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HF 1239

as introduced - 90th Legislature (2017 - 2018) Posted on 03/15/2017 12:32pm

KEY: stricken = removed, old language.
underscored = added, new language.
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A bill for an act
relating to human services; establishing new employment services under the home
and community-based services waivers; amending Minnesota Statutes 2016,
sections 245D.03, subdivision 1; 252.41, subdivision 3; 252.42; 252.451,
subdivisions 2, 3, 5; 256B.4913, by adding a subdivision; 256B.4914, subdivisions
3, 5, 8, 16; repealing Minnesota Statutes 2016, section 252.41, subdivision 8.

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

Section 1.

Minnesota Statutes 2016, section 245D.03, subdivision 1, is amended to read:


Subdivision 1.

Applicability.

(a) The commissioner shall regulate the provision of home
and community-based services to persons with disabilities and persons age 65 and older
pursuant to this chapter. The licensing standards in this chapter govern the provision of
basic support services and intensive support services.

(b) Basic support services provide the level of assistance, supervision, and care that is
necessary to ensure the health and welfare of the person and do not include services that
are specifically directed toward the training, treatment, habilitation, or rehabilitation of the
person. Basic support services include:

(1) in-home and out-of-home respite care services as defined in section 245A.02,
subdivision 15, and under the brain injury, community alternative care, community access
for disability inclusion, developmental disability, and elderly waiver plans, excluding
out-of-home respite care provided to children in a family child foster care home licensed
under Minnesota Rules, parts 2960.3000 to 2960.3100, when the child foster care license
holder complies with the requirements under section 245D.06, subdivisions 5, 6, 7, and 8,
or successor provisions; and section 245D.061 or successor provisions, which must be
stipulated in the statement of intended use required under Minnesota Rules, part 2960.3000,
subpart 4;

(2) adult companion services as defined under the brain injury, community access for
disability inclusion, and elderly waiver plans, excluding adult companion services provided
under the Corporation for National and Community Services Senior Companion Program
established under the Domestic Volunteer Service Act of 1973, Public Law 98-288;

(3) personal support as defined under the developmental disability waiver plan;

(4) 24-hour emergency assistance, personal emergency response as defined under the
community access for disability inclusion and developmental disability waiver plans;

(5) night supervision services as defined under the brain injury waiver plan; and

(6) homemaker services as defined under the community access for disability inclusion,
brain injury, community alternative care, developmental disability, and elderly waiver plans,
excluding providers licensed by the Department of Health under chapter 144A and those
providers providing cleaning services only.

(c) Intensive support services provide assistance, supervision, and care that is necessary
to ensure the health and welfare of the person and services specifically directed toward the
training, habilitation, or rehabilitation of the person. Intensive support services include:

(1) intervention services, including:

(i) behavioral support services as defined under the brain injury and community access
for disability inclusion waiver plans;

(ii) in-home or out-of-home crisis respite services as defined under the developmental
disability waiver plan; and

(iii) specialist services as defined under the current developmental disability waiver
plan;

(2) in-home support services, including:

(i) in-home family support and supported living services as defined under the
developmental disability waiver plan;

(ii) independent living services training as defined under the brain injury and community
access for disability inclusion waiver plans; and

(iii) semi-independent living services;

(3) residential supports and services, including:

(i) supported living services as defined under the developmental disability waiver plan
provided in a family or corporate child foster care residence, a family adult foster care
residence, a community residential setting, or a supervised living facility;

(ii) foster care services as defined in the brain injury, community alternative care, and
community access for disability inclusion waiver plans provided in a family or corporate
child foster care residence, a family adult foster care residence, or a community residential
setting; and

(iii) residential services provided to more than four persons with developmental
disabilities in a supervised living facility, including ICFs/DD;

(4) day services, including:

(i) structured day services as defined under the brain injury waiver plan;

(ii) day training and habilitation services under sections 252.41 to 252.46, and as defined
under the developmental disability waiver plan; and

(iii) prevocational services as defined under the brain injury and community access for
disability inclusion waiver plans; deleted text beginand
deleted text end

(5) deleted text beginsupporteddeleted text end employmentnew text begin exploration servicesnew text end as defined under the brain injury,
developmental disability, deleted text beginanddeleted text end community access for disability inclusionnew text begin, and community
alternative care
new text end waiver plansdeleted text begin.deleted text endnew text begin;
new text end

new text begin (6) employment development services as defined under the brain injury, developmental
disability, community access for disability inclusion, and community alternative care waiver
plans; and
new text end

new text begin (7) employment support services as defined under the brain injury, developmental
disability, community access for disability inclusion, and community alternative care waiver
plans.
new text end

Sec. 2.

