24 Counties to authorize mediation to keep Prime West as their one health care plan

By Karen Edelbach

The Clearwater County Board of Commissioners met on  August 6, 2019 for a special meeting regarding the 2020 procurement process for health plan selection decisions that were made by the Minnesota Department of Human Services (DHS). 

Jamie Halverson, Director of Clearwater County DHS, and Marissa Hetland, Director of Nursing were in attendance to explain a resolution to pursue mediation by retaining the law firm of Lockridge Grindal Nauen, PLLP for purposes of representing Clearwater County in the mediation process, as well as all 24 counties under the Prime West Rural Minnesota Health Care Access Initiative (dba Prime West Health). They must apply before August 15. 

"After I provided my review to the State DHS, they decided to apply more than one health care plan. It was always one plan before Prime West," Ms. Halverson explained. "The Counties would like to file for mediation."

"Why we want a single plan," was explained. "Prime West is financially different. They have put $122 million back into the communities they serve since started," she said. 

"Clearwater County has received around $220,000 back into the County, for a small investment," Chairman John Nelson said. 

"This would require staff to know several health care plans, and would be extremely costly tentatively," Ms. Halverson stated. "This process happens every three to five years." The Chairman added that the health plans would all audit.

"Why are they coming after this little group (of counties)," Commissioner Mark Titera asked. 

"It comes down to having choice," Marissa Hetlund speculated, since no reason was given by DHS. "You can talk to a person at Prime West, and they listen. We have a voice with them."

Others added that in their experience or those they know, they believe Prime West serves the needs here in the best way. 

Clearwater County is one of the twenty-four Counties that has agreed to authorize Prime West to act on its behalf through a joint powers agreement under Minnesota Statute 471.59 who elected to purchase health care services on behalf of persons within the County eligible for Health Care Services for Families and Children through Prepaid Medical Assistance (MA) and MinnesotaCare, as well as persons eligible for Minnesota Senior Health Options/Senior CarePlus (MSHO/MSC+). 

The County informed the DHS that the County had selected Prime West to purchase  health care services for eligible persons within the County; and also desired that Prime West be selected as the single plan for both MA and MSHO/MSC+ to serve all persons within the County as allowed under Federal and state law starting on Jan. 1, 2020.

The DHS notified the County around July 25 that Prime West was not invited to contract to provide services as the single plan for all persons within the County who are eligible to participate in the programs, but has offered no explanation for its decision not to select Prime West as the single health plan. The have not identified any evidence that the Commissioner of Human Services considered contracting with Prime West on a single health plan basis as required by Minnesota Statute 256B.694. 

The 24 Counties, including Clearwater, strongly disagree with the State DHS' decision not to select Prime West as the single health plan for both MS and MSHO/MSC+ in the County as allowed by federal and state law. The Counties seek to pursue all action necessary to challenge the Department of Human Services' decision.