2023 Annual Report
A note from John Dahm
Accra President and CEO
Dear Accra stakeholders,
In 2023, Accra made significant strides toward its vision to build an ecosystem that delivers personalized care in the home to better meet the needs of Minnesotans, while continuing to improve lives through high-quality individualized homecare services.
Amidst a rapidly changing healthcare industry, Accra produced stellar results. Our revenues increased by 7.8% to $371 million in 2023. Moreover, Accra produced a Return on Mission (ROM) of 1.02%, eclipsing our results from the past two years.
Facing the issues of rising costs and a workforce shortage, Accra stepped up to meet the challenge. We streamlined operations and paid staff competitive wages to retain our talented team. Additionally, we furthered our commitment to the client and employee experience by maintaining a significant investment of time, resources and personnel dedicated to our infrastructure through IT, human resources and EVV software.
Navigating Transitions
The upcoming transition from the PCA and CSG programs to the Community First Services & Supports (CFSS) program presents Minnesota's most significant change to homecare in decades. Preparing for the CFSS transition was one of Accra’s top priorities in 2023, and we are ready to guide clients through the transition due to the meticulous, hard work of Accra staff to ensure continuity of homecare services.
Following DHS’s decision to require electronic visit verification (EVV), we improved the client experience by deploying the Accra Access online portal and Accra Mobile app, allowing responsible parties and caregivers to manage client care electronically. For caregivers, electronic time entry through the app and portal facilitates smoother and quicker payroll processing, while clients have real-time visibility of budget balances and usage details for their services.
Leaning Into Legislative Advocacy
Accra was once again heavily engaged in the Minnesota legislative session, meeting with bipartisan legislators and clients in client homes and providing legislators with the opportunity to witness the positive effects of homecare first-hand.
During the legislative session, Accra joined with several community partners to advocate for an increase in the base hourly wage for PCAs and an increase in the corresponding reimbursement rate for providers. The advocacy efforts helped lead to a new two-year CBA, which will increase base wages for PCAs to $20 per hour by Jan. 1, 2025. Accra also participated in collaborative advocacy to allow parents and spouses to serve as paid caregivers providing services to their loved ones.
Expanding Access to Care
As we strive toward our vision for a better homecare ecosystem, Accra will continue to advance our technological capabilities and create access to homecare and mental health services that will fill current care gaps in Minnesota. We will evaluate opportunities to develop new systems, including telemedicine alternatives, that advance access to care.
I am proud of all the Accra team achieved in 2023. Our employees and caregivers alike maintained a fervent dedication to our mission of improving lives by providing individualized homecare services to people living at home. Working together, we will continue to support and enhance the lives of our clients and communities.
John Dahm
Accra President and CEO
Highlights from 2023 to present
Introducing Community First Services and Supports
Community First Services and Supports (CFSS) is a new self-directed option developed by the State of Minnesota to offer those who require home services more choice, control and flexibility with the services and supports needed to live and work in the community. The implementation date for CFSS is October 1, 2024.
When implemented, CFSS will replace the Personal Care Assistance (PCA) program and the state-funded Consumer Support Grant (CSG) benefit over the course of an estimated 15-month transition period. Accra will provide homecare services under both the CFSS Agency and Budget models and is prepared to provide the level of high-quality services that clients can rely on.
Advancing Accessibility Through Accra Access
The Accra Access online portal continues to add users and new features that allow responsible parties and caregivers to manage client care. The portal provides real-time visibility of budget balances and usage details for each client and their associated services. It also allows each program to publish announcements and general resources that are accessible to responsible parties in a self-service capacity.
As of July 2024, there are over 15,000 Accra clients and caregivers with Accra Access accounts. The portal is continually updated with new features, including a job board that connects responsible parties looking for additional support to caregivers who are looking to take on additional clients and the ability for responsible parties to have different roles within each service line a client receives. For caregivers, electronic time entry on the web facilitates smoother and quicker payroll processing.
Taking Payroll on the Go with Accra Mobile
Following the Minnesota Department of Human Services’ decision to require Electronic Visit Verification (EVV), Accra developed an app capable of mobile caregiver shift entry, called the Accra Mobile app. Since rollout of the app began in 2023, nearly 8,000 caregivers have started using the app, which connects seamlessly with the Accra Access online portal. Through the app, responsible parties can approve or reject shifts logged by caregivers, view weekly summaries of time, and see the status of the time shift data as it moves through processing and payment.
Increasing PCA Wages
During the 2023 Minnesota Legislative session, Accra joined with several community partners, including the Minnesota Home Care Association, The Arc MN, the Minnesota First Provider Alliance, Minnesota CCD and SEIU, to advocate for an increase in the base hourly wage for PCAs and for an increase in the corresponding reimbursement rate for providers.
The new two-year CBA increases base wages for PCAs to $19/hour, which went into effect Jan. 1, 2024, and $20/hour effective Jan. 1, 2025. Concurrently, the corresponding reimbursement rate paid to all providers increases by 21.3% effective Jan. 1, 2024, and an additional 4.3% effective Jan. 1, 2025. A tiered wage will also be implemented, effective Jan. 1, 2025, to provide higher wages to PCAs based on total hours of service. While Accra applauds the increase in the base wage rate for PCAs, we also recognize that the reimbursement rate is not keeping pace with the increases in base wages required of PCA Choice providers.
