HF 4447

as introduced - 92nd Legislature (2021 - 2022) Posted on 03/28/2022 06:46pm

A bill for an act
relating to human services; providing strategies to retain, recruit, and revitalize
the human services frontline workforce; establishing a systemic critical incident
review team; increasing ICF/DD operating payment rates; modifying CFSS payment
rates; modifying elderly waiver payment rates; modifying the disability waiver
rate system base wage index; modifying the entities that may provide SNAP
employment and training services; establishing workforce incentive fund grants;
establishing mental health provider supervision grants; modifying income for tax
purposes; appropriating money; amending Minnesota Statutes 2020, sections
256.01, by adding a subdivision; 256B.0913, subdivisions 4, 5; 256B.5012, by
adding a subdivision; 256S.15, subdivision 2; 256S.18, by adding a subdivision;
256S.19, subdivision 3; 256S.211, by adding subdivisions; 256S.212; 256S.213;
256S.214; 256S.215; 290.0132, by adding a subdivision; 290.0674, subdivision
2a; Minnesota Statutes 2021 Supplement, sections 256B.851, subdivision 5;
256D.051, subdivision 22; 256S.21; 256S.2101, subdivision 2, by adding a
subdivision; 290A.03, subdivision 3; Laws 2022, chapter 33, section 1, subdivision
5a; proposing coding for new law in Minnesota Statutes, chapters 245I; 256;
repealing Minnesota Statutes 2020, section 256S.19, subdivision 4.

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

Section 1.

new text begin [245I.041] MENTAL HEALTH PROVIDER SUPERVISION GRANTS.
new text end

new text begin Subdivision 1. new text end

new text begin Grant program established. new text end

new text begin The commissioner of human services shall
award grants to licensed or certified mental health providers that meet the criteria in
subdivision 3 to fund supervision of interns and clinical trainees who are working toward
becoming licensed mental health professionals and to subsidize the costs of mental health
professional licensing applications and examination fees for clinical trainees.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following terms have the
meanings given.
new text end

new text begin (b) "Mental health professional" means an individual with a qualification specified in
section 245I.04, subdivision 2.
new text end

new text begin (c) "Underrepresented community" has the meaning given in section 148E.010,
subdivision 20.
new text end

new text begin Subd. 3. new text end

new text begin Eligible providers. new text end

new text begin In order to be eligible for a grant under this section, a mental
health provider must:
new text end

new text begin (1) provide at least 25 percent of the provider's yearly patient encounters to state public
program enrollees or patients receiving sliding fee schedule discounts through a formal
sliding fee schedule meeting the standards established by the United States Department of
Health and Human Services under Code of Federal Regulations, title 42, section 51c.303;
or
new text end

new text begin (2) primarily serve persons from communities of color or underrepresented communities.
new text end

new text begin Subd. 4. new text end

new text begin Application; grant award. new text end

new text begin A mental health provider seeking a grant under
this section must apply to the commissioner at a time and in a manner specified by the
commissioner. The commissioner must review each application to determine if the application
is complete, the mental health provider is eligible for a grant, and the proposed project is
an allowable use of grant money. The commissioner must determine whether to award a
grant to an applicant and the amount of any awarded grant.
new text end

new text begin Subd. 5. new text end

new text begin Allowable uses of grant money. new text end

new text begin A mental health provider must use grant
money received under this section for one or more of the following:
new text end

new text begin (1) to pay for direct supervision hours for interns and clinical trainees, in an amount up
to $7,500 per intern or clinical trainee;
new text end

new text begin (2) to establish a program to provide supervision to multiple interns or clinical trainees;
or
new text end

new text begin (3) to pay mental health professional licensing application and examination fees for
clinical trainees.
new text end

new text begin Subd. 6. new text end

new text begin Program oversight. new text end

new text begin During the grant period, the commissioner may require
grant recipients to provide the commissioner with information necessary to evaluate the
program.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 2.

Minnesota Statutes 2020, section 256.01, is amended by adding a subdivision to
read:

new text begin Subd. 12b. new text end

new text begin Department of Human Services systemic critical incident review team. new text end

new text begin (a)
The commissioner may establish a Department of Human Services systemic critical incident
review team to review required critical incident reports under section 626.557 for which
the Department of Human Services is responsible under section 626.5572, subdivision 13;
chapter 245D; or Minnesota Rules, chapter 9544. When reviewing a critical incident, the
systemic critical incident review team must identify systemic influences to the incident
rather than determining the culpability of any actors involved in the incident. The systemic
critical incident review may assess the entire critical incident process from the point of an
entity reporting the critical incident through the ongoing case management process.
Department staff must lead and conduct the reviews and may utilize county staff as reviewers.
The systemic critical incident review process may include but is not limited to:
new text end

new text begin (1) data collection about the incident and actors involved. Data may include the critical
incident report under review; previous incident reports pertaining to the person receiving
services; the service provider's policies and procedures applicable to the incident; the
coordinated service and support plan as defined in section 245D.02, subdivision 4b, for the
person receiving services; or an interview of an actor involved in the critical incident or the
review of the critical incident. Actors may include:
new text end

new text begin (i) staff of the provider agency;
new text end

new text begin (ii) lead agency staff administering home and community-based services delivered by
the provider;
new text end

new text begin (iii) Department of Human Services staff with oversight of home and community-based
services;
new text end

new text begin (iv) Department of Health staff with oversight of home and community-based services;
new text end

new text begin (v) members of the community including advocates, legal representatives, health care
providers, pharmacy staff, or others with knowledge of the incident or the actors in the
incident; and
new text end

new text begin (vi) staff from the Office of the Ombudsman for Mental Health and Developmental
Disabilities;
new text end

new text begin (2) systemic mapping of the critical incident. The team conducting the systemic mapping
of the incident may include any actors identified in clause (1), designated representatives
of other provider agencies, regional teams, and representatives of the local regional quality
council identified in section 256B.097; and
new text end

new text begin (3) analysis of the case for systemic influences.
new text end

new text begin (b) The critical incident review team must aggregate data collected and provide the
aggregated data to regional teams, participating regional quality councils, and the
commissioner. The regional teams and quality councils must analyze the data and make
recommendations to the commissioner regarding systemic changes that would decrease the
number and severity of critical incidents in the future or improve the quality of the home
and community-based service system.
new text end

new text begin (c) A selection committee must select cases for the systemic critical incident review
process from among the following critical incident categories:
new text end

new text begin (1) cases of caregiver neglect identified in section 626.5572, subdivision 17;
new text end

new text begin (2) cases involving financial exploitation identified in section 626.5572, subdivision 9;
new text end

new text begin (3) incidents identified in section 245D.02, subdivision 11;
new text end

new text begin (4) incidents identified in Minnesota Rules, part 9544.0110; and
new text end

new text begin (5) service terminations reported to the department in accordance with section 245D.10,
subdivision 3a.
new text end

new text begin (d) The systemic critical incident review under this section must not replace the process
for screening or investigating cases of alleged maltreatment of an adult under section 626.557.
The department, under the jurisdiction of the commissioner, may select for systemic critical
incident review cases reported for suspected maltreatment and closed following initial or
final disposition.
new text end

new text begin (e) A member of the systemic critical incident review team must not disclose what
transpired during the review, except to carry out the duties of the review. The proceedings
and records of the review team are protected nonpublic data as defined in section 13.02,
subdivision 13, and are not subject to discovery or introduction into evidence in a civil or
criminal action against a professional, the state, or a county agency arising out of the matters
that the team reviews. Information, documents, and records otherwise available from other
sources are not immune from discovery or use in a civil or criminal action solely because
the information, documents, and records were assessed or presented during review team
proceedings. A person who presented information before the systemic critical incident
review team or who is a member of the team must not be prevented from testifying about
matters within the person's knowledge. In a civil or criminal proceeding, a person must not
be questioned about the person's presentation of information to the review team or opinions
formed by the person as a result of the review.
new text end

Sec. 3.

