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Waiver Reimagine October feedback event summary: Improving and expanding access to self-directed services

Waiver Reimagine October feedback event summary: Improving and expanding access to self-directed services

Waiver Reimagine is a project that aims to improve and simplify services for people in Minnesota who use disability waivers. For more background information on Waiver Reimagine, go to:

Input from people with disabilities who access waivers and their families, as well as counties, tribal nations, providers and advocates has and will continue to inform Waiver Reimagines goals and the project’s course. The Minnesota Department of Human Services (DHS) is hosting a series of online events between August and November 2020 to gather feedback about specific parts of the project. The following October event summary is the third in a series of topic briefs that explore key Waiver Reimagine improvements. This page:

  • Provides information about the October event topic: Improving and expanding access to self-directed services
  • Documents input DHS received on the future of self-directed services
  • Describes how DHS will put the input/feedback we gathered into action.

Summary of the October event

During the October event, DHS shared plans for the future of self-direction in Minnesota. We asked participants for feedback on how we should expand access to self-directed services and make them easier to use.

Event participants shared that they want a self-direction program that is:

  • Available to everyone who accesses waivers
  • Inclusive of many (if not all) services
  • Consistently administered
  • Easy to understand through policy and resources.

DHS will use the information participants shared to:

  • Identify the types of supports that would be available for self-direction
  • Develop tools and resources to help people more easily access self-directed services
  • Improve clarity and consistency in how self-directed services are administered.

Background

During the next couple of years, Minnesota seeks to reshape the current disability waiver system from four waivers into two waivers, creating a “two-waiver system.” The two-waiver system would center on where people live and receive services instead of a diagnosis. In the new system, the option to self-direct services would be expanded to all people who use waiver services, regardless of where they live.

Right now, consumer directed community supports (CDCS), is the only self-directed option under the four current disability waivers. CDCS gives people who live independently or with family the option to employ their service providers and decide how their budget is used. People who live in group/shared living arrangements like family foster care, corporate foster care and customized living cannot self-direct any of their services.

As DHS prepares to expand the option to self-direct services to everyone, we are exploring which services people who live in group/shared living arrangements would be able to self-direct and how these options would compare to those of people who live independently or with family. We also are planning additional opportunities for people to mix and match services to best fit their needs.

These changes would:

  • Empower people with greater choice and control over their services
  • Increase flexibility and opportunities for people to design the services that are right for them
  • Provide equity to people across waiver programs.

Expanding access to self-direction will require state legislative and federal approval. Your ideas and input will shape our plans and recommendations as we design the changes. There will be many more opportunities to provide input and stay engaged.

Event specifics

In October, we asked participants to share their ideas for improving and expanding access to self-direction. Participants gave input by filling out a pre-event input form and/or joining the two online feedback events. To recruit participants, we posted information about the input form and events on the Waiver Reimagine page and notified potential participants through a DHS Disability Services Division eList announcement. DHS, along with our communication partner, The Improve Group, also conducted direct outreach from Sept. 28-Oct. 5, 2020, to those who had previously expressed interest in joining Waiver Reimagine feedback events.

The pre-event input form received 146 responses from Sept. 28-Oct. 5, 2020. About 60 percent of respondents were representatives of service providers, lead agencies and advocacy organizations. Forty percent were people who access services, family members, member of the public or people who didn’t identify a role.

Those interested also had the option to register for one of two online feedback sessions held on Oct. 12, 2020, and Oct. 13, 2020. There were 65 participants between the two events: 35 attended the first session and 30 joined the second session. A mix of stakeholders attended each event. People who access services and their family members made up at least half of the participants at both sessions. Of the 37 people accessing services and their family members who participated, three-quarters indicated that they or their family member currently use CDCS. Registrations from people and families were prioritized and participants were selected to ensure representation from all regions of Minnesota.

During each session, DHS staff briefly shared information about our goals for improving and expanding access to self-direction and answered participants’ questions about the changes. Participants joined small groups to provide input on:

  • Ideas to reshape self-directed services
  • What supports are needed to help people self-direct services
  • What prevents people from self-directing services
  • Which services should be available for people to self-direct when they live in shared/group living arrangements.

A recording of the event presentation and question-and-answer sessions is available to view until March 31, 2021.

Findings

Event participants shared their thoughts about how DHS should expand access to self-directed services and make them easier to use. Participants envision:

  • A self-direction program that is easy to understand, simple to navigate and inclusive of many (if not all) services
  • A program that is clearly and consistently administered, while still offering opportunities for person-centered flexibility
  • Additional support to access self-direction, including user-friendly tools and resources and lead agency staff who are well-trained in the program and how to administer it.

Event participants appreciate DHS’ plans to expand access to self-direction and felt that the changes could increase individualization and person-centeredness. They also shared factors DHS should consider in developing the changes, including concerns about potential unintended consequences, challenges in accessing services and the need for more information.

This aligns with findings from the pre-event input form. While most respondents believe that all people should have the option to self-direct services, they noted that confusion and lack of necessary information about self-direction is a barrier to access.

Using participant feedback

DHS will use the information participants shared to inform policy decisions as we work to expand and improve self-directed service options. More specifically, we plan to use the participant feedback to:

  • Identify the types of supports that would be available for self-direction
  • Create tools and resources to make self-directed services simpler and easier for more people to access
  • Make the administration of self-directed services more clear and consistent across Minnesota
  • Offer additional opportunities to provide input on self-directed services.

Additional resources

Continued feedback will influence how we carry out and communicate about Waiver Reimagine. We hope more participants join us to provide input during future feedback events. To learn more about the project and the events:

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