1st Engrossment - 94th Legislature (2025 - 2026)
Posted on 04/03/2025 03:43 p.m.
A bill for an act
relating to human services; modifying community first services and supports
reimbursement rates; increasing certain budgets for consumer-direct community
supports; establishing the Minnesota Caregiver Defined Contribution Retirement
Fund Trust; appropriating money; amending Minnesota Statutes 2024, sections
179A.54, by adding a subdivision; 256B.0659, subdivision 17a; 256B.85,
subdivisions 7a, 8, 16; 256B.851, subdivisions 5, 6.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Minnesota Statutes 2024, section 179A.54, is amended by adding a subdivision
to read:
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(a)
The state and an exclusive representative certified pursuant to this section may establish a
joint labor and management trust, referred to as the Minnesota Caregiver Defined
Contribution Retirement Fund Trust, for the exclusive purpose of creating, implementing,
and administering a retirement plan for individual providers of direct support services who
are represented by the exclusive representative.
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(b) The state must make financial contributions to the Minnesota Caregiver Defined
Contribution Retirement Fund Trust pursuant to a collective bargaining agreement negotiated
under this section. The financial contributions by the state must be held in trust for the
purpose of paying, from principal, income, or both, the costs associated with creating,
implementing, and administering a defined contribution retirement plan for individual
providers of direct support services working under a collective bargaining agreement and
providing services through a covered program under section 256B.0711. A board of trustees
composed of an equal number of trustees appointed by the governor and trustees appointed
by the exclusive representative under this section must administer, manage, and otherwise
jointly control the Minnesota Caregiver Defined Contribution Retirement Fund Trust. The
trust must not be an agent of either the state or the exclusive representative.
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(c) A third-party administrator, financial management institution, other appropriate
entity, or any combination thereof may provide trust administrative, management, legal,
and financial services to the board of trustees as designated by the board of trustees from
time to time. The services must be paid from the money held in trust and created by the
state's financial contributions to the Minnesota Caregiver Defined Contribution Retirement
Fund Trust.
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(d) The state is authorized to purchase liability insurance for members of the board of
trustees appointed by the governor.
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(e) Financial contributions to or participation in the management or administration of
the Minnesota Caregiver Defined Contribution Retirement Fund Trust must not be considered
an unfair labor practice under section 179A.13, or a violation of Minnesota law.
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This section is effective July 1, 2025.
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Minnesota Statutes 2024, section 256B.0659, subdivision 17a, is amended to read:
(a) An enhanced rate of 107.5 percent of the rate paid for
personal care assistance services shall be paid for services provided to persons who qualify
for ten or more hours of personal care assistance services per day when provided by a
personal care assistant who meets the requirements of subdivision 11, paragraph (d).new text begin This
paragraph expires upon the effective date of paragraph (b).
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(b) Effective January 1, 2026, or upon federal approval, whichever is later, an enhanced
rate of 112.5 percent of the rate paid for personal care assistance services shall be paid for
services provided to persons who qualify for ten or more hours of personal care assistance
services per day when provided by a personal care assistant who meets the requirements of
subdivision 11, paragraph (d).
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deleted text begin (b)deleted text end new text begin (c)new text end A personal care assistance provider must use all additional revenue attributable
to the rate enhancements under this subdivision for the wages and wage-related costs of the
personal care assistants, including any corresponding increase in the employer's share of
FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers'
compensation premiums. The agency must not use the additional revenue attributable to
any enhanced rate under this subdivision to pay for mileage reimbursement, health and
dental insurance, life insurance, disability insurance, long-term care insurance, uniform
allowance, contributions to employee retirement accounts, or any other employee benefits.
deleted text begin (c)deleted text end new text begin (d)new text end Any change in the eligibility criteria for the enhanced rate for personal care
assistance services as described in this subdivision and referenced in subdivision 11,
paragraph (d), does not constitute a change in a term or condition for individual providers
as defined in section 256B.0711, and is not subject to the state's obligation to meet and
negotiate under chapter 179A.
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This section is effective the day following final enactment.
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Minnesota Statutes 2024, section 256B.85, subdivision 7a, is amended to read:
(a) An enhanced rate of 107.5 percent of the rate paid for
CFSS must be paid for services provided to persons who qualify for ten or more hours of
CFSS per day when provided by a support worker who meets the requirements of subdivision
16, paragraph (e).new text begin This paragraph expires upon the effective date of paragraph (b).
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(b) Effective January 1, 2026, or upon federal approval, whichever is later, an enhanced
rate of 112.5 percent of the rate paid for CFSS must be paid for services provided to persons
who qualify for ten or more hours of CFSS per day when provided by a support worker
who meets the requirements of subdivision 16, paragraph (e).
