Sponsor: Social Services
Title
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Personnel Complement Increase in the Social Services Department.
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Recommendation
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Approve an increase in the personnel complement of the Aging & Disability Services and MnCHOICES Division, within the Social Services Department, by 80.0 Full Time Equivalent
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Background and Rationale
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The Aging and Disability Services | MnCHOICES division (ADS-MnCHOICES) of the Social Services Department provides programs designed to support the elderly and people with disabilities to live in the community as independently as possible. The ADS-MnCHOICES Division provides MnCHOICES assessments, which determine eligibility for services for people who need home and community-based services, including the Alternative Care Program, Elderly Waiver, Brain Injury Waiver, Community Alternative Care Waiver, Community Access for Disability Inclusion Waiver, Developmental Disability Waiver, and Community First Services and Supports (previously known as personal care assistance (PCA) and Consumer Support Grant). The division also provides case management services for seniors and people with disabilities.
Lead agencies are required to provide MnCHOICES assessments by Minnesota Statute 256B.0911. These services must be available to any person regardless of public program eligibility and statute also requires that an individual “must be visited by a long-term consultation team within 20 working days after the date on which an assessment was requested or recommended.” Annual MnCHOICES reassessments and case management services are also required.
Community need for both MnCHOICES assessments and case management have increased significantly in the wake of the COVID-19 pandemic. In addition, new unfunded mandates by the Minnesota Department of Human Services (DHS) have further increased workloads. This means that current resident need far exceeds current staffing capacity. This has resulted in long wait times for residents who need a MnCHOICES assessment, case management, and waiver services.
The ADS-MnCHOICES division has worked diligently to find workflow efficiencies and to move existing positions to areas of the division that have the greatest need. These changes are not sufficient to meet current community need. DHS recently rolled out a new MnCHOICES tool that is expected to be more efficient and therefore has allowed for more assessments to be assigned to each assessor. However, this is not sufficient to meet the needs of the community or address the backlog. Some additional stressors for the division include DHS discontinuing the ability for a case manager to complete an annual reassessment via paper (rather than an assessor completing in the MnCHOICES tool). This change took effect as of October 1st, 2024. This DHS change resulted in additional assessments that must be completed by certified assessors in the MnCHOICES tool. This increased the assessment workload by approximately 1,000 assessments annually. Additionally, post Covid (between 2021 and 2023) there has been an increase in requests for MnCHOICES assessment of about 5% each year. Another recent change affecting workload is the DHS roll out of Community First Services and Supports, which converts Consumer Support Grant and PCA into Community First Services and Supports. This new change has no additional funding to support it and yet adds additional administrative burden on counties. Previously, Consumer Support Grant allowed counties to bill a 5% administration fee per case. There is no administration fee for Community First Services and Supports. Finally, since 2017 total assessments has increased by 40%.
Budget shortfalls have caused an elimination of 28 Full Time Equivalents (FTE) in ADS-MnCHOICES since 2018, while other neighboring counties have continued to hire in this area. Anoka County has increased their FTE by 19 since 2021, Dakota County has increased their MnCHOICES area by 29 FTE for 2025, Hennepin County also increased their FTE by a total of 70 in 2023 and 2024. To serve Ramsey County residents and meet statutory requirements, the Social Services Department is requesting 80 new FTE. This will allow us to address the current crisis and ensure that ADS-MnCHOICES staff can serve Ramsey County residents in a timely manner and in compliance with state statute. Our current data indicates we will be able to resolve the current backlogs across the division by mid-2026. Backlogs include new referrals (for an initial assessment), current backlog of initial assessments, backlog of annual reassessments, backlog of case management assignment (due to a shortage of case managers), and backlog of service agreements.
The additional positions will be funded primarily with random moments revenue from the state and federal government. Random moments are a revenue source for counties via the State of Minnesota’s Social Services Time Study. ADS-MnCHOICES Division participates in the Social Service Time Study and employees are sent a “random moment” and respond to it by selecting a code that matches the work they were doing at the time the random moment was received. Counties are then reimbursed quarterly by the State of Minnesota based on these time study responses.
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County Goals (Check those advanced by Action)
☒ Well-being ☐ Prosperity ☐ Opportunity ☐ Accountability
Racial Equity Impact
Ramsey County is the most diverse county in the state of Minnesota. Recipients of Home and Community-Based Services in Ramsey County are very diverse. As of January 2023, 18,092 residents in Ramsey County received Home and Community Based Services. Of the residents receiving Community Alternative Care, Community Access for Disability Inclusion, and Brain Injury waivers, 55% were racially and ethnically diverse residents. Of residents receiving Developmental Disability waiver, 36% were racially and ethnically diverse residents. Of residents receiving Elderly waiver and Alternative Care, 63% were racially and ethnically diverse residents. This data is from the State’s Long-Term Services and Support dashboard. The delays in ADS-MnCHOICES means that racially and ethnically diverse residents are disproportionately impacted by wait times for services.
Community Participation Level and Impact
Community members have expressed their concern and frustration with long wait times and delays in receiving needed services through our Community Advisory Council committees. ADS-MnCHOICES staff and leaders also hear directly from residents who reach out. Residents call to ask when they will receive their assessment and/or services daily. Additional FTEs allows SSD to serve more residents and to serve them quicker. This will positively impact community.
☒ Inform ☒ Consult ☐ Involve ☐ Collaborate ☐ Empower
Fiscal Impact
Health and Wellness leadership have been working with the Ramsey County Manager and Finance to secure the funding needed for this initiative. The $1,071,162 million one-time cost for 2025 will be funded through county wide funding sources within the Health and Wellness Service Team and County Manager’s Office 2025 budget. No additional levy is needed, and the positions will be built into the 2026-2027 proposed budget. Finance and Health and Wellness will monitor this in 2025, and report back as requested.
Last Previous Action
On 03/11/2025 the Social Services department presented an overview of the Aging & Disability Services and MnCHOICES Division to the Ramsey County Board of Commissioners.
On 12/13/2022, MnCHOICES was allocated $1.1 million dollars of American Rescue Plan Act (ARPA) funding. This was funding was used to pay salary and benefits for 18 limited duration positions. Employees funded by ARPA completed 1,833 initial MnCHOICES assessments. ARPA also paid for overtime for employees. Overtime work resulted in completion of 264 additional assessments. In total, 2,097 assessments were completed via ARPA funding.
Attachments
None.