1.1 	A bill for an act
1.2 	relating to human services; modifying the community first services and supports 
1.3 	program;amending Minnesota Statutes 2024, section 256B.85, subdivisions 6, 
1.4 	10, 18a, by adding subdivisions; Minnesota Statutes 2025 Supplement, section 
1.5 	256B.85, subdivisions 12, 17a.
1.6 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.7 	Section 1. Minnesota Statutes 2024, section 256B.85, subdivision 6, is amended to read:
1.8 		Subd. 6.Community first services and supports service delivery plan. (a) The CFSS 
1.9 	service delivery plan must be developed and evaluated through a person-centered planning 
1.10 	process by the participant, or the participant's representative or legal representative who 
1.11 	may be assisted by a consultation services provider. The CFSS service delivery plan must 
1.12 	reflect the services and supports that are important to the participant and for the participant 
1.13 	to meet the needs assessed by the certified assessor and identified in the support plan 
1.14 	identified in sections 256B.092, subdivision 1b, and 256S.10. The CFSS service delivery 
1.15 	plan must be reviewed by the participant, the consultation services provider when the 
1.16 	participant has utilized one, and the agency-provider or FMS provider prior to starting 
1.17 	services and at least annually upon reassessment, or when there is a significant change in 
1.18 	the participant's condition, or a change in the need for services and supports.
1.19 	(b) The commissioner shall establish the format and criteria for the CFSS service delivery 
1.20 	plan.
1.21 	(c) The CFSS service delivery plan must be person-centered and:
1.22 	(1) specify the consultation services provider, agency-provider, or FMS provider selected 
1.23 	by the participant;
2.1 	(2) reflect the setting in which the participant resides that is chosen by the participant;
2.2 	(3) reflect the participant's strengths and preferences;
2.3 	(4) include the methods and supports used to address the needs as identified through an 
2.4 	assessment of functional needs;
2.5 	(5) include the participant's identified goals and desired outcomes;
2.6 	(6) reflect the services and supports, paid and unpaid, that will assist the participant to 
2.7 	achieve identified goals, including the costs of the services and supports, and the providers 
2.8 	of those services and supports, including natural supports;
2.9 	(7) identify the amount and frequency of face-to-face supports and amount and frequency 
2.10 	of remote supports and technology that will be used;
2.11 	(8) identify risk factors and measures in place to minimize them, including individualized 
2.12 	backup plans;
2.13 	(9) be understandable to the participant and the individuals providing support;
2.14 	(10) identify the individual or entity responsible for monitoring the plan;
2.15 	(11) be finalized and agreed to in writing by the participant and signed by individuals 
2.16 	and providers responsible for its implementation;
2.17 	(12) be distributed to the participant and other people involved in the plan;
2.18 	(13) prevent the provision of unnecessary or inappropriate care;
2.19 	(14) include a detailed budget for expenditures for budget model participants or 
2.20 	participants under the agency-provider model if purchasing goods; and
2.21 	(15) include a plan for worker training and development provided according to 
2.22 	subdivision 18a detailing what service components will be used, when the service components 
2.23 	will be used, how they will be provided, and how these service components relate to the 
2.24 	participant's individual needs and CFSS support worker services.
2.25 	(d) The CFSS service delivery plan must describe the units or dollar amount available 
2.26 	to the participant. The total units of agency-provider services or the service budget amount 
2.27 	for the budget model include both annual totals and a monthly average amount that cover 
2.28 	the number of months of the service agreement. The amount used each month may vary, 
2.29 	but additional funds must not be provided above the annual service authorization amount, 
2.30 	determined according to subdivision 8, unless a change in condition is assessed and 
3.1 	authorized by the certified assessor and documented in the support plan and CFSS service 
3.2 	delivery plan.
3.3 	(e) In assisting with the development or modification of the CFSS service delivery plan 
3.4 	during the authorization time period, the consultation services provider shall:
3.5 	(1) consult with the FMS provider on the spending budget when applicable; and
3.6 	(2) consult with the participant or participant's representative, agency-provider, and case 
3.7 	manager or care coordinator.