new text begin [256.4778] WORKFORCE INCENTIVE FUND GRANTS.
new text end

new text begin Subdivision 1. new text end

new text begin Grant program established. new text end

new text begin The commissioner shall establish grants
for behavioral health, housing, disability, and home and community-based older adult
providers to assist with recruiting and retaining direct support and frontline workers.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following terms have the
meanings given.
new text end

new text begin (b) "Commissioner" means the commissioner of human services.
new text end

new text begin (c) "Eligible employer" means a nonprofit organization enrolled in Minnesota health
care programs or providing housing services that is at least one of the following:
new text end

new text begin (1) a provider of home and community-based services under chapter 245D;
new text end

new text begin (2) an agency provider or financial management services provider under section 256B.85;
new text end

new text begin (3) a home care provider licensed under sections 144A.43 to 144A.482;
new text end

new text begin (4) a facility certified as an intermediate care facility for persons with developmental
disabilities as defined under section 245D.02, subdivision 11a;
new text end

new text begin (5) a provider of home care services as defined under section 256B.0651, subdivision
1, paragraph (d);
new text end

new text begin (6) an agency as defined under section 256B.0949, subdivision 2;
new text end

new text begin (7) a provider of mental health day treatment services for children or adults as defined
under sections 245.4871, subdivision 10, and 256B.0671, subdivision 3, paragraph (b);
new text end

new text begin (8) a provider of emergency services as defined under section 256E.36;
new text end

new text begin (9) a provider of housing support as defined in chapter 256I;
new text end

new text begin (10) a provider of housing stabilization services as defined in section 256B.051;
new text end

new text begin (11) a provider of transitional housing programs as defined under section 256E.33;
new text end

new text begin (12) a provider of substance use disorder services as defined in chapter 245G;
new text end

new text begin (13) an eligible financial management services provider serving people through
consumer-directed community supports under chapter 256S and sections 256B.092 and
256B.49 or consumer support grants under section 256.476;
new text end

new text begin (14) a provider of customized living services as defined in section 256S.02; or
new text end

new text begin (15) a provider of services for children with an emotional disorder or adults with mental
illness under section 245I.011 or 256B.0671, including:
new text end

new text begin (i) assertive community treatment;
new text end

new text begin (ii) intensive residential treatment services;
new text end

new text begin (iii) adult rehabilitative mental health services;
new text end

new text begin (iv) mobile crisis services;
new text end

new text begin (v) children's therapeutic services and supports;
new text end

new text begin (vi) children's residential services;
new text end

new text begin (vii) psychiatric residential treatment facilities;
new text end

new text begin (viii) outpatient mental health treatment provided by mental health professionals,
community mental health center services, or certified community behavioral health clinics;
or
new text end

new text begin (ix) intensive mental health outpatient treatment services.
new text end

new text begin (d) "Eligible worker" means a worker who earns $30 per hour or less and has worked
in an eligible profession for at least six months. An eligible worker may receive up to $5,000
annually in payments from the workforce incentive fund.
new text end

new text begin Subd. 3. new text end

new text begin Allowable uses of money. new text end

new text begin (a) Grantees must use money awarded under this
section to provide payments to eligible workers for the following purposes:
new text end

new text begin (1) retention and incentive payments;
new text end

new text begin (2) postsecondary education loan and tuition payments;
new text end

new text begin (3) child care costs;
new text end

new text begin (4) transportation-related costs; or
new text end

new text begin (5) other costs associated with retaining and recruiting workers, as approved by the
commissioner.
new text end

new text begin (b) The commissioner must develop a grant cycle distribution plan that allows for
equitable distribution of funding among eligible employer types. The commissioner's
determination of the grant awards and grant amounts is final and is not subject to appeal.
new text end

new text begin (c) The commissioner must make efforts to prioritize eligible employers owned by Black,
Indigenous, and people of color and small to midsize eligible employers.
new text end

new text begin Subd. 4. new text end

new text begin Attestation. new text end

new text begin As a condition of obtaining grant payments under this section, an
eligible employer must attest and agree to the following:
new text end

new text begin (1) the employer is an eligible employer;
new text end

new text begin (2) the total number of eligible employees;
new text end

new text begin (3) the employer will distribute the entire value of the grant to eligible employees
identified by the employer, as allowed under this section;
new text end

new text begin (4) the employer will create and maintain records of the total amount of grant money
awarded and how that money was distributed to eligible employees; and
new text end

new text begin (5) the employer will not use the money appropriated under this section for any purpose
other than the purposes permitted under this section.
new text end

new text begin Subd. 5. new text end

new text begin Self-directed services workforce. new text end

new text begin Grants paid to eligible employees providing
services within the covered programs defined in section 256B.0711 do not constitute a
change in a term or condition for individual providers in covered programs and are not
subject to the state's obligation to meet and negotiate under chapter 179A.
new text end

new text begin Subd. 6. new text end

new text begin Grants not to be considered income. new text end

new text begin (a) Notwithstanding any law to the
contrary, grant awards under this section must not be considered income, assets, or personal
property for purposes of determining eligibility or recertifying eligibility for:
new text end

new text begin (1) child care assistance programs under chapter 119B;
new text end

new text begin (2) general assistance, Minnesota supplemental aid, and food support under chapter
256D;
new text end

new text begin (3) housing support under chapter 256I;
new text end

new text begin (4) the Minnesota family investment program and diversionary work program under
chapter 256J; and
new text end

new text begin (5) economic assistance programs under chapter 256P.
new text end

new text begin (b) The commissioner of human services must not consider grant awards under this
section as income or assets under section 256B.056, subdivision 1a, paragraph (a); 3; or 3c,
or for persons with eligibility determined under section 256B.057, subdivision 3, 3a, or 3b.
new text end

new text begin Subd. 7. new text end

new text begin Audits and recoupment. new text end

new text begin (a) The commissioner may perform an audit under
this section up to six years after the grant is awarded to ensure the grantee:
new text end

new text begin (1) used the money solely for the purposes stated in subdivision 3;
new text end

new text begin (2) was truthful when making attestations under subdivision 4; and
new text end

new text begin (3) complied with the conditions of receiving a grant under this section.
new text end

new text begin (b) If the commissioner determines that a grantee used awarded money for purposes not
authorized under this section, the commissioner must treat any amount used for a purpose
not authorized under this section as an overpayment. The commissioner must recover any
overpayment.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 4.

Minnesota Statutes 2020, section 256B.0913, subdivision 4, is amended to read:

Subd. 4.

Eligibility for funding for services for nonmedical assistance recipients.

(a)
Funding for services under the alternative care program is available to persons who meet
the following criteria:

(1) the person is a citizen of the United States or a United States national;

(2) the person has been determined by a community assessment under section 256B.0911
to be a person who would require the level of care provided in a nursing facility, as
determined under section 256B.0911, subdivision 4e, but for the provision of services under
the alternative care program;

(3) the person is age 65 or older;

(4) the person would be eligible for medical assistance within 135 days of admission to
a nursing facility;

(5) the person is not ineligible for the payment of long-term care services by the medical
assistance program due to an asset transfer penalty under section 256B.0595 or equity
interest in the home exceeding $500,000 as stated in section 256B.056;

(6) the person needs long-term care services that are not funded through other state or
federal funding, or other health insurance or other third-party insurance such as long-term
care insurance;

(7) except for individuals described in clause (8), the monthly cost of the alternative
care services funded by the program for this person does not exceed 75 percent of the
monthly limit described under section 256S.18. This monthly limit does not prohibit the
alternative care client from payment for additional services, but in no case may the cost of
additional services purchased under this section exceed the difference between the client's
monthly service limit defined under section 256S.04, and the alternative care program
monthly service limit defined in this paragraph. If care-related supplies and equipment or
environmental modifications and adaptations are or will be purchased for an alternative
care services recipient, the costs may be prorated on a monthly basis for up to 12 consecutive
months beginning with the month of purchase. If the monthly cost of a recipient's other
alternative care services exceeds the monthly limit established in this paragraph, the annual
cost of the alternative care services deleted text begin shall deleted text end new text begin must new text end be determined. In this event, the annual cost
of alternative care services deleted text begin shall deleted text end new text begin must new text end not exceed 12 times the monthly limit described in
this paragraph;

(8) for individuals assigned a case mix classification A as described under section
256S.18, with (i) no dependencies in activities of daily living, or (ii) up to two dependencies
in bathing, dressing, grooming, walking, and eating when the dependency score in eating
is three or greater as determined by an assessment performed under section 256B.0911, the
monthly cost of alternative care services funded by the program cannot exceed $593 per
month for all new participants enrolled in the program on or after July 1, 2011. This monthly
limit shall be applied to all other participants who meet this criteria at reassessment. This
monthly limit deleted text begin shall deleted text end new text begin must new text end be increased annually as described in section 256S.18. This monthly
limit does not prohibit the alternative care client from payment for additional services, but
in no case may the cost of additional services purchased exceed the difference between the
client's monthly service limit defined in this clause and the limit described in clause (7) for
case mix classification A; deleted text begin and
deleted text end

(9) the person is making timely payments of the assessed monthly fee deleted text begin . deleted text end new text begin ; and
new text end

new text begin (10) for a person participating in consumer-directed community supports, the person's
monthly service limit must be equal to the monthly service limits in clause (7), except that
a person assigned a case mix classification L must receive the monthly service limit for
case mix classification A.
new text end

A person is ineligible if payment of the fee is over 60 days past due, unless the person agrees
to:

(i) the appointment of a representative payee;

(ii) automatic payment from a financial account;

(iii) the establishment of greater family involvement in the financial management of
payments; or

(iv) another method acceptable to the lead agency to ensure prompt fee payments.

