SF 3246

Introduction - 94th Legislature (2025 - 2026)

Posted on 07/18/2025 01:27 p.m.

A bill for an act
relating to human services; modifying community first services and supports
requirements; specifying consultation services as an optional service under the
agency-provider model; amending Minnesota Statutes 2024, section 256B.85,
subdivisions 2, 5, 6, 7, 8a, 11, 13, 17, 17a, 20, by adding a subdivision.

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

Section 1.

Minnesota Statutes 2024, section 256B.85, subdivision 2, is amended to read:

Subd. 2.

Definitions.

(a) For the purposes of this section and section 256B.851, the terms
defined in this subdivision have the meanings given.

(b) "Activities of daily living" or "ADLs" means:

(1) dressing, including assistance with choosing, applying, and changing clothing and
applying special appliances, wraps, or clothing;

(2) grooming, including assistance with basic hair care, oral care, shaving, applying
cosmetics and deodorant, and care of eyeglasses and hearing aids. Grooming includes nail
care, except for recipients who are diabetic or have poor circulation;

(3) bathing, including assistance with basic personal hygiene and skin care;

(4) eating, including assistance with hand washing and applying orthotics required for
eating or feeding;

(5) transfers, including assistance with transferring the participant from one seating or
reclining area to another;

(6) mobility, including assistance with ambulation and use of a wheelchair. Mobility
does not include providing transportation for a participant;

(7) positioning, including assistance with positioning or turning a participant for necessary
care and comfort; and

(8) toileting, including assistance with bowel or bladder elimination and care, transfers,
mobility, positioning, feminine hygiene, use of toileting equipment or supplies, cleansing
the perineal area, inspection of the skin, and adjusting clothing.

(c) "Agency-provider model" means a method of CFSS under which a qualified agency
provides services and supports through the agency's own employees and policies. The agency
must allow the participant to have a significant role in the selection and dismissal of support
workers of their choice for the delivery of their specific services and supports.

(d) "Behavior" means a description of a need for services and supports used to determine
the home care rating and additional service units. The presence of Level I behavior is used
to determine the home care rating.

(e) "Budget model" means a service delivery method of CFSS that allows the use of a
service budget and assistance from a financial management services (FMS) provider for a
participant to directly employ support workers and purchase supports and goods.

(f) "Complex health-related needs" means an intervention listed in clauses (1) to (8) that
has been ordered by a physician, advanced practice registered nurse, or physician's assistant
and is specified in an assessment summary, including:

(1) tube feedings requiring:

(i) a gastrojejunostomy tube; or

(ii) continuous tube feeding lasting longer than 12 hours per day;

(2) wounds described as:

(i) stage III or stage IV;

(ii) multiple wounds;

(iii) requiring sterile or clean dressing changes or a wound vac; or

(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require specialized
care;

(3) parenteral therapy described as:

(i) IV therapy more than two times per week lasting longer than four hours for each
treatment; or

(ii) total parenteral nutrition (TPN) daily;

(4) respiratory interventions, including:

(i) oxygen required more than eight hours per day;

(ii) respiratory vest more than one time per day;

(iii) bronchial drainage treatments more than two times per day;

(iv) sterile or clean suctioning more than six times per day;

(v) dependence on another to apply respiratory ventilation augmentation devices such
as BiPAP and CPAP; and

(vi) ventilator dependence under section 256B.0651;

(5) insertion and maintenance of catheter, including:

(i) sterile catheter changes more than one time per month;

(ii) clean intermittent catheterization, and including self-catheterization more than six
times per day; or

(iii) bladder irrigations;

(6) bowel program more than two times per week requiring more than 30 minutes to
perform each time;

(7) neurological intervention, including:

(i) seizures more than two times per week and requiring significant physical assistance
to maintain safety; or

(ii) swallowing disorders diagnosed by a physician, advanced practice registered nurse,
or physician's assistant and requiring specialized assistance from another on a daily basis;
and

(8) other congenital or acquired diseases creating a need for significantly increased direct
hands-on assistance and interventions in six to eight activities of daily living.

(g) "Community first services and supports" or "CFSS" means the assistance and supports
program under this section needed for accomplishing activities of daily living, instrumental
activities of daily living, and health-related tasks through hands-on assistance to accomplish
the task or constant supervision and cueing to accomplish the task, or the purchase of goods
as defined in subdivision 7, clause (3), that replace the need for human assistance.

