WRAC meeting captions, April 24, 2025

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>> Welcome, everyone. We are just waiting for more people to join, so give us a couple minutes.
>> Welcome, everyone, who is joining. We are just taking a couple moments to let folks log on, and we will get started in a couple minutes.
>> Welcome, everyone. I still see a few people logging on, so we'll get started at five after.
>> Okay, it looks like maybe we can go ahead and get started. DHS team, give me a thumbs up if that sounds good to you all. Okay. Welcome, everyone. My name is Katie Pratt and I'm with the office of dispute resolution. I'll be helping facilitate the meeting today. I was here at your last meeting in February and got to meet many of you, and I'm very pleased to be back and join this conversation. I look forward to spending the next couple of hours together. I will turn it over to I think maybe Leigh Ann or Heidi to say a welcome from DHS.
>> My apologies, I'm learning here how to use this system. Good morning, welcome, everyone. I'm not sure Heidi is with us yet. I am Leigh Ann Ahmad and I am a manager with the disability services division. Really pleased to be here today and helping to coordinate the logistics of today's meeting, and I see Heidi.
>> Hi, good morning. Sorry, I was having a little trouble getting into the meeting, but I think I'm going to turn it over to Natasha to give the welcome today.
>> Good morning, everyone. Yes, I also had a few technical challenges, so thank you for bearing with us. On behalf of DHS, want to see again a big welcome to all of you, our bimonthly waiver reimagine advisory Council. Thank you for being here and thank you to Katie and her team for being our fearless facilitators today.
>> Wonderful. Okay, and we see the link to live captions there, hopefully you all have that link. Here's what we have on deck for the agendas today. We are starting with welcoming as we are doing now, little bit of the recap of where we were in February, and then I will be talking for a little bit to share some feedback that I learned from members between the February meeting and now. I had the opportunity to hear some feedback from members outside of these meetings, and I just wanted to share he is some themes that I heard and some ideas for what this means for WRAC going forward. We will do that, then we will hear some updates from the DHS team. As you know, it's a busy time at the legislature, lots of things changing day today there, so I know we will get the latest information during that update section. So that is the first half of the meeting, and then the second half of the meeting will be really focused on hearing some new information from the DHS team about the road map of how they are thinking about waiver reimagine and how this intersects with the work of WRAC going forward. So that'll be interesting to hear what they have on deck for the road map. We will close out the meeting with a discussion of a potential change to the way collaboration works and structuring agendas based on some of the feedback I was able to hear from members, so we want to discuss with you all a possible near-term shift and how things are put together and bringing in some cochairs. So we will talk about that towards the end of the meeting. Great. Next slide, please. Last meeting was in February, and you all have access to the slides, the meeting summary, as well as I believe the transcript from that meeting. But as a high-level reminder of the topics that were discussed, DHS shared they are making a change in the facilitation and want to take a different approach so this group can be as effective as possible and make the most of your work together, so they talked about that facilitation, and that is where myself and my colleague, Jessica, who is not able to be here today, but we came in and had our first meeting and got to know you all. The next section of the February agenda was focused on the budget and what is the budget picture with waivers, some of the challenges, the way costs are looking and trends over time. So you have the slides to that. And some updates from DHS on the timeline towards getting the waiver reimagine project moving forward. So those are big picture updates. I don't know, see seven team if there's additional detail you want to add recapping the last meeting. Okay. Great. Just reading the chat, one person said they weren't able to join with the other link, so I think there's still a little bit of technology glitches today. I am always surprised, as much as we have done technology and virtual life, it never ceases to bring ongoing challenges. It keeps us on our toes, I guess. Great, I just want to spend a few minutes talking about feedback that myself and Jessica heard from WRAC members, and we will have time for some discussion and similar reflection reflection on that. Broadly, Jessica and I, we scheduled three sessions, three 1-hour sessions and members could join or not if they were available. We ended up having about ten people participate in those sessions. Not the full breadth of perspectives of the workgroup, but we did feel like across the sessions we heard different things, which was good. We didn't all just here one set of feedback. We heard a range of different experiences on WRAC, so that was helpful. We had really fantastic conversations with members. They shared great feedback, great insights, great perspectives on the process so far, so I thank the people who showed up and took time out of their day to give us some feedback. Next slide. The themes I want to report out on today is talking a little bit about some of the strengths we observed of WRAC so far based on the feedback people gave. Some of the format limitations and trade-offs that we heard from members, some of the challenges regarding scope, collaboration, and suggestions as a facilitator, what I might suggest as ways to move forward and enhance collaboration. Next slide. Strengths. One thing that was very clear from the members we talked to is that WRAC is made up of just a very passionate, dedicated group of people who are here, above and beyond, many things they have going on and they like to take time because they believe in the people that are being served by waivers, they believe in working together to make the system better. So just very passionate people, and a lot of knowledge and experience. So that is another strength. It was clear to us that there is an incredible amount of lived experience with disability waivers across the workgroup, everything from how I experience the program, the services I received, how the program is managed, a systems perspective of how this fits into other systems in the state. So tons of experience, and really a value across members, too. Even though you may not see eye to eye and everything all the time, there is an appreciation for that depth of experience on the committee. So that's another strength. Another strength, everybody is here because they see opportunities to improvement, for improvement in the system. It is not, we have fixed everything, there's nothing to be done. Everybody really believes, everyone that we spoke to you, believes there are opportunities for change, for meaningful change that can make the waiver system better. So that's awesome. We also got a sense that, despite some of the challenges of this particular committee, it is important there is an advisory committee, that members want to see WRAC continue, they want to see substantive work, and are willing to keep showing up. And that's great. That was a really positive strength, as well. Next slide. One of the themes that came up a lot in these conversations is the format -- I would say limitations, but also trade-offs. There's pros and cons to some of the format and logistical issues. The fact that there are pros and cons means that they are not entirely easy to solve. One challenge that many people mentioned is it is just such a big group. It's difficult to have conversations, it is sometimes hard to feel connected as a workgroup because of the size of the group. That said, a benefit of the large size is that they really are a variety of perspectives, very different vantages on the system. He make the group smaller, maybe it's easier to have some of those conversations, but you lose some of that perspective, so there's a trade-off there. Another challenge that came up a lot with the group is just that virtual is challenging. As we all know, there's things, we see each other as little squares on the screen, we can't see everybody's faces all at once, we don't read body language, intonation quite the same way virtual, and we see that a lot in the work of my office. That said, virtual is more accessible in a variety of ways. It's easy to fit into people's schedules, it means less travel time, so there is that trade-off again with virtual. Another challenge, this came up again in all the conversations, is that a bimonthly two hour session is just not a lot of time relative to the scope of this project, which is big. It touches a lot of people. There's a lot of moving pieces. How do you tackle that when you just have a couple hours every other month? Again, the flip side of that is that two hours is a doable time commitment for people who are fully scheduled in their work and maybe wouldn't have a lot of time to dedicate to WRAC outside of the two hour bimonthly meeting. So trade-off there. And the length of time between meetings in addition to not a lot of time, two months goes by and a lot changes in two months. think change at the legislature, the work plan of waiver or imagine, things change in the lives of all of you. So that is a lot of ground to cover in make up when you come back together in two months. But, again, that trade-off is doable to meet every two months. Okay, next slide. Collaboration. I am just realizing... Can you go one side forward for a second? Yeah, let's go back again. I'm realizing, I think a slide did not get in here to talk about scope, but I can just share what I heard about scope, because that was one of the challenges that people brought up, is there is not necessarily a shared understanding of what the scope of WRAC should be. An analogy that came up, and I think it was a helpful analogy for this group to think through, is building a building. Putting together -- when you're building a building, you start from square one and draw out the infrastructure and the architecture on paper and start from scratch. Is that the goal of WRAC, is to really help build and construct the architecture? Or is the purpose and the scope of WRAC more to just help with refining, maybe remodeling some sections of the architecture of WRAC? So not a full, we are going to build the architecture collaboratively from the ground up, but we are going to collaborate on some critical pieces of where we can work together. Or on the other end of the spectrum, is the scope of WRAC and really the role of WRAC to make more of hanging pictures, where we are putting the furniture, and decorating? If you think of that as a continuum -- I hope that analogies making sense to you -- there wasn't a sense that there was a shared agreement on what that scope should be. And a sense from members that they were different expectations about what level they wanted to be involved. So that is a point of maybe clarity that the group can find moving forward. That is scope. Moving on to collaboration, this was another area of challenge that members brought up. Again, the members that I talked to. One, there was a concern that there is not genuine interest by DHS in acting on ideas and concerns from WRAC members. These concerns that I'm bringing up our perceptions. It's not me to judge whether that's true or false, but just a perception that is there. Again, let's talk about that. Why is that perception? How can we work through that? Not all members felt free to voice their views. There was a sense that, if I say something in the WRAC meeting, I might be disparaged by other members, that my views are not necessarily respected if they go against the grain. So, again, that is a perception maybe not shared by everybody, but let's talk about that. How could we improve upon that? There is another concern that too much time has been spent on airing grievances and not enough time on problem solving. A number of people said they really want to get into, let's do that work together of making things different and less time spent on just what isn't working or the problems with the system. Some members reported that at times it is feeling divisive and that's not good for their experience. I would say across the conversations we have people did feel like the group needs a reset. It needs a little bit of a, let's relook at this, let's press reset. We want to be effective, we want to collaborate effectively, and we need to put some energy into pushing reset and making that happen. Most agree that facilitation itself has not been the issue, so it is not a critical gap in facilitation. That is just helpful to know going forward. Next slide. So, here are some suggestions that my colleague Jessica and I came up with. These have not been vetted in terms of whether they would be feasible in all aspects, but some ideas that came to mind, we would love your thoughts on these. One is we thought that mental reset, not to underestimate that. There could be a way to come in from our office, for example, and provide some training of what are some of the tools that you all might in your toolkit to really collaborate more effectively going forward. My office works with many different collaborative groups across the state, in many different sectors. There is not a collaborative group that I have yet met that is doing everything perfectly and has -- and doesn't have any room for improvement. Collaboration is a fine art. It's very challenging, it is evolving, it is dynamic, and there are spaces where we can all think about it differently and improve, myself included when I'm part of the collaborative process. So, are there skills and trainings and mindsets that we can pass along to help you work better? One other idea is, would it be possible for this group to have one in-person meeting? Regularly would be challenging logistically, but knowing that you're traveling from different parts of the state, could you come together for one in-person meeting? That could go a long way to meeting each other and having that relationship building and getting a sense of each other in a new light. Some changes that could be possible or worth keeping in mind for meeting structure, could there be some subgroup meetings between the bimonthly meetings, a way to have some side conversations within the parameters and the structural constraints, but be able to keep this conversations going? Could there be some space to split? It was also clear in these conversations that there are some parts of the committee that want to dig into this topic, and others maybe want to dig into this topic, and maybe you don't do everything all together at a time. For example, could you have a bimonthly meeting where the last hour is spent in a subgroup topic, or a way to figure out what people are most interested in and hone in on this conversations? And then, could there be a longer meeting? If you going to meet every two months, doesn't make sense to me for a longer period of time and maybe have some specific topics that are led by members? Again, suggestions that we need some thinking about how to pull this together logistically. And then one more near-term suggestion, we are going to return to it at the end of the meeting, because I think DHS is proposing kind of a near term change and we want to talk at three, but the rest of the conversation today might inform this. To bring in tri-chairs made up of WRAC members to be more involved in helping to craft those agendas and steering the work of WRAC. We will return to that idea. Okay, that is the end of me talking. I want to say thank you again for everybody gave feedback. He was really invaluable, and we have time, I just want to open the floor for a couple minutes if anybody has any response to these. If this matches your experience, if there's anything you heard here that is new to you, or if you wanted to add any additional information to this feedback. [Silence]
>> Go ahead.
>> Hi, thank you. I am Kelly, the mom of the young adult who has autism. I'm just looking for clarification. It sounds like this meeting again is going to be about the actual functional part of the meeting and not really discussing we very imagine. I'm just concerned, because waiver we imagine is moving forward without us. Whether we talk about it or not. There's a lot going on in the legislation right now. A lot of carve out bills are happening because people feel like their needs are not being met with the way that waiver reimagine is being rolled out. I'm just wondering, we have asked many times in past meetings to actually have meaningful conversations about waiver reimagine policy, not about how the group functions, even though that's very important, too, don't get me wrong. I just want to know when we are going to hear what part of our input has actually been placed into waiver reimagine policy and at what point we are going to have meaningful conversation to course correct so that needs can be met, so our people's needs can be met based on what their actual needs are and not the location in which they live.
>> Thank you, Kelly. I can speak for the agenda, which is the section about talking about how the group operates is a small part of the agenda and the next sections are about what is going on at the legislature and the work plan for WRAC, so I'll be curious if those parts of the agenda are more responsive to what you are bringing up.
>> Okay, thank you.
>> Yep. Any other comments? I'm watching for hands raised. Pat, go ahead.
>> Yeah, hi. As you are giving --
>> Is anybody else having any audio difficulty or is it just me? speak I'm hearing somebody else chime in.
>> Can you hear me?
>> We can hear you. Can you hear us? Hello?
>> It looks like -- I don't know if anybody has the ability to contact.
>> I am a self advocate and a parent of a son who is on the waiver. I appreciated the feedback that you gave since the last meeting. The only thing I was thinking of as you are talking about getting us up to date and looking to the future and possible changes is there is so much going on at the federal level that of course is going to affect us, and on the one hand it might be premature because at the federal level there is so much chaos it is hard to know day today what's even going on, but it seems like somewhere along the line -- I, for one, have been thinking -- and this is maybe going to come out in the legislative report -- how our state is preparing. I guess it's hard to prepare when you don't know what you're preparing for, but some kind of mention that this is going on, and at some point to know more or how we can prepare. Maybe that's premature, but that was one thing that was on my mind. Thanks.
>> Great, thank you, Pat. I'm hearing a request to get some updates on what is known about the federal landscape and how it will impact Minnesota and what that might mean for the work of WRAC. That will be noted. Thank you. I don't see other hands raised, so with that we will move on to the next slide. Great. I will hand it over to Heidi to give some legislative updates.
>> All right, thank you. I want to talk a little bit about, first, where we are at in the legislative session, and what's happening, and I will give some updates related to waiver reimagine. At this point in session, the house and the the Senate have each put together their omnibus bills. They are actually finalizing those this week in their finance and Ways and Means committees, and those will be going to the house and Senate floor respectfully and they will vote on it. Based on the way the bills look right now, they are very different from each other, so there is a very high likelihood that there will be a conference committee and they will iron out the differences and come to an agreement on what the final Health and Human Services bill will look like. At this point in session our role at DHS is to provide technical assistance to the House and the Senate to make sure that the language that is in the bills achieves what they are hoping for, so the goals they are trying to achieve. We will look from a technical perspective and make sure it does actually accomplish what they're trying to accomplish. So there is still a lot of discussions that need to happen, and I will say, even though things are in both bills, it's a higher likelihood it will move forward, but it's a family not a guarantee, because there are still out of work and discussions that need to happen. So I will go through what my understanding is of what is in each of the bills related to waiver reimagine, and if there's anything that I have missed that you are aware of, please don't hesitate to speak up and say that I have missed something. Currently both the house and the Senate have moved the implementation date from January 1st 2027 to January 1st, 2028, 4 waiver reimagine. Both bills also require DHS to include a home care nursing allowance in the individual budget methodology. The house bill has little more language, so it also requires the implementation of the person portal on January 1st, 2027. To that would be a year prior to the full implementation, according to the house bill. And it also removes the WRAC committee and replaces it with a legislative task force that has a broader representation of people including legislators on the task force. It is convened by DHS, and DHS will provide the administrative support, but it has a broader scope than the WRAC and broader membership. The other thing that is in the house language is the requirement for us to report to the legislature on -- I think it is by December 2026, the full plan for what we would submit to the federal government, the full waiver plan language, and also a requirement to report on how the individual budgets are based on assessed need and the location where a person lives, and if there are any additional funding requests that would be needed in order for a person to be able to live in the least restrictive environment. I see some questions that were submitted based on how I described things. Okay, Kelly, what reference is that?
>> I heard you say you are providing technical assistance for policy to them, or they come and I'm just wondering, are you talking about to the legislators who are helping with these policies that are going to be hopefully looked at in the conference committee?
>> Yes. When we provide technical amendments, we provide that to the legislators. So typically the house and Senate chairs of the committee will ask us to look over the bill and make sure it makes sense that it is implementable from a DHS policy perspective. So we provide that to them. An absolutely, the legislators will be relying on you all to provide your community perspective on what your preferences are and what you will be advocating for.
>> That's wonderful. So it sounds like you would have the ability to share some of the input that has already been provided on WRAC so that the bills, when they go for it, actually makes sense. Thank you for clarifying that. I appreciate that.
>> Sure. There is a question about when the task force would start. It looks like the first meeting would have to be convened no later than November the 30th 2025, so that means, assuming the session ends at the end of May, then DHS would be responsible for working with people that are identified on the list to have the list of people who participate in the task force by the end of September, and then the first meeting we need to occur by the end of November. Will the task force include the current WRAC members? I haven't done a crosswalk or seen a crosswalk on -- he doesn't specifically say the current WRAC members will be part of the task force. There's a list of numbers that must be included. For example, they must be two providers of disability waiver services, they must be two family members of people who receive services, two representatives of advocacy organizations. So there is a list, and many of them are identified to be appointed by the governor. So there is a process at the state similar to the process people had in identifying WRAC members. The task force is not included in the Senate version of the bill, but it is still in the house version of the bill. I believe. I don't know. Maybe it was -- the version I'm looking at still includes the task force, and this week when the bills go through the house Ways and Means Committee and the Senate Finance Committee things may come out that had a cost that wasn't accounted for in the spreadsheet, so after this week we will have a better idea of what those final amounts are. I didn't go through the entire list of people who were included. I can read that out if that would be helpful, because I didn't mean to imply that certain people were not included. There are two members from the house and two members from the Senate, for people who are currently receiving disability waiver services. So that's right at the top. I apologize for giving the impression that they weren't included. One county employee who conducts long-term care, consultation, assessments. One representative from DHS with knowledge of provider requirements. One employee from the Council on disability, two representatives from disability advocacy organization, two family members of people receiving disability waiver services, two providers of disability waiver services, one employee from the ombudsman from developmental health and disabilities, one from the implementation office, assistant Commissioner of the DHS a administration that oversees disability services, a member of the disability Law Center, and that is the list. Each of those items has a requirement of who has to appoint those people. Several are appointed by the governor. The ones that specifically say for the ombudsman, the ombudsman will appoint that person for the implementation office, the director of that office will appoint that person. So that is identified in the language, as well.
>> It looks like this couple hands raised. I don't know if your hand is raised from before.
>> I'm sorry, I'll take it down.
>> And Tricia has a hand raised.
>> The task force language has been withdrawn.
>> Oh, okay. That is updated information from what I have. Thank you thank you.
>> Just to be clear to the group, it doesn't appear that there was ever any intention to dismantle the WRAC and replace it with a task force, but beyond that, it has been withdrawn. So there is not going -- to my knowledge, there's not going to be a task force. So I don't think -- unless somebody has other information, I don't think that is even a point of possibility at this point. Thank you.
>> I will verify that as we move on in the agenda. I will verify that with our team. Because this is what I got from a legislative team, so I will verify that was removed in those final hearings before the bill was moved out of the Health and Human Services committee.
>> Thanks. Just goes to show how convoluted and complex the entire process can be.
>> Yes, exactly. I did see some comments about, what is the WRAC being removed. Again, these are proposals the legislature had been thinking about, so even if that wasn't the language that's moving forward, then it is a moot point, the just for you to know, these are not ideas that DHS was bringing forward, so we can't really speak to why the legislators had made the decisions they made of what is in the bill. I think that's all I have for the update, but definitely stay tuned in the next few weeks to see what shakes out related to waiver reimagine and the final bills.
>> Thanks. It looks like one more hand came up. Jennifer, go ahead.
>> This is Jennifer. I work for Mille Lacs band and I wanted to know why tribal nations are not included on this list, of who has to be included if this task force does proceed forward.
>> That's a great question. Again, that is not a question I can answer. That is something that we would as DHS provide in our technical assistance back to the legislature. That is definitely something that we would say, that we need to acknowledge that it is not just counties that are doing assessments and determining eligibility for the waiver programs, that we do recommend to has a tribal representative, as well.
>> Thank you for bringing that forward.
>> Great. Thanks for those updates, and I think everyone is appreciating the dynamic nature of the legislative discussions. I'm glad we can get some real-time updates and feedback here on this conversation. Wonderful. I want to turn it over to the assistant Commissioner for a quick update from her.
>> Thanks, Katie. I just wanted to take this opportunity to share with all of you that I am leaving DHS on or about June 6th of this summer, so since we had some opportunities here, I wanted to express my gratitude for all the work and the feedback that you have provided us, and certainly waiver reimagine will continue, contingent on this legislative session, as we've been talking. Part of my job in the coming months to help arrange and start the process of finding the successor assistant Commissioner for aging and disability services. You will see the position will be publicly posted in the next couple weeks, and certainly this project is a very high priority for the Department of Human Services, not just the aging and disability services administration. So I fully anticipate that even after my departure things will continue to operate as they have been or with whatever changes that you will decide where the legislature decides that we need to implement. So, again, just wanted to say thank you and wanted to share that news with you. That's all from me.
>> Thank you, Natasha. We will all miss you and wish you well on your next adventure. I am going to turn it over now to Curtis. We are going to shift gears a little bit and this is going to be more into the meat of what -- how the work is moving forward, and some feedback on that. I will let you take it away.
>> Thanks, Katie. I think most of you know me, I'm a manager in the disability services division. I have a section that includes a bunch of folks. I've been involved with this project are pretty much the onset. Like I said, I think a number of you are familiar with me, but I'm happy to be here today. Based on some of the comments that people made, whether live or in the chat, I'm hoping this section of the meeting gets us on the road of getting into the guts of waiver reimagine implementation and satisfies or at least brings us closer to satisfying the need to get into the actual policy and actually have the concrete discussions. I'm hearing people hoping for that. Nine or so slides, I'm going to take a few moments to backtrack a little bit and review goals and review phases of the work, the most importantly I'm going to outline a new work structure. I have advocated for including this in the meeting because I think as WRAC members it's important to know how we are structuring the work and he was in front of the work so that you can engage with us. We are going to talk about cocreation of agendas in the future, and I think having this information will help you all engage with us to have the exact kind of conversations that Katie and others have been talking about having. First I want to briefly go through the goals of waiver reimagine. I'm not going to read all the slide, but I think you are familiar with the goals. At a high level, that her access and flexibility, equitable access, and self-direction. One of the reasons I wanted to put the slide lighting here -- a couple of reasons, really -- internally, as we build our implementation strategy and lay out the work in front of us, we are trying to keep these goals front and center. One of the strategies I have in our meetings is to have these virtually in front of us all the time so we don't forget why we are doing this. Another thing, this slide and I think the next one as well were used in a presentation that DHS made to the house and human services committee on March 19th. Some of you may have seen those there. I thought it would be important for all of you, including those who didn't attend the hearing, whether in person or virtually, to CDs, as well. I don't want to spend a ton of time on this unless there are questions, but let's go to the next slide. Waiver reimagine phases. Again, something I think you're all familiar with, but this is something we try to put in front of ourselves to ground us as we start chunking out the work in front of us. I don't want to spend a ton of time on this, but again, as with the other slide, something that was shared in the human services committee presentation. I want to make sure everyone saw it. Let's go to the next slide. Work structure, now we are getting into the guts of what I want to talk with you about. we are aligning ourselves differently around the work to accelerate our progress toward implementation of waiver reimagine. As he can see, it's a very dynamic situation. This slide is already going to need some changes. Our assistant Commissioner, Natasha, who just told us about the change in her situation, will have to be updating our sponsors are as we move through that change. But let's take this and spend a moment or two with it. The things I wanted to point out to you, we have an executive sponsor, we have executive sponsors both at the assistant Commissioner level and the director level. Keep in mind, as you work with us as the WRAC, what do these people do in their sponsorship role connect there are people who need to know, this project is staying on track. Is it being implemented? Are there barriers? Are we running into cost problems, or are we actually accomplishing those objectives I pointed out to you? Those are the top people to be talking with about that. Below then we have a layer of people with responsibilities in green that are more about coordinating the work. I think what is really relevant about those positions requires us to talk about those six boxes below them, which I think is what's really exciting about this approach and gets at some of the concerns I've seen in the chat. Just to read off the boxes, there's a topic or work laying around budgets and choices. Those of you who wondered, where is MnCHOICES in this conversation? There it is. Budgets and MnCHOICES. We need individualized budgets and MnCHOICES. By the way, we are going to go through each of these boxes at least briefly or as long as people want to, frankly. On the coming slides. So this isn't just a quick drive by here. The second box in green is community engagement. The third box is policy. The fourth box is the person portal. The fifth box is IT systems work, and the sixth is readiness and change. These are an initial set in our latest reset of our work, the six main lanes we see as driving us toward implementation. I think it is entirely possible that we will find other lanes that need to be added later or we might need to redefine some of the lanes. As you think about a road map for completing waiver reimagine, there will certainly be big activities that require us to coordinate across lanes. For instance, communicating and informing and training people up on how to implement or how to exercise their responsibilities in waiver reimagine. We will likely require coordination across multiple of these groups. Communications, policy, budgets. I know that will need to happen as we move forward. I'm going to pause here for a moment just to see if there any questions so far before we dive into the individual slides for each of the topic areas. I don't know if we have anything in the chat from folks.
>> I'm not seeing anything.
>> Well, let's move onto topic one, individualized budgets and MnCHOICES. Each of these topic areas will have a lead. I don't have the names of each of the leads for the topic areas to share with you today, but I do have a lead for this area, because it is me. I'd be happy to answer any questions you have about this from what I know today. The bullets on the slide indicate an initial set of focus areas that have been identified to fit within this Lane. In this case we have the MnCHOICES data validity and collection, budget recalibration and analysis, test budgets, and individualized budget implementation, which is a pretty wide category. One thing that I know of that needs to be included here is the development of the budget exception process. I'm going to pause again to see if people have questions about this slide.
>> Curtis, there is one overarching question about whether this was presented to the legislature.
>> No, this was not presented to the legislature. This is working within our existing legislative mandate. This is just how we are choosing to structure the work so we can effectively implement what we have been directed to do. But we are certainly open to suggestions from folks if there is something missing or problematic about it.
>> I just wanted to mention, when I had individual conversations with people when I first came into this role there was a strong feeling about the need to bring in MnCHOICES into the conversation. So I just wanted to -- I know Curtis mentioned it, but I wanted to highlight again how that is what we are dealing with part of this work.
>> And just to add onto that, Heidi, I'm really curious to see if people have questions or want more detail on what specifically it is about MnCHOICES, and you will certainly have more opportunities to engage on that. One thing I forgot to mention, as well, at the outset, I'm really hopeful this information feeds into the concept of cocreating future agendas and that this information will make DHS's approach more transparent to you, and to the extent that we do move ahead with cocreation, that will give you all a better opportunity to inform what it is you want us to be talking about at the next meeting. I think this information, if I were in your shoes, would be super helpful to me in sorting out, I want to hear more about this, I need us to revisit that, I need to know when you're actually going to be building this part of what we are doing.
>> N, Curtis, it looks like Lisa and then Dr. Kayte has her hands up. I think you have your hands up from before but correct me if I'm wrong. We will go to Lisa first.
>> Good morning. My name is Lisa. I have a daughter, 27, using waiver services, so I'm on the committee as a voice of family using waiver services. Curtis, I'm glad you are presenting. It is reminding me way back probably two years ago, you are in a session and you had made the comment that your involvement in waiver reimagine is most exciting to you because of the groundwork of expanding self-direction. And I should stop and say we have been using the self directing CDCS feature with my daughters' services are probably 18 years, so I am no stranger to that, and I agree with you of expanding. Then you touched on just now budget exceptions. What I want to ask is, tying in your role, Curtis, but self-direction and all of your knowledge, and then the WRAC work or lack of work thus far on budget exceptions as it would relate to state plan services, using the funds to access nursing services, and I say all this because I want to tie it to the very current work in our legislature as we speak on the a 4 amendment, which I'm curious if anyone on this call has any knowledge of the current amendment. Does DHS support this? If not, why? If so, why? And I bring it up because the amendment if passed would do nothing but to ensure that the work WRAC has done and should continue to do around self-direction sticks. So A4 needs to pass under the language written in the Senate, not the house, so we can ensure that one piece of what we are working on as waiver reimagine is to ensure that people that are already self directing successfully can keep self directing successfully. There's too much work happening outside of WRAC that takes that away. A4 amendment puts it back in and solidifies it. But, again, there continues to be work at the legislative session, or the legislative work outside of WRAC, the I don't think WRAC members understand what's going on. But this A4 amendment is absolutely critical to everything we've done, yet we don't talk about it as WRAC. So, again, Curtis, you are the perfect person to go on record. You support self-direction, we want to expand it, that is in our charter, we have budget problems and exception problems. Most significantly around the nursing part. A4 amendment fixes that. If you stick with the Senate language. I want to know, are we going to make WRAC aware that? Are you going to support it? Where does DHS stand?
>> I think Natasha wants to weigh in on that. Are you available? Speak I am, yeah. I wanted to just kind of lay out for folks what we can and can't do at this point in the legislative session. As Heidi mentioned at the beginning, we are not able to support or oppose things that are happening in omnibus negotiations right now. Those really are decisions that legislators are making in consultation with each other across committees and with the constituents they hear from. So we aren't going to be able to go on record supporting or opposing anything. As Heidi said, our role is to provide that technical assistance, so MEC new or updated language we have the ability to implement, but that is not the same as supporting or opposing a bill. Even if the bill came forward that was not in our policy direction, for example, we would still provide technical assistance. It's just not something we can go on record with right now.
>> Thanks for your question, and I'm so gratified that you remembered my comments from several years ago. I still feel pretty strongly about that. I think expanding people's ability to self direct is a real benefit to everyone. And I'm hopeful we can accomplish this through not just waiver reimagine but through our collective policymaking and lawmaking in Minnesota. I also see in the chat, when waiver reimagine is implemented, the current difference is individualized budgets would no longer exists, correct? There would be one formula for people receiving services in a nonresidential setting? That is correct. It would be one budget across those waiver programs, when individualized budget. There wouldn't be, as is currently the case, if you're using CDCS -- if you are on the waiver with the same assessment, a somewhat different one on the CADI waiver. Other questions?
>> Dr. Kate has her hand raised.
>> I'm Dr. Kate and I am a service user. My concern is appropriate budgets for all, especially for those who live in the community.
>> Thank you, Dr. Kate. A principal flash point on this whole effort is the amounts of those individualized budgets and their sufficiency. It is a point well made, and we will be back to this group hopefully with a cocreated agenda in the future to talk about specifically what the WRAC members are concerned about regarding those budgets and how we proceed with them. Obviously there will be a legislature very interested in how we progress with those, as well. But I think, if I can just add on and tripled down, basically, I think it is gratifying that we have now brought MnCHOICES into this conversation with folks. I think it will create a more transparent engagement with you all. Anything more on the slide? Otherwise we can move on to topic two.
>> Curtis, before you go there, I think it would be helpful for Heidi to go back to the topic about the task force that is proposed if she was able to find some more information. I will turn it to you.
>> Thank you. I put a comment in the chat but wanted to make sure that everybody saw this. The house omnibus bill does still include the language and the funding in their spreadsheet for the waiver reimagine task force. The Senate does not. So this is part of the discussion that will need to happen. And I did note that we need to provide related to tribal member on the task force. So everybody is clear, that language does still continue to be in the house omnibus bill.
>> Great, thanks for that update. It looks like one more comment in the chat, the same budget formula implemented with waiver reimagine will go a long way to reducing confusion and improving informed choice and equity for those accessing waiver services. Okay, take it away.
>> Agreed, as a person who has been on the receiving end of those questions and confusion over the years, chasing it waiver designation because when waiver has a more preferable budget than another. So it would pull that out of the system. I think we can move on to topic two. There are six total, so we will get through these. Topic two, communications planning and community engagement. There's a lot going on here, but the one thing that speaks to me in this is our ability to engage with the community more generally, both in terms of getting feedback, input from them, and also informing them of what's coming in preparing them for what's coming. Obviously this will likely overlay this topic with other work, as all topics are dependent on communications planning and community engagement. Rather than blab away at you further on this, I'm curious if there any comments, suggestions, reactions to this topic. Again, there will be a topic lead for this, and this is in the future agenda, to give the opportunity to say, I need the latest on what you're doing around communications planning and community engagement.
>> Jennifer has her hand up. Jennifer, go ahead.
>> When I hear communications planning and community engagement, I think of -- are you talking about individuals who are already on it waiver and you wanted to get their feedback? I guess to clarify it. Or communication planning, community engagement within our committee.
>> I am not a lead in this area, but I would take it more general. I think one of the areas we have made -- and I mean as a nation, in designing these programs, has been with talking about the interested or current recipient population. I think we need to be looking at potential recipients, too, potential users. That's how we get into situations that aren't equitable. If you look at the imbalances in terms of who is accessing these waivers, it might be because the design of the waiver has excluded some people. Sorry if that's a generalized rant, but I think that applies to all the work we do and we need to be casting our net more widely than just the current recipients. But certainly the current recipients and not just WRAC. Hopefully this information we collect more generally can be brought back and inform the conversation that we have here. Does that make sense?
>> That makes sense.
>> I can add a bit, Curtis.
>> Please.
>> I been doing a little bit of this work, though I won't be the lead. Hi, everyone. I'm Leigh Ann. I mentioned earlier I'm a manager with the disability services division. It's a great question. What we have been doing, team members across DHS and across the division, we have started mapping out individuals as well as organizations that we would like to put into one spot and address the very long term ongoing multi-approach communications and engagement plan. First and foremost, we want to make sure who are all the folks they need to get email updates or see the website updates as we continue building out waiver reimagine, and then who are all the folks that we would like to invite to forums, and how we can offer to do presentations to spaces that already exist. Who isn't at the table that we need to be thinking through more thoughtfully about bringing to the table? So I will be leading this group long term but I would think, as we move forward and talk about the tri-facilitation mode, if we adopt that, perhaps that could be a June discussion of looking through what is the beginning of our mapped out engagement plan and what is missing, who's missing, how we go about it more effectively.
>> Can I just add, if we are looking at current waiver participants, easy button, we could just utilize that everybody has a case manager from a lead agency and uses case managers to reach out to those individuals to ask them specific questions and ask them if they do want to come to a forum and things like that.
>> Absolutely. And we have got beta sources, we've got websites, we've got the hub, we have people who participate in participant forums. So we are just trying to address all the spaces begins in those invitations out to. A lot of work yet to be done, but the goal is to cast the net very wide as Curtis said.
>> Tricia, go ahead, and then there's a couple comments in the chat to read.
>> Thank you. If I'm jumping the gun here, just let me know. We can table it and get back to it. We keep talking about this tri-facilitation. I'm just wondering, where did this idea come from and what kind of resources, data, or support did DHS use to bring forth this idea of the tri-facilitation? Like I said, if we need to table it until you get to that part more, that's fine.
>> If you are referring to what we mentioned earlier in the slides about having tri-chairs, we will be talking about that later, so I would say hold onto that for now.
>> Thank you.
>> Yeah, appreciate it. Curtis, I don't know if you want to -- I can read the comments. Kelly says, to increased meeting engagement, the WRAC public meeting links need to be up by the same time we get our links. Our meetings should also be advertised. The public link was missing up until the start of this meeting but it is there now. So that maybe a process improvement piece. Dr. Kate says please work to have marginalized communities as part of this communication. Please also include more people with disabilities as they are often also marginalized. Natasha wanted everyone to know she is stepping away but will be back, and then Dr. Kate also says please follow up with case managers as they do not always pass on information.
>> Great stuff. I especially appreciate Dr. Kate's comment about marginalized communities. Totally agree. Finding ways to get that information out and bring people in. It is concerning to me that sometimes we build and design for the people who have been building and designing and excluding the people who have been excluded. So you just get more excluded every day. I'm going to be done with the editorial comments. If we are okay, we'll move to topic three. Topic three, policy. Boy, that seems like a general name. I don't know, Leigh Ann, do you want to take this one? Otherwise I could jump in on it.
>> I can get started and you can help me out. I will be leaving the policy area, and what we'll be doing -- I don't know if you said this, Curtis, but one of the pieces of being part of this new structure that I appreciate so much is that it gives us structure and it gives us a formula that each of us needs, can undertake, and a way for us to elevate issues that we hear from our community engagement and from our subgroups up to the governance, because the work, as you know, is so complex. Waiver reimagine, in addition to assessments and individualized budget, is also a look at many different dependent policy areas. So we have a lot of work to do to identify which policies need to be fine-tuned to get to our stated goals of waiver reimagine, and what are our blind spots, like we are all the other policy areas that might be dependent on it as we go through the work. And so we will do a crosswalk and identification of policy areas that will be impacted in waiver reimagine. We will implement those policy changes as needed. I am hopeful then, again, depending whether this group stays the way it is or we enhance and change some of the facilitation structure in the future. I would be looking to bring back policies to this group and having dialogue and discussion and asking which areas need to be changed or improved. And then a big task for this group will also be -- when I say this group, I meant the policy area will be for us to develop our waiver plan application, which of course has community input as its first stop, including the WRAC, and then submitting to CMS. Because this work has yet to be approved by the centers for Medicaid services. So those are some examples of the work we will be doing in policy.
>> Thanks, Leigh Ann. I certainly appreciate any time we do any kind of complicated work, that it often has impacts on what we might otherwise think are unrelated policy areas that need to be revisited and cleaned up, because everything relates. It is systems. We have some hands up, I think. I'm not sure who is first.
>> Tricia, is your hand up from before? Okay, then Jennifer.
>> Hi. Thank you again. With the policy area, this one is a huge one for me, because I feel with DHS a lot of policies are changed, implemented, and the information from the people that they are being affected by our not being implemented within that policy. So I feel like what we really need to do is start a list of all the barriers. What is not working? I know it sounds negative, but that has to be the starting point, and have an action plan with that. What are some solutions for each barrier, and what policies does that touch, and how do we reword that, add to it, take away from it? Working with the Mille Lacs band, we are a service provider for some of the waivers and help enrolling members onto Avery's, we found tribes are excluded in a lot of areas of a Medicaid waiver, and I am appalled by that, and I think that is something that every single step of the way, that we look at the policy areas, making sure that tribes are included in all these policies that we are revising and looking at. But I really think we need to just, even though it is kind of a negative thing, what's not working, but it is the truth. We need to get it all in one place of what's not working so we know what we are working towards to find the solutions, to make this long process of getting services, or not even accessing services, how do we fix these barriers? CFSS, that is some garbage. It was nearly impossible to get PCA services and now it is even more. From somebody starting on a waiver to getting their MnCHOICES assessment to getting to talk to the case manager about service provider, if we are lucky that can take four months, if we are lucky. That is really fast process. Now with CFSS we have to wait for the service consultation, which is at minimum two months to get that now. So now we are looking at six months even get a PCA service agreement in place. We are not even looking at service providers that offer PCA. Are they even in this area? But that is something new, it policy came and they change and I wasn't even aware how that was going to impact our people, and everybody that I talk to you at the county and stuff like that, they are unhappy with how that rolled out, as well, because it was under my impression that the CFSS model was going to be better because we were going to add more services under that designation. And now they have added more steps to it, so they made it more barriers to even access the services. So that is just an example of where policy failed because they didn't listen to the people who utilize the services. I will just leave it there. Policy is a huge thing we need to work hard on.
>> Absolutely. I noted that we don't need to just list out the policies, we need to be using this as an opportunity as much as we can with this amount of resources and attention. This is our opportunity to do that. I believe, Heidi, correct me if I'm wrong, or courteous, it has been many, many, many years, at least 15 years, since we have actually applied for new laborers. So I'm really excited about what this opportunity means in terms of us taking a look at the whole story that we tell as a community about our waiver program under waiver reimagine. Otherwise we are often in a state of renewal and amendment, which is great work and very important, but this process is really going to allow us to start from the top and tell the story of waiver reimagine from a two-waiver system, and by building in this lane, readiness I believe is one of the lanes you're going to get to with topic six, and building in a robust community engagement approach. Let's do this in a way that is very meaningful and transparent, and let's involve everyone from the beginning as much as we can so that we don't have problems down the road. There's a lot of lessons to be learned from a lot of our major projects including CFSS, and the community engagement strategies we are considering, how do we start with a lead agency, and counties, where would they be able to get input on a regular basis? So I appreciate the feedback you've given so far, Jennifer.
>> I don't see other hands raised, but there's a couple comments in the chat. Lisa says, Jennifer, that is where charter comes in. You make good points, for sure. WRAC needs to look at the charter and agree on how to move forward. For my understanding, what is the charter being referred to there? Lisa, or do some of you at DHS --
>> This is Lisa. I'll just jump in. I have it in my hands. I don't know if I'm on camera here. Anyway, we have had a Waiver Reimagine Advisory Committee charter that was approved back in March 18th of 2022. It's about eight pages long or so. That is something that we kicked this whole thing off with, so the charter has never changed in all these years, so I always use that is my go-to. That's where we pull our work from, so it ties to it Jennifer is talking about, and I personally think we have lost sight of that. We don't look at the charter. They have lost our way in terms of what is our purpose as WRAC. So I think what is interesting is listening to topic three under policy, that is immensely important and ties to the charter, and I bring the question, are we changing our charter? It is so old, and so many things have changed in the three years, whether we were involved or not. So I would look at, has the charter become stale? I will ask that of the group.
>> That's great. That's helpful, Lisa, from a facilitation perspective, I've had bring that charter current and make sure it continues to be useful to the group. And I believe there is one other comment from Lisa. Heidi, I don't know if you want to chime in on this.
>> Sure. The comment is that the legislature is moving forward with changing the two-waiver system to be based on need, not where you live, so complete changed all the work WRAC has done for three years. Please comment on this. As I mentioned earlier, the house version has language related to DHS needing to report to the legislature on how the budget system addresses what a person's needs are, not where they live. That is not in the Senate language. We are not making any changes to the structure of the waiver reimagine project until we know what the legislature will end up with at the end. At this point we are still moving forward with the direction we have been given by the legislature until the legislature changes that direction.
>> Great. Okay. Curtis, I think you can move on to the next topic.
>> Can I add one thing, based on Lisa's comment? This is Kelly.
>> Go ahead.
>> I just want to clarify it. I touched on this earlier in the beginning of the meeting, but the reason we have all these policies coming forward from different groups and different people is because people are concerned their needs are not going to be met, and waiver reimagine is moving forward with or without people's input. We have got at least three policies I know of -- their people concerned, there is a carve out bill, let HF1978, asking for people have died abilities into the mental disabilities to get more nursing hours. We are basing it on where they live. We also have different people asking to keep nursing in the CDCS choice, because somehow that got taken out and thrown on Medical Assistance, even though we have said in these meetings that's not going to work for people. I just want to hit home, the reason people are going and making these carve out policies is because we are not making meaningful decisions in here that are basing waiver reimagine on needs. I will just share I'm a little frustrated that we canceled last December's meeting because we were going to pause and reflect, but yet CFSS still rolled out February 1st, if I recall the date. So this is still going forward, and I don't see meaningful change, and we have got to get to the point where you've got this to people here, listen to what we are saying, and please, we have got to get this going so we can make it make sense for everybody.
>> Thanks, Kelly. If I may, I'm going to move on to topic four and hopefully we will have time to have a conversation about future agenda-setting. So topic four is the home and community-based services portal. This is a person portal, the intent of which is to put information directly into the hands of each recipient electronically, so people can look up what their individualized budget is, and have helpful information about the status of their support plan or other information. The design of this portal, the impetus was to support waiver reimagine, but the application is much more broad than that in terms of working with the community. But right now we are in a process of requirements gathering, selecting a vendor, and launching a portal. There's going to be a ton of engagement around this topic. I'm just going to pause now and see if there are questions or comments on.
>> Curtis, it is Lisa. I'm going to jump in really quick. Is the portal being proposed as something brand-new that doesn't exist today?
>> Correct. It would be a portal that individual recipients would be able to go into and access information that their case manager would also be able to access, because we want to make sure that we have real accurate information, that everybody is looking at the same thing. But that people would be able to directly access and have more control, more information and more control over their situation. I hope that made sense. Did that help, Lisa?
>> I just want to add, Curtis, it is not a new requirement. This has been in statute since waiver reimagine was in statute, to require us to do a person portal.
>> Exactly. It's not a new expectation, but it would be a new thing. We don't have a portal today. But we have been working -- we have had this expectation on us for a number of years. Other questions, comments? Oh, and I see Dr. Kate has a comment. You're making the assumption that everyone has access to the Internet. That is a faulty assumption. Very true. Which means that the portal can be on the way that people access information, and we will have to look at what other mechanisms there are for doing so.
>> I have a question. This is Mary. What kind of information is going to be available? Is this going from MnCHOICES, we assess your needs as thus and such, and you might want to consider this and that service? The budget amounts are pretty clear cut, what kind of information?
>> Thanks, Mary. I am laughing only because I'm involved in the conversations about the budget amounts, nothing is as clear-cut as you might think. But for the budget amounts, I believe you are looking at how we can include support plan information. Having a robust dialogue about what we can share that would be helpful and not harmful. One of the things that we had a lot of dialogue around his sharing what's happening in terms of utilization and spending in your plan, and that can be harmful in that the data we have through our systems is typically lacking about 60 days behind reality. So that can be difficult. If I'm looking at my bank balance and it is 60 days out of date, that could get me into trouble. But we are looking at that and, frankly, we are looking at an implementation that would be a base implementation really would anticipate adding additional functionality over time, and building this as a robust solution for folks. I don't know if you have other comments on this, but we are very excited about this and don't see this as something that would be implemented and it's done and we never look at it again.
>> I would just add that folks who are on the CDCS option, this is opening up why the ability to see budgets across the system, and the hope is that it would be more information that really gets to those goals, the stated goals of waiver reimagine, to be able to have more information, to enhance informed choice and opportunities for self-direction, to be prepared for those conversations.
>> I see one more comment. How is the new portal different from what is available today? I don't know, Heidi or Leigh Ann, if you have a comment. We don't have a portal available today, so people don't have direct access electronically to their information. So this would be a new thing. People can find out about their support plan or whatever from the documents that have been shared with them by the case manager, by contacting case manager, but in one aspect is to be a way to access your information without having to rely on your case manager. Or wait for your case manager to get back to you with this information. And Polly said people might be thinking of the FMS portals. This would be different from that. But there's nothing more on this one, I'm going to move us on to topic five. IT systems. This is the behind the scenes stuff that the public often isn't aware of, but that can really upset the apple cart when it comes to what happens with the end product. For now I will just say that we have intensive engagement with our systems people behind the scenes across the board to make sure that the wiring that has to occur behind the scenes to enable waiver reimagine is being addressed and is happening on a timely basis. So I'm going to just pause there and take a breath and let people ask questions. By the way, I also see that Patricia had her and raised.
>> Sorry we missed you, Tricia.
>> That's okay, sorry. I'm joining by phone today and it's not ideal. I just wanted to point out about the portal, that it's a wonderful opportunity for DHS to partner with stakeholders. Back it up, get stakeholders right there with you at that stage of design before you even get to any implementation, because that portal -- stakeholders are going to have so much valuable insight for you in creating that, and I think it's a great opportunity for partnership.
>> Totally agree. Ideally before implementation, but that portal will be one of the things that I'm really excited about, its ability to be adapted over time. If I've learned nothing else in my experience in three plus decades of working in this field, what people want today is going to be different from what they want in five years. I like the idea of having some flexibility with that portal. IT systems, any questions on this slide? If there are not, I would not be surprised. This isn't the most transparent slide. The last of the topics, and then we can recap and move on with the agenda. System readiness and change management. Identifying training needs, data development. My favorite topic, minimize disruption. There is a lot that can be captured under this topic area, and I would suggest it might be the most open to adaptation as we move forward. In the interest of time, I'm going to pause, take a breath, and ask for questions, comments.
>> Tricia, is your hand up new or still from before?
>> Obviously still up from before, sorry!
>> It's okay. It is challenging.
>> I do think some of the concerns that were mentioned previously about CFSS, that kind of readiness could potentially drop into this. Obviously the topic areas have to chip into readiness. We can't let it be somebody else's problem. But I do like the idea of having a champion for readiness. I'm a big fan of that in our bureaucratic systems. Somebody has to ask the question, heavily laid out the process? To have measures about what is supposed to happen and how long it is supposed to take each step of the way so we can quickly identify something is broken? I see a comment from Lisa. If these objectives were applied to past rollouts, do you think they would have been more successful and why? MnCHOICES 2.0, examples. Theoretically, yes. But, again, these concepts that we are laying out here subject to how how they are executed. I think that is where WRAC comes to play, in part, but not to put it on you. Having that accountability to you and the public about if we are executing what we said we would do, and if you are getting enough information to tell whether that's happening. I hope that, it makes sense. I'm very conscious --
>> I would add, Curtis --
>> And end up with something like that. Go ahead, Leigh Ann.
>> I would just add, the structure is really what is the highlight here, having these layers and having this governance of the sponsorship and requiring us all to come together as leads once a week to highlight updates and uncover blind spots and seek clarity on decisions. It's going to be important and why I do think this is setting us up for more success.
>> We definitely have learned from other projects and what has worked well and what has not worked well. This structure is similar to other complex projects that DHS has had in addition to the ones that Lisa identified, so they are trying to learn from what has worked and what hasn't worked and incorporate that.
>> Well, that concludes the set of topic areas --
>> Sue has her hand up.
>> Hi, I represent day employment services within organization in Rochester, Minnesota. I really appreciate this thorough explanation and breakdown of the topics. I just had a thought that, in reality, each one of these topics could serve as a minimal subcommittee to waiver reimagine, where volunteers could sit on one of these subcommittees to kind of expedite the discussion in the process forward. That if we did that, for example, I would likely volunteer for communications, then it would help. Not that, Curtis, as you say, we are involved in all of this and all topics related, particularly ITN some of the others, but we could give some input specific toward waiver reimagine and its success with ideas that we may have on them. I think they would be good subcommittees.
>> Thanks, Sue. Just to clarify, you're talking about subcommittees to the WRAC, the Waiver Reimagine Advisory Committee?
>> Yes, subcommittees with DHS lead on each of them, but subcommittees to the WRAC with WRAC members serving on them as volunteers. Because all the topics relate to what we are doing.
>> That's great, Sue, and I think from facilitation -- I see a comment coming in, with all due respect, if DHS believes we have expertise in these areas, people should be paid, no volunteers. So some differences of thinking there, but I think the idea of how WRAC members gave more specialized and targeted involvement in these different work streams, I think that's a good idea to wrestle with and think about what might be the right mechanism if there is interest.
>> Thank you.
>> Great.
>> Well, thank you all for your engagements. Lots of great feedback. I don't want to make the mistake of jumping in too soon, Katie, if there's more questions, but if not I will turn it over to you.
>> Thank you, Curtis. Before we leave this topic, are there any final global comments or observations or questions before we move on? Okay. Thank you, Curtis. I think we can go to the next slide, then. Great. I will talk a little bit about this, and Heidi can jump in, as well. This is less of a facilitation proposal and I would say tweak to the functioning of WRAC. This is based on the feedback I heard in the feedback sessions, an idea to propose to this group. This really comes from, again, feedback that my office heard, that there feels like a disconnect between DHS and these meetings where DHS is doing a lot of work between meetings, a lot is happening between meetings, and they don't always feel as cocreated or collaboratives as members would like, also reflecting on some feedback my office heard that sometimes the agendas, it is not quite clear to members by particular agenda items appeared when they did and what the logical rationale was that went into the creation of agendas. So the thought was that, to have more cofacilitation, coplanning between WRAC members and DHS, that there could potentially be three members identified -- and we can talk about a process for that in a second -- that would meet with the DHS team between these meetings to debrief one meeting, so looking at how this discussion went in April, and then what would be the agenda that would come forward in June, and to help cocreate an craft that agenda along with DHS. Again, just a tweak, not a radical overhaul, but a way to have some more of that cocreation built in. And we can discuss the process of how those cochairs might be identified. Heidi, is there anything else you want to chime in on before we open it up for discussion?
>> I just wanted to clarify the comment about representing at least two areas. When we are talking about areas, we mean there's people on this committee who are people receiving services, family members at people receiving services, providers, agencies, advocacy, and others, too. So what we are talking about is having not all be family members, not all be providers, for example, representing different perspectives so they can have that as we work to develop the agendas.
>> Thanks for that clarification, Heidi. Really, the intent is -- the feedback my office heard, we want to get into substance, we want to get into the meat of the issues. That's crafty agenda so it feels like those needs are getting met. Really broadly, how a nomination process might work for this, we give some feedback on how this might look, potentially after this meeting a short description would go out to you all the email laying out the basics of what the role would be, how much time would be expected. Again, knowing that people are very busy trying to make this not onerous. And asking people to nominate cochairs. Either self nominating or nominating one of your colleagues, then a simple voting process, and selecting the members who have the most votes, but making sure again that those two areas are represented. And potentially this could move forward with those tri-chairs meeting before the June meeting. With that idea, we have one comment coming and already that a service user must be on this planning committee, so that comment is out there. I would just offer, again, from the feedback my office heard, I think the hope would be that this group would come together to really think about what is the collective work that we can all build a shared understanding around, how we can come together and do our best work, putting the common needs of the committee front and center, rather than a particular viewpoint or a particular vantage periods that would be an observation or a need I heard. Tricia, go ahead.