The lead agency may extend the client's eligibility as necessary while making
arrangements to facilitate payment of past-due amounts and future premium payments.
Following disenrollment due to nonpayment of a monthly fee, eligibility deleted text begin shall deleted text end new text begin must new text end not be
reinstated for a period of 30 days.

(b) Alternative care funding under this subdivision is not available for a person who is
a medical assistance recipient or who would be eligible for medical assistance without a
spenddown or waiver obligation. A person whose initial application for medical assistance
and the elderly waiver program is being processed may be served under the alternative care
program for a period up to 60 days. If the individual is found to be eligible for medical
assistance, medical assistance must be billed for services payable under the federally
approved elderly waiver plan and delivered from the date the individual was found eligible
for the federally approved elderly waiver plan. Notwithstanding this provision, alternative
care funds may not be used to pay for any service the cost of which: (i) is payable by medical
assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to pay a
medical assistance income spenddown for a person who is eligible to participate in the
federally approved elderly waiver program under the special income standard provision.

(c) Alternative care funding is not available for a person who resides in a licensed nursing
home, certified boarding care home, hospital, or intermediate care facility, except for case
management services which are provided in support of the discharge planning process for
a nursing home resident or certified boarding care home resident to assist with a relocation
process to a community-based setting.

(d) Alternative care funding is not available for a person whose income is greater than
the maintenance needs allowance under section 256S.05, but equal to or less than 120 percent
of the federal poverty guideline effective July 1 in the fiscal year for which alternative care
eligibility is determined, who would be eligible for the elderly waiver with a waiver
obligation.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 5.

Minnesota Statutes 2020, section 256B.0913, subdivision 5, is amended to read:

Subd. 5.

Services covered under alternative care.

Alternative care funding may be
used for payment of costs of:

(1) adult day services and adult day services bath;

(2) home care;

(3) homemaker services;

(4) personal care;

(5) case management and conversion case management;

(6) respite care;

(7) specialized supplies and equipment;

(8) home-delivered meals;

(9) nonmedical transportation;

(10) nursing services;

(11) chore services;

(12) companion services;

(13) nutrition services;

(14) family caregiver training and education;

(15) coaching and counseling;

(16) telehome care to provide services in their own homes in conjunction with in-home
visits;

(17) consumer-directed community supports deleted text begin under the alternative care programs which
are available statewide and limited to the average monthly expenditures representative of
all alternative care program participants for the same case mix resident class assigned in
the most recent fiscal year for which complete expenditure data is available deleted text end ;

(18) environmental accessibility and adaptations; and

(19) discretionary services, for which lead agencies may make payment from their
alternative care program allocation for services not otherwise defined in this section or
section 256B.0625, following approval by the commissioner.

Total annual payments for discretionary services for all clients served by a lead agency
must not exceed 25 percent of that lead agency's annual alternative care program base
allocation, except that when alternative care services receive federal financial participation
under the 1115 waiver demonstration, funding shall be allocated in accordance with
subdivision 17.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 6.

Minnesota Statutes 2020, section 256B.5012, is amended by adding a subdivision
to read:

new text begin Subd. 19. new text end

new text begin ICF/DD rate increases effective January 1, 2023. new text end

new text begin (a) For the rate period
beginning January 1, 2023, the commissioner must increase operating payments for each
facility reimbursed under this section by an amount equal to five percent of the operating
payment rates that were effective on December 31, 2022.
new text end

new text begin (b) For each facility, the commissioner must apply the rate increase based on occupied
beds, using the percentage specified in this subdivision multiplied by the total payment rate,
including the variable rate but excluding the property-related payment rate in effect on
December 31, 2022. The total rate increase must include the adjustment provided in section
256B.501, subdivision 12.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, or 60 days following
federal approval, whichever is later. The commissioner of human services shall notify the
revisor of statutes when federal approval is obtained.
new text end

Sec. 7.

Minnesota Statutes 2021 Supplement, section 256B.851, subdivision 5, is amended
to read:

Subd. 5.

Payment rates; component values.

(a) The commissioner must use the
following component values:

(1) employee vacation, sick, and training factor, 8.71 percent;

(2) employer taxes and workers' compensation factor, 11.56 percent;

(3) employee benefits factor, 12.04 percent;

(4) client programming and supports factor, 2.30 percent;

(5) program plan support factor, 7.00 percent;

(6) general business and administrative expenses factor, 13.25 percent;

(7) program administration expenses factor, 2.90 percent; and

(8) absence and utilization factor, 3.90 percent.

(b) For purposes of implementation, the commissioner shall use the following
implementation components:

(1) personal care assistance services and CFSS: deleted text begin 75.45 deleted text end new text begin 83.2 new text end percent;

(2) enhanced rate personal care assistance services and enhanced rate CFSS: deleted text begin 75.45 deleted text end new text begin 83.2 new text end
percent; and

(3) qualified professional services and CFSS worker training and development: deleted text begin 75.45 deleted text end new text begin
83.2 new text end percent.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, or 60 days following
federal approval, whichever is later. The commissioner of human services shall notify the
revisor of statutes when federal approval is obtained.
new text end

Sec. 8.

Minnesota Statutes 2021 Supplement, section 256D.051, subdivision 22, is amended
to read:

Subd. 22.

Duties of commissioner.

In addition to any other duties imposed by law, the
commissioner shall:

(1) supervise the administration of SNAP employment and training services to county,
Tribal, and contracted agencies new text begin and public and nonprofit postsecondary institutions new text end under
this section and Code of Federal Regulations, title 7, section 273.7;

(2) disburse money allocated and reimbursed for SNAP employment and training services
to county, Tribal, and contracted agencies new text begin and public and nonprofit postsecondary institutions new text end ;

(3) accept and supervise the disbursement of any funds that may be provided by the
federal government or other sources for SNAP employment and training services;

(4) cooperate with other agencies, including any federal agency or agency of another
state, in all matters concerning the powers and duties of the commissioner under this section;

(5) coordinate with the commissioner of employment and economic development to
deliver employment and training services statewide;

(6) work in partnership with counties, Tribes, and other agencies new text begin and public and nonprofit
postsecondary institutions new text end to enhance the reach and services of a statewide SNAP
employment and training program; and

(7) identify eligible nonfederal funds to earn federal reimbursement for SNAP
employment and training services.

Sec. 9.

Minnesota Statutes 2020, section 256S.15, subdivision 2, is amended to read:

Subd. 2.

Foster care limit.

The elderly waiver payment for the foster care service in
combination with the payment for all other elderly waiver services, including case
management, must not exceed the monthly case mix budget cap for the participant as
specified in sections 256S.18, subdivision 3, and 256S.19, deleted text begin subdivisions deleted text end new text begin subdivision new text end 3 deleted text begin and
4 deleted text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 10.

Minnesota Statutes 2020, section 256S.18, is amended by adding a subdivision
to read:

new text begin Subd. 3a. new text end

new text begin Monthly case mix budget caps for consumer-directed community
supports. new text end

new text begin The monthly case mix budget caps for each case mix classification for
consumer-directed community supports must be equal to the monthly case mix budget caps
in subdivision 3.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 11.

Minnesota Statutes 2020, section 256S.19, subdivision 3, is amended to read:

Subd. 3.

Calculation of monthly conversion budget deleted text begin cap without consumer-directed
community supports deleted text end new text begin caps new text end .

