SF 4698

Introduction - 94th Legislature (2025 - 2026)

Posted on 03/24/2026 10:48 a.m.

A bill for an act
relating to human services; modifying the community first services and supports
program; amending Minnesota Statutes 2024, section 256B.85, subdivisions 6,
10, 18a, by adding subdivisions; Minnesota Statutes 2025 Supplement, section
256B.85, subdivisions 12, 17a.

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

Section 1.

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. The CFSS service delivery
plan must be reviewed by the participant, the consultation services provider new text begin when the
participant has utilized one new text end , 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.

(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, agency-provider, 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) In 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) 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. 2.

Minnesota Statutes 2024, section 256B.85, subdivision 10, is amended to read:

Subd. 10.

Agency-provider and FMS provider qualifications and duties.

(a)
Agency-providers identified in subdivision 11 and FMS providers identified in subdivision
13a deleted text begin shall deleted text end new text begin must new text end :

(1) enroll as a medical assistance Minnesota health care programs provider and meet all
applicable provider standards and requirements including completion of required provider
training as determined by the commissioner;

(2) demonstrate compliance with federal and state laws and policies for CFSS as
determined by the commissioner;

(3) comply with background study requirements under chapter 245C and maintain
documentation of background study requests and results;

(4) verify and maintain records of all services and expenditures by the participant,
including hours worked by support workers;

(5) not engage in any agency-initiated direct contact or marketing in person, by telephone,
or other electronic means to potential participants, guardians, family members, or participants'
representatives;

(6) directly provide services and not use a subcontractor or reporting agent;

(7) meet the financial requirements established by the commissioner for financial
solvency;

(8) have never had a lead agency contract or provider agreement discontinued due to
fraud, or have never had an owner, board member, or manager fail a state or FBI-based
criminal background check while enrolled or seeking enrollment as a Minnesota health care
programs provider; and

(9) have an office located in Minnesota.

(b) In conducting general duties, agency-providers and FMS providers deleted text begin shall deleted text end new text begin must new text end :

(1) new text begin bill for and new text end pay support workers based upon actual hours of services provided;

(2) new text begin bill for and new text end pay for worker training and development services based deleted text begin upon actual
hours of services provided or deleted text end new text begin on new text end the unit cost of the training session purchased new text begin or in the
manner defined by the commissioner new text end ;

(3) withhold and pay all applicable federal and state payroll taxes;

(4) make arrangements and pay unemployment insurance, taxes, workers' compensation,
liability insurance, and other benefits, if any;

(5) enter into a written agreement with the participant, participant's representative, or
legal representative that assigns roles and responsibilities to be performed before services,
supports, or goods are provided and that meets the requirements of subdivisions 20a, 20b,
and 20c for agency-providers;

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

(7) comply with the labor market reporting requirements described in section 256B.4912,
subdivision 1a;

(8) comply with any data requests from the department consistent with the Minnesota
Government Data Practices Act under chapter 13; new text begin and
new text end

(9) maintain documentation for the requirements under subdivision 16, paragraph (e),
clause (2), to qualify for an enhanced rate under this section deleted text begin ; and deleted text end new text begin .
new text end

deleted text begin (10) request reassessments 60 days before the end of the current authorization for CFSS
on forms provided by the commissioner.
deleted text end

new text begin (c) Agency-providers and FMS providers must inform the commissioner of changes in
the employment status and affiliation of support workers and of individuals providing worker
training and development. Agency-providers and FMS providers must notify the
commissioner on a form prescribed by the commissioner:
new text end

new text begin (1) within six months following the date upon which a support worker is no longer
employed by or otherwise affiliated with the CFSS agency-provider or participant employer
for whom the support worker previously provided CFSS services; and
new text end

new text begin (2) within 30 days following the date upon which an individual providing worker training
and development is no longer employed by or otherwise affiliated with the CFSS
agency-provider or participant employer for whom the individual previously provided
worker training and development services.
new text end

Sec. 3.

Minnesota Statutes 2025 Supplement, section 256B.85, subdivision 12, is amended
to read:

Subd. 12.

Requirements for enrollment of CFSS agency-providers.