(h) "Community first services and supports service delivery plan" or "CFSS service
delivery plan" means a written document detailing the services and supports chosen by the
participant to meet assessed needs that are within the approved CFSS service authorization,
as determined in subdivision 8. Services and supports are based on the support plan identified
in sections 256B.092, subdivision 1b, and 256S.10.

(i) "Consultation services" means deleted text begin a Minnesota health care program enrolled provider
organization that provides assistance to the deleted text end new text begin assisting a new text end participant in making informed
choices about CFSS services in general and self-directed tasks in particular, and in developing
a person-centered CFSS service delivery plan to achieve quality service outcomes.

(j) "Critical activities of daily living" means transferring, mobility, eating, and toileting.

(k) "Dependency" in activities of daily living means a person requires hands-on assistance
or constant supervision and cueing to accomplish one or more of the activities of daily living
every day or on the days during the week that the activity is performed; however, a child
must not be found to be dependent in an activity of daily living if, because of the child's
age, an adult would either perform the activity for the child or assist the child with the
activity and the assistance needed is the assistance appropriate for a typical child of the
same age.

(l) "Extended CFSS" means CFSS services and supports provided under CFSS that are
included in the CFSS service delivery plan through one of the home and community-based
services waivers and as approved and authorized under chapter 256S and sections 256B.092,
subdivision 5, and 256B.49, which exceed the amount, duration, and frequency of the state
plan CFSS services for participants. Extended CFSS excludes the purchase of goods.

(m) "Financial management services provider" or "FMS provider" means a qualified
organization required for participants using the budget model under subdivision 13 that is
an enrolled provider with the department to provide vendor fiscal/employer agent financial
management services (FMS).

(n) "Health-related procedures and tasks" means procedures and tasks related to the
specific assessed health needs of a participant that can be taught or assigned by a
state-licensed health care or mental health professional and performed by a support worker.

(o) "Instrumental activities of daily living" means activities related to living independently
in the community, including but not limited to: meal planning, preparation, and cooking;
shopping for food, clothing, or other essential items; laundry; housecleaning; assistance
with medications; managing finances; communicating needs and preferences during activities;
arranging supports; and assistance with traveling around and participating in the community,
including traveling to medical appointments. For purposes of this paragraph, traveling
includes driving and accompanying the recipient in the recipient's chosen mode of
transportation and according to the individual CFSS service delivery plan.

(p) "Lead agency" has the meaning given in section 256B.0911, subdivision 10.

(q) "Legal representative" means parent of a minor, a court-appointed guardian, or
another representative with legal authority to make decisions about services and supports
for the participant. Other representatives with legal authority to make decisions include but
are not limited to a health care agent or an attorney-in-fact authorized through a health care
directive or power of attorney.

(r) "Level I behavior" means physical aggression toward self or others or destruction of
property that requires the immediate response of another person.

(s) "Medication assistance" means providing verbal or visual reminders to take regularly
scheduled medication, and includes any of the following supports listed in clauses (1) to
(3) and other types of assistance, except that a support worker must not determine medication
dose or time for medication or inject medications into veins, muscles, or skin:

(1) under the direction of the participant or the participant's representative, bringing
medications to the participant including medications given through a nebulizer, opening a
container of previously set-up medications, emptying the container into the participant's
hand, opening and giving the medication in the original container to the participant, or
bringing to the participant liquids or food to accompany the medication;

(2) organizing medications as directed by the participant or the participant's representative;
and

(3) providing verbal or visual reminders to perform regularly scheduled medications.

(t) "Participant" means a person who is eligible for CFSS.

(u) "Participant's representative" means a parent, family member, advocate, or other
adult authorized by the participant or participant's legal representative, if any, to serve as a
representative in connection with the provision of CFSS. If the participant is unable to assist
in the selection of a participant's representative, the legal representative shall appoint one.

(v) "Person-centered planning process" means a process that is directed by the participant
to plan for CFSS services and supports.

(w) "Service budget" means the authorized dollar amount used for the budget model or
for the purchase of goods.

(x) "Shared services" means the provision of CFSS services by the same CFSS support
worker to two or three participants who voluntarily enter into a written agreement to receive
services at the same time, in the same setting, and through the same agency-provider or
FMS provider.

