Waiver Reimagine September feedback event summary: Reshaping the disability waivers – What influences a person’s choice about where they live?
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 Reimagine’s 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 is a summary of the September event. It is the second in a series of topic briefs that will explore key Waiver Reimagine improvements.
- Provides information about the September event topic: Reshaping the disability waivers
- Documents input DHS received on who makes decisions about where people live and what influences those choices
- Describes how DHS will put the input/feedback we gathered into action.
Summary of the September event
During the September event, we shared plans to reshape the disability waivers. We also asked participants for input on who makes decisions about where people live and what influences those choices.
Event participants identified several factors that guide choices about where people live. The factors range from what the person wants, to a person’s safety, to the affordability of housing options.
DHS will use what we learned to help guide how we:
- Develop and carry out the waiver reconfiguration
- Identify housing choice-related topics to explore in greater detail
- Connect people to relevant existing resources.
During the next couple of years, Minnesota seeks to reshape the current disability waiver system from four waivers into two waivers. The new two-waiver system would center on where people live and receive services instead of their diagnosis.
Right now, a person’s diagnosis or required level of care determines their eligibility for one of the four current disability waivers:
- Brain Injury (BI)
- Community Alternative Care (CAC)
- Community Access for Disability Inclusion (CADI)
- Developmental Disabilities (DD).
Basing the waivers on living setting will make the system easier to understand and use because:
- People who live independently or with family will use the Individual Support Waiver.
- People who live in a group/shared living arrangement will use the Residential Support Waiver.
This change will:
- Simplify the waiver system while maintaining current levels of care and eligibility requirements
- Help people access the most appropriate services and supports
- Empower people with more flexibility and control over their services
- Provide equity to people across waiver programs.
Transitioning to the two-waiver system would take several years, and it would require state legislative and federal approval. Your ideas and input will shape our plans and recommendations as we design the changes.
We asked participants during the September event to provide input on what guides choices about where people live. Participants shared their ideas by filling out a pre-event input form and/or joining the online event. To recruit participants, we posted information about the input form and event 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. 9-21, 2020, to those who had previously expressed interest in joining Waiver Reimagine feedback events.
The pre-event input form received 44 responses from Sept. 11-15, 2020. About 68 percent of respondents were representatives of service providers, lead agencies and advocacy organizations, while 32 percent were people, family members and members of the public.
Event participants had the option to register for one of two online feedback sessions held Sept. 22, 2020, and Sept. 23, 2020. There were 72 participants between the two events, with 42 attending the first session and 30 joining the second session. Representation was similar at both events: Overall, two-thirds of participants represented service providers, lead agencies and advocacy organizations; one-third were people, family members and members of the public. Participants were selected to ensure representation from all regions of Minnesota and to maximize the number of organizations that could take part. All people and families who registered were invited to attend either session.
During each session, DHS staff briefly shared information about our goals for the two-waiver system and answered participants’ questions about the improvements. To help inform plans to reshape the waivers, participants joined small groups to provide input on the factors that influence people’s choices about where they live and to discuss two fictional scenarios to explore decision-making around housing. A recording of the presentation shared at the event sessions is available to view until March 31, 2021.
Event participants’ input fell into 10 categories (or factors) to consider in deciding where people live. These factors — and their interconnections — will inform how DHS designs the Individual Support and Residential Support waivers and how people access them:
- What the person wants.
- A desire for multiple housing choices that offer flexible and creative combinations of services and supports.
- A person’s safety.
- A person’s independence and how they define it.
- The ability to access quality care.
- A person’s desire and ability to live with family.
- Opportunities to socialize and a person’s compatibility with any housemates.
- The availability of community connections and friends and family who support the person.
- Life changes that cause a person to re-examine their wants and needs.
- Affordability of housing options.
Key findings from the pre-event input form responses include:
- Among people and their family members, most said family members decided where people live.
- Advocates, lead agency employees and service providers most frequently said that legal representatives and/or people decide where people live.
- People and their family members value support for daily living needs, safety and regular opportunities to be involved with the community when deciding where people should live.
- Advocates, lead agency employees and service providers said access to transportation, support for daily living needs and housing costs are most important to the people they support in deciding where to live.
Using participant feedback
DHS will draw on the decision-making factors that participants shared to inform how we reshape the disability waivers, identify housing-related topics to explore in greater detail and connect people to relevant existing resources. We plan to use participant feedback to:
- Help us reshape the waivers, create the process to determine which waiver is right for a person and identify how people will be able to move between the new waivers. This will include developing new policies to support the changes.
- Identify topics related to housing choices to explore in greater detail based on what we learned
- Connect people to existing DHS resources and efforts relevant to the factors participants identified as important in choosing where to live.
- Offer more opportunities during the next couple of years to provide input on Waiver Reimagine, including plans to reshape the waivers.
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: