Minnesota Minnesota

Manual

Manual


Minnesota LTSS Advisory Council meeting minutes

Date: June 18, 2026

Facilitator: Michele Craig, Public Consulting Group

Approved by council vote: Aug. 20, 2026

Council members in attendance

  • · Addyson Carpenter: virtual
  • · Alexandra Kotze: virtual
  • · Anna Hegland: in-person
  • · Barbara Weckmann Brekke: in-person
  • · Colin Stemper: in-person
  • · Darla Thompson: virtual
  • · Genevieve Gaboriault: in-person
  • · Jay Johnson: virtual
  • · Jillian Nelson: virtual, joined after the April meeting vote
  • · Jennifer Giesen: in-person
  • · Lisa Vala: virtual
  • · Lori Schluttenhofer: virtual
  • · Nicole Hansen: virtual, not present after second recommendation vote
  • · Patricia Wright: virtual
  • · Patrick Meacham: in-person
  • · Rick Varco: virtual
  • · Roxanne Portner: virtual
  • · Sherry Gustafson: virtual
  • · Sherri Pickthorn: virtual, joined after the April meeting minutes vote
  • · Tarryl Clark: virtual
  • DHS support staff in attendance

  • · Rachel Shands: in-person
  • PCG support staff in attendance

  • · Michele Craig: in-person
  • · Jeremy Thomas: in-person
  • · Ryan White: virtual
  • · Katie Alijewicz: virtual
  • · James Nyberg: virtual
  • · Moncia Villareal: virtual
  • · Audrey Davis: virtual
  • · Jonathan Sauerschell: virtual
  • · Heather Fladmark: virtual
  • Council members not in attendance

  • · Jennifer Ballinger
  • · Lance Hegland
  • · Lisa Antony-Thomas
  • · Louella Kaufer
  • · Musab Khalif
  • · Zahnia Harut
  • DHS support staff not in attendance

  • · Jensina Rosen
  • Agenda topics

    Welcome, housekeeping and introduction

  • · Agenda review.
  • · Jennifer Giesen from the Minnesota Disability Law Center was introduced as a new member of the advisory council.
  • Council action

  • · Review of April 16, 2026, meeting minutes.
  • · Action: Adoption of April 16, 2026, meeting minutes.
  • · PCG asked the Council if there were any comments or requested edits to the meeting minutes. No comments or requested edits.
  • · Roll-call vote responses for adoption of minutes:
  • Addyson Carpenter: yes
  • Alexandra Kotze: yes
  • Anna Hegland: yes
  • Barbara Weckmann Brekke: yes
  • Colin Stemper: yes
  • Genevieve Gaboriault: yes
  • Jay Johnson: yes
  • Jennifer Ballinger: not present for vote
  • Jillian Nelson: not present for vote
  • Jennifer Giesen: abstain due to not being a member of the Council for the April 2026 meeting
  • Lance Hegland: not present for vote
  • Lisa Antony-Thomas: not present for vote
  • Lisa Vala: yes
  • Lori Schluttenhofer: yes
  • Louella Kaufer: not present for vote
  • Musab Khalif: not present for vote
  • Nicole Hansen: yes
  • Patricia Wright: yes
  • Patrick Meacham: yes
  • Rick Varco: yes
  • Roxanne Portner: yes
  • Sherri Pickthorn: not present for vote
  • Sherry Gustafson: yes
  • Tarryl Clark: yes
  • Zahnia Harut: not present for vote
  • Town hall updates

  • · PCG provided an update on the revised schedule of town hall meetings in July and next steps.
  • · Meetings were originally scheduled to occur between June 23, 2026-July 15, 2026. To provide an opportunity for community partners to hear about any new ideas that may emerge from the July workgroups, meetings have been moved to later in July.
  • · Community partners may join using the links provided and no registration is required.
  • · PCG sent council members the town hall meeting guide that has additional details on planning and logistics, including the questions that will be used to gather feedback.
  • · If Ccouncil members have any questions or comments, please send them directly to Michele Craig at PCG.
  • · PCG will work with DHS to refine the meeting content based on today’s meeting and the July workgroup meetings.
  • · Council members will be notified if there are substantive changes.
  • · PCG will send council members optional language to use to distribute the town hall information and links to participate.
  • · The council was asked if they had any comments or questions and there were no comments or questions raised.
  • · Council members are welcome to attend but not required.
  • 2026 legislative session

  • · This agenda item was added at the request of some council members to discuss as a full council as each of the three workgroups discussed the impact of the outcome of the session.
  • · A council member framed the conversation stating that many of the council’s ideas were implemented in legislative changes, resulting in significant cuts to long-term services and supports — and the total cuts were beyond the council’s original savings target. The member questioned whether the council should continue pursuing additional cuts, given impacts on vulnerable populations. The member suggested the council might have effectively completed its work, but recommended documenting and recognizing the value and origin of its contributions in the final report.
  • · DHS explained that although the Legislature adopted related savings, it did not attribute any of these to the council’s target or reduce the council’s required savings target, meaning the council’s task remains unchanged. DHS noted timing challenges: Future evaluation of targets will occur after 2027 with new leadership, while the council must still complete its report by December.
  • · Another council member added that their workgroups talked about ensuring that the cost reduction measures adopted in the 2026 legislative session that were also ideas brought forward by the council are included in the final report. The member expressed hope to advocate that the cost savings amount be applied to the council’s target in next year’s session.
  • · A member asked if cost savings reductions proposals (including the legislative contingencies for competitive workforce factor and county share) are for this biennium only or would be applied ongoing.
  • · DHS responded that their understanding is that the intent is to identify ongoing reductions and they will follow up with DHS finance staff to ensure that is the intent.
  • · A council member emphasized the importance of including implemented ideas and associated savings in the council’s report. They expressed hope that remaining recommendations could still be adopted in the 2027 session.
  • · A council member provided context that end-of-session legislative decisions drove many outcomes. The member supported documenting the achieved savings in the council’s report, encouraged separating completed work from potential future recommendations and emphasized urgency in using current influence to shape future decisions.
  • · Another council member agreed with prior speakers on including savings in the report and recognizing completed work. The member highlighted the opportunity to use the council’s expertise to propose long-term system improvements, not just cuts. The member raised concern about ongoing mandated cuts and questioned how proactive the council can be in influencing future legislative sessions. The member emphasized the strategic importance of coordinated advocacy.
  • · A council member questioned how much additional cuts are feasible, given substantial recent reductions and requested clear data on unacknowledged savings to support advocacy with legislators. Member stressed the importance of using that data in community and political engagement, especially during campaign fundraising. Member also highlighted the strain on providers and the disability services community.
  • · A council member urged that the report go beyond financial figures and reflect real human impacts. The member described cumulative and compounding pressures on providers, counties and individuals due to repeated cuts and policy changes. The member stressed the importance of capturing systemwide and personal consequences, not just dollar savings, in the council’s recommendations.
  • Workgroup updates

    Eligibility workgroup

  • · The workgroup has advanced the cost savings ideas to reinstate Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) fees and eliminate Community First Services and Supports (CFSS) consultation services.
  • · The workgroup tabled a few ideas, including reducing CFSS authorizations by one 15-minute unit, transferring all services and case management when a person moves to a new county. The workgroup began discussion in June on two new ideas: putting some limits around Medical Assistance for Employed Persons with Disabilities (MA-EPD) such as asset limits or premiums and if any limits could be instituted for paid parent services.
  • Benefits workgroup

  • · The workgroup spent most of their discussions on the idea to require people 65 and older to move to the Elderly Waiver (EW).
  • · They put forward two different versions for the fiscal note, with and without exceptions.
  • · They discussed the four cost savings ideas from the governor’s budget related to nursing facility reimbursement and agreed to advance those ideas to full council for consideration to include in the legislative report.
  • Provider rates workgroup

  • · The recent legislative session was the primary topic of conversation in their June meeting.
  • · Workgroup leads stated that the workgroup is committed to and wants to be helpful trying to find ideas, but it is difficult to find additional cuts with all the other reductions.
  • · The workgroup discussed some new ideas that included cost savings from rolling back the new certified assessor team enacted by the Legislature and limiting paid spousal or parental hours in CFSS.
  • Fiscal analysis discussion

  • · DHS presented fiscal analysis for cost savings recommendation ideas under discussion by the council.
  • DHS clarified that the costs are in ranges. As these are not fiscal notes, they will not have one number like they would in a fiscal note. Fiscal notes are based on legislation (bill language), so figures without that language are provided as estimates within a range.
  • · TEFRA fees
  • Fiscal estimates were presented for three scenarios:
  • · >675% of the federal poverty guidelines: $20 million-$25 million in savings
  • · >545% of the federal poverty guidelines: $35 million-$40 million in savings
  • · >275% of the federal poverty guidelines: $70 million-$75 million in savings
  • A council member asked if these estimates are for the biennium? DHS said it is for the biennium.
  • A council member asked if this includes the fees and the loss of participation. DHS said it does include both and noted that this is an estimate since the state no longer collects these fees, current data on the impact of fees is limited.
  • A council member noted they believed the previous fees were set for families at 275% of the federal poverty guidelines.
  • DHS shared the link to the formula for the computation of parental fees from June 1, 2014 (archived June 1, 2016): https://hcopub.dhs.state.mn.us/hcpmstd/16_20_10.htm.
  • · Elimination of CFSS consultation services
  • DHS presented that this initiative would be budget neutral because services will be accessed elsewhere in the system.
  • A council member said that they can see how that works for waiver services, but what about those on Medical Assistance fee for service?
  • DHS clarified that they also think costs will migrate between services.
  • Several council members expressed disappointment and disagreed with the budget neutrality finding, saying the service is duplicative and there must be savings involved with eliminating consultation services.
  • Another council member noted that they are not surprised that this proposal is budget neutral and that there are people who need these consultation services.
  • A council member commented in the chat that Itasca county has a social worker assigned to assist MA CFSS-only clients with their plans.
  • · People 65+ on the Brain Injury (BI) and Community Access for Disability Inclusion (CADI) waivers move to Elderly Waiver (with exceptions).
  • DHS presented that one version of this initiative (allowing certain exceptions) would achieve $20 million-$25 million in savings.
  • A council member noted that the figure is much lower than expected based on past analyses, recalling a previous figure of $80 million.
  • DHS noted that the estimate for the next version of this recommendation will be more in line with those expectations.
  • A council member asked how this recommendation saves money.
  • DHS clarified that savings are derived from lower rates on EW and case mix budget caps on EW as well.
  • A council member asked if there would be issues with Olmstead or other legal issues.
  • A member noted that this option preserves choice compared to the next option.
  • · People 65+ on BI and CADI move to EW (no exceptions)
  • DHS presented that this would achieve $100 million-$105 million in savings.
  • A council member asked if this would give people the option to move back to the CADI?
  • DHS clarified that the assumption with this proposal is that it provides no exceptions for people to move back to CADI after turning 65.
  • A council member observed that they are on CADI and when looking at the option to move to EW their budget would have increased significantly, which made them questions how there would be savings.
  • Break and public comment sign-up

  • · Two people signed up in the meeting chat.
  • First-round rating voting on recommendations

  • · Before starting the discussion on voting, DHS shared an update on the total LTSS cost reduction from the recent legislative session which was just slightly over $306 million.
  • · The meeting then proceeded to the voting procedure; voting yes would indicate that the idea should be explored further ahead of the August meeting, not necessarily support of the idea.
  • Facilitator presented the voting procedure based on what is described in the council’s charter.
  • A council member asked if members could abstain from their vote. DHS replied yes.
  • A council member noted that there are things on this list they don’t support but want to discuss further.
  • A council member questioned what the outcome of today’s vote means.
  • DHS and facilitator clarified that a yes vote advances recommendations for a final vote at the next council meeting and a no vote is to remove the idea from consideration.
  • A council member suggested a range vote, ranking recommendations on a scale of 1-10, to capture nuanced feelings.
  • DHS explained that we want clarity after this meeting and explained that a rating system would not meet the goals of the voting process (e.g., whether to advance recommendations).
  • A discussion ensued among members about the voting process, with some concerns expressed about the approach, particularly that the council should have had a say in determining the voting process.
  • The council achieved consensus that the voting process would proceed as planned.
  • A council member asked about voting on items that have no fiscal impact, reiterating the concern that the CFSS consultation service not having any savings does not make sense.
  • DHS confirmed that members will be asked to vote on the items that have no fiscal impact.
  • DHS clarified that the items being voted on today are the items put forth from the work groups. The next meeting with the final vote may include additional items.
  • The meeting then proceeded to voting on recommendations.
  • Recommendation: Eliminate CFSS Consultation Services

  • · Description and impact
  • Many council members view the consultation service as duplicative of case management and recommend consolidating it into existing case management services.
  • This proposal would require legislative and federal approval and could change how people access CFSS, particularly for those who rely on consultation services because they do not have a case manager.
  • Eliminating consultation services was also a common theme in community partner survey responses, including from people receiving services, counties, Tribal Nations and managed care organizations. According to DHS’s fiscal impact presentation, the proposal is expected to be cost neutral.
  • · A council member stated that they support eliminating consultation services and noted that they would like to see the numbers on this to see how budget neutrality was determined.
  • · A council member noted that consultation services are a key part of self-directed service delivery. The member said that while there might be some duplication, there are still a significant number of people that do not have a clear view of their service options and benefit from this service.
  • · A council member expressed they would prefer a modified version.
  • · Another council member shared they would like further conversation about including an exception for people who don't have access to managed care or county case managers and consultation services are not duplication.
  • · Vote record:
  • Addyson Carpenter: yes
  • Alexandra Kotze: yes
  • Anna Hegland: yes
  • Barbara Weckman Brekke: yes
  • Colin Stemper: yes
  • Darla Thompson: yes
  • Genevieve Gaboriault: yes
  • Jay Johnson: yes
  • Jennifer Ballinger, not present for vote
  • Jennifer Giesen: yes
  • Jillian Nelson: yes
  • Lance Hegland: not present for vote
  • Lisa Antony-Thomas: not present for vote
  • Lisa Vala: yes
  • Lori Schluttenhofer: yes
  • Louella Kaufer, not present for vote
  • Musab Khalif: not present for vote
  • Nicole Hansen: yes
  • Patricia Wright: yes
  • Patrick Meacham: yes
  • Richard Varco: no
  • Roxanne Portner: yes
  • Sherry Gustafson: yes
  • Sherri Pickthorn: yes
  • Tarry Clark: yes
  • Zahnia Harut: not present for vote
  • · Vote tally
  • 20 members in attendance voted
  • 6 members absent
  • 95% (19) yes
  • 5% (1) no
  • · After vote, a council member clarified that we need more fiscal information and noted that they supported moving forward, but with the expectation that there actually is a fiscal impact.
  • Recommendation: Reinstate TEFRA fees

  • · Description and impact
  • The proposal would reinstate parental fees for families with incomes at or above 675% of the federal poverty guidelines (or an alternative federal poverty guideline, as will be decided in the future) whose child qualifies for MA under the TEFRA option.
  • Implementation requires legislative and federal approval. An estimated 4.3% of families receiving MA under TEFRA would be affected under the 675% of FPF version. The change might reduce MA and HCBS use, as some families could delay or forgo services.
  • As noted in the fiscal impact presentation, three federal poverty guidance thresholds are under consideration, each with different cost savings. The eligibility workgroup has not reviewed these options; the current vote is on including the recommendation overall. The workgroup will discuss thresholds in July, with final recommendations presented for a vote in August.
  • · A council member stated they support reinstating TEFRA fees at 675% of federal poverty guidelines. The member explained that this is a good option when facing the reality of cutting services for the participants with the most need.
  • · No statement of dissent provided.
  • · There was additional council member discussion about the need to clarify which federal poverty guideline(s) will be included for the final recommendation and agreed this will be discussed in the July workgroup meeting.
  • · Vote record
  • Addyson Carpenter: yes
  • Alexandra Kotze: yes
  • Anna Hegland: yes
  • Barbara Weckman Brekke: yes
  • Colin Stemper: yes
  • Darla Thompson: yes
  • Genevieve Gaboriault: yes
  • Jay Johnson: yes
  • Jennifer Ballinger: not present for vote
  • Jennifer Giesen: yes
  • Jillian Nelson: yes
  • Lance Hegland: not present for vote
  • Lisa Antony-Thomas: not present for vote
  • Lisa Vala: yes
  • Lori Schluttenhofer: yes
  • Louella Kaufer: not present for vote
  • Musab M Khalif: not present for vote
  • Nicole Hansen: yes
  • Patricia Wright: yes
  • Patrick Meacham: yes
  • Richard Varco: abstain
  • Roxanne Portner: yes
  • Sherri Pickthorn: yes
  • Sherry Gustafson: yes
  • Tarryl Clark: yes
  • Zahnia Harut: not present for vote
  • · Vote tally
  • 20 members in attendance for vote
  • 6 members absent
  • 95% (19) yes
  • 5% (1) abstain
  • Recommendation: Require people age 65 and Older on the BI and CADI waivers to move to EW

