LETTERS TO THE EDITOR: Data in inclusion report paints false picture of progress

To the editor:

We appreciate the motivation behind “The Case for Inclusion Report,” to improve the lives of people with disabilities. We were disappointed, however, that DHS was not given a chance to respond to your coverage of a report that paints a false picture of Minnesota’s progress in supporting community inclusion of people with intellectual and developmental disabilities.

An accurate portrayal of Minnesota’s progress would show that both the number of Minnesotans with disabilities supported with services in the community and the investments in those services have steadily grown over many years. Between 2014 and 2018, for example, the number of people served under the developmental disabilities waiver alone increased from 15,893 to 18,603 and investments in those services rose from more than $1 billion to $1.4 billion and continues to grow.

The report’s overall methodology has flaws that distort Minnesota’s performance compared to other states. These flaws include use of erroneous information and old data— some as old as 2008—from varied sources; and misleading state rankings based on compressed scores within a 100-point range.

Here are a few examples:
• Minnesota appears to have been docked points on a score for “reaching those in need” because of erroneous information that our state has narrow eligibility criteria for developmental disabilities services. In fact, Minnesota has long had broad eligibility criteria for services, encompassing intellectual and developmental disabilities and related conditions.
• As of 2016, Minnesota basically eliminated its waiting lists for home and community-based waiver services. Instead agencies work under a new process to secure funding for individuals at a reasonable pace. As of June 30, 2018, the average length of time someone waits to have access to developmental disabilities waiver funding is 61 days. DHS staff manage dollars to assure people across the state have equitable access to services in a timely manner.
• A compressed set of relative scores does not reflect a real difference in the level, quality and outcome of services provided. A small change, such as 5 points out of 100, would move Minnesota’s ranking from 21st to 5th. Twenty-five states have scores within four points of Minnesota’s. Minnesota’s performance may be distorted too by our state having a more mature home and community-based services system than most other states. Minnesota is one of only 15 states to have closed state institutions for people with disabilities. This is a milestone Minnesota reached 20 years ago, as it was building community services and supports.

We recognize our system must continue transforming to meet the choices and needs of people with disabilities now and in the future. That work is already well under way. This transformation includes new employment services designed to expand opportunities that have been lacking for people with disabilities. While more work remains, we are seeing progress. For example, average monthly earnings of Minnesotans with intellectual and developmental disabilities in competitive employment rose markedly from 2015 to 2017, as have the numbers of people with intellectual and developmental disabilities in competitive employment.

Other recent reforms include more services to support community living, new provider standards, more equitable rate setting, assessment and support planning improvements, help to increase person-centeredness, positive support strategies and increased quality management. We are now embarking on an initiative to “reimagine” our waiver system, with service menu changes, individualized budgeting and other improvements.

As we strive to provide an array of services that promote inclusion of people with intellectual and developmental disabilities, a better gauge of success is progress on metrics set out in Minnesota’s Olmstead Plan. This plan is the blueprint for how state agencies are collaborating to improve outcomes for people with disabilities. Among many key areas where Minnesota has made progress are the elimination of waiting lists for all disability waivers and the use of positive supports for people with complex conditions.

Minnesota and other states face significant challenges in meeting the needs and choices of people with disabilities. Most immediately, a serious workforce shortage is being addressed by both the legislature and the Olmstead Subcabinet. We can learn from other states and sharing what successful states do. As we manage these challenges, though, let’s start by using current and accurate data and information about Minnesota’s disability services system.

-Claire Wilson, Deputy Commissioner, Minnesota Department of Human Services
-Alexandra Bartolic, Disability Services Director, Minnesota Department of Human Services