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deleted text begin (b)deleted text end new text begin (c)new text end An agency provider must use all additional revenue attributable to the rate
enhancements under this subdivision for the wages and wage-related costs of the support
workers, including any corresponding increase in the employer's share of FICA taxes,
Medicare taxes, state and federal unemployment taxes, and workers' compensation premiums.
The agency provider must not use the additional revenue attributable to any enhanced rate
under this subdivision to pay for mileage reimbursement, health and dental insurance, life
insurance, disability insurance, long-term care insurance, uniform allowance, contributions
to employee retirement accounts, or any other employee benefits.
deleted text begin (c)deleted text end new text begin (d)new text end Any change in the eligibility criteria for the enhanced rate for CFSS as described
in this subdivision and referenced in subdivision 16, paragraph (e), does not constitute a
change in a term or condition for individual providers as defined in section 256B.0711, and
is not subject to the state's obligation to meet and negotiate under chapter 179A.
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This section is effective the day following federal approval.
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Minnesota Statutes 2024, section 256B.85, subdivision 8, is amended to read:
(a) All community
first services and supports must be authorized by the commissioner or the commissioner's
designee before services begin. The authorization for CFSS must be completed as soon as
possible following an assessment but no later than 40 calendar days from the date of the
assessment.
(b) The amount of CFSS authorized must be based on the participant's home care rating
described in paragraphs (d) and (e) and any additional service units for which the participant
qualifies as described in paragraph (f).
(c) The home care rating shall be determined by the commissioner or the commissioner's
designee based on information submitted to the commissioner identifying the following for
a participant:
(1) the total number of dependencies of activities of daily living;
(2) the presence of complex health-related needs; and
(3) the presence of Level I behavior.
(d) The methodology to determine the total service units for CFSS for each home care
rating is based on the median paid units per day for each home care rating from fiscal year
2007 data for the PCA program.
(e) Each home care rating is designated by the letters P through Z and EN and has the
following base number of service units assigned:
(1) P home care rating requires Level I behavior or one to three dependencies in ADLs
and qualifies the person for five service units;
(2) Q home care rating requires Level I behavior and one to three dependencies in ADLs
and qualifies the person for six service units;
(3) R home care rating requires a complex health-related need and one to three
dependencies in ADLs and qualifies the person for seven service units;
(4) S home care rating requires four to six dependencies in ADLs and qualifies the person
for ten service units;
(5) T home care rating requires four to six dependencies in ADLs and Level I behavior
and qualifies the person for 11 service units;
(6) U home care rating requires four to six dependencies in ADLs and a complex
health-related need and qualifies the person for 14 service units;
(7) V home care rating requires seven to eight dependencies in ADLs and qualifies the
person for 17 service units;
(8) W home care rating requires seven to eight dependencies in ADLs and Level I
behavior and qualifies the person for 20 service units;
(9) Z home care rating requires seven to eight dependencies in ADLs and a complex
health-related need and qualifies the person for 30 service units; and
(10) EN home care rating includes ventilator dependency as defined in section 256B.0651,
subdivision 1, paragraph (g). A person who meets the definition of ventilator-dependent
and the EN home care rating and utilize a combination of CFSS and home care nursing
services is limited to a total of 96 service units per day for those services in combination.
Additional units may be authorized when a person's assessment indicates a need for two
staff to perform activities. Additional time is limited to 16 service units per day.
(f) Additional service units are provided through the assessment and identification of
the following:
(1) 30 additional minutes per day for a dependency in each critical activity of daily
living;
(2) 30 additional minutes per day for each complex health-related need; and
(3) 30 additional minutes per day for each behavior under this clause that requires
assistance at least four times per week:
(i) level I behavior that requires the immediate response of another person;
(ii) increased vulnerability due to cognitive deficits or socially inappropriate behavior;
or
(iii) increased need for assistance for participants who are verbally aggressive or resistive
to care so that the time needed to perform activities of daily living is increased.
(g) The service budget for budget model participants shall be based on:
(1) assessed units as determined by the home care rating; and
(2) an adjustment needed for administrative expenses.new text begin This paragraph expires upon the
effective date of paragraph (h).
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(h) Effective January 1, 2026, or upon federal approval, whichever is later, the service
budget for budget model participants shall be based on:
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(1) assessed units as determined by the home care rating and the payment methodologies
under section 256B.851; and
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(2) an adjustment needed for administrative expenses.
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This section is effective the day following final approval.