Minnesota Statutes 2016, section 252.41, subdivision 3, is amended to read:


Subd. 3.

Day training and habilitation services for adults with developmental
disabilities.

new text begin(a) new text end"Day training and habilitation services for adults with developmental
disabilities" means services that:

(1) include supervision, training, assistance, and deleted text beginsupported employment,deleted text endnew text begin center-basednew text end
work-related activities, or other community-integrated activities designed and implemented
in accordance with the individual service and individual habilitation plans required under
Minnesota Rules, parts 9525.0004 to 9525.0036, to help an adult reach and maintain the
highest possible level of independence, productivity, and integration into the community;
and

(2) are provided by a vendor licensed under sections 245A.01 to 245A.16 and 252.28,
subdivision 2
, to provide day training and habilitation services.

new text begin (b) new text endDay training and habilitation services reimbursable under this section do not include
special education and related services as defined in the Education of the Individuals with
Disabilities Act, United States Code, title 20, chapter 33, section 1401, clauses (6) and (17),
or vocational services funded under section 110 of the Rehabilitation Act of 1973, United
States Code, title 29, section 720, as amended.

new text begin (c) Day training and habilitation services do not include employment exploration,
employment development, and employment supports services as defined in the home and
community-based waivers for people with disabilities authorized under sections 256B.092
and 256B.49.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 3.

Minnesota Statutes 2016, section 252.42, is amended to read:


252.42 SERVICE PRINCIPLES.

The design and delivery of services eligible for reimbursement should reflect the
following principles:

(1) services must suit a person's chronological age and be provided in the least restrictive
environment possible, consistent with the needs identified in the person's individual service
and individual habilitation plans under Minnesota Rules, parts 9525.0004 to 9525.0036;

(2) a person with a developmental disability whose individual service and individual
habilitation plans authorize deleted text beginemployment or employment-relateddeleted text endnew text begin center-based work-relatednew text end
activities shall be given the opportunity to participate in deleted text beginemployment and employment-relateddeleted text endnew text begin
center-based work-related
new text end activities deleted text beginin which nondisabled persons participatedeleted text end;

(3) a person with a developmental disability participating in work shall be paid wages
commensurate with the rate for comparable work and productivity except as regional centers
are governed by section 246.151;

(4) a person with a developmental disability shall receive services which include services
offered in settings used by the general public and designed to increase the person's active
participation in ordinary community activities;

(5) a person with a developmental disability shall participate in the patterns, conditions,
and rhythms of everyday living and working that are consistent with the norms of the
mainstream of society.

Sec. 4.

Minnesota Statutes 2016, section 252.451, subdivision 2, is amended to read:


Subd. 2.

Vendor participation and reimbursement.

Notwithstanding requirements in
chapters 245A and 245D, and sections 252.28, 252.41 to 252.46, and 256B.501, vendors
of deleted text beginday training and habilitationdeleted text endnew text begin employment supportnew text end services may enter into written
agreements with qualified businesses to provide additional training and supervision needed
by individuals to maintain their employment.

Sec. 5.

Minnesota Statutes 2016, section 252.451, subdivision 3, is amended to read:


Subd. 3.

Agreement specifications.

Agreements must include the following:

(1) the type and amount of supervision and support to be provided by the business to
the individual in accordance with their needs as identified in their individual service plan;

(2) the methods used to periodically assess the individual's satisfaction with their work,
training, and support;

(3) the measures taken by the qualified business and the vendor to ensure the health,
safety, and protection of the individual during working hours, including the reporting of
abuse and neglect under state law and rules;

(4) the training and support services the vendor will provide to the qualified business,
including the frequency of on-site supervision and support; and

(5) any payment to be made to the qualified business by the vendor. Payment to the
business must be limited to:

(i) additional costs of training coworkers and managers that exceed ordinary and
customary training costs and are a direct result of employing a person with a deleted text begindevelopmentaldeleted text end
disability; and

(ii) additional costs for training, supervising, and assisting the person with a
deleted text begin developmentaldeleted text end disability that exceed normal and customary costs required for performing
similar tasks or duties.