(y) "Support worker" means a qualified and trained employee of the agency-provider
as required by subdivision 11b or of the participant employer under the budget model as
required by subdivision 14 who has direct contact with the participant and provides services
as specified within the participant's CFSS service delivery plan.

(z) "Unit" means the increment of service based on hours or minutes identified in the
service agreement.

(aa) "Vendor fiscal employer agent" means an agency that provides financial management
services.

(bb) "Wages and benefits" means the hourly wages and salaries, the employer's share
of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation,
mileage reimbursement, health and dental insurance, life insurance, disability insurance,
long-term care insurance, uniform allowance, contributions to employee retirement accounts,
or other forms of employee compensation and benefits.

(cc) "Worker training and development" means services provided according to subdivision
18a for developing workers' skills as required by the participant's individual CFSS service
delivery plan that are arranged for or provided by the agency-provider or purchased by the
participant employer. These services include training, education, direct observation and
supervision, and evaluation and coaching of job skills and tasks, including supervision of
health-related tasks or behavioral supports.

Sec. 2.

Minnesota Statutes 2024, section 256B.85, subdivision 5, is amended to read:

Subd. 5.

Assessment requirements.

(a) The assessment of functional need must:

(1) be conducted by a certified assessor according to the criteria established in section
256B.0911, subdivisions 17 to 21, 23, 24, and 29 to 31;

(2) be conducted face-to-face, initially and at least annually thereafter, or when there is
a significant change in the participant's condition or a change in the need for services and
supports, or at the request of the participant when the participant experiences a change in
condition or needs a change in the services or supports; and

(3) be completed using the format established by the commissioner.

(b) The results of the assessment and any recommendations and authorizations for CFSS
must be determined and communicated in writing by the lead agency's assessor as defined
in section 256B.0911 to the participant or the participant's representative and chosen CFSS
providers within ten business days and must include the participant's right to appeal the
assessment under section 256.045, subdivision 3.

deleted text begin (c) The lead agency assessor may authorize a temporary authorization for CFSS services
to be provided under the agency-provider model. The lead agency assessor may authorize
a temporary authorization for CFSS services to be provided under the agency-provider
model without using the assessment process described in this subdivision. Authorization
for a temporary level of CFSS services under the agency-provider model is limited to the
time specified by the commissioner, but shall not exceed 45 days. The level of services
authorized under this paragraph shall have no bearing on a future authorization. For CFSS
services needed beyond the 45-day temporary authorization, the lead agency must conduct
an assessment as described in this subdivision and participants must use consultation services
to complete their orientation and selection of a service model.
deleted text end

Sec. 3.

Minnesota Statutes 2024, section 256B.85, is amended by adding a subdivision to
read:

new text begin Subd. 5a. new text end

new text begin Temporary authorization without assessment. new text end

new text begin The lead agency assessor
may authorize a temporary authorization for CFSS services to be provided under the
agency-provider model. The lead agency assessor may authorize a temporary authorization
for CFSS services to be provided under the agency-provider model without using the
assessment process described in subdivision 5. Authorization for a temporary level of CFSS
services under the agency-provider model is limited to the time specified by the
commissioner, but shall not exceed 45 days. The level of services authorized under this
subdivision shall have no bearing on a future authorization. For CFSS services needed
beyond the 45-day temporary authorization, the lead agency must conduct an assessment
as described in subdivision 5.
new text end

Sec. 4.

Minnesota Statutes 2024, section 256B.85, subdivision 6, is amended to read:

Subd. 6.

Community first services and supports service delivery plan.

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

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

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

(1) specify the consultation services provider deleted text begin , deleted text end new text begin selected by the participant, if any, and
either the new text end agency-provider deleted text begin , deleted text end or FMS provider selected by the participant;

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

(f) new text begin Prior to starting services and at least annually upon reassessment, or when there is a
significant change in the participant's condition or a change in the need for services and
supports, the CFSS service delivery plan must be reviewed by the participant, by the
consultation services provider, unless the participant has selected the agency-provider model
without optional consultation services, and by either the agency-provider or FMS provider.
new text end

new text begin (g) new text end The CFSS service delivery plan must be approved by the lead agency for participants
without a case manager or care coordinator who is responsible for authorizing services. A
case manager or care coordinator must approve the plan for a waiver or alternative care
program participant.

Sec. 5.