  • · Description and impact
  • The proposal would require people to move to EW when they turn 65 as well as current participants 65 and older to transition to EW.
  • Implementation requires legislative and federal approval and might cause service disruptions. Participation in CADI and BI is expected to decline, while EW enrollment would increase.
  • To minimize impacts, the benefits workgroup developed two versions of this recommendation, each with different cost savings, as discussed in the fiscal impact review. The workgroup has not yet evaluated these fiscal impacts; today’s vote concerns overall inclusion of the recommendation. Further discussion will occur in the July benefits workgroup, with a final version presented for a vote in August.
  • · A council member stated the Elderly Waiver is designed to serve this population, and considering the reductions, this was the largest item that can help meet the target. Member noted that further discussion is needed about wording to avoid adverse impacts for people and that they are a yes vote on this recommendation.
  • · A council member stated that EW and CADI were designed for two different populations and needs. They advocate for keeping people who have a disability who qualify for the CADI waiver on the CADI waiver even after the age of 65. There are people on the CADI waiver whose needs would not be met on the EW, primarily noting the lack of assistive technology in the EW.
  • · A council member asked in the chat if population aging statistics (i.e., Baby Boom bubble) has been considered in the fiscal impact analysis.
  • · A council member shared that the state budget forecast accounts for these changes.
  • · Another council member clarified that they plan to vote a reserved yes today despite having significant concerns and strongly opposes moving everyone to EW. They agreed that assistive technology is a great example of something that wouldn’t be accessible for people who move over and they look forward to getting public input on this idea.
  • · Vote tally
  • Addyson Carpenter: yes
  • Alexandra Kotze: yes
  • Anna Hegland: yes
  • Barbara Weckman Brekke: yes
  • Colin Stemper: yes
  • Darla Thompson: yes
  • Genevieve Gaboriault: no
  • Jay Johnson: yes
  • Jennifer Ballinger: not present for vote
  • Jennifer Giesen: no
  • Jillian Nelson: no
  • Lance Hegland: not present for vote
  • Lisa Antony-Thomas: not present for vote
  • Lisa Vala: yes
  • Lori Schluttenhofer: yes
  • Louella Kaufer: not present for vote
  • Musab M Khalif: not present for vote
  • Nicole Hansen: not present for vote
  • Patricia Wright: no
  • Patrick Meacham: yes
  • Richard Varco III: abstain/maybe
  • Roxanne Portner: yes
  • Sherri Pickthorn: yes
  • Sherry Gustafson: abstain/maybe
  • Tarryl Clark: yes
  • Zahnia Harut: not present for vote
  • · Vote tally
  • 19 members present for vote
  • 7 members absent
  • 68% (13) yes
  • 21% (4) no
  • 11% (2) abstain/maybe
  • Recommendation: Eliminate the planned closure rate adjustment (PCRA) for nursing facilities

