Co-design with self-advocates, counties and Tribal Nations

Co-design means people who use services help shape a design before key decisions are fixed, with real influence over the result. It is different from informing people of a decision or consulting them on a near-final draft. All three have a place. Informing suits settled facts, like a new form's release date. Consulting suits choices among limited options. Co-design suits problems where people's lived experience is the best evidence about what will work, such as how a budget tool explains choices or how a person-centered plan is written. The mistake leaders make most often is calling consultation co-design, which people notice and remember.

Self-advocates and families bring knowledge no one else has, but participation has costs. Make it accessible from the start: plain language and easy-read materials sent in advance, enough time, support people welcomed, interpreters and accessible formats, and meeting times and places that work for participants. Compensate people for their time and expertise where your program's rules allow, and cover costs like transportation. Be clear about what can still change, what cannot and why, and report back on how input was used. DHS already runs channels that leaders can connect with, including the Advisory Task Force on Waiver Reimagine established by the Legislature, the Disability Hub MN Virtual Insight Panel for people with disabilities and families, and a Professional Insight Panel for county and Tribal Nation staff, providers and advocates.

Counties and Tribal Nations are partners with different roles and capacities. Counties, Tribal Nations and managed care organizations carry out MnCHOICES assessments and support planning, so any change to waivers, budgets or planning lands in their workflows first. A large metro county and a small rural county may have very different staffing, technology and caseloads, and a single rollout plan will not fit both. Plan training, phased timelines and feedback loops that account for those differences.

Tribal Nations are sovereign governments, not stakeholders. Minnesota Statutes section 10.65 requires DHS and other listed agencies to have a Tribal consultation policy, designate a Tribal liaison and consult with Minnesota Tribal governments on matters with Tribal implications. Consultation is government-to-government and led through the agency's formal process. Program leaders should involve the DHS Tribal liaison early, not after a design is complete, and should never treat a Tribal staff member's comments in a working group as a substitute for consultation.

Fictional case: Ingrid leads a DSD team redesigning the plain-language explanation people will see about support ranges and budgets. The team has a draft ready and plans to hold one listening session next week, then finalize. A self-advocate on an existing panel, Marcus, says the session feels like a formality. A Tribal Nation's human services director has not yet been contacted.

For one current project, write which decisions are open to co-design, which are open to consultation and which are settled. Identify one accessibility or compensation step you will add, and note whether and when the Tribal liaison needs to be involved.

Privately think about the last time you asked for input. Were you informing, consulting or co-designing, and how did you describe it to the people involved?