Guardians ask, what could Waiver Reimagine mean to you?

For those who don’t follow DHS waiver policy change, listen up! DHS is working on a massive project to streamline […]

Image of a figure of a budget range by support range with data.

For those who don’t follow DHS waiver policy change, listen up! DHS is working on a massive project to streamline Minnesota’s Medicaid waivers. It’s called Waiver Reimagine and the second phase is due to launch in 2026. The second phase is primarily about instituting individual waiver budgets. 

Historically in Minnesota, Medicaid waiver budgets have been based on need and if on a traditional waiver, decided by individual teams and do not have a budget cap. CDCS (Consumer Directed Community Services) budgets are based on need and determined by an algorithm and do have a budget cap.  Under Waiver Reimagine, the current four waiver types: Developmental Disabilities (DD), Community Access Disability Inclusion (CADI), Brain Injury (BI), and Community Alternative Care (CAC)) will go away and there will be two waivers, yet to be named, but something like Living Independently and Living in Residential Care. All individual budgets will be capped and based on both need (good) and where a person lives (bad). It is bad because this falsely suggests a person’s support needs change based on location. Subject to change of course, here are the latest published budget ranges. See Figure 3: Budget Range by Support Range.   Need levels are listed across the top from low to high and will be determined by the new MNChoices 2.0 Assessment. Where you live is on the left. As you can clearly see, larger budgets are provided for those receiving services in provider-controlled settings and smaller budgets are provided for those living independently. This is bad. 

Image of a figure of a budget range by support range with data.

Under the Olmstead decision, people with disabilities have a civil right to be full members of their communities and live in the most integrated community setting appropriate to their needs.  Budgets based on where a person lives are anti-Olmstead as DHS is providing less money to live in one’s own home versus a provider-controlled setting. 

DHS also must adhere to independent living first policy under Minn. Stat. §256B.4905, subd. 8.  Providing budgets that are less for independent living versus provider-controlled setting is not supporting independent living first. 

Waiver Reimagine budgets that provide more money for those living in provider-controlled settings are at direct odds with Olmstead and Minnesota living independently promises. 

So how many Minnesotans might this affect? Well, the HRSI Fiscal Impact Study estimates that 6000 waiver recipients will experience a budget reduction! This includes nearly 1:2 on a CAC waiver and 1:5 on a DD waiver. One must ask, if this many waiver recipients are to receive budget cuts, without any change in need, is this budget framework really working? 

Do you know what your current waiver budget is? If not call your case manager and ask. If you are one of the 6,000 expected to receive a cut, you might want to contact your legislator and tell your story. Legislation (SF4733) addresses concerns around Waiver Reimagine and is being sponsored by Sen. John Hoffman, Chair of the Human Services Committee. 

Concerned Guardians 

Lisa Vala, Plymouth 
Pat Hannon, Plymouth 
Jane Steinhagen, Edina 
Jackie Olson, Edina 
Laura Hunt, Edina 

  • Wash your hands! Hands that look can still have icky germs!
  • Work with your care provider to stay healthy. Protect yourself. Vaccines are your best protection against being sick.

You are not alone. Minnesota Autism Resource Portal.