(a) The elderly waiver monthly conversion budget cap for the
cost of elderly waiver services deleted text begin without consumer-directed community supports deleted text end must be
based on the nursing facility case mix adjusted total payment rate of the nursing facility
where the elderly waiver applicant currently resides for the applicant's case mix classification
as determined according to section 256R.17.

(b) The elderly waiver monthly conversion budget cap for the cost of elderly waiver
services deleted text begin without consumer-directed community supports shall deleted text end new text begin must new text end be calculated by
multiplying the applicable nursing facility case mix adjusted total payment rate by 365,
dividing by 12, and subtracting the participant's maintenance needs allowance.

(c) A participant's initially approved monthly conversion budget cap for elderly waiver
services deleted text begin without consumer-directed community supports deleted text end shall be adjusted at least annually
as described in section 256S.18, subdivision 5.

new text begin (d) Conversion budget caps for individuals participating in consumer-directed community
supports are also set as described in paragraphs (a) to (c).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 12.

Minnesota Statutes 2021 Supplement, section 256S.21, is amended to read:

256S.21 RATE SETTING; APPLICATION.

The payment methodologies in sections 256S.2101 to 256S.215 apply to new text begin :
new text end

new text begin (1) new text end elderly waiver, elderly waiver customized living, and elderly waiver foster care under
this chapter;

new text begin (2) new text end alternative care under section 256B.0913;

new text begin (3) new text end essential community supports under section 256B.0922; and

new text begin (4) new text end community access for disability inclusion customized living and brain injury
customized living under section 256B.49.

Sec. 13.

Minnesota Statutes 2021 Supplement, section 256S.2101, subdivision 2, is
amended to read:

Subd. 2.

Phase-in for elderly waiver rates.

Except for home-delivered meals deleted text begin as
described in section 256S.215, subdivision 15 deleted text end , all rates and rate components for elderly
waiver, elderly waiver customized living, and elderly waiver foster care under this chapter;
alternative care under section 256B.0913; and essential community supports under section
256B.0922 deleted text begin shall deleted text end new text begin must new text end be the sum of deleted text begin 18.8 deleted text end new text begin 21.6 new text end percent of the rates calculated under sections
256S.211 to 256S.215, and deleted text begin 81.2 deleted text end new text begin 78.4 new text end percent of the rates calculated using the rate
methodology in effect as of June 30, 2017. deleted text begin The rate for home-delivered meals shall be the
sum of the service rate in effect as of January 1, 2019, and the increases described in section
256S.215, subdivision 15.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 14.

Minnesota Statutes 2021 Supplement, section 256S.2101, is amended by adding
a subdivision to read:

new text begin Subd. 3. new text end

new text begin Phase-in for home-delivered meals rate. new text end

new text begin The home-delivered meals rate for
elderly waiver under this chapter; alternative care under section 256B.0913; and essential
community supports under section 256B.0922 must be the sum of 65 percent of the rate in
section 256S.215, subdivision 15, and 35 percent of the rate calculated using the rate
methodology in effect as of June 30, 2017.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 15.

Minnesota Statutes 2020, section 256S.211, is amended by adding a subdivision
to read:

new text begin Subd. 3. new text end

new text begin Updating service rates. new text end

new text begin On January 1, 2023, and every two years thereafter,
the commissioner shall recalculate rates for services described in section 256S.2101,
subdivision 2, as directed by section 256S.215. Prior to recalculating the rates, the
commissioner shall:
new text end

new text begin (1) update the base wages in section 256S.212 based on the most recently available
Bureau of Labor Statistics Minneapolis-St. Paul-Bloomington, MN-WI MetroSA data;
new text end

new text begin (2) update the payroll taxes and benefits factor in section 256S.213, subdivision 1, based
on the most recently available nursing facility cost report data;
new text end

new text begin (3) update the registered nurse management and supervision wage component and the
unlicensed supervisor supervision wage component as directed in section 256S.213,
subdivisions 4 and 5; and
new text end

new text begin (4) update the adjusted base wage for the services as directed in section 256S.214.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 16.

Minnesota Statutes 2020, section 256S.211, is amended by adding a subdivision
to read:

new text begin Subd. 4. new text end

new text begin Updating the home-delivered meals rate. new text end

new text begin On July 1 of each year, the
commissioner shall update the home-delivered meals rate in section 256S.215, subdivision
15, by the percent increase in the nursing facility dietary per diem using the two most recent
and available nursing facility cost reports.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 17.

Minnesota Statutes 2020, section 256S.212, is amended to read:

256S.212 RATE SETTING; BASE WAGE INDEX.

Subdivision 1.

Updating SOC codes.

If any of the SOC codes and positions used in
this section are no longer available, the commissioner shall, in consultation with stakeholders,
select a new SOC code and position that is the closest match to the previously used SOC
position.

Subd. 2.

Home management and support services base wage.

For customized living deleted text begin , deleted text end new text begin
and new text end foster care deleted text begin , and residential care deleted text end component services, the home management and support
services base wage equals 33.33 percent of the Minneapolis-St. Paul-Bloomington, MN-WI
MetroSA average wage for new text begin home health and new text end personal deleted text begin and home deleted text end care deleted text begin aide deleted text end new text begin aides new text end (SOC code
deleted text begin 39-9021 deleted text end new text begin 31-1120 new text end ); 33.33 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA
average wage for food preparation workers (SOC code 35-2021); and 33.34 percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for maids and
housekeeping cleaners (SOC code 37-2012).

Subd. 3.

Home care aide base wage.

For customized living deleted text begin , deleted text end new text begin and new text end foster care deleted text begin , and
residential care deleted text end component services, the home care aide base wage equals deleted text begin 50 deleted text end new text begin 75 new text end percent of
the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for home health new text begin
and personal care new text end aides (SOC code deleted text begin 31-1011 deleted text end new text begin 31-1120 new text end ); and deleted text begin 50 deleted text end new text begin 25 new text end percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants
(SOC code deleted text begin 31-1014 deleted text end new text begin 31-1131 new text end ).

Subd. 4.

Home health aide base wage.

For customized living deleted text begin , deleted text end new text begin and new text end foster care deleted text begin , and
residential care deleted text end component services, the home health aide base wage equals deleted text begin 20 deleted text end new text begin 33.33 new text end percent
of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for licensed
practical and licensed vocational nurses (SOC code 29-2061); deleted text begin and 80 deleted text end new text begin 33.33 new text end percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants
(SOC code deleted text begin 31-1014 deleted text end new text begin 31-1131 new text end ) new text begin ; and 33.34 percent of the Minneapolis-St. Paul-Bloomington,
MN-WI MetroSA average wage for home health and personal care aides (SOC code
31-1120) new text end .

Subd. 5.

Medication setups by licensed nurse base wage.

For customized living deleted text begin , deleted text end new text begin and new text end
foster care deleted text begin , and residential care deleted text end component services, the medication setups by licensed nurse
base wage equals deleted text begin ten deleted text end new text begin 25 new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA
average wage for licensed practical and licensed vocational nurses (SOC code 29-2061);
and deleted text begin 90 deleted text end new text begin 75 new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average
wage for registered nurses (SOC code 29-1141).

Subd. 6.

Chore services base wage.

The chore services base wage equals deleted text begin 100 deleted text end new text begin 50 new text end percent
of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for landscaping
and groundskeeping workers (SOC code 37-3011) new text begin ; and 50 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for maids and housekeeping cleaners
(SOC code 37-2012) new text end .

Subd. 7.

Companion services base wage.

The companion services base wage equals
deleted text begin 50 deleted text end new text begin 80 new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage
for new text begin home health and new text end personal deleted text begin and home deleted text end care aides (SOC code deleted text begin 39-9021 deleted text end new text begin 31-1120 new text end ); and deleted text begin 50 deleted text end new text begin
20 new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for
maids and housekeeping cleaners (SOC code 37-2012).

Subd. 8.

Homemaker services and assistance with personal care base wage.

The
homemaker services and assistance with personal care base wage equals deleted text begin 60 deleted text end new text begin 50 new text end percent of
the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for new text begin home health
and new text end personal deleted text begin and home deleted text end care deleted text begin aide deleted text end new text begin aides new text end (SOC code deleted text begin 39-9021 deleted text end new text begin 31-1120 new text end ); deleted text begin 20 deleted text end new text begin and 50 new text end percent of
the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants
(SOC code deleted text begin 31-1014 deleted text end new text begin 31-1131 new text end ) deleted text begin ; and 20 percent of the Minneapolis-St. Paul-Bloomington,
MN-WI MetroSA average wage for maids and housekeeping cleaners (SOC code 37-2012) deleted text end .

Subd. 9.

Homemaker services and cleaning base wage.

The homemaker services and
cleaning base wage equals deleted text begin 60 percent of the Minneapolis-St. Paul-Bloomington, MN-WI
MetroSA average wage for personal and home care aide (SOC code 39-9021); 20 percent
of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing
assistants (SOC code 31-1014); and 20 deleted text end new text begin 100 new text end percent of the Minneapolis-St. Paul-Bloomington,
MN-WI MetroSA average wage for maids and housekeeping cleaners (SOC code 37-2012).

Subd. 10.

Homemaker services and home management base wage.

The homemaker
services and home management base wage equals deleted text begin 60 deleted text end new text begin 50 new text end percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for new text begin home health and new text end personal deleted text begin and home deleted text end
care deleted text begin aide deleted text end new text begin aides new text end (SOC code deleted text begin 39-9021 deleted text end new text begin 31-1120 new text end ); deleted text begin 20 deleted text end new text begin and 50 new text end percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants (SOC code
deleted text begin 31-1014 deleted text end new text begin 31-1131 new text end ) deleted text begin ; and 20 percent of the Minneapolis-St. Paul-Bloomington, MN-WI
MetroSA average wage for maids and housekeeping cleaners (SOC code 37-2012) deleted text end .

Subd. 11.

In-home respite care services base wage.

The in-home respite care services
base wage equals deleted text begin five deleted text end new text begin 15 new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA
average wage for registered nurses (SOC code 29-1141); 75 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for deleted text begin nursing assistants deleted text end new text begin home health and
personal care aides new text end (SOC code deleted text begin 31-1014 deleted text end new text begin 31-1120 new text end ); and deleted text begin 20 deleted text end new text begin ten new text end percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for licensed practical and licensed
vocational nurses (SOC code 29-2061).

Subd. 12.

Out-of-home respite care services base wage.

The out-of-home respite care
services base wage equals deleted text begin five deleted text end new text begin 15 new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI
MetroSA average wage for registered nurses (SOC code 29-1141); 75 percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for deleted text begin nursing assistants deleted text end new text begin
home health and personal care aides new text end (SOC code deleted text begin 31-1014 deleted text end new text begin 31-1120 new text end ); and deleted text begin 20 deleted text end new text begin ten new text end percent of
the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for licensed practical
and licensed vocational nurses (SOC code 29-2061).

Subd. 13.

Individual community living support base wage.

The individual community
living support base wage equals deleted text begin 20 deleted text end new text begin 60 new text end percent of the Minneapolis-St. Paul-Bloomington,
MN-WI MetroSA average wage for deleted text begin licensed practical and licensed vocational nurses deleted text end new text begin social
and human services aides new text end (SOC code deleted text begin 29-2061 deleted text end new text begin 21-1093 new text end ); and deleted text begin 80 deleted text end new text begin 40 new text end percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants
(SOC code deleted text begin 31-1014 deleted text end new text begin 31-1131 new text end ).

Subd. 14.

Registered nurse base wage.

The registered nurse base wage equals 100
percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for
registered nurses (SOC code 29-1141).

Subd. 15.

deleted text begin Social worker deleted text end new text begin Unlicensed supervisor new text end base wage.

The deleted text begin social worker deleted text end new text begin
unlicensed supervisor new text end base wage equals 100 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for deleted text begin medical and public health social deleted text end new text begin
first-line supervisors of personal service new text end workers (SOC code deleted text begin 21-1022 deleted text end new text begin 39-1098 new text end ).

new text begin Subd. 16. new text end

new text begin Adult day services base wage. new text end

new text begin The adult day services base wage equals 75
percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for home
health and personal care aides (SOC code 31-1120); and 25 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants (SOC code
31-1131).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 18.

Minnesota Statutes 2020, section 256S.213, is amended to read:

256S.213 RATE SETTING; FACTORS new text begin AND SUPERVISION WAGE
COMPONENTS new text end .

Subdivision 1.

Payroll taxes and benefits factor.

The payroll taxes and benefits factor
is the sum of net payroll taxes and benefits, divided by the sum of all salaries for all nursing
facilities on the most recent and available cost report.

Subd. 2.

General and administrative factor.

The general and administrative factor is
deleted text begin the difference of net general and administrative expenses and administrative salaries, divided
by total operating expenses for all nursing facilities on the most recent and available cost
report deleted text end new text begin 14.4 percent new text end .

Subd. 3.

Program plan support factor.

new text begin (a) new text end The program plan support factor is deleted text begin 12.8 deleted text end new text begin ten new text end
percent new text begin for the following services new text end to cover the cost of direct service staff needed to provide
support for deleted text begin home and community-based deleted text end new text begin the new text end service when not engaged in direct contact with
participants deleted text begin . deleted text end new text begin :
new text end

new text begin (1) adult day services;
new text end

new text begin (2) customized living; and
new text end

new text begin (3) foster care.
new text end

new text begin (b) The program plan support factor is 15.5 percent for the following services to cover
the cost of direct service staff needed to provide support for the service when not engaged
in direct contact with participants:
new text end

new text begin (1) chore services;
new text end

new text begin (2) companion services;
new text end

new text begin (3) homemaker services and assistance with personal care;
new text end

new text begin (4) homemaker services and cleaning;
new text end

new text begin (5) homemaker services and home management;
new text end

new text begin (6) in-home respite care;
new text end

new text begin (7) individual community living support; and
new text end

new text begin (8) out-of-home respite care.
new text end

Subd. 4.

Registered nurse management and supervision deleted text begin factor deleted text end new text begin wage component new text end .

The
registered nurse management and supervision deleted text begin factor deleted text end new text begin wage component new text end equals 15 percent of
the registered nurse adjusted base wage as defined in section 256S.214.

Subd. 5.

deleted text begin Social worker deleted text end new text begin Unlicensed supervisor new text end supervision deleted text begin factor deleted text end new text begin wage
component new text end .

The deleted text begin social worker deleted text end new text begin unlicensed supervisor new text end supervision deleted text begin factor deleted text end new text begin wage component new text end
equals 15 percent of the deleted text begin social worker deleted text end new text begin unlicensed supervisor new text end adjusted base wage as defined
in section 256S.214.

new text begin Subd. 6. new text end

new text begin Facility and equipment factor. new text end

new text begin The facility and equipment factor for adult
day services is 16.2 percent.
new text end

new text begin Subd. 7. new text end

new text begin Food, supplies, and transportation factor. new text end

new text begin The food, supplies, and
transportation factor for adult day services is 24 percent.
new text end

new text begin Subd. 8. new text end

new text begin Supplies and transportation factor. new text end

new text begin The supplies and transportation factor
for the following services is 1.56 percent:
new text end

new text begin (1) chore services;
new text end

new text begin (2) companion services;
new text end

new text begin (3) homemaker services and assistance with personal care;
new text end

new text begin (4) homemaker services and cleaning;
new text end

new text begin (5) homemaker services and home management;
new text end

new text begin (6) in-home respite care;
new text end

new text begin (7) individual community living support; and
new text end

new text begin (8) out-of-home respite care.
new text end

new text begin Subd. 9. new text end

new text begin Absence factor. new text end

new text begin The absence factor for the following services is 4.5 percent:
new text end

new text begin (1) adult day services;
new text end

new text begin (2) chore services;
new text end

new text begin (3) companion services;
new text end

new text begin (4) homemaker services and assistance with personal care;
new text end

new text begin (5) homemaker services and cleaning;
new text end

new text begin (6) homemaker services and home management;
new text end

new text begin (7) in-home respite care;
new text end

new text begin (8) individual community living support; and
new text end

new text begin (9) out-of-home respite care.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 19.

Minnesota Statutes 2020, section 256S.214, is amended to read:

256S.214 RATE SETTING; ADJUSTED BASE WAGE.