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Minnesota Statutes 2024, section 256B.85, subdivision 16, is amended to read:
(a) Support workers shall:
(1) enroll with the department as a support worker after a background study under chapter
245C has been completed and the support worker has received a notice from the
commissioner that the support worker:
(i) is not disqualified under section 245C.14; or
(ii) is disqualified, but has received a set-aside of the disqualification under section
245C.22;
(2) have the ability to effectively communicate with the participant or the participant's
representative;
(3) have the skills and ability to provide the services and supports according to the
participant's CFSS service delivery plan and respond appropriately to the participant's needs;
(4) complete the basic standardized CFSS training as determined by the commissioner
before completing enrollment. The training must be available in languages other than English
and to those who need accommodations due to disabilities. CFSS support worker training
must include successful completion of the following training components: basic first aid,
vulnerable adult, child maltreatment, OSHA universal precautions, basic roles and
responsibilities of support workers including information about basic body mechanics,
emergency preparedness, orientation to positive behavioral practices, orientation to
responding to a mental health crisis, fraud issues, time cards and documentation, and an
overview of person-centered planning and self-direction. Upon completion of the training
components, the support worker must pass the certification test to provide assistance to
participants;
(5) complete employer-directed training and orientation on the participant's individual
needs;
(6) maintain the privacy and confidentiality of the participant; and
(7) not independently determine the medication dose or time for medications for the
participant.
(b) The commissioner may deny or terminate a support worker's provider enrollment
and provider number if the support worker:
(1) does not meet the requirements in paragraph (a);
(2) fails to provide the authorized services required by the employer;
(3) has been intoxicated by alcohol or drugs while providing authorized services to the
participant or while in the participant's home;
(4) has manufactured or distributed drugs while providing authorized services to the
participant or while in the participant's home; or
(5) has been excluded as a provider by the commissioner of human services, or by the
United States Department of Health and Human Services, Office of Inspector General, from
participation in Medicaid, Medicare, or any other federal health care program.
(c) A support worker may appeal in writing to the commissioner to contest the decision
to terminate the support worker's provider enrollment and provider number.
(d) A support worker must not provide or be paid for more than 310 hours of CFSS per
month, regardless of the number of participants the support worker serves or the number
of agency-providers or participant employers by which the support worker is employed.
The department shall not disallow the number of hours per day a support worker works
unless it violates other law.
(e) CFSS qualify for an enhanced ratenew text begin or budgetnew text end if the support worker providing the
services:
(1) provides services, within the scope of CFSS described in subdivision 7, to a participant
who qualifies for ten or more hours per day of CFSS; and
(2) satisfies the current requirements of Medicare for training and competency or
competency evaluation of home health aides or nursing assistants, as provided in the Code
of Federal Regulations, title 42, section 483.151 or 484.36, or alternative state-approved
training or competency requirements.new text begin This paragraph expires upon the effective date of
paragraph (f).
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(f) Effective January 1, 2026, or upon federal approval, whichever is later, CFSS qualify
for an enhanced rate or budget if the support worker providing the services:
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(1) provides services, within the scope of CFSS described in subdivision 7, to a participant
who qualifies for ten or more hours per day of CFSS; and
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(2) satisfies the current requirements of Medicare for training and competency or
competency evaluation of home health aides or nursing assistants, as provided in the Code
of Federal Regulations, title 42, section 483.151 or 484.36, or alternative state-approved
training or competency requirements.
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This section is effective the day following federal approval.
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Minnesota Statutes 2024, section 256B.851, subdivision 5, is amended to read:
(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: 88.19 percent;
(2) enhanced rate personal care assistance services and enhanced rate CFSS: 88.19
percent; and
(3) qualified professional services and CFSS worker training and development: 88.19
percent.new text begin This paragraph expires upon the effective date of paragraph (c).
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(c) Effective January 1, 2026, or upon federal approval, whichever is later, for purposes
of implementation, the commissioner shall use the following implementation components:
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(1) personal care assistance services and CFSS: 92.20 percent;
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(2) enhanced rate personal care assistance services and enhanced rate CFSS: 92.20
percent; and
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(3) qualified professional services and CFSS worker training and development: 92.20
percent.
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deleted text begin (c)deleted text end new text begin (d)new text end Effective January 1, 2025, for purposes of implementation, the commissioner
shall use the following implementation components:
(1) personal care assistance services and CFSS: 92.08 percent;
(2) enhanced rate personal care assistance services and enhanced rate CFSS: 92.08
percent; and
(3) qualified professional services and CFSS worker training and development: 92.08
percent.new text begin This paragraph expires upon the effective date of paragraph (c).