3.8 	(f) The CFSS service delivery plan must be approved by the lead agency for participants 
3.9 	without a case manager or care coordinator who is responsible for authorizing services. A 
3.10 	case manager or care coordinator must approve the plan for a waiver or alternative care 
3.11 	program participant.

3.12 	Sec. 2. Minnesota Statutes 2024, section 256B.85, subdivision 10, is amended to read:
3.13 		Subd. 10.Agency-provider and FMS provider qualifications and duties. (a) 
3.14 	Agency-providers identified in subdivision 11 and FMS providers identified in subdivision 
3.15 	13a shall must:
3.16 	(1) enroll as a medical assistance Minnesota health care programs provider and meet all 
3.17 	applicable provider standards and requirements including completion of required provider 
3.18 	training as determined by the commissioner;
3.19 	(2) demonstrate compliance with federal and state laws and policies for CFSS as 
3.20 	determined by the commissioner;
3.21 	(3) comply with background study requirements under chapter 245C and maintain 
3.22 	documentation of background study requests and results;
3.23 	(4) verify and maintain records of all services and expenditures by the participant, 
3.24 	including hours worked by support workers;
3.25 	(5) not engage in any agency-initiated direct contact or marketing in person, by telephone, 
3.26 	or other electronic means to potential participants, guardians, family members, or participants' 
3.27 	representatives;
3.28 	(6) directly provide services and not use a subcontractor or reporting agent;
3.29 	(7) meet the financial requirements established by the commissioner for financial 
3.30 	solvency;
4.1 	(8) have never had a lead agency contract or provider agreement discontinued due to 
4.2 	fraud, or have never had an owner, board member, or manager fail a state or FBI-based 
4.3 	criminal background check while enrolled or seeking enrollment as a Minnesota health care 
4.4 	programs provider; and
4.5 	(9) have an office located in Minnesota.
4.6 	(b) In conducting general duties, agency-providers and FMS providers shall must:
4.7 	(1) bill for and pay support workers based upon actual hours of services provided;
4.8 	(2) bill for and pay for worker training and development services based upon actual 
4.9 	hours of services provided or on the unit cost of the training session purchased or in the 
4.10 	manner defined by the commissioner;
4.11 	(3) withhold and pay all applicable federal and state payroll taxes;
4.12 	(4) make arrangements and pay unemployment insurance, taxes, workers' compensation, 
4.13 	liability insurance, and other benefits, if any;
4.14 	(5) enter into a written agreement with the participant, participant's representative, or 
4.15 	legal representative that assigns roles and responsibilities to be performed before services, 
4.16 	supports, or goods are provided and that meets the requirements of subdivisions 20a, 20b, 
4.17 	and 20c for agency-providers;
4.18 	(6) report maltreatment as required under section 626.557 and chapter 260E;
4.19 	(7) comply with the labor market reporting requirements described in section 256B.4912, 
4.20 	subdivision 1a;
4.21 	(8) comply with any data requests from the department consistent with the Minnesota 
4.22 	Government Data Practices Act under chapter 13; and
4.23 	(9) maintain documentation for the requirements under subdivision 16, paragraph (e), 
4.24 	clause (2), to qualify for an enhanced rate under this section; and.
4.25 	(10) request reassessments 60 days before the end of the current authorization for CFSS 
4.26 	on forms provided by the commissioner.
4.27 	(c) Agency-providers and FMS providers must inform the commissioner of changes in 
4.28 	the employment status and affiliation of support workers and of individuals providing worker 
4.29 	training and development. Agency-providers and FMS providers must notify the 
4.30 	commissioner on a form prescribed by the commissioner:
5.1 	(1) within six months following the date upon which a support worker is no longer 
5.2 	employed by or otherwise affiliated with the CFSS agency-provider or participant employer 
5.3 	for whom the support worker previously provided CFSS services; and
5.4 	(2) within 30 days following the date upon which an individual providing worker training 
5.5 	and development is no longer employed by or otherwise affiliated with the CFSS 
5.6 	agency-provider or participant employer for whom the individual previously provided 
5.7 	worker training and development services.