Minnesota Statutes 2024, section 256B.85, subdivision 7, is amended to read:

Subd. 7.

Community first services and supports; covered services.

Services and
supports covered under CFSS include:

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

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

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

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

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

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

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

(6) services new text begin described under subdivision 17 new text end provided by a consultation services provider
deleted text begin as defined under subdivision 17, that is under contract with the department and enrolled as
a Minnesota health care program provider deleted text end new text begin meeting the requirements of subdivision 17a new text end ;

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

(8) CFSS services provided by a support worker who is a parent, stepparent, or legal
guardian of a participant under age 18, or who is the participant's spouse. Covered services
under this clause are subject to the limitations described in subdivision 7b; and

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

Sec. 6.

Minnesota Statutes 2024, section 256B.85, subdivision 8a, is amended to read:

Subd. 8a.

Authorization; exceptions.

All CFSS services must be authorized by the
commissioner or the commissioner's designee as described in subdivision 8 except when:

(1) the lead agency temporarily authorizes services in the agency-provider model as
described in subdivision deleted text begin 5, paragraph (c) deleted text end new text begin 5a new text end ;

(2) CFSS services in the agency-provider model were required to treat an emergency
medical condition that if not immediately treated could cause a participant serious physical
or mental disability, continuation of severe pain, or death. The CFSS agency provider must
request retroactive authorization from the lead agency no later than five working days after
providing the initial emergency service. The CFSS agency provider must be able to
substantiate the emergency through documentation such as reports, notes, and admission
or discharge histories. A lead agency must follow the authorization process in subdivision
5 after the lead agency receives the request for authorization from the agency provider;

(3) the lead agency authorizes a temporary increase to the amount of services authorized
in the agency or budget model to accommodate the participant's temporary higher need for
services. Authorization for a temporary level of CFSS services is limited to the time specified
by the commissioner, but shall not exceed 45 days. The level of services authorized under
this clause shall have no bearing on a future authorization;

(4) a participant's medical assistance eligibility has lapsed, is then retroactively reinstated,
and an authorization for CFSS services is completed based on the date of a current
assessment, eligibility, and request for authorization;

(5) a third-party payer for CFSS services has denied or adjusted a payment. Authorization
requests must be submitted by the provider within 20 working days of the notice of denial
or adjustment. A copy of the notice must be included with the request;

(6) the commissioner has determined that a lead agency or state human services agency
has made an error; or

(7) a participant enrolled in managed care experiences a temporary disenrollment from
a health plan, in which case the commissioner shall accept the current health plan
authorization for CFSS services for up to 60 days. The request must be received within the
first 30 days of the disenrollment. If the recipient's reenrollment in managed care is after
the 60 days and before 90 days, the provider shall request an additional 30-day extension
of the current health plan authorization, for a total limit of 90 days from the time of
disenrollment.

Sec. 7.

Minnesota Statutes 2024, section 256B.85, subdivision 11, is amended to read:

Subd. 11.

Agency-provider model.

(a) The agency-provider model includes services
provided by support workers and staff providing worker training and development services
who are employed by an agency-provider that meets the criteria established by the
commissioner, including required training.

(b) The agency-provider shall allow the participant to have a significant role in the
selection and dismissal of the support workers for the delivery of the services and supports
specified in the participant's CFSS service delivery plan. The agency must make a reasonable
effort to fulfill the participant's request for the participant's preferred support worker.

(c) A participant may use authorized units of CFSS services as needed within a service
agreement that is not greater than 12 months. Using authorized units in a flexible manner
in either the agency-provider model or the budget model does not increase the total amount
of services and supports authorized for a participant or included in the participant's CFSS
service delivery plan.

(d) A participant may share CFSS services. Two or three CFSS participants may share
services at the same time provided by the same support worker.

(e) The agency-provider must use a minimum of 72.5 percent of the revenue generated
by the medical assistance payment for CFSS for support worker wages and benefits, except
all of the revenue generated by a medical assistance rate increase due to a collective
bargaining agreement under section 179A.54 must be used for support worker wages and
benefits. The agency-provider must document how this requirement is being met. The
revenue generated by the worker training and development services and the reasonable costs
associated with the worker training and development services must not be used in making
this calculation.

(f) The agency-provider model must be used by participants who are restricted by the
Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160 to
9505.2245.