(a) new text begin Except as
provided in paragraph (b), new text end all CFSS agency-providers must provide new text begin to the commissioner new text end ,
at the time of enrollment, reenrollment, and revalidation as a CFSS agency-provider in a
format determined by the commissioner, information and documentation that includes but
is not limited to the following:

(1) the CFSS agency-provider's current contact information including address, telephone
number, and email address;

(2) proof of surety bond coverage. Upon new enrollment deleted text begin , deleted text end or if the agency-provider's
Medicaid revenue in the previous calendar year is less than or equal to $300,000, the
agency-provider must purchase a surety bond of deleted text begin $50,000 deleted text end new text begin $100,000 new text end . If the agency-provider's
Medicaid revenue in the previous calendar year is greater than $300,000 new text begin but less than or
equal to $750,000 new text end , the agency-provider must purchase a surety bond of deleted text begin $100,000 deleted text end new text begin $200,000 new text end .
new text begin If the agency-provider's Medicaid revenue in the previous calendar year is greater than
$750,000, the agency-provider must purchase a surety bond of $300,000. new text end 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. Any action to obtain
monetary recovery or sanctions from a surety bond must occur within six years from the
date the debt is affirmed by a final agency decision. An agency decision is final when the
right to appeal the debt has been exhausted or the time to appeal has expired under section
256B.064;

(3) proof of fidelity bond coverage in the amount of deleted text begin $20,000 deleted text end new text begin $50,000 new text end per provider
location;

(4) proof of workers' compensation insurance coverage;

(5) proof of liability insurance;

(6) a copy of the CFSS agency-provider's organizational chart identifying the names
and roles of all owners, managing employees, staff, board of directors, and additional
documentation reporting any affiliations of the directors and owners to other service
providers;

(7) proof that the CFSS agency-provider has written policies and procedures including:
hiring of employees; training requirements; service delivery; new text begin identification, prevention,
detection, and reporting of fraud or any billing, record keeping, or other administrative
noncompliance; new text end and employee and consumer safety, including the process for notification
and resolution of participant grievances, incident response, identification and prevention of
communicable diseases, and employee misconduct;

(8) proof that the CFSS agency-provider has all of the following forms and documents:

(i) a copy of the CFSS agency-provider's time sheet; and

(ii) a copy of the participant's individual CFSS service delivery plan;

(9) a list of all training and classes that the CFSS agency-provider requires of its staff
providing CFSS services;

(10) documentation that the CFSS agency-provider and staff have successfully completed
all the training required by this section;

(11) documentation of the agency-provider's marketing practices;

(12) disclosure of ownership, leasing, or management of all residential properties that
are used or could be used for providing home care services;

(13) documentation that the agency-provider will use at least the following percentages
of revenue generated from the medical assistance rate paid for CFSS services for CFSS
support worker wages and benefits: 72.5 percent of revenue from CFSS providers, except
100 percent 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 revenue generated by the worker training and development services and the
reasonable costs associated with the worker training and development services shall not be
used in making this calculation; deleted text begin and
deleted text end

(14) documentation that the agency-provider does not burden participants' free exercise
of their right to choose service providers by requiring CFSS support workers to sign an
agreement not to work with any particular CFSS participant or for another CFSS
agency-provider after leaving the agency and that the agency is not taking action on any
such agreements or requirements regardless of the date signed deleted text begin . deleted text end new text begin ;
new text end

new text begin (15) a copy of the CFSS agency-provider's self-auditing policy and other materials
demonstrating the CFSS agency-provider's internal program integrity procedures;
new text end

new text begin (16) a copy of the CFSS agency-provider's policy for notifying individuals providing
worker training and development of the individual's obligation to notify the commissioner
within 30 days that the individual is no longer employed by or affiliated with the CFSS
agency-provider;
new text end

new text begin (17) a copy of the CFSS agency-provider's policy for notifying support workers of the
support worker's obligation to notify the commissioner within six months that the support
worker is no longer employed by or affiliated with the CFSS agency-provider;
new text end

new text begin (18) a copy of the CFSS agency-provider's policy for notifying the commissioner within
30 days that an individual providing worker training and development is no longer employed
by or affiliated with the CFSS agency-provider; and
new text end

new text begin (19) a copy of the CFSS agency-provider's policy for notifying the commissioner within
six months that a support worker is no longer employed by or affiliated with the CFSS
agency-provider.
new text end

(b) CFSS agency-providers deleted text begin shall provide to the commissioner the information specified
in paragraph (a) deleted text end new text begin must annually provide to the commissioner the information described in
paragraph (a), clauses (2) to (5) new text end .

