VAA Redesign meetings

Community Conversations (PDF) about Adult Protective Services (APS) were done by community members or facilitated by community organizations for their members in October and November, 2019. These conversations with community members helped gather and amplify the voices of people who have been, or could be, impacted by APS. 

The Community Conversation process (PDF) was designed so that anyone who wanted to participate could, regardless of their current knowledge of the Vulnerable Adult Act or adult protective services. The Vulnerable Adult Act (VAA) Redesign Community Conversations Kick-Off webinar was held on September 26. 2019. You can access the webinar slides and the webinar audio transcript here for more information: 9/26/19 Webinar PowerPoint (PDF); 9/26/19 Webinar Audio Transcript (PDF).  

The input collected from Community Conversations that occurred across the state was shared and discussed at the November 22nd Community Stakeholder Summit at the Minnesota Humanities Center in St. Paul and provided a foundation for a redesigned VAA. 

The first stakeholder engagement event for the VAA Redesign project, the Community Stakeholder Summit, was held on November 22 at the Minnesota Humanities Center in St. Paul for community members and staff representatives from organizations that hosted Community Conversations. Prior to the event, Minnesota Management Analysis and Development (MAD) collected 59 Community Conversations exploring community values related to Adult Protection scenarios. MAD compiled the Community Conversation results and facilitated the Community Stakeholder Summit (PDF) where participants reviewed input previously gathered (PDF) and helped refine foundational values for a redesigned VAA.

The collected input from Community Conversations and the Community Stakeholder Summit (PDF) touched on numerous topics and values, including these three examples:

• "Safety" was one of the high level values identified in the Community Conversations, and discussions included recognition that what "safety" means to each person can be different.
• An over-focus on blame was discussed, including perceptions that the current adult protection system is too focused on blame rather than focusing on providing people supports they need to prevent future maltreatment.
• Stakeholders agreed cultural relevancy is an important value and should be incorporated into a redesigned adult protection system to promote cultural responsiveness.

Two Institutional Stakeholder Summit events were held in December for the VAA Redesign project. The first Institutional Stakeholder Summit was held on December 3 at the Hiway Federal Credit Union in St. Paul for people who work in close collaboration with Adult Protective Services (APS). The approximately 40 attendees included representatives from providers and provider organizations, advocacy organizations, attorneys, state agencies, county APS, and law enforcement. The second Institutional Stakeholder Summit was held on December 13, at the Elmer L. Andersen Building in St. Paul for approximately 70 county and tribal APS workers and supervisors. 

Minnesota Management Analysis and Development (MAD) facilitated the two Institutional Stakeholder Summit events and built upon previous information collected by MAD in Community Conversations (PDF) engagement activities and the Community Stakeholder Summit (PDF) in November. 

Attendees at the Institutional Stakeholder Summits worked in small groups to further define and refine foundational values that should drive Minnesota’s APS system and efforts to redesign the VAA. The collected input from Community Conversations, Community Stakeholder Summit, and Institutional Stakeholder Summits have touched on numerous topics and values, including these examples:

• Punitive nature of current VAA – for example, emphasis on assigning blame – should shift to an increased focus on support for VAs and prevention of maltreatment
• Redesign process offers an opportunity to re-think what “success” looks like
• Need to balance independence and self-determination with safety and protection
• Desire to remain aligned with national trends and standards

The VAA Redesign stakeholder engagement process has included Community Conversations, a Community Stakeholders Summit, and two Institutional Stakeholders Summits, all facilitated by Minnesota’s Management Analysis and Development (MAD) Division. MAD has collected and summarized a number of learning points from the engagement process (PDF) thus far. Below are a few of the items that have emerged:

• Overall, community and institutional stakeholders’ values do not align with the current VAA 
• Safety and protection are highly valued, but need to be balanced with vulnerable adults’ right of self-determination 
• The current system is seen as punitive and focused on blame, but APS workers are concerned about losing real or perceived authority to take action to protect vulnerable adults 
• There is disagreement over whether evidence-based and promising practices should be mandated by the VAA 
• The system is not culturally responsive 
• Adult protection is under-resourced, resulting in funding inequities 
• Many critical definitions are outdated or need revision

The next step in the Vulnerable Adult Act Redesign Stakeholder Engagement Process (PDF) is for Solution Groups to translate the collected stakeholders’ input regarding values and desired outcomes into potential solutions.

