HF 3199

as introduced - 92nd Legislature (2021 - 2022) Posted on 03/03/2022 06:43pm

A bill for an act
relating to human services; increasing the limit on hours of personal assistance
services that can be provided by parents of minor children and by spouses;
amending Minnesota Statutes 2020, sections 256B.4911, by adding a subdivision;
256B.85, by adding a subdivision; Minnesota Statutes 2021 Supplement, section
256B.85, subdivisions 6, 7.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2020, section 256B.4911, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin Services provided by parents and spouses. new text end

new text begin (a) Upon federal approval, this
subdivision limits medical assistance payments under the consumer-directed community
supports option for personal assistance services provided by a parent to the parent's minor
child or by a spouse. This subdivision applies to the consumer-directed community supports
option available under all of the following:
new text end

new text begin (1) alternative care program;
new text end

new text begin (2) brain injury waiver;
new text end

new text begin (3) community alternative care waiver;
new text end

new text begin (4) community access for disability inclusion waiver;
new text end

new text begin (5) developmental disabilities waiver;
new text end

new text begin (6) elderly waiver; and
new text end

new text begin (7) Minnesota senior health option.
new text end

new text begin (b) For the purposes of this subdivision, "parent" means a parent, stepparent, or legal
guardian of a minor.
new text end

new text begin (c) If multiple parents are providing personal assistance services to their minor child or
children, each parent may provide up to 40 hours of personal assistance services in any
seven-day period regardless of the number of children served. The total number of hours
of personal assistance services provided by all of the parents must not exceed 80 hours in
a seven-day period regardless of the number of children served.
new text end

new text begin (d) If only one parent is providing personal assistance services to a minor child or
children, the parent may provide up to 60 hours of personal assistance services in a seven-day
period regardless of the number of children served.
new text end

new text begin (e) If a spouse is providing personal assistance services, the spouse may provide up to
60 hours of personal assistance services in a seven-day period.
new text end

new text begin (f) This subdivision must not be construed to permit an increase in the total authorized
consumer-directed community supports budget for an individual.
new text end

new text begin (g) If parents are providing all of their minor child's authorized units of personal assistance
services or if the person's spouse is providing all of the person's authorized units of personal
assistance services, the consumer-directed community supports community support plan
must include clearly identified measures to prevent social isolation of the minor or married
person. If the staffing situation described in this paragraph is temporary and due to a staffing
crisis, the consumer-directed community supports community support plan must also include
clearly identified measures to recruit additional direct care staff to provide personal assistance
services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall inform the revisor of statutes
when federal approval is obtained.
new text end

Sec. 2.

Minnesota Statutes 2021 Supplement, section 256B.85, subdivision 6, is amended
to read:

Subd. 6.

Community first services and supports service delivery plan.

(a) The CFSS
service delivery plan must be developed and evaluated through a person-centered planning
process by the participant, or the participant's representative or legal representative who
may be assisted by a consultation services provider. The CFSS service delivery plan must
reflect the services and supports that are important to the participant and for the participant
to meet the needs assessed by the certified assessor and identified in the coordinated service
and support plan identified in sections 256B.092, subdivision 1b, and 256S.10. The CFSS
service delivery plan must be reviewed by the participant, the consultation services provider,
and the agency-provider or FMS provider prior to starting services and at least annually
upon reassessment, or when there is a significant change in the participant's condition, or
a change in the need for services and supports.

(b) The commissioner shall establish the format and criteria for the CFSS service delivery
plan.

(c) The CFSS service delivery plan must be person-centered and:

(1) specify the consultation services provider, agency-provider, or FMS provider selected
by the participant;

(2) reflect the setting in which the participant resides that is chosen by the participant;

(3) reflect the participant's strengths and preferences;

(4) include the methods and supports used to address the needs as identified through an
assessment of functional needs;

(5) include the participant's identified goals and desired outcomes;

(6) reflect the services and supports, paid and unpaid, that will assist the participant to
achieve identified goals, including the costs of the services and supports, and the providers
of those services and supports, including natural supports;

(7) identify the amount and frequency of face-to-face supports and amount and frequency
of remote supports and technology that will be used;

(8) identify risk factors and measures in place to minimize them, including individualized
backup plans;

(9) be understandable to the participant and the individuals providing support;

(10) identify the individual or entity responsible for monitoring the plan;

(11) be finalized and agreed to in writing by the participant and signed by individuals
and providers responsible for its implementation;

(12) be distributed to the participant and other people involved in the plan;

(13) prevent the provision of unnecessary or inappropriate care;

(14) include a detailed budget for expenditures for budget model participants or
participants under the agency-provider model if purchasing goods; deleted text begin and
deleted text end

(15) include a plan for worker training and development provided according to
subdivision 18a detailing what service components will be used, when the service components
will be used, how they will be provided, and how these service components relate to the
participant's individual needs and CFSS support worker services deleted text begin . deleted text end new text begin ;
new text end

new text begin (16) include clearly identified measures to prevent social isolation of a minor participant
if all of the minor participant's support workers are the participant's parents, or of a married
participant if the participant's spouse is the participant's only support worker; and
new text end

new text begin (17) include clearly identified measures to recruit additional support workers if the
staffing situation described in clause (16) is temporary and due to a staffing crisis.
new text end

(d) The CFSS service delivery plan must describe the units or dollar amount available
to the participant. The total units of agency-provider services or the service budget amount
for the budget model include both annual totals and a monthly average amount that cover
the number of months of the service agreement. The amount used each month may vary,
but additional funds must not be provided above the annual service authorization amount,
determined according to subdivision 8, unless a change in condition is assessed and
authorized by the certified assessor and documented in the coordinated service and support
plan and CFSS service delivery plan.

