DHS outlines Waiver Reimagine goals; families, advocates warn proposed changes could force institutional placements

The Department of Human Services presented an overview of its Waiver Reimagine project to the House Human Services Finance and Policy Committee. DHS officials said the multi-year initiative aims to simplify four disability waivers, create a common service menu, implement individual budgets grounded in assessment data and increase opportunities for self-direction.

Elise Bailey, budget director at DHS, summarized the project's goals: simplify information so people and families can understand available services, ensure equitable access to funding regardless of diagnosis or location, and expand informed choice and self-direction. "If we were to build it today, how would we build it and what would it look like?" Bailey said, describing why DHS has studied consolidation and budgeting since 2017.

Colin Stemper, chief administrative officer for aging and disability services at DHS, said phase 1 — a common service menu across waivers — was completed in 2021 and phase 2 will consolidate four diagnosis-based waivers into two waivers organized around residential settings and individual budgets based on assessed needs and typical costs. He said budgets will align with current statutory rates and that people will know their budget prior to service planning. "We're trying to put more power and control in the people and families' hands," Stemper said.

DHS officials told the committee implementation has been delayed to Jan. 1, 2027 to collect updated MNChoices assessment data and to complete technical work, community engagement and legacy-system updates. DHS said it has convened a Waiver Reimagine Advisory Committee and conducted outreach including virtual meetings with stakeholders, tribes and racially diverse communities.

Public testimony that followed was strongly critical. Family members and disability advocates said the proposed budgeting and service changes risk reducing in-home supports and compel placements in congregate settings. Kathy Ware, a parent and MNChoices assessor, said she has communicated with DHS for years and warned that the proposed budgets would make it impossible for her profoundly disabled son to continue living at home: "Waiver reimagine doesn't do that. So if you implement waiver reimagine, Colin, as it is right now, Kylan will not be able to live at home with me," Ware said.

Other witnesses echoed concerns that MNChoices assessment changes are unstable and that budgets based on current use rather than authorized need will result in cuts. Tricia Brisbane, a Waiver Reimagine Advisory Committee member, said: "If we proceed with waiver reimagine as proposed, Minnesota will lead a new path as a state to reinstitutionalize its citizens with disabilities." Several presenters asked for a task force or pause and for DHS to provide communications with the Centers for Medicare & Medicaid Services if federal rules are being interpreted to restrict services.

Committee members asked DHS to continue engagement and to return with follow-up; DHS said it will continue outreach and planned recalibration of budgets using the updated assessment data. The committee did not vote on legislation; several witnesses asked legislators to consider House File 2038 (a task-force bill) to slow or rework aspects of the proposal.