As part of the DHS Aging and Adult Services’ effort to redesign the Vulnerable Adult Act (VAA), five Solution Groups were formed to use input received throughout 2019 to develop recommendations for how to better align Adult Protective Services (APS) with stakeholders’ values. Each Solution Group met three times in February and March. They were facilitated by Management Analysis and Development (MAD) consultants. Each of the five groups focused on different aspects of the VAA or parts of the APS system. The Solution Group topic areas were:

• Definitions 
• Intake and Prevention 
• Investigations and Services 
• Collaboration and Data Sharing 
• Prevention, Public Awareness, and Reporting

Each Solution Group had members representing a wide variety of perspectives, including from advocacy organizations, provider organizations, state agencies, and APS staff from counties in both Greater Minnesota and the Twin Cities metro area. Two of the Solution Groups (Investigations and Services and Collaboration and Data Sharing) also had representatives from law enforcement and the courts system.

Using the stakeholder feedback that had been received up to that point, DHS Adult Protection staff and MAD consultants worked to identify a list of prioritized questions for each Solution Group to answer. These questions emerged from stakeholders as key areas of interest and issues where the current VAA may not align with stakeholder values.

At each Solution Group meeting, MAD consultants facilitated group members through a process of discussing each question and developing consensus around a recommendation. Once the group developed a recommendation, each member was asked to identify their level of support or opposition to the recommendation, as well as identify any reservations or concerns about each recommendation.

The Vulnerable Adult Act Redesign: Solution Group Recommendations (PDF) provides detailed recommendations and comments from the Solution Group activities.

Please contact us with questions or comments at VAARedesign.dhs@state.mn.us

The World Café event for all community and institutional stakeholders is canceled due to the COVID-19 crisis. Minnesota’s Management Analysis and Development (MAD) Division and the Department of Human Services (DHS) will work to identify next steps in the VAA Redesign process. These are extraordinary times. Kindness, patience, ethical practices, and following public health advice will get us through. Take care!

Minnesota’s Management Analysis and Development (MAD) Division and the Department of Human Services (DHS) Continuing Care Administration, Aging and Adult Services Division worked over the course of a year to get input from a variety of stakeholders on how to develop a more person-centered and equity-based adult protection system through redesign of the Vulnerable Adult Act (VAA). In July, 2020, MAD compiled a summary report of this work for DHS Continuing Care Administration, Aging and Adult Services Division titled, “Recommendations and stakeholder input for redesigning the Vulnerable Adult Act.” (PDF) 

A public comment form will be added to this website soon to provide an opportunity for stakeholders to review and react to recommendations resulting from the Solution Groups process.

We want your feedback! Public Comment on Vulnerable Adult Act Redesign Recommendations open until August 17, 2020

Due to the COVID-19 crisis the World Café event previously planned to review VAA Redesign recommendations and solicit feedback was canceled. Therefore, Minnesota’s Management Analysis and Development (MAD) Division is collecting input through a public comment form on behalf of DHS to provide an opportunity for stakeholders to review and react to recommendations resulting from the Solution Groups process. The public comment form will be open until August 17, 2020. An addendum to the report that includes the public comment on the report will be posted later in September.

Addendum to the “Recommendations and stakeholder input for redesigning the Vulnerable Adult Act” summary report

Thank you to all those who provided additional comments and feedback regarding the Vulnerable Adult Redesign Recommendations. Public comment on stakeholder recommendations is collected in “Addendum to the recommendations and stakeholder input for redesigning the Vulnerable Adult Act” (PDF). A summary of the addendum is included as Appendix B in the updated summary report “Recommendations and stakeholder input for redesigning the Vulnerable Adult Act” (PDF).

Please contact us with questions or comments at VAARedesign.dhs@state.mn.us. 

