During 2021, the Department of Social Services faced many challenges due to the COVID-19 pandemic; however, not only did our department continue to serve Missourians and provide needed benefits, we also made important improvements for children and youth in our care, cost-savings, healthcare, and recruitment and retention. Here are some of the highlights from the year:
- We helped Missourian's in need.
Year after year, DSS team members go above and beyond to help support others during times of need. In 2021 our team donated to charities through our annual charitable campaign, adopted countless families and children in need to ensure they had a holiday to remember, donated gifts and supplies to foster families and Missouri’s children in foster care, and dedicated their time and service to help support victims of multiple natural disasters, including Louisiana residents devastated by Hurricane Ida.
- We helped keep children and youth in foster care remain in home settings.
Our Children’s Division (CD) team understands the impact of a safe, stable environment for children who have experienced any form of trauma. In 2021 our CD team in partnership with the Department of Mental Health and local community mental health providers implemented a pilot program called Crisis Mobility (now referred to as REACH) in select areas of the state, a program dedicated to keeping the youth in our care in stable, home settings. Thanks to our dedicated team members who helped start this initiative, our pilot areas reported successful stabilization of over 100+ youth referred to the program!
- We moved more children and youth to permanency.
The goal of permanency is to find the youth in foster care a safe, permanent home that will allow them to grow and thrive. Sometimes this means returning home safely with their families, other times this means finding alternate options that are best for each individual youth. In 2021, the Children’s Division / Division of Legal Services Permanency Attorney Initiative resulted in 2,500 children finding a safe, permanent home, with more than 1,900 of those permanencies reported between March and September alone!
- We met department-wide staffing shortages head on.
Like many other agencies and employers, in 2021 the Department of Social Services experienced an increase in turnover and a decrease in new applicants to fill vacancies. With the help of our dedicated staff, we were able to continue serving Missourians and work to expand our workforce by:
- Strengthening community partnerships and rebuilding relationships with colleges and career centers.
- Piloting a Children’s Division (CD) Case Aide position to help circuits experiencing the highest staffing shortages. The pilot program was so successful and CD is now moving forward with implementing statewide.
- The Division of Youth Services offering paid internships and partnering with our Human Resources Department and the Office of Administration to use CARES relief funding to advertise vacancies and increase recruitment efforts, including hosting on-site events that resulted in 35 job offers.
- The Family Support Division establishing “nesting areas” for newly hired team members that allows supervisors and trainers to work intensively with new hires until they are ready to move to their regular work area. This concept has been successful in improving both retention and job satisfaction.
- We offered healthcare coverage to more Missourians.
In accordance with the Cole County Circuit Court’s order on August 10, Missouri Medicaid (MO HealthNet) coverage was made available to even more Missourians through the Adult Expansion Group (AEG) option. MO HealthNet Division and Family Support Division team members worked tirelessly to make sure waivers and application processes were in place for eligible Missourians to successfully apply and receive coverage. Our communications team also worked to implement updates and gather important information to ensure participants and providers had important details regarding this new coverage. In addition, Family Support Division Income Maintenance team members have been working overtime to help ensure every application is processed timely. As of December 30, 2021, approximately 51,613 Missourians have been successfully enrolled in AEG coverage.
- We found new ways to manage our work and hold ourselves accountable to Missouri citizens
In 2021, the Family Support Division Income Maintenance Team implemented a new tasking system that allows team members to track tasks and offers a real-time dashboard to measure individual and team productivity. This system allows management to quickly identify areas that require improvement and shift trained team members to focus on alternate tasks as needed. The system has proved so valuable that our Child Support team is in the process of developing a tasking system to meet their needs.
- We helped nursing facilities receive reimbursement for nearly $114 million in COVID-related costs.
