2003: Legislature Changes the Way Medicaid Waiver Payments are Made to Counties
In January 2003, Minnesota is in the midst of a budget crisis.
In order to control spending increases, the state began basing its DD Waiver allocations on spending from the prior year. The Department of Human Services adopted a process known as "rebasing, which essentially bases next year's budget on last year's expenses, plus an adjustment for inflation and other cost factors.
- Initially, this change reduced DD Waiver funds that counties could spend by $55 million (which was eventually reduced to $16 million).
- Also, the 2003 Legislature made counties responsible for funding any spending in excess of their allocation amounts.
These changes were designed to ensure that spending would stay within the state budget by reducing the flexibility counties had to increase their spending.

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