(c) All CFSS agency-providers deleted text begin shall deleted text end new text begin must new text end require all employees in management and
supervisory positions and owners of the agency who are active in the day-to-day management
and operations of the agency to complete mandatory training as determined by the
commissioner. Employees in management and supervisory positions and owners who are
active in the day-to-day operations of an agency who have completed the required training
as an employee with a CFSS agency-provider do not need to repeat the required training if
they are hired by another agency and they have completed the training within the past deleted text begin three deleted text end new text begin
two new text end years. CFSS agency-provider billing staff deleted text begin shall deleted text end new text begin must new text end complete training about CFSS
program financial management. Any new owners or employees in management and
supervisory positions involved in the day-to-day operations deleted text begin are required to deleted text end new text begin must new text end complete
mandatory training as a requisite of working for the agency.

(d) Agency-providers deleted text begin shall deleted text end new text begin must new text end submit all required documentation in this section within
30 days of notification from the commissioner. If an agency-provider fails to submit all the
required documentation, the commissioner may take action under subdivision 23a.

new text begin (e) In addition to the other requirements of this subdivision, a CFSS agency-provider
enrolling for the first time must provide, at the time of initial enrollment as a CFSS
agency-provider and in a format determined by the commissioner, proof of sufficient initial
operating capital to support the infrastructure necessary for ongoing compliance with the
requirements of this section. A CFSS agency-provider may demonstrate sufficient operating
capital by submitting:
new text end

new text begin (1) copies of business bank account statements showing at least $5,000 in cash reserves;
new text end

new text begin (2) proof of a cash reserve or business line of credit sufficient to equal two payrolls of
the agency-provider's current or projected business; or
new text end

new text begin (3) any other information as determined by the commissioner.
new text end

new text begin (f) In addition to the other requirements of this subdivision, a CFSS agency-provider
must provide the following to the commissioner at the time of revalidation as a CFSS
agency-provider in a format determined by the commissioner:
new text end

new text begin (1) documentation of the payroll paid for the preceding 12 months or other time period
as prescribed by the commissioner; and
new text end

new text begin (2) financial statements demonstrating compliance with the use of revenue requirements
of subdivision 11, paragraph (e).
new text end

Sec. 4.

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

new text begin Subd. 16b. new text end

new text begin Support workers; notice of change of employment required. new text end

new text begin Within six
months of ceasing employment as a support worker with a CFSS agency-provider or
participant employer, the support worker must notify the commissioner on a form prescribed
by the commissioner that the support worker is no longer employed by or otherwise affiliated
with the CFSS agency-provider or participant employer for whom the support worker was
previously providing CFSS services.
new text end

Sec. 5.

Minnesota Statutes 2025 Supplement, 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) be under contract with the department and enrolled as a Minnesota health care program
provider;

(3) not be 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 deleted text begin , deleted text end 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 deleted text begin $50,000 deleted text end new text begin $100,000 new text end .
If the agency-provider's Medicaid revenue in the previous calendar year is greater than
$300,000 new text begin but less than or equal to $750,000 new text end , the consultation service provider must purchase
a surety bond of deleted text begin $100,000 deleted text end new text begin $200,000 new text end . new text begin If the consultation service provider's Medicaid revenue
in the previous calendar year is greater than $750,000, the consultation service provider
must purchase a surety bond of $300,000. new text end 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) be 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. 6.