For the purposes of section 256S.215, the adjusted base wage for each position equals
the position's base wage under section 256S.212 plus:

(1) the position's base wage multiplied by the payroll taxes and benefits factor under
section 256S.213, subdivision 1;

deleted text begin (2) the position's base wage multiplied by the general and administrative factor under
section 256S.213, subdivision 2; and
deleted text end

deleted text begin (3) deleted text end new text begin (2) new text end the position's base wage multiplied by the new text begin applicable new text end program plan support factor
under section 256S.213, subdivision 3 deleted text begin . deleted text end new text begin ; and
new text end

new text begin (3) the position's base wage multiplied by the absence factor under section 256S.213,
subdivision 9, if applicable.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 20.

Minnesota Statutes 2020, section 256S.215, is amended to read:

256S.215 RATE SETTING; COMPONENT RATES.

Subdivision 1.

Medication setups by licensed nurse component rate.

The component
rate for medication setups by a licensed nurse equals the medication setups by licensed
nurse adjusted base wage.

Subd. 2.

Home management and support services component rate.

The component
rate for home management and support services is new text begin calculated as follows:
new text end

new text begin (1) sum new text end the home management and support services adjusted base wage deleted text begin plus deleted text end new text begin and new text end the
registered nurse management and supervision deleted text begin factor. deleted text end new text begin wage component;
new text end

new text begin (2) multiply the result of clause (1) by one plus the general and administrative factor;
and
new text end

new text begin (3) sum the results of clauses (1) and (2).
new text end

Subd. 3.

Home care aide services component rate.

The component rate for home care
aide services is new text begin calculated as follows:
new text end

new text begin (1) sum new text end the home health aide services adjusted base wage deleted text begin plus deleted text end new text begin and new text end the registered nurse
management and supervision deleted text begin factor. deleted text end new text begin wage component;
new text end

new text begin (2) multiply clause (1) by one plus the general and administrative factor; and
new text end

new text begin (3) sum the results of clauses (1) and (2).
new text end

Subd. 4.

Home health aide services component rate.

The component rate for home
health aide services is new text begin calculated as follows:
new text end

new text begin (1) sum new text end the home health aide services adjusted base wage deleted text begin plus deleted text end new text begin and new text end the registered nurse
management and supervision deleted text begin factor. deleted text end new text begin wage component;
new text end

new text begin (2) multiply the result of clause (1) by one plus the general and administrative factor;
and
new text end

new text begin (3) sum the results of clauses (1) and (2).
new text end

Subd. 5.

Socialization component rate.

The component rate under elderly waiver
customized living for one-to-one socialization equals the home management and support
services component rate.

Subd. 6.

Transportation component rate.

The component rate under elderly waiver
customized living for one-to-one transportation equals the home management and support
services component rate.

Subd. 7.

Chore services rate.

The 15-minute unit rate for chore services is calculated
as follows:

(1) sum the chore services adjusted base wage and the deleted text begin social worker deleted text end new text begin unlicensed supervisor new text end
supervision deleted text begin factor deleted text end new text begin wage component new text end ; deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by one plus the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by one plus the supplies and transportation factor;
and
new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1) deleted text end by four.

Subd. 8.

Companion services rate.

The 15-minute unit rate for companion services is
calculated as follows:

(1) sum the companion services adjusted base wage and the deleted text begin social worker deleted text end new text begin unlicensed
supervisor new text end supervision deleted text begin factor deleted text end new text begin wage component new text end ; deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by one plus the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by one plus the supplies and transportation factor;
and
new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1) deleted text end by four.

Subd. 9.

Homemaker services and assistance with personal care rate.

The 15-minute
unit rate for homemaker services and assistance with personal care is calculated as follows:

(1) sum the homemaker services and assistance with personal care adjusted base wage
and the deleted text begin registered nurse management and deleted text end new text begin unlicensed supervisor new text end supervision deleted text begin factor deleted text end new text begin wage
component new text end ; deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by one plus the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by one plus the supplies and transportation factor;
and
new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1) deleted text end by four.

Subd. 10.

Homemaker services and cleaning rate.

The 15-minute unit rate for
homemaker services and cleaning is calculated as follows:

(1) sum the homemaker services and cleaning adjusted base wage and the deleted text begin registered
nurse management and deleted text end new text begin unlicensed supervisor new text end supervision deleted text begin factor deleted text end new text begin base wage new text end ; deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by one plus the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by one plus the supplies and transportation factor;
and
new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1) deleted text end by four.

Subd. 11.

Homemaker services and home management rate.

The 15-minute unit rate
for homemaker services and home management is calculated as follows:

(1) sum the homemaker services and home management adjusted base wage and the
deleted text begin registered nurse management and deleted text end new text begin unlicensed supervisor new text end supervision deleted text begin factor deleted text end new text begin wage component new text end ;
deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by one plus the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by one plus the supplies and transportation factor;
and
new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1) deleted text end by four.

Subd. 12.

In-home respite care services rates.

(a) The 15-minute unit rate for in-home
respite care services is calculated as follows:

(1) sum the in-home respite care services adjusted base wage and the registered nurse
management and supervision deleted text begin factor deleted text end new text begin wage component new text end ; deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by one plus the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by one plus the supplies and transportation factor;
and
new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1) deleted text end by four.

(b) The in-home respite care services daily rate equals the in-home respite care services
15-minute unit rate multiplied by 18.

Subd. 13.

Out-of-home respite care services rates.

(a) The 15-minute unit rate for
out-of-home respite care is calculated as follows:

(1) sum the out-of-home respite care services adjusted base wage and the registered
nurse management and supervision deleted text begin factor deleted text end new text begin wage component new text end ; deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by one plus the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by one plus the supplies and transportation factor;
and
new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1) deleted text end by four.

(b) The out-of-home respite care services daily rate equals the 15-minute unit rate for
out-of-home respite care services multiplied by 18.

Subd. 14.

Individual community living support rate.

The individual community living
support rate is calculated as follows:

(1) sum the deleted text begin home care aide deleted text end new text begin individual community living support new text end adjusted base wage
and the deleted text begin social worker deleted text end new text begin registered nurse management and new text end supervision deleted text begin factor deleted text end new text begin wage component new text end ;
deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by one plus the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by one plus the supplies and transportation factor;
and
new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1) deleted text end by four.

Subd. 15.

Home-delivered meals rate.

The home-delivered meals rate equals deleted text begin $9.30 deleted text end new text begin
$8.17 new text end . deleted text begin The commissioner shall increase the home delivered meals rate every July 1 by the
percent increase in the nursing facility dietary per diem using the two most recent and
available nursing facility cost reports.
deleted text end

Subd. 16.

Adult day services rate.

The 15-minute unit rate for adult day services deleted text begin , with
an assumed staffing ratio of one staff person to four participants, is the sum of deleted text end new text begin is calculated
as follows new text end :

(1) deleted text begin one-sixteenth of the home care aide deleted text end new text begin divide the adult day new text end services adjusted base wage deleted text begin ,
except that the general and administrative factor used to determine the home care aide
services adjusted base wage is 20 percent deleted text end new text begin by five to reflect an assumed staffing ratio of one
to five new text end ;

(2) deleted text begin one-fourth of the registered nurse management and supervision factor deleted text end new text begin sum the result
of clause (1) and the registered nurse management and supervision wage component new text end ; deleted text begin and
deleted text end

(3) deleted text begin $0.63 to cover the cost of meals. deleted text end new text begin multiply the result of clause (2) by one plus the
general and administrative factor;
new text end

new text begin (4) multiply the result of clause (2) by one plus the facility and equipment factor;
new text end

new text begin (5) multiply the result of clause (2) by one plus the food, supplies, and transportation
factor; and
new text end

new text begin (6) sum the results of clauses (2) to (5) and divide the result by four.
new text end

Subd. 17.

Adult day services bath rate.

The 15-minute unit rate for adult day services
bath is deleted text begin the sum of deleted text end new text begin calculated as follows new text end :

(1) deleted text begin one-fourth of the home care aide deleted text end new text begin sum the adult day new text end services adjusted base wage deleted text begin ,
except that the general and administrative factor used to determine the home care aide
services adjusted base wage is 20 percent deleted text end new text begin and the nurse management and supervision wage
component new text end ;

(2) deleted text begin one-fourth of the registered nurse management and supervision factor deleted text end new text begin multiply the
result of clause (1) by one plus the general and administrative factor new text end ; deleted text begin and
deleted text end

(3) deleted text begin $0.63 to cover the cost of meals. deleted text end new text begin multiply the result of clause (1) by one plus the
facility and equipment factor;
new text end

new text begin (4) multiply the result of clause (1) by one plus the food, supplies, and transportation
factor; and
new text end

new text begin (5) sum the results of clauses (1) to (4) and divide the result by four.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 21.

