DHS REFORM 2020 UPDATES - Reform 2020 envisions more choice, independence for people with disabilities

Joe is able to transfer from his bed to his wheelchair with limited assistance from his support staff. While it may be faster some days for his support staff to complete the transfer for him, Joe and his support staff plan enough time for him to complete as much of the transfer as he can. In this way, Joe is able to build the muscle strength and skill in transferring that promote his confidence, independence and overall well-being.

Jessica is a young girl whose disability has impacted her ability to communicate verbally. She has begun using a communication board to assist her. While she and her support staff developed ways to communicate before, the support staff now works with her to build skills in using the board. With the focus on her skill development, Jessica is gaining the ability and confidence to interact with others and more fully express her thoughts and needs. As she becomes more fluent in using the communication board, her family is considering using some of her service funding to purchase an upgraded communication device that will allow her to communicate even more effectively.

This is the first in a series of articles focusing on people who use the Minnesota Department of Human services (DHS) and the ways our department is working with them and others to realize a new vision for long-term services and supports. In this vision, quality, person-centered services and supports are not only sustained for the future but enhanced and maximized through new tools and technologies and new service approaches.

The examples above reflect some of what we are hearing as we talk to Minnesotans about Reform 2020 proposals and how they want to see long-term services and supports in Minnesota evolve. People with disabilities want to continue to receive services but also want opportunities to do as much as they can for themselves, have flexibility to have choices and to be as independent as possible.

Reform 2020 is the banner under which DHS is redesigning long-term services and supports to ensure that people get the right services at the right time by promoting low-cost, high-impact services earlier; decreasing reliance on costly services; and changing the system’s orientation so that home and community-based services are available when people need them. The examples above relate to Community First Services and Supports (CFSS), which, upon federal approval, would reform the Personal Care Assistance Program to one that is more accessible and flexible for the people who use it.

Under the CFSS model, individuals can get help with activities of daily living but also get flexible services, such as instruction, coaching, prompting and home modifications and technology to replace human assistance. Provider standards are also changing and are encouraging the development of agencies and staff with specialized skills. This will help people with disabilities to get services better tailored to their individual needs.

The new MnCHOICES assessment tool will look comprehensively at each person and his or her situation, including employment, community participation and housing support. A budget will be developed based on each person’s needs for assistance with activities of daily living and/or behavioral intervention and the current home care rating scale that is used to determine the PCA units numbers. People can buy services from an agency or hire their own staff. They also can convert some of their service dollars for technology and home modifications that replace human assistance.

Future articles will look at other components of the comprehensive Reform 2020 effort to restructure long-term care to emphasize consumer choice, quality and sustainability.

Just as these proposals were developed in partnership with community stakeholders, DHS continues to need stakeholder support as these ideas are discussed at the Minnesota Legislature and with federal officials and as we work toward implementation of reforms in the most productive way. As we have been in the past, we are all in this work together, responding to challenges with innovation, creativity and deep commitment to helping individuals reach their potential.

Approximately 133,000 Minnesotans with disabilities access Medical Assistance services administered by DHS. The department helps people with disabilities with health care, long-term services and support, employment training and housing so they can lead productive and enriching lives. About 47 percent of all Medical Assistance funding administered by DHS is for people with disabilities. The remainder is for seniors (22 percent), children and parents (30 percent) and other adults without children (1 percent).

Loren Colman is assistant commissioner for the Continuing Care Administration of the Minnesota Department of Human Services, a position he has held since 2003. Colman directs the divisions of Disability Services, Aging and Adult Services, Deaf and Hard of Hearing Services and Nursing Facility Rates and Policy.

Contact the Disability Linkage Line at 1-866-333-2466 for more information.