Waiver Reimagine is the name of ongoing work DHS is doing to simplify waiver services, reshape the waiver program structure and transition to an individual budgeting model for people who access disability waivers. For more information about this work, see the Waiver Reimagine webpage.
This webpage provides information about DHS’ work to simplify the service menu. We combined similar services across the disability waivers to make them easier to use and help people match the right services to their needs. In the new system, we simplified 12 services into six new service categories. The new services offer the same level of support, even though the names changed.
As of Jan. 1, 2021, a person who receives a service affected by these changes will receive the simplified service during a service change or at their annual reassessment.
If a service is not listed on this page, it is not affected by the Waiver Reimagine service changes. To see another visual of the service changes, visit the Waiver Reimagine streamlined service crosswalk in the Community-Based Services Manual.
The following sections provide examples of people’s service plans in 2020, compared to their service plans in 2021, when they transition to the new services.
| Existing services | Simplified service |
|---|---|
| Community residential services |
| Malik’s services in 2020 | Malik’s services in 2021 |
|---|---|
| Malik has been living in a foster care setting for the last year. They receive employment supports while working at the local live bait and tackle shop and seasonally at the ice rink. | Malik has a reassessment for services in May 2021. Based on their needs identified during their annual reassessment, Malik wants to continue living in the licensed residential setting and continue receiving employment support services. |
|
Services Malik received in 2020:
|
Services Malik will receive in 2021:
|
| Family residential services |
| Catalina’s services in 2020 | Catalina’s services in 2021 |
|---|---|
|
Catalina lives in a family foster care home. She has staff members who provide care while her foster parents get a break from caregiving one time per month. For the last five years, Catalina has been receiving services during the day through DT&H to build her skills to live more independently. |
Catalina has an annual reassessment for services in August 2021. Based on her needs identified during her reassessment, Catalina decides she wants to continue living with her foster family and continue receiving services during the day to help develop community living skills. She wants to explore her employment options, too. Catalina’s foster parents want to continue getting a break from caregiving one time per month. |
|
Services Catalina received in 2020:
|
Services Catalina will receive in 2021:
|
| Existing services | Simplified service |
|---|---|
| Individualized home supports without training |
| Kyle’s services in 2020 | Kyle’s services in 2021 |
|---|---|
|
Kyle lives in his own home and receives several services that support him to live independently. |
Kyle has a reassessment for services in January 2021. His reassessment determines that he is still eligible for waiver services. During the reassessment, Kyle shares that he needs grab bars to be installed in his shower for safe transferring. Kyle’s current support plan meets his ongoing assessed needs. His lead agency authorizes environmental accessibility adaptations to install grab bars in his shower. |
|
Services Kyle received in 2020:
|
Services Kyle will receive in 2021:
|
| Existing services | Simplified service |
|---|---|
| Individualized home supports with training |
| Francine’s services in 2020 | Francine’s services in 2021 |
|---|---|
|
Several years ago, Francine experienced a fall. She receives services during the day to receive specific training about sensory/motor development. Francine also receives day services to help her develop and maintain community living skills. She receives personal support and ILS training from the same provider. |
Francine has an annual reassessment for services in April 2021. Her reassessment determines that she is still eligible for waiver services. Her current support plan continues to meets her assessed needs. |
|
Services Francine received in 2020:
|
Services Francine will receive in 2021:
|
Tera, Teka and Thelma live together in a four-bedroom, single-family home owned by Thelma’s parents. The three women went to school together and recently finished their transition programs. Together with their families, they felt it was time to move into their own home, and they wanted to live together. They all receive daily SLS with shared staffing and shared asleep overnight services. Their current services in their home are not individualized to what each of them needs. As their renewals occur, their case managers need to update their support plans to be person-specific.
