Evaluation of Minnesota’s Home and Community-Based Services Assessment Process

Son/Grandson using digital tablet with his mother/grandmother

Problem

A need for insights to improve equity in Minnesota’s HCBS assessment process.

There are several known barriers influencing access to and use of HCBS. These barriers include knowledge of available services, languages for services, lack of culturally relevant information on services, lack of training on cultural humility and inclusivity for coordinators and care providers, cultural stigma against care for disabilities, and differences in eligibility. Black, Indigenous, and other communities of color have been disproportionately harmed by such barriers.

Solution

Engage community members to capture their experiences with Minnesota’s HCBS assessment process.

NORC, in partnership with local Minnesota community organizations, is leading a qualitative, culturally responsive equity evaluation. Through this evaluation, we aim to develop a deeper understanding of how people learn about HCBS services, what works and what does not work about the initial HCBS assessment process, and why people choose or do not choose HCBS services. We are engaging a mix of community members with experiences relevant to the diversity of the HCBS population with regards to age, disability, geographic location (rural, urban, suburban, tribal), participation in the HCBS process (providers, consumers, caregivers), and racial and ethnic identity, including immigrants and people from other marginalized communities. Our approach includes convening a diverse Community Advisory Board (CAB) to inform and decide on evaluation design, research questions, data collection approaches, analysis and interpretation of results, and dissemination. In addition, we are conducing semi-structured interviews with HCBS lead agency staff and community members eligible for HCBS and their caregivers. Where possible, we will recruit and train community members to serve as interviewers.

Result

Insights that can improve Minnesota’s HCBS policies.

Findings from this evaluation are forthcoming. These findings will be disseminated with research participants, community members, community organizations, and Minnesota policymakers. With input from a multidisciplinary advisory group of leaders and subject matter experts, these findings will be used to inform future work to develop measures, recommendations, and a framework to identify, measure, and assess disparities in the HCBS assessment process.