  • · Description and impact
  • Nursing facilities may be paid a rate add-on to incentivize the permanent closure of nursing facility beds and compensate them for the bed closures.
  • PCRA was implemented before the current cost-based reimbursement system, value-based reimbursement (VBR). Under VBR, nursing facility providers are reimbursed based on actual costs, including adjustments to reflect increases in fixed costs per day due to decreases in occupancy. Under current law, PCRA add-ons are paid in perpetuity until the facility ceases operation, resulting in duplicate payment for reduced bed capacity in both in VBR and PCRA.
  • Legislative and federal approval would be required. Because the proposal would decrease overall payment to nursing facilities, there might be an impact to people using these services.
  • · A council member stated the nursing facilities representative had the opportunity to join the council and they didn’t.
  • · No statement of dissent provided.
  • · A council member wrote in the meeting chat that the nursing home trade associations were not able to participate in the council due to an interpretation of the law that identifies members of the council.
  • · Vote record
  • Addyson Carpenter: yes
  • Alexandra Kotze: yes
  • Anna Hegland: yes
  • Barbara Weckman Brekke: yes
  • Colin Stemper: yes
  • Darla Thompson: yes
  • Genevieve Gaboriault: yes
  • Jay Johnson: yes
  • Jennifer Ballinger: not present for vote
  • Jennifer Giesen: yes
  • Jillian Nelson: yes
  • Lance Hegland: not present for vote
  • Lisa Antony-Thomas: not present for vote
  • Lisa Vala: yes
  • Lori Schluttenhofer: yes
  • Louella Kaufer: not present for vote
  • Musab M Khalif: not present for vote
  • Nicole Hansen: not present for vote
  • Patricia Wright: yes
  • Patrick Meacham: yes
  • Richard Varco: yes
  • Roxanne Portner: yes
  • Sherri Pickthorn: yes
  • Sherry Gustafson: yes
  • Tarryl Clark: yes
  • Zahnia Harut: not present for vote
  • · Vote tally
  • 19 members present for vote
  • 7 members absent
  • 100% (19) yes
  • Recommendation: Eliminate the performance-based incentive program (PIPP) for nursing facilities

  • · Description and impact
  • PIPP is a competitive program that selects and funds provider-initiated projects aimed at improving the quality and efficiency of nursing home care. Like PCRA, PIPP was implemented at a time when reimbursement rates were not cost-based. The program allowed nursing facilities to pay for additional costs related to these projects. However, under VBR, rates are already adjusted to reflect these costs, therefore this recommendation proposes the elimination of the PIPP as a duplicative payment.
  • Legislative and federal approval would be required. Because the proposal would decrease overall payment to nursing facilities, there might be an impact to people using these services.
  • · A council member stated nursing facilities had an opportunity to participate and they did not.
  • · A council member stated these funds have been shown to support quality improvement efforts. It’s a small amount of money that has a good impact for resident quality of life.
  • · Vote record
  • Addyson Carpenter: yes
  • Alexandra Kotze: yes
  • Anna Hegland: yes
  • Barbara Weckman Brekke: yes
  • Colin Stemper: yes
  • Darla Thompson: yes
  • Genevieve Gaboriault: no
  • Jay Johnson: yes
  • Jennifer Ballinger: not present for vote
  • Jennifer Giesen: no
  • Jillian Nelson: yes
  • Lance Hegland: not present for vote
  • Lisa Antony-Thomas: not present for vote
  • Lisa Vala: yes
  • Lori Schluttenhofer: yes
  • Louella Kaufer: not present for vote
  • Musab M Khalif: not present for vote
  • Nicole Hansen: not present for vote
  • Patricia Wright: yes
  • Patrick Meacham: yes
  • Richard Varco: yes
  • Roxanne Portner: no
  • Sherri Pickthorn: yes
  • Sherry Gustafson: yes
  • Tarryl Clark: yes
  • Zahnia Harut: not present for vote
  • · Vote tally
  • 19 members present for vote
  • 7 members absent
  • 84% (16) yes
  • 16% (3) no
  • Recommendation: Cap health insurance reimbursement for nursing facilities at $15,000 per enrollee

  • · Description and impact
  • Before cost-based payment rates established under the VBR, payments to nursing facilities for employee health insurance were included in the operating rates and thus subject to limits. 
  • Since VBR removed this reimbursement limit nine years ago, health insurance costs have increased by 69 percent. Some facilities with self-funded health insurance plans were reimbursed more than $30,000 per enrollee per year in the 2024 calendar year, more than triple the state contribution in the current plan year for state employees.
  • Legislative and federal approval would be required. Because the proposal would decrease nursing facility payment, there might be an impact to people using these services.
  • · A council member stated nursing facilities had an opportunity to participate and they did not.
  • · No statement of dissent provided.
  • · A member asked where these items will be discussed in the future.
  • Facilitator replied that this was part of the benefits group and can be discussed in any group; proposed adding it to the agenda for all three workgroups.
  • The member agreed and noted that they need the data before the meeting.
  • · Vote record
  • Addyson Carpenter: yes
  • Alexandra Kotze: yes
  • Anna Hegland: yes
  • Barbara Jean Weckman Brekke: yes
  • Colin Stemper: yes
  • Darla Thompson: yes
  • Genevieve Gaboriault: yes
  • Jay Johnson: yes
  • Jennifer Ballinger: not present for vote
  • Jennifer Giesen: yes
  • Jillian Nelson: yes
  • Lance Hegland: not present for vote
  • Lisa Antony-Thomas: not present for vote
  • Lisa Vala: yes
  • Lori Schluttenhofer: yes
  • Louella Kaufer: not present for vote
  • Musab M Khalif: not present for vote
  • Nicole Hansen: not present for vote
  • Patricia Wright: yes
  • Patrick Meacham: yes
  • Richard Varco: yes
  • Roxanne Portner: yes
  • Sherri Pickthorn: yes
  • Sherry Gustafson: yes
  • Tarryl Clark: yes
  • Zahnia Harut: not present for vote
  • · Vote tally
  • 19 members present for vote
  • 7 members absent
  • 100% (19) yes
  • Recommendation: Increase quality in nursing facilities