Minnesota Statutes 2020, section 290.0132, is amended by adding a subdivision
to read:

new text begin Subd. 31. new text end

new text begin Workforce incentive fund grant payments. new text end

new text begin The amount of workforce
incentive grants under section 256.4778 is a subtraction.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for taxable years beginning after December
31, 2021.
new text end

Sec. 22.

Minnesota Statutes 2020, section 290.0674, subdivision 2a, is amended to read:

Subd. 2a.

Income.

(a) For purposes of this section, "income" means the sum of the
following:

(1) federal adjusted gross income as defined in section 62 of the Internal Revenue Code;
and

(2) the sum of the following amounts to the extent not included in clause (1):

(i) all nontaxable income;

(ii) the amount of a passive activity loss that is not disallowed as a result of section 469,
paragraph (i) or (m) of the Internal Revenue Code and the amount of passive activity loss
carryover allowed under section 469(b) of the Internal Revenue Code;

(iii) an amount equal to the total of any discharge of qualified farm indebtedness of a
solvent individual excluded from gross income under section 108(g) of the Internal Revenue
Code;

(iv) cash public assistance and relief;

(v) any pension or annuity (including railroad retirement benefits, all payments received
under the federal Social Security Act, Supplemental Security Income, and veterans benefits),
which was not exclusively funded by the claimant or spouse, or which was funded exclusively
by the claimant or spouse and which funding payments were excluded from federal adjusted
gross income in the years when the payments were made;

(vi) interest received from the federal or a state government or any instrumentality or
political subdivision thereof;

(vii) workers' compensation;

(viii) nontaxable strike benefits;

(ix) the gross amounts of payments received in the nature of disability income or sick
pay as a result of accident, sickness, or other disability, whether funded through insurance
or otherwise;

(x) a lump-sum distribution under section 402(e)(3) of the Internal Revenue Code of
1986, as amended through December 31, 1995;

(xi) contributions made by the claimant to an individual retirement account, including
a qualified voluntary employee contribution; simplified employee pension plan;
self-employed retirement plan; cash or deferred arrangement plan under section 401(k) of
the Internal Revenue Code; or deferred compensation plan under section 457 of the Internal
Revenue Code;

(xii) nontaxable scholarship or fellowship grants;

(xiii) the amount of deduction allowed under section 199 of the Internal Revenue Code;

(xiv) the amount of deduction allowed under section 220 or 223 of the Internal Revenue
Code;

(xv) the amount deducted for tuition expenses under section 222 of the Internal Revenue
Code; and

(xvi) the amount deducted for certain expenses of elementary and secondary school
teachers under section 62(a)(2)(D) of the Internal Revenue Code.

In the case of an individual who files an income tax return on a fiscal year basis, the
term "federal adjusted gross income" means federal adjusted gross income reflected in the
fiscal year ending in the next calendar year. Federal adjusted gross income may not be
reduced by the amount of a net operating loss carryback or carryforward or a capital loss
carryback or carryforward allowed for the year.

(b) "Income" does not include:

(1) amounts excluded pursuant to the Internal Revenue Code, sections 101(a) and 102;

(2) amounts of any pension or annuity that were exclusively funded by the claimant or
spouse if the funding payments were not excluded from federal adjusted gross income in
the years when the payments were made;

(3) surplus food or other relief in kind supplied by a governmental agency;

(4) relief granted under chapter 290A;

(5) child support payments received under a temporary or final decree of dissolution or
legal separation; deleted text begin and
deleted text end

(6) restitution payments received by eligible individuals and excludable interest as
defined in section 803 of the Economic Growth and Tax Relief Reconciliation Act of 2001,
Public Law 107-16 new text begin ; and
new text end

new text begin (7) workforce incentive grant payments under section 256.4778 new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for taxable years beginning after December
31, 2021.
new text end

Sec. 23.

Minnesota Statutes 2021 Supplement, section 290A.03, subdivision 3, is amended
to read:

Subd. 3.

Income.

(a) "Income" means the sum of the following:

(1) federal adjusted gross income as defined in the Internal Revenue Code; and

(2) the sum of the following amounts to the extent not included in clause (1):

(i) all nontaxable income;

(ii) the amount of a passive activity loss that is not disallowed as a result of section 469,
paragraph (i) or (m) of the Internal Revenue Code and the amount of passive activity loss
carryover allowed under section 469(b) of the Internal Revenue Code;

(iii) an amount equal to the total of any discharge of qualified farm indebtedness of a
solvent individual excluded from gross income under section 108(g) of the Internal Revenue
Code;

(iv) cash public assistance and relief;

(v) any pension or annuity (including railroad retirement benefits, all payments received
under the federal Social Security Act, Supplemental Security Income, and veterans benefits),
which was not exclusively funded by the claimant or spouse, or which was funded exclusively
by the claimant or spouse and which funding payments were excluded from federal adjusted
gross income in the years when the payments were made;

(vi) interest received from the federal or a state government or any instrumentality or
political subdivision thereof;

(vii) workers' compensation;

(viii) nontaxable strike benefits;

(ix) the gross amounts of payments received in the nature of disability income or sick
pay as a result of accident, sickness, or other disability, whether funded through insurance
or otherwise;

(x) a lump-sum distribution under section 402(e)(3) of the Internal Revenue Code of
1986, as amended through December 31, 1995;

(xi) contributions made by the claimant to an individual retirement account, including
a qualified voluntary employee contribution; simplified employee pension plan;
self-employed retirement plan; cash or deferred arrangement plan under section 401(k) of
the Internal Revenue Code; or deferred compensation plan under section 457 of the Internal
Revenue Code, to the extent the sum of amounts exceeds the retirement base amount for
the claimant and spouse;

(xii) to the extent not included in federal adjusted gross income, distributions received
by the claimant or spouse from a traditional or Roth style retirement account or plan;

(xiii) nontaxable scholarship or fellowship grants;

(xiv) alimony received to the extent not included in the recipient's income;

(xv) the amount of deduction allowed under section 220 or 223 of the Internal Revenue
Code;

(xvi) the amount deducted for tuition expenses under section 222 of the Internal Revenue
Code; and

(xvii) the amount deducted for certain expenses of elementary and secondary school
teachers under section 62(a)(2)(D) of the Internal Revenue Code.

In the case of an individual who files an income tax return on a fiscal year basis, the
term "federal adjusted gross income" shall mean federal adjusted gross income reflected in
the fiscal year ending in the calendar year. Federal adjusted gross income shall not be reduced
by the amount of a net operating loss carryback or carryforward or a capital loss carryback
or carryforward allowed for the year.

(b) "Income" does not include:

(1) amounts excluded pursuant to the Internal Revenue Code, sections 101(a) and 102;

(2) amounts of any pension or annuity which was exclusively funded by the claimant
or spouse and which funding payments were not excluded from federal adjusted gross
income in the years when the payments were made;

(3) to the extent included in federal adjusted gross income, amounts contributed by the
claimant or spouse to a traditional or Roth style retirement account or plan, but not to exceed
the retirement base amount reduced by the amount of contributions excluded from federal
adjusted gross income, but not less than zero;

(4) surplus food or other relief in kind supplied by a governmental agency;

(5) relief granted under this chapter;

(6) child support payments received under a temporary or final decree of dissolution or
legal separation;

(7) restitution payments received by eligible individuals and excludable interest as
defined in section 803 of the Economic Growth and Tax Relief Reconciliation Act of 2001,
Public Law 107-16;

(8) alimony paid; deleted text begin or
deleted text end

(9) veterans disability compensation paid under title 38 of the United States Code new text begin ; and
new text end

new text begin (10) workforce incentive grant payments under section 256.4778 new text end .

(c) The sum of the following amounts may be subtracted from income:

(1) for the claimant's first dependent, the exemption amount multiplied by 1.4;

(2) for the claimant's second dependent, the exemption amount multiplied by 1.3;

(3) for the claimant's third dependent, the exemption amount multiplied by 1.2;

(4) for the claimant's fourth dependent, the exemption amount multiplied by 1.1;

(5) for the claimant's fifth dependent, the exemption amount; and

(6) if the claimant or claimant's spouse had a disability or attained the age of 65 on or
before December 31 of the year for which the taxes were levied or rent paid, the exemption
amount.

