SF 3757

Introduction - 94th Legislature (2025 - 2026)

Posted on 02/24/2026 09:50 a.m.

A bill for an act
relating to human services; establishing an individual authorized budget reduction
limit on reductions resulting from implementation of waiver reimagine phase II;
requiring a cost-of-living adjustment in the waiver reimagine phase II methodology;
amending Laws 2021, First Special Session chapter 7, article 13, section 73, as
amended.

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

Section 1.

Laws 2021, First Special Session chapter 7, article 13, section 73, as amended
by Laws 2025, First Special Session chapter 9, article 2, section 56, is amended to read:

Sec. 73. WAIVER REIMAGINE PHASE II.

(a) Effective January 1, 2027, or upon federal approval, whichever is later, the
commissioner of human services must implement a two-home and community-based services
waiver program structure, as authorized under section 1915(c) of the federal Social Security
Act, that serves persons who are determined by a certified assessor to require the levels of
care provided in a nursing home, a hospital, a neurobehavioral hospital, or an intermediate
care facility for persons with developmental disabilities.

(b) The commissioner of human services must implement an individualized budget
methodology, as authorized under section 1915(c) of the federal Social Security Act, that
serves persons who are determined by a certified assessor to require the levels of care
provided in a nursing home, a hospital, a neurobehavioral hospital, or an intermediate care
facility for persons with developmental disabilities.

(c) The commissioner must develop an individualized budget methodology exception
to support access to self-directed home care nursing services. Lead agencies must submit
budget exception requests to the commissioner in a manner identified by the commissioner.
Eligibility for the budget exception in this paragraph is limited to persons meeting all of the
following criteria in the person's most recent assessment:

(1) the person is assessed to need the level of care delivered in a hospital setting as
evidenced by the submission of the Department of Human Services form 7096, primary
medical provider's documentation of medical monitoring and treatment needs;

(2) the person is assessed to receive a support range budget of E or H; and

(3) the person does not receive community residential services, family residential services,
integrated community supports services, or customized living services.

(d) Home care nursing services funded through the budget exception developed under
paragraph (c) must be ordered by a physician, physician assistant, or advanced practice
registered nurse. If the participant chooses home care nursing, the home care nursing services
must be performed by a registered nurse or licensed practical nurse practicing within the
registered nurse's or licensed practical nurse's scope of practice as defined under Minnesota
Statutes, sections 148.171 to 148.285. If after a person's annual reassessment under Minnesota
Statutes, section 256B.0911, any requirements of this paragraph or paragraph (c) are no
longer met, the commissioner must terminate the budget exception.

(e) The commissioner of human services may seek all federal authority necessary to
implement this section.

(f) The commissioner must ensure that the new waiver service menu and individual
budgets allow people to live in their own home, family home, or any home and
community-based setting of their choice. The commissioner must ensure, within available
resources and subject to state and federal regulations and law, that waiver reimagine does
not result in unintended service disruptions.

(g) No later than July 1, 2026, the commissioner must:

(1) develop and implement an online support planning and tracking tool to provide
information in an accessible format to support informed choice for people using disability
waiver services that allows access to the total budget available to a person, the services for
which they are eligible, and the services they have chosen and used;

(2) explore operability options that facilitate real-time tracking of a person's remaining
available budget throughout the service year; and

(3) seek input from people with disabilities about the online support planning and tracking
tool prior to the tool's implementation.

new text begin (h) When implementing waiver reimagine phase II, the commissioner of human services
must not reduce the individual authorized budget amount of any waiver services recipient
by more than ten percent unless there is a decrease in need documented in the recipient's
MnCHOICES assessment.
new text end

new text begin (i) When determining whether a reduction in a recipient's authorized budget amount
violates paragraph (h), the commissioner must use:
new text end

new text begin (1) the recipient's authorized budget amount most recently approved by the recipient's
case manager prior to waiver reimagine phase II implementation; and
new text end

new text begin (2) the documented needs in the recipient's most recent MnCHOICES assessment prior
to waiver reimagine phase II implementation.
new text end

new text begin (j) If a recipient's documented needs in the MnCHOICES assessments completed after
waiver reimagine phase II implementation remain the same as or exceed the level of needs
documented in paragraph (i), clause (2), the reduction limit in paragraph (h) continues to
apply to every subsequent determination of that recipient's individual authorized budget
amount.
new text end

new text begin (k) If a recipient's documented needs in a MnCHOICES assessment completed after
implementation of waiver reimagine phase II decrease from the level of needs documented
in paragraph (i), clause (2), the reduction limit in paragraph (h) no longer applies to that
recipient's individual authorized budget amount and the commissioner must determine the
budget amount based on the methodology established by waiver reimagine phase II for
every subsequent determination of that recipient's individual authorized budget amount.
new text end

new text begin (l) The commissioner must incorporate into the methodology established in waiver
reimagine phase II a cost-of-living adjustment for all waiver recipient individual authorized
budgets.
new text end

new text begin (m) The commissioner must include the reduction limits and cost-of-living adjustment
in this section in any proposed statutory language codifying the implementation and
methodology of waiver reimagine phase II.
new text end