Position Statement — Quality Assurance in Minnesota

The State of Minnesota must work to maintain federal funding for Home and Community Based Services (HCBS) by establishing a quality assurance system to monitor and report on the quality of supports in Minnesota for individuals with intellectual and other developmental disabilities that complies with the Quality Framework introduced by the Center for Medicaid Services (CMS).


Position Statement

The Arc Minnesota supports the continued funding of the State Quality Council and funding for Regional Quality Councils at the local level to ensure the quality of services and supports for individuals with intellectual and developmental disabilities in Minnesota. The State Quality Council and future Regional Quality Councils must:

  • Include the participation of persons with intellectual and developmental disabilities, self-advocates, advocacy organizations, parents, and providers;
  • Assist the Department of Human Services to focus on all seven areas of the CMS framework for quality assurance;
  • Facilitate a person-centered focus on the needs of the individual;
  • Provide a process to solicit family and self-advocate input to determine whether current services and supports are creating positive, desirable outcomes for the individual consumer;
  • Provide an ongoing review process for all levels of the system; and
  • Be focused on continuous improvement in services and supports for each individual consumer.

The Arc Minnesota supports ongoing research to study trends and problem areas in disability services and supports, gather needed information, monitor the performance of state and county agencies, and make suggestions for program improvements and quality outcomes.

In 2003, CMS issued its Quality Framework that asks states using HCBS funding to maintain an ongoing quality assurance system to monitor and report on the quality of supports for individuals with intellectual and other developmental disabilities. The framework intends that state quality assurance efforts have components that foster discovery, remediation, and continuous improvement. It looks at the performance of service providers and at the performance of county and state agencies.

The seven areas of focus in the framework are: System Performance, Participant Access, Provider Capacity and Capabilities, Participant Safeguards, Participant Rights and Responsibilities, Participant Centered Service Planning and Delivery, and Participant Outcomes and Satisfaction.

Currently, Minnesota uses standards-based licensing (245D) that focuses on providers; it does not consider quality based on the needs of individual consumers or on positive outcomes for consumers. Standards-based licensing monitors compliance with minimum standards, but it has no provision to plan for continuous service improvement or to measure consumer outcomes and satisfaction. Also, as CMS has stated, Minnesota and other states do not formally monitor the performance of our system as a whole or the performance of county and state agencies. Recent cases of abuse and neglect and the Jensen lawsuit settlement make progress on statewide quality assurance more urgent.


Approved by The Arc Minnesota Position Statements Task Force on July 29, 2014.

Approved by The Arc Minnesota Public Policy Committee on August 20, 2014.

Approved by The Arc Minnesota Board of Directors on September 13, 2014.

Approved by delegates at The Arc Minnesota Annual Business Meeting, November 14, 2014.