outpatient treatment in a different city or
county.
There are three providers who offer counseling, crisis stabilization, diagnostic testing and a variety of
support groups. HDC is currently the only provider in Lake County with psychiatric services. In addition
to HDC, there are three other providers offering Adult Rehabilitative and Mental Health Services
(ARMHS) locally. Psychiatrists, Advanced Practice Nurses and Psychologists are of limited supply locally
and statewide.
Emergency mental health holds have historically been handled primarily by Miller Dwan Medical Center
and St. Luke’s Hospital. There is a population of adults with serious and persistent mental illness and are
not MA eligible, but require significant services to keep them stabilized in community care. The MCO(s)
are requested to address how assistance with the cost of those services might be addressed, as
ultimately having lower cost community services will save MA dollars if hospitalizations are minimized.
Mental Health services for children are targeted primarily at keeping children functioning well in their
own homes and community. LCHHS has a Mental Health worker that goes into clients homes and works
with children and families. LCHHS also has been approved as a provider for Children’s Therapeutic
Services and Support (CTSS). This service is also provided by HDC and Accend Services. LCHHS also is a
provider of Children’s Mental Health Case Management, so most children can get their services right in
the home instead of going to an office. There is still an option for children to utilize other providers as
they choose. Accend Services provides therapy in the schools for any child that is in need through the
SLMHS grant. Other providers provide therapy in schools for current clients.
Lake County is served by Arrowhead Economics Opportunity Agency (AEOA), which is a public transit
provider. AEOA provides bus transportation to residents of Lake County. Trained volunteer drivers are
available through AEOA to provide MA recipients with medical transportation where necessary, both in
and outside of Lake County. Special transportation services are available to those who need them
through Northern Access in Duluth.
Lake County is a member of the North Shore Collaborative (NSC) that provides prevention and early
intervention services to children and families in Lake and Cook Counties. The goals of the NSC are to
help children succeed in school, to increase buy-in and involvement of under-represented partners and
to increase community awareness of the value of collaboration.
Public Health duties and concerns in Lake County are handled by the in-house Public Health Unit. LCHHS
further contracts with independent RN Contractors to ensure additional help is available for Public
Health, should it be needed.
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Lake of the Woods County:
Agency Name: Lake of the Woods County Social Services
Director’s Name: Nancy Wendler
Address: 206 8th Ave. SE – Suite 200, Baudette, MN 56623
FAX Number: 218-634-4520
Social Services
Name
Nancy Wendler
Title
Director of
Social Services
Telephone Number
218-634-2642
Public Health
Michelle Brown
218-634-1795
Nancy Wendler
Director of
Public Health
Director of
Social Services
Chemical Dependency
Transportation
137
218-634-2642
Lake of the Woods County is a fairly remote, sparsely populated county in comparison to the area of
land it includes. There are approximately 4,000 people living in Lake of the Woods and our population
seems small in comparison to most other counties. However, the need for services is as great for the
few we serve as it is for the bigger numbers in larger counties. It is sometimes difficult to put together a
full range of comprehensive services, and the professionals and practitioners often are forced to wear
many hats to provide the variety of services needed in the community
A great deal of work has been done over the past twelve years to implement services and encourage
providers to look to Lake of the Woods County for possible expansion of their services in hopes to best
serve the residents of our community.
Although Lake of the Woods County’s distance from many of the services provided in larger
communities sometimes limits us as to what services we can provide, we also have some distinct
advantages due to being small and having fewer clients. We can provide a more intimate system due to
the lower caseload sizes and coordination of services is more easily accomplished. Often an individual
plan can be developed for our consumer which is tailor made for them.
Access continues to be a problem for most health care as we are remote and rural and people have to
travel to receive the care they require. We rely heavily on volunteer drivers to get people to their
appointments. Having adequate providers for the various services is also an issue. There are not enough
people in any one category to encourage a provider to establish services in Lake of the Woods County.
We are often dependent on services in neighboring counties and either have to provide transportation
for individuals to access them, or try to encourage the provider to establish a satellite office in our
county.
Issues that exist in accessing health care in Lake of the Woods County are:
•
•
Meeting the needs of the aging population
•
•
Access to psychiatric and mental health service providers
•
Lack of providers in all areas of health service delivery
•
Meeting the needs for out-patient chemical dependency treatment
•
•
•
•
Lack of volunteer drivers for out of town transportation to medical treatment
Lake of the Woods County currently has one dentist that accepts MA clients. Lake of the Woods County
residents are forced to travel out of county for chemical dependency services. There are limited mental
health services for both adults and children.
In general, Lake of the Woods County is lacking in all children’s mental health services. There is a lack of
psychiatric services for children and infant mental health, limited Children’s Therapeutic Services and
Support (CTSS) type services, parenting services, preventative services, and medication management.
The local physicians have been providing medication management for children. This has been a concern
over the past several years especially when we have had a shortage of doctors and a movement of
locums in and out of the area that has not provided a very consistent process for managing meds. The
providers available for children’s therapy are the same as those for adult services; however, none of
138
them specialize in children’s therapy. Children must travel long distances, about 180 miles, for adequate
evaluations and diagnostics.
There is one local provider for in-home family therapy – Lutheran Social Services. While they provide an
excellent service, the one individual who services Lake of the Woods County is often times full and
unable to take new clients and clients are put on a waiting list.
Under Adult Mental Health, the major concerns and issues involve lack of providers, lack of
transportation, and lack of specialists, however with the number of children involved in Lake of the
Woods County it is difficult to justify building services locally with providers who could only serve
children.
Transportation is one of the largest barriers to accessing health care services in Lake of the Woods
County. The volunteer driver network is very limited. Social workers are often left to provide
transportation for children because of these limitations. Access issues also include methods to reach
recipients without phones and supportive services in making/keeping appointments.
The local public transportation system is very limited in the services they can provide. They only provide
services within the county and then mostly within the city limits of Baudette, so the only out-of-county
transportation service available is through volunteer drivers. The hours of availability for the bus system
are also limited to 8:00 a.m. to 4:00 p.m. Monday through Friday, and there is just one bus in service at
any given time. There are no taxi services available in Lake of the Woods County.
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Le Sueur County:
Agency Name: Le Sueur County Human Services
Director’s Name: Susan Rynda
Address: 88 South Park Avenue, Le Center, MN 56057
FAX Number: 507-357-6122
Name
Title
Telephone
Number
507-357-8237
Social Services
Linda Fischenich
Deb Serich
507-357-8514
Public Health
Cindy Shaughnessy
Supervisor
Sue Rynda
507-357-8515
Lowell Freeman
Director/
Supervisor
Child Services Supervisor
Chemical Dependency
Lowell Freeman
Child Services Supervisor
507-357-8280
Transportation
Deb Serich
Supervisor
507-357-8514
140
507-357-8247
507-357-8280
Le Sueur County is a rural county located between the Twin Cities metropolitan area to the North and
the Mankato metropolitan area to our South. We are a designated Metropolitan Statistical Area (MSA).
Our estimated population is 27,810 (2013 Census). The population has grown 10.3% since 2000 with
14.2% of the county population 65 years of age or older and 23.6% under 18 years of age. The ethnic
make-up of the population is predominately Caucasian, with the Hispanic/Latino population at 5.6%.
English and Spanish are the predominant languages spoken, although this area has strong Czech,
German and Irish influences culturally. Le Sueur County has several small communities and four school
districts located within the county borders. The Courthouse is centrally located within the county in the
county seat of Le Center.
The county has several small communities that do have medical clinics located within them and one
hospital in the town of Le Sueur with limited services. Access to specialty care is an issue which many
residents must drive several miles outside of the area to receive services. This places a high demand
upon transportation services. The County does have transportation services available, but the inability
for volunteer drivers to bill for non-load miles has caused significant challenges to this program. The
community of Le Sueur does have a city transit system, but there are no other public transportation
systems available.
Other than specialty care noted above, access to dental services remains a concern within this area.
141
Southwest Health and Human Services (Lincoln, Lyon, Murray, Pipestone, Rock and Redwood
Counties):
Agency Name: Southwest Health and Human Services
Director’s Name: Christopher J. Sorensen
Address: 607 West Main Street, Marshall, MN 56258
FAX Number: 507-537-6747
Name
Title
Telephone
Number
507-532-1260
Social Services
Cindy Nelson
Division Director
Eligibility Supervisors
Public Health
Kathy Herding and
Jennifer Beek
Carol Biren
Stacy Jorgenson
Public Health
Administrator
Christine Versavel
507-532-1241
Chemical Dependency
Stacy Jorgenson
507-825-8566
Transportation
Kathy Herding and
Jennifer Beek
Eligibility Supervisors
507-836-6144 Ext.
2003
142
507-836-6144 Ext.
2003
507-532-4136
507-825-8566
Southwest Health and Human Services is a multi-county human services agency covering a large part of
Southwestern Minnesota. SWHHS is joint powers agency consisting of Lincoln, Lyon, Murray, Pipestone,
Rock and Redwood Counties with our administrative headquarters in Marshall, MN. We have offices in
all of the county seats and are open every day to see consumers in all of our locations.
Southwest Health and Human Services provides services in one of the most rural parts of Minnesota.
Although rural, our service area is increasingly diverse serving a variety of new immigrants communities
and larger communities of color that need our attention from an economic, social, and linguistic point of
view.
Travel to providers in this rural area is always a consistent challenge in addition to specialty providers
that can serve our small communities. Additionally, there are limitations of access to dental services in
our SW region is an ongoing and chronic issue particularly for our MA populations.
143
McLeod County:
Agency Name: McLeod Social Service Center
Director’s Name:
Gary Sprynczynatyk
Address:
Telephone Number:
1805 Ford Avenue North
Glencoe, MN 55336
(320) 864-3144
FAX Number:
(320) 864-5265
Social Services
Name
Donna Birk
Leah Lundgren
Sally Aubol-Grangroth
Donna Krauth
Title
LTC/DD Supervisor
MH/CD Supervisor
Child/Family Supervisor
IM Supervisor
Telephone Number
320-864-1239
320-864-1431
320-864-1338
320-864-1391
Public Health
Kathy Nowak
Director
320-864-1373
Leah Lundgren
Supervisor
320-864-1431
Leah Lundgren
Supervisor
320-864-1431
Chemical Dependency
Leah Lundgren
Supervisor
320-864-1341
Transportation
Gary Sprynczynatyk
Director
320-864-1395
144
McLeod County is located in west central Minnesota, population 36,651. The population of persons age
65 and over is above 16.4% with a growing number of at least 5.2% of the population as Hispanic
persons. It is important to continue or duplicate the existing Care Coordination Model. The level of
customer service and satisfaction is very high, operating closely with Public Health Nursing, not dual
case management, but mutually available for case consultation. It is also important to maintain the
existing Primary Care networks and growing network of dental providers.
Hospitals include Hutchinson Health (HH, integrated the Clinic) with 66 acute care licensed beds, and
Glencoe Regional Health Services (GRHS) as a 25-bed Critical Access Hospital and 40-unit independent
senior apartment complex. There are approximately 26 primary care physicians and many specialty care
physicians and more on a consultation basis. Three nursing homes operate with a licensed capacity of
300 total long term care beds. There are 22 dentists but few will accept new medical assistance clients.
McLeod is working with Children’s Dental Services - - providing preventative and dental treatments
monthly for the Medical Assistance (MA) population and pregnant women. The majority of MA
beneficiaries receive health care in Hutchinson and Glencoe, but some also go to Waconia, Rochester,
and the Twin Cities. **McLeod County is an Accountable Rural Community Health (ARCH) model in both
hospitals, promoting Triple Aim: 1) Improving care outcomes and quality; 2) Reducing health care
spending; and 3) Improving populations’ health.
HH is the major mental health provider, usually at capacity with a 12-bed inpatient mental health unit.
GRHS offers mental health through a partnership with HealthLink Now, a telemedicine-based mental
health care. McLeod County is hiring authority for ten state agency positions assigned to Tri-Star
Assertive Community Treatment (ACT) team through the 18-county SWMN Adult Mental Health
Consortium. McLeod County is also a member of the 5-county Pact for Families Childrens’ Mental
Health and Family Collaborative.
HH is the primary Chemical Dependency provider for outpatient adult services. All inpatient treatment
is referred out of the county to providers including Project Turnabout (Granite Falls), Brown County
Evaluation Center (New Ulm), and New Ulm Medical Center, Liberalis (females), Waverly, and
Integrations (Hutchinson) who provides outpatient treatment to both adolescents and adults. McLeod
has 3 Rule 25 chemical dependency counselors, interested in early intervention and community-based
services.
Public Health goals: Increasing Child & Teen Check-Up rates; decrease effects of Chronic Disease;
Combat Obesity (nutrition and activity); reduce Tobacco use; improve Violence Prevention
assessments/intervention; improve outcomes for pregnant women and families exposed to violence;
and focusing on strategies to reduce the incidence of low birth weight.
McLeod County participates in a two-county, general public transportation system called Trailblazer
Transit (shared with Sibley County), and looking to form partnerships with cities in Wright County.
Trailblazer Transit has a dial-a-ride service and dwindling volunteer driver service. Thirteen (13) bus
schedules (21 vehicles = 19 buses and 2 vans; soon to be adding 2 mini-vans) operate Monday through
Friday from 6:30a.m. until 5:30p.m. The volunteer driver service of about 10 unpaid volunteers is
dwindling, but driving their own vehicles, support the bus operation to provide early morning, late
evening, weekend and holiday transports, outside the counties’ borders but within Minnesota. The
state funded “Local Access Plan” will be the primary transportation vehicle for county residents.
145
Mahnomen County:
Agency Name: Mahnomen County Social Services
Director’s Name: Julie Hanson
Address: 311 N Main Street, Mahnomen, MN 56557
FAX Number: 218-935-5459
Social Services
Name
Julie Hanson
Julie Hanson
Public Health
Jamie Hennen
Julie Hanson
Julie Hanson
Chemical Dependency
Julie Hanson
Transportation
Julie Hanson
146
Title
Director
Telephone Number
218-935-2568
Director
218-935-2527
Mahnomen is a very small rural county with few healthcare services. One hospital and two main medical
centers, Sanford and Essentia, have clinics within our boundaries. Our mental health services are
provided regionally by Northwestern Mental Health Center. There is one local dentist. Transportation is
very difficult.
147
Marshall County:
Agency Name:
Marshall County Social Services
Director’s Name:
Chris Kujava
Address:
208 E. Colvin Ave. Ste. 14
Warren, MN 56762
Telephone Number:
218-745-5124
FAX Number:
218-745-5260
Social Services
Name
Chris Kujava
Title
Director
Telephone Number
218-745-5124
Public Health
Gail Larson
Stacy Laudal
Stacy Anderson and
Ruth Finseth
Ruth Finseth
Mary Jo Larson
Social Service Supervisors
218-745-5154
218-745-5124
218-745-5124
Administrative Assistant
218-745-5124
218-745-5124
Chemical Dependency
Transportation
148
General County Service Delivery and Access Issues:
Some of the issues that the county deals with are:
1.)
Lack of dentists taking new public assistance clients.
2.)
Lack of public transportation.
3.)
Lack of child and adult psychiatrists
4.)
Lack of local adolescent chemical dependency (CD) treatment options
5.)
Lack of adult daycare
Transportation is a major barrier to the residents of Marshall County. Issues include the isolation of
many of the county’s residents: vast distances to travel, insufficient public transportation, needs of the
non-English speaking persons to communicate with interpreter services, the increasing elderly
population without extended family supports, and the many people who lack telephones for support
and for scheduling activities.
Many clients need to drive 100+ miles one-way to find a dentist that will see them. There is a lack of
providers willing to take on more public assistance clients. Some clients may be seeing providers that
the county does not know about and private paying for services or clients may be enrolled in a MCO and
using their contracted providers. Dentists in the area that want to contract with MCOs or DHS have
already done so; they just are not taking any new clients.
Marshall County Social Services completes Rule 25 CD assessments and makes recommendations and
referrals according to an individual’s level of need and treatment considerations. Our Rule 25 Assessor
works with the court system, service providers, individuals and families in various court proceedings,
pre-petition screenings for commitments, commitment hearings and court ordered treatment as well as
voluntary services. Individuals are referred to various providers for treatment as stated below, and case
management is provided to assist in accessing and following through with treatment needs. As there
are no treatment providers within our county, transportation can be an issue. Individuals who do not
have their own transportation rely on family, friends, and at times utilize volunteer drivers. Marshall
County currently has only one adolescent treatment provider within the area, and they provide
outpatient only. Adolescents needing inpatient treatment need to go to treatment some distance away.
Adult Mental Health services in Marshall County consist of case management, counseling, flex funding,
pre-petition screenings, community-based services including Community Support Program (CSP), Adult
Rehabilitative Mental Health Services (ARMHS), Intensive Residential Treatment Services (IRTS),
vocational assistance, money management, transportation, waivered services, Personal Care Attendant
(PCA) and Adult Mental Health Initiative (AMHI) staff and transitional services for youth 18-21. Marshall
County Social Services provides case management services which can include Rule 79 Case
Management. Services provided to adults with mental health needs are coordinated with providers
serving our county.
Due to our rural community, travel to appointments can sometimes be difficult. Currently we utilize
volunteer drivers to assist with transporting to mental health/medical appointments. County, CSP, and
AMHI staff as well as county care teams assist with assuring that the consumers’ mental health and
medical needs are addressed through coordinating and communicating services needed. The shortage of
available psychiatrists can sometimes result in long waits for appointments and/or result in emergency
holds. There are crisis beds available in Thief River Falls and Crookston, MN.
Currently we have one hospital available for 72-hour holds. This hospital serves the entire region;
therefore the limited amount of beds makes accessing this service difficult at times.
149
We have experienced a shortage of child psychiatrists in the area, which may result in long waits for
appointments. Northwestern Mental Health Center has begun utilizing tele-mental health to assist in
alleviating this shortage issue. Doctors and nurse practitioners/physicians assistants have been utilized
for medication management. Transportation is also an issue, with families needing to travel for
appointments.
Marshall County Social Services currently contracts their Volunteer Driver Program with the two MCOs
that operate in this county. If the recipient has a car or another ride available with a family member or
friend, they contact the county for prior authorization and are reimbursed by the county. If the
recipient does not have access to transportation, they can call their MCO (if enrolled in managed care)
or call the county (if fee-for-service) to arrange for a volunteer driver.
Marshall County’s Volunteer Driver Program is usually able to provide transportation for those who
need the service. However, there are times (for example: emergencies, short notice, etc.) when a driver
cannot be arranged.
Public health services are provided by North Valley Public Health. Services include home visits to
pregnant women, newborns and moms, families with children, screenings for school children, PCA
screenings, participation in Long Term Care Consultations with county Social Workers, Geriatric Care
Coordination for Nursing Facility MSHO clients, facilitation of Interagency Early Intervention Committee,
provider of Child & Teen Check Ups, provider of Outreach program for C&TC Program, tracking
immunizations and developmental screenings for children, provide immunizations including flu shots for
children and adults, facilitation of the Child Abuse Prevention committee, health screenings for adults,
smoking prevention programs, public health preparedness coordination, correctional health services,
and environmental health services.
150
Meeker County:
Agency Name: Meeker County Social Services
Director’s Name: Clark Gustafson
Address: 114 No. Holcombe Ave., Litchfield, MN 55355
FAX Number: 320-693-5344
Social Services
Public Health
Name
Clark Gustafson
LoAnn Shepard
Diane Winter
Mental Health –
Adults
Pat Thomas
Chemical Dependency
Pat Thomas
Transportation
Fiscal
Senior Health Care
(MSHO)
Pat Thomas
LoAnn Shepard
Marlene Remmel
Pam White
151
Title
Director
Financial/Clerical
Supervisor
Director,
Public Health
Social Worker
Supervisor
Social Worker
Supervisor
Social Worker
Supervisor
Financial/Clerical
Supervisor
Fiscal Supervisor
Telephone Number
320-693-5301
320-693-5311
320-693-5370
320-693-5313
320-693-5313
320-693-5313
320-693-5311
320-693-5310
320-693-5315
Meeker County has a population of 23,300 and is located in west central Minnesota. Litchfield, located
in the center of the county, is the county seat and home to 6,726 residents. Since 2000, Meeker County
has had a population growth of 2.51 percent.
Other cities in the county include Dassel, population 1,469 (located on the eastern edge of the county),
Grove City, population 635 (in the west end of the county), Cosmos, population 473 (southern edge),
Eden Valley, population 1,042 (northern edge), and Watkins, population 962 (northeastern section of
the county). Bordering counties include Stearns, Wright, McLeod, Renville, and Kandiyohi.
Within the population, 17.4% are over age 65. Hispanics comprise 3.3% of the population and are well
established. There are no other minorities with significant numbers in the county.
In the county, there is Meeker Memorial Hospital (MMH) with 33 licensed beds (25 medical surgical and
8 behavioral health), located in Litchfield. There are three nursing homes with a total licensed capacity
of 194 beds, and they are located in Dassel, Watkins, and Litchfield. There are 13 primary care
physicians and five mid-level providers (nurse practitioners) in the County.
There are six dentists in the Meeker County. Five dentists practice in Litchfield and no dentist in the
county will accept new MA clients.
Meeker County has small numbers when measurements of poverty are reviewed. The MFIP caseload is
about 59 cases and much lower than the state average. The unemployment rate is 4.1%. Meeker
County is ranked 57th in the state for median income. The per capita welfare costs in Meeker County are
some of the lowest of the 87 counties in Minnesota.
The majority of MA recipients receive health care in Litchfield. Others go to Willmar, St. Cloud,
Hutchinson, and the Twin Cities for care and to see medical specialists. A number of Meeker County
residents go to Litchfield for care at either of Affiliated Community Medical Centers East or West Clinics.
Specialists do come to the two clinics in Litchfield, as well as to Meeker Memorial Hospital. The major
medical vendors in the county receive about 8-10% of their business from MA clients. We find this low
percent lessens their interest and willingness to invest time in the development of managed care for the
MA population.
