Waiver Reimagine

Waiver Reimagine is the name of ongoing work DHS is doing to make system-level improvements to Minnesota’s four disability waiver programs. For people who receive services and families, the Waiver Reimagine project will:

Make it easier for people and families to describe the services they want
Provide information about services and budgets to give people more choice and control over planning services and supports
Provide equitable access to services and funding across waiver programs regardless of disability and in which county or tribal nation a person lives
Increase options to self-direct services, use technology and remote supports as alternative support options

Phase 2
Advisory Committee
History
Resources
FAQ

Phase 2

During the 2021 first special session, the Minnesota Legislature authorized DHS to begin the next phase of the Waiver Reimagine project to support and expand informed choices and informed decision making by:
- Reshaping the four current disability waiver programs into a two-waiver structure
- Moving people who use disability waivers to individualized budgets
- Increasing access to and options for self-directed services
- Developing a web-based online support-planning tool for people with disabilities and their families. The tool will provide information about their assessment, support plan, services, budgets and resources to help them plan for services.
Public engagement

DHS will continue consulting with people who receive services and other interested parties over the next several years on different aspects of the project. We will notify people who receive services and other interested parties about specific engagement opportunities as they are available.

As part of the Phase 2 authorization, the Legislature created the Waiver Reimagine Advisory Committee.

Project timelines

In addition to the ongoing policy and system development already under way to support Phase 2, DHS plans to complete the following work:
- 2022 – Launch the Waiver Reimagine Advisory Committee: Continued engagement of interested parties and policy development.
- 2023 – MnCHOICES revision launches: Continued engagement of interested parties and policy development focused on budget exceptions, self-direction policy, and lead agency (county and Tribal Nation) waiver budget management
- 2024 – Gather public comment on two new waiver plans: Submit federal 1915c waiver plans to Centers for Medicare & Medicaid Services for two new waivers. Gather updated service and assessment data, including the MnCHOICES revision.
- 2025 – Continue to analyze MnCHOICES and MMIS data to update individual budget methodology. Work with the Centers for Medicare & Medicaid Services for waiver plan approval.
- 2026 – Waiver Reimagine Phase 2 launches on a rolling basis at a person’s reassessment, starting Jan. 1, 2026.
Waiver Reimagine Advisory Committee

The Waiver Reimagine Advisory Committee will provide feedback and help to develop several proposed plans for Waiver Reimagine. The WRAC will start meeting in early 2022. The meetings will be held virtually every other month for a total of six meetings per year. For more information or to apply to join the committee, visit the Waiver Reimagine Advisory Committee webpage.
History

2017-2018
- The 2017 Minnesota Legislature required DHS to conduct two studies to identify efficiencies, simplifications and improvements to the four home and community-based service (HCBS) waiver programs for people with disabilities. For information about these studies, visit Waiver Reimagine reports.
2019-2020
- The 2019 Minnesota Legislature authorized DHS to make system-level improvements to Minnesota’s disability waiver programs in a two-phase process to implement Waiver Reimagine changes, starting with creating common services across all disability waivers. The federal Centers for Medicare & Medicaid Services approved the waiver amendments to simplify and streamline the service menu.
- DHS also conducted further research and analysis, developed policy recommendations and consulted with interested parties to help plan Phase 2 of Waiver Reimagine. DHS included these findings in a report to the Legislature, Waiver Reimagine – Phase 1 Service Streamline and Phase 2 Recommendations for Reshaping Waivers and Individualized Budgets (PDF) (January 2021).
2021
- The simplified/common service menu became available in January 2021
- During the 2021 1st Special Session, the Minnesota Legislature authorized DHS to implement Phase 2 of the Waiver Reimagine project, which includes reshaping the four current disability waivers into a two-waiver structure and transitioning to individualized budgets.
Waiver Reimagine Phase 1 (completed)

The first phase streamlined and simplified the waiver service menu across the four waivers.

