Reform 2020


The 2011 Legislature directed DHS to reform Medical Assistance, Minnesota’s Medicaid program, to achieve better outcomes for people with disabilities, seniors and other enrollees. Federal approval will be sought so the state can make changes in the areas of community integration and independence, improved health, reduced reliance on institutional care, attainment of housing and employment and reduced use of services that are less effective. This initiative is called Reform 2020.

DHS held public meetings in June, July and August 2012 for clients, stakeholders and others to learn about Reform 2020 and provide comment. Staff presented an overview of Reform 2020 (PDF) and specifics on mental health, Community First Services and Supports, autism and other proposals contained in the section 1115 waiver proposal.

CMS Approves Reform 2020 Section 1115 waiver

On October 18, 2013 the Department of Human Services (DHS) received approval from the Centers for Medicare and Medicaid Services (CMS) for federal financial participation (FFP) on the Alternative Care Program. This approval relates to the contingency items that were a part of Reform 2020. As required by Minnesota Laws 2013, DHS submitted a plan for investing the state dollars made available by the enhanced FFP for Alternative Care to Minnesota Management and Budget (MMB). This plan for the contingency items includes investments in proposals that were passed by the legislature: Enhancing Vulnerable Adult Protection; First Contact – Simplification, Access and Transition Support; HCBS Critical Access Study and Service Development; and Work – Empower and Encourage Independence. This plan was approved by MMB on October 30, 2013. The spreadsheet below provides an overview of the approved plan:

Approved Reform 2020 Implementation Plan (PDF)

Please refer to the Reform 2020 Waiver Web Page for more detail.

More information about the approval as well as the Reform 2020 plan will be distributed in the coming weeks.

Demonstration to Integrate Care for Dual Eligibles

On September 12, 2013, DHS and the Centers for Medicare and Medicaid Services (CMS) signed a Memorandum of Understanding (MOU) establishing a Demonstration to Align Administrative Functions for improvements in Beneficiary Experience (Demonstration). This demonstration began on September 13, 2013 and continues until December 31, 2016 and is designed to reduce costs associated with beneficiaries eligible for both Medicare and Medicaid, or dual eligibles. (For historical information please go to Dual Demo historical information).

Long-Term Care Realignment waiver proposal

On February 13, 2012 and November 21, 2012, the state of Minnesota submitted two Medicaid section 1115 demonstration proposals, entitled Long Term Care Realignment and Reform 2020; Pathways to Independence. The Reform 2020 section 1115 waiver approved on October 18, 2013 combines components of both demonstration proposals into one demonstration to allow people to access the home and community-based services they need to support independence, increase community integration and reduce reliance on institutional care. Please refer to the Reform 2020 Waiver Web Page for more detail.

Related links

DHS web pages

  • Health Care Delivery System Demonstration
  • Demonstration to Integrate Care for Dual Eligibles
  • Health care homes
  • Children with autism spectrum disorders
  • Existing DHS waivers and requests
  • Enrollment and spending reports and forecasts

  • Other websites

  • Medical Assistance Reform legislation (Minnesota Statutes 256B.021)
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