152
Mille Lacs County:
Agency Name: Mille Lacs County Community and Veterans Services
Director’s Name: Beth Crook
Address: 525 2nd Street Southeast, Milaca, MN 56353
FAX Number: 320-983-8306
Social Services
Name
Suzanne Lelwica
Title
Asst Director
Telephone Number
320-983-8212
Beth VanderPlaats
320-983-8376
Public Health
Kay Nastrom
Char Kohlgraf
Char Kohlgraf
Unit Supervisor
Community Health
Unit Supervisor
Disability Services
Unit Supervisor
SAA
Chemical Dependency
Char Kohlgraf
SAA
SAA
Transportation
Paul Prokosch
Fiscal Unit
Supervisor
320-983-8210
153
320-983-8416
320-983-8279
SAA
Mille Lacs County (MLC):
Approximate total population is 27,000
Approximate MA/PMAP/MinnesotaCare enrollees: 5000
Largest race: Caucasian second largest race: American Indian
49.8 % of population has less than or equal to High School diploma
35.8% population is living at or below 200% poverty level
Health Care Services:
2 Full service Hospitals
4 Primary Care Clinics
Adult Mental Health contracted beds are with Cambridge Medical Center
MLC does not have any of the following services located within our borders:
No Adult/child psychiatry, no ACT, no ICRS, no Crisis, no IRTS
Transportation Service: Timber Trails (Mille Lacs/Kanabec Counties)
Mille Lacs County Community and Veterans Services
County contracts with MCO(s) to provide: CMH-TCM and AMH-TCM
154
Morrison County:
Agency Name: Morrison County Social Services
Director’s Name:
Brad Vold
Address:
213 SE 1st Ave, Little Falls, MN 56345
Telephone Number:
320-632-0247
FAX Number:
320-632-0225
Social Services
Brad Vold
Name
Karen Sczysdorski
Cyndi Bachan
Public Health
Brad Vold
Paul Bukovich
Melanie Erickson
Chemical Dependency
Paul Bukovich
Transportation
Paul Bukovich
Louise Welle
155
Title
Social Services
Director
Financial
Assistance
Supervisors
Interim
Director
Social Services
Supervisor
Social Services
Supervisor
Social Services
Supervisor
Social Services
Supervisor
Associate
Director
of
Nursing
–
Public Health
Telephone Number
320-632-0247
320-632-0221
320-632-0214
320-632-0357
320-632-0255
320-630-0267
320-632-0255
320-632-0255
320-632-0347
According the Community Health Survey conducted in Morrison County, County Health Rankings for
Morrison County noted a significant disparity between residents’ perception of their health and those of
Minnesota statewide. Seventeen percent rated themselves in poor or fair health compared to 11% for
Minnesota. Respondents also reported having 3.9 poor mental health days out of the last 30 compared
to 2.6 for the state. The county experienced 17 drug poisoning deaths in 2010 (latest data available) – a
high number given the small population. While, the link between poor mental health and drug
use/abuse may not be causal but is certainly contributory.
Community Health Rankings place Morrison County as 80th out of the 87 Minnesota counties. One in 10
adults could not see a doctor due to cost; diabetes and premature age-adjusted mortality are both
higher than the state mean; 21% of adults smoke (vs 16% for MN); 23% drink to access (vs 19% for MN).
All of Morrison County is HPSA (Health Professional Shortage Area) designated for Mental Health. Little
Falls City and Township, Pierz City and Township, Randall City and most of western Morrison County are
designated HPSA for Primary Care.
Teams of Public Health and hospital staff spent several months looking at the data gathered from the
Morrison Todd Wadena Board of Health Community Health Survey, County Data Tables, Minnesota
Student Surveys, and other sources. Using state-wide indicators provided by the Minnesota Department
of Health, trending behavioral patterns and commonalities began to materialize. The community health
assessment teams discussed this information and identified ten community health priority areas.
•
Access to Health Care – affordable care, perception of importance, prevention care
•
Aging Demographic – rising elderly dependency rate and increasing numbers
•
ATOD - alcohol, tobacco, other drugs
•
Cancer - screening and early detection
•
Chronic Disease - diabetes, heart disease, stroke, high cholesterol, hypertension
•
Mental Health - depression, anxiety, suicide, stress
•
Adult & Childhood Obesity- poor nutrition and physical inactivity
•
Parenting - injury prevention, immunizations, etc.
•
Social Determinants of Health - poverty, housing, employment, environment, etc.
•
Unintended Injury- motor vehicle accidents, etc.
Through additional discussion the top three priorities- adult and childhood obesity, mental health, and
social determinants of health- were identified based on their significance, prevalence, and alignment
with current agency capacity. The hospital systems had chosen their top three priorities prior to
finalization of the community improvement plan top priorities; and this was a factor in the final
priorities chosen by the participating partners.
156
Mower County:
Agency Name: Mower County Health and Human Services
Director’s Name: Lisa L. Kocer
Address: PO Box 537, Austin, MN 55912
FAX Number: 507-437-9721
Name
Title
Social Services
Lindsay Brekke
Todd Lysne
Public Health
Pam Kellogg-Marmsoler
Chris Swatfager
Lindsay Brekke
Chemical Dependency
Chris Swatfager
Transportation
Todd Lysne
157
Child and Family Social
Services Supervisor
Supervisor
Community Health
Supervisor
Adult/Waiver Social
Services Supervisor
Child and Family Social
Services Supervisor
Adult/Waiver Social
Services Supervisor
Supervisor
Telephone
Number
507-437-9735
507-437-9723
507-437-9713
507-437-9793
507-437-9735
507-437-9793
507-437-9723
Mower County is a rural county located in Southeaster Minnesota, bordered on the east by Fillmore
County, on the north by Dodge and Steele Counties, on the west by Freeborn County, and on the south
by the State of Iowa. The Mower County Community is made up of an estimated population of 39,272
according to the 2012 United States Census data. The county seat is Austin, Minnesota with an
estimated population of 24,834. According to the 2012 Census, 25.3% of the population is under the age
of eighteen. Over 50% of the county’s school age children qualify for free and reduced lunch. The 2012
county-level poverty rate for Mower County was at 15.8% compared to the state average of 11.2%.
Mower County has one private not-for–profit hospital and clinic in Austin including primary, secondary
and specialty care services with satellite clinics located in the cities of Adams and Leroy. All are part of
the Mayo Clinic Health Systems.
Mower County also has 2 walk-in clinics located in Austin that provide care for more minor illnesses such
as ear aches, colds and flu and cuts and abrasion care. There are multiple pharmacies in Austin that
provide influenza immunizations to persons over age 10.
Mower County has independent mental health providers in the area that provide mental health care
and case management. Clinic and hospital based psychiatric services are limited to a few physicians and
psychiatrists and providers change frequently. First time and emergency appointments are difficult to
obtain. There is a need for services for persons in need of chemical dependency treatment.
Mower County has several dentists located mostly in the Austin area. These dentists in general do not
take on clients with Minnesota Health plan coverage thereby causing a hardship for those citizens to
access dental care in a timely and convenient manner. The closest dentist that will take new clients is 40
miles away in Rochester. There are long delays in receiving care as well as transportation issues to get to
the appointments.
Transportation to get to medical services in a rural county is limited for those who live outside of the city
of Austin.
There are home and community based care agencies that serve the population in Mower County. At
times it is difficult for residents that live in more rural areas to receive access to those home based
health care services.
Mower County has an increasing population of residents who have moved to area with limited English
proficiency. Over the past several years there have been people from South America, Africa, and South
East Asia that have settled in Mower County. Many of these people speak different languages and
dialects. All individuals are in need of culturally competent health services and some of the most recent
immigrants are in need of interpreter services and health education materials translated into a language
that they can understand.
158
Nicollet County Section:
Agency Name: Nicollet County Social Services
Director’s Name: Joan Tesdahl
Address: 108 S MN Ave #200, St Peter MN 56082
FAX Number: 507-934-9562
Social Services
Public Health
Chemical Dependency
Transportation
Child Welfare
Child Protection
Truancy
Minor Parent
Name
Joan Tesdahl
Mary Hildebrandt
Sue Serbus
Cindy McCabe
Sue Serbus
Dawn Michels
Cindy McCabe
159
Title
Director
Director
Supervisor
Supervisor
Supervisor
Supervisor
Supervisor
Telephone Number
507-934-8576
507-934-7211
507-934-8573
507-386-4510
507-934-8573
507-934-8545
507-386-4510
Nicollet County recipients encounter problems with access include transportation and numbers of
providers including specialty providers. Transportation is a large concern in the Nicollet County area, as
so many of our towns are outside of the area where medical providers are located. Also, there is a
concern regarding accessing dental providers, as well. There are too few of dental providers in the area
for our population to access.
The ongoing issue continues to be lack of dental providers in the area whom are accepting patients that
are on the health care programs thru the county. The agency has needed to make referrals to places
that are outside of the area, which also creates transportation issues/concerns. This could include
SMILES that is located in Savage. We have also referred quite numerous folks to a dental provider
located in LeCenter, MN.
Nicollet County has a history of jointly planning and developing integrated mental health services with
counties located in region 9. The health plans are expected to work with the county in this common
purpose.
Currently, in Nicollet County, social services offer children mental health services. This can include
(based on individual needs of family and availability of funds) the following: case management which
can involve advocacy in the health and education systems, respite care, assistance with getting eligibility
for healthcare, help with getting a diagnostic, obtaining individual and family counseling, skills workers
(children’s therapeutic supports and services), etc. Funding is through private health insurance (third
party), medical assistance, prepaid medical assistance and Minnesota Care.
Children’s mental health services are a mandated, voluntary service. Current issues (gaps) that our area
of service have include: a- not enough psychiatrists locally, b- waiting lists for skills workers, and cprivate insurances that do not cover the services of skills workers.
Transportation is an issue in the rural counties. Nicollet County does not have a rural transit system. And
now with recent changes in the MA/transportation reimbursement process, this makes it really hard for
our volunteer drivers to service our children and families. Volunteer drivers are only paid from the point
that they pick up the child/family to the appointment, back from the appointment to the home of the
child/family. The volunteer driver is not paid from their home and back again after they drop off the
child/ family. They are not paid for no-load miles. In our county, which geographically is 43 miles wide
at its longest and approximately 22 miles from north to south; this makes it more difficult for volunteers
to give of their time.
Nicollet County does not have a children’s mental health collaborative. We do have active family
services collaborative.
Child welfare includes the areas of child protection, minor parent and truancy. The child welfare
clientele utilize various medical plans (third party/private insurance, medical assistance, managed care,
Minnesota care, etc) to access health care. The following barriers that exist include: clients lack of follow
through of filling out the forms for eligibility, also not filling out forms for redeterminations in a timely
manner, transportation as described above, etc.
There is not a well-developed transit system within Nicollet County. In the city of St Peter, we use the St
Peter Transit. In North Mankato, individuals can use the city buses, which are not very reliable. We also
use Kato Cab out of Mankato. For transportation in rural Nicollet County, we use volunteer drivers. This
is coordinated by Nicollet County Public Health.
160
Nicollet County has a strong belief to assure that the health care needs of its residents are met. Public
health agencies in Minnesota have developed expertise over many years of working intensively with
populations that have been outside those typically served by the fee for service medical community and
in serving many parts of the population eligible for PMAP. Nicollet County Public Health has a strong
interest in establishing a collaborative partnership in order to continue to expand and improve services
to individuals and families in the home, clinic, and community.
Public Health has expertise in working with high risk, hard to reach pregnant women, both during
pregnancy and for parenting visits after the birth of the child. MCOs are asked to work with county to
assure that services are delivered to these women. The clients seen are frequently not consistent in
using the traditional medical system (for example, a high rate of no show and/or noncompliance in
following medical recommendations for treatment/prevention). MCOs are asked to work with Public
Health to assure that enhanced prenatal services are accessed by these “at risk” women and families.
Public Health offers health promotion programs that are population based, group and individually
provided. Most are targeted towards lifestyle changes in nutrition, exercise, sexuality, injury
prevention, disease prevention, and other areas which are critical in decreasing the incidence of chronic
and an acute onset of the disease. Medication management, a major problem in the control of chronic
health disease with older adults is provided.
161
Nobles County:
Agency Name: Nobles County Community Services
Director’s Name: Stacie Golombiecki
Address: 318 9th Street, PO Box 189, Worthington, MN 56187
FAX Number: 507-372-5094
Social Services
Title
Adult/ Children
Name
Darci Goedtke
Heather Kirchner
Tammy Fishel
IM Supervisor
Telephone Number
507-295-5240
507-295-5348
507-295-5226
Public Health
Terri Janssen
PH Supervisor
507-295-5285
Darci Goedtke
SS Supervisor
507-295-5240
Heather Kirchner
SS Supervisor
507-295-5348
Chemical Dependency
Heather Kirchner
SS Supervisor
507-295-5348
Transportation
Tammy Fishel
IM Supervisor
507-295-5226
162
Nobles County is a very rural, very diverse community. Recent information indicates some 52 different
languages and dialects spoken within the county’s main employer – a JBS pork processing plant.
According to the MN data portal, Nobles County ranks higher than the state average in many areas
including: people living in poverty, people without health insurance, children with elevated blood lead
levels, and premature births. A lack of adequate housing appears to cause many issues as well.
Health care is accessed primarily through help from medical staff, family, friends, church groups,
interpreters, health care navigators/ health coaches, public health nurses, and case managers. People
utilize independent vehicles, walking, volunteer driver services, taxi and medical transportation to get to
services. Transportation options can be a barrier for persons in rural communities and often a lack of
financial resources prevents persons from accessing care.
Language and a lack of information in languages other than English also present a barrier for persons
needing services. There has also been a perception shared that medical services are just for persons
who have lived here all their lives vs. for all persons. This has been stated to us by many persons of
diverse populations in various settings.
The gaps in available services are most predominantly access to dental care for person on public
assistance, access to psychiatry and other mental health services, lack of adolescent and adult MH crisis
placements and CD services for adolescents and adults.
163
Norman County
Norman County Human Services
Norman Mahnomen Public Health
Director’s Name: Chris Kujava
Director’s Name: Jamie Hennen
Address: 15 2nd avenue East, Ada, MN 56510
Address: 15 2nd avenue East, Ada, MN 56510
FAX Number: 218-784-7142
Fax Number:
Social Services
Public Health
Chemical Dependency
Name
Chris Kujava
Jamie Hennen
Chris Kujava
Title
Director
Director
Director/supervisor
Telephone Number
21-784-5400
218-784-5425
218-784-5400
Chris Kujava
Director/supervisor
218-784-5400
Chris Kujava
Director/supervisor
218-784-5400
Lead Eligibility Worker
218-784-5400
Director/supervisor
218-784-5400
Transportation
Mary Doyea
Elderly Waiver
Chris Kujava
164
Norman County is in short supply of Mental Health Professionals. Norman County relies on
Northwestern Mental Health Center (NWMHC) in Crookston to supply a majority of mental health
services. They have a difficulty attracting and retaining an adequate supply of psychiatrists. To address
this issue of not successfully recruiting psychiatrists the NWMHC has turned to tele-mental health as a
way to provide services. This form of treatment has increased accessibility and appears to be resolving
issues in delaying psychiatric care. NWMHC also hired an advanced practice nurse to assist in
medication monitoring. NWMHC does use NCSS office to provide psychiatric mental health every other
Friday
The rural nature and size of our county does present transportation challenges. Many residents do not
have cars or have vehicles that are not reliable. This is particularly true of our low income residents that
receive public assistance.
Some of the concerns for Norman County include:
•
•
•
Lack of providers in all areas of health service delivery
•
•
•
•
Limited volunteer drivers for out of town transportation to medical treatment
Norman County has only one provider who will take enrollees from one MCO only. This MCO only
covers about 5% of the county population leaving the other 95% to get their dental care out of county.
There are transportation issues, many no-shows and an overall lack of dental care when the recipients
have to go out of county for care. Providers tend to either not be taking any more MA patient referrals
or they have their appointments booked for months. This limits access and leads to residents of
Norman County to drive even further distances for care. Norman County MA recipients frequently lack
dental care for those reasons. Historically there has been reluctance among local dentists to serve MA
recipients, largely because of a perceived higher rate of missed appointments, treatment noncompliance, additional documentation requirements, and low reimbursement rates. These factors have
resulted in decreased access to dental care. Because of the reluctance among local dentists to service
local MA recipients, almost all seek services outside of the county.
Rule 25 assessments are completed by a contracted provider, Northwestern Mental Health Center.
Transportation to CD treatment is an issue for Norman County residents mainly because
facilities/services are located outside the county. There are no CD providers in Norman County. The
average range is approximately 45 miles to treatment/services. One of the main barriers is when there
is an emergency need getting transportation for the client to the facility needed
Although improving slowly there are issues with dual diagnosis. The CD treatment component tends to
not want to treat a client due to mental health symptoms and the mental health treatment tends to
claim they cannot provide treatment due to CD issues. This issue has shown improvement but still
remains an issue. Facilities need to have programs that deal with MI/CD and to start specialty programs.
Norman County is implementing best practices strategies in addressing chemical dependency issues by
attempting to utilize MI/CD dual diagnosis outpatient programs for those with co-occurring disorders
whenever possible.
165
Our sense is that the majority of people seeking treatment are doing so through pressure, by the legal
system, by family, and by significant others, such as employers. This leads to lower success rates in
effectively treating their CD issues due to the fact the client is not buying into the fact they need help
but are just made to complete treatment. The treatment system needs more flexibility to provide
services that are truly individualized. Our recipients are currently locked into treatment that often does
not allow this. Norman County eagerly waits to see the results of what changes will come about through
the State’s efforts to redesign services.
Completing paperwork and documentation is very frustrating and time consuming for providers, which
discourages innovation. The reality is a lot of time and energy is expended on completing paperwork,
with the outcome being less time available for actual treatment or the development of more effective
treatment models.
Norman County has an adequate number of outpatient providers in the area however it would be
helpful to have a provider in Norman County. Due to the county’s size it is more than likely not feasible.
The closest inpatient program is 45 minutes away. Norman County utilizes 4 detox centers, five
inpatient locations, 4 halfway houses, four CD board and lodges and numerous outpatient treatment
options within 100 miles,.
Transportation is an issue for many in that their vehicles are often unreliable, or they have no other
means than the public transportation system or to find someone who will drive them (but at a cost to
the person).
Norman County contracts Northwestern Mental Health Center (NWMHC) for a majority of mental health
care including psychiatric services, in home therapy, Community Support Plan (CSP), Adult Rehabilitative
Mental Health Services (ARMHS), outpatient counseling and mental health assessments. NWMHC
struggles with hiring psychiatric care and they addressed the need by utilizing tele-mental health
services and special care nursing. Norman County contracts with NWMHC to provide our CSP. They
work very closely with case managers and other staff at our department to meet the needs of
consumers. Some of the services provided by our Community Support Program include medication
monitoring, assistance in developing independent living skills, client outreach, crisis assistance, and
emergency assistance. We also contract with Thief River Medical Center and NWMCH for an emergency
24-hour crisis phone line.
NWMHC is a state certified provider in Norman County for ARMHS. They provide independent living
skills training for consumers who have a serious mental illness using both individual and/or group
sessions
Emergency mental health holds have historically been handled by the Regional Treatment Center in
Fergus Falls or the NW Medical Center in Thief River Falls. With the closure of the State RTC’s, several
16-bed community hospital units have been developed. The Fergus Falls 16-bed unit is currently the
closest.
There are no local sex offender outpatient treatment programs through our local mental health center.
To receive treatment for sex offenders they have to go out of region with Bemidji or Thief River Falls
being the two main areas. This has led to transportation issues, more no shows than tolerated which
leads to correctional placements. Resources are in short supply for this population group and there are
challenges in serving them because of their criminality. Regional treatment is needed and research on
effective therapy needs to take place. The cost to this treatment for children in a correctional facility is
extremely high which leads to budget issues in a small rural county. Cost can be upwards of $200 a day
with treatment needed for an average of 8 to 12 months.
166
There is one local ARMHS provider. This MA service has been very helpful by providing additional one to
one contact with clients who need support in the community. Funds received through the Region 1
Mental Health Initiative have allowed us to expand some services. We have also supported one
Intensive Residential Treatment Services (IRTS) facility and a foster care home for high need clients. A
high priority will continue to be placed on expanding the supply of safe, affordable housing, with a need
to secure grants and other funding sources to replace or renovate housing that is currently unsafe and
unhealthy.
Transportation is an issue for Norman County residents because services take place outside the county
with the exception of one provider. We are working on tele-mental health to address some of these
issues.
The PCA program appears to be in jeopardy. We are already seeing signs of a shortage of PCA providers
and trained staff.
Reimbursement issues are presenting challenges in locating and retaining mental health professionals.
The ability to recruit and retain psychiatrists is an ongoing challenge.
The lack of a local 24 hour crisis hot line (services) in the county. Services are currently purchased out of
the county by NWMHC of Crookston.
There is a lack of IRTS in the county which adds additional challenges and concerns in providing the full
continuum of care for those with mental illness in the local area. There is a regional IRTS facility and one
in Moorhead that is utilized by Norman County residents.
The mental health needs and timely access to services for children is always a concern. This is especially
evident for children who are in need of protection and are removed from their homes. These children
must have a current mental health screening, or one must be completed shortly after they enter
placement, to ensure the mental health needs of these children are identified and services accessed.
Another concern is the growing mental health needs of children in the correction system. Norman
County is in need of lesser restrictive settings to help address Mental Health needs without utilizing a
secure placement.
Targeted case management (TCM) services are available upon request to all adult/child persons who are
eligible and are provided by Norman County Social Services. At time there may be dual targeted case
management services due to complexity of clients and the NWMHC would be the other provider
Children within child protection caseloads for over 60 days are now screened for children’s mental
health issues. At that point a diagnostic assessment for mental health may be also be required.
Access is often a problem for the following reasons:
• Transportation;
• Recruiting psychiatric and professional providers is often difficult.
The following mental health and social issues result in on-going county concerns and leads to increased
mental health needs:
*Lack of crisis services – services are limited and there is no local in-patient psychiatric unit for
children, in our region. The nearest facilities are in ND.
*Increased drug and alcohol abuse/dual diagnosis;
*Stigma related to mental health needs and services;
*Child Protection issues;
167
*Increased diagnosis of mood disorders;
*Fetal Alcohol Syndrome/Dual Diagnosis;
*Correctional/Mental Health.
These issues, along with low service accessibility, often lead to more serious high end service needs, the
highest being out-of-home placement. As the cost of out-of-home placement increases, a primary goal
is to provide more preventative or early identification services that will curb escalating needs to protect
children and families.
Norman County Social Services contracts with Tri Valley Opportunity Council (TVOC) for transportation
of health care program recipients whom do not have their own means of transportation. TVOC services
are primarily offered on a dial a ride system, but there is a limited two day a week bus system
Special transportation is available through Medi-Van. Emergency medical transportation needs are met
by Bridges Ambulance Services located in Ada, MN. There is a lack of available transit options for urgent
medical services that must be met on “short notice”. The numbers of volunteers available and willing
to provide transportation service are extremely limited. Medi-Van always meets the special needs of
health care recipients; however, this service is costly. It would be helpful if there could be a special
transportation provider for the local service area.
•
•
Special Programs:
Norman County is an active partner in the Children’s Justice Initiative (CJI) which looks at “the best
interest of the child”. Local partners are very much vested in this initiative and the ultimate goal is that
the children always have permanency and live in safe, nurturing, homes. We continue to explore ways to
quickly identify issues so that children and families receive appropriate services at the right time and in
the right place. The outcome will be one of positive systemic change in Norman County: individuals will
experience greatly improved social and physical health, less family dysfunction, and decreased need for
government intervention in their lives.