| Tera’s services in 2020 | Tera’s services in 2021 |
|---|---|
|
Tera attends DT&H and receives daily SLS with shared staffing. Tera has seizures that occur mostly during the nighttime hours. She uses shared asleep overnight services through SLS. |
Tera has an annual reassessment for services in October 2021. She decides to continue working with her day service provider, and she will transition from DT&H to day support services. She also decides to begin employment exploration to learn about types of employment that interest her. The reassessment determines Tera needs support with some activities of daily living (ADLs), including transferring, positioning, bathing, dressing and grooming. Her assessment shows she is eligible for personal care assistance (PCA). She decides to start PCA to receive those supports. In addition to PCA, Tera will use individualized home supports with training, Monday through Friday, to work on her support plan goals. |
|
Services Tera received in 2020:
|
Services Tera will receive in 2021:
|
| Teka’s services in 2020 | Teka’s services in 2021 |
|---|---|
|
Teka uses employment exploration services and receives daily SLS with shared staffing. Teka sometimes wakes up in the middle of the night, wanders and leaves the house. This happened six times in the last year. When this happens, an SLS staff member is on site to redirect Teka, ensure she remains in the home and prompt her to return to sleep. |
Teka has an annual reassessment for services in July 2021. She decides to continue with her employment goals and transition to employment development this year. For support at home, Teka will transition from SLS to individualized home supports with training. She will receive 24-hour emergency assistance to meet her overnight support needs. |
|
Services Teka received in 2020:
|
Services Teka will receive in 2021:
|
| Thelma’s services in 2020 | Thelma’s services in 2021 |
|---|---|
|
Thelma has been recovering from a major surgery. She receives support through SLS in the late afternoon to participate in virtual board games with her friends to remain connected during recovery. Thelma receives daily nursing visits to support her during her recovery. Overnight, Thelma often needs assistance using the bathroom. This need has increased during her recovery period after her surgery. Thelma presses her call button to wake staff to help her to the bathroom and get back to bed because her nighttime medications cause dizziness. |
Thelma has an annual reassessment for services in May 2021. She decides she is not ready to start working because she is recovering from her surgery. She wants to continue receiving support during the afternoons to connect with her friends. She will continue receiving skilled nursing visits. Thelma will receive 24-hour emergency assistance to meet her overnight support needs. |
|
Services Thelma received in 2020:
|
Services Thelma will receive in 2021:
|
For additional examples about transitioning from SLS to individualized home supports, visit the Service plan options for SLS page in the Community-Based Services Manual.
| Existing services | Simplified service |
|---|---|
| Individualized home supports with family training |
| Arthur’s services in 2020 | Arthur’s services in 2021 |
|---|---|
|
Arthur lives with his parents, who provide informal support during the week. Staff members provide in-home respite every other Saturday. Arthur and his parents receive training through in-home family supports. Arthur receives support and training to access his chosen community activities, navigate his community, develop household management skills and build resiliency. Arthur’s parents receive training to increase their skills to provide care for Arthur and support his training goals. |
Arthur has an annual reassessment for services in July 2021. The reassessment determines that Arthur is still eligible for waiver services. His current support plan meets his assessed needs. |
|
Services Arthur received in 2020:
|
Services Arthur will receive in 2021:
|
| Existing services | Simplified service |
|---|---|
| Day support services |
| Ruth’s services in 2020 | Ruth’s services in 2021 |
|---|---|
|
Ruth lives with her parents, who provide informal support during the week. She receives homemaker services because her primary caregivers (i.e., parents), who are regularly responsible for these activities, are unable to manage them. Ruth receives DT&H to develop skills that help her be more independent and included in her community. Her support plan focuses on opportunities for her to develop community relationships and use various community resources. |
Ruth has an early reassessment in February 2021, due to a change in condition. Her lead agency identifies that she needs additional support time in her existing services and a referral for respite. Ruth wants to continue increasing her skills for community integration, involvement and immersion into community life and activities. She will transition from DT&H to day support services. This transition means she will also transition from DT&H transportation to waiver transportation (one-way). |
|
Services Ruth received in 2020:
|
Services Ruth will receive in 2021:
|
| Victor’s services in 2020 | Victor’s services in 2021 |
|---|---|
|
Victor lives in his own home. He receives personal support and SLS from the same provider and DT&H from a different provider. Victor receives DT&H to develop work skills by completing work through a contract. He is taking classes to build a resume, learn workplace etiquette and solve problems. He is considering finding his own job in the community. |
Victor has an annual reassessment for services in March 2021. The reassessment determines that Victor is still eligible for waiver services. His current support plan meets his assessed needs. Victor will transition from personal support and SLS to individualized home supports with training because the same provider is delivering the services. To continue his work-skill development, he will transition from DT&H to prevocational services. To support his goal to find a job in the community, he will start receiving employment exploration services. |
|
Services Victor received in 2020:
|
Services Victor will receive in 2021:
|
| Existing services | Simplified service |
|---|---|
| Not applicable | Integrated community supports |
| Deshaun’s services in 2020 | Deshaun’s services in 2021 |
|---|---|
|
Deshaun lives in his own apartment. In 2020, he had an assessment that determined he was eligible for waiver services. He receives services to support household management and community participation, manage his health needs and help him navigate relationships with his neighbors. |
Deshaun has an annual reassessment for services in August 2021. He continues to have assessed needs for support and training in household management, community participation, health needs and relationships with his neighbors. During the reassessment, Deshaun shares that he wants to move to a new location, closer to his childhood home community. He also wants to start working again. Deshaun wants to receive as many of his supports and training as possible from the same provider. Deshaun’s case manager helps him find a new apartment. The apartment is an approved integrated community supports setting. Deshaun tours the apartment and likes it, so he agrees to move in. Deshaun shares with his case manager that he wants to receive services from the provider who controls the setting. The case manager makes a referral to the integrated community supports provider, and the provider accepts. The provider works with Deshaun to develop a support plan. Deshaun will receive integrated community supports with an average of 2.25 hours per day of 1:1 staffing. Deshaun will also receive employment exploration services from a different provider. |
|
Services Deshaun received in 2020:
|
Services Deshaun will receive in 2021:
|
