Recap of June 28th MA Reform Waiver & My Life, My Choices Discussion

The Department of Human Services released the first draft for public comment of the waiver application Medicaid Reform 2020: Pathways to Independence on June 18^th. Reform 2020 is also referred to as the MA Reform Waiver, or the 1115 waiver. The waiver requests permission from the Centers for Medicaid and Medicare services to operate services in Minnesota more flexibly by receiving waivers from certain federal rules.

On June 28^th, MN-CCD and Lutheran Social Service of Minnesota convened a discussion of about 70 advocates, parents, and providers to review the waiver’s impact on self-direction for people with disabilities and to review how the waiver aligns with the initiative My Life, My Choices. My Life, My Choices seeks a world where people with disabilities live with minimal constraints and maximum freedoms. Many of the reforms necessary to reach a My Life, My Choices world lie in the details and implementation of the MA Reform Waiver.

John Tschida of Courage Center and Anne Henry of the MN Disability Law Center presented some of the details of the waiver.

A couple of highlights of the proposal impacting self-direction include:

• Implementation of Community First Services and Supports (CFSS) in place of current PCA program – Included in the Affordable Care Act as Community First Choice Option, CFSS provides greater flexibility in PCA services and brings an enhanced 6% match to Minnesota from CMS.
• Fiscal Support Entities will become Fiscal Management Entities – Minnesota will contract with a more limited number of providers instead of the current 15 providers statewide to provide fiscal management for self-directed services like CDCS, CFSS and CSG.

Following the presentation on the specific content of the waiver proposal, small groups came together to share their reactions. Comments were collected that may be included in the public comments that MN-CCD submits to DHS. Some feedback from the small group discussions included:

• The need to include a person-centered approach, with the person with disabilities at the center of the planning and prioritizing their own preferences
• A need for “level of risk” to be defined
• Greater use of technology in serving people with disabilities

The public comments on the waiver proposal that are currently being collected by DHS through July 17^th present an incredible opportunity to share the potential impact of the waiver proposal on you or the people you support AND to provide your expertise and suggestions for moving forward. MN-CCD encourages organizations to submit their own comments on the waiver. You can read the press release from DHS on the waiver, or review the waiver and make comments on the DHS website. If you would like your comments to possibly be submitted with the MN-CCD comments, please email asimons@arcmn.org.