The MO HealthNet Division (MHD) helped nursing facilities create invoices for costs related to COVID-19 testing and other COVID-19 related expenditures and provided an online portal for providers to submit these invoices. DSS team members worked to manually process each invoice, sending them to our Division of Finance & Administrative Services and Office of Administration for payment. As of December 1, 2021 MHD processed payments from 3,115 testing invoices totaling $52.1 million. In addition, MHD processed 3,076 other COVID-19 related invoices for a total of $61.7 million, for a combined total of $113.8 million.
- We offered MO HealthNet Participants a cure for Hepatitis C.
In 2021 MO HealthNet announced Project HepCure, a new initiative that offers a prescription treatment for MO HealthNet participants who have been diagnosed with Hepatitis C at no cost to them. MO HealthNet worked to educate providers and participants of this new treatment, and as of the end of September 2021 nearly 3,000 participants have received this treatment.
- We saved money in the Medicaid pharmacy program that can be used to fund other state priorities.
In 2021, the MO HealthNet Division (MHD) modified payment policies for prescriptions and dedicated new team members to pharmacy program integrity, avoiding $112 million in pharmacy payments annually. MHD also improved drug rebate collections by $200 million per quarter (a 10% increase).
- We responded to COVID.
- While each of our team members and divisions were impacted by the COVID-19 pandemic, our Division of Youth Services (DYS) team members faced unique challenges and overcame obstacles every week while providing treatment care to youth in residential and community settings. Our dedicated team members remained in-person and worked tirelessly to ensure the needs of the youth in our care were met. Team members utilized testing protocols to safely conduct family visits, incorporate enrichment opportunities and outings, and continue to offer the nationally recognized service we provide.
- Our MO HealthNet team facilitated the administration of nearly 100,000 COVID vaccines to MO HealthNet participants by Missouri pharmacies through advertised community testing.
- Our Missouri Medicaid Audit and Compliance (MMAC) team received a “no findings” report from the Office of Inspector General (OIG) after enrolling over 1,000 new MO HealthNet healthcare providers during the first 60 days of the pandemic to ensure Missouri Medicaid participants had access to care.
- We improved healthcare systems for Missouri’s foster youth.
In 2021, the MO HealthNet Division (MHD) and Children’s Division (CD) partnered to pilot the Cerner Corporations HealtheIntent platform for children in foster care. This platform is a management system with disease and wellness standards of care that combines data from various sources. The purpose of the system is to establish consistent standards to measure medical services and review the outcomes. The HeatheRecord provides a view of clinical information of the child's medical history for the past two years.
- We prepared our youth for adulthood.
- In October 2021, the Division of Youth Services (DYS), Family Support Division (FSD) Child Support program, and community partners collaborated to launch the Parenthood Can Wait program. This pilot program aims to help the youth in DYS care gain the knowledge, skills and access the resources they need to help realize their life goals, reach economic stability, and become future responsible parents. Parenthood Can Wait will be integrated into the existing school day for DYS youth, and mentor services will remain available through aftercare.
- The Children’s Division implemented the ROYALS Unit statewide, a team dedicated specifically to helping older youth as they prepare to leave CD’s care. The ROYALS Unit was an idea brought forth by our team through the Show-Me Challenge, and they were awarded first-place for their efforts. With the focused help of our ROYALS Unit, youth are more prepared than ever before to begin life as successful adults and Missouri citizens.
- We implemented new technology to fight fraud, waste, and abuse in the Medicaid program.
Beginning April 2021, Missouri Medicaid Audit & Compliance (MMAC) added a new technology tool (FWA Finder©) to the recently certified Medicaid fraud, abuse and detection system that results in at least a 5 to 1 return on investment. The FWA Finder© ingests millions of Missouri Medicaid claims per billing cycle for over 65 provider types using the most advanced technology to quickly and efficiently identify improperly paid claims and suspected Medicaid fraud. The new FWA Finder© solution will help MMAC protect the integrity of the Missouri State Medicaid Program by detecting and preventing fraud, waste and abuse, and recovering improperly expended Medicaid funds, while ensuring high quality care for Missouri citizens.