(d) For purposes of this subdivision, the following terms have the meanings given:

(1) "exemption amount" means the exemption amount under section 290.0121,
subdivision 1, paragraph (b), for the taxable year for which the income is reported;

(2) "retirement base amount" means the deductible amount for the taxable year for the
claimant and spouse under section 219(b)(5)(A) of the Internal Revenue Code, adjusted for
inflation as provided in section 219(b)(5)(C) of the Internal Revenue Code, without regard
to whether the claimant or spouse claimed a deduction; and

(3) "traditional or Roth style retirement account or plan" means retirement plans under
sections 401, 403, 408, 408A, and 457 of the Internal Revenue Code.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for refunds based on rent paid in 2022
and property taxes payable in 2023.
new text end

Sec. 24.

Laws 2022, chapter 33, section 1, subdivision 5a, is amended to read:

Subd. 5a.

Base wage index; calculations.

The base wage index must be calculated as
follows:

(1) for supervisory staff, 100 percent of the median wage for community and social
services specialist (SOC code 21-1099), with the exception of the supervisor of positive
supports professional, positive supports analyst, and positive supports specialist, which is
100 percent of the median wage for clinical counseling and school psychologist (SOC code
19-3031);

(2) for registered nurse staff, 100 percent of the median wage for registered nurses (SOC
code 29-1141);

(3) for licensed practical nurse staff, 100 percent of the median wage for licensed practical
nurses (SOC code 29-2061);

(4) for residential asleep-overnight staff, the minimum wage in Minnesota for large
employers, with the exception of asleep-overnight staff for family residential services, which
is 36 percent of the minimum wage in Minnesota for large employers;

(5) for residential direct care staff, the sum of:

(i) 15 percent of the subtotal of 50 percent of the median wage for home health and
personal care aide (SOC code 31-1120); 30 percent of the median wage for nursing assistant
(SOC code 31-1131); and 20 percent of the median wage for social and human services
aide (SOC code 21-1093); and

(ii) 85 percent of the subtotal of 40 percent of the median wage for home health and
personal care aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant
(SOC code 31-1014); 20 percent of the median wage for psychiatric technician (SOC code
29-2053); and 20 percent of the median wage for social and human services aide (SOC code
21-1093);

(6) for adult day services staff, 70 percent of the median wage for nursing assistant (SOC
code 31-1131); and 30 percent of the median wage for home health and personal care aide
(SOC code 31-1120);

(7) for day support services staff and prevocational services staff, 20 percent of the
median wage for nursing assistant (SOC code 31-1131); 20 percent of the median wage for
psychiatric technician (SOC code 29-2053); and 60 percent of the median wage for social
and human services aide (SOC code 21-1093);

(8) for positive supports analyst staff, 100 percent of the median wage for substance
abuse, behavioral disorder, and mental health counselor (SOC code 21-1018);

(9) for positive supports professional staff, 100 percent of the median wage for clinical
counseling and deleted text begin school psychologist deleted text end new text begin psychologists-other new text end (SOC code deleted text begin 19-3031 deleted text end new text begin 19-3039 new text end );

(10) for positive supports specialist staff, 100 percent of the median wage for psychiatric
technicians (SOC code 29-2053);

(11) for individualized home supports with family training staff, 20 percent of the median
wage for nursing aide (SOC code 31-1131); 30 percent of the median wage for community
social service specialist (SOC code 21-1099); 40 percent of the median wage for social and
human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric
technician (SOC code 29-2053);

(12) for individualized home supports with training services staff, 40 percent of the
median wage for community social service specialist (SOC code 21-1099); 50 percent of
the median wage for social and human services aide (SOC code 21-1093); and ten percent
of the median wage for psychiatric technician (SOC code 29-2053);

(13) for employment support services staff, 50 percent of the median wage for
rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for
community and social services specialist (SOC code 21-1099);

(14) for employment exploration services staff, 50 percent of the median wage for
rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for
community and social services specialist (SOC code 21-1099);

(15) for employment development services staff, 50 percent of the median wage for
education, guidance, school, and vocational counselors (SOC code 21-1012); and 50 percent
of the median wage for community and social services specialist (SOC code 21-1099);

(16) for individualized home support without training staff, 50 percent of the median
wage for home health and personal care aide (SOC code 31-1120); and 50 percent of the
median wage for nursing assistant (SOC code 31-1131);

(17) for night supervision staff, 40 percent of the median wage for home health and
personal care aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant
(SOC code 31-1131); 20 percent of the median wage for psychiatric technician (SOC code
29-2053); and 20 percent of the median wage for social and human services aide (SOC code
21-1093); and

(18) for respite staff, 50 percent of the median wage for home health and personal care
aide (SOC code 31-1131); and 50 percent of the median wage for nursing assistant (SOC
code 31-1014). deleted text begin .
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, or 60 days following
federal approval, whichever is later. The commissioner of human services shall notify the
revisor of statutes when federal approval is obtained.
new text end

Sec. 25. new text begin APPROPRIATION; ON-SITE WORKFORCE SUPPORT SERVICES AT
POSTSECONDARY INSTITUTIONS.
new text end

new text begin $100,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
of human services for planning necessary to develop an on-site workforce support services
program at postsecondary institutions to support the placement of workforce services at
Minnesota State Colleges and Universities campuses to increase the number of low-income
students and students of color participating in the Supplemental Nutrition Assistance Program
who successfully complete degrees and transition into employment after degree completion.
Workforce services must include career counseling, support services, and resources to
resolve barriers to degree completion. The general fund base for this purpose is $2,430,000
in fiscal year 2024 and $3,240,000 in fiscal year 2025.
new text end

Sec. 26. new text begin APPROPRIATION; BEHAVIORAL HEALTH PEER TRAINING.
new text end

new text begin $1,000,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
of human services for training and development for mental health certified peer specialists,
mental health certified family peer specialists, and recovery peer specialists. Training and
development may include but is not limited to initial training and certification. This
appropriation is ongoing.
new text end

Sec. 27. new text begin APPROPRIATION; MIDSKILLED HEALTH CARE OCCUPATIONS.
new text end

new text begin $1,911,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
of human services to support demonstration sites that deliver wraparound workforce services
and household economic support. The commissioner shall work in collaboration with
postsecondary institutions to support adults receiving assistance through the Supplemental
Nutrition Assistance Program or the Minnesota family investment program in obtaining
postsecondary degrees affiliated with health care occupations. To the extent practicable,
the demonstration sites must be evenly divided between greater Minnesota and the Twin
Cities metropolitan area and must include at least one Tribal site. The general fund base for
this purpose is $7,075,000 in fiscal year 2024 and $10,112,000 in fiscal year 2025. This
appropriation is available until June 30, 2026.
new text end

Sec. 28. new text begin APPROPRIATION; ONLINE TOOL ACCESSIBILITY AND CAPACITY
EXPANSION.
new text end

new text begin $395,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
of human services to expand the capacity and accessibility of online tools for people receiving
services and direct support workers. The base for this appropriation is $664,000 in fiscal
year 2024 and $681,000 in fiscal year 2025.
new text end

Sec. 29. new text begin APPROPRIATION; SYSTEMIC CRITICAL INCIDENT REVIEW TEAM.
new text end

new text begin $500,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
of human services to implement the systemic critical incident review process in Minnesota
Statutes, section 256.01, subdivision 12b. The base for this appropriation is $500,000 in
fiscal year 2024 and $500,000 in fiscal year 2025.
new text end

Sec. 30. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2020, section 256S.19, subdivision 4, new text end new text begin is repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

APPENDIX

Repealed Minnesota Statutes: 22-07143

256S.19 MONTHLY CASE MIX BUDGET CAPS; NURSING FACILITY RESIDENTS.

Subd. 4.

Calculation of monthly conversion budget cap with consumer-directed community supports.

For the elderly waiver monthly conversion budget cap for the cost of elderly waiver services with consumer-directed community supports, the nursing facility case mix adjusted total payment rate used under subdivision 3 to calculate the monthly conversion budget cap for elderly waiver services without consumer-directed community supports must be reduced by a percentage equal to the percentage difference between the consumer-directed community supports budget limit that would be assigned according to the elderly waiver plan and the corresponding monthly case mix budget cap under this chapter, but not to exceed 50 percent.