Payments made to a qualified business under this section must not include incentive
payments to the qualified business or salary supplementation for the person with a
deleted text begin developmentaldeleted text end disability.

Sec. 6.

Minnesota Statutes 2016, section 252.451, subdivision 5, is amended to read:


Subd. 5.

Vendor payment.

(a) For purposes of this section, the vendor shall bill and
the commissioner shall reimburse the vendor for deleted text beginfull-day or partial-day servicesdeleted text endnew text begin employment
support units of service
new text end to a client that would otherwise have been paid to the vendor for
providing direct services, provided that both of the following criteria are met:

(1) the vendor provides services and payments to the qualified business that enable the
business to perform support and supervision services for the client that the vendor would
otherwise need to perform; and

(2) the client for whom a rate will be billed will receive deleted text beginfull-day or partial-day servicesdeleted text endnew text begin
employment support units of service
new text end from the vendor and the rate to be paid the vendor will
allow the client to work with this support and supervision at the qualified business instead
of receiving these services from the vendor.

(b) Medical assistance reimbursement of services provided to persons receiving deleted text beginday
training and habilitation
deleted text endnew text begin employment supportnew text end services under this section is subject to the
limitations on reimbursement for vocational services under federal law and regulation.

Sec. 7.

Minnesota Statutes 2016, section 256B.4913, is amended by adding a subdivision
to read:


new text begin Subd. 7. new text end

new text begin New services. new text end

new text begin A service added to section 256B.4914 after January 1, 2014, is
not subject to the rate stabilization adjustment in this section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 8.

Minnesota Statutes 2016, section 256B.4914, subdivision 3, is amended to read:


Subd. 3.

Applicable services.

Applicable services are those authorized under the state's
home and community-based services waivers under sections 256B.092 and 256B.49,
including the following, as defined in the federally approved home and community-based
services plan:

(1) 24-hour customized living;

(2) adult day care;

(3) adult day care bath;

(4) behavioral programming;

(5) companion services;

(6) customized living;

(7) day training and habilitation;

(8) housing access coordination;

(9) independent living skills;

(10) in-home family support;

(11) night supervision;

(12) personal support;

(13) prevocational services;

(14) residential care services;

(15) residential support services;

(16) respite services;

(17) structured day services;

deleted text begin (18) supported employment services;
deleted text end

deleted text begin (19)deleted text endnew text begin (18)new text end supported living services;

deleted text begin (20)deleted text endnew text begin (19)new text end transportation services; deleted text beginand
deleted text end

new text begin (20) employment exploration services;
new text end

new text begin (21) employment development services;
new text end

new text begin (22) employment support services; and
new text end

deleted text begin (21)deleted text endnew text begin (23)new text end other services as approved by the federal government in the state home and
community-based services plan.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 9.

Minnesota Statutes 2016, section 256B.4914, subdivision 5, is amended to read:


Subd. 5.

Base wage index and standard component values.

(a) The base wage index
is established to determine staffing costs associated with providing services to individuals
receiving home and community-based services. For purposes of developing and calculating
the proposed base wage, Minnesota-specific wages taken from job descriptions and standard
occupational classification (SOC) codes from the Bureau of Labor Statistics as defined in
the most recent edition of the Occupational Handbook must be used. The base wage index
must be calculated as follows:

(1) for residential direct care staff, the sum of:

(i) 15 percent of the subtotal of 50 percent of the median wage for personal and home
health aide (SOC code 39-9021); 30 percent of the median wage for nursing aide (SOC
code 31-1012); and 20 percent of the median wage for social and human services aide (SOC
code 21-1093); and

(ii) 85 percent of the subtotal of 20 percent of the median wage for home health aide
(SOC code 31-1011); 20 percent of the median wage for personal and home health aide
(SOC code 39-9021); 20 percent of the median wage for nursing aide (SOC code 31-1012);
20 percent of the median wage for psychiatric technician (SOC code 29-2053); and 20
percent of the median wage for social and human services aide (SOC code 21-1093);

(2) for day services, 20 percent of the median wage for nursing aide (SOC code 31-1012);
20 percent of the median wage for psychiatric technician (SOC code 29-2053); and 60
percent of the median wage for social and human services aide (SOC code 21-1093);

(3) for residential asleep-overnight staff, the wage will be $7.66 per hour, except in a
family foster care setting, the wage is $2.80 per hour;