5.8 	Sec. 3. Minnesota Statutes 2025 Supplement, section 256B.85, subdivision 12, is amended 
5.9 	to read:
5.10 		Subd. 12.Requirements for enrollment of CFSS agency-providers. (a) Except as 
5.11 	provided in paragraph (b), all CFSS agency-providers must provide to the commissioner, 
5.12 	at the time of enrollment, reenrollment, and revalidation as a CFSS agency-provider in a 
5.13 	format determined by the commissioner, information and documentation that includes but 
5.14 	is not limited to the following:
5.15 	(1) the CFSS agency-provider's current contact information including address, telephone 
5.16 	number, and email address;
5.17 	(2) proof of surety bond coverage. Upon new enrollment, or if the agency-provider's 
5.18 	Medicaid revenue in the previous calendar year is less than or equal to $300,000, the 
5.19 	agency-provider must purchase a surety bond of $50,000 $100,000. If the agency-provider's 
5.20 	Medicaid revenue in the previous calendar year is greater than $300,000 but less than or 
5.21 	equal to $750,000, the agency-provider must purchase a surety bond of $100,000 $200,000. 
5.22 	If the agency-provider's Medicaid revenue in the previous calendar year is greater than 
5.23 	$750,000, the agency-provider must purchase a surety bond of $300,000. The surety bond 
5.24 	must be in a form approved by the commissioner, must be renewed annually, and must 
5.25 	allow for recovery of costs and fees in pursuing a claim on the bond. Any action to obtain 
5.26 	monetary recovery or sanctions from a surety bond must occur within six years from the 
5.27 	date the debt is affirmed by a final agency decision. An agency decision is final when the 
5.28 	right to appeal the debt has been exhausted or the time to appeal has expired under section 
5.29 	256B.064;
5.30 	(3) proof of fidelity bond coverage in the amount of $20,000 $50,000 per provider 
5.31 	location;
5.32 	(4) proof of workers' compensation insurance coverage;
5.33 	(5) proof of liability insurance;
6.1 	(6) a copy of the CFSS agency-provider's organizational chart identifying the names 
6.2 	and roles of all owners, managing employees, staff, board of directors, and additional 
6.3 	documentation reporting any affiliations of the directors and owners to other service 
6.4 	providers;
6.5 	(7) proof that the CFSS agency-provider has written policies and procedures including: 
6.6 	hiring of employees; training requirements; service delivery; identification, prevention, 
6.7 	detection, and reporting of fraud or any billing, record keeping, or other administrative 
6.8 	noncompliance; and employee and consumer safety, including the process for notification 
6.9 	and resolution of participant grievances, incident response, identification and prevention of 
6.10 	communicable diseases, and employee misconduct;
6.11 	(8) proof that the CFSS agency-provider has all of the following forms and documents:
6.12 	(i) a copy of the CFSS agency-provider's time sheet; and
6.13 	(ii) a copy of the participant's individual CFSS service delivery plan;
6.14 	(9) a list of all training and classes that the CFSS agency-provider requires of its staff 
6.15 	providing CFSS services;
6.16 	(10) documentation that the CFSS agency-provider and staff have successfully completed 
6.17 	all the training required by this section;
6.18 	(11) documentation of the agency-provider's marketing practices;
6.19 	(12) disclosure of ownership, leasing, or management of all residential properties that 
6.20 	are used or could be used for providing home care services;
6.21 	(13) documentation that the agency-provider will use at least the following percentages 
6.22 	of revenue generated from the medical assistance rate paid for CFSS services for CFSS 
6.23 	support worker wages and benefits: 72.5 percent of revenue from CFSS providers, except 
6.24 	100 percent of the revenue generated by a medical assistance rate increase due to a collective 
6.25 	bargaining agreement under section 179A.54 must be used for support worker wages and 
6.26 	benefits. The revenue generated by the worker training and development services and the 
6.27 	reasonable costs associated with the worker training and development services shall not be 
6.28 	used in making this calculation; and
6.29 	(14) documentation that the agency-provider does not burden participants' free exercise 
6.30 	of their right to choose service providers by requiring CFSS support workers to sign an 
6.31 	agreement not to work with any particular CFSS participant or for another CFSS 
6.32 	agency-provider after leaving the agency and that the agency is not taking action on any 
6.33 	such agreements or requirements regardless of the date signed.;
7.1 	(15) a copy of the CFSS agency-provider's self-auditing policy and other materials 
7.2 	demonstrating the CFSS agency-provider's internal program integrity procedures;
7.3 	(16) a copy of the CFSS agency-provider's policy for notifying individuals providing 
7.4 	worker training and development of the individual's obligation to notify the commissioner 
7.5 	within 30 days that the individual is no longer employed by or affiliated with the CFSS 
7.6 	agency-provider;
7.7 	(17) a copy of the CFSS agency-provider's policy for notifying support workers of the 
7.8 	support worker's obligation to notify the commissioner within six months that the support 
7.9 	worker is no longer employed by or affiliated with the CFSS agency-provider;
7.10 	(18) a copy of the CFSS agency-provider's policy for notifying the commissioner within 
7.11 	30 days that an individual providing worker training and development is no longer employed 
7.12 	by or affiliated with the CFSS agency-provider; and
7.13 	(19) a copy of the CFSS agency-provider's policy for notifying the commissioner within 
7.14 	six months that a support worker is no longer employed by or affiliated with the CFSS 
7.15 	agency-provider.
