I am a member of the state DWRS Advisory Committee, which meets 4-5 times per year. One of the subjects we look at is the Exception process and results.
There is an Exception process within DWRS, that allows for exceptional rates to be applied on an individual case-by-case basis, if the current framework does NOT provide sufficient rates for waivered disability services.
In our meeting on July 21, the 2Q 2022 data on the Exception process was reviewed. Here are some interesting facts that were presented:
- 1528 requests were submitted, which is actually slightly less than same quarter last year
- 82% of the requests were approved, or 1253 requests were approved
- The average change from the framework rate is +60.2%
- Renewal requests were 69% of the total, and new requests were 31%
- Average processing time to approve a request is 1 day
- 84 Lead Agencies (Counties or Tribes) submitted requests, which equates to 6 per month
- The largest service category with approved requests was Residential, 66%
- The second largest service category with approved requests was Employment Services, 14%. The remaining categories were single digit.
- The total number of approved authorizations or service agreements under DWRS is 21,442. So, in this quarter 6.4% of the existing authorizations had an approved exception applied to them.
- The Exception process is quite stable, and the data does not change remarkably from quarter to quarter.
The Healthcare Workforce crisis, inflation, the new Waiver Reimagine rate modifications, and other situations would suggest that the Exception process is not being pursued by Individuals, Families, Service Providers, and Case Managers as much as it could be. I have tried to get feedback as to why there appears to be a reluctance to use the DWRS Exception Process but there is no information about this.
I do know that developing a case for an exception is not trivial. The Lead Agency needs to work with the service provider and family to develop the exception request. The Lead Agency then submits the request to the state. Individuals and families or even Service Providers cannot go directly to the state with an exception request. Obviously, the Case Manager working for the Lead Agency has to do most of the legwork. But in my limited experience, Service Providers and families are reluctant to use this process.
If you are having difficulty with getting or keeping services for your loved one with IDD, get your service provider(s) and Case Manager to consider using the Exception process.
You can learn more by visiting this link: https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=DHS16_182164