Norman County is a part of an eight county Adult Mental Health Regional Initiative (AMHI) Project. The
project receives state funding to use flexibly in the system design and service delivery to persons with
mental illness. The money that is received from the State that flows to the region is critical in providing
a continuum of care.
Norman-Mahnomen-Polk Community Health Board is a sub-unit of local government created by a joint
powers agreement between the county commissioner boards of Norman and Mahnomen Counties.
Norman-Mahnomen-Polk Community Health Board functions as one unit serving three counties and
does business as Norman-Mahnomen Public Health. The mission of Norman-Mahnomen-Polk Public
Health is to improve, promote and protect the health of individuals, families and communities. The
agency is an integral part of the community, working closely with the citizens and other agencies to
ensure a safe and healthy environment to live in.
There is clearly an ongoing need for local government to be involved in quality assurance so that the
public receives appropriate care. There is a lack of funding for this role. The most complicated and
expensive clients are often labeled “vulnerable adults” and the responsibility for their care is shifted
back to the counties, who must now serve them without reimbursement.
The dentist to population ratio in rural Minnesota is far below the national average of one dentist for
every 1,800 people (MDH, 2002). Designated as a Dental Health Professional Shortage Area, the MCO
must work with public health C&TC outreach staff that will assist with targeted outreach to clinic
patrons to better address issues such as “no shows”, treatment compliance, follow-up, referral and
transportation issues.
168
Olmsted County
Agency Name: Olmsted County Community Services
Director’s Name: Paul Fleissner
Address: 2117 Campus Dr SE Rochester, MN 55904
FAX Number: 507-328-6297
Social Services
Name
Jim Behrends
Jodi Wentland
Heidi Welsch
Title
Associate Dir.
Associate Dir
Associate Dir.
Telephone Number
507-328-6352
507-328-6351
507-328-6354
Pete Giesen
Margene Gunderson
Dan Jensen
Mary O’Neil
Director
Program Mgr.
507-328-7434
507-328-7525
507-328-7450
507-328-6851
Chemical Dependency
Pat McEvoy
Jodi Wentland
Mary O’Neil
Program Mgr.
Associate Dir.
Program Mgr.
507-328-6256
507-328-6351
507-328-6247
Transportation
Diane Tradup
Volunteer
Coordinator
507-328-6371
Public Health
169
While the community is generally a healthy one and has been recognized nationally for its high quality of
life, there are people in Olmsted County who have tremendous needs and face formidable challenges
that make daily life a struggle. Some live in poverty, some are homeless, and some are hungry; others
are struggling in school or live in abusive relationships. Some are struggling to learn English and obtain
job skills or an education, while also trying to support a family. Some are elderly, chronically ill, or
disabled, often with little or no family support. Many individuals are drawn to the county to seek
medical care at Mayo Clinic and end up relocating as a result.
As Olmsted County’s population has grown in both size and diversity, also has the scope and complexity
of our community’s human service and workforce development issues. Human services and economic
development are closely inter-related around issues of job training, housing, child-care, transportation,
literacy and higher education. Future, growth of Olmsted County including Mayo Clinic’s “Destination
Medical Center” will depend on the community leaders in public, private, and non-profit sectors working
together to sustain a healthy future and a high quality of life.
During 2013, OCPHS conducted Community Health Needs Assessment in collaboration with Mayo Clinic,
and Olmsted Medical Center. The findings from this assessment will contribute to a community wide
plan that will set priorities for work within the community for several years. The top Community Health
Priorities identified during the Community Needs Assessment include:
• Mental Health
• Obesity
• Financial Stress/Homelessness
• Diabetes
• Vaccine Preventable Diseases
Most significant human service issues or problems facing Olmsted County at the present time:
• Affordable / accessible housing
• Poverty and the need for livable wages
Most significant unmet needs in Olmsted County at the present time:
• Psychiatric services availability
• Dental access for low income residents
Demographic projections show an aging population, leading to increasing health needs related to
chronic diseases and decreased independence. The young to middle-aged adult population is also
increasing, which can be expected to provide both economic support and actual care for the elderly.
Health needs for this portion of the population, such as those related to childbirth and parenting,
occupational health, and safety and chronic diseases related to lifestyle choices may also increase. The
number of school-aged children will continue to increase, even though their actual percentage of the
population will decrease. Health problems related to this age group include risk-taking behaviors, such
as the abuse of alcohol, tobacco and other drugs, and will require steady attention and monitoring.
Health problems tend to cluster in vulnerable population groups. Minority individuals and families,
those living with low incomes, and those who have difficulty with the English language tend to
experience multiple, and often times complex, health needs. Olmsted County residents are quite similar
to other Minnesota residents in many areas. The leading causes of death in Olmsted County continue to
be cancer, heart disease, chronic lower respiratory disease, stroke and unintentional injury. 1 Many of
the deaths may be preventable through behavior changes such as increasing physical activity levels,
eating lower-fat diets, and reducing tobacco and alcohol consumption.
1
2010 Minnesota County Health Tables, Minnesota Department of Health, Center
170
Otter Tail County:
Agency Name: Otter Tail County Human Services
Director’s Name:
Deb Sjostrom, Interim Director
Address:
530 Fir Ave West
Telephone Number:
218-998-8185
FAX Number:
218-998-8213
Social Services
Title
LTC Unit Supervisor
Telephone Number
218-998-8338
Public Health
Stacy Shebeck
Cheryl Ranum
Diane Thorson
Financial Unit
Supervisor’s
Director
218-998-8239
218-385-5460
218-998-8333
Margaret Williams
218-998-8170
Tamra Jokela
Chemical Dependency
Margaret Williams
Transportation
All of the above
MH/CD/Specialty
Unit Supervisor
Child Services
Supervisor
MH/CD/Specialty
Unit Supervisor
Fiscal
Leon Anderson
Fiscal Supervisor
218-998-8158
Jody Lien
Name
171
218-998-8195
218-998-8170
Otter Tail County is blessed with access to health care services in 7 of the 8 communities that have a
school district and/or employment centers of the counties. The smaller communities often have a single
provider for dental, vision, pharmacy, and chiropractic services. It is critical that provider agreements
are made available to these providers to avoid loss of the service in a community and subsequent
transportation barriers that could arise. The ethnic makeup of the communities of Pelican Rapids,
Fergus Falls, and Perham is changing as refugees resettle in these areas.
Enrollees primarily access services within the community with a primary care clinic closest to where they
live. Primary care and hospital services may be accessed within Otter Tail County and the neighboring
counties of Becker, Clay, Douglas, Grant, Wadena, or Wilkin. Tertiary care and specialty services are
accessed in Fargo, N.D., St, Cloud, Minneapolis/St. Paul, or Rochester. Primary Care Medical Services
primary networks are Essentia, Lake Region Healthcare, Sanford, and Tri-County Health Care. Dental,
chiropractic, behavioral health, and vision care is provided by independent practitioners. An Apple Tree
Dental Clinic as a safety net provider. Fergus Falls is a regional center for access to state operated
services for dental care, chemical addiction, and behavioral health hospitalization. Behavioral health
services are available within schools through Lakeland Mental Health Center and Lutheran Social
Services.
Issues that exist around health care services include:
o Language barriers which require the use of telephonic interpreter service for as many as twelve
languages.
o Transportation barriers for persons that may not require medical transport but do require
assistance getting from the house to the source of transportation. Also, providers are unable to be
reimbursed for unloaded miles. This can be an issue when clients need assistance getting to
specialty care several miles away, then hospitalized, and the driver cannot be reimbursed for their
mileage to return home.
o Long wait times for appointments for accessing services for behavioral health, dental care, and
preventive exams. Appointments may be as long as 3 months.
o Reimbursement rates for providers who are no longer a part of a network, especially when the
provider is a sole provider in a community. Adding costs for transporting clients a greater distance
and the challenges of locating volunteer drivers adds to the problem.
o The need to maintain access to pharmacy services within communities with a clinic is critical.
These providers support the community in ways “mail order” pharmacies do not. They are there
for immediate filling of new prescriptions as well.
o Chemical Dependency Assessments are required for to authorize services that Rule 25 deems
appropriate. Staff have experienced health plan denial of the treatment plan if the client has had
several other attempts at treatment regardless of the dimension scores on the Rule 25 assessment.
There is a major time factor involved between some health plans requiring a new assessment every
6 months when CCDTF allows updates to the assessment every 6 months. Treatment has been
denied for inpatient treatment for marijuana addiction,
o In response to the ACA, communities have or are developing urgent care services, community
paramedic services. Helping enrollees understand and accessing them will be needed.
o Public Health is working with providers to increase access to intensive behavioral therapy to
address issues related to obesity, tobacco use, and promoting breastfeeding. Billing codes and
reimbursement rates for these services should mirror Medicare coverage.
o Age-appropriate immunizations are an ongoing issue as new vaccines are made available.
172
Pennington County:
Agency Name:
Pennington County Human Services
Director’s Name:
Ken Yutrzenka
Address:
318 Knight Ave. North
Thief River Falls, MN 56701
Telephone Number:
(218) 681-2880
FAX Number:
(218) 683-7013
Social Services
Name
Julie Sjostrand
Kathleen Herring
Public Health
Anita Cardinal
Julie Sjostrand
Julie Sjostrand
Chemical Dependency
Julie Sjostrand
Transportation
Kathleen Herring
173
Title
Social
Services
Supervisor
Financial
Assistance
Supervisor
Public Health
Director
Social
Services
Supervisor
Social
Services
Supervisor
Social
Services
Supervisor
Financial
Assistance
Supervisor
Telephone Number
218-681-2880 Ext. 227
218-681-2880 Ext. 235
218-681-0876
218-681-2880 Ext. 227
218-681-2880 Ext. 227
218-681-2880 Ext. 227
218-681-2880 Ext. 235
Health care is accessible in Pennington County. Where services are not locally available or specialty
services are needed, consumers need to travel regionally (Grand Forks, Fargo) and further
(Minneapolis/St. Paul, Rochester). Pennington County’s primary medical provider is Sanford Health,
Thief River Falls. Sanford Health just completed and moved into a new hospital and clinic complex in
October 2014.
Local dental access still remains the largest health care gap for MA FFS and PMAP enrollees. In many
circumstances MA/PMAP enrollees must travel out of the area for dental care.
Behavioral health and chemical dependency (CD) services are available in the county. Sanford Health
offers a 10 bed acute care inpatient hospital as well as comprehensive outpatient psychiatric and
psychology and IRTS level services. CD services including assessment and outpatient programming are
available locally. Detox and residential CD programming are not available locally and must be accessed
outside of Pennington County. Pennington County is also a member of the NW 8 Adult Mental Health
Initiative (AMHI). The AMHI focuses on program development and ensuring the mental health safety
net for the region.
Pennington County also provides behavioral health services for children and their families. Sanford
Health, Thief River Falls is the provider for children’s outpatient therapy, psychiatry, Intensive In-home
therapy and also operates Pathfinders Children’s Treatment Center, a residential mental health service
program.
Public health services are available in Pennington County through Inter-County Nursing
Services. Public Health provides the six essential public health activities defined by Minnesota Statute.
As described earlier, dental care remains the most significant health service that is unable to address all
MA/PMAP enrollees, locally. This limitation also provides transportation/travel issues for some
participants who must travel long distances for this service and where transportation options are also
limited.
Chemical dependency detox is also a significant service gap. With the nearest detox facility located
about 2 hours away, individuals are leaning heavier on the local hospital’s Emergency Department to
address immediate detox needs.
Transportation services, although available, are also limited in scope and MA/PMAP enrollees could
benefit from additional resources.
174
Pine County:
Agency Name: Pine County Health and Human Services
Director’s Name: Becky Foss
Address: 315 Main Street South, Suite 200, Pine City, MN 55063
FAX Number: (320) 591-1601
Social Services
Public Health
Name
Beth Jarvis
Barbara Schmidt
Peggy Brackenbury
Becky Foss
Gwen Lewis
Barbara Schmidt
Beth Jarvis
Chemical Dependency
Barbara Schmidt
Transportation
Barbara Schmidt, Peggy
Brackenbury
175
Title
Social Services
Supervisor
Financial
Assistance
Supervisor II
Director
PH Supervisor
Social Services
Supervisor
Social Services
Supervisor
Social Services
Supervisor
Social Services
Supervisor
Telephone Number
(320) 591-1582
(320) 216-4106
(320) 216-4107
(320) 216-4104
(320) 216-4109
(320) 216-4106
(320) 591-1582
(320) 216-4106
(320) 216-4106
Pine County has a population of approximately 30,000 people. Pine County is a geographically large, yet
rural county. It encompasses over 1,400 square miles. Interstate 35 runs through the county. The
southern part of Pine County is located about one hour north of the Cities area and the northern part of
the county is approximately one hour south of Duluth. Pine County has a history of high unemployment
rates and high rates of people living in poverty. According to the Kids Count Data Center, there were
15.3% of children in Minnesota living in poverty in 2011. However, in Pine County, there were 24.0% of
children living in poverty that same year. It should also be noted that American Indians are the largest
ethnic minority population in Pine County. The Mille Lacs Band of Ojibwe has their District Three
located in Pine County.
The Northern tier of Pine County (North of Sandstone) will typically access medical care and mental
health services in Cloquet or Duluth (Carlton County or St. Louis County). The southern tier of Pine
County will typically access medical care and mental health care in Pine County or to the south or west
of Pine County. Transportation is a barrier for many individuals who want to access medical care or
mental health services. Because individuals in Pine County typically need to travel a good distance to
see a medical care provider, a reliable vehicle is a must. Unfortunately, there are many individuals who
do not have reliable, affordable transportation. This is one critical component that must be considered
by any potential responders.
Riverwood Mental Health Center closed unexpectedly in March of 2014. This left numerous individuals
without continuity in their mental health care. Pine County has seen many area agencies respond to the
Riverwood closure. Specifically, Therapeutic Services Agency, Greater Minnesota Family Services,
Nystrom and Associates and Lighthouse Child and Family Services are now serving many of Riverwood’s
former consumers.
In the past two months, there have been concerns reported to this agency regarding the lack of options
available to MA and MinnesotaCare enrollees as it pertains to dental and eye care. These concerns
should also be considered by any potential responders. Child and adult psychiatry is difficult to access in
Pine County. Again, traveling a far distance would be a requirement and providers rarely have timely
openings for new clients.
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Polk County:
Agency Name: Polk County
Administrator’s Name: Chuck Whiting
Address: 612 N. Broadway, Room 211, Crookston, MN 56716
FAX Number: 218-3808
County Contacts:
Human Services
Public Health
Agency name:
Director's Name:
Polk County Social Services
Kent Johnson
Address:
612 N. Broadway, Room 302
Crookston, MN 56716
(218) 470-8405
(218) 281-3926
Telephone:
FAX:
Agency name:
Director's
Name:
Address:
Telephone:
FAX:
Polk County Public Health
Sarah Reese
721 S. Minnesota, Suite 1
Crookston, MN 56716
(218) 281-3385
(218) 281-7376
Social Services
Public Health
Mental Health
Name
Jeannette Knott
Victoria Ramirez
Karen Warmack
Molly Paulsrud
Sarah Reese
Doreen Narlock
Karen Warmack
Phone #
(218) 470-8482
(218) 470-8418
(218) 399-8522
(218) 470-8417
(218) 281-3385
(218) 773-4990
(218) 399-8522
Jeannette Knott
Title
Lead Coordinator
(Children’s Mental Health)
(Adult Mental Health)
LeAnn Holte
Financial Assistance Supervisor II
(218) 470-8459
Jeannette Knott
Chemical
Dependency
Transportation
177
(218) 470-8482
(218) 470-8482
Acute care and related health care services for Polk County revolves around 3 areas of provider
concentration serving the east, central and western parts of the county.
The eastern portion of the county is served by Essentia Health of Fosston, an acute care hospital, nursing
home, assisted living, and home care programs with an associated medical clinic at Fosston and one at
Oklee. Referrals from the Fosston area are primarily to the Altru Health System in Grand Forks, ND, 80
miles to the northwest and the Sanford Hospital in Bemidji, 35 miles to the southeast. Some patients
directly seek primary care in Bemidji. One physician group in Fosston is an affiliate of the Essentia Clinic
of Fargo, ND; some specialty care referrals access the clinic in Fargo. Primary care physicians staff the
Essentia Clinic, in Fosston.
Central Polk County is served through the Riverview Healthcare Association in Crookston, the county
seat. Riverview Healthcare Association includes a hospital, outpatient CD, nursing home, clinic, assisted
living, home care program, and associated medical clinic. The central Polk area is also served by AltruCrookston Clinic with primary care physicians, MD specialists, podiatrists and mid-level practitioners. In
addition to the clinic in Crookston, these physicians and practitioners also maintain clinics at Fertile, Red
Lake Falls East Grand Forks, and Erskine to serve those communities.
With the Altru-Crookston Clinic being a satellite of the Altru Health System in Grand Forks, most
referrals are to the Altru Hospital.
East Grand Forks and the western portion of the county receives both primary and specialized care
services from the major health care provider in the region, the Altru Hospital/Clinic across the river in
Grand Forks, ND. In addition, Sanford operates a clinic in the East Grand Forks community. This clinic
has primary care physicians, specialists and mid-level practitioners. As a result, some specialty care
referrals may go to Fargo. Additionally, Riverview has an orthopedic clinic in East Grand Forks.
Fertile, in south central Polk County, has a nursing home, and an Altru-Crookston satellite clinic and a
Riverview satellite clinic. Erskine, located in the lakes’ area of central Polk County also, has an Altru
satellite clinic and Essentia satellite clinic. In addition to these service locations, some Polk residents
seek primary care services in Warren, Thief River Falls, Red Lake Falls and Ada, and nearby cities with
trade areas including parts of Polk County.
Other health care providers such as dentists, chiropractors, optometrists and pharmacists, generally,
practice alone or in small group practices throughout the county. Major concentrations of these
professionals, however, are in Fosston, Crookston, East Grand Forks, and Grand Forks. Six ambulance
services are licensed to serve residents, and three are located within county borders.
The major provider of outpatient mental health services in the region is Northwestern Mental Health
Center located in Crookston, with satellite clinics and services throughout northwestern Minnesota.
Altru in Grand Forks provides inpatient treatment. Sanford - Thief River Falls provides inpatient
treatment and a full range of mental health services.
Polk County enjoys good working relationships with the various health and human service providers.
Examples of strong partnerships include: Polk County Social Services and Polk County Public Health team
approach to Long-Term Care assessments and case management services, the Polk County Family
Services Collaborative, the Polk County Immunization Registry through Communities Caring for Children,
the Crookston Wellness Coalition, and the Polk County Chemical Health Initiative.
178
Pope County:
Agency Name: Pope County Human Services
Director’s Name: Nicole Names
Address: 211 E Minnesota Ave., Suite 200, Glenwood, MN 56334
FAX Number: 320-634-0164
Social Services
Name
Nicole Names and Phyllis
Reller
Paula Hoverud
Title
Director &
Sup.
Supervisor
Public Health
Sharon Braaten
PH Director
Phyllis Reller
Supervisor
320-634-7755
Phyllis Reller
Supervisor
320-634-7755
Chemical Dependency
Phyllis Reller
Supervisor
320-634-7755
Transportation
Paula Hoverud
Supervisor
320-634-7755
179
Telephone Number
320-634-7755
320-634-7755
320-634-7822
Pope County residents primarily go to the clinic or hospital in Glenwood, Starbuck or to the north to
Douglas County or west to Morris. Other providers are sought out as needed. PrimeWest is a primary
provider in Pope County.
Transportation – availability is limited, frequency of routes are limited & assistance on and off public
transit is not available.
Specialists & dental access are currently unavailable in Pope County.
Specialists and dental access are limited in their availability to the county's MA and MinnesotaCare
enrollees.
180
Ramsey County:
Agency Name: Ramsey County Community Human Services (RCCHSD)
Director’s Name: Meghan Mohs
Address: 160 East Kellogg Blvd. Saint Paul, Minnesota 55101
FAX Number: 651-266-4439
Social Services
Name
Melissa Huberty
Telephone Number
651-266-3623
Diane Holmgren
Title
Division
Director
Division
Director
Manager
Tina Curry
Public Health
Alyssa Conducy
Manager
651-266-3518
Linda Hall
Manager
651-266-4070
Chemical Dependency
Alyssa Conducy
Manager
651-266-3518
Transportation
Ali Ali
Manager
651-266-3849
181
651-266-4365
651-266-1221
Ramsey County has seen growing diversity reflected in a new economic and cultural dynamism
throughout the county. We have also witnessed the very real and painful struggle on the part of some
to adapt to a new culture and marketplace. This transition is often made much more difficult because of
poverty and isolation, which is in part, due to the struggle to cope with a lack of English language skills.
In turn, the poverty and isolation experienced by some of our limited English proficient residents greatly
increases the need for timely and effective human services.
Clients access dental care by contacting the clinic for an appointment. Information on providers who
accept MA and MinnesotaCare is provided via Public Health and Web link. There is a lack of dentists
who accept MA which results in long delays accessing care.
Detoxification is provided by the Ramsey County Detox Center for adults and adolescents, 24 hours per
day, seven days a week. The Detoxification Center is a sub-acute residential facility providing medical
monitoring, chemical dependency assessments, screening, and referral to appropriate treatment
programs for individuals who are intoxicated or experiencing withdrawal symptoms.
Service Coordination/Case Management provides information and referral resources; coordination of
services; crisis intervention and community outreach as an alternative or adjunctive service to other
types of chemical dependency treatment. Case managers assess, with the client, family members, and
other professionals, what services are appropriate for supporting recovery. Case managers then
arrange, coordinate and monitor services and also provide some of these services directly.
Chemical Dependency issues identified in Ramsey County:
• Lack of programming for mothers with children.
• Increased funding for intensive case management.
• Providers unable to service medically complicated clients.
• Increased programming for dually diagnosed clients.
• Lack of programming for sex offenders.
• Limited aftercare services
• Increased support for transportation to treatment.
• Expansion of psychiatric and medication management services in residential programs.
Adult Mental Health issues identified in Ramsey County:
• Lack of resources for child care and transportation create barriers for accessing care.
• Bicultural and bilingual mental health providers are quite limited and the cost of providing
interpreters is very high for agencies.
• Clients experience numerous challenges navigating health system which could be mitigated
through the assistance of a care coordinator. This would result in an increase treatment
compliance and response.
• Individuals with mental health or chemical health problems report that health care providers
lack empathy and understanding of their disorders.
Children’s Mental Health issues identified in Ramsey County:
• Lack of child psychiatry including neuropsychiatry.
• Lack of safety net for children who are refused admission to hospitals and other residential
settings due to aggressive behaviors.
182
•
•
•
•
Limited number of professionals experienced in working with co-occurring disorders (including
chemical dependency and developmental delays).