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deleted text begin (d)deleted text end new text begin (e)new text end The commissioner shall use the following worker retention components:
(1) for workers who have provided fewer than 1,001 cumulative hours in personal care
assistance services or CFSS, the worker retention component is zero percent;
(2) for workers who have provided between 1,001 and 2,000 cumulative hours in personal
care assistance services or CFSS, the worker retention component is 2.17 percent;
(3) for workers who have provided between 2,001 and 6,000 cumulative hours in personal
care assistance services or CFSS, the worker retention component is 4.36 percent;
(4) for workers who have provided between 6,001 and 10,000 cumulative hours in
personal care assistance services or CFSS, the worker retention component is 7.35 percent;
and
(5) for workers who have provided more than 10,000 cumulative hours in personal care
assistance services or CFSS, the worker retention component is 10.81 percent.new text begin This paragraph
expires upon the effective date of paragraph (f).
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(f) Effective January 1, 2026, or upon federal approval, whichever is later, the
commissioner shall use the following worker retention components:
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(1) for workers who have provided fewer than 1,001 cumulative hours in personal care
assistance services or CFSS, the worker retention component is zero percent;
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(2) for workers who have provided between 1,001 and 2,000 cumulative hours in personal
care assistance services or CFSS, the worker retention component is 4.05 percent;
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(3) for workers who have provided between 2,001 and 6,000 cumulative hours in personal
care assistance services or CFSS, the worker retention component is 6.24 percent;
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(4) for workers who have provided between 6,001 and 10,000 cumulative hours in
personal care assistance services or CFSS, the worker retention component is 9.23 percent;
and
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(5) for workers who have provided more than 10,000 cumulative hours in personal care
assistance services or CFSS, the worker retention component is 12.69 percent.
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deleted text begin (e)deleted text end new text begin (g)new text end The commissioner shall define the appropriate worker retention component based
on the total number of units billed for services rendered by the individual provider since
July 1, 2017. The worker retention component must be determined by the commissioner
for each individual provider and is not subject to appeal.
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(h) Effective January 1, 2027, or upon federal approval, whichever is later, for purposes
of implementation, the commissioner shall use the following implementation components
if a worker has completed either the orientation for individual providers offered through
the Home Care Orientation Trust or an orientation defined and offered by the commissioner:
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(1) for workers who have provided fewer than 1,001 cumulative hours in personal care
assistance services or CFSS, the worker retention component is 1.88 percent;
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(2) for workers who have provided between 1,001 and 2,000 cumulative hours in personal
care assistance services or CFSS, the worker retention component is 5.92 percent;
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(3) for workers who have provided between 2,001, and 6,000 cumulative hours in personal
care assistance services or CFSS, the worker retention component is 8.11 percent;
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(4) for workers who have provided between 6,001 and 10,000 cumulative hours in
personal care assistance services or CFSS, the worker retention component is 11.10 percent;
and
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(5) for workers who have provided more than 10,000 cumulative hours in personal care
assistance services or CFSS, the worker retention component is 14.56 percent.
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This section is effective the day following final enactment.
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Minnesota Statutes 2024, section 256B.851, subdivision 6, is amended to read:
(a) The commissioner must determine
the rate for personal care assistance services, CFSS, extended personal care assistance
services, extended CFSS, enhanced rate personal care assistance services, enhanced rate
CFSS, qualified professional services, and CFSS worker training and development as
follows:
(1) multiply the appropriate total wage component value calculated in subdivision 4 by
one plus the employee vacation, sick, and training factor in subdivision 5;
(2) for program plan support, multiply the result of clause (1) by one plus the program
plan support factor in subdivision 5;
(3) for employee-related expenses, add the employer taxes and workers' compensation
factor in subdivision 5 and the employee benefits factor in subdivision 5. The sum is
employee-related expenses. Multiply the product of clause (2) by one plus the value for
employee-related expenses;
(4) for client programming and supports, multiply the product of clause (3) by one plus
the client programming and supports factor in subdivision 5;
(5) for administrative expenses, add the general business and administrative expenses
factor in subdivision 5, the program administration expenses factor in subdivision 5, and
the absence and utilization factor in subdivision 5;
(6) divide the result of clause (4) by one minus the result of clause (5). The quotient is
the hourly rate;
(7) multiply the hourly rate by the appropriate implementation component under
subdivision 5. This is the adjusted hourly rate; and
(8) divide the adjusted hourly rate by four. The quotient is the total adjusted payment
rate.
(b) In processing new text begin personal care assistance provider agency and CFSS provider agency
new text end claims, the commissioner shall incorporate the worker retention component specified in
subdivision 5, by multiplying one plus the total adjusted payment rate by the appropriate
worker retention component under subdivision 5, paragraph (d).