>> Thank you. I just wanted to say, first of all, I think this is a really great and much needed step in collaborating with the waiver reimagine advisory committee. I think it will be pivotal in the lady move forward, seeing that level of partnership. To put on my lens of working in family engagement for so long, I wanted to ask, will there be competition for these individuals who put in this extra time?
>> This is Adrienne. I can speak to that we are still confirming there will be a budget for that. However, it would be similar to the reimbursement process we have for the WRAC meetings now.
>> It's definitely a good start. When you look at the different aspects of engagement, partnering, collaborating, having a true voice, being equal at the table, that compensation can go a long way in setting that town. Thanks.
>> I can just add, Tricia, for the conversations I had with the DHS team, there is real awareness that the time commitment is real, and the amount of time that you all put into this. I just think there is an appreciation there and an understanding of how much time goes into this. Go ahead.
>> My thoughts aren't totally organized here, but would it be possible for these, let's say, three people to somehow be open to -- I don't know, emails or conversations, so they could maybe be a bridge between these meetings with DHS and those of us on the WRAC committee? Not to make it cumbersome, doing all these emailing or having all these conversations and whatnot, but maybe even last half hour of the WRAC meeting to be devoted to people that are interested in one of the three topics. If the topics are different, or a smaller group, just to have more -- like if there's questions. Either way, to get feedback from those of us that weren't there, or if we have questions about something. I'm just throwing that out there is a possibility.
>> Thank you, Pat. Let me just ask a clarifying question. Do you think this is important so that there can be more opportunity for people to voice concerns and needs connect tell me more about why -- I like this idea but I want to know more of the rationale behind it.
>> Right, right. Well, I have thought about it for a long time. Yeah, because when we are in smaller groups, like we were saying before, it can be easier to have discussion and questions that might not come up during the larger group, but also, if these three people -- I guess I'm not sure -- the three people would be representatives of the different groups that were talked about, but in terms of, would they be divided by topics? I guess that's the part maybe I'm confused about. Or -- like the three people would come together with DHS and the people involved, and then there would be discussion there and being hopefully part of the planning of the agendas and cocreating. But, if it were me, I would want to be hearing more from the group itself. Maybe that's just me, but that seems important, and me being part of the group, if there were three people that were meeting more regularly or in death or you want to call it, it might be nice to hear more about that discussion from another perspective, maybe, as a WRAC participant rather than DHS.
>> Yeah. Thank you, Pat. That helps a lot. And I'm watching the clock, so we want to make sure we have time to end on time. I think there's great things to wrestle with. I think one of the challenges will be how you have those spaces for small group or more informal discussion, or more reciprocal conversations, without taking a committee structure as a whole and feeling like there are side conversations that aren't inclusive to the whole group into the whole committee. So that would be something we want to figure out how to manage and how to balance, and I can put my group design process hat on and think that through. But I think there might be ways to meet both needs. Go ahead.
>> No, go ahead. I had one last thing if we have time, but go ahead. What were you going to say?
>> I was also going to clarify, with the cochairs, we can send out information on this in the email. The role of the cochairs would really be to set agendas and to bring topics back to the committee as a whole. Their role would not be to have separate problem-solving conversations with DHS, because that's not fair to all the committee members. Whoever the 3R that sits on this, they are not going to represent all the perspectives, even if they represent different user groups. You have many, many different perspectives, experiences on this committee. So the task of those three would be how we set the best container so that we can have the right decisions and make the wisest decisions together as a group, not that we are going to go over here and make decisions at the rest of the group isn't involved in, if that makes sense.
>> Yeah, totally. I guess for the transparency, that could be sending out -- well, maybe collecting from people, what they would like, and obviously this is a work in process, but I think there's ways of having it be a mutual benefit and also to be transparent. But probably the people need to hopefully -- the three people need to figure out with DHS and maybe bring that back to us, and maybe we can add -- not to make it into this long process, but just -- like we have been doing, so everybody has an opportunity to say, oh, it might look like this. You know, to cover some potential stumbling blocks, like Curtis says, to be preventative.
>> That's great. I see that Dr. Kate has her hand up, and we will go to you, as well. Will the cochairs pull agenda topics together from our charter cannot can introduce agenda topics which change the charter? Lisa, tear point, I think that would be really great thing, if we could find a way that the cochairs could maybe take a fresh look at that charter and bring ideas back to the group and say, here's how we are aligned with the charter, here are adjustments we might need to make. I think we could think about how to do that. That's a great suggestion. I would love it if in the final minutes -- sorry I'm rushing a little bit, I want to be respectful of people's time -- if you could use the chat, if anyone, knowing we don't have all the details worked out, but if anybody is really opposed to this idea, that would be helpful to know, and if you think this would be a helpful mechanism, that would be helpful to know. If you're willing to put that into the chat, that would be great. Dr. Kate, I will turn it to you.
>> I have serious concerns if the service user is not on this committee. I reject the idea that decisions about agendas are being made about users without direct input on already marginalized in many ways, and I don't feel it is appropriate to make decisions without input from people using waivers.
>> Okay. The concern is that this group of cochairs needs to include a user. Pat, did you have another comment?
>> No, sorry. I forgot to take the hand off.
>> Okay. I am hearing -- there's a couple responses to Dr. Kate, or I saw some thumbs up, that a user should be on this committee. Again, is there any -- is there anybody who has serious concerns come if it were to move forward with a user as one of the members, is there any concerns about bringing together a group of chairs? Okay. Thanks for those who are chiming in. The other thing, this is a process piece. We can modify, if this gets stood up and it's not working well, it can be modified. So it's not set in stone. But appreciate the feedback coming in on chat. With that, we are at a time, the next meeting is Thursday, June 26th, so please have that on your calendars. I am seeing generally that people are interested in moving through Dominic ahead with this idea, so please watch for more information. I will meet with the DHS team to see where he can go with this idea. DHS, anything else to say before we close out?
>> I will certainly say thank you all. I didn't know what to expect from the presentation. It was fantastic feedback. Thank you.
>> This is Jennifer. I just wanted to throw this out there, since we are trying to realign and get this committee back up and running in a good way, I guess, how many people into having sooner meetings than bimonthly? Otherwise I feel like, come the end of the year, we are really not going to get much done. It might take all summer long to figure out who is cochair and what is the agenda, and that really is disheartening to me, because I just want to see movement and progress. I see my community members 'lack of access of services, the time frame to get on a waiver, to access the services, it is so long, and I just really want to get to work and make these positive changes for everybody. I don't know how many people want to.
>> Jennifer, just ask a clarifying question, what would be the right cadence in your mind? Once a month connect this type of meeting once a month?
>> I'm actually thinking biweekly, because right now we need to get a look at the charter, get going on the cochairs, get going on the agenda. What are we working on? What is the priority list connect with the action plan? And then we can say, do we still keep meeting biweekly connect maybe it doesn't need to be two hours, but at least biweekly for one hour, and at first meeting we can say, maybe it does need to be an hour and a half or two hours. But I think we really need to get through this quickly so we can start doing the work that needs to be done. Otherwise we are just talking.
>> Great. Thanks for the clarification. I see some chats in agreement. It is helpful to you maybe if people don't feel comfortable here, let me or let the DHS space 19 know on the side. It's helpful for us to know if that doesn't work for people. Obviously DHS has staffing time constraints, so that is something we will have to look at, as well, but your desire to meet tomorrow, Jennifer, is noted, and I will say I rarely come to grips with are like, "let's meet more and move faster X-Men" so that's great that you have that energy and that commitment. Terrific. Great. Okay. Thank you, everyone. Have a great week. Thanks for all your participation here today, and take care.