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Reform 2020 Section 1115 Waiver Proposal

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Overview

The 2011 Legislature directed DHS to reform Medical Assistance, the state’s Medicaid program. Goals of Reform 2020 include: community integration and independence; improved health; reduced reliance on institutional care; maintained or obtained employment and housing; and long-term sustainability of needed services through better alignment of available services that most effectively meet people's needs. To accomplish these goals, the legislature designated 12 separate initiatives under Minnesota Statutes, Section 256B.021, subd. 4. Several of these initiatives require a waiver from the Center for Medicare and Medicaid Services (CMS) under section 1115 of the Social Security Act.

DHS thanks everyone who has participated in the public input processes for Reform 2020. Your continued input and engagement is appreciated.

CMS holds public comment period on November 2012 proposal

On Nov. 21, 2012, DHS resubmitted the Reform 2020 waiver proposal to CMS. You are invited to submit comments on the waiver proposal during the 30-day federal comment period , from Dec. 5, 2012 through Jan. 6, 2013.

• Reform 2020: Pathways to Independence waiver proposal – November 2012 (PDF)

• Attachment L: Public comments (PDF)

• Fact sheet summarizing key initiatives in the waiver proposal (PDF)

To request a paper copy of the proposal, please contact Quitina Cook at 651-431-2191.

September 2012 draft proposal and second DHS public comment period

DHS released a new draft of the waiver proposal in September and announced a second public comment period in the Sept. 24, 2012 State Register (PDF). The 30-day public comment period on the September draft proposal ended Oct. 24, 2012. Comments received (see Attachment R in November proposal above) were reviewed and informed the final proposal submitted to CMS in November 2012.

• Reform 2020: Pathways to Independence waiver proposal – September 2012 (PDF)

• Attachment L: Public comments (PDF)

Webinar held on fiscal analysis

DHS held a webinar Oct. 12, 2012 on the Reform 2020 fiscal analysis and historical data. The waiver document includes a budget neutrality analysis from the federal perspective and does not address state savings. The webinar further discussed the CMS submission and a separate state fiscal analysis. Materials from the webinar are provided below.

• Reform 2020 fiscal analysis overview presentation (PDF)

• Reform 2020 fiscal analysis summary (PDF)

• Reform 2020 state fiscal analysis (PDF); Reform 2020 state fiscal analysis (XLS)

• Waiver proposal Attachment O: Federal budget neutrality analysis (XLS)

• Waiver proposal Attachment P: Historical financial data (XLS)

June 2012 draft proposal and DHS public comment period

DHS’ draft proposal released in June was announced in the June 18, 2012 State Register (PDF) and in a DHS news release. The 30-day public comment period on the draft proposal ended July 17. Comments received (see Attachment L above) were reviewed and informed the final proposal.

• Draft Reform 2020 waiver proposal – June 2012 (PDF)

• Summary of key points in Reform 2020 waiver proposal (PDF)

DHS held two public hearings in June specifically for the public to provide comments on the draft waiver proposal. Four additional meetings were held in July and a fifth in August on the reform initiative and specific sections of the draft proposal.

Reform 2020 waiver timeline

• August 2011 through May 2012: Develop proposals

• June: Draft waiver proposal released for a public comment and tribal consultation period

• August: Waiver proposal submitted to CMS

• September-October: DHS holds second comment period.

• November: DHS resubmits proposal to CMS

• December: Complete negotiations with CMS on the terms and conditions of the waiver

• January 2013: Budget and policy proposals necessary to implement the reforms included in Gov. Mark Dayton’s budget proposal for the 2013 legislative session

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