(4) for behavior program analyst staff, 100 percent of the median wage for mental health
counselors (SOC code 21-1014);

(5) for behavior program professional staff, 100 percent of the median wage for clinical
counseling and school psychologist (SOC code 19-3031);

(6) for behavior program specialist staff, 100 percent of the median wage for psychiatric
technicians (SOC code 29-2053);

(7) for supportive living services staff, 20 percent of the median wage for nursing aide
(SOC code 31-1012); 20 percent of the median wage for psychiatric technician (SOC code
29-2053); and 60 percent of the median wage for social and human services aide (SOC code
21-1093);

(8) for housing access coordination staff, 50 percent of the median wage for community
and social services specialist (SOC code 21-1099); and 50 percent of the median wage for
social and human services aide (SOC code 21-1093);

(9) for in-home family support staff, 20 percent of the median wage for nursing aide
(SOC code 31-1012); 30 percent of the median wage for community social service specialist
(SOC code 21-1099); 40 percent of the median wage for social and human services aide
(SOC code 21-1093); and ten percent of the median wage for psychiatric technician (SOC
code 29-2053);

(10) for independent living skills staff, 40 percent of the median wage for community
social service specialist (SOC code 21-1099); 50 percent of the median wage for social and
human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric
technician (SOC code 29-2053);

(11)new text begin effective January 1, 2018,new text end for deleted text beginsupporteddeleted text end employmentnew text begin support servicesnew text end staff, deleted text begin20deleted text endnew text begin 50new text end
percent of the median wage for deleted text beginnursing aidedeleted text endnew text begin rehabilitation counselornew text end (SOC code deleted text begin31-1012deleted text endnew text begin
21-1015
new text end); deleted text begin20 percent of the median wage for psychiatric technician (SOC code 29-2053);deleted text end
and deleted text begin60deleted text endnew text begin 50new text end percent of the median wage fornew text begin community andnew text end social deleted text beginand humandeleted text end services deleted text beginaidedeleted text endnew text begin
specialist
new text end (SOC code deleted text begin21-1093deleted text endnew text begin 21-1099new text end);

new text begin (12) for employment exploration services staff, 50 percent of the median wage for
rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for
community and social services specialist (SOC code 21-1099);
new text end

new text begin (13) for employment development services staff, 50 percent of the median wage for
education, guidance, school, and vocational counselors (SOC code 21-1012); and 50 percent
of the median wage for community and social services specialist (SOC code 21-1099);
new text end

deleted text begin (12)deleted text endnew text begin (14)new text end for adult companion staff, 50 percent of the median wage for personal and
home care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides,
orderlies, and attendants (SOC code 31-1012);

deleted text begin (13)deleted text endnew text begin (15)new text end for night supervision staff, 20 percent of the median wage for home health
aide (SOC code 31-1011); 20 percent of the median wage for personal and home health
aide (SOC code 39-9021); 20 percent of the median wage for nursing aide (SOC code
31-1012); 20 percent of the median wage for psychiatric technician (SOC code 29-2053);
and 20 percent of the median wage for social and human services aide (SOC code 21-1093);

deleted text begin (14)deleted text endnew text begin (16)new text end for respite staff, 50 percent of the median wage for personal and home care
aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides, orderlies,
and attendants (SOC code 31-1012);

deleted text begin (15)deleted text endnew text begin (17)new text end for personal support staff, 50 percent of the median wage for personal and
home care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides,
orderlies, and attendants (SOC code 31-1012);

deleted text begin (16)deleted text endnew text begin (18)new text end for supervisory staff, the basic wage is $17.43 per hour with exception of the
supervisor of behavior analyst and behavior specialists, which must be $30.75 per hour;

deleted text begin (17)deleted text endnew text begin (19)new text end for registered nurse, the basic wage is $30.82 per hour; and

deleted text begin (18)deleted text endnew text begin (20)new text end for licensed practical nurse, the basic wage is $18.64 per hour.

(b) Component values for residential support services are:

(1) supervisory span of control ratio: 11 percent;

(2) employee vacation, sick, and training allowance ratio: 8.71 percent;

(3) employee-related cost ratio: 23.6 percent;

(4) general administrative support ratio: 13.25 percent;

(5) program-related expense ratio: 1.3 percent; and

(6) absence and utilization factor ratio: 3.9 percent.