Insufficient number of experienced in-home therapists.
Lack of services for youth transitioning to adulthood, especially for those who do not qualify for
adult mental health case management.
Limited number of professionals that meet the cultural and language needs of families.
Ramsey County is one of eight (8) metropolitan counties in the Metro Counties Consortium (MCC)
whose membership consists of Anoka, Chisago, Dakota, Hennepin, Isanti, Sherburne, and Washington.
The MCC have formalized the terms and conditions through which they will cooperatively manage and
administer Access Transportation Services (ATS) of Non-Emergency Medical Transportation (NEMT)
services by way of a Cooperative Agreement.
The Ramsey County Board of Commissioners established several advisory committees in 1975.
• The Adults Services Committee represents three distinct groups: Adults age 60 and older who
have difficulty living independently and who are unable to provide for their own needs; adults
who are at risk of abuse, neglect or material exploitation; and persons between age 18 and 60
who have a major physical or neurological disability but who do not have a primary diagnosis of
developmental disability or mental illness.
• The Chemical Health Committee represents low income adolescents and adults who have
serious alcohol or drug abuse problems and who seek treatment, or for whom treatment is
being sought, people of color who need culturally specific services to ensure access to drug or
alcohol treatment resources, and families or significant others who have been affected by the
problems of chemical dependency.
• The Children’s Mental Health Advisory Council represents families with a child or children who
fit the legal description of Emotionally Disturbed or Severely Emotionally Disturbed, an organic
disorder of the brain or a clinically significant disorder of thought, mood, perception,
orientation, memory, or behavior that is listed in the Diagnostic and Statistical Manual and
which seriously limits a child’s capacity to function in primary aspects of daily living, such as
personal relations, living arrangements, work school, and recreation.
• The Children’s Services Review Panel represents families with one of more children under the
age of 18 where the caretakers, for whatever reason, are unable or unwilling to provide for the
child’s physical, emotional, or developmental needs and where safety is a concern and the
child(ren) is(are) in need of protection.
• The Developmental Disabilities Committee represents individuals with mental retardation or
related conditions who are limited in their ability to function in at least three major life activities
including people with an IQ of less than 70 and/or cerebral palsy, epilepsy, or autism, and
substantial difficulties in at least three major life areas such as self care, toileting, household and
money management, community living, and leisure.
• The Low Income Committee represents individuals and families who need help meeting their
basic needs for food, shelter, and clothing, including persons who qualify for public assistance
because their income or assets fall below Federal or State poverty guidelines.
• The Mental Health Advisory Council represents adults with mental illness, an organic disorder
of the brain or a clinically significant disorder of thought, mood, perception, orientation,
memory, or behavior that seriously limits their capacity to function in primary aspects of daily
living such as personal relations, living arrangements, work, and recreation.
Ramsey County Public Health provides a wide array of essential public health services which include
preventing the spread of disease, protecting against environmental hazards, preventing injuries,
promoting and encouraging healthy behaviors, responding to disaster, and assuring the quality and
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accessibility of health services. Our mission is to improve, protect, and promote the health,
environment and the well-being of people in our community.
Ramsey County is fortunate to have a network of community clinics which are available to serve the
medical and dental needs of clients in our community. However, medical services are more readily
available than dental services. Dental services are more challenging to obtain both in terms of accessing
timely appointments, and availability of accessible locations. Low reimbursement rates affect
availability of services.
Requests for public health nurses to make home visits have increased, and staff identify that it is difficult
for clients to obtain affordable chore and homemaking services.
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Red Lake County:
Agency Name: Red Lake County Social Services Center
Director’s Name: Kristi Nelson
Address: 125 Edward Ave, Red Lake Falls, MN 56750
FAX Number: 218-253-2926
Social Services
Name
Kristi Nelson
Penny Grove
Public Health
Anita Cardinal
Kristi Nelson
Kristi Nelson
Chemical Dependency
Kristi Nelson
Transportation
Penny Grove
185
Title
Social Services
Director
Administrative
Assistant
Public Health
Director
Social Services
Director
Social Services
Director
Social Services
Director
Administrative
Assistant
Telephone Number
218-253-4131
218-253-4131
218-681-0876
218-253-4131
218-253-4131
218-253-4131
218-253-4131
Transportation is an issue in general. Red Lake County has three satellite clinics but no primary clinic
within its boundaries. These satellite clinics provide minimal care. Red Lake County has no
emergency/hospitalization services. Red Lake County has one dental provider that is not currently
accepting new MA clients. Residents of Red Lake County are left with few choices except to access
providers located in neighboring communities (generally within Polk and Pennington counties). Due to
current restrictions in DHS policy, barriers are created for individuals who may have a working vehicle
but lack insurance, driver’s license or ability to purchase fuel prior to the appointment. This decreases
the use of preventative care services that are a cost savings to the Medicaid system. Community
members that have no independent or family transportation options can contact Tri-Valley Rural
Transportation Collaborative program in Crookston, MN for a volunteer driver. It is increasingly difficult
to recruit volunteer drivers which could have a severe impact on the pool of volunteer drivers and
dramatically impact the availability of transportation services in the future. Additionally the closest
specialty care services are located in Fargo, ND or in the Metro. Due to the current policy on no-load
miles, we are having greater difficulty getting community members to any specialty care services.
Overall, Red Lake County has a dental provider to population ratio of 1:4115 which is significantly worse
than the state ratio of 1:1660. There is a lack of dental providers who will see MA clients in Red Lake
County. The MCO(s) should support this effort or any effort to bring dental care to MA and low income
individuals in Red Lake County. Paying higher reimbursement rates and making billing more consistent
across payer sources to attract local providers makes more sense in our rural area than paying the
transportation costs to travel up to three hours away for the nearest dental provider accepting MA.
Red Lake County has a limited pool of workers. Most agencies that provide health/home care services
have been increasingly unable to recruit and train staff. This was the main cause for the loss of our only
nursing facility in 2013. This limits the feasibility of creating services within Red Lake County, as we are
unable to currently find staff for the minimal providers available within the county. Services that are
available in the surrounding counties to Medicaid enrollees generally have access barriers in regards to
availability of appointments for existing providers, and the times/days that the services are available.
186
Renville County:
Agency Name: Renville County Human Services
Director’s Name: Gerald A. Brustuen
Address: 105 S. 5th St. Ste. 203H, Olivia, MN 56277
FAX Number: 320-523-3565
Social Services
Name
Wendy Wulkan
Jill Pelzel
Public Health
Jill Bruns
Wendy Wulkan
Wendy Wulkan
Chemical Dependency
Wendy Wulkan
Transportation
Jill Pelzel
Jill Pelzel
187
Title
Social Services
Supervisor
Income Maintenance
Supervisor
Telephone Number
320-523-3543
Social Services
Supervisor
Social Services
Supervisor
Social Services
Supervisor
Income Maintenance
Supervisor
Income Maintenance
Supervisor
320-523-3543
320-523-3521
320-523-3723
320-523-3543
320-523-3543
320-523-3521
320-523-3521
Renville County is located in the south region of Minnesota. The population is 15,730. The county covers 983
square miles. There are 16.0 persons per square miles in comparison to the state average of 66.6. The Upper
and Lower Sioux Indian Reservations lie along its borders, as well as the Minnesota River. The county contains
10 cities and 27 organized townships. The town of Olivia is located in central Renville County and is the county
seat.
The total elderly population over age 65 in 2010 was 3,045. Renville County has a total dependency ratio of
61.8 compared to 49.1 for the State of Minnesota. The population distribution of Renville County has a child
dependency ration (30.5 compared to 29.9 for MN) and high elderly dependency ratio (31.3 compared to 19.2
for MN) and therefore, should expect a greater preponderance of health and social concerns particular to those
ages. These figures indicate that there are relatively few people between the ages of 18 and 65 to care for
children and the elderly. For instance, caregiver ratios in Renville County are alarming with a high ratio of 31.3
elderly persons to one potential caregiver, whether in the paid long-term care work or as a family caregiver.
There is one municipal hospital located in Renville County. There are some bordering hospitals in other
counties that also serve the health needs of the people. There are four medical clinics within the county, with
nine primary care physicians, one surgeon, one nurse practitioner, and three physician assistants. Renville
County has one mental health center, which offers a satellite office. Renville County has five nursing homes,
several foster care homes and group homes for the disabled and mentally retarded, and a developmental
achievement center. There are two optometry, three dental, four chiropractic, and three pharmacy practices in
the county. Renville County contains five public school districts and one private school.
Family-based services are currently provided by Greater Minnesota Family Services of Willmar. It would be
anticipated the RFP responder would contract for these services if credentialing and plan participation
requirement were met.
Renville County is one of five counties involved with PACT For Families, a Children’s Mental Health and Family
Collaborative. PACT For Families provides early intervention with mental health counselors and social workers
that work in the school and community. PACT For Families through flexible funding is attempting to accomplish
wide spread systems’ change to improve the lives of children with severe emotional disturbance (SED) and their
families.
Renville County is part of a 13 county County-Based Purchasing Partnership, PrimeWest Health Services
(PWHS). The county, providers and consumers are very satisfied with PWHS. Any access issues and/or limited
services issues are addressed and dealt with by the partners. As long as PWHS’s Care Coordination model and
any willing provider policy is continued and/or duplicated consumers access to quality care will continue to be
superb.
Renville County Human Services and Renville County Public Health work hand in hand to provide dual case
coordination and case management services to our consumers in partnership with PWHS.
188
Rice County:
Agency Name: Rice County Social Services
Director’s Name: Mark Shaw
Address: 3230 NW Third Street, Faribault, MN. 55021
FAX Number: (507) 332-6247
Social Services
Name
Mark Shaw
Director
Michele Evans
Supervisor
) 332-6205
Public Health
Deb Purfeerst
Director
) 332-5914
Christine Kern
Supervisor
) 332-6227
James Marthaler
Supervisor
) 332-6242
Chemical Dependency
Suzi Kleindl
Supervisor
) 332-6269
Transportation
Michele Evans
Supervisor
) 3322-6205
189
Title
Telephone Number
) 332-6206
With a population of approximately 65,000 residents, Rice County is located in south central Minnesota
along Interstate 35; 40 minutes south of the Twin Cities Metropolitan area. Area residents are served by
District One and Northfield Hospitals along with numerous medical and behavioral health clinics. Rice
County’s population has been growing increasingly diverse and serves a growing number of Somali and
Hispanic individuals. Primary access to healthcare is provided through Hiawathaland Transit in both
Faribault and Northfield. Limited transportation options remain in rural Rice County including the cities
of Dundas, Lonsdale and Morristown. Access to dental services for children and adults on MA and
MinnesotaCare is challenging as well as finding bi-lingual medical and behavioral health providers.
190
Roseau County:
Agency Name: Roseau County Social Services
Director’s Name: David Anderson
Address: 208 6th St. SW, Roseau, MN 56751
FAX Number: 218-463-3872
Social Services
Name
Karla Langaas
Jodee Haugen
Public Health
Julie Pahlen
Karla Langaas
Karla Langaas
Chemical Dependency
Karla Langaas
Transportation
Jodee Haugen
191
Title
Social Service
Supervisor
IM Supervisor
Telephone Number
218-463-2411
Public Health
Director
Social Service
Supervisor
Social Service
Supervisor
Social Service
Supervisor
IM Supervisor
218-463-3211
218-463-2411
218-463-2411
218-463-2411
218-463-2411
218-463-2411
Roseau County has a rather unique economic situation in that two major employers (Polaris and Marvin
Windows) are both located in the county, providing a total of approximately 5000 jobs to a relatively
small population base. The county population is approximately 16,000 persons. What this means is that
when either of these two major employers experiences a down turn in sales, the ripple effect is quite
significant. The flip side of this, of course, is that the significant number of people employed by these
two manufacturers provides a positive economic base for Roseau County. There are few ethnic
minorities in Roseau County, the most significant being approximately 225 Southeast Asian, and about
350 Native Americans. There are a very few older Lao family members who do not speak English; and so
far, all have family members who provide translation services for them.
Located on the Canadian border, Roseau County is largely a rural county. The population tends to be
centered around four towns, all located on Minnesota Highway 11. The nearest large towns are Grand
Forks, ND and Bemidji, MN, both about 135 miles away. Thief River Falls, MN is 64 miles away and
Roseau County residents also make use of the medical and mental health services there. Residents
have access to limited specialty medical services in our local clinic located in Roseau. Other specialty
services are accessed at Sanford in Thief River Falls or Altru in Grand Forks. Lifecare Roseau offers
kidney dialysis for some patients as deemed appropriate for their setting. There is limited public
transportation within our county, and none to towns outside our county. There are two providers of
public transportation: Far North Transit and Senior Medical Travel. Both operate throughout the county
and Senior Medical Travel provides transportation to other cities for senior citizens needing
transportation. Health plans must identify how they will address this issue through an accessible service
network within the county.
Currently, there is difficulty accessing dental services; there is no radiation therapy for cancer patients
(also a trip to Grand Forks) and other specialty services are not always available, however, the
aforementioned items are the issues we hear about most often.
Medical specialties are generally not available locally. If a specialist is needed for a patient, the usual
referral is to Grand Forks, and occasionally to the Twin Cities.
192
St. Louis County:
Agency Name: St. Louis County Public Health and Human Services Department
Director’s Name: Ann M. Busche
Address: 320 West Second Street
Duluth, MN 55802
FAX Number: 218-726-2093
Social Services
Name
Shelley Saukko
Janet Eichholz
Public Health
Amy Westbrook
Mark Nelson
Holly Church
Chemical Dependency
Mark Nelson
Transportation
Janet Eichholz
Elderly and Disabilities
Mark Nelson
193
Title
Deputy
Director
Division
Director
Division
Director
Senior
Manager
Division
Director
Senior
Manager
Senior
Manager
Senior
Manager
Telephone Number
218-726-2210
218-741-7525
218-725-5267
218-726-2085
218-725-5161
218-726-2085
218-742-9525
218-726-2085
St. Louis County is the largest county east of the Mississippi and contains a combination of both rural
and urban populations; Duluth is a seaport and a city of the first class, followed by mid-size cities of
Virginia and Hibbing, Ely, and Aurora (the Iron Range). Each contains one or more hospitals, clinics, and
independent health care professionals. County Public Health & Human Services (PHHS) has offices in
Duluth, Virginia, Hibbing, or Ely; it provides a wide array of services through direct service and
purchased services. Adult services include SPMI case management by PHHS; along with some contracts
for MH-TCM with our two community mental health centers. PHHS administers CADI waivers and does
Level II screenings for clients with mental illness needing nursing home level placements; the PHHS does
not provide ARMHS directly but does have the responsibility to locally certify ARMHS providers. PHHS
provides personnel as well as local contracts for Crisis Response; there are three ACT teams and three
Intensive Residential Treatment Programs; PHHS holds contracts for a wide array of outreach, homeless
support, psychiatric services and court services; the State has contracts with local hospitals for longer
term psychiatric hospitalization and hold orders; there are two supported employment work sites to
employ clients with SPMI; Region 3 Adult Mental Health Initiative provides subsidies for family foster
care homes to provide for clients with SPMI; PATH programs are active in St. Louis County in
cooperation with our community mental health centers.
Children’s services include a number of community wide multi-agency efforts to assure quality planning
and delivery of children's mental health services: Rule 79 case management, early intervention and
screening, in-home family therapy, screening for PCA, intensive day treatment, in-school mental health
services, mentoring and behavioral aide, parent coaching and education, CADI screening, Family Group
Decision Making for permanency, CTSS, respite care, short term crisis shelter, foster care, therapeutic
foster care, group home placement, residential placement, and transition into adult services. The
County Board has a Local Coordinating Council and a Local Advisory Council for children and families.
Public Health Programs include Maternal Child Health, Superior Babies, Follow-Along, Nurse-Family
Partnership, MCH Home Visiting, WIC, Child & Teen Checkups Outreach and Follow up, Early Hearing
and Detection Intervention, Birth Defect Information System, Home and Community Based Services, PCA
Assessments, MSHO/MSC+ Care Coordination, Access to Waivered Services, LTCC, CAC and CADI case
management, and referral.
As St. Louis County is one of the largest counties in the nation, there are issues of isolation and inability
of providers to serve the population needs in remote, rural areas. The time for travel for the provider is
not reimbursed in a manner that makes it economically viable to serve all groups. We are encouraging
the use of telemedicine, and the installation of fiber optic networks is helping; however, the technology
may not be accessible in all locations. Also of concern are the health disparities that have been
identified among different populations in PHHS: based on zip code data, residents might expect to live
11 years less and/or have more deaths in their neighborhoods due to lower median income and chronic
stress due to race (St. Louis County Health Status Report, 2012).
Challenges to service delivery and access reported by staff include: keeping up with frequent policy and
program changes, the large rural area making it difficult for providers to find qualified staff to care for
high need participants, a limited workforce, insufficient transportation to access services such as
specialized medical services in the northern part of PHHS, finding providers willing to travel, limited
placement choices for participants with mental health needs, difficulty finding resources for high need
children ages 16 and under, finding respite services for caregivers, lack of culturally appropriate services
for individuals of color, gaps for specialized services and/or residential placements for sex offenders with
DD or mental health issues, shorter nursing home stays with an increasing number of participants
requesting relocation back into the community, lack of in-home services to allow people to remain in
their homes and age in place, difficulty in communication with nursing homes, home care agencies
194
billing client obligations before providing services, and changing enrollment counts and demographics
from year to year. (MN Department of Human Services Waiver Review Report, 11/2012).
Access to physical, mental, and dental health care is limited by cost, lack of insurance, lack of reliable
transportation, lack of providers [dentists], and/or lack of culturally appropriate service provision. In
many parts of PHHS certain health care services are limited or unavailable, including psychiatrists, PhD
psychologists, and dentists that will accept MA reimbursement. In many cases it takes several months
to get an appointment with a psychiatrist; psychiatric services in general and inpatient psychiatry
specifically have become difficult to obtain on the Range; the addition of the Wellstone Center offers
some relief. Transportation is an ongoing challenge to assessors, providers and service recipients.
Although the MCO(s) are required to provide all MA services for public assistance clients, with similar
policies and practices as the MA rules and regulations, there are strikingly large differences between
MCO(s) in what they provide and how they provide it. The MCO(s) are encouraged to work together to
standardize forms, coding, prior authorization requirements, and other procedures which fall under
Chapter 16. The MCO(s) individually should streamline the prior authorization process and allow the
professional judgment of trained clinicians to play a larger part in service authorization.
195
Scott County:
Agency Name: Scott County Health and Human Services
Director’s Name: Judith Brumfield
Address:
300 Government Center
200 Fourth Avenue West
Shakopee, Minnesota 55379
FAX Number: 952-496-8430
Social Services
Name
Pam Selvig
Title
Social Services
Director
Telephone Number
952-496-8492
Barb Dahl
Economic
Assistance
Director
952-496-8151
Public Health
Merrilee Brown
Public Health
Director
952-496-8520
Pam Selvig
952-496-8492
Pam Selvig
Chemical Dependency
Pam Selvig
Transportation
Troy Beam
Social Services
Director
Social Services
Director
Social Services
Director
Transit Manager
952-496-8277
196
952-496-8492
952-496-8492
The Minnesota State Demographic Center states that in 2013 Scott County had an estimated population
of 136,926 residents. This is an increase of 5% from the 2012 figure of 133,326 residents. This made
Scott County the fastest growing County in the state. It is also estimated that by 2020 the population
size will grow by an additional 23,000 residents bringing the total population to almost 160,000.
The unemployment rate for Scott County residents has seen a steady drop. In October 2014, the
unemployment rate was 2.9% which was slightly below the State of Minnesota’s total unemployment
percentage of 3.2%. This is the lowest rate of unemployment since 2006. The median household
income is $84, 571. This leaves approximately 5.2% of the population living below the poverty level.
The largest obstacle to accessing health care in the county is lack of transportation options. Without
access to a car, residents have limited options for getting to or from a health care appointment.
SmartLink is the Dial-A-Ride, ADA, and Medical Assistance service provider for both Scott and Carver
counties but this is the only public transportation option available. In addition to transportation, there is
also a lack of medical resources available to for some services. For example, there are limited choices as
it pertains to dental and vision care especially for individuals who are currently on Medical Assistance.
Public Health staff report that it is not uncommon to meet children that are 8 or 9 years old who have
never been to a dentist.
When residents in the county do access health care they do so through the following ways:
• Primary care clinic or physician: Some residents currently have someone who is their primary care
physician. This could be someone located in the county or in a different county.
• Urgent Care or Emergency Room Care: For individuals who do not have a primary care physician or
clinic they are connected to, some individuals seek out emergency or urgent care services. Urgent care
is also sought out for none life threating illnesses that provide the convenience of evening and
weekend hours.
• Scott County Mobile Clinic: Residences who are uninsured, underinsured or underserved, receive
services via a clinic that goes to various locations in Scott County every two to three weeks. They
provide adult and child health screening, preventive care, and health information.
• River Valley Nursing Center: This provider serves uninsured and under-insured people in Scott County
by connecting them to local resources and free or low-cost health care services.
• Scott County Public Health: Public Health staff provides immunizations, child and teen checkups,
education and referrals to county residents.
• St. Mary’s Clinic: St. Mary’s provides free health care to low income, uninsured persons residing in the
seven county metro.
Scott County has few local Metropolitan Health Plan (MHP) providers or clinical systems in the county.
Therefore, residents with MHP are required to travel longer distances for medical care.
There is also a lack of specialty care, primarily nephrology, cardiology, and infectious disease care, in
Scott County. Many residents are required to travel to Minneapolis for these types of services. The lack
of specialty care increases transportation barriers and staff time spent on transporting recipients to
receive necessary care. There are also minimum resources for infectious disease. For example, Scott
County has a contract with Hennepin County regarding Tuberculosis.
197
Sherburne County:
Agency Name: Sherburne County Health & Human Services
Director’s Name: Mary Jo Cobb
Address: 13880 Business Center Drive Elk River, MN 55330
FAX Number: 763-765-4096
Health & Human Services
Name
Mary Jo Cobb
Title
Director
Telephone Number
763-765-4055
Gina Anderson ancial Assistance Supervisor
763-765-4040
Public Health
Kathy Landwehr
Public Health Supervisor
763-765-4107
Marcy Mears
Mental Health Supervisor
763-765-4018
Marcy Mears
763-765-4018
Chemical Dependency
Marcy Mears
763-765-4018
Adult Services/Transportation
Jill Schweisthal
763-765-4022
Child Welfare
Jodi Heurung
Child Welfare Supervisor
763-765-4008
198
Sherburne County is located in the central part of Minnesota and includes the cities of Becker, Big Lake,
Clear Lake, Elk River, and Zimmerman, and a portion of the cities of Princeton and St. Cloud. There are
two major highways that go through Sherburne County connecting residents to the Minneapolis-Saint
Paul, St. Cloud, and Brainerd lakes areas. A railroad line follows Highway 10, this rail line carries
approximately 75-80 freight and passenger trains per day through the County. This includes the
Northstar Commuter Rail which provides scheduled commuter rail services between Big Lake and
downtown Minneapolis. (Demographics to be provided by DHS)
Sherburne County has a limited number of medical and dental clinics however; the county is located in
close proximity to Stearns County, which houses a number of major medical service providers for the
Central Minnesota Region. Sherburne County residents access services in Stearns and also the metro
counties, as well as the St. Cloud Hospital and Fairview Northland Regional Hospital located in Princeton.
