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With An Eye to the Future

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Olmstead Plan Chronology

Department of Administration Governor's Council on Developmental Disabilities
July 1, 2019

2019

January 4, 2019

The OIO released a plain language report on the Minnesota Olmstead Plan Review 2015–2018. This document provided answers to the following questions in plain language:

  • What is the Minnesota Olmstead Plan?
  • What is person-centered planning?
  • What is the Olmstead Implementation Office (OIO)?
  • What does the OIO report say about the Minnesota Olmstead Plan?
  • What is Minnesota still working on?
  • How do I learn more about the Minnesota Olmstead Plan and the 2015–18 report?
  • How can I contact the OIO with questions?

January 8, 2019

The OIO released a plain language report titled What's In The Minnesota Olmstead Plan. This report provides information on the history of the Plan, the purpose of the Olmstead Subcabinet, the goals in each of the thirteen topic areas included in the Plan, and next steps.

The 2018 Strategic Review of the Olmstead Plan, which was accepted by the Subcabinet on September 24, 2018, was also updated and released. This performance improvement process reviewed Plan implementation from September 2015 through August 2018. Examining Plan implementation over a three-year period allowed for identification of significant accomplishments in measurable goals and strategies and associated workplans. Most importantly, the review identified the progress or lack of progress on measurable goals that relate to the improvement in the lives of people with disabilities. The report is organized into the thirteen topic areas included in the Olmstead Plan. Each topic area includes the measurable goals in that area and the status of each goal based on performance to date. Goals are identified as having achieved the overall goal, making progress toward the overall goal, or needing improvement to reach the overall goal. Some goals are identified as in process. This means there is not yet two years of data to determine progress, or that data is not yet available to determine progress. At the time the report was released, 8 goals were achieved, 14 goals were making progress toward the overall goal, 7 goals needed improvement, and 19 goals were in process. Also included in each topic area is a review of major accomplishments achieved through the workplan implementation. This report also identifies areas of consideration where more progress could be made through changes in workplans, strategies, or measurable goals. Lessons learned from this review may be applied during the Olmstead Plan amendment process occurring from December 2018 through March 2019.

January 28, 2019

This was the first Subcabinet meeting under newly elected Governor Tim Walz. Commissioner Jennifer Ho (MHFA) was introduced as the new Olmstead Subcabinet Chair (formally announced by Governor Walz on January 25, 2019); this was her first Subcabinet meeting. Additionally, it was announced that the Subcabinet would continue to operate under Executive Order 15-03. It was also noted the court retained jurisdiction over the Plan until December 2019.

The Olmstead Plan Quality of Life Survey: First Follow-Up – 2018 was reviewed again by the Subcabinet and accepted. Updates to this report included subgroup analyses and regression tables. For additional details on this report, see page 21 of the January 28, 2019 meeting materials. The final report can be found here, and a two-page summary of the report can be found here.

February 22, 2019

The OIO released a three-page summary of 2019 draft amendments. The purpose of this document was to provide a brief summary of the draft amendments being proposed by Subcabinet agencies to inform additional public comment (held from February 26th to March 11th).

February 25, 2019

It was noted during the Subcabinet meeting that Governor Walz's budget was released on February 19th. Commissioner Ho also discussed a request to commissioners to provide a brief overview of agency budget proposals that relate to the implementation of the Olmstead Plan at the March Subcabinet meeting.

The Subcabinet reviewed and approved the February quarterly report, including data acquired through January 31, 2019. This report included progress toward goals related to:

  • Movement of people with disabilities from segregated to integrated settings (n=610).
  • Movement of individuals from waiting lists.
  • Quality of Life measurement results.
  • Increasing system capacity and options for integration.

Two-thirds of Olmstead Plan measurable goals (15 of 24) were met, on track to be met, or in process. Notable successes included:

  • During the last four quarters, 150 individuals left ICF/DD programs for more-integrated settings. This exceeded the annual goal of 72 (Transition Services Goal One A).
  • During the last four quarters, 830 individuals with disabilities under age 65 in a nursing facility longer than 90 days moved to more integrated settings. This exceeded the annual goal of 740 (Transition Services Goal One B).
  • During the last four quarters, 1,188 individuals moved from other segregated settings to more integrated settings. This exceeded the annual goal of 500 (Transition Services Goal One C).
  • The utilization of the Person Centered Protocols improved over the last four quarters. Of the eight person-centered elements measured in the protocols, performance on seven of the eight elements improved over the 2017 baseline. Five of the eight elements show progress over the previous quarter, and six of the eight were at 90 percent or greater in this quarter (Person-Centered Planning Goal One).
  • There were fewer individuals waiting for access to a DD waiver. At the end of the current quarter 74 percent of individuals were approved for funding within 45 days. Another 23 percent had funding approved after 45 days.
    There was an increase in the number of individuals obtaining competitive integrated employment. More than 2,682 individuals found employment. This was short of the annual goal of 3,028 (Employment Goal One).
  • There was an increase in the number of peer support specialists who were employed. There were 76 peer support specialists employed. This was an increase of 60, which exceeded the annual goal to increase by 30 (Employment Goal Four).
  • There was an increase in the number and percentage of students with disabilities in the most integrated setting (Education Goal One).
  • Accessibility improvements were made to 1,658 curb ramps, 85 accessible pedestrian signals, and 28.34 miles of sidewalks in the last year (Transportation Goal One).

Measurable goals targeted for improvement included:

  • Transition Services Goal Two, to decrease the percentage of people at AMRTC who no longer meet hospital level of care and are currently awaiting discharge to the most integrated setting to ≤ 30 percent by June 30, 2019.
    • AMRTC continued to serve a large number of individuals who no longer need hospital level of care, including those under a mental health commitment and those who need competency restoration services. In the last quarter, over 60 percent of admissions to AMRTC were patients who were committed after a finding of incompetency. During this last quarter there was a higher percentage of individuals awaiting discharge who were civilly committed after being found incompetent (41.6 percent) than for those under mental health commitment (35.3 percent). This was a change in trend from all previous reporting periods, in which the reverse was true. AMRTC continued to work with courts around the state on approving DHS discharges and transfers; however, this continued to be a barrier to discharge for individuals civilly committed after being found incompetent. The planned responses to meet, or be on track to meet, this goal remained unchanged from the November 2018 quarterly report.
  • Transition Services Goal Three, to increase the average monthly number of individuals leaving the MSH for a more integrated setting to ≥ 9 by December 31, 2019.
    • The planned responses to meet, or be on track to meet, this goal remained unchanged from the November 2018 quarterly report.
  • Transition Services Goal Four, to increase the percent of individuals' transition plans that meet the required person-centered, informed choice and transition protocol to 100 percent.
    • In January 2018, Lead Agency Review began requiring lead agencies to remediate missing or non-compliant person-centered review protocols. When findings from case file review indicated files did not contain all required documentation, the agency was required to bring all cases into full compliance by obtaining or correcting the documentation. Corrective action plans will be required when patterns of noncompliance are evident. Because the move occurred prior to the Lead Agency site review, transition measures related to the contents of the My Move Plan Summary cannot be remediated. However, Lead Agencies were provided information about which components of the My Move Plan were compliant/non-compliant for each of the transition cases that were reviewed.
  • Positive Supports Three, to reduce the number of reports of emergency use of mechanical restraints with approved individuals to no more than 93 reports and 7 individuals by December 31, 2019.
    • The planned responses to meet, or be on track to meet, this goal remained unchanged from the November 2018 quarterly report.
  • Positive Supports Four, to reduce the number of students experiencing emergency use of restrictive procedures and the number of incidents of emergency use of restrictive procedures by 80 students or 0.02 percent of the total number of students receiving special education services by June 30, 2018.
    • For data reliability purposes, the student enrollment data was based on the state enrollment counts for students receiving special education services. It is worth noting that MDE does not have the ability to cross check the districts' reporting of students experiencing the use of physical holds with the quarterly reporting of students experiencing the use of seclusion. Accordingly, a student may be counted more than once if they are both physically held and secluded. In addition, a student may be counted more than once if they move to another district and are physically held in both districts during the same school year. Data on the staff development work activities and outcomes is described in more detail in the 2019 Restrictive Procedures Workgroup Legislative Report. Multiple districts reported a reduction in the use of restrictive procedures after implementing professional development grant activities over the 2016–17 and 2017–18 school years. For the 2017–18 school year, while the use of physical holding increased, the use of seclusion decreased by 11.6 percent and the number of students experiencing the use of a seclusion decreased by 15.1 percent. To improve data consistency and quality, MDE updated the seclusion reporting form based upon feedback from the 2018 Restrictive Procedures Workgroup. In addition, MDE conducted 12 trainings throughout the state to assist districts in understanding restrictive procedure laws and to assist them in developing processes to have more consistent understanding of terms and reporting. MDE also hired a data analyst in September of 2018, and her duties include analysis of restrictive procedures data. Data quality improvements also included a transition to improved software for data analysis.
    • The 2018 Restrictive Procedures Workgroup reached consensus on a revised statewide plan, which included specific targets to reduce the use of seclusion and number of students experiencing the use of seclusion in the school setting. In addition, the revised plan included stakeholder support and goals for recommendations to the commissioner and the legislature in three areas: funding for staff development grants, expansion of mental health services, and additional funding for technical assistance. These recommendations address identified needs for improved availability of mental health services across the state; improving staff capacity to implement evidence-based practices/positive supports; and providing time for staff to meet and discuss student needs related to reducing emergencies that result in the use of a restrictive procedure.
      • It was noted during the Subcabinet meeting that the Restrictive Procedure Workgroup reached consensus among school districts and advocates on the measurable targets for reduction of use of seclusion in educational settings, which should help in holding school districts accountable and in reaching goals for the coming year.
  • Positive Supports Five, to reduce the number of students experiencing emergency use of restrictive procedures and the number of incidents of emergency use of restrictive procedures by 563 incidents or 0.2 incidents of restrictive procedures per student who experienced the use of restrictive procedure by June 30, 2018.
    • See planned responses under Positive Supports Four.
  • Crisis Services One and Two, to increase the percentage of children and adults who remain in the community after a crisis episode to 85 percent or more for children and 64 percent or more for adults by June 30, 2018.
    • There has been an overall increase in the number of episodes of children receiving mental health crisis services, with likely more children being seen by crisis teams. In particular, the number of children receiving treatment services after their mental health crisis has increased by more than 30 percent since baseline and by almost 50 percent since December of 2016. While children remaining in the community after crisis is preferred, it is important for children to receive the level of care necessary to meet their needs at the time.
    • DHS will continue to work with mobile crisis teams to identify training opportunities for serving individuals in crisis, and to support the teams as they continue to support more individuals with complex conditions and living situations. Mobile crisis teams focus on minimizing disruption in the life of an individual during a crisis. This is done by utilizing an individual's natural supports that already exist in their home or community whenever possible. It is important for the individual to receive the most appropriate level of care. Sometimes that can be in the community and sometimes that may be a higher level of care. A higher level of care should not necessarily be perceived as negative if it is the appropriate level of care. There is no way to predict who will need which level of care at any given time or why. Having an assessment from the mobile crisis team will increase the likelihood that the person has the opportunity to be assessed and have a plan developed that will help them stay in the most integrated setting possible. DHS has worked with mobile crisis teams to identify training opportunities that would help increase their capacity to address the complexities they are seeing and has committed to providing trainings in identified areas specific to crisis response. This increases the teams' ability to work with individuals with complex conditions/situations effectively. DHS will continue to work with providers to explore trends that might be contributing to children presenting in crisis with the need for a higher level of care.

In addition to the quarterly report, the Subcabinet reviewed the process used to solicit public input on the Plan, the Report on Public Input Themes and Agency Responses, and how the comments received compared with those received in 2016, 2017, and 2018. It was noted that comments received include two types of themes:

  • Themes that relate to topic areas in the Plan
  • Themes that relate to topics not currently addressed in the Plan (i.e., guardianship and public safety)

Commissioner Ho proposed that white papers be drafted on the issues of guardianship and public safety. However, it was suggested that a review of existing materials around these topics be conducted before preparing white papers. The Subcabinet agreed that findings from a review of existing materials would be presented at the March 25th meeting.

Additionally, agencies provided a brief summary of the proposed changes to the Plan and any modifications from the December 2018 drafts. The Subcabinet provisionally accepted the amendments to the Plan, pending final public comment.

February 26, 2019

Draft proposed amendments to the Olmstead Plan's measurable goals were released, which show changes to the original language in the Plan based on the first round of public comment (December 20, 2018–January 31, 2019). These amendments were provisionally accepted by the Subcabinet on February 25, 2019, pending a final public comment period from February 26 to March 11, 2019. The Subcabinet planned to review the Olmstead Plan amendments for final approval at the March 25, 2019, Subcabinet meeting.

March 25, 2019

It was noted at the Olmstead Subcabinet meeting that the revised Plan was to be filed with the court by the end of March. Additionally, a status conference with Senior US District Court Judge Donovan Frank was scheduled for April 16th to review the status of the Plan and reports that had been filed with the court since the last status conference in July 2018. It was also reiterated that the 2015 Executive Order under which the Subcabinet operates would expire on April 7th and that the Governor's Office was in the process of developing a new executive order.