7.16 	(b) CFSS agency-providers shall provide to the commissioner the information specified 
7.17 	in paragraph (a) must annually provide to the commissioner the information described in 
7.18 	paragraph (a), clauses (2) to (5).
7.19 	(c) All CFSS agency-providers shall must require all employees in management and 
7.20 	supervisory positions and owners of the agency who are active in the day-to-day management 
7.21 	and operations of the agency to complete mandatory training as determined by the 
7.22 	commissioner. Employees in management and supervisory positions and owners who are 
7.23 	active in the day-to-day operations of an agency who have completed the required training 
7.24 	as an employee with a CFSS agency-provider do not need to repeat the required training if 
7.25 	they are hired by another agency and they have completed the training within the past three
7.26 	two years. CFSS agency-provider billing staff shall must complete training about CFSS 
7.27 	program financial management. Any new owners or employees in management and 
7.28 	supervisory positions involved in the day-to-day operations are required to must complete 
7.29 	mandatory training as a requisite of working for the agency.
7.30 	(d) Agency-providers shall must submit all required documentation in this section within 
7.31 	30 days of notification from the commissioner. If an agency-provider fails to submit all the 
7.32 	required documentation, the commissioner may take action under subdivision 23a.
8.1 	(e) In addition to the other requirements of this subdivision, a CFSS agency-provider 
8.2 	enrolling for the first time must provide, at the time of initial enrollment as a CFSS 
8.3 	agency-provider and in a format determined by the commissioner, proof of sufficient initial 
8.4 	operating capital to support the infrastructure necessary for ongoing compliance with the 
8.5 	requirements of this section. A CFSS agency-provider may demonstrate sufficient operating 
8.6 	capital by submitting:
8.7 	(1) copies of business bank account statements showing at least $5,000 in cash reserves;
8.8 	(2) proof of a cash reserve or business line of credit sufficient to equal two payrolls of 
8.9 	the agency-provider's current or projected business; or
8.10 	(3) any other information as determined by the commissioner.
8.11 	(f) In addition to the other requirements of this subdivision, a CFSS agency-provider 
8.12 	must provide the following to the commissioner at the time of revalidation as a CFSS 
8.13 	agency-provider in a format determined by the commissioner:
8.14 	(1) documentation of the payroll paid for the preceding 12 months or other time period 
8.15 	as prescribed by the commissioner; and
8.16 	(2) financial statements demonstrating compliance with the use of revenue requirements 
8.17 	of subdivision 11, paragraph (e).

8.18 	Sec. 4. Minnesota Statutes 2024, section 256B.85, is amended by adding a subdivision to 
8.19 	read:
8.20 		Subd. 16b.Support workers; notice of change of employment required. Within six 
8.21 	months of ceasing employment as a support worker with a CFSS agency-provider or 
8.22 	participant employer, the support worker must notify the commissioner on a form prescribed 
8.23 	by the commissioner that the support worker is no longer employed by or otherwise affiliated 
8.24 	with the CFSS agency-provider or participant employer for whom the support worker was 
8.25 	previously providing CFSS services.