•
•
•
•
•
•
The following issues exist around accessing health care services:
Lack of dental providers accepting state funded healthcare
Lack of in-home family therapy and service providers
Lack of in-patient CD facilities and a need for long term support systems
Not enough support from health plans on the prevention in obesity and substance abuse
Lack of psychiatrists and crisis services for both children and adults
Transportation is limited and current options do not meet the needs of our clients
There are no health care services currently unavailable. While Sherburne County has a low ratio of
doctors and dentists, the area is regionally situated in between two major metropolitan areas, St. Cloud
and the Twin Cities. Both of these cities have a large number of medical and dental providers however;
in most cases the distance limits the availability.
Mental health, dental, in-patient CD and in-home family services are limited in their availability due to
lack of providers.
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Sibley County:
Agency Name: Sibley County Public Health and Human Services
Director’s Name: Vicki Stock
Address: 111 8th St. PO Box 237
Gaylord, MN 55334
FAX Number: 507-237-4031
Social Services
Name
Tamra Rovney
Carol Larson
Public Health
Rachel Fruhwirth
Tamra Rovney
Linda Hoechst
Chemical Dependency
Linda Hoechst
Transportation
Vicki Stock
200
Title
Social Services
Supervisor
Financial
Assistance
Supervisor
Public Health
Supervisor
Social Services
Supervisor
Social Services
Supervisor
Social Services
Supervisor
Director
Telephone Number
507-237-4011
507-237-4000
507-237-4000
507-237-4011
507-237-4000
507-237-4000
507-237-4000
Sibley County has one Critical Access Hospital Ridgeview Sibley Medical Center. The hospital provides
part time paramedic services that currently serve only the Arlington area. Ridgeview Sibley Medical
Center has four clinics where medical personnel rotate through Winthrop, Gaylord, Arlington, and
Henderson. They offer Urgent Care at the Arlington site. New Ulm Medical Center has a satellite clinic in
Winthrop. Open Door Clinic Van and Open Door Dental Van provide services one time weekly at the
Sibley County Public Health and Human Service Center site. There are four practicing dental providers,
four practicing chiropractors, one eye care provider, and four pharmacies in Sibley County. Due to the
lack of providers and services available many Sibley County residents seek care outside of the county.
This includes the lack of visiting medical specialists, dialysis centers, dental providers accepting medical
assistance programs, pediatric specialists, mental health professionals and other specialty services.
There is no available birthing center in the county.
Sibley County provides transit services via the Sibley/McLeod Trailblazer public transit system.
Transportation options are limited as there is on public transit bus system with limited hours and service
available. Transportation for medical care outside of the county is even more difficult other the limited
volunteer service. Trailblazer is a public dial-a-ride system. The service is provided Monday through
Friday 6:30am to 5:30pm and operates within the two county boundaries. For transportation outside
the two county boundaries or outside of normal operating hours, Trailblazers also manages a volunteer
driver system which can be costly.
Sibley County residents are served mainly by Sioux Trails Mental Health Center which is a four county
Rule 29 licensed clinic. Hutchinson Area Health Center, New Ulm Medical Center, and Immanuel St.
Joseph’s in Mankato provide the majority of holds and short term treatment. There is a Crisis Center
located in Mankato that is used frequently for short term crisis needs. Psychiatrists for adult and
children’s mental health are limited along with psychiatric nursing services.
Sibley County Public Health and Human Services provides case management services through the CADI,
CAC, AC, EW, DD, and BI Waivers, Adult Mental Health, Children’s Mental Health, and Adult and Child
protection. Case management services are provided by both social workers and nurses. Care
coordination and case management is the key to providing quality managed care. County residents more
readily accept a local person whom they know and trust to address and manage their complex needs.
Sibley County Public Health along with health care and community members are taking strides to
improve the health in our community and to make healthy lifestyles a priority. The MCO would need to
support promoting healthy lifestyles throughout all programs, incentives, and working with providers to
make preventive care the priority in all populations served in order to prevent chronic disease. The
MCO must assure that all infants, children, and adults will receive age appropriate immunizations and
assure that all providers enter vaccinations into Minnesota Immunization Information Connection (MIIC)
so that all providers in all settings will have access to up-to-date vaccination history for all persons. The
MCO must also assure that supportive programs for young families, including infant care safety seats,
home visits for education and support, Child & Teen Checkup services, and needed health education and
follow up be provided to at risk families to promote optimum outcomes in behavior, child development,
emotional and physical health and parenting skills to prevent neglect and abuse.
201
Stearns County:
Agency Name: Stearns County Human Services
Director’s Name: Mark Sizer, Administrator
Address: 705 Courthouse Square, PO Box 1107, St. Cloud, MN 56302
FAX Number: 320-656-6134
Social Services (see Other)
Public Health
Chemical Dependency
Transportation
Other – Long Term Care/DD
Services
Other - Family and Children
Services (truancy, permanency,
child welfare)
Other - Community Corrections
Other - Child Support
Other - Adoption
Other - Finance & Technology
Name
Title
Telephone Number
Janet Goligowski
Renee Frauendienst
Janet Reigstad
Brenda Mahoney
Janet Reigstad
Janet Goligowski
Janet Reigstad
Director
Director
Director
Director
Director
Director
Director
320-656-6202
320-656-6284
320-656-6125
320-656-6075
320-656-6125
320-656-6202
320-656-6125
Brenda Mahoney
Director
320-656-6075
Becky Bales Cramlet
Janet Goligowski
Brenda Mahoney
Dona Pederson
Director
Director
Director
Director
320-656-6404
320-656-6202
320-656-6075
320-656-6297
202
Stearns County has a large geography, 53 miles east to west and 34 miles north to south. Stearns County
has a mix of urban and rural with the urban population being concentrated in the most eastern part of
the county in the St. Cloud area. There is a vast difference between the availability and accessibility of
health services between the western and the eastern parts of the county. An additional complexity is
that the City of St. Cloud lies within the three counties of Stearns, Sherburne, and Benton and enrollees
sometimes move frequently between the counties. When looking at the Minnesota Department of
Education data of students self reporting their primary language spoken in the home, over the past 6
years, the English speaking population decreased by 1% and the languages that saw the largest increases
were Somali, Oromo, Arabic, Spanish, and Nuer. The top 10 community health issues as identified in the
2014 Community Health planning process were: parenting skills, mental health, lack of physical activity,
poor nutrition, tobacco use by women, alcohol use, integration of newly arrived persons, sexually
transmitted infections, financial stress, and dental access.
There are many more transportation options in the St. Cloud area than in the rural part of Stearns
County. Even if the health plan is able to pay for transportation, the time that it takes to travel to where
the health service is, becomes prohibitive to the enrollee. Stearns County has identified an additional
barrier in that many of the enrollees are not able to navigate the system and do not receive the care
they need because of an inability to understand how to obtain the service they need.
St. Cloud is a regional center and many of the providers accept clients from a much wider reach than
Stearns County alone. On several occasions, despite the fact that health providers physically exist in
Stearns County, Stearns County enrollees are placed on waiting lists because enrollees from other
counties are being served by the provider, especially true for CD and mental health providers.
Stearns County is fortunate to have a wealth of health care providers located within the county. As
mentioned above, these services are not always readily available to the Stearns County enrollees. Also,
most of the Stearns County providers exist in the St. Cloud area and due to distance become virtually
“unavailable” to the enrollees living in rural Stearns County. There is a need of therapies and/or
inpatient treatment including residential services for children with mental health concerns and coexisting developmental or cognitive challenges.
Dentistry service continues to be identified as a service that is limited for enrollees. A long term
difficulty has been the lengthy waiting lists for adult and pediatric psychiatrists as well as chemical
dependency treatment. There is also a need for increased numbers of providers who are trained in
trauma-informed mental health care.
203
Stevens County:
Agency Name: Stevens County Human Services
Director’s Name: Joanie Murphy
Address: 400 Colorado Ave., Suite 104, Morris, MN 56267
FAX Number: 320-589-3972
Social Services
Name
Gary Knochenmus
Title
Telephone Number
320-208-6600
Kim Gullickson
320-208-6600
Public Health
Sandy Tubbs
Income Maintenance
Supervisor
Director
Joanie Murphy
Director
323-208-6600
Gary Knochenmus
320-208-6600
Chemical Dependency
Gary Knochenmus
320-208-6600
Transportation
Joanie Murphy
Director
320-208-6600
204
320-208-6671
Swift County:
Agency Name:
Swift County Human Services
Director’s Name:
Deanna Steckman
Address:
410 21st Street South, PO Box 208, Benson MN 56215
Telephone Number:
320 843-3160
FAX Number:
320 843-4582
Social Services
Title
Supervisor
Telephone Number
320 843-3160
Name
Linda Erhardt
Lorri Pederson
Julie Jahn
Supervisor
320 843-3160
Public Health
Elizabeth Auch
Administrator
320 843-4546
Lorri Pederson
Supervisor
320 843-3160
Lorri Pederson
Supervisor
320 843-3160
Chemical Dependency
Linda Erhardt
Supervisor
320 843-3160
Transportation
Ted Nelson
Prairie Five
RIDES
877-757-4337
205
Swift County has three major towns: Kerkhoven (persons seek medical care in Willmar); Benson (persons
seek medical care in Benson and/or Willmar); and Appleton (persons seek medical care in Appleton,
Benson, Montevideo, Madison, Morris, or Willmar). According to the 2013 American Fact Finder, 35% of
the Swift County population receives public coverage for health insurance.
There are issues for accessing health care services: transportation (limited public transportation-MCOs
contract with same transportation provider that Swift County Human Services contracts with), hours
available for receiving health care services (after “work hours” there is limited availability to seek health
care services-except for urgent care and the emergency department), and lack of ‘drop-in’ day care.
Persons living on incomes that qualify for MA or MnCare are generally working low-paying positions
with little to no ability to leave work during work hours due to 1-no replacements and/or 2-no sick time
or personal time off available. Consequently, they use the Emergency Room if they need healthcare.
Childcare is an issue for families with young children – with no ‘drop-in’ care available, who will
supervise the children while the parent is in for an appointment (self or child).
Within Swift County, there are no chemical health treatment services of any type available. The dentists
in Swift County do not accept Medical Assistance consumers due to low payment rates, lack of
providers-meaning our dentist is already working numerous evening and weekend hours, and the
notorious no-show from ‘typical’ MA consumers. Swift County has psychiatric hours from Woodland
Center’s a couple of times a month-otherwise there are no psychiatric providers in Swift County. There
are no child residential treatment services available in Swift County – the nearest is 90 miles away – not
easily accessed by family if child is in need of placement.
Health Care services limited in their availability to anyone in Swift County, not just MA and
MinnesotaCare enrollees, include ob/gyn, mental health counseling, chemical health
treatment/services, tertiary care.
206
Todd County:
Agency Name: Todd County Health & Human Services
Director’s Name:
Jackie Och, Director
Address:
212 2nd Ave S Long Prairie, MN 56347
Telephone Number:
320-732-4500
FAX Number:
320-732-4445
Social Services
Public Health
Chemical Dependency
Transportation
Name
Emily Steinert
Lisa Chapin
Michael Steinbeisser
Emily Steinert
Lisa Chapin
207
Title
Manager, Family
Services Unit
Manager, Financial
Support Unit
Manager,
Adult/Disability Unit
Manager,
Manager, Family
Services Unit
Manager,
Manager, Financial
Support Unit
Telephone
Number
320-732-4476
320-732-4493
320-732-0991
320-732-0991
320-732-4476
320-732-0991
320-732-4493
Located in central Minnesota, Todd County is approximately 110 miles northwest of the Twin Cities
Metropolitan Area. The total population according to the United States 2010 Census is 24,895. The
County measures 41 miles from north to south and 24 miles from east to west, covering more than 979
square miles. Within Todd County, there are 11 incorporated cities and 28 townships. The county seat is
Long Prairie; it is the largest city with a population of 3,458. Staples is the second largest city with a
population of 2,981. In Todd County, 92.6% of the residents identify predominantly as White alone,
although there is a growing Hispanic/Latino population, representing 5.2% of county residents. In the
City of Long Prairie, the Hispanic/Latino population accounts for 29.5% of city residents.1 The median
household income in Todd County is $45,287, about $14,000 below Minnesota’s median household
income of $59,126. Individuals living below poverty in Todd County comprise 15.9% of the population
compared to the State average of 11.2%. In the City of Staples alone 32.1% of residents are living below
the poverty line.2 Of our school age children, 57% qualify for free or reduced school lunches compared
to 38.5% statewide.3
Todd County has two hospitals and five health care clinics. In 2013, 74% of adult residents reported
visiting a health care professional in the last year for a routine check-up. Although 28% reported not
receiving or delaying medical care in the past year; the main reasons include not viewing the issue as
serious enough, cost being too much, and/or deductible was too expensive4. A lack of dental and
psychiatric services is also a major concern including limited resources for behavior health, inpatient and
outpatient services. The growing diverse population necessitates bi-lingual and effective interpretation
services be made available for successful treatment and programs.
Todd County Health and Human Services provides several home and community-based services as well
as financial support programs organized under its five units. As a consolidated agency, we provide
coordinated services to ensure our residents’ and clients’ needs are met. The Financial Support Services
Unit provides medical assistance, financial support, energy assistance, and child support services. The
Adult Disability Unit implements services and programs focused on adult mental health, adult
protection, chemical dependency, and waiver programs for the elderly, developmentally disabled,
individuals with brain injuries, chronically ill, and disabled individuals. In addition, the Adult Disability
Unit includes a Medicare certified home care agency that conducts home visits and provides home
health aides, monthly public health nurse clinics, and senior exercise classes. The Family Services unit
includes both public health nurses and social workers who support families and children through several
programs, including WIC, child and teen checkups, follow along program, immunizations, early
childhood screenings, preconception health, maternal child health visits, childcare assistance, child
welfare assistance, car seat program, school nursing, Nurse Family Partnership, child care and foster
care licensing, child protection, and adoption services. The Community Planning Unit provides services,
grants, and overall departmental planning focused on primary prevention and community health,
including the environmental health program; disease prevention and control; public health emergency
preparedness; nurse training and education; senior services and referrals; and, obesity and alcohol,
tobacco, and other drug prevention.
1
US Census Bureau, 2010 Census
U.S. Census Bureau, 2008-2012 American Community Survey
3
Minnesota Department of Education, 2013-2014 school year
4
Health4Life 2013 Community Health Survey
2
208
Traverse County:
Agency Name: Traverse County Social Service
Director’s Name: Rhonda Antrim
Address: PO Box 46
FAX Number: 320-563-4230
Social Services
Name
Rhonda Antrim
Director
Marg Schmitz
Financial Supervisor
320-422-7777
Public Health
Sandy Tubbs
Director
320-208-6670
Lee Hydeen-Niss
Social Worker
320-422-7777
Darlis Morth
Social Worker
320-422-7777
Chemical Dependency
Lee Hydeen-Niss
Social Worker
320-422-7777
Transportation
Rhonda Antrim
Director
320-422-7777
209
Title
Telephone Number
320-422-7777
Traverse County is the smallest per capita county in Minnesota. We border North Dakota, South Dakota,
and the Sisseton Wahpeton Sioux Tribe. Traverse County is also the oldest per capita county in
Minnesota which poses some unique challenges in terms of transportation.
Health care services are primarily accessed through Sanford Clinic and Hospital, located in Wheaton,
MN. Specialists are available on at least a monthly basis, as well as referrals to Fargo and other Sanford
Clinics for specialty care. The City of Browns Valley also has a clinic that is well-utilized by Browns Valley
residents. Referrals for specialty care from there are primarily to Sisseton, SD or Sioux Falls, SD.
The primary issue surrounding access is transportation. Volunteer drivers are at a premium. Other
transit options include Rainbow Rider but the hours are limited, especially in Browns Valley.
The only services that are unavailable in Traverse County are birth/prenatal and chemical dependency.
Assessments are available through social services, but outpatient and inpatient treatment options are
not located within 45 miles. Prenatal and birthing options are typically referred to St. Francis in
Breckenridge or Fargo.
Services that are limited to the Medicaid and Minnesota Care enrollees include dental. AppleTree and
surrounding providers have been known to service this population. Our local provider will as well, on a
limited basis. New patients are a challenge to find dental care for.
210
Wabasha County:
Agency Name: Wabasha County Social Services
Director’s Name: John Dahlstrom
Address: 411 Hiawatha Drive E, Wabasha, MN 55981
FAX Number: (651-565-3084
Social Services
Name
John Dahlstrom
Lisa McNally
Public Health
Judy Barton
Social
Services Director
Supervisor
Luke Simonett
651-565-3027
Luke Simonett
651-565-3027
Chemical Dependency
Luke Simonett
651-565-3027
Transportation
Lisa McNally
651-565-3043
Waiver Clients / MN
Choices - Tammy Fiedler
Supervisor
Home and Community
Based Services Supervisor
Title
211
Telephone Number
651-565-3035
651-565-3043
651-565-3204
651-565-3222
Wabasha County is in SE Minnesota and is included in the Rochester, MN Metropolitan Statistical Area.
The population is 21,676.
Wabasha County shares the same challenges that many of the small rural counties in Minnesota have,
including limited medical transportation services and a lack of local providers in the areas of mental
health, dental, and chemical dependency treatment.
212
Wadena County:
Agency Name: Wadena County Human Services
Director’s Name: Tanya Leskey
Address: 124 First Street SE, Wadena, MN 56482
FAX Number: 218-631-7616
Social Services
Name
Lori Miller
Mike Willie
Pam Jenson
Public Health
Title
Telephone
Number
218-631-7605
218-631-7605
Cindy Pederson
Administrative Services
Supervisor
Lori Miller
218-631-7605
Mike Willie
218-631-7605
Chemical Dependency
Mike Willie
218-631-7605
Transportation
Pam Jenson
Administrative Services
Supervisor
218-631-7605
213
218-631-7629
Wadena County consists of six cities covering 543 square miles. It has a population of 13,682 consisting
primarily of individuals of German or Scandinavian descent, with a sizeable Finnish community
concentrated within the Menahga and Sebeka area. English and Finn are the primary spoken and
written languages with the county. Minorities are limited to less than 100 African American, Native
American and Hispanic people. Wadena County has a higher than average number of elderly per
capita. The average family size is three. Wadena County ranks as one of the poorest county for both
household and per capita income; median household income is $37,609 and per capita income is
reported at $20,589. There is an unemployment rate of 4.9%. The county seat is Wadena and has a
population of 3,937. There is one hospital in the county and three clinics. It is difficult for residents of
Wadena County to obtain sufficient dental and psychiatric services without driving some distance from
the county.
214
Washington County:
Agency Name: Washington County Community Services
Director’s Name: Dan Papin
Address: 14949 62nd St N, PO Box 30, Stillwater, MN 55082-0030
FAX Number: 651-430-6636
Social Services
Name
Sarah Amundson
Title
Division Manager
Telephone Number
651-430-6597
Linda Bixby
Division Manager
651-430-6472
Public Health
Jill Timm
651-275-7286
Kathy Mickelson
Senior Program
Manager
Division Manager
Sarah Amundson
Division Manager
651-430-6597
Chemical Dependency
Kathy Mickelson
Division Manager
651-430-6532
Transportation
Sarah Tripple
Policy Analyst
651-430-6480
215
651-430-6532
The population in Washington County is expected to increase by 36% and almost 100,000 people, by
2040. Over the past decade, the proportion of Washington County’s older population, as well as its
ethnic and immigrant populations, has grown at a faster pace than the rest of the state. These growing
populations will continue to exert pressure on health care resources, leading to a greater demand for
culturally specific services and services for the aging.
There is a lack of adequate public transportation in Washington County, presenting significant
challenges for low income individuals and those with disabilities. Transit Link is available to all residents
during limited times and Metro Mobility operates in only 50% of the county for those eligible for that
level of service. Because of this, it is important that MCO(s)/participating entities provide accessible,
reliable and flexible transportation options for MA/MinnesotaCare enrollees.
Community-based nursing services are not covered or supported by all of our existing MCO(s) and are an
important service to meet the needs of those who are elderly, disabled and/or have special needs. Inhome nursing services are a better fit for individuals that struggle with compliance or are civilly
committed and court ordered to take medication.
Some necessary dental services are not covered and there is a lack of providers. Individuals need to
travel out of the county to get dental care due to limited providers within the county. This leads to
challenges maintaining routine and preventative care, and difficulties attending to acute problems.
Necessary services, such as anesthesia, are not a covered benefit. Children’s Dental Services has a
favorable access model, providing services to children and pregnant women in local schools and Head
Start centers, and are currently helping fill a gap in Newport and Cottage Grove in the southern part of
the county, Forest Lake in the northern part of the county, and expanding to Stillwater in 2015.
Access to out-patient psychiatry is very limited in the county, and there are no psychiatric hospitals or
residential treatment facilities. The county is also lacking supportive services to meet the needs of youth
with mental health issues. Individuals must access psychiatric care in the greater metro area due to the
lack of options within the county. Attracting and retaining psychiatric providers and services at an
appropriate reimbursement rate to deal with high need SPMI individuals is an existing service gap that
needs to be filled. A lack of adequate services to meet the need of those who are SMPI, leads to costly
alternatives such as emergency room visits. Finally, many individuals currently being served through
adult mental health case management services find the “Silver Sneakers” program a very attractive and
valuable feature offered by their health plan.
Chemical Health: Continuity of care in CD treatment is difficult when individuals drop off a managed
care program prior to completing their treatment episode. There is often a lack of coordination or care
continuity, including limited treatment data-sharing between PMAPs and CCDTF. Detoxification services
are not covered in PMAPs and there is lack of adequate transportation surrounding outpatient and/or
chemical health treatment and aftercare. Individuals enrolled in a PMAP are excluded from
participating in the Chemical Health Pilot program, and therefore do not have the opportunity to access
a navigator who can assist with continuity of care, accountability and support to change their addiction
patterns.
Public Health: Most families served via the Public Health Home Visiting Program also have a primary
care provider who is in tune with the family and their ongoing health care needs. Despite this, consistent
primary care is often lacking for the families served. Utilization of monthly immunization clinics offered
through Public Health is down; but overall immunization rates are also low, indicating a gap that is not
yet fully understood.