The Subcabinet reviewed current practices around guardianship at the national and state level. It was noted that there is tension between the Americans with Disabilities Act choice and integration mandates and the current application of guardianship. It was suggested that the Plan could align with existing efforts in reinforcing guardianship, including:

  • DHS collaboration with Working Interdisciplinary Network of Guardianship Stakeholders (WINGS) in publishing a series of YouTube videos about why giving people the ability to choose actually improves quality of life and improves their safety.
  • Volunteers of America sponsoring training on alternative decision-making models and increasing awareness.

Public input themes and agency responses were also reviewed by the Subcabinet. The public comment period yielded more than 49 comments from approximately 41 people with disabilities, families, supporters, lead agencies, and providers. It was noted that the majority of comments received were focused on issues that were already included in the Olmstead Plan workplans or could be added to the workplans. The March 2019 revision of the Plan was reviewed by the Subcabinet and approved with agreed-upon edits (below), to be filed with the court by March 29th:

  • Adjusting Lifelong Learning and Education Strategy Goal One
  • A new letter from the chair
  • Changes related to a new executive order
  • No changes to the vision statement
  • No changes to person-centered planning
  • Strategy language on "diversify [workforce]" or topic of barriers

Each commissioner provided a brief overview of their agency's budget proposals as they relate to the implementation of the Plan, in light of Governor Walz's budget being released on February 19th. Details of those proposals can be found on page 6 of the March 25, 2019, meeting minutes.

March 29, 2019

Governor Walz issued Executive Order 19-13, which ordered the following:

  • That a Subcabinet, to implement Minnesota's Olmstead Plan is constituted of the following members:
    • The Ombudsman for the State of Minnesota Office of the Ombudsman for Mental Health and Developmental Disabilities
    • Executive Director of the Minnesota Governor's Council on Developmental Disabilities
  • The Chair, Commissioner, or Chair's or Commissioner's designee of the following agencies:
    • Department of Human Services
    • Housing Finance Agency
    • Department of Employment and Economic Development
    • Department of Transportation
    • Department of Corrections
    • Department of Health
    • Department of Human Rights
    • Department of Education
    • Department of Veterans Affairs
    • Department of Public Safety
    • Metropolitan Council
  • The Governor will designate one of the members of the Subcabinet to serve as chair.
  • The Subcabinet will allocate such resources as it deems to be reasonably necessary, including retention of expert consultants, and consult with other entities and State agencies, when appropriate, to carry out its work.
  • The duties of the Subcabinet are to:
    • Work to identify and address barriers to providing services and meaningful opportunities within the most integrated settings for persons with disabilities throughout Minnesota.
    • Work to identify and address areas of disparity in opportunities for individuals with disabilities to live, work, and engage in the most integrated settings.
    • Engage communities with the greatest disparities in health outcomes for individuals with disabilities and work to identify and address barriers to equitable health outcomes.
    • Provide oversight for and monitor the implementation and amendment of the Olmstead Plan and the impact of the Plan on the lives of people with disabilities.
    • Provide ongoing recommendations for further amendment of the Olmstead Plan.
    • Ensure interagency coordination of the Olmstead Plan implementation and amendment process.
    • Convene periodic public meetings to engage the public regarding Olmstead Plan implementation and amendments.
    • Engage persons with disabilities and other interested parties in Olmstead Plan implementation and amendment process and develop tools to keep these individuals aware of the progress on the Plan.
    • Continue to implement the Quality of Life survey process to measure the quality of life of people with disabilities over time and continue to identify and implement quality improvement strategies.
    • Convene, as appropriate, workgroups consisting of people with disabilities, families of people with disabilities, advocacy organizations, service, treatment, and health care providers, and/or governmental entities of all levels that are both members, and nonmembers, of the Subcabinet.
  • The OIO will carry out the responsibilities assigned by the Subcabinet, as directed by the Chair of the Subcabinet.
  • The Subcabinet will maintain procedures to ensure that they define a clear decision-making process, facilitate execution of the Subcabinet's duties, and appropriately define the role of the OIO and revise such procedures as necessary.
  • The OIO will provide staffing and administrative support to the Subcabinet.
  • Executive Order 15-03 is rescinded.

Additionally, the 2019 Olmstead Plan was released. Shortly after, on March 31st, the public comments received regarding the 2019 update to the Plan (December 20, 2018–January 31, 2019, and February 26, 2019–March 11, 2019) were released.

April 22, 2019

At the start of this Subcabinet meeting, Commissioner Ho noted that it was the first meeting under new Executive Order 19-13, which reauthorized the Subcabinet and expanded its membership to include the Department of Public Safety, Department of Veterans Affairs, and the Metropolitan Council. Two other recently issued executive orders were discussed:

  • Executive Order 19-14, which provides for state agency coordination of the Americans with Disabilities Act.
  • Executive Order 19-15, which provides for increased state employment of individuals with disabilities.

It was noted that the Olmstead Plan March 2019 Revision was filed with the court by the end of March as required by the court order. The status conference with the court on April 16th was also discussed. At this meeting, Commissioner Ho provided an update to the court on Olmstead Plan implementation. This included an overview of goal areas in which progress had been made and goal areas that were targeted for improvement. The court was also informed of the Quality of Life Survey and the Olmstead Plan amendment process, including how public comments were reviewed throughout the process. The court was complimentary about the executive order, the current administration, and the trajectory and momentum it brings to Olmstead Plan implementation. The court indicated it would issue an order in the next few weeks. At the time of this meeting, jurisdiction extended through December 4, 2019, which meant that there would be three quarterly reports to be filed within that timeframe.

May 28, 2019

The March 2019 revised Olmstead Plan required a baseline to be established for Community Engagement Goal Two. During this meeting, the Olmstead Subcabinet approved the baseline for the goal, which is as follows:

  • By April 30, 2020, the (A) number of individuals with disabilities to participate in public input opportunities related to the Olmstead Plan and (B) the number of comments received by individuals with disabilities (including comments submitted on behalf of individuals with disabilities) will increase by 5 percent over baseline.

The baseline for the number of individuals who participated in public input opportunities related to the Olmstead Plan was set at 192, and the number of comments received was set at 249, based on participation in public comment for the 2019 amendment process.

The Subcabinet also reviewed and approved the May quarterly report, including data acquired through April 30, 2019. This report included progress toward goals related to:

• Movement of people with disabilities from segregated to integrated settings (n=649).

• Movement of individuals from waiting lists.

• Quality of Life measurement results.

• Increasing system capacity and options for integration.