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

new text begin Subd. 17b. new text end

new text begin Exemption from consultation services. new text end

new text begin (a) Notwithstanding any provision
of this section to the contrary, except subdivision 5a, a participant is exempt from the
requirement to obtain consultation services if the participant is receiving CFSS services
from an agency-provider, the participant is not changing the CFSS agency-provider, and
one of the following additional conditions are met:
new text end

new text begin (1) if the participant has received consultation services in the past, the participant's
condition has not changed significantly since the participant most recently received
consultation services; or
new text end

new text begin (2) if the participant has not received consultation services, the participant's condition
has not changed significantly since the participant's most recent assessment, most recent
reassessment, or most recent CFSS service delivery plan review.
new text end

new text begin (b) A lead agency that determines the exemption from consultation services under this
subdivision does not apply must document in the participant's case record the basis for
determining that the participant is required to obtain consultation services.
new text end

new text begin (c) Nothing in this subdivision prevents a participant, participant's legal representative,
or lead agency from requesting consultation services at any time.
new text end

new text begin (d) Nothing in this subdivision requires a lead agency to forego requiring a participant
receive consultation services when documentation indicates a significant change in the
participant's condition.
new text end

Sec. 7.

Minnesota Statutes 2024, section 256B.85, subdivision 18a, is amended to read:

Subd. 18a.

Worker training and development services.

(a) The commissioner deleted text begin shall deleted text end new text begin
must new text end develop the scope of tasks and functions, service standards, and service limits for
worker training and development services.

(b) Worker training and development costs are in addition to the participant's assessed
service units or service budget. Services provided according to this subdivision must:

(1) help support workers obtain and expand the skills and knowledge necessary to ensure
competency in providing quality services as needed and defined in the participant's CFSS
service delivery plan and as required under subdivisions 11b and 14;

(2) be provided or arranged for by the agency-provider under subdivision 11, or purchased
by the participant employer under the budget model as identified in subdivision 13;

(3) be delivered by an individual competent to perform, teach, or assign the tasks,
including health-related tasks, identified in the plan through education, training, and work
experience relevant to the person's assessed needs; and

(4) be described in the participant's CFSS service delivery plan and documented in the
participant's file.

(c) Services covered under worker training and development deleted text begin shall deleted text end new text begin must new text end include:

(1) support worker training on the participant's individual assessed needs and condition,
provided individually or in a group setting by a skilled and knowledgeable trainer beyond
any training the participant or participant's representative provides;

(2) tuition for professional classes and workshops for the participant's support workers
that relate to the participant's assessed needs and condition;

(3) direct observation, monitoring, coaching, and documentation of support worker job
skills and tasks, beyond any training the participant or participant's representative provides,
including supervision of health-related tasks or behavioral supports that is conducted by an
appropriate professional based on the participant's assessed needs. These services must be
provided at the start of services or the start of a new support worker except as provided in
paragraph (d) and must be specified in the participant's CFSS service delivery plan; and

(4) the activities to evaluate CFSS services and ensure support worker competency
described in subdivisions 11a and 11b.

(d) The services in paragraph (c), clause (3), are not required to be provided for a new
support worker providing services for a participant due to staffing failures, unless the support
worker is expected to provide ongoing backup staffing coverage.

(e) Worker training and development services shall not include:

(1) general agency training, worker orientation, or training on CFSS self-directed models;

(2) payment for preparation or development time for the trainer or presenter;

(3) payment of the support worker's salary or compensation during the training;

(4) training or supervision provided by the participant, the participant's support worker,
or the participant's informal supports, including the participant's representative; or

(5) services in excess of the limit set by the commissioner per annual service agreement,
unless approved by the department.

new text begin (f) Worker training and development for a recipient must be documented in a manner
determined by the commissioner and must include the full name and individual provider
identifier of the individual providing worker training and development.
new text end

Sec. 8.

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

new text begin Subd. 18c. new text end

new text begin Worker training and development; notice of change of employment
required. new text end

new text begin Within 30 days of ceasing employment providing worker training and development
on behalf of a CFSS agency-provider or a participant employer, the individual providing
worker training and development must notify the commissioner on a form prescribed by
the commissioner that the individual is no longer providing worker training and development
on behalf of the CFSS agency-provider or the participant employer.
new text end

Sec. 9.

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

new text begin Subd. 27. new text end

new text begin Uniformity with state requirements. new text end

new text begin Managed care plans and county-based
purchasing plans must not impose requirements on CFSS services that are more restrictive
or otherwise exceed the requirements imposed by the commissioner with respect to:
new text end

new text begin (1) determining CFSS service authorization amounts under subdivision 8;
new text end

new text begin (2) assigning unique Minnesota provider identifiers;
new text end

new text begin (3) submitting claims; or
new text end

new text begin (4) documenting daily time and activities.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2027.
new text end