216
Watonwan County:
Agency Name: Watonwan County Human Services
Director’s Name: David Christianson
Address: 715 2nd Ave South St. James, MN 56081
FAX Number: 507-375-7359
Social Services
Public Health
Chemical Dependency
Accounting/clerical
Child Welfare
Child Protection
Truancy
Minor Parent
Name
David Christianson
David Christianson
Amy Pluym
Kathy Carlson
Kathy Carlson
Erin Sandbo-Marks
Kathy Carlson
217
Title
Director
Director
Supervisor
Supervisor
Supervisor
Supervisor
Supervisor
Telephone Number
507-375-7825
507-375-7825
507-375-7840
507-375-7839
507-375-7839
507-375-7803
507-375-7839
There are problems with access to health care which include transportation and numbers of providers
including specialty providers.
Transportation is a large concern in the Watonwan County area, as we have limited public
transportation. Another area of concern is accessing dental care. Very few of dental providers will
accept medical assistance. The county agency makes referrals to places that are outside of the area,
SMILES in Savage and HCMC in Minneapolis, which also creates transportation issues and concerns. We
are lucky to have Apple Tree Dental in Madelia, but they have a very long waiting list.
Our county’s clients are being asked to contact dental providers to see if those providers accept the
specific health care / managed care program that they are enrolled in. After contacting a certain
number of dental providers, then the clients are urged to contact their plan and let them know of which
dental providers they have called, what was the response, etc. At that time, then the managed care
plan is asked to assist the client.
Watonwan County works with a variety of inpatient treatment providers, which are all located in other
counties. Health plans should consider continuity of care for individuals and to incorporate as providers
in their networks these CD service providers and county Rule 25 assessors.
Watonwan County contracts with Sioux Trails Mental Health. This is a Rule 29 facility, with one office
located in Watonwan County. The services provided by Sioux Trails include services such as
Psychological & Psychiatric Evaluations; Medication Management; Individual, Group, and Family
Therapy; Crisis Hotline, Training Consultation, and Education.
The county also uses a wide variety of other out-patient mental health providers outside of the county
depending on client need. Health plans should consider continuity of care for individuals receiving care
in the county and to incorporate as providers in their networks these mental health providers.
Watonwan County provides its own Community Support Services. We also have a “Drop in
Center/Resource Center” called Friends on 1st which provides educational and social recreational
opportunities for adults with Serious and Persistent Mental Illness (SPMI).
Watonwan County has a history of jointly planning and developing integrated mental health services
with counties located in region 9. The health plans are expected to work with the county in this
common purpose.
Watonwan County encourages involvement in family, civil and criminal court proceedings, pre-petition
screenings and commitment hearings, and other issues including court ordered treatment.
218
Wilkin County
Agency Name: Wilkin County Family Service Agency
Director’s Name: David L. Sayler
Address: PO Box 369, 300 South Fifth Street, Wilkin County Courthouse, Breckenridge, MN 56520-0369
FAX Number: 218-643-7175
Name
Title
Social Service Programs –
Becky Tripp
Adult Services
Social Service Programs –
Becky Tripp
Children Services
Financial Assistance Programs Karen Kath
Public Health
Debra Jacobs
Mental Health – Adult
Becky Tripp
Becky Tripp
Chemical Dependency
Dave Sayler
Volunteer Transportation
Linda Dietz
Other – please list:
Arlene Meyer
Foster Care & Child Care
Licensing
Telephone
Number
218-643-8013
218-643-8013
Financial Assistance Specialist 218-643-7161
Director – Public Health
218-643-7122
218-643-8013
218-643-8013
Human Services Director
218-643-7161
Coordinator on Aging
218-643-7122
Licensing Specialist
218-643-7161
219
Oral healthcare to people who face barriers to accessing quality care is a critical need. The
inability to access dental care is a significant unmet healthcare need for low income and special
needs children, adults and elders in Minnesota. The lack of access to dental care is an even
greater challenge in rural Minnesota. Many factors contribute to this problem including a
shortage of dentists, higher poverty levels, lower numbers of insured individuals or families, and
geographic isolation, making access to oral healthcare in rural areas particularly acute.
The Wilkin County Family Service Agency is the primary provider of Rule 25 assessments. The Wilkin
County Public Health Nursing Services is a contracted provider for the current MCOs to conduct Rule 25
assessments. Upon completion of the assessment and determination of level of care, the Wilkin
County Public Health Nursing Services then assists the recipient in entering into a treatment program
through coordination with the MCO. When medical treatment for detoxification is needed for
recipients, these services are provided by a ten-bed detoxification facility owned and operated by
Productive Alternatives, Inc. Wilkin County also contracts with the Clay County Receiving Center in
Moorhead, MN for detoxification services.
The adult mental health initiatives have developed an array of regional mental health services to serve
adults with serious mental illness or SPMI. The adult mental health initiative promotes a partnership
with local mental health providers, consumers, family members and advocates in the development and
oversight of mental health services. Wilkin County has limited outpatient psychiatric services. Many
adults are prescribed mental health medications by their primary health care provider. It is imperative
that collaboration occur with primary health care providers to promote and facilitate mental health
screening, psychiatric consultations and referral resources/relationships between primary health care
providers and the mental health delivery system. In addition, other resources need to be considered
and utilized to support access of psychiatric care in rural Minnesota including transportation as well via
telemedicine. Lastly, it is important that the mental health system of care also support and facilitate
physical health screenings and the integration of mental health and physical health care for their
members. Many adult mental health consumers have co-occurring conditions of mental illness and
chemical dependency. The screening of mental and chemical health needs of recipients and promotion
of integrated treatment that incorporates IDDT (Integrated Dual Diagnosis Treatment) is an important
aspect of the local mental health delivery system. However, funding to support IDDT has created
challenges for providers.
The Wilkin County Children’s Collaborative consists of partnerships between mental health providers,
public health, probation, social services, schools and other local agencies focused upon the
enhancement and expansion of prevention and intervention services for children with behavioral and
emotional disturbances. Child and adolescent psychiatric care is a scarce resource in Wilkin County.
Psychiatric care for children with emotional disturbance is provided by psychiatrists who are willing to
work with children as well as pediatricians. Accessing appropriate psychiatric care in a rural county
such as Wilkin can create challenges and the needed to use other types of resources such as
transportation and telemedicine to support access to psychiatric care. Pediatricians are critical
providers in the identification and treatment of emotional disturbances of young children.
Children with co-occurring disorders present challenges in meeting their treatment needs.
Collaboration and coordination among providers is needed to assure proper screening, assessment and
treatment of co-occurring conditions such as chemical dependency, fetal alcohol syndrome and autism
spectrum disorder. Such coordination and collaboration can be challenging as many health care
providers have fiscal constraints that limit their ability to participate in consultation activities as current
funding resources do not support those types of activities.
220
Wilkin County promotes the delivery of evidenced and/or research based practices in the delivery of
children’s mental health services. In addition, Wilkin County has promoted early screening,
identification and intervention of mental health needs for young children through the use of the ASQSE. Collaboration with local public health agencies, pediatrician’s, mental health agencies in the mental
health screening of infants and toddlers, diagnostic assessment (DC: 0-3) and treatment for children
ages birth to three is important to promote early identification and intervention.
Schools are also critical partners in meeting the mental health and behavioral needs of children.
Partnerships exist in Wilkin County between schools, mental health providers and social services in
the delivery of an array of mental health services.
Families also have direct impact in a child’s mental health recovery. The current funding resources
limit the mental health provider’s ability to address the individual mental health treatment need of
the child with family issues that have direct impact to the child’s recovery. It is a critical need to
recognize the impact that the family system has on a child’s mental health recovery. This recognition
would need to include the understanding and fiscal resources to support therapeutic intervention
with the family when the child is not present.
The Wilkin County Family Service Agency has a volunteer driver program, which can transport
ambulatory, medically low risk, individuals without transportation resources, to medical appointments.
Wilkin County requests approvals from the recipient’s MCO 48 working hours in advance of the
appointment. This is a volunteer program and rides will be provided when drivers are available and can
safely transport individuals. Barriers to transportation include the fact that Wilkin County does not
have public transportation running throughout the county and only Breckenridge/Wahpeton has
common carrier services, within the city limits and surrounding area, provided by the Twin Town Taxi.
Public health agencies have developed a process for facilitating the communication of public health
to each other, to MCOs, local providers, and policy makers. Through the use of an inclusive and
interactive process, partnering opportunities have been identified to support the achieving of public
health goals as it relates to immunizations, prenatal/postnatal/newborn outcomes, health promotion
related to cardiovascular disease and cancer as well as Child and Teen Checkups.
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Winona County:
Agency Name: Winona County Community Services
Director’s Name: Beth M. Wilms
Address: 202 West Third Street
Winona, MN 55987
FAX Number: 507-454-9381
Social Services
Name
Karen Bunkowski
Sharon Summers
Public Health
Beth M. Wilms
Karen Bunkowski
Sharon Summers
Chemical Dependency
Karen Bunkowski
Transportation
Karen Moore
Public Health
Jonelle Hubbard
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Title
Community
Services
Supervisors
CHS Adm
Community
Services
Supervisor
Community
Services
Supervisor
Community
Services
Supervisor
Community
Services
Supervisor
Community
Services
Supervisor
Telephone Number
507-457-6264
507-457-6272
507-457-6205
507-457-6264
507-457-6272
507-457-6264
507-457-6235
507-457-6261
There is a need for alternative health care benefits beyond chiropractic. Such providers, such as
homeopathic, acupuncture etc. can reduce costs of medications.
Transportation to medical care is a problem in that relying so strongly on a volunteer driver program has
created lack of availability often due to a lack of volunteers or a lack of volunteers able and willing to
transport difficult clients or disabled persons.
Lack of local access to dental care, eye care, and psychiatric care creates problems.
Dental care, oral surgery, psychiatric services, in-patient chemical dependency treatment and integrated
child mental health/special education treatment services are our major areas with availability issues.
Client case management services are provided by the MCO(s) through contracts with local agencies.
When a client transitions from one MCO to another the case manager notes the change and the record
remains intact with all history.
Dental rates paid to providers by MA are insufficient for providers to want to serve this population. A
secondary issue is that many MA clients fail to keep their appointments, which poses a problem for the
dental providers who cannot readily fill a chair for a no-show. A Mobile Dental Unit has been helpful
and fills with patients, however, it is not always available to complete more complex dental work when
discovered.
Winona County is responsible for assessments (Rule 24 & 25) to determine eligibility to access the
Consolidated Chemical Dependency Treatment Fund (CCDTF). Youth must be sent long distance for
treatment and there is no local outpatient care for youth. In the recent past an outpatient CD treatment
program model with follow up after care has been implemented for the local jail population diagnosed
with CD. This has been a successful collaboration among the Jail, the DHS staff and the local vendor,
Wenden.
Winona County serves as a hub for services within the CREST AMHI and as a result surrounding counties
tap into our county’s providers and draw down services even faster.
There is a need for earlier identification and intervention of co-occurring disorders so that treatment can
be more effective and address these issues simultaneously.
No mental health service available in the jail causes problems with community adjustment and
deterioration and subsequent hospitalizations.
The mental health needs and timely access to services for children is always a concern. This is especially
evident for children who are in need of protection and are removed from their homes.
Winona County has a Purchase of Transportation Services Contract with SEMCAC of Rushford, MN. They
are the provider for common carrier services. Transportation through SEMCAC requires advance notice
and is dependent on the availability of volunteers to do the driving. Volunteers are not always available
leaving a person with a future appointment and no transportation. The transportation issue is major
and the current system is very inflexible and does not respond to reasonable need.
Winona County is involved in a number of programs and collaborative projects which strive to
provide a seamless service system.
223
Winona and Houston County PHN have a joint dental project to increase screening and access to dental
hygiene services. Winona County is an active partner in the Children’s Justice Initiative (CJI), which looks
at “the best interest of the child”. Winona County is a part of a ten county Adult Mental Health
Regional Initiative (AMHI) Project. The project, (CREST), receives state funding to use flexibly in the
system design and service delivery to persons with mental illness. Doula services are available locally.
Pre-natal and post-partum care should not be limited and public health nursing visits and lactation
specialists also need to be provided. Car seats need to be provided, as this is a state law. Incentives to
clients to maintain their health care and human services appointments should occur.
The mission of Winona County Community Health Services is “to provide quality health care and
educational services to the people of Winona County.” Winona County CHS has demonstrated
knowledge in physical activity promotion through experience in our own employee wellness program.
224
Wright County:
Agency Name: Wright County Human Services
Director’s Name: Jami Goodrum Schwartz
Address: 1004 Commercial Drive Buffalo, MN 55313
FAX Number: 763-682-7701
Social Services
Name
Michelle Miller
Kimberly Johnson
Public Health
Carol Schefers
Michelle Miller
Michelle Miller
Chemical Dependency
Michelle Miller
Transportation
Kimberly Johnson
225
Title
Social
Services
Manager
Financial
Services
Manager
Public Health
Director
Social Service
Manager
Social Service
Manager
Social Service
Manager
Financial
Services
Manager
Telephone Number
763-682-7480
763-682-7412
763-682-7404
763-682-7480
763-682-7480
763-682-7480
763-682-7412
Wright County is the tenth largest county in Minnesota by population. It is located approximately 45
miles to the west of Minneapolis. Wright County covers 660.75 square miles including Buffalo,
Monticello, Maple Lake, Delano, Cokato, Annandale, portions of Rockford, and Otsego to name a few.
There are several hospitals located within Wright County which serve the area, if more specialized care
is needed patients are transferred to out of county facilities to access the care needed. The Buffalo
hospital now has a level two nursery available.
Wright County lacks:
•
Dental care providers that accept state funded health care clients.
•
Chemical Dependency. Many patients must be transferred out of county
•
Transportation. We have too few options, we have a lack of volunteer drivers, and there is
difficulty in coordinating transportation services for the clients
There are no services currently unavailable because we are located close enough to St. Cloud and the
Twin City Metro area that patients are able to access other services if necessary
Specialized dental services are currently limited in their availability to the county’s MA and
MinnesotaCare enrollees.
226
Yellow Medicine County:
Agency Name: Yellow Medicine County Family Service Center
Director’s Name:
Rae Ann Keeler-Aus
Address:
930 4th Street, Suite 4, Granite Falls MN 56241
Telephone Number:
320.564.2211
FAX Number:
320.564.4165
Social Services
Name
Melissa Helgeson
Mary Potter
Robin Schoep
Title
Supervisor
Supervisor
Supervisor
Telephone Number
320.564.2211
320.564.2211
320.564.2211
Public Health
Liz Auch
Director
800.657.3291
Melissa Helgeson
Mary Potter
Supervisor
Supervisor
320.564.2211
320.564.2211
Chemical Dependency
Melissa Helgeson
Stephanie Olson
Rae Ann Keeler-Aus
Supervisor
Assessor
Director
320.564.2211
Transportation
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320.564.2211
Yellow Medicine County, population 10,438, is located in the southwestern part of Minnesota and
borders South Dakota on its western edge. Granite Falls, our largest community and county seat has a
population of 3,070. There are 9 incorporated communities plus the Upper Sioux Community in Yellow
Medicine County. The total land area of YMC is 763 square miles. Yellow Medicine County is sparsely
populated with people spread across a large land area.
Yellow Medicine County has an aging population and a large number of persons receiving waivered
services. We rely on our provider system to meet the needs of the community. But we have limited
transportation options within the county that creates additional burden to accessing care. Consumers
access care both within the county and in larger neighboring cities.
With our heavy dependence on agriculture production, our consumers’ needs increase and decrease
based on the volatility of the ag economy. Wages that result in working poor families results in
increased need for county social services.
Yellow Medicine County is home to the Upper Sioux Agency and Prairie’s Edge Casino Resort. This had
added jobs to the area and income for tribal members. Our Social Services unit works very closely with
the Upper Sioux Social Service department to coordinate services for children.
Yellow Medicine is one of 12 county members of Southern Prairie Community Care, an integrated health
care delivery system.
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APPENDIX M - COUNTY ASSURANCES
To be completed by all responders responding to this RFP.
The responder assures the following by initialing in the space to the left of each statement.
______1.
The responder assures that it will provide the health care services listed in the model contracts
and the services further negotiated during contract negotiations. Contract language and services
may change based on any new legislative requirements.
______2.
The responder assures that it is in current compliance with all applicable state and federal
statutory and regulatory requirements as identified in the model contract.
______3.
The responder assures that it has safeguards in place regarding conflicts of interest in purchases
involving Medicaid funds, as required by Minnesota Statutes, section 256B.0914.
______4.
The responder assures that the responder and its providers will accept all enrollees without
regard to physical or mental condition, health status, need for health services, disability, marital
status, age, sex, sexual orientation, national origin, race, color, religion or political beliefs.
______5.
The responder assures that it will monitor and ensure appropriate access to services where the
provider is limited, or where a service is only available through a sole source vendor (e.g. dental
or mental health services).
______6.
The responder assures that it will provide provider network updates as required by the STATE,
whether there are deletions from or additions to its network.
______7.
The responder assures that it will develop contractual relationships with the counties’ to access
the existing network of providers.
______8.
The responder assures that it will work collaboratively with the counties’ Public Health Agencies.
_____ 9.
The responder assures that it will work with the counties to address the following concerns:
•
•
•
•
•
•
Meeting the needs of Limited English Proficiency (LEP) populations;
Maintaining and improving client choice of providers;
Improving timely, non-emergency access to providers;
Improving prevention and early intervention services;
Coordinating American Indian Services with Indian Health Services (IHS) and Tribal Health
Services;
Improving the availability of psychiatrists and /or psychologists.
_____ 10.
The responder assures that it will participate as cooperative and collaborative members in the
health care efforts with the counties.
______11.
The responder assures that it will cooperate with the entity as arranged for by the State in an
annual independent, external review of the quality of services furnished under the contract.
______12.
The responder assures that it will meet the requirements for delegation for any delegated
activities related to quality improvement.
229
______13.
The responder assures that it will maintain documentation sufficient to support its care
management responsibilities.
______14.
The responder assures that it will provide that the State may evaluate through inspection or
other means, the quality, appropriateness, and timeliness of services or administrative
procedures performed under the contracts.
______15.
The responder assures that all incentives must comply with the federal managed care incentive
arrangement requirements.
______16.
The responder assures that it will take reasonable measures to determine third party
reimbursement.
______17.
The responder assures that it will have administrative and management arrangements or
procedures, including a mandatory compliance plan, that are designed to guard against fraud
and abuse.
By signing this statement, you certify that the information provided is accurate and that you are
authorized to sign on behalf of, and legally bind, the responder.
Authorized Signature: __________________________________________________________________
Printed
Name:________________________________________________________________________________
Title:
_____________________________________________________________________
Date:_________________________________
Telephone Number:______________________________________
230
APPENDIX N - COUNTY EXHIBITS
Counties participated as regions to develop their list of county specific questions and issues. The
responder must complete and submit detailed responses for each question identified by those counties
within a specific region for which the responder is submitting a proposal. The responses should be
focused to specifically address the regional county questions.
The questions listed in this appendix were drafted by the counties and may reference managed care
organizations (MCOs). For purposes of responding to this Appendix, assume that any reference to MCOs
pertains to all responders.
Region 1 - Kittson, Marshall, Norman, Pennington, Polk, Red Lake and Roseau Counties
1.
Describe what services require prior authorization? For those services requiring prior
authorization, what timeline does the responder have for authorization of each of the services?
2.
Does the responder currently pay for no-load miles? If not, how will the responder address the
full cost reimbursement of providing transportation services that will ensure transportation
access?
3.
Describe how the responder will reduce the barriers and increase access to dental access in
access.
4.
Does the responder follow the Medicaid fee-for-service reimbursement rates? Or does the
responder supplement certain services at rates above traditional fee-for-service rates (e.g.
pharmacy, dental)?
5.
Describe the reimbursement and access efforts around screening and implementation of
chronic disease management programs by both public health and primary healthcare providers.
6.
Describe the responder’s process for providers to become part of the network?
7.
Describe how the responder will coordinate and support individuals with dual diagnosis.
Region 2 - Beltrami, Clearwater, Hubbard, Lake of the Woods and Mahnomen Counties
1.
Describe how the responder, within the guidelines of DHS, will simplify the transportation
paperwork to improve access to transportation for health care services.
2.
Describe how the responder will address the issue of no load miles for Medical Assistance
transportation.
3.
Describe how the responder will pay for reasonable and appropriate mental health crisis
transports.
4.
What are the responder’s timelines around prior authorization for mental health and chemical
health crisis placements?
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5.
Describe how the responder will address the remoteness of frontier counties for accessing
health care.
6.
Describe how the responder will expand access to psychiatric services for adults and children.
7.
Describe how the responder will promote, expand, and improve mental health services (i.e.
CTSS, ARMHS, and Medication Management).
8.
Will the responder consider supplemental funding for mileage reimbursement, telemedicine
reimbursement, provider recruitment, payment for no shows, detox and payment for collateral
contact (consultative/collaborative meeting with a MH Professional)? If so, provide a detailed
explanation.
9.
Describe how the responder will promote public health?
10.
Describe how the responder will support programming around healthy lifestyles to prevent
obesity and diabetes?
Region 3 - Aitkin, Carlton, Cook, Itasca, Koochiching, Lake and St. Louis Counties
1.
One of the top public health issues we are facing in Northeastern Minnesota is the escalating
role that prescription opioids, heroin and methadone play in our communities. We have a
growing number of addicted citizens who present complications to our criminal justice, child
protection and health care systems. We need a strong, proactive partnership in helping to
reduce this growing addition epidemic. Describe what the responder thinks this partnership will
look like.
Answer the following questions noting that mental health issues remain a primary area of
concern when measured on community public health assessments, surveys and encounter data.
2.
Describe how the responder will work to expand access and reduce obstacles by providing
adequate reimbursement to innovative partnerships integrating behavioral health care with
primary care services.
3.
Describe how the responder will expand the use of telemental health throughout the region,
including support for the use of video telepresence in conjunction with our regional Mobile
Crisis Team, local emergency departments, school-linked services and home visiting services
provided by public health nurses on prenatal/postpartum visits, elderly and disabled
populations.
4.
Describe how the responder will support the new regional crisis stabilization center in Duluth,
called Birch Tree Center, that will expand crisis level access in this more appropriate setting, and
provide discharge/continuity of care services throughout the region while decreasing the over
dependency on local emergency departments.
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5.
As regional Accountable Care Organizations (ACOs) and Integrated Health Partnerships (IHPs)
evolve in our region, describe how the responder will creatively partner with area county public
health & human service agencies to maximize the benefits both to the new partnerships, but
also the community members that we serve.
6.
Arrowhead Health Alliance (AHA), whose members include Carlton, Cook, Koochiching, Lake and
St. Louis Counties, and regional Community Health Boards (CHB), work on regional health
improvement projects. Describe how the responder will work to partner and promote the work
of both AHA and the two regional CHBs.