More than three-quarters of Olmstead Plan measurable goals (11 of 14) were met, on track to be met, or in process. Notable successes included:

  • During this quarter, 48 individuals left ICF/DD programs for more integrated settings. After one quarter, 67 percent of the annual goal of 72 has been achieved. (Transition Services Goal One A)
  • During this quarter, 233 individuals with disabilities under age 65 in a nursing facility longer than 90 days moved to more integrated settings. After one quarter, 31 percent of the annual goal of 740 has been achieved. (Transition Services Goal One B)
  • During this quarter, 322 individuals moved from other segregated settings to more integrated settings. After one quarter, 64 percent of the annual goal of 500 has been achieved. (Transition Services Goal One C) Quarterly Report on Olmstead Plan Measurable Goals 4 Report Date: May 28, 2019
  • The utilization of the Person Centered Protocols has continued to improve during this quarter as indicated by the presence of eight person-centered elements in case files reviewed. Performance improved over last quarter on all eight elements. Performance on six of the eight elements was at least 90 percent and five of the eight were above 95 percent. (Person-Centered Planning Goal One)
  • There are fewer individuals waiting for access to a DD waiver. At the end of the current quarter 71 percent of individuals were approved for funding within 45 days. Another 25 percent had funding approved after 45 days. (Timeliness of Waiver Funding Goal One)
  • The number of transit service hours in Greater Minnesota increased by 169,316 over baseline during the last year. (Increasing System Capacity and Options for Integration)

Measurable goals targeted for improvement included:

  • Transition Services Goal Two to decrease the percentage of people at AMRTC who no longer meet hospital level of care and are currently awaiting discharge to the most integrated setting to ≤ 30 percent by June 30, 2019.
    • AMRTC continued to serve a large number of individuals who no longer need hospital level of care, including those under a mental health commitment and those who need competency restoration services. Those committed after a finding of incompetency accounted for approximately 50 percent of AMRTC's census in this quarter. During this quarter there was a higher percentage of individuals awaiting discharge under mental health commitment (34.8 percent) than for those who were civilly committed after being found incompetent (23.9 percent). The patient acuity and complexity of discharge planning increases as AMRTC admits more patients from community hospitals and other DHS sites. There were proposals at the legislature to establish a Community Competency Restoration Task Force to evaluate and study community competency restoration programs and develop recommendations to address the needs of individuals deemed incompetent to stand trial. This legislative proposal was approved. DHS continued to convene a cross-division, cross-administration working group to improve the timely discharge of individuals at MSH and AMRTC to identify barriers, current and future strategies, and any needed efficiencies that could be developed between AMRTC and MSH to support movement to community. Counties and community providers will be consulted and engaged in this effort as well. Annual reporting to the Olmstead Subcabinet on the status of these efforts was scheduled to begin by December 31, 2018.
  • Transition Services Goal Three to increase the average monthly number of individuals leaving the MSH for a more integrated setting to ≥ 10 by December 31, 2019.
    • The planned responses to meet, or be on track to meet, this goal remained unchanged from the November 2018 quarterly report.
  • Positive Supports Goal Three to reduce the number of reports of emergency use of mechanical restraints to no more than 93 reports by June 30, 2019.
    • The planned responses to meet, or be on track to meet, this goal remained unchanged from the November 2018 quarterly report.

June 24, 2019

The Subcabinet received updates on legislative proposals related to the priorities in the Olmstead Plan as a follow-up to the March 25, 2019, Subcabinet meeting that included an overview of legislative proposals:

  • Bridges mental health systems program received a $500,000 increase.
  • Funding was approved for Homework Starts with Home that focuses on housing stabilization for students experiencing homelessness.
  • $60 million in Housing Infrastructure Bonds was provided to build and preserve homes for people with the lowest incomes. DEED received $3.5 million per year to continue providing Vocational Rehabilitation Services.
  • MDHR did not get the budget they requested.
  • Complaints coming into MDHR have historically been around disability. This has now been surpassed by complaints related to race. They do not have information yet on the intersectionality of these complaints.
  • Legislation was passed that relates to protecting vulnerable adults. It relates to licensure and regulatory pieces for nursing homes and assisted living facilities.
  • Bills passed relating to initiatives for prevention and treatment of opioid abuse.
  • Funding was approved for suicide prevention efforts and community-based suicide prevention grants.
  • Funding and policy language were approved for the Minnesota Quitline, which is a tobacco cessation effort.
  • Bills related to clean drinking water were passed.
  • $90 million was approved for new special education funding for Minnesota public schools. Special education costs are growing faster than the funding sources. This funding should be very helpful to the school districts and should result in better services for students.
  • MDE secured a 2 percent increase in general education formula for both years of the biennium.
  • There were no legislative actions that provided any additional funding necessary for the DOT to meet the Olmstead goals.
  • A separate budget line was approved for Metro Mobility as requested by the governor. The expectation is that, at least for the first year, there will be sufficient budget to meet the demand. The service area is being expanded to include Lakeville.
  • MDVA received their base funding, which includes Minnesota Assistance Council for Veterans (MAC-V). MAC-V provides assistance to veterans and their families who are homeless or experiencing other life crises.
  • MDVA was also able to move some money internally to help veteran homelessness, specifically to help with landlord issues and veterans with multiple barriers.
  • DPS received funding for the Office of Justice program, which will support victim services for homeless individuals and people with disabilities.
  • DOC received funding to add an Ombudsman for Corrections.
  • The approved base funding for OMHDD includes a position dedicated to assisting in Olmstead and Jensen work.
  • The retained funding for GCDD includes a position dedicated to assisting in Olmstead work.
  • DHS received additional funding that has a direct impact on Olmstead work, including the following:
    • An additional $1.2 million to expand the school-linked mental health grants.
    • Certified community behavioral health clinics expanded and added to the Medicaid benefit set.
    • Funding for the competency restoration task force to determine how to more effectively transition people out of hospitals and treatment centers when that level of care is no longer needed.
    • Improvements to Minnesota Adult Abuse Reporting Center (MAARC) for vulnerable adults for an assisted living report card and for expanded grants to counties and tribes to do adult protection work.
    • The Waiver Reimagine project to streamline and simplify the disability waiver system and have a sustainable individual budgeting model.
    • Modifications for the disability waiver rate-setting framework.
    • A $32 million increase for personal care assistance wages and benefits.
    • The sunset on the provider tax did not occur. This means that funding continues for health care services.

The Subcabinet also viewed the video OIO Communications staff created in recognition of the 20th anniversary of the Olmstead decision (June 22, 2019). The video can be accessed at https://www.youtube.com/watch?v=XdqxcZn04sc.

It was noted that jurisdiction of the court, which was scheduled to end on December 4, 2019, was extended until September 2020, and that all existing reporting requirements would be kept in place until that time.

The Community Engagement Workgroup Charter, which includes the purpose of the workgroup, the scope of work, and deadlines for deliverables, was reviewed and approved. The workgroup's charter can be found on page 11 of the June 24, 2019, meeting materials.

July 22, 2019

Members discussed the direction of the Subcabinet and scope of work, considering the following:

  • Reestablishment of an Executive Committee.
  • Discussion of the focus of the Subcabinet meetings to ensure the time spent is valuable to members and increases the impact of the Plan for people with disabilities.
  • Consideration of what "outside the box" resources members could offer to enhance the work of the Plan.
  • Consideration of the frequency and time allotted for the Subcabinet meetings.