8.26 	Sec. 5. Minnesota Statutes 2025 Supplement, section 256B.85, subdivision 17a, is amended 
8.27 	to read:
8.28 		Subd. 17a.Consultation services provider qualifications and 
8.29 	requirements. Consultation services providers must meet the following qualifications and 
8.30 	requirements:
9.1 	(1) meet the requirements under subdivision 10, paragraph (a), excluding clauses (4) 
9.2 	and (5);
9.3 	(2) be under contract with the department and enrolled as a Minnesota health care program 
9.4 	provider;
9.5 	(3) not be the FMS provider, the lead agency, or the CFSS or home and community-based 
9.6 	services waiver vendor or agency-provider to the participant;
9.7 	(4) meet the service standards as established by the commissioner;
9.8 	(5) have proof of surety bond coverage. Upon new enrollment, or if the consultation 
9.9 	service provider's Medicaid revenue in the previous calendar year is less than or equal to 
9.10 	$300,000, the consultation service provider must purchase a surety bond of $50,000 $100,000. 
9.11 	If the agency-provider's Medicaid revenue in the previous calendar year is greater than 
9.12 	$300,000 but less than or equal to $750,000, the consultation service provider must purchase 
9.13 	a surety bond of $100,000 $200,000. If the consultation service provider's Medicaid revenue 
9.14 	in the previous calendar year is greater than $750,000, the consultation service provider 
9.15 	must purchase a surety bond of $300,000. The surety bond must be in a form approved by 
9.16 	the commissioner, must be renewed annually, and must allow for recovery of costs and fees 
9.17 	in pursuing a claim on the bond;
9.18 	(6) employ lead professional staff with a minimum of two years of experience in 
9.19 	providing services such as support planning, support broker, case management or care 
9.20 	coordination, or consultation services and consumer education to participants using a 
9.21 	self-directed program using FMS under medical assistance;
9.22 	(7) report maltreatment as required under chapter 260E and section 626.557;
9.23 	(8) comply with medical assistance provider requirements;
9.24 	(9) understand the CFSS program and its policies;
9.25 	(10) be knowledgeable about self-directed principles and the application of the 
9.26 	person-centered planning process;
9.27 	(11) have general knowledge of the FMS provider duties and the vendor fiscal/employer 
9.28 	agent model, including all applicable federal, state, and local laws and regulations regarding 
9.29 	tax, labor, employment, and liability and workers' compensation coverage for household 
9.30 	workers; and
9.31 	(12) have all employees, including lead professional staff, staff in management and 
9.32 	supervisory positions, and owners of the agency who are active in the day-to-day management 
10.1 	and operations of the agency, complete training as specified in the contract with the 
10.2 	department.

10.3 	Sec. 6. Minnesota Statutes 2024, section 256B.85, is amended by adding a subdivision to 
10.4 	read:
10.5 		Subd. 17b.Exemption from consultation services. (a) Notwithstanding any provision 
10.6 	of this section to the contrary, except subdivision 5a, a participant is exempt from the 
10.7 	requirement to obtain consultation services if the participant is receiving CFSS services 
10.8 	from an agency-provider, the participant is not changing the CFSS agency-provider, and 
10.9 	one of the following additional conditions are met:
10.10 	(1) if the participant has received consultation services in the past, the participant's 
10.11 	condition has not changed significantly since the participant most recently received 
10.12 	consultation services; or
10.13 	(2) if the participant has not received consultation services, the participant's condition 
10.14 	has not changed significantly since the participant's most recent assessment, most recent 
10.15 	reassessment, or most recent CFSS service delivery plan review.
10.16 	(b) A lead agency that determines the exemption from consultation services under this 
10.17 	subdivision does not apply must document in the participant's case record the basis for 
10.18 	determining that the participant is required to obtain consultation services.
10.19 	(c) Nothing in this subdivision prevents a participant, participant's legal representative, 
10.20 	or lead agency from requesting consultation services at any time.
10.21 	(d) Nothing in this subdivision requires a lead agency to forego requiring a participant 
10.22 	receive consultation services when documentation indicates a significant change in the 
10.23 	participant's condition.

10.24 	Sec. 7. Minnesota Statutes 2024, section 256B.85, subdivision 18a, is amended to read:
10.25 		Subd. 18a.Worker training and development services. (a) The commissioner shall
10.26 	must develop the scope of tasks and functions, service standards, and service limits for 
10.27 	worker training and development services.