(c) Component values for family foster care are:

(1) supervisory span of control ratio: 11 percent;

(2) employee vacation, sick, and training allowance ratio: 8.71 percent;

(3) employee-related cost ratio: 23.6 percent;

(4) general administrative support ratio: 3.3 percent;

(5) program-related expense ratio: 1.3 percent; and

(6) absence factor: 1.7 percent.

(d) Component values for day services for all services are:

(1) supervisory span of control ratio: 11 percent;

(2) employee vacation, sick, and training allowance ratio: 8.71 percent;

(3) employee-related cost ratio: 23.6 percent;

(4) program plan support ratio: 5.6 percent;

(5) client programming and support ratio: ten percent;

(6) general administrative support ratio: 13.25 percent;

(7) program-related expense ratio: 1.8 percent; and

(8) absence and utilization factor ratio: 3.9 percent.

(e) Component values for unit-based services with programming are:

(1) supervisory span of control ratio: 11 percent;

(2) employee vacation, sick, and training allowance ratio: 8.71 percent;

(3) employee-related cost ratio: 23.6 percent;

(4) program plan supports ratio: deleted text begin3.1deleted text endnew text begin 15.5new text end percent;

(5) client programming and supports ratio: deleted text begin8.6deleted text endnew text begin 4.7new text end percent;

(6) general administrative support ratio: 13.25 percent;

(7) program-related expense ratio: 6.1 percent; and

(8) absence and utilization factor ratio: deleted text begin3.9deleted text endnew text begin 8.0new text end percent.

(f) Component values for unit-based services without programming except respite are:

(1) supervisory span of control ratio: 11 percent;

(2) employee vacation, sick, and training allowance ratio: 8.71 percent;

(3) employee-related cost ratio: 23.6 percent;

(4) program plan support ratio: 3.1 percent;

(5) client programming and support ratio: 8.6 percent;

(6) general administrative support ratio: 13.25 percent;

(7) program-related expense ratio: 6.1 percent; and

(8) absence and utilization factor ratio: 3.9 percent.

(g) Component values for unit-based services without programming for respite are:

(1) supervisory span of control ratio: 11 percent;

(2) employee vacation, sick, and training allowance ratio: 8.71 percent;

(3) employee-related cost ratio: 23.6 percent;

(4) general administrative support ratio: 13.25 percent;

(5) program-related expense ratio: 6.1 percent; and

(6) absence and utilization factor ratio: 3.9 percent.

(h) On July 1, 2017, the commissioner shall update the base wage index in paragraph
(a) based on the wage data by standard occupational code (SOC) from the Bureau of Labor
Statistics available on December 31, 2016. The commissioner shall publish these updated
values and load them into the rate management system. This adjustment occurs every five
years. For adjustments in 2021 and beyond, the commissioner shall use the data available
on December 31 of the calendar year five years prior.

(i) On July 1, 2017, the commissioner shall update the framework components in
paragraphs (b) to (g); subdivision 6, clauses (8) and (9); and subdivision 7, clauses (16) and
(17), for changes in the Consumer Price Index. The commissioner will adjust these values
higher or lower by the percentage change in the Consumer Price Index-All Items, United
States city average (CPI-U) from January 1, 2014, to January 1, 2017. The commissioner
shall publish these updated values and load them into the rate management system. This
adjustment occurs every five years. For adjustments in 2021 and beyond, the commissioner
shall use the data available on January 1 of the calendar year four years prior and January
1 of the current calendar year.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 10.

Minnesota Statutes 2016, section 256B.4914, subdivision 8, is amended to read:


Subd. 8.

Payments for unit-based services with programming.

Payments for unit-based
services with programming, including behavior programming, housing access coordination,
in-home family support, independent living skills training, hourly supported living services,new text begin
employment exploration services, employment development services,
new text end and deleted text beginsupporteddeleted text end
employmentnew text begin support servicesnew text end provided to an individual outside of any day or residential
service plan must be calculated as follows, unless the services are authorized separately
under subdivision 6 or 7:

(1) determine the number of units of service to meet a recipient's needs;

(2) personnel hourly wage rate must be based onnew text begin:
new text end

new text begin (i) the most currently available Bureau of Labor Statistics Minnesota-specific rates for
the employment support, employment exploration, and employment development services
upon implementation of those services; and
new text end

new text begin (ii)new text end the 2009 Bureau of Labor Statistics Minnesota-specific rates or rates derived by the
commissioner as provided in subdivision 5new text begin, for other unit-based services with programmingnew text end;

