Sponsor: Social Services
Title
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Establishment of Withdrawal Management Services Per Diem Rate
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Recommendation
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Approve establishment of withdrawal management services per diem rate of $590, effective upon board approval, or shortly after.
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Background and Rationale
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Ramsey County has 50 dually licensed withdrawal management and detox beds at the Ramsey County Detoxification Center located at 402 University Avenue East in Saint Paul. However, to comply with Minnesota Department of Human Services required staffing ratios, 22 beds can be operational with current authorized budget positions.
Withdrawal management is a licensed program that provides short-term medical services on a 24-hour basis for the purpose of stabilizing intoxicated patients, managing their withdrawal, and facilitating access to substance use disorder treatment as indicated by a comprehensive assessment.
Ramsey County’s program is a medically monitored withdrawal management program and meets the requirements set forth in Minnesota Statutes 245F.12, subdivision 3 which includes a Registered Nurse (RN) on site 24 hours a day, 7 days a week and a Medical Director available.
This program provides intensive inpatient withdrawal management services which includes:
• An initial health assessment conducted by an RN upon admission;
• Availability of a medical evaluation and consultation with an RN 24 hours a day;
• Availability of a qualified medical professional by phone or in person for consultation 24 hours a day;
• Availability to be seen within 24 hours or sooner by a qualified medical professional if the initial health assessment indicates the need to be seen;
• Availability of on-site monitoring of patient care 7 days a week by a qualified medical professional; and
• Availability of appropriately trained licensed staff to administer medications according to prescriber-approved orders.
Withdrawal management services are paid by Prepaid Medical Assistance Programs (PMAP) at a rate set by the state currently $590 per day. Below is breakdown of services per diem rate for withdrawal management services from the Minnesota Department of Human Services. More information about the per diem rate can be found at: <https://edocs.dhs.state.mn.us/lfserver/Public/DHS-7612-ENG>
|
Treatment Settings Descriptions |
Base Rate |
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Withdrawal Management Medically Monitored (daily rate - code 0919) |
$515 |
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Room and Board Associated with Withdrawal Management (daily rate - code 1002) |
$75 |
|
Total Per diem rate for Withdrawal Management |
$590 |
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County Goals (Check those advanced by Action)
☒ Well-being ☐ Prosperity ☐ Opportunity ☐ Accountability
Racial Equity Impact
The Detoxification and Withdrawal Management strategy is aimed at addressing disparities and ensuring that people in recovery who are the most severely marginalized by race, economic and other stigma can access recovery support services in the amount, duration, locality and by the providers of their choice. Services are accessible and affordable and with this lens, the budget is set to meet the needs of all Ramsey County residents.
Community Participation Level and Impact
There is no direct community engagement with residents to establish the per diem rate.
☒ Inform ☐ Consult ☐ Involve ☐ Collaborate ☐ Empower
Fiscal Impact
Over the past year, Health and Wellness Administration has been focused on launching the Withdrawal Management program within the Social Services division. After reviewing the current market rates, Health and Wellness Service Team is recommending charging a per diem fee of $590 for withdrawal management clients. Program leadership anticipates that the program will average a daily census of 12 clients of which approximately 55% would be Medical Assistance (MA) eligible. As part of the intake process, the frontline staff will be trained in helping clients navigate the process to apply for MA.
HWST is projecting an annual revenue of $2.5M with 12 clients eligible for Withdrawal Management claims daily. This revenue will be reflected in 2024 and 2025 budgets and will off-set operational costs within the Withdrawal Management area.
The anticipated service start date will be the 4th quarter of 2023.
Last Previous Action
None.
Attachments
1. Minnesota Department of Human Services Rate Schedule