Details of the discussion can be found on page 5 of the July 22, 2019, meeting minutes. Commissioner Ho suggested a presentation at the August Subcabinet meeting on the options and recommendations about how to move the work forward. She asked members to think about who should be on the Executive Committee.

August 26, 2019

The Subcabinet reviewed and approved revisions to the Subcabinet Procedures. The revisions bring the procedures in line with the Executive Order, including the increased membership of the Subcabinet and increased duties. The revisions also reflect the expansion of the Executive Committee from three members (DHS, DEED, and MHFA) to five members (now including MDE and DOC, with invitations also extended to GCDD and OMHDD to attend meetings). Commissioner Ho said that the next step is for the Executive Committee to determine a date in September to meet and discuss recommendations regarding structure of Subcabinet meetings, and how best to move the work of the Subcabinet forward.

The Subcabinet also reviewed and approved the August quarterly report, including data acquired through July 31, 2019. This report included progress toward goals related to:

  • Movement of people with disabilities from segregated to integrated settings (n = 586).
  • Movement of individuals from waiting lists.
  • Quality of Life measurement results.
  • Increasing system capacity and options for integration.

More than half of the Olmstead Plan measurable goals (11 of 19) were met, on track to be met, or in process. Notable successes included:

  • Progress on movement of people with disabilities from segregated to integrated settings:
    • During this quarter, 66 individuals left ICF/DD programs for more integrated settings. After two quarters, the total number is 114, which exceeds the annual goal of 72. (Transition Services Goal One A)
    • During this quarter, 290 individuals with disabilities under age 65 in a nursing facility longer than 90 days moved to more integrated settings. After two quarters, 56 percent of the annual goal of 750 has been achieved. (Transition Services Goal One B)
    • During this quarter, 322 individuals moved from other segregated settings to more integrated settings. After two quarters, the total number is 612, which exceeds the annual goal of 500. (Transition Services Goal One C)
  • There are fewer individuals waiting for access to a DD waiver. At the end of the current quarter 76 percent of individuals were approved for funding within 45 days. Another 21 percent had funding approved after 45 days. (Timeliness of Waiver Funding Goal One)

Measurable goals targeted for improvement included:

  • Transition Services Goal Two to decrease the percent of people at AMRTC who no longer meet hospital level of care and are currently awaiting discharge to the most integrated setting to ≤ 30 percent by June 20, 2019.
    • AMRTC continues to serve a large number of individuals who no longer need hospital level of care, including those under a mental health commitment and those who need competency restoration services. Those committed after a finding of incompetency accounted for approximately 43 percent of AMRTC's census in this quarter. During this quarter there was a higher percentage of individuals awaiting discharge under mental health commitment (29 percent) than for those who were civilly committed after being found incompetent (19.4 percent). The planned responses to meet, or be on track to meet, this goal remained unchanged from the May 2019 quarterly report.
  • Transition Services Goal Three to increase the average monthly number of individuals leaving the MSH for a more integrated setting to ≥ 10 by December 31, 2019.
    • The planned responses to meet, or be on track to meet, this goal remained unchanged from the November 2018 quarterly report.
  • Positive Supports Goal Three to reduce the number of reports of emergency use of mechanical restraints to no more than 93 reports by June 30, 2019.
    • The planned responses to meet, or be on track to meet, this goal remained unchanged from the November 2018 quarterly report.
  • Employment Goal Three to increase the number of students with Developmental Cognitive Disabilities (DCD) ages 19–21 who enter into competitive, integrated employment by 150 by June 20, 2019.
    • The Employment Capacity Building Cohort (ECBC) is an interagency activity of MDE, DEED, and DHS that engages local-level school district and county teams in professional development and technical assistance focused on continuous improvement in rates of competitive integrated employment for students with cognitive disabilities ages 19 to 21 years. Twenty school districts and local partner teams provided supports to students through the ECBC during the 2018–2019 school year. The ECBC team activities included information sessions on Workforce Innovation and Opportunity Act (WIOA) and limitations on the use of sub-minimum wages; Pre-employment Transition Services; DB101 estimator sessions; utilization of the Informed Choice Conversation and Informed Choice Toolkit materials; piloting a new customized Minnesota Career Information System (MCIS) for students with disabilities; conducting individual career interest and learning style inventories; and learning about essential job development strategies. The 2018–2019 number of students continues an observed annual decline that began in 2017–2018. The factors involved in this annual measure are complex. MDE, DEED, and DHS have identified the quality of local-level partnerships between school districts, vocational rehabilitation (VR) services, and disability services as an important factor, and they are involved in planning for how to improve these partnerships statewide.
    • In the summer of 2019, MDE, DEED, and DHS staff convened an ECBC Design Team including local-level representatives of schools, vocational rehabilitation services, and disability services. The state agency staff and Design Team are reviewing data collected from current ECBC teams that indicates possible improvements in the design of ECBC, as well as identifying options for scale-up of ECBC participation by moving more ECBC training, team planning, and networking between teams to an online platform accessible to outstate Minnesota. It is expected that including more Minnesota school districts in training, network support from other successful school districts, and customized technical assistance from state agencies (MDE, DEED, and DHS) will improve the statewide rate of competitive integrated employment.
  • Community Engagement Goal One to increase the number of individuals with disabilities participating in governor-appointed Boards and Commissions, the Olmstead Subcabinet Community Engagement Workgroup, Specialty Committee and other Workgroups and Committees established by the Olmstead Subcabinet to 215 members by June 30, 2018.
    • During 2017 and 2018, the Minnesota Department of Human Rights and the Olmstead Implementation Office (OIO) collaborated on a project to improve the representation and recruitment of individuals with disabilities on boards and councils. This included outreach and recruitment efforts in both the metro area and Greater Minnesota. In 2017, there were five informational sessions held throughout the state with people of color and individuals with disabilities. The purpose was to help participants learn more about serving on governor-appointed boards and councils and the process for applying for and receiving an appointment. In addition, a facilitated training session was held for members of governor-appointed Boards and Commissions on strategies for creating more accessible and inclusive boards and councils. There were no information sessions held in 2018 or 2019. The project with MDHR concluded in December 2018. OIO will identify new partners to facilitate further learning opportunities for people with disabilities who are interested in applying for membership on governor-appointed boards and councils.
  • Preventing Abuse and Neglect Goal Four to decrease the number of students with disabilities identified as victims in determinations of maltreatment by 5 percent from baseline to 19 students by July 31, 2019.
    • Because the factors in the statewide rate of student maltreatment are unique in each case and complex at all levels, it is difficult for MDE to identify any single common root cause for the observed statewide increase in incidence. In addition, it is difficult to predict this data year-to-year given the small number of cases each year in Minnesota, and this number being very small in comparison to the overall population of students with disabilities in public schools. Historically, MDE receives a higher rate of reports of alleged maltreatment involving students with disabilities (approximately 60 percent), and it is consistent that there are more determinations of maltreatment involving students with disabilities than for students without disabilities. The increase in the number of students with disabilities determined to have been maltreated may be linked to improved reporting of student maltreatment statewide. This may be related to increased awareness of mandated reporting.
    • The MDE Student Maltreatment Team continues to fulfill requirements for increasing statewide awareness of mandated reporting by enhancing training, technical assistance, and online resources for schools. MDE will continue to offer all Minnesota schools support and to recommend opportunities for participation in Positive Behavioral Interventions and Supports to reduce and prevent incidents of abuse and neglect.

