HF 4568

as introduced - 93rd Legislature (2023 - 2024) Posted on 03/21/2024 03:44pm

A bill for an act
relating to human services; modifying state disability determination procedures;
modifying provisions governing consumer-directed community supports; amending
Minnesota Statutes 2022, sections 256.01, subdivision 29; 256B.4911, by adding
subdivisions.

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

Section 1.

Minnesota Statutes 2022, section 256.01, subdivision 29, is amended to read:

Subd. 29.

State medical review team.

(a) To ensure the timely processing of
determinations of disability by the commissioner's state medical review team under sections
256B.055, subdivisions 7, paragraph (b), and 12, and 256B.057, subdivision 9, the
commissioner shall review all medical evidence and seek information from providers,
applicants, and enrollees to support the determination of disability where necessary. Disability
shall be determined according to the rules of title XVI and title XIX of the Social Security
Act and pertinent rules and policies of the Social Security Administration.

(b) Prior to a denial or withdrawal of a requested determination of disability due to
insufficient evidence, the commissioner shall (1) ensure that the missing evidence is necessary
and appropriate to a determination of disability, and (2) assist applicants and enrollees to
obtain the evidence, including, but not limited to, medical examinations and electronic
medical records.

(c) Any appeal made under section 256.045, subdivision 3, of a disability determination
made by the state medical review team must be decided according to the timelines under
section 256.0451, subdivision 22, paragraph (a). If a written decision is not issued within
the timelines under section 256.0451, subdivision 22, paragraph (a), the appeal must be
immediately reviewed by the chief human services judge.

new text begin (d) The commissioner must accept a referral for a determination of disability under this
subdivision from any hospital-based or clinic-based licensed independent clinical social
worker, licensed graduate social worker, or licensed independent social worker in the state
of Minnesota, regardless of whether the referring social worker is employed by a county or
Tribal agency.
new text end

Sec. 2.

Minnesota Statutes 2022, section 256B.4911, is amended by adding a subdivision
to read:

new text begin Subd. 7. new text end

new text begin Budget procedures. new text end

new text begin When a lead agency authorizes or reauthorizes
consumer-directed community supports services for a home and community-based services
waiver participant, the lead agency must provide to the waiver participant and the waiver
participant's legal representative the following information in an accessible format and in
a manner that meets the participant's needs:
new text end

new text begin (1) an explanation of how the participant's consumer-directed community supports
services budget was calculated, including a detailed explanation of the variables used in the
budget formula;
new text end

new text begin (2) a copy of the formula used to calculate the participant's consumer-directed community
supports services budget;
new text end

new text begin (3) an explanation of the services and an estimate of the budget that would be available
to the participant if the participant elects to use traditional waiver services; and
new text end

new text begin (4) information about the participant's right to appeal the consumer-directed community
supports services budget in accordance with sections 256.045 and 256.0451.
new text end

Sec. 3.

Minnesota Statutes 2022, section 256B.4911, is amended by adding a subdivision
to read:

new text begin Subd. 8. new text end

new text begin Consumer-direct community supports policy. new text end

new text begin Policies governing the
consumer-directed community supports program must be created solely by the commissioner.
Lead agencies must not create or implement any policies that are in addition to or inconsistent
with policies created by the commissioner or federal or state laws. Any handbooks,
procedures, or other guidance documents maintained by a lead agency do not have the force
or effect of law, and must not be given deference if introduced in a state fair hearing
conducted under sections 256.045 and 256.0451.
new text end

Sec. 4. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES;
CONSUMER-DIRECTED COMMUNITY SUPPORTS.
new text end

new text begin By December 31, 2024, the commissioner of human services shall seek any necessary
changes to home and community-based services waiver plans regarding consumer-directed
community supports in order to:
new text end

new text begin (1) amend the consumer-directed community supports budget formula to eliminate the
step 2 base rate adjustment that requires the base rate to be multiplied by a factor of 0.7;
new text end

new text begin (2) clarify that allowable goods and services for a consumer-directed community supports
participant do not need to be for the sole benefit of the participant, and that goods and
services may benefit others if there is also a direct benefit to the participant based on the
participant's assessed needs;
new text end

new text begin (3) clarify that goods or services that support the participant's assessed needs for
community integration and inclusion are allowable under the consumer-directed community
supports program;
new text end

new text begin (4) clarify that the rate authorized for services approved under the consumer-directed
community supports personal assistance category may exceed the reasonable range of similar
services in the participant's community if the participant has an assessed need for an enhanced
rate; and
new text end

new text begin (5) clarify that a participant's spouse or a parent of a minor participant, as defined in the
waiver plans, may be paid for consumer-directed community support services at a rate that
exceeds that which would otherwise be paid to a provider of a similar service or that exceeds
what is allowed by the commissioner for the payment of personal care assistance services
if the participant has an assessed need for an enhanced rate.
new text end