Accra’s Legislative Activity
In the fall of 2023, Accra met with bipartisan legislators and clients in client homes, providing legislators the opportunity to discuss the importance of homecare and witness its positive effects first-hand. The Accra public affairs team continued engagement with legislators and candidates by hosting an educational webinar centered on Accra services and the value of homecare in Minnesota. The webinar introduced Accra, the services we provide, the advantages of homecare and CFSS. These efforts contribute to Accra’s status as a resource for all things homecare and continue to strengthen legislative relationships.
Keeping Case Managers and Clients Informed with the Accra Advocate and FMS Champion
In March 2023, Accra launched its first ever newsletter, the Accra Advocate. This monthly newsletter is designed for social workers and county case managers, providing updates related to social services in Minnesota and sharing valuable resources.
In April 2023, Accra launched the FMS Champion, a quarterly newsletter for families participating in the FMS program at Accra. This newsletter shares the latest news and updates in the FMS world and informs clients about resources, learning opportunities and upcoming events.
Celebrating the Career of Sue Morgan
After nearly fifteen years of service at Accra, Chief Operating Officer Sue Morgan retired in January 2024. Sue served as Chief Operating Officer from 2021 to 2024, and in that time, helped usher the organization through many challenges, opportunities, and periods of evolution. During her time as COO, Sue oversaw the expansion of all Accra programs, including the creation of Accra’s Mental Health Services program and HealtheMed partnership.
Sue began her career as a registered nurse in Lake City, Minnesota, and dedicated her career to providing care to those in need, embodying Accra’s mission to improve lives. Accra is grateful for her dedication and leadership and wishes her the best in this new stage of life.
Appointing David Hancox as Interim Chief Operating Officer
In January 2024, Accra’s Chief Administrative Officer (CAO) David Hancox took on the mantle of Interim Chief Operating Officer. As CAO and Interim COO, David is responsible for oversight of Accra’s core service lines and the majority of Accra’s senior leadership team. David has served as CAO since October 2014.
Bringing the Clinic to the Client with Clinic@Home
To bridge the communication gap between homecare providers and physicians, Accra partnered with HealtheMed to offer Clinic@Home, an integrated digital system of care that enables clients to receive remote patient monitoring and some health care services at home.
The goal of Clinic@Home is to help clients live independently, while reducing the number of hospitalizations or readmissions by monitoring for potential adverse health events.
The integrated system facilitates seamless coordination between a patient’s homecare provider, their physician and their entire care team. Covered 100% by Medicaid, eligible clients gain access to personalized and proactive health insights, customized health education and hybrid telemedicine offering high-tech solutions with high-touch care.
Furthering Accra’s Diversity, Equity and Inclusion Journey
Throughout 2023, Accra focused its DEI efforts on the theme of “Develop, Engage, Integrate.” Accra participated in a scrubs camp, designed to educate and excite students about healthcare careers and the impact that DEI has in the workplace. In the fall, Accra organized a neurodiversity panel that informed employees on how to destigmatize neurodiversity and best support neurodiverse co-workers and staff. Accra also coordinated its second annual Spirit Week, celebrating the diversity of employees with a full week of fun activities, engagement exercises and opportunities to give back to our communities. Separately, Accra launched a DEI Do Good Day to support communities where employees live and serve. In a staff survey, more than 90% of Accra staff stated that they believe Accra is dedicated to DEI.
For 2024, Accra’s DEI efforts have embraced the theme of “Together Everyone Achieves More (TEAM).” The Accra team participated in a dignity volunteer campaign that collected over 60 dignity items and donated them to shelters across Minnesota. The organization also hosted a presentation on LGBTQ allyship and has continued to organize monthly support groups that provide a collective processing space for current events.
Our Programs
Leadership Team & Board of Directors
Executive Team
John Dahm, President and CEO
David Hancox, Chief Administrative Officer & Interim Chief Operating Officer
LeAnn Frette, Chief Solutions Officer
Amy Hilsgen, Chief Human Resources Officer
Tim Jones, Chief Technology Officer
Chad Derner, Chief Financial Officer
Senior Leadership Team
Peter Noss, Senior Integration Director
Rochelle Wodarz, Senior Program Director of PCA/CFSS and Compliance
Tyler Langenfeld, Senior Director of Strategic Development and 245D Services
Valerie Patino, Senior Program Director of FMS and Mental Health
Hannah Rutt, Senior HR Director
KC Ferk, Senior Program Director of Strategy and Development
Board of Directors
Chairperson: Mark Heston, Founder and CEO, Heston + Associates Consulting
John Dahm, President and CEO, Accra
Steve Suckow, Director, Corporate Advisory, BMO Harris Bank
Monica Theisen, Senior Audit Manager, Eide Bailly LLP
Robin Brown, SVP, IT, Cirrus Aircraft
Bonnie Hays, Manager, Hennepin Health Plan
Christianna Finnern, Shareholder, Winthrop & Weinstine
Mike Holz, Vice President, SureScripts, LLC