October 4, 2019

This was the first meeting of the Olmstead Subcabinet Executive Committee under the Walz-Flanagan administration. It was determined that the Executive Committee would meet four times per year and its role would be to:

  • Act as a steering committee for the Subcabinet.
  • Review reports such as the Quarterly Reports and provide recommendations to the Subcabinet.
  • Review input from the public comment process and identify priority areas of focus for the Subcabinet.
  • Identify areas that would benefit from interagency collaboration and direction to address barriers and disparities to create One Minnesota.
  • Provide a forum to discuss challenges and interagency solutions when there are challenges in making progress.

It was noted that the role of the Subcabinet, which would meet six times per year, would be to:

  • Approve all necessary reports and Plan amendments pursuant to Court requirements.
  • Identify and work toward solutions to priority areas of focus identified by the Executive Committee.

These roles will be presented to the Subcabinet during their October 28, 2019, meeting.

The prevention of abuse and neglect public awareness campaign was also discussed. The campaign work group noted that they were in the process of completing supplemental interviews with individuals from racial and ethnic groups (e.g., African American, Somali, Hmong, American Indian, Hispanic) for incorporation into existing video products. Other communities discussed for future consideration included people who are elderly with disabilities, individuals with disabilities experiencing homelessness, and school-age children with disabilities (and their families).

The Olmstead Implementation Office (OIO) also provided a brief update on the upcoming public input process that will help inform the upcoming Plan amendment process and work of the Subcabinet. Available listening sessions and webinars were announced, and Subcabinet members were invited to attend.

October 28, 2019

It was noted at the Olmstead Subcabinet meeting that the Community Engagement Workgroup held their first meeting on October 10, 2019, and that the workgroup would meet again on December 12, 2019. It was also noted that the first public input session was held on October 26, 2019, and that another session would be held on November 2, 2019.

The Subcabinet reviewed and approved the proposed roles and responsibilities of the Executive Committee and Subcabinet, as discussed by the Executive Committee during their meeting on October 4, 2019. Roles and responsibilities for each group are outlined on pages 23–27 of the Subcabinet's meeting materials, including a proposed meeting schedule for the two groups.

The annual Plan amendment process, which was underway at the time of the Subcabinet meeting, was discussed, including the amendment timeline. The Subcabinet is scheduled to review the first draft of proposed amendments at the December 2019 meeting and a second draft at the February 2020 meeting. The final amendment of the Plan is scheduled for review and approval at the March 2020 Subcabinet meeting.

November 25, 2019

It was noted at the Subcabinet meeting that the DOC would be holding three listening sessions to propose new goals for the Olmstead Plan—one at the Lino Lakes Correctional Facility, one at the Shakopee Correctional Facility, and a third session, which will be open to the public.

It was also announced during this meeting that Darlene Zangara accepted a new position as the Executive Director of the Minnesota Commission of the Deaf, DeafBlind, and Hard of Hearing. The job posting for her replacement as director of the Olmstead Implementation Office was being prepared. Executive Committee members were informed that they will be asked to designate a member of their team to serve on the selection committee, which will also include Colleen Wieck and Roberta Opheim.

Other announcements included:

  • The federal court scheduled the next bi-annual status conference for Monday, January 13, 2020 (later rescheduled to April 2, 2020).
  • The current cohort of the Olmstead Academy will be showcasing their work in the Lake Superior Conference room on Friday, December 13, 2019, from 1 to 1 pm.
  • The first round of the Olmstead Public Input Process included five listening sessions, as well as email comments. Comments have been distributed to the Subcabinet agency leads. The second round of public input will take place from January 6, 2020, through January 31, 2020, and will include gathering comments by teleconference and email. The Executive Committee will review the themes of the public input at their January meeting, which will guide the work going forward.

The Subcabinet also reviewed and approved the November quarterly report, including data acquired through October 31, 2019. This report included progress toward goals related to:

  • Movement of people with disabilities from segregated to integrated settings (n = 547).
  • Movement of individuals from waiting lists.
  • Quality of Life measurement results.
  • Increasing system capacity and options for integration.

More than three-quarters of the Olmstead Plan measurable goals (19 of 24) were met, on track to be met, or in process. Notable successes included:

  • Progress on movement of people with disabilities from segregated to integrated settings:
    • During this quarter, 32 individuals left ICF/DD programs to more integrated settings. After three quarters, the total number of 146 exceeds the annual goal of 72. (Transition Services Goal One A)
    • During this quarter, 209 individuals with disabilities under age 65 in a nursing facility longer than 90 days moved to more integrated settings. After three quarters, 84 percent of the annual goal of 750 has been achieved. (Transition Services Goal One B)
    • During this quarter, 256 individuals moved from other segregated settings to more integrated settings. After three quarters, the total number of 868 exceeds the annual goal of 500. (Transition Services Goal One C)
  • Timeliness of Waiver Funding Goal One:
    • There are fewer individuals waiting for access to a DD waiver. At the end of the current quarter 66 percent of individuals were approved for funding within 45 days. Another 27 percent had funding approved after 45 days.
  • Increasing system capacity and options for integration:
    • The utilization of the Person-Centered Protocols continues to show improvement. During this quarter, of the eight person-centered elements measured in the protocols, performance on all elements improved over the 2017 baseline. Seven of the eight elements show progress over the previous quarter, and six of the eight are at 94 percent or greater in this quarter. (Person-Centered Planning Goal One)
    • The number of women with disabilities and/or serious mental illness who had a cervical cancer screening was 33,786, which is an increase of 12,393 over baseline. (Health Care and Health Living Goal One)
    • The number of children and adults with disabilities who had an annual dental visit was 51,898 over baseline. (Health Care and Healthy Living Goal Two)
    • The percentage of people receiving crisis services within ten days of referral was 96.6 percent. This met the annual goal of 88 percent. (Crisis Services Goal Five)

Measurable goals targeted for improvement included:

  • Transition Services Goal Three to increase the average monthly number of individuals leaving the MSH for a more integrated setting to ≥ 10 by December 31, 2019.
    • The planned responses to meet or be on track to meet this goal remained unchanged from the November 2018 quarterly report.
  • Positive Supports Goal Three to reduce the number of reports of emergency use of mechanical restraints to no more than 93 reports by June 30, 2019.
    • The planned responses to meet or be on track to meet this goal remained unchanged from the November 2018 quarterly report.
  • Housing and Services Goal One to increase the number of people with disabilities who live in the most integrated housing of their choice where they have a signed lease and receive financial support to pay for the cost of their housing by 5,569 over baseline to 11,564 (about a 92 percent increase) by June 30, 2019.
    • When there is a tight housing market, access to housing is reduced and landlords may be unwilling to rent to individuals with public assistance, limited rental history, or other similar factors. DHS will continue to increase housing supports in Minnesota to address these barriers. The specific programs being measured in the above goal will not show the full picture of the impact of these supports, but some of these new services and supports will include the Community Living Infrastructure grants supporting individuals in the community to find housing, increase to MSA Housing Assistance in July 2020, and the new Housing Stabilization Services Medicaid Services available in July 2020, which will allow providers to bill for housing search and other support services for an individual moving from homelessness (or other housing instability) to more stable housing situations.
  • Employment Goal Two to increase the number of individuals in competitive integrated employment by 1,200 individuals to 9,937 by June 30, 2019.
    • Possible contributing factors to explain the increase in the number of people in certain Medicaid programs in competitive integrated employment include:
      • Improving economy: During the same time period of this data, the overall unemployment rate in Minnesota fell from 4.2 percent in June 2014 to 3.5 percent in June 2017 to 2.9 percent in June 2018.
      • Increased awareness and interest: Providers and lead agencies are paying attention to the goals of people to work in competitive integrated employment.
      • Implementation of the Workforce Innovation and Opportunities Act (WIOA): Signed into law in July 2014, this act amended Section 511 of the Rehabilitation Act and placed additional requirements on employers who hold special wage certificates to pay people with disabilities sub-minimum wages. In response to WIOA requirements, some employers may have increased wages to above minimum wage or some service providers may have put greater emphasis on services leading to competitive integrated employment. During this time period, however, there was not a similar growth in employment among people with disabilities at the national level.
      • Interagency efforts to increase competitive integrated employment: During the time period of this data, DHS, DEED, and MDE have all made efforts to meet Minnesota's Employment First Policy and Olmstead Plan goals. This included interagency coordination and projects contained as part of the employment section of Minnesota's Olmstead Plan.
    • Moving forward, DHS continues to work to ensure that all Minnesotans with disabilities have the option of competitive integrated employment. DHS seeks to meet its Olmstead Plan measurable goal and continuously improve efforts around employment. Part of these efforts include:
      • Carrying out The Minnesota Technical Assistance Project (MN-TAP): Launched in 2018, MN-TAP is a two-year project funded by DHS and is designed to improve employment outcomes for people with disabilities. As part of the project, the Institute for Community Inclusion at the University of Massachusetts Boston, in partnership with the Institute on Community Integration at the University of Minnesota, will be providing technical assistance (TA) to two cohorts of provider agencies, each cohort with six agencies. A total of 12 organizations will participate over the course of the two years. The goal of the TA is to help providers expand their capacity to support people with intellectual/developmental disabilities (I/DD) in obtaining and succeeding in competitive, integrated employment opportunities.
      • Providing three new employment services in the Medicaid Home and Community Based Services (HCBS) waivers: As of September 2019, Minnesota has fully transitioned HCBS waiver services to include three new employment services: Exploration, Development, and Support. These services not only help better identify what employment supports someone is receiving, but they also provide new resources to support competitive, integrated employment for people receiving waiver services.
      • Implement memorandum of understanding with DHS and DEED: In September 2019, DHS and DEED signed a memorandum of understanding (MOU) outlining how the two agencies will work together in supporting common customers (people receiving waiver services who want employment) to be successful in finding and maintaining competitive, integrated employment as well as in making informed choices about employment. This MOU grounds the agencies in shared values, clarifies federal guidance, and explains how they will coordinate efforts, how services sequence, how they will increase shared service providers, and how they will work to create seamless referrals/transitions between programs.
  • Education Goal Two to increase the percentage of students with disabilities who have enrolled in an integrated postsecondary setting in the fall after graduation to 35 percent by June 30, 2019.
    • Minnesota saw a decrease in the percentage of students with disabilities enrolling in institutions of higher education through the fall of 2017. The trend for students with disabilities follows the trend for all students in general. During the same time period, enrollment in an accredited institution of higher education for students without disabilities declined by 1.6 percent (from 74.5 percent in 2014 to 72.9 percent in 2017). To be considered enrolled in an accredited institution of higher education for the purposes of SLEDS reporting, a student must be on a credit earning track toward a certificate, diploma, two- or four-year degree, or other formal award.
    • Analysis of the reported data included comparisons with other postsecondary outcomes data for students with disabilities available in SLEDS. Current SLEDS data indicates that 3,090 (45 percent) of students with disabilities who graduated in 2017 were subsequently employed in competitive integrated employment, which is an increase from 44 percent in 2016. While Minnesota saw a decrease in the percentage of students with disabilities enrolling in accredited institutions of higher education, the data suggests the possibility that other students may be accessing work-related job-specific skills training and certificate programs, including those available from technical colleges. Minnesota continues to have a strong employment outlook and many students with disabilities may be choosing to enter the job market in entry-level positions, gaining experience and independence, or saving money for college as higher education expenses continue to be on the rise.
    • Based on a review of disaggregated data, a targeted activity was designed to increase successful postsecondary enrollment results for Black and American Indian students with disabilities. This aligns with MDE's current federal State Systemic Improvement Plan (SSIP). For the last two school years, 2017–18 and 2018–19, MDE staff have partnered with TRIO Student Support Services currently serving students at institutions of higher education.
    • During the school year 2019–20, MDE will work to scale up these efforts by ensuring ongoing print and online accessibility of the Minnesota Postsecondary Resource Guide. MDE staff will also widely publicize online training resources that are currently located on the Normandale Community College website at http://www.normandale.edu/osdresources.

December 16, 2019

The first round of public comments on the Olmstead Plan, which ended on November 20, 2019, included the OIO hosting five sessions and attending an Advocating Change Together meeting. The Department of Corrections also planned three listening sessions:

  • December 17, 2019, at Shakopee Correctional Facility
  • December 23, 2019, at Lino Lakes Correctional Facility
  • January 21, 2020, at the Department of Corrections

The Olmstead Subcabinet reviewed and accepted (with suggested edits) the first draft of proposed amendments to the Olmstead Plan goals. A discussion of the proposed amendments can be found in the meeting minutes. Of note, the Subcabinet agreed that for annual goals that are being reset with the same number and percentage, more precise language would be used in the future, noting that the goals are not "new," but "repeated," as that language is more reflective of a deadline extension. Potential future improvements to the Plan were discussed and included:

  • Using the same or similar timeframes and dates for measuring goals.
  • Using both numbers and percentages in goal statements.
  • Determining baselines for all goals.