7.
Northeast Minnesota struggles with an extreme shortage of both adult and child psychiatrists,
compared to the needs of our citizens. Describe how the responder will address this chronic
shortage of psychiatric access.
8.
Region III counties struggle with access to and payment for children and adult mental health
residential services. Describe how the responder will work with our regional counties to address
the shortage and the access to these residential services.
9.
Describe how the responder will support early intervention services for children at risk,
throughout Region III?
10.
Universal Home Visiting (UHV) is a high value service for pregnant women and new mothers
throughout Region III. Describe how the responder will financially support our counties’ UHV
programs through billing and reimbursements for this much needed service?
Region 4 - Becker, Clay, Douglas, Grant, Otter Tail, Pope, Stevens, Traverse and Wilkin Counties
1.
Describe how the responder will plan address the following access transportation barriers:
a. Payment for no-load miles for volunteer drivers.
b. The provision of physical assistance for those requiring help with mobility.
2.
Describe how the responder will assure dental care is available within a 60 mile radius and
reduce the wait time for appointments.
3.
Describe how the responder will coordinate and authorize chemical health treatment based on
the results of the Rule 25 Assessment.
4.
Describe what alternative solutions or strategies the responder will develop or authorize to
assure the psychiatric needs of adults and children are met.
5.
Describe how the responder will address access to Intensive Behavioral Therapy (IBT) for
addressing obesity, tobacco, and lactation services.
6.
Describe how the responder will assure the provider network is aware of available interpreter
services.
7.
Describe how the responder will address the integration of primary care, mental and behavioral
health and community services.
233
8.
Describe how the responder will incorporate technology in meeting health care needs.
9.
Describe how the responder will develop a standardized referral, authorization and billing
process with other MCOs providing service in the county?
Region 5 - Cass, Crow Wing, Morrison, Todd and Wadena Counties
1.
Describe how the responder will address gaps between MA/MinnesotaCare enrollee needs and
local dental provider network minimal services available.
2.
Describe how the responder will address the process required for prior authorization, maximum
number of visits, and reimbursement for nurse family home visiting for early childhood visits.
3.
Describe how the responder will work with providers in recruiting, training, and retaining staff.
Is the responder willing to evaluate reimbursements to encourage retention?
4.
Describe how the responder will increase accessibility for a family or primary care physician to
use child psychiatry. Will the responder increase the rate paid to providers? Use telehealth?
5.
Describe how the responder will recruit mental health providers so there is a choice of mental
health providers in all communities within Region V and also allow for increased services to an
individual when necessary to meet their needs.
6.
Describe how the responder will streamline the documentation requirements so all providers
require the same documentation (same forms to be filled out regardless of the MCO).
7.
Describe how the responder will assure that adequate treatment options will be available at all
stages of the treatment continuum for those in need of chemical dependency treatment,
regardless of any co-occurring disorders.
8.
Describe how the responder will increase the number of local mental health (MH)network
providers for those providing the service. Many public programs do MH screens of children 0-3
years of age with limited referral and treatment resources.
9.
Describe how the responder will increase local networks for treatment/placement options for
juvenile sex offenders.
10.
Describe how the responder will increase the availability of health food options and the number
of weight loss programs.
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Regions 6 & 8 - Big Stone, Chippewa, Cottonwood, Jackson, Kandiyohi, Lac Qui Parle, Lincoln, Lyon,
McLeod, Meeker, Murray, Nobles, Pipestone, Redwood, Renville, Rock, Swift and Yellow Medicine
Counties
1.
Describe how the responder will assist in recruiting volunteer drivers. Describe how the
responder will propose to handle no-load miles. Describe how the responder will assist in
volunteer driver recruitment via marketing.
2.
Describe how the responder will work with local counties when a member who has Serious and
Persistent Mental Illness (SPMI) or needs a mental health placement. Describe how the
responder plans to engage county case managers when they are working with clients with SPMI
with a high value placed on improved communication, coordination and checking with counties
before placements are made. The counties are looking for responders to support the county
having a strong role in case management.
3.
Describe how the responder will assure there is an adequate network for mental health services
in the region. Responders should determine where gaps are and take an active role in
addressing known gaps such as psychiatry, IRTs, and day treatment.
4.
Describe how the responder will assure dental services in those areas of our region lacking in
providers that accept public health care program patients. Describe how the responder will
continue or establish mobile dental outreach programs, partner with local dentists to increase
participation via increased rates (counties would propose MA rate + 40%), assist in decreasing
no show rates for dental appointments and create incentives for providers to participate.
5.
Describe how the responder will address the lack of providers for outpatient and adolescent
treatment in the region. Describe how the responder will work with service providers to expand
or develop services. Describe how the responder will assist counties with locating resources
that are not available in the region but are willing to expand their provider network to meet the
need for service.
6.
Current MCOs have been willing to offer higher rates in key areas to improve access and health
outcomes. Describe how the responder will propose investing additional funding into rates to
improve health outcomes, access to care, and to cover the cost of the service provided in the
below key areas:
a. Dental rates
b. Rule 25 assessments
c. No load miles for transportation
d. Intensive Residential Treatment rates (IRT)
e. Day Treatment
f. Consider Tiers for Care Coordination rates
g. Infant and family home visiting reimbursement
7.
Describe how the responder will work to assure a broad provider network and appropriate
choice in providers and describe how the responder will respond if contacted by a county when
a gap in the provider network has been identified. Counties expect MCOs to provide choice as
well as not limit the network. Counties expect MCOs to contract with key local providers and to
actively work to increase the provider network in key areas that are lacking. Some key areas
identified by counties are:
a. Transportation
235
b.
c.
d.
e.
Children’s mental health services
Psychiatry
Dental with emphasis on pediatric
CD providers with emphasis on outpatient and adolescent
8.
Describe how the responder will provide excellent customer service for county staff and resolve
any issues in a timely manner? Health Plans will have a dedicated contact person for counties
to work with to resolve issues. Health Plans will expect their staff to resolve issues in a timely
manner and have regular, consistent communication with counties.
9.
Describe how the responder will work with our region to address a serious gap in provider
networks for specialized or expanded services in the community, particularly mental health
services, urgent/after-hours care, Community Health Workers etc.? Describe how the
responder will identify service development (either within our outside of our region) as a
priority for staff. MCOs have a provider network contact who works with local counties to
identify gaps in provider networks. They offer to work with service providers in other areas of
the state to provide models, expansion, or increased capacity to meet the need. They will
consider rate changes to support or incent development.
Examples of this are:
a. Community placement options for mental health clients with high behavior need and/or
are aggressive.
b. Dental Providers
c. Mental Health Providers including children’s and psychiatry.
10.
Counties are expecting responders to become aware of local public health priorities and
incorporate these into any incentives or prevention programs they develop or administer.
Counties also expect responders to consult with public health representatives during the
development process to assure that their investments meet a local need and are realistic for
implementation. Describe how the responder will identify key areas to invest in prevention
services that are not typically a part of the standard benefit set and how will you support local
SHIP (Statewide Health Improvement Program) efforts?
Region 7 - Benton, Chisago, Isanti, Kanabec, Mille Lacs, Pine, Sherburne, Stearns and Wright Counties
1.
Describe the current process and past success in recruiting and expanding the dental network
that will accept MA enrollees and provide culturally appropriate services? Describe how the
responder plans to incentivize enrollees to keep their appointments and dentists to accept MA
enrollees?
2.
Describe how the responder will meet the needs of the enrollees to address the Family Home
Visiting capacity and increase the reimbursement rate and number of visits allowed?
3.
Describe how the responder will support and enable enrollees to achieve healthy birth
outcomes through education and outreach or other methods?
4.
Describe how the responder will reduce the long waiting lists for Chemical Dependency
treatment and provide long-term supports to maintain sobriety?
236
5.
Currently, there are a limited number of local adult psychiatrists and crisis services providers.
Describe how the responder will recruit and expand the network of these providers that accept
MA? How would you work with these providers to expand the hours of services including nights
and weekends?
6.
Currently, there are a limited number of local pediatric psychiatrists and crisis services
providers. Describe how the responder will recruit and expand the network of these providers
that accept MA? How would you work with these providers to expand the hours of services
including nights and weekends?
7.
Describe how the responder will recruit and expand the network of infant and early childhood
mental health specialists?
8.
Describe how the responder will reduce barriers to simplify and expedite transportation
requests and ensure timely availability of rides?
9.
Describe what efforts the responder will take to prevent child and adult obesity?
10.
Describe how the responder will initiate or increase its efforts for prevention of tobacco use
including e-cigarettes?
Region 9 - Blue Earth, Brown, Faribault, Freeborn, LeSueur, Martin, Nicollet, Sibley, Waseca and
Watonwan
1.
Will the responder require prevention activities/efforts for young families including:
a. Requiring Health Care providers to perform a complete Child & Teen checkup and bill
for it;
b. Early prenatal care;
c. Parenting education;
d. Family home visiting;
If so, describe how the responder will accomplish this?
2.
Describe how the responder will support local community efforts to decrease obesity and
increase active living? (Ex. support local Statewide Health Improvement Programs (SHIP))
3.
Describe how the responder will ensure enrollees will receive culturally competent health
services that address the social determinants of health that reduce health inequities in a
timely manner?
4.
Describe how the responder will work with other MCOs to create administrative simplification
and reduce costs for the Counties? (Ex. common language, universal forms, high cost of mailing
enrollment packets)
5.
Describe how the responder will assure Chemical Dependency treatment is individualized to
meet their enrollees needs and how will they address enrollees’ chronic and relapsing chemical
dependency?
237
6.
Describe the responders’ incentives to recruit and retain dental providers?
7.
Describe how the responder will help enrollees to access health care after hours, Holidays and
on weekends to provide transportation to tertiary care providers (Ex. dialysis on Saturday) in a
timely manner?
8.
Describe how the responder will reimburse for community support services’ social rehab
services as a preventative service to reduce high inpatient residential costs? (Ex. groups
provided at resource centers) *There is Regional Data to support this.
9.
Describe how the responder will work with the Region to expand client incentives for accessing
appropriate care?
10.
Describe how the responder will develop sustainable services that are not currently available?
(Ex. Behavioral Health Aides, Community Health workers, Play therapy and in-home family
therapy)
Region 10 - Dodge, Fillmore, Goodhue, Houston, Mower, Olmsted, Rice, Steele, Wabasha and Winona
Counties
1.
Describe how the responder will work with local dentists to provide access for all children and
adults? How will they supplement the lack of services? Describe how the responder will
improve access for dental care through payment methods and through use of other providers?
2.
Describe how the responder will offer services that support educational opportunities and
prevention strategies? What reimbursement does the health plan offer for detoxification
services?
3.
Describe how the responder will work with the region to support initiatives, education and
information on mental health issues? Describe how mental health screenings for adults can be
improved? Describe how mental health screenings for adults can be improved through
incentives?
4.
Describe how the responder will assure that there is access to mental health services for
children and youth in the counties? Describe how mental health screenings for children / youth
be improved? Describe how mental health screenings for children / youth be improved through
incentives?
5.
There is a lack of transportation service to rural areas and after hours. Describe how the
responder will provide transportation when there is inadequate medical transportation service
(limited services, limited hours) to meet demand? No-go rides, no-show rides or late
cancellations cost county transportation programs money. Describe what the responder will do
to ease this financial burden?
6.
Describe how the responder will access to psychiatry, particularly for an urgent need? Will you
provide reimbursement for determining eligibility for TCM?
7.
Describe how the responder can provide obesity screening for newborns to be added to
incentives program? Describe how the responder will support local community efforts to
decrease obesity in our region?
238
8.
Describe how the responder will assure that all people would get culturally competent health
services in a timely manner?
9.
Describe how the responder will make prevention efforts in support of young families be a
priority for health plans including prenatal care, post-partum, and parenting education.
Region 11 – Anoka, Carver, Dakota, Hennepin, Ramsey, Scott and Washington Counties
1.
Describe how the MCO currently and in the past has maximized the integration of primary
health, behavioral health, Public Health, and Social Services. Provide a detailed description (and
any data in support) of your current or developing internal infrastructure that helps maximize
the integration of primary health, behavioral health, Public Health, and Social Services.
2.
Describe how the MCO has in past collaborated and will continue to collaborate with the County
and other MCOs to measure performance metrics around:
a. Increasing culturally responsive services access and delivery to reduce barriers
associated with racial and/or ethnic disparities
b. Ensuring continuity of care for recipients who are transitioning coverage from one MCO
to another or experiencing breaks in coverage for any number of reasons.
c. Improving client outcomes and satisfaction by tracking and reducing access/provider
wait time and other relevant metrics.
3.
Describe how the MCO will address the continuing lack of comprehensive oral health services
for all ages in urban, suburban, and rural county locations. Please provide examples of how you
are currently and will in the future address this issue. Also provide detailed explanations of how
you currently approach or will approach the areas below.
a. Inadequate dental education and preventive care
b. The need for incentives or other alternative responses to increase the number of
enrollees receiving adequate preventive and restorative care
c. Assure local access to dental providers accepting new patients including general
dentistry for routine dental care, as well as expanding specialty dental providers such as
Oral Surgeons, and Orthodontists.
4.
Describe the steps and approaches the MCO is taking to:
a. Assure timely access to CD assessments and behavioral health services for children and
adults including psychiatry, psychopharmacologic treatment, specialized behavioral
supports and chemical health assessments/treatment
b. Develop and deliver a supportive longitudinal model of care to meet the needs of
enrollees with chronic, relapsing symptoms of chemical dependency.
c. Successfully coordinate the care between yourself and the CCDTF
Please share performance metrics regarding access and developing a supportive longitudinal
model of care.
239
5.
Describe how MCO’s will address local service capacity and treatment coordination with services
such as child mental health inpatient, Rule 5, crisis residential, child day treatment, culturally
specific mental health providers and specialized populations.
6.
What specific improvements are being made in consideration of the state’s direction to promote
a continuum of care model for severe substance abuse which reflects a supportive longitudinal
model of care and recovery and less an episodic service model? Please include what specific
steps the MCO is taking to better integrate services for enrollees with dual disorders since
national research data indicates that approximately 50 percent of persons who have a serious
mental illness have a co-occurring substance use/abuse disorder.
7.
Describe how your MCO meets the transportation needs of the enrollees within the county.
a. Provide your current process for identifying and filling the transportation provider
network gaps. Please provide a GIS map of the respective coverage for the county.
b. Explain how your transportation network provides a continuum of transportation from
common carriers (bus, taxi) to specialized transportation services, including nonemergency medical transportation with wheelchair lift equipped vehicles and
emergency transportation in the network.
c. List your action steps to improve the transportation system simplicity, coverage to rural
areas, flexibility, and improved exception approval criteria for case-by-case specific
needs and season-to-season mobility changes.
d. Provide current/future quality assurance and performance metrics that provide checks
balances for evaluating and retaining reliable transportation providers.
8.
Describe how the MCO will partner with Public Health to provide incentives and assure early
detection and treatment of preventable chronic health conditions, and support other Public
Health initiatives including, but not limited to treatment of smoking cessation, immunizations,
obesity, prenatal, breastfeeding, violence prevention, postpartum care, and Child & Teen
Checkups.
9.
What outcome data are you willing to provide on a regular basis to each county so that it is
aware of health trends and changes in the population it serves? How will you gather and use
county specific feedback in evaluating and adjusting your service and internal/external capacity
practices through the life of the contract?
10.
Describe how the MCO will assure a holistic approach to improve outcomes for children with
mental health issues, including an infrastructure that: provides timely access to the services of
child and adolescent psychiatrists; offers sufficient and flexible supportive services, including
community alternatives to long-term residential treatment, to meet the unique needs of each
child; models strong coordination of children’s mental health services with the child protection
and juvenile justice systems; and delivers metrics to illustrate effectiveness.
240
APPENDIX O - STATE EXHIBITS
DHS Questions/Issues
The responder must complete and submit detailed responses for each of the State’s questions.
Dental
1. Describe the metrics the responder uses to evaluate the adequacy of your dental network.
Outpatient Services
2. Describe the responder‘s utilization management policies and procedures for clinic and hospitaladministered drugs. What role does the responder have in management of clinic and hospitaladministered drugs? What role does your PBM have? How does the responder prevent duplication of
billing between the pharmacy POS claim type and the professional/institutional claim type?
3. Describe the MCO’s/participating entity‘s specialty drug program. What aspects of the specialty drug
program are managed by the MCO/participating entity and what aspects are managed by your
Pharmacy Benefit Manager (PBM)? If your specialty drug program includes a limited specialty pharmacy
network, what criteria does the responder use to select the specialty pharmacy(ies) in the network?
Chemical Dependency
4. Describe the MCO’s/participating entity’s proposed method of assessment and how they will
coordinate the cost of care between the CCDTF and the responder and how will the responder address
clients with multiple addictions, including those needing treatment for opiate addiction?
5. Describe how the responder will address the needs of enrollees with chronic, relapsing symptoms of
chemical dependency and the needs of those who need extended treatment involvement.
Mental Health – Adult
6. Specific to enrollees with serious mental illness and considering social-economic factors of this
population, describe which sources the responder will use to acquire social-economic information and
how it will use available data to increase access to preventative and routine health care, increase
continuous and consistent treatment for other chronic health conditions, and promote healthy lifestyles
and wellness of these enrollees .
7. Describe the responder’s established collaborative efforts with the County Adult Mental Health
initiatives and Tribal mental health authorities which have improved service access and delivery. How
long have the efforts and agreements been in place and how frequently are they updated? Describe the
frequency of structured contact and communications between the responder and the County Adult
Mental Health Initiatives and the Tribal mental health authorities. Also, describe contractual
agreements with community based health providers requiring ongoing collaborative efforts to serve
recipients with serious mental illness. Include specific information about collaborative agreements and
contracts which include policies and procedures to best serve recipients undergoing civil commitment.
Also include specific information about collaborative agreements intended to prevent of unnecessary
higher levels of services.
241
8. Concerning mental health diagnostic assessments: How does the responder ensure that inpatient
psychiatric discharge plans include a complete Diagnostic Assessment? How does the responder ensure
that Diagnostic Assessment received by network mental health providers meet the diagnostic
assessment standards established in Minnesota Rules, Part 95605.0372, subpart 1? How does the
MCO/participating entity ensure that diagnostic assessments are sufficiently thorough for enrollees with
complex mental health conditions or co-occurring conditions? What percentage of payments for
diagnostic assessments are ultimately withheld or taken back due to an audit finding of an inadequate
diagnostic assessment?
9. How does the responder assure mental health and developmental screening as part of well-child visits?
How does the responder create expectations for clinics that children with positive screens will receive
appropriate follow-up care, referral to services and coordination of care?
Claim and Network Operations
10. In the responder’s contracts with network providers, how frequently do you make modifications to the
contracts? Describe your processes and timelines for notifying providers of contract changes and
implementing the changes. Include details about opportunities for accepting and incorporating
feedback from providers related to contract changes. How frequently is provider feedback ultimately
incorporated into your or your subcontractors’ contract modifications? Also, describe the interaction
between your or your subcontractors’ contract process for MHCP and other product lines including
commercial or Medicare.
11. Identify the emerging professions that you include in your network. Examples include, but are not
limited to, dental therapists, advanced dental therapists, community health workers, community
paramedics, licensed non-nurse midwives and doulas. For each emerging profession identified, describe
any process and criteria used to enroll/credential individual professionals. Also, for each profession
identified describe the process used to monitor utilization, quality outcomes, and cost.
12. Of the claims you or receive from providers, what percentage are ultimately paid and what percentage
are ultimately denied? Of the paid claims, what percentage do you consider “clean claims” as defined
by MN Statute 62Q.75 Subd 1 (b)? What percent of clean claims are paid within a thirty calendar day
timeframe? What percent of all claims are paid within a ninety calendar day timeframe? If you employ
subcontractors to process some or all of your claims, please provide a separate response specific to each
subcontracted entity. Subcontractors include third party administrators, dental benefit managers,
pharmacy benefit managers, behavioral health administrators or any other organization paying claims
on behalf of your responder.
242
APPENDIX P – QUALITY OF CARE AND SERVICES EVALUATION
The purpose of the Quality of Care and Services Evaluation Section of the 2016 RFP is to evaluate the
quality of the responder’s proposed network of primary and specialty care health providers and their
care outcomes. The focus will be on identifying the highest overall performing network of clinics to serve
public program enrollees.
The evaluation of network and provider health care outcomes is a new procurement direction for DHS.
It is intended to signal to Responders that in future procurements the quality of the network’s outcomes
will become an increasingly important consideration in the RFP selection process.
Instructions: The responder must submit a list of the physician clinics included in their network (see
attached pages 22-24 of the MDH “Clinic and Provider Registration for clinic site definitions). Use the
Excel template, “Quality of Care and Services Evaluation Template” attached below to submit your list.
The list must include the following clinic information:
•
County
•
Provider name, complete address including zip code, and contact telephone number,
•
National Provider Identifier (NPI),
•
Minnesota Community Measurement (MNCM) Clinic ID number
Section Evaluation: DHS will utilize Statewide Quality Reporting and Measurement System (SQRMS)
results from three consecutive years (2011, 2012 and 2013) to calculate a physician clinic network three
year average rate for the following SQRMS performance measures:
•
Optimal Asthma Control Adults
= 1.25 points possible
•
Optimal Asthma Control Children
•
Optimal Diabetes Care
•
Optimal Vascular Care
Scoring: Scoring will be based upon the competitive procurement process where only the highest overall
performing clinic networks will be recognized. Assigned points for each performance measure will be
100 percent for the highest performance category, and a smaller proportion for those clinic networks
that are greater than the median performance but lower than the highest category. Clinic networks
with performance below the median will receive no points.
Benchmarks for each of the four measures will be calculated as the 50th and 75th percentiles of the
three-year average MHCP rate for all county networks submitted. If the denominator of a three-year
average rate for a county network is less than 30, it will be excluded from the benchmark calculation.
DHS will score each responder’s county clinic network performance using the following scale:
•
If the county clinic network rate 95% upper confidence limit is equal to or greater than the 75th
percentile, all the points will be assigned.
•
If the county clinic network rate 95% upper confidence limit is greater than or equal to the
median and less than the 75th percentile, 50 percent of the available points will be assigned.
•
If the county clinic network rate 95% upper confidence limit is less than the median, zero points
will be assigned.
•
If some of the responder clinics in the county have not reported SQRMS data for all three
calendar years, the 95% upper confidence limit for a county clinic network will be proportionally
adjusted downward before comparison with the benchmarks.
•
Zero points will be assigned for each measure, if none of the responder’s clinics have reported
SQRMS data for all three calendar years.
•
If the denominator of the three year average rate for a county network is less than 30, that
network will be assigned 50 percent of the available points for that measure.
