{"report_id":221,"form_id":"23","user_id":81,"organization_id":10,"question_id":"100","question_type":"Free_Text","text_answer":"No asleep staff for the overnight shift was influenced by the staff who was scheduled being ill and no one else available to cover the shift. Other staff were unwilling to cover this shift because the home is further away than most of the provider\u2019s other homes. Also, the asleep shift was likely to be awake because the person was known for having challenging behaviors.  Further supporting staff\u2019s unwillingness to cover this shift was that they would only receive $10\/hour.\r\n\r\nAn additional factor that influenced the shift to go unfilled was that the provider didn\u2019t feel pressure to fill the shift. The individual\u2019s team, including the case manager at Hennepin County, had previously agreed that due to known staffing shortages with the provider, when an overnight asleep was not available the individual\u2019s plan would allow for only the one awake overnight staff.\r\n\r\nMinnesota\u2019s Rate Management System (RMS) determines a reimbursement rate for an individuals required supports (staffing pattern), which is agreed upon by the provider and case manager at the county per the DHS 6790 form.  This RMS rate then affects the provider determining they could pay overnight staff $10\/hour for asleep shifts.  \r\n\r\nAnother influence was the Minnesota State Legislature, who creates laws governing provider rates, enforcing a 7% decrease in reimbursement rates to providers in July of 2018.  This impacted the provider\u2019s ability to give an annual raises to staff and in turn influenced the provider having a staff shortage.  This was influenced by Federal (CMS) action determining Minnesota\u2019s reimbursement rates were increased too much in recent years, and the Minnesota Department of Human Services\u2019 decision to determine which rates needed to be cut and by how much to come into compliance with the CMS decision.","created_by":81,"updated_by":81,"updated_at":"5\/25\/2021 10:28:56 am","created_at":"5\/25\/2021 10:28:56 am","id":16216}