At a high level, proposed amendments included:

  • One goal to increase the input that people with disabilities have in their choices and lives
  • Three goals that increase the number of people moving from segregated to more integrated places
  • One goal to increase the number of accessible pedestrian signals
  • One goal to reduce hospital stays for people with disabilities
  • One goal to improve access to dental services for people with disabilities
  • Five goals to decrease the use of restraints
  • Three goals to improve crisis services
  • Two goals to increase participation of people with disabilities in engagement activities related to the Olmstead Plan

The amendments will be attached to the 2019 Annual Report that is submitted to the court. A public comment period on the proposed amendments will take place from January 6 to January 31. The January 2020 public comment period will include three webinars, as well as comments accepted by email and phone. Additional proposed amendments were scheduled to be reviewed at the February 2020 Subcabinet meeting.

The Subcabinet also reviewed and approved the 2019 Annual Report, including data acquired through October 31, 2019. This report included progress toward goals related to:

  • Movement of people with disabilities from segregated to integrated settings.
  • Movement of individuals from waiting lists.
  • Quality of Life measurement results.
  • Increasing system capacity and options for integration.

This annual report covered the 47 measurable goals in the Olmstead Plan. Thirty-two of the annual goals were either met, on track to be met, or in process. Fifteen annual goals were not met. Areas critical to the Plan where measurable progress is being made include:

  • Progress on movement of people with disabilities from segregated to integrated settings:
    • In the first three quarters of the 2019 goal, 146 individuals left Intermediate Care Facilities for Individuals with Developmental Disabilities (ICF/DD) programs to more integrated settings. This exceeds the 2019 annual goal of 72. (Transition Services Goal One A)
    • In the first three quarters of the 2019 goal, 849 individuals with disabilities under age 65 in a nursing facility longer than 90 days moved to more integrated settings. This exceeds the 2019 annual goal of 750. (Transition Services Goal One B)
    • In the first three quarters of the 2019 goal, 868 individuals moved from other segregated settings to more integrated settings. This exceeds the 2019 annual goal of 500. (Transition Services Goal One C)
  • Timeliness of Waiver Funding Goal One:
    • There are fewer individuals waiting for access to a DD waiver in the last quarter reported. Over the last four quarters, 72 percent of individuals were approved for funding within 45 days. Another 24 percent had funding approved after 45 days.
  • Increasing system capacity and options for integration:
    • The utilization of the Person-Centered Protocols continues to show improvement. Over the last four quarters, of the eight person-centered elements measured in the protocols, performance on all elements improved over the 2017 baseline. Seven of the eight elements show progress over the previous Annual Report, six of the eight have been above 90 percent over the last year, and three have been above 95 percent in all quarters reported. (Person-Centered Planning Goal One)
    • The number of women with disabilities and/or serious mental illness who had a cervical cancer screening was 33,786, which is an increase of 12,393 over baseline. (Health Care and Health Living Goal One)
    • There was an increase in the number of peer support specialists who are employed. There are 76 peer support specialists employed. This was an increase of 60, which exceeded the annual goal to increase by 30. (Employment Goal Four)
    • There was an increase in the number and percentage of students with disabilities in the most integrated setting. (Education Goal One)
    • There was an increase in the number of school districts that completed training in active consideration of assistive technology. (Education Goal Three A)
    • Accessibility improvements were made to 1,658 curb ramps, 85 accessible pedestrian signals, and 28.34 miles of sidewalks in the last year. (Transportation Goal One)
    • The number of transit service hours in Greater Minnesota increased by 169,316 over baseline during the last year. (Transportation Goal Two)
    • The number of women with disabilities and/or serious mental illness who had a cervical cancer screening was 33,786, which is an increase of 12,393 over baseline. (Health Care and Healthy Living Goal One)
    • The number of children and adults with disabilities who had an annual dental visit was 51,898 over baseline. (Health Care and Healthy Living Goal Two)
    • The percentage of people receiving crisis services within ten days of referral was 96.6 percent. This met the annual goal of 88 percent. (Crisis Services Goal Five)

The following measurable goals were targeted for improvement. These goals were identified as not meeting projected targets.

  • Transition Services Goal Three to increase the number of individuals leaving the MSH to a more integrated setting.
  • Housing and Services Goal One to increase the number of people with disabilities who live in the most integrated housing of their choice.
  • Employment Goal One and Two to increase the number of people receiving services from Vocational Rehabilitation Services and State Services for the Blind and certain Medicaid funded programs in competitive integrated employment.
  • Employment Goal Three to increase the number of students with Developmental Cognitive Disabilities (DCD) in competitive integrated employment.
  • Education Goal Two to increase the percent of students with disabilities enrolling in integrated postsecondary education settings.
  • Education Goal Three B to increase the percent of students with disabilities in districts trained in active consideration of assistive technology.
  • Positive Supports Goal Three to reduce the number of reports of emergency use of mechanical restraints with approved individuals.
  • Positive Supports Four and Five to reduce the number of students experiencing emergency use of restrictive procedures and the number of incidents of emergency use of restrictive procedures.
  • Crisis Services One and Two to increase the percent of children and adults who remain in the community after a crisis episode.
  • Community Engagement Goal One to increase the number of individuals with disabilities participating in governor-appointed Boards and Commissions, and the Olmstead Subcabinet Community Engagement Workgroup.
  • Preventing Abuse and Neglect Goal Four to decrease the number of students with disabilities identified as victims in determinations of maltreatment.

The following measurable goals are in process and have no current annual goals. New annual goals are being proposed and included in the Addendum for the following goals:

  • Transition Services Goal Two to decrease the percent of people at AMRTC who no longer meet hospital level of care and are currently awaiting discharge to the most integrated setting.
  • Person-Centered Planning Goal Two (A/B/C) to increase the percent of individuals reporting they have input in major life decisions, everyday decisions, and their supports and services as measured by the National Core Indicators Survey.
  • Positive Supports Goal One to reduce the number of individuals experiencing a restrictive procedure.
  • Positive Supports Goal Two to reduce the number of reports of restrictive procedures.
  • Crisis Services Goal Four A to increase the percent of people who are housed five months after discharge from the hospital (due to a crisis).
  • Crisis Services Goal Four B to increase the percent of people who receive appropriate community services within thirty days of discharge from the hospital (due to a crisis).

It was noted at the Subcabinet meeting that a position for new leadership of the Olmstead Implementation Office was recently posted and would be open through January 3, 2020.

2019