(3) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (2). This is defined as the customized direct-care rate;

(4) multiply the number of direct staff hours by the appropriate staff wage in subdivision
5, paragraph (a), or the customized direct-care rate;

(5) multiply the number of direct staff hours by the product of the supervision span of
control ratio in subdivision 5, paragraph (e), clause (1), and the appropriate supervision
wage in subdivision 5, paragraph (a), clause deleted text begin(16)deleted text endnew text begin (18)new text end;

(6) combine the results of clauses (4) and (5), and multiply the result by one plus the
employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (e), clause
(2). This is defined as the direct staffing rate;

(7) for program plan support, multiply the result of clause (6) by one plus the program
plan supports ratio in subdivision 5, paragraph (e), clause (4);

(8) for employee-related expenses, multiply the result of clause (7) by one plus the
employee-related cost ratio in subdivision 5, paragraph (e), clause (3);

(9) for client programming and supports, multiply the result of clause (8) by one plus
the client programming and supports ratio in subdivision 5, paragraph (e), clause (5);

(10) this is the subtotal rate;

(11) sum the standard general and administrative rate, the program-related expense ratio,
and the absence and utilization factor ratio;

(12) divide the result of clause (10) by one minus the result of clause (11). This is the
total payment amount;

(13) for deleted text beginsupporteddeleted text end employmentnew text begin supports or employment explorationnew text end provided in a shared
manner, divide the total payment amount in clause (12) by the number of service recipients,
not to exceed deleted text beginthreedeleted text endnew text begin sixnew text end. For independent living skills training provided in a shared manner,
divide the total payment amount in clause (12) by the number of service recipients, not to
exceed two; and

(14) adjust the result of clause (13) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 11.

Minnesota Statutes 2016, section 256B.4914, subdivision 16, is amended to read:


Subd. 16.

Budget neutrality adjustments.

(a) The commissioner shall use the following
adjustments to the rate generated by the framework to assure budget neutrality until the rate
information is available to implement paragraph (b). The rate generated by the framework
shall be multiplied by the appropriate factor, as designated below:

(1) for residential services: 1.003;

(2) for day services: 1.000;

(3) for unit-based services with programming: deleted text begin0.941deleted text endnew text begin 1.00new text end; and

(4) for unit-based services without programming: 0.796.

(b) Within 12 months of January 1, 2014, the commissioner shall compare estimated
spending for all home and community-based waiver services under the new payment rates
defined in subdivisions 6 to 9 with estimated spending for the same recipients and services
under the rates in effect on July 1, 2013. This comparison must distinguish spending under
each of subdivisions 6, 7, 8, and 9. The comparison must be based on actual recipients and
services for one or more service months after the new rates have gone into effect. The
commissioner shall consult with the commissioner of management and budget on this
analysis to ensure budget neutrality. If estimated spending under the new rates for services
under one or more subdivisions differs in this comparison by 0.3 percent or more, the
commissioner shall assure aggregate budget neutrality across all service areas by adjusting
the budget neutrality factor in paragraph (a) in each subdivision so that total estimated
spending for each subdivision under the new rates matches estimated spending under the
rates in effect on July 1, 2013.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 12. new text beginFEDERAL WAIVER AMENDMENTS.
new text end

new text begin The commissioner of human services shall submit necessary waiver amendments to the
Centers for Medicare and Medicaid Services to add employment exploration services,
employment development services, and employment support services to the home and
community-based services waivers authorized under Minnesota Statutes, sections 256B.092
and 256B.49. The commissioner shall also submit necessary waiver amendments to remove
community-based employment from day training and habilitation and prevocational services.
The commissioner shall submit the necessary waiver amendments by October 1, 2017.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 13. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2016, section 252.41, subdivision 8, new text end new text begin is repealed.
new text end

APPENDIX

Repealed Minnesota Statutes: 17-3071

252.41 DEFINITIONS.

Subd. 8.

Supported employment.

"Supported employment" means employment of a person with a disability so severe that the person needs ongoing training and support to get and keep a job in which:

(1) the person engages in paid work at a work site where individuals without disabilities who do not require public subsidies also may be employed;

(2) public funds are necessary to provide ongoing training and support services throughout the period of the person's employment; and

(3) the person has the opportunity for social interaction with individuals who do not have disabilities and who are not paid caregivers.