(g) Participants purchasing goods under deleted text begin this deleted text end new text begin the agency-provider new text end model, along with
support worker services, must:

(1) specify the goods in the CFSS service delivery plan and detailed budget for
expenditures that must be approved by the lead agency, case manager, or care coordinator;
and

(2) use the FMS provider for the billing and payment of such goods.

(h) The agency provider is responsible for ensuring that any worker driving a participant
under subdivision 2, paragraph (o), has a valid driver's license and the vehicle used is
registered and insured according to Minnesota law.

new text begin (i) The use of consultation services under the agency-provider model is optional. A
participant may select the agency-provider model without using consultation services to
make the selection, to complete orientation to CFSS, or to select the agency-provider model.
new text end

new text begin (j) If a participant selects the agency-provider model without optional consultation
services, the agency-provider must provide an initial and annual orientation to CFSS
information and policies and a copy of the participant protections under subdivision 20 at
the start of services.
new text end

Sec. 8.

Minnesota Statutes 2024, section 256B.85, subdivision 13, is amended to read:

Subd. 13.

Budget model.

(a) Under the budget model participants exercise responsibility
and control over the services and supports described and budgeted within the CFSS service
delivery plan. Participants must use new text begin consultation services specified in subdivision 17 and
new text end services specified in subdivision 13a provided by an FMS provider. Under this model,
participants may use their approved service budget allocation to:

(1) directly employ support workers, and pay wages, federal and state payroll taxes, and
premiums for workers' compensation, liability, family and medical benefit insurance, and
health insurance coverage; and

(2) obtain supports and goods as defined in subdivision 7.

(b) Participants who are unable to fulfill any of the functions listed in paragraph (a) may
authorize a legal representative or participant's representative to do so on their behalf.

(c) If two or more participants using the budget model live in the same household and
have the same support worker, the participants must use the same FMS provider.

(d) If the FMS provider advises that there is a joint employer in the budget model, all
participants associated with that joint employer must use the same FMS provider.

(e) The commissioner shall disenroll or exclude participants from the budget model and
transfer them to the agency-provider model under, but not limited to, the following
circumstances:

(1) when a participant has been restricted by the Minnesota restricted recipient program,
in which case the participant may be excluded for a specified time period under Minnesota
Rules, parts 9505.2160 to 9505.2245;

(2) when a participant exits the budget model during the participant's service plan year.
Upon transfer, the participant shall not access the budget model for the remainder of that
service plan year; or

(3) when the department determines that the participant or participant's representative
or legal representative is unable to fulfill the responsibilities under the budget model, as
specified in subdivision 14.

(f) A participant may appeal in writing to the department under section 256.045,
subdivision 3, to contest the department's decision under paragraph (e), clause (3), to disenroll
or exclude the participant from the budget model.

Sec. 9.

Minnesota Statutes 2024, section 256B.85, subdivision 17, is amended to read:

Subd. 17.

Consultation services deleted text begin duties deleted text end .

new text begin Consultation services are a required service
for the budget model and an optional service for the agency-provider model. new text end Consultation
services deleted text begin is a required service that includes deleted text end new text begin include new text end :

(1) entering into a written agreement with the participant, participant's representative,
or legal representative that includes but is not limited to the details of services, service
delivery methods, dates of services, and contact information;

(2) providing an initial and annual orientation to CFSS information and policies, including
selecting a service model;

(3) assisting with accessing FMS providers or agency-providers;

(4) providing assistance with the development, implementation, management,
documentation, and evaluation of the person-centered CFSS service delivery plan;

(5) maintaining documentation of the approved CFSS service delivery plan;

(6) distributing copies of the final CFSS service delivery plan to the participant and to
the agency-provider or FMS provider, case manager or care coordinator, and other designated
parties;

(7) assisting to fulfill responsibilities and requirements of CFSS, including modifying
CFSS service delivery plans and changing service models;

(8) if requested, providing consultation on recruiting, selecting, training, managing,
directing, supervising, and evaluating support workers;

(9) evaluating services upon receiving information from an FMS provider indicating
spending or participant employer concerns;

(10) reviewing the use of and access to informal and community supports, goods, or
resources;

(11) a semiannual review of services if the participant does not have a case manager or
care coordinator and when the support worker is a paid parent of a minor participant or the
participant's spouse;

(12) collecting and reporting of data as required by the department;

(13) providing the participant with a copy of the participant protections under subdivision
20 at the start of consultation services;

(14) providing assistance to resolve issues of noncompliance with the requirements of
CFSS;

(15) providing recommendations to the commissioner for changes to services when
support to participants to resolve issues of noncompliance have been unsuccessful; and

(16) other duties as assigned by the commissioner.

