Reflections on 10 Years of Disability Employment Systems Change: Minnesota’s Medicaid Infrastructure Grant MaryAlice Mowry, MIG Director September 12, 2011 National Home and Community-Based Services Conference
Jan 03, 2016
Reflections on 10 Years of Disability Employment Systems Change:Minnesota’s Medicaid Infrastructure Grant
MaryAlice Mowry, MIG DirectorSeptember 12, 2011National Home and Community-Based Services Conference
Systems Change Model: Self-Organizing Systems
A collection of individual agents, who have the freedom to act in unpredictable ways, and whose actions are interconnected such that they produce system-wide patterns.
• Ensures that all parts of a complex system act together in coherent ways.
• Over time participants will generate coherent patterns across the system.
Short List of Simple Rules
• Make connections; act across “silos”.
• It’s got to be about infrastructure.
• It has to be sustainable.• This is about ALL people with
disabilities.• It’s about people, not programs
Pathways to Employment: Short List of Simple Rules
Pathways to Employment: Changing the Conditions for Self-Organizing
• Multi-agency collaborative design• Blending and braiding funding• 5-year Strategic Plan• Grant-making that created new
opportunities• Encouraged innovation by imposing only
essential constraints• Built upon “exchanges” that already
existed
Systems Change Model: Change Maturity Model
ControlWork
The new idea has been integrated
into the system and is part of the expectations.
UnknownWork
Ideas and opportunities exist that we don’t know
anything about.
Adaptive WorkWe begin to adapt the new ideas to fit
our systems.
Learning WorkWe begin to learn about new ideas.
Identify what needs to leave the system…
• Vision/Core ValuesMN Department of Human Services
Continuing Care Division Vision
C ─ Community membership / integration H ─ Health, wellness and safety O ─ Own place to live I ─ Important long-term relationships C ─ Control over supports E ─ Employment earnings and stable income
• Changing mindsets
Pathways to Employment: Control Work within DHS - Disability Services Division
Pathways to Employment: Control Work / Sustainability Planning
• Creating a communications framework– Integrated messaging– Tools
• Supporting development of external capacity– MN Employment Policy Initiative– MN Training and Technical Assistance Center– MDE grants– Seven-County Metro Group
DB101:A Platform for Transformation• Support at all stages
• An expanded benefits planning systems
• What DB101 has to offer• Content• Estimators• Experts
Exploration & Planning Tool
DLL & db101.org
Phone & Online Assistance
Formal Benefits Planning
Work Incentives Connection
In-depth Phone & 1:1 Assistance
Data & Information
DHS
Back-end Support
Pathways to Employment: Control Work / Sustainability Planning
• Developing and embedding expertise– Training– Policy– Assessment
• Creating policy agenda and developing policy capacity– Medicaid Buy-In policy that incents work– Tracking employment-related policy across
agency
Sources: State taxes paid from MN Dept. of Revenue; Total annual premiums billed from MN Dept. of Human Services Special Recovery Unit. *reports amount of state taxes paid after tax credits**Represents total return to State, ½ of premiums collected go to federal government per federal medical assistance percentage
• Developing collaborative relationships within DHS and externally– “Connecting the dots” – keeping apprised of and
supporting various disability employment –related efforts
• Health Care Eligibility• Health Care Financing• Minnesota Family Investment Program• “Employment is a key protective factor…”
• Seizing opportunities– Money Follows the Person– Medicaid Reform Waiver
Pathways to Employment: Control Work / Sustainability Planning, cont.
An “Opt Out” System
Make Work
Part of the Plan
DB101Tools, resources, training and communications for Professionals
Waivered Services
Assessment (MN Choices)
Advocacy
Consistent Communicatio
nsInter- and
Intra-agency collaboration
Provider capacity
State policy
DB101On-line and “live chat” tools and resources for PWD and families