1.1 	A bill for an act
1.2 	relating to human services; modifying waiver reimagine individualized budget 
1.3 	requirements;amending Laws 2021, First Special Session chapter 7, article 13, 
1.4 	section 73, as amended.
1.5 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.6 	Section 1. Laws 2021, First Special Session chapter 7, article 13, section 73, as amended 
1.7 	by Laws 2025, First Special Session chapter 9, article 2, section 56, is amended to read:
1.8 	Sec. 73. WAIVER REIMAGINE PHASE II.
 1.9 	(a) Effective January 1, 2027, or upon federal approval, whichever is later, the 
1.10 	commissioner of human services must implement a two-home and community-based services 
1.11 	waiver program structure, as authorized under section 1915(c) of the federal Social Security 
1.12 	Act, that serves persons who are determined by a certified assessor to require the levels of 
1.13 	care provided in a nursing home, a hospital, a neurobehavioral hospital, or an intermediate 
1.14 	care facility for persons with developmental disabilities.
1.15 	(b) The commissioner of human services must implement an individualized budget 
1.16 	methodology, as authorized under section 1915(c) of the federal Social Security Act, that 
1.17 	serves persons who are determined by a certified assessor to require the levels of care 
1.18 	provided in a nursing home, a hospital, a neurobehavioral hospital, or an intermediate care 
1.19 	facility for persons with developmental disabilities. The commissioner must not implement 
1.20 	an individualized budget methodology that determines an individualized budget based on 
1.21 	where a person lives. The commissioner may implement an individualized budget 
1.22 	methodology only if the methodology determines an individualized budget solely on the 
1.23 	basis of the assessed needs of the individual.
2.1 	(c) The commissioner must develop an individualized budget methodology exception 
2.2 	to support access to self-directed home care nursing services. Lead agencies must submit 
2.3 	budget exception requests to the commissioner in a manner identified by the commissioner. 
2.4 	Eligibility for the budget exception in this paragraph is limited to persons meeting all of the 
2.5 	following criteria in the person's most recent assessment:
2.6 	(1) the person is assessed to need the level of care delivered in a hospital setting as 
2.7 	evidenced by the submission of the Department of Human Services form 7096, primary 
2.8 	medical provider's documentation of medical monitoring and treatment needs;
2.9 	(2) the person is assessed to receive a support range budget of E or H; and
2.10 	(3) the person does not receive community residential services, family residential services, 
2.11 	integrated community supports services, or customized living services.
2.12 	(d) Home care nursing services funded through the budget exception developed under 
2.13 	paragraph (c) must be ordered by a physician, physician assistant, or advanced practice 
2.14 	registered nurse. If the participant chooses home care nursing, the home care nursing services 
2.15 	must be performed by a registered nurse or licensed practical nurse practicing within the 
2.16 	registered nurse's or licensed practical nurse's scope of practice as defined under Minnesota 
2.17 	Statutes, sections 148.171 to 148.285. If after a person's annual reassessment under Minnesota 
2.18 	Statutes, section 256B.0911, any requirements of this paragraph or paragraph (c) are no 
2.19 	longer met, the commissioner must terminate the budget exception.
2.20 	(e) The commissioner of human services may seek all federal authority necessary to 
2.21 	implement this section.
2.22 	(f) The commissioner must ensure that the new waiver service menu and individual 
2.23 	budgets allow people to live in their own home, family home, or any home and 
2.24 	community-based setting of their choice. The commissioner must ensure, within available 
2.25 	resources and subject to state and federal regulations and law, that waiver reimagine does 
2.26 	not result in unintended service disruptions.
2.27 	(g) No later than July 1, 2026, the commissioner must:
2.28 	(1) develop and implement an online support planning and tracking tool to provide 
2.29 	information in an accessible format to support informed choice for people using disability 
2.30 	waiver services that allows access to the total budget available to a person, the services for 
2.31 	which they are eligible, and the services they have chosen and used;
2.32 	(2) explore operability options that facilitate real-time tracking of a person's remaining 
2.33 	available budget throughout the service year; and
3.1 	(3) seek input from people with disabilities about the online support planning and tracking 
3.2 	tool prior to the tool's implementation.

3.3 	EFFECTIVE DATE. This section is effective the day following final enactment.