Total Points for Appendix P = 5 points
243
APPENDIX P – QUALITY OF CARE AND SERVICES EVALUATION
(Continued)
Appendix P - Quality of Care and Services Evaluation - Clinic and Provider Registration
Appendix P Clinic and
Provider Registration
Appendix P - Quality of Care and Services Evaluation – County Provider List Template
County Provider List
Template.xlsx
244
APPENDIX Q - HEALTH CARE REFORM INITIATIVES
The responder should use the template below to describe what health care reform initiatives it has or
will undertake to improve the quality of health care and lower health care costs. The responder shall
describe both current and planned activities for each question listed in the template.
The total number of points awarded for Appendix Q is ten (10) points.
Appendix Q HC
Reform Template.doc
245
APPENDIX R - SPECIFICATIONS FOR PROVIDER NETWORK LISTING
Before the State can sign a contract with any responder to serve these populations, the responder
must have MDH approval of its service area and network.
A. All responders must provide the following:
 Submit a provider network listing electronically on a CD/DVD using the Provider Network List
template (Excel file). If the responder does not follow the specifications, the provider network
listing will be returned to the responder, and the responder will be asked to resubmit the
provider network listing according to the specifications. It is imperative that the responder
follow the specifications for the submission of the network. The provider network list should
include up-to-date comprehensive provider information. The State requires that responders
submit an “Evidence of Contract” form (see below), and may request additional proof of
contract status (e.g., contracts, signature pages, etc.) for any or all provider types.
Report Specifications:
A participating Provider Network List template is included below with a Data Dictionary that includes the
instructions for completing the provider listing.
provnettemp_DHS_R
FP.xlsx
•
Responders may submit the provider network listing as a .Zip file to minimize the file size.
•
Responders must submit an “Evidence of Contract” form.
networkevidencefor
m.docx
•
Provider networks must include Essential Community Providers (ECPs) available within the designated
service area as required by Minnesota Statutes 62Q.19.
•
Responders must submit documents which demonstrate their capacity to serve the anticipated
enrollment in the service area covered by this procurement. This includes the following:
1.
Geographic Access Maps (aka, “the Accessibility Report”). The following geographic maps should be
submitted:
 A map reflecting all counties to be included in the network service area.
Individual maps should be submitted demonstrating access at 30 miles/30 minutes from all parts of
the service area for the following provider types:



Hospitals
Primary Care, including Pediatric Providers
Mental Health Providers
Individual maps for each provider type should be submitted demonstrating the location of the
following provider types within the responder’s service area:



Pediatric Specialty providers
Chemical Dependency providers
Dental providers including pediatric dental providers
246

























Allergy, Immunology and Rheumatology
Anesthesiology Physicians and Certified Registered Nurse Anesthetists Cardiovascular Disease
Chemical Dependency Outpatient Services
Chemical Dependency Inpatient (Residential) Services (Do not include “detox” facilities.)
Colon and Rectal Surgery
Dermatology
Endocrinology
Gastroenterology
Genetics
Nephrology
Neurology and Neurological Surgery
Obstetrics and Gynecology Physicians, and Certified Nurse Midwife, Certified Professional
Midwife, OB/GYN Nurse Practitioner
Oncology
Ophthalmology
Orthopedic Surgery
Otolaryngology
Physical Medicine and Rehabilitation and Occupational Medicine
Pulmonary Disease
Radiology and Nuclear Medicine
General and Vascular Surgery
Cardiac and Thoracic Surgery
Reconstructive Surgery
Urology
Physical Therapy, Occupational Therapy and Speech Therapy
Chiropractic
Please provide one map demonstrating the location of Home Health Care agencies and the counties that
they serve.
2.
Provide a comparative analysis of network by identifying any gaps in coverage (by county) for the
following identified provider types:
 Primary Care
 Hospital
 Behavioral Health (Mental health and Chemical Dependency services)
 Dental Services
Analysis documentation should describe where access is not sufficient, including when geographic
mileage access criteria are not met, the reason access is not sufficient and how the responder will
ensure access to services covered under the contract. Responders may be asked to submit a
“Request for Waiver” documenting the reasons that all access criteria cannot be met.
B.
The counties are interested in whether their local providers are included in the responder’s network.
Therefore, counties will be included in the review of the provider networks. Please submit the following
lists of providers by county:
• Primary Care Clinics (please make sure that these are primary care clinics)
• Hospitals
• Dental Providers
• Behavioral Health Providers (include Mental Health and Chemical Dependency)
INSTRUCTIONS:
• Use the attached Excel spreadsheet to report the above providers.
247
County Network
Template.xlsx
•
•
•
Click on the tab of the county or counties that the responder will be including in the list of providers
and complete the template.
Include providers in bordering counties and states. Remove the county tabs that are not used or
populated.
Make sure to include each provider type listed above.
The counties provided the State with lists of providers that are most important for county recipients to
access health care. These lists (in Excel and Microsoft Word) can be found in Appendix L – County Specific
Information. NOTE: Not all counties submitted a list of providers.
If this information is not submitted, your proposal will not be accepted or scored.
248
APPENDIX S – REQUIRED PROPOSAL CONTENTS CHECKLIST
Responses to this RFP must consist of all of the following components. Each of these components must be
separate from the others and uniquely identified with labeled tabs in your printed copy and bookmarked in your
electronic RFP response. For the Technical Bid Requirements, complete components 1-3 below. For the Price Bid
Requirements, complete component 4 below. Please note that the Technical Proposal is due on April 6, 2015 and
the Price Bid Proposal is due on June 1, 2015.
☐1. Table of Contents
2. Technical Proposal Requirements
☐a. Executive Summary
☐b. Description of the Applicant Organization
☐c. Service Delivery Plan
☐d. Professional Responsibility
☐e. Feasibility Study (applies to responders who are submitting a proposal for the first time)
3. Appendices
☐a. Responder Information and Declarations (Appendix A)
☐b. Exceptions to Terms and Conditions (Appendix B)
☐c. Affidavit of Noncollusion (Appendix C)
☐d. Trade Secret/Confidential Data Notification (Appendix D)
☐e. Affirmative Action Data Page (Appendix E)
☐f. Certification and Restriction on Lobbying (Appendix F)
☐g. Disclosure of Ownership (Appendix G)
☐h. Professional Responsibility Disclosure (Appendix H)
☐i. Submission of Certified Financial Audit, IRS Form 990, or Most Recent Board-Reviewed Financial
Statements (Appendix I)
☐j. MCO Enrollment Limit Declaration (Appendix J)
☐k. Disclosure of Funding Form (Appendix K)
☐l. County Specific Information (Appendix L) - No information needs to be submitted.
☐m. County Assurances ( Appendix M)
☐n. County Exhibits (Appendix N)
☐o. State Exhibits (Appendix O)
☐p. Quality of Care and Services Evaluation (Appendix P)
☐q. Health Care Reform Initiatives (Appendix Q)
☐r. Specifications for Provider Network Listing (Appendix R)
4. Price Bid Proposal Requirements
☐a. Completed Price Bid Template
249
Phone: 507-431-6566 | Email: [email protected]
Address: 2300 Park Drive, Suite 100, Owatonna, MN 55060
Reprocurement Impact on
WADENA COUNTY
As a result of the 2016 Families and Children reprocurement, South Country Health Alliance (SCHA) has
received notification that we will be offered the ability to contract with the state for only one of our 11
service area counties.
Below are the impacts to your county resulting from the potential loss of SCHA’s Medical Assistance (MA)
and MinnesotaCare business, effective January 1, 2016. There will be no change to SCHA’s services or
coverage through the end of 2015. Affected members will be contacted directly by SCHA and the state.
SCHA continues to rate high in member satisfaction and maintain excellent quality in services:
● Rated a 4-star health plan.
● Rated #1 among Minnesota health plans in Overall Customer Service for MA and in Getting
Needed Care, Getting Care Quickly and Shared Decision Making for MinnesotaCare.
● Rated #2 among Minnesota health plans in Rating of Personal Doctor, How Well Doctors
Communicate and Overall Customer Service for MinnesotaCare.
● Rated above state average among Minnesota health plans in Rating of All Health Care, Rating of
Personal Doctor and Shared Decision Making for MA.
Impact on Members
●
●
●
Disruption of care for more than 31,000 SCHA members enrolled in MA and MinnesotaCare.
○ Affects 2,660 Wadena County members
Loss of the “local connection” with SCHA and the coordination of care between SCHA, local
providers, public health, social services and other community resources.
Loss of programming and initiatives unique to SCHA that improve and increase access to dental,
mental health and child welfare services. Examples include:
○ SCHA’s Community Reinvestment Grant program, which put nearly $3 million back into
our communities in 2014
○ Extra preventive dental visits
○ Healthy Pathways, a mental health prevention and early intervention service
Impact on Providers
●
●
Upends 14 years of relationship building with local providers. Providers acknowledge that SCHA
sets itself apart from other health plans in our responsiveness, our clear understanding of the
need to support rural health care delivery and our process of recognizing and rewarding the
quality and outcomes delivered to our members.
Loss of value-based contracting opportunities. Through SCHA’s Pay for Performance (P4P)
program in 2014, we reimbursed $560,250 to providers, rewarding them for their quality care to
our members.
○ Providers participating in P4P contracts:
■ New Ulm Medical Center
■ Unity Family Health Care
Phone: 507-431-6566 | Email: [email protected]
Address: 2300 Park Drive, Suite 100, Owatonna, MN 55060
●
●
●
■ Lakewood Health System
■ First Light Health System
■ Tri-County Health Care
■ Mayo Clinic Health System
■ Benedictine Living Community of Mora
Loss of 200% enhanced dental payments to improve access to local dental providers.
Threatens initiatives with Wadena County including:
○ City of Wadena for Maslowski Wellness and Research Center programming ($229,418 in
grant funding awarded in 2014)
○ Tri-County Health Care to develop its Community Paramedic program ($105,581 in grant
funding awarded in 2014)
Threatens the development of Diamond View, a health information exchange spearheaded by
SCHA. Diamond View achieves health data interoperability between providers, county partners
and health plans, facilitating secure and instant sharing of members’ medical information that can
improve patient care and health outcomes.
Other Impacts
●
●
●
●
●
Loss of influence in the development and delivery of Medicaid services:
○ Members through the Member Advisory Committee
○ County and provider partners through close collaboration and committees
○ Other county citizens through the Joint Powers Board
Loss of $34,766 in SCHA funding for Wadena County’s Community Care Connector position.
Unique to SCHA, the Connector is employed by the county and acts as a local SCHA expert for
both members and county workers, helping to improve the efficiency and quality of service for
members.
Loss of member incentives for preventive care and safety programs in Wadena County (figures
from 2014) that may in turn be spent in the community:
○ $14,375 for preventive care incentives
○ $1,356 in free car seats and training to use them
○ $1,400 in fitness program discounts
Loss of enhanced payment for county family home visiting services
If SCHA cannot sustain the loss of 85% of our membership, other functions will be threatened:
○ Non-renewal of the Medicare Advantage contracts for SeniorCare Complete (MSHO) and
AbilityCare (SNBC)
○ Ends SCHA Care Coordination contracts for senior members: 2,375 total across all
counties enrolled
○ Ends SCHA Care Coordination contracts for SNBC members: 2,335 total across all
counties enrolled
○ The dissolution of the health plan itself, displacing nearly 100 employees
If you have additional information you would like to share, please contact Cea Grass at 507-431-6566 or
[email protected].
Last Updated: 7/30/2015
DDA
David Drown Associates, Inc.
Public Finance Advisors
Minneapolis Office:
5029 Upton Avenue South
Minneapolis, MN 55410-2244
(612)920-3320 xtn 105 | fax (612) 605-2375
www.daviddrown.com
29 July, 2015
Wadena County Board
Wadena County Courthouse
415 Jefferson Street South
Wadena MN 56482
RE:
City of Sebeka
2014 TIF Reports
Dear County Board Members:
Attached please find one completed copy of the Annual Disclosure Report as it pertains to the 2014 TIF
Reports for the City of Sebeka. If you have any questions, please feel free to contact me as listed above.
On behalf of the City of Sebeka,
Elizabeth Blakesley, Associate
David Drown Associates, Inc.
[email protected]
CITY OF SEBEKA, MINNESOTA
Annual Disclosure of Tax Increment Districts for the Year Ended December 31, 2014
Name of TIF District:
Current net tax capacity
Original net tax capacity
Captured net tax capacity
Principal and interest payment
due in 2015
Tax increment received in 2014
Tax increment expended in 2014
First tax increment receipt
Date of required decertification
TIF 1 - 3
Centennial Apts.
TIF 2 - 1
7,828
300
7,528
2,496
6
2,490
13,500
36,576
14,184
13,597
June, 2001
Dec. 31, 2026
5,428
42,313
June, 2003
Dec. 31, 2028
Additional information regarding each district may be obtained from:
Sally Sandberg, Clerk-Treasurer
City of Sebeka
PO Box 305
Sebeka, MN 56477
Phone: 218-837-5773
[email protected]
TIF 3 - 1
Heritage
House
3,953
16
3,937
13,145
11,459
June, 2002
Dec. 31, 2027
NOTICE OF WADENA COUNTY BOARD OF COMMISSIONERS’ MEETING
The Wadena County Board of Commissioners will have a closed meeting on
Tuesday, August 4, 2015 at 9:55 a.m.
in the Commissioner’s Room on the upper level of the Wadena County Courthouse, 415
Jefferson Street South, Wadena Minnesota.
The purpose of this meeting will be to meet in Closed Session, permitted under Minnesota State
Statute 13D.03, subd. 1 – The purpose of the meeting will be to meet in Closed Session for the
purpose of discussing Labor Negotiations Strategy.
.
Curt Kreklau
Action Requested
Action/Motion
Discussion
Information Item
Report
Resolution
Other
Board Action Form
Title : Acceptance of 7-16-15 minutes of the Planning Commission & Approval of Conditional Use Permit
Date of Meeting: 8-4-15
Total time requested: 10 minutes at 10:30 a.m.
Department Requesting Action: Planning & Zoning
Presenting Board Action/Discussion at Meeting: Deana Malone – Zoning Administrator
Background
Paul & Susan Wieseler application for Conditional Use to authorize a mobile home as a second dwelling for
an immediate family member and also used as a guest house on their property located in Section 13, Township 137 North,
Range 35 West, Red Eye Township, described: NW1/4 NE1/4 except West 10 Acres
Options
Recommendation
Motion to accept the Planning Commission meeting minutes of July 16, 2015. Motion to
approve the Planning Commission’s recommendation to allow a mobile home as a second dwelling structure for
use as a residence for an immediate family member and guest house on their property in Section 13 of Red Eye
Township.
Financial Implications: $
Funding Source: General Revenue
Comments
Action
Motion:
Second:
Passed
Failed
Tabled
Signatures
Voting in Favor
Budgeted:
Yes
No
Hillukka
Stearns
Bounds
Munson
Hofer
Voting Against
Hillukka
Stearns
Bounds
Munson
Hofer
STATE OF MINNESOTA}
COUNTY OF Wadena}
I, Curt Kreklau, Jr., County Coordinator, Wadena County, Minnesota hereby certify that I have compared the foregoing copy of the proceedings of the County Board of
said County with the original record thereof on file in the Administration Office of Wadena County in Wadena, Minnesota as stated in the minutes of the proceedings
of said board and that the same is a true and correct copy of said original record and of the whole thereof, and that said motion was duly passed by said board at said
meeting. Witness my hand and seal:
Seal
Planning Commission Meeting Minutes, July 16, 2015
The meeting was called to order at 7:20 p.m. by Chairperson Arleen Paulson. Motion made by Tom Miller to approve
the minutes of the May 21, 2015, meeting that were previously mailed out. Motion seconded by Jon Kangas and
carried.
Public hearing was held on the application for Conditional Use Permit for Paul and Susan Wieseler, on the property
described as: NW1/4 NE1/4 except West 10 Acres, Section 13, Township 137 North, Range 35 West, Red Eye
Township, located in an A-2 Mixed Forestry & Agriculture District.
Representing the application was Susan Wieseler.
Chairperson Paulson read the details of the application and stated the application, if approved, would allow a mobile
home as a second dwelling for an immediate family member and also used as a guest house. Deana Malone
presented an aerial view of the property which depicts the new home that was built and the location of the prior
building site, as well as photos of the prior building site that were pulled from the Assessor’s records.
Chairperson Paulson asked if there were any questions of the board members. The age of the septic system was
requested and it was stated that a Compliance Inspection was on file for the mobile home dated 4-9-14 and it is in
compliance and this septic is separate from the new home septic system. It was asked how many acres were in the
parcel and 30 acres was the answer stated by the applicant.
With no further questions from the Planning Commission, Chairperson Paulson asked if there was anyone in the
audience in favor of the application. There was no one present at the hearing in favor or in opposition to the
application and no correspondence was received. The question was raised as to what a future plan for the mobile
home might be if the son moves out. The applicant responded that they have 4 daughters besides who all live away
from the area and the mobile home would be used for them to stay in when they visit as her and her husband’s
home is not large enough. Deana added that when the permit for the new home was issued it was with the provision
that the mobile home be removed from the property; however, later the Wieselers decided they would maybe like to
keep it there for just such use and that is why they applied for the CUP. The board members moved on to the
following findings of fact:
1. Will the requested use be compatible with the surrounding area and not significantly depreciate nearby
properties?
(X ) Yes
( ) No
Why or Why not?
Because there are a number of small acreage rural homes in that area and is very typical of what is right there.
2. Will the establishment of the requested use impede the normal and orderly development and improvement of
surrounding vacant property for uses predominant in the area? ( ) Yes ( X) No
Why or why not?
Same reason as number 1 above.
3. Are adequate utilities, access roads, drainage and other necessary facilities being provided?
( X) Yes
( ) No
Why or Why not?
Facilities are already available and are in compliance.
4. Have adequate measures been taken or will they be taken to provide off street/road parking and loading space
to serve the proposed use? (X) Yes ( ) No Why or Why not?
They have plenty of room for parking.
5. Are adequate measures in place to prevent or control offensive odor, fumes, dust, noise, and vibration so as not
to constitute a nuisance, and measures taken to control lighted signs or other lights in such a manner that no
disturbance to neighboring properties will result? ( ) Yes ( ) No Why or Why not?
Not Applicable.
6. Is the requested use consistent with the Wadena County Land Use Control Ordinance?
(X ) Yes ( ) No
Explain:
It gives people a place to live because it’s not good agricultural land for sure.
7. Is the requested use in conflict with the Wadena County Comprehensive Plan? ( ) Yes (X ) No
Explain:
Parcel is already down to that size and it’s not being broken up any smaller.
The Wadena County Planning Commission has reviewed each of the required factors and established whether or not
it is consistent with the land use ordinance and the Comprehensive Plan when deciding to recommend action for
approval or denial of this application for Conditional Use to the Wadena County Board of Commissioners at their
next regularly scheduled meeting held August 4, 2015, at 10:30 a.m.
Based on the information provided and facts addressed above, Commissioner Jon Kangas made a motion to
recommend approval of the application with the foregoing findings of fact. Commissioner Gordy Aagard seconded
the motion, motion carried.
Mrs. Wieseler was informed again of the meeting date and time of the County Board of Commissioners and
encouraged to attend in case of questions.
Having no further business for the Planning Commission, Charles Funk made a motion to adjourn the meeting, with a
second by Jon Kangas, the meeting was adjourned at 7:30 p.m.
_______________________________________
Deana Malone, Secretary
Members Present: Arleen Paulson, Tom Miller, Rodney Bounds, Jon Kangas, Gordy Aagard, Charles Funk
Members Absent:
Guests: 1
A Resolution Establishing a Conditional Use
WHEREAS, Paul & Susan Wieseler have made an application for Conditional Use to authorize a
mobile home as a second dwelling for an immediate family member and also used as a guest house
on their property located in Section 13, Township 137 North, Range 35 West, Red Eye Township,
described: NW1/4 NE1/4 except West 10 Acres; and
WHEREAS, this use may be allowed in the specified Zoning District as a Conditional Use according
to Section 7. C., of the Wadena County Zoning Ordinance #1; and
WHEREAS, fully noticed Public Hearing was held on the application on Thursday, July 16, 2015, at
the Wadena County Courthouse at 7:00 p.m., and
WHEREAS, the Planning Commission did due diligence in hearing the application and have made a
recommendation to the Wadena County Board of Commissioners to approve the application with
the following Findings of Fact:
1. The requested use will be compatible with the surrounding area and not significantly
depreciate nearby properties; because there are a number of small acreage rural homes in
that area and is very typical of what is right there;
2. The establishment of the requested use will not impede the normal orderly development
and improvement of surrounding vacant property for uses predominant in the area for the
same reason as number on above;
3. There are adequate utilities, access roads, drainage and other necessary facilities being
provided because the facilities are already available and are in compliance;
4. Adequate measures have been taken to provide off-street parking and loading/unloading
space to serve the proposed use as there is plenty of room for parking;
5. Adequate measures are in place to prevent or control offensive odor, fumes, dust, noise, and
vibration so as not to constitute a nuisance, and measures are taken or in place to control
lighted signs or other lights in such a manner that no disturbance to neighboring properties
will result and the consensus was this was not applicable in this case ;
6. The requested use is consistent with the Wadena County Land Use Control because it gives
people a place to live because it’s not good agricultural land for sure;
7. The requested use is not in conflict with the Wadena County Comprehensive Plan because
the parcel is already down to that size and it’s not being broken up any smaller.
NOW, THEREFORE BE IT RESOLVED, the Wadena County Board of Commissioners approve the
recommendation of the Planning Commission for issuance of the Conditional Use Permit for Paul &
Susan Wieseler to authorize a mobile home as a second dwelling for an immediate family member
and also used as a guest house on their property referenced above.
THE WADENA COUNTY
BOARD OF COMMISSIONERS
IN TESTIMONY WHEREOF THE WADENA COUNTY BOARD OF COMMISSIONERS has caused
this resolution to be adopted this ________ day of _______________, 2015.
ATTEST:
COMMISSIONERS
WADENA COUNTY BOARD OF
________________________________
Curtis J. Kreklau Jr, Coordinator
BY________________________________________
Rodney Bounds, Chairperson
Page 2 of 2
Board Action Tracking Number:
NOTICE OF WADENA COUNTY BOARD OF COMMISSIONERS’ MEETING
The Wadena County Board of Commissioners will have a closed meeting on
Tuesday, August 4, 2015 at 10:40 a.m.
in the Commissioner’s Room on the upper level of the Wadena County Courthouse, 415
Jefferson Street South, Wadena Minnesota.
The purpose of the meeting will be to meet in Closed Session, permitted under Minnesota State
Statute 13D.05, subd. 3(a) –for the purpose of conducting employee performance reviews.
.
Curt Kreklau

Wadena County Board of Commissioners AGENDA Call To Order

Transcription

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