Sec. 10.

Minnesota Statutes 2024, section 256B.85, subdivision 17a, is amended to read:

Subd. 17a.

Consultation services provider qualifications and
requirements.

Consultation services providers must meet the following qualifications and
requirements:

(1) meet the requirements under subdivision 10, paragraph (a), excluding clauses (4)
and (5);

(2) deleted text begin are deleted text end new text begin be new text end under contract with the department new text begin and enrolled as a Minnesota health care
program provider new text end ;

(3) deleted text begin are not deleted text end new text begin not be new text end the FMS provider, the lead agency, or the CFSS or home and
community-based services waiver vendor or agency-provider to the participant;

(4) meet the service standards as established by the commissioner;

(5) have proof of surety bond coverage. Upon new enrollment, or if the consultation
service provider's Medicaid revenue in the previous calendar year is less than or equal to
$300,000, the consultation service provider must purchase a surety bond of $50,000. If the
agency-provider's Medicaid revenue in the previous calendar year is greater than $300,000,
the consultation service provider must purchase a surety bond of $100,000. The surety bond
must be in a form approved by the commissioner, must be renewed annually, and must
allow for recovery of costs and fees in pursuing a claim on the bond;

(6) employ lead professional staff with a minimum of two years of experience in
providing services such as support planning, support broker, case management or care
coordination, or consultation services and consumer education to participants using a
self-directed program using FMS under medical assistance;

(7) report maltreatment as required under chapter 260E and section 626.557;

(8) comply with medical assistance provider requirements;

(9) understand the CFSS program and its policies;

(10) deleted text begin are deleted text end new text begin be new text end knowledgeable about self-directed principles and the application of the
person-centered planning process;

(11) have general knowledge of the FMS provider duties and the vendor fiscal/employer
agent model, including all applicable federal, state, and local laws and regulations regarding
tax, labor, employment, and liability and workers' compensation coverage for household
workers; and

(12) have all employees, including lead professional staff, staff in management and
supervisory positions, and owners of the agency who are active in the day-to-day management
and operations of the agency, complete training as specified in the contract with the
department.

Sec. 11.

Minnesota Statutes 2024, section 256B.85, subdivision 20, is amended to read:

Subd. 20.

Participant protections.

(a) All CFSS participants have the protections
identified in this subdivision.

(b) Participants or deleted text begin participant's deleted text end new text begin participants' new text end representatives must be provided with
adequate information, counseling, training, and assistance, as needed, to ensure that the
participant is able to choose and manage services, models, and budgets. new text begin For budget model
participants and participants who selected the agency-provider model with optional
consultation services, new text end this information must be provided by the consultation services provider
at the time of the initial or annual orientation to CFSS, at the time of reassessment, or when
requested by the participant or participant's representative. new text begin For participants who selected
the agency-provider model without optional consultation services, this information must
be provided by the agency-provider at the time of the initial or annual orientation to CFSS,
at the time of reassessment, or when requested by the participant or participant's
representative. new text end This information must explain:

(1) person-centered planning;

(2) the range and scope of participant choices, including the differences between the
agency-provider model and the budget model, available CFSS providers, and other services
available in the community to meet the participant's needs;

(3) the process for changing plans, services, and budgets;

(4) identifying and assessing appropriate services; and

(5) risks to and responsibilities of the participant under the budget model.

(c) The consultation services provider new text begin or agency-provider, as applicable, new text end must ensure
that the participant chooses freely between the agency-provider model and the budget model
and among available agency-providers and that the participant may change agency-providers
after services have begun.

(d) A participant who appeals a reduction in previously authorized CFSS services may
continue previously authorized services pending an appeal in accordance with section
256.045.

(e) If the units of service or budget allocation for CFSS are reduced, denied, or terminated,
the commissioner must provide notice of the reasons for the reduction in the participant's
notice of denial, termination, or reduction.

(f) If all or part of a CFSS service delivery plan is denied approval by the lead agency,
the lead agency must provide a notice that describes the basis of the denial.