On November 24, 2020 Lizzie McNamara, Senior Management Consultant at Minnesota’s Management Analysis and Development Unit in MMB, and Peter Larson, Training and Communications Specialist with the DHS Adult Protection Unit, presented and recorded via Webex an Informational update regarding the Vulnerable Adult Act Redesign project for APS. (Transcript  PDF) The presentation outlines context for the VAA Redesign project, reviews the stakeholder engagement process and recommendations that were developed, and frames next steps in the VAA Redesign project.

The recorded presentation will be available online until Wednesday, December 23, 2020. 

Please contact us with questions or comments at VAARedesign.dhs@state.mn.us. 

The Vulnerable Adult Act (VAA) Redesign focuses on outcomes and service response offerings for vulnerable adults served in our state supported, county administered adult protective services (APS) system. The goal of the VAA Redesign is to improve the policy framework such that Minnesota uses a more person-centered approach and that adults who are vulnerable to abuse, neglect and financial exploitation experience equity, dignity and consistent outcomes from adult protective services regardless of the county they live in.

We are grateful to the over 260 stakeholders who engaged with us in Phases 1 and 2 of re-envisioning the Vulnerable Adult Act, and to Minnesota Management and Budget, Management Analysis and Development for their consultation on this project. Stakeholders who dedicated their time and shared their values, perspectives, and expertise included folks representing the public, multiple agencies, and a wide group of organizations including state and national leaders, advocacy and social service organizations, ombudsman, law enforcement, city and county attorneys, the court, providers, tribal agencies, and over 20 counties.  

All stakeholders shared the same goal: improving our state’s response to vulnerable adults who are reported to the DHS Minnesota Adult Abuse Reporting Center (MAARC) as abused, neglected or exploited. Stakeholder support for the DHS operated Minnesota Adult Abuse Reporting Center (MAARC) affirmed the vision of stakeholders and law makers in 2012 who acted to simplify and centralize the reporting system for suspected maltreatment, both for mandated reporters and the public.  

The clearest messages received from stakeholders include: Minnesota’s system of protection for vulnerable adults lacks consistency across the state, as vulnerable adults receive a different response depending on the county responsible; the lack of a stable funding system contributes to inequities in service response; the balance needs to shift from a focus on investigation and blame to a person-centered assessment and engagement with the vulnerable adult and their chosen supports for a response that supports safety and prevention; an investigatory response is especially counterproductive in situations of self-neglect; there is a service gap when people who do not meet the statutory definition of a vulnerable adult or an event does not meet the statutory definition of maltreatment enter our system through the MAARC report door; resources are needed for APS to support vulnerable adults in ways other than a restrictive guardianship; the adult protection system needs an improved sensitivity to culture and must address racial inequity.

The Redesign left us with a few unanswered questions that will need further exploration. Remaining questions include: how to balance privacy and choice with protection of the vulnerable person; how to improve equity in a system where the social service and law enforcement response are combined; what amount of funding is needed to improve prevention and service response; what steps are needed to improve equity in the system.  

Where are we going?

The over 60 stakeholder recommendations that resulted from the Redesign will take Minnesota’s adult protection system to the next level of a person-centered response to MAARC reports

Stakeholder solutions are being reviewed for policy and budget implications. DHS is analyzing which solutions will require statutory changes and which solutions can be implemented through the state’s existing role in Minnesota’s state supervised, county administered adult protection system. DHS is also conducting analysis of budget implications for stakeholder recommended solutions. DHS will work with stakeholders to develop and move forward proposals for legislative policy makers consistent with highly supported stakeholder solutions.  

DHS estimates a multi-year implementation and evaluation plan for the VAA Redesign.

Phase 1 Review APS National Models and Best Practices (2019)
Phase 2 Stakeholder Engagement Recommendations (2020) 
Phase 3 Policy Analysis/Proposal Budget Analysis (2021) 
Phase 4 Phased Policy and Budget Proposals (2021-23) 
Phase 5 Outcome Evaluation (2024-25)

Updates will be posted.