The simplified menu became available in January 2021. It combines 12 previous services into six new options. People will receive these new services on a rolling basis, either as part of their annual reassessment or during a service change. With the completion of the first phase, the system is now prepared for the second phase.

Phase 1 information and resources
For more Waiver Reimagine information and resources, click the Resources tab above.
Resources

DHS has published the findings from the Waiver Reimagine project in the Waiver Reimagine Project Legislative Report (PDF). This report is the summary of the work done during 2018. The report presents a complete picture of the recommendations for both the individual budget and waiver reconfiguration studies. Below you will find more detailed reports on the work that was done throughout the study that ultimately resulted in the recommendations included in the legislative reports, organized by study.

The 2019 Minnesota Legislature asked DHS to conduct further research, analysis and stakeholder engagement for implementing the second phase of Waiver Reimagine. DHS included these findings in a report to the Legislature, Waiver Reimagine – Phase 1 Service Streamline and Phase 2 Recommendations for Reshaping Waivers and Individualized Budgets (PDF) (January 2021)

We will add more resources to this page as they are completed.
- 2020 Waiver Reimagine Communications and Engagement Summary Report, DHS-7841C (PDF): Explanation of Phase 1 of Waiver Reimagine and the feedback about the project from interested parties around Minnesota.
- December 2020 presentation: A System that Works Better for People (PDF): Presentation that explains the Waiver Reimagine project.
Individual budgeting
- Analysis of Budget Methodologies & Research Into Other State Activities: a comparison of budget model types and how they are used in other states (PDF) (4/16/18): Human Services Research Institute (HSRI) report of research into both Minnesota’s consumer-directed community supports budget methodology and individual budget methodologies used elsewhere.
- Analysis of MnCHOICES: report of analysis of MnCHOICES user data (PDF) (4/30/18): HSRI report of results from the analysis of MnCHOICES data.
- Budget Methodology Proposal: plan to develop the budget methodology (PDF) (5/31/18): HSRI proposal for Minnesota individual budget methodology.
- Review of Implementation Needs: implementation strategy for a new budget methodology (PDF) (5/31/18): HSRI report of individual budget implementation needs.
- Analysis of Service Use and Spending: a report of analysis on service utilization and cost for current waiver participants & four sets of utilization tables (PDF) (9/9/18): HSRI report of analysis for current use and spending patterns.
- Development of the Preliminary Support Range Framework: budget range descriptions as developed with expert panel (PDF) (10/1/18): HSRI proposal of support range frameworks.
- Development of the Preliminary Support Range Framework (PDF) (10/15/18): HSRI proposal of support range descriptions.
- Individual Budgeting Fiscal Impact Report: report on analysis of the fiscal impact of the budget methodology recommendations (PDF) (12/28/18): HSRI report of the fiscal impacts of the proposed individual budget model.
Waiver reconfiguration
- Analysis of Federal Authorities & Research Into Other State Activities: A Comparison of Waiver Authorities and Structure, and How They Are Used in Other States (PDF) (4/13/18): HSRI report of Medicaid history and home and community-based services (HCBS) authorities. Includes findings from six other states about how they deliver long-term services and supports based on their goals.
- HSRI report on Stakeholder Focused Discussions: A summary of the Stakeholder Engagement Effort (PDF) (6/4/18): Background and findings from discussions with interested parties about current experiences with home and community-based services in Minnesota.
- Feasibility & Recommendation Report: reconfiguration options and preliminary recommendation (PDF) (9/14/18): HSRI report on the research and review of Minnesota’s four current disability waivers (DD, CADI, CAC and BI) with reconfiguration options and recommendation.
- Waiver Transition Report: a plan and additional considerations for waiver implementation (PDF) (10/19/18): HSRI report on consolidation of four waivers into two based on living setting and how to achieve this goal.
FAQ

Waiver Reimagine aims to simplify the disability waiver system and create more options for people who use disability waiver services and their families.

For questions and answers about waiver services and Waiver Reimagine, visit the Waiver Reimagine frequently asked questions page.