(e) In assisting with the development or modification of the CFSS service delivery plan
during the authorization time period, the consultation services provider shall:

(1) consult with the FMS provider on the spending budget when applicable; and

(2) consult with the participant or participant's representative, agency-provider, and case
manager or care coordinator.

(f) The CFSS service delivery plan must be approved by the consultation services provider
for participants without a case manager or care coordinator who is responsible for authorizing
services. A case manager or care coordinator must approve the plan for a waiver or alternative
care program participant.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall inform the revisor of statutes
when federal approval is obtained.
new text end

Sec. 3.

Minnesota Statutes 2021 Supplement, section 256B.85, subdivision 7, is amended
to read:

Subd. 7.

Community first services and supports; covered services.

Services and
supports covered under CFSS include:

(1) assistance to accomplish activities of daily living (ADLs), instrumental activities of
daily living (IADLs), and health-related procedures and tasks through hands-on assistance
to accomplish the task or constant supervision and cueing to accomplish the task;

(2) assistance to acquire, maintain, or enhance the skills necessary for the participant to
accomplish activities of daily living, instrumental activities of daily living, or health-related
tasks;

(3) expenditures for items, services, supports, environmental modifications, or goods,
including assistive technology. These expenditures must:

(i) relate to a need identified in a participant's CFSS service delivery plan; and

(ii) increase independence or substitute for human assistance, to the extent that
expenditures would otherwise be made for human assistance for the participant's assessed
needs;

(4) observation and redirection for behavior or symptoms where there is a need for
assistance;

(5) back-up systems or mechanisms, such as the use of pagers or other electronic devices,
to ensure continuity of the participant's services and supports;

(6) services provided by a consultation services provider as defined under subdivision
17, that is under contract with the department and enrolled as a Minnesota health care
program provider;

(7) services provided by an FMS provider as defined under subdivision 13a, that is an
enrolled provider with the department;

(8) CFSS services provided by a support worker who is a parent, stepparent, or legal
guardian of a participant under age 18, or who is the participant's spouse. deleted text begin These support
workers shall not: deleted text end new text begin Covered services under this clause are subject to the limitations described
in subdivision 7b; and
new text end

deleted text begin (i) provide any medical assistance home and community-based services in excess of 40
hours per seven-day period regardless of the number of parents providing services,
combination of parents and spouses providing services, or number of children who receive
medical assistance services; and
deleted text end

deleted text begin (ii) have a wage that exceeds the current rate for a CFSS support worker including the
wage, benefits, and payroll taxes; and
deleted text end

(9) worker training and development services as described in subdivision 18a.

Sec. 4.

Minnesota Statutes 2020, section 256B.85, is amended by adding a subdivision to
read:

new text begin Subd. 7b. new text end

new text begin Services provided by parents and spouses. new text end

new text begin (a) This subdivision applies to
services and supports described in subdivision 7, clause (8).
new text end

new text begin (b) If multiple parents are support workers providing CFSS services to their minor child
or children, each parent may provide up to 40 hours of medical assistance home and
community-based services in any seven-day period regardless of the number of children
served. The total number of hours of medical assistance home and community-based services
provided by all of the parents must not exceed 80 hours in a seven-day period regardless of
the number of children served.
new text end

new text begin (c) If only one parent is a support worker providing CFSS services to the parent's minor
child or children, the parent may provide up to 60 hours of medical assistance home and
community-based services in a seven-day period regardless of the number of children served.
new text end

new text begin (d) If a spouse is a support worker providing CFSS services, the spouse may provide up
to 60 hours of medical assistance home and community-based services in a seven-day period.
new text end

new text begin (e) Paragraphs (b) to (d) must not be construed to permit an increase in either the total
authorized service budget for an individual or the total number of authorized service units.
new text end

new text begin (f) A parent or spouse must not receive a wage that exceeds the current rate for a CFSS
support worker, including the wage, benefits, and payroll taxes.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall inform the revisor of statutes
when federal approval is obtained.
new text end

Sec. 5. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; HOME
AND COMMUNITY-BASED SERVICES WAIVER AMENDMENTS.
new text end

new text begin No later than September 30, 2022, the commissioner of human services must submit to
the Centers for Medicare and Medicaid Services all initial amendments necessary to
implement Minnesota Statutes, section 256B.4911, subdivision 6.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end