10.28 	(b) Worker training and development costs are in addition to the participant's assessed 
10.29 	service units or service budget. Services provided according to this subdivision must:
11.1 	(1) help support workers obtain and expand the skills and knowledge necessary to ensure 
11.2 	competency in providing quality services as needed and defined in the participant's CFSS 
11.3 	service delivery plan and as required under subdivisions 11b and 14;
11.4 	(2) be provided or arranged for by the agency-provider under subdivision 11, or purchased 
11.5 	by the participant employer under the budget model as identified in subdivision 13;
11.6 	(3) be delivered by an individual competent to perform, teach, or assign the tasks, 
11.7 	including health-related tasks, identified in the plan through education, training, and work 
11.8 	experience relevant to the person's assessed needs; and
11.9 	(4) be described in the participant's CFSS service delivery plan and documented in the 
11.10 	participant's file.
11.11 	(c) Services covered under worker training and development shall must include:
11.12 	(1) support worker training on the participant's individual assessed needs and condition, 
11.13 	provided individually or in a group setting by a skilled and knowledgeable trainer beyond 
11.14 	any training the participant or participant's representative provides;
11.15 	(2) tuition for professional classes and workshops for the participant's support workers 
11.16 	that relate to the participant's assessed needs and condition;
11.17 	(3) direct observation, monitoring, coaching, and documentation of support worker job 
11.18 	skills and tasks, beyond any training the participant or participant's representative provides, 
11.19 	including supervision of health-related tasks or behavioral supports that is conducted by an 
11.20 	appropriate professional based on the participant's assessed needs. These services must be 
11.21 	provided at the start of services or the start of a new support worker except as provided in 
11.22 	paragraph (d) and must be specified in the participant's CFSS service delivery plan; and
11.23 	(4) the activities to evaluate CFSS services and ensure support worker competency 
11.24 	described in subdivisions 11a and 11b.
11.25 	(d) The services in paragraph (c), clause (3), are not required to be provided for a new 
11.26 	support worker providing services for a participant due to staffing failures, unless the support 
11.27 	worker is expected to provide ongoing backup staffing coverage.
11.28 	(e) Worker training and development services shall not include:
11.29 	(1) general agency training, worker orientation, or training on CFSS self-directed models;
11.30 	(2) payment for preparation or development time for the trainer or presenter;
11.31 	(3) payment of the support worker's salary or compensation during the training;
12.1 	(4) training or supervision provided by the participant, the participant's support worker, 
12.2 	or the participant's informal supports, including the participant's representative; or
12.3 	(5) services in excess of the limit set by the commissioner per annual service agreement, 
12.4 	unless approved by the department.
12.5 	(f) Worker training and development for a recipient must be documented in a manner 
12.6 	determined by the commissioner and must include the full name and individual provider 
12.7 	identifier of the individual providing worker training and development.

12.8 	Sec. 8. Minnesota Statutes 2024, section 256B.85, is amended by adding a subdivision to 
12.9 	read:
12.10 		Subd. 18c.Worker training and development; notice of change of employment 
12.11 	required. Within 30 days of ceasing employment providing worker training and development 
12.12 	on behalf of a CFSS agency-provider or a participant employer, the individual providing 
12.13 	worker training and development must notify the commissioner on a form prescribed by 
12.14 	the commissioner that the individual is no longer providing worker training and development 
12.15 	on behalf of the CFSS agency-provider or the participant employer.

12.16 	Sec. 9. Minnesota Statutes 2024, section 256B.85, is amended by adding a subdivision to 
12.17 	read:
12.18 		Subd. 27.Uniformity with state requirements. Managed care plans and county-based 
12.19 	purchasing plans must not impose requirements on CFSS services that are more restrictive 
12.20 	or otherwise exceed the requirements imposed by the commissioner with respect to:
12.21 	(1) determining CFSS service authorization amounts under subdivision 8;
12.22 	(2) assigning unique Minnesota provider identifiers;
12.23 	(3) submitting claims; or
12.24 	(4) documenting daily time and activities.

12.25 	EFFECTIVE DATE. This section is effective January 1, 2027.