(c) The commissioner must publish the total final payment rates.
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(d) The commissioner shall increase the authorized amount for the CFSS budget model
of those CFSS participant-employers employing individual providers who have provided
more than 1,000 hours of services and individual providers who have completed the
orientation offered by the Home Care Orientation Trust or an orientation defined and offered
by the commissioner. The commissioner shall determine the amount and method of the
authorized amount increase.
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This section is effective January 1, 2026, or upon federal approval,
whichever is later. The commissioner shall notify the revisor of statutes when federal
approval is obtained.
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Effective January 1, 2026, or upon federal approval, whichever is later, the commissioner
must increase the consumer-directed community support budgets identified in the waiver
plans under Minnesota Statutes, sections 256B.092 and 256B.49, and chapter 256S; and
the alternative care program under Minnesota Statutes, section 256B.0913, by 0.13 percent.
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This section is effective the day following final enactment.
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Effective January 1, 2026, or upon federal approval, whichever is later, the commissioner
must increase the consumer-directed community supports budget exception percentage
identified in the waiver plans under Minnesota Statutes, sections 256B.092 and 256B.49,
and chapter 256S; and the alternative care program under Minnesota Statutes, section
256B.0913, from 7.5 to 12.5.
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This section is effective the day following final enactment.
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(a) The commissioner of human services shall issue stipend payments to collective
bargaining unit members as required by the labor agreement between the state of Minnesota
and the Service Employees International Union (SEIU) Healthcare Minnesota & Iowa.
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(b) The definitions in Minnesota Statutes, section 290.01, apply to this section.
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(c) For the purposes of this section, "subtraction" has the meaning given in Minnesota
Statutes, section 290.0132, subdivision 1, and the rules in that subdivision apply to this
section.
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(d) The amount of stipend payments received by SEIU Healthcare Minnesota & Iowa
collective bargaining unit members under this section is a subtraction.
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(e) The amount of stipend payments received by SEIU Healthcare Minnesota & Iowa
collective bargaining unit members under this section is excluded from income as defined
in Minnesota Statutes, sections 290.0693, subdivision 1, paragraph (i), and 290A.03,
subdivision 3.
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(f) Notwithstanding any law to the contrary, stipend payments under this section must
not be considered income, assets, or personal property for purposes of determining or
recertifying eligibility for:
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(1) child care assistance programs under Minnesota Statutes, chapter 142E;
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(2) general assistance, Minnesota supplemental aid, and food support under Minnesota
Statutes, chapter 256D;
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(3) housing support under Minnesota Statutes, chapter 256I;
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(4) the Minnesota family investment program under Minnesota Statutes, chapter 142G;
and
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(5) economic assistance programs under Minnesota Statutes, chapter 256P.
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(g) The commissioner of human services must not consider stipend payments under this
section as income or assets under Minnesota Statutes, section 256B.056, subdivision 1a,
paragraph (a); 3; or 3c, or for persons with eligibility determined under Minnesota Statutes,
section 256B.057, subdivision 3, 3a, or 3b.
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This section is effective the day following final enactment.
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$30,750,000 in fiscal year 2026 is appropriated from the general fund to the commissioner
of human services for stipends of $1,200 to collective bargaining unit members for retention
and defraying any health insurance costs they may incur. Stipends are available once per
fiscal year per member for fiscal year 2026 and fiscal year 2027. Of this amount, $750,000
is for administration of the health care cost stipends. This is a onetime appropriation and is
available until June 30, 2027.
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$2,250,000 in fiscal year 2026 is appropriated from the general fund to the commissioner
of human services for onetime stipends of $750 for collective bargaining unit members who
complete designated, voluntary training made available through or recommended by the
State Provider Cooperation Committee. Of this amount, $250,000 is for administration of
the training stipends. This is a onetime appropriation and is available until June 30, 2027.
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$5,000,000 in fiscal year 2026 and $500,000 in fiscal year 2027 are appropriated from
the general fund to the commissioner of human services for an orientation program defined
by the SEIU collective bargaining agreement. Of these amounts, $3,000,000 in fiscal year
2026 is a onetime appropriation for orientation start-up costs and is available until June 30,
2027. Of these amounts, $2,000,000 in fiscal year 2026 and $500,000 in fiscal year 2027
are for ongoing orientation-related costs.
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$350,000 in fiscal year 2026 is appropriated from the general fund to the commissioner
of human services for a vendor to create the Minnesota Caregiver Defined Contribution
Retirement Fund Trust under Minnesota Statutes, section 179A.54, subdivision 12. This is
a onetime appropriation and is available until June 30, 2027.
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