  • · Description and impact
  • VBR methodology reimburses based on a provider’s costs and ties payment limits to a nursing home’s quality scores. 
  • An independent evaluation of VBR by a team from Purdue University and the University of Minnesota in 2021 found no evidence that VBR’s quality incentives led to higher facility quality. They concluded that a revised threshold formula is needed for the VBR to meet the intended goals of increasing quality for Minnesotans accessing nursing home care.
  • This recommendation proposes changing the computation of the reimbursement limit for care-related costs within the VBR rate setting formula to create a stronger quality incentive while at the same time reward cost efficiencies.
  • Legislative and federal approval would be required. Because the proposal would decrease payment to some facilities, there might be an impact to people using these services.
  • · A council member stated that the nursing facility costs have increased very rapidly and should be part of the discussion.
  • · No statement of dissent provided.
  • · Vote record
  • Addyson Carpenter: yes
  • Alexandra Kotze: yes
  • Anna Hegland: yes
  • Barbara Jean Brekke: yes
  • Colin Stemper: yes
  • Darla Thompson: yes
  • Genevieve Gaboriault, abstain/maybe
  • Jay Johnson: yes
  • Jennifer Ballinger: not present for vote
  • Jennifer Giesen: abstain/maybe
  • Jillian Nelson: yes
  • Lance Hegland: not present for vote
  • Lisa Antony-Thomas: not present for vote
  • Lisa Vala: yes
  • Lori Schluttenhofer: yes
  • Louella Kaufer: not present for vote
  • Musab M Khalif: not present for vote
  • Nicole Hansen: not present for vote
  • Patricia Wright: yes
  • Patrick Meacham: yes
  • Richard Varco: yes
  • Roxanne Portner: yes
  • Sherri Pickthorn: yes
  • Sherry Gustafson: yes
  • Tarryl Clark: yes
  • Zahnia Harut: not present for vote
  • · Vote tally
  • 19 members present for vote
  • 7 members absent
  • 89% (17) yes
  • 11% (2) abstain/maybe
  • Summary and next steps

  • · A council member asked that we make clear in the minutes that a yes vote was not an indication of support, rather it is a vote to continue discussion. Facilitator noted that all recommendations received enough votes for continued discussion.
  • · A council member asked if there has been any movement on the fiscal impact on the competitive workforce factor (CWF) as proposed. DHS responded that it’s a priority and intends to share before the next workgroup meeting.
  • Public comment period

  • · Two people signed up in the meeting chat to provide public comment but were not present in the meeting when the public comment period began.
  • · No public comment was provided.
  • Action items

  • · Prepare CWF data and send to the Council.
  • Assigned to: DHS and PCG
  • Due date: Before July workgroup meetings
  • · Revisit fiscal analysis on the recommendation to eliminate CFSS consultation services and share updates with council.
  • Assigned to: DHS and PCG
  • Due date: Before July workgroup meetings or as soon as possible
  • · DHS follow up with DHS finance staff to confirm if contingent cost reductions in current law will be applied ongoing or just in the next biennium.
  • Assigned to: DHS
  • Due date: Before July workgroup meetings
  • · July and August workgroups: Council members continue to revise and finalize recommendation ideas for the August final vote; DHS/PCG continue to support with fiscal and impact analysis.
  • Assigned to: Council, DHS and PCG
  • Due date: July and August 2026.
  • Report this page