Minnesota Legislature
HF 2210
as introduced - 92nd Legislature (2021 - 2022) Posted on 03/15/2021 03:09pm
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A bill for an act
relating to human services; establishing a 24-hour customized living service rate
floor for certain facilities; amending Minnesota Statutes 2020, sections 256B.4914,
subdivision 6; 256S.203; proposing coding for new law in Minnesota Statutes,
chapter 256S.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2020, section 256B.4914, subdivision 6, is amended to read:
Subd. 6.
Payments for residential support services.
(a) For purposes of this subdivision,
residential support services includes 24-hour customized living services, community
residential services, customized living services, family residential services, foster care
services, integrated community supports, and supportive living services daily.
(b) Payments for community residential services, corporate foster care services, corporate
supportive living services daily, family residential services, and family foster care services
must be calculated as follows:
(1) determine the number of shared staffing and individual direct staff hours to meet a
recipient's needs provided on site or through monitoring technology;
(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics
Minnesota-specific rates or rates derived by the commissioner as provided in subdivision
5;
(3) except for subdivision 5, paragraph (a), clauses (4) and (21) to (23), multiply the
result of clause (2) by the product of one plus the competitive workforce factor in subdivision
5, paragraph (b), clause (1);
(4) 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 (3);
(5) multiply the number of shared and individual direct staff hours provided on site or
through monitoring technology and nursing hours by the appropriate staff wages;
(6) multiply the number of shared and individual direct staff hours provided on site or
through monitoring technology and nursing hours by the product of the supervision span
of control ratio in subdivision 5, paragraph (b), clause (2), and the appropriate supervision
wage in subdivision 5, paragraph (a), clause (21);
(7) combine the results of clauses (5) and (6), excluding any shared and individual direct
staff hours provided through monitoring technology, and multiply the result by one plus
the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (b),
clause (3). This is defined as the direct staffing cost;
(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared
and individual direct staff hours provided through monitoring technology, by one plus the
employee-related cost ratio in subdivision 5, paragraph (b), clause (4);
(9) for client programming and supports, the commissioner deleted text begin shalldeleted text end new text begin mustnew text end add $2,179; and
(10) for transportation, if provided, the commissioner deleted text begin shalldeleted text end new text begin mustnew text end add $1,680, or $3,000
if customized for adapted transport, based on the resident with the highest assessed need.
(c) The total rate must be calculated using the following steps:
(1) subtotal paragraph (b), clauses (8) to (10), and the direct staffing cost of any shared
and individual direct staff hours provided through monitoring technology that was excluded
in clause (8);
(2) sum the standard general and administrative rate, the program-related expense ratio,
and the absence and utilization ratio;
(3) divide the result of clause (1) by one minus the result of clause (2). This is the total
payment amount; and
(4) adjust the result of clause (3) by a factor to be determined by the commissioner to
adjust for regional differences in the cost of providing services.
(d) The payment methodology for customized living, 24-hour customized living, and
residential care services must be the customized living tool. Revisions to the customized
living tool must be made to reflect the services and activities unique to disability-related
recipient needsnew text begin and the rate adjustments described in section 256S.205new text end .
(e) Payments for integrated community support services must be calculated as follows:
(1) the base shared staffing deleted text begin shalldeleted text end new text begin mustnew text end be eight hours divided by the number of people
receiving support in the integrated community support setting;
(2) the individual staffing hours deleted text begin shalldeleted text end new text begin mustnew text end be the average number of direct support hours
provided directly to the service recipient;
(3) the personnel hourly wage rate must be based on the most recent Bureau of Labor
Statistics Minnesota-specific rates or rates derived by the commissioner as provided in
subdivision 5;
(4) except for subdivision 5, paragraph (a), clauses (4) and (21) to (23), multiply the
result of clause (3) by the product of one plus the competitive workforce factor in subdivision
5, paragraph (b), clause (1);
(5) 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 (4);
(6) multiply the number of shared and individual direct staff hours in clauses (1) and
(2) by the appropriate staff wages;
(7) multiply the number of shared and individual direct staff hours in clauses (1) and
(2) by the product of the supervisory span of control ratio in subdivision 5, paragraph (b),
clause (2), and the appropriate supervisory wage in subdivision 5, paragraph (a), clause
(21);
(8) combine the results of clauses (6) and (7) and multiply the result by one plus the
employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (b), clause
(3). This is defined as the direct staffing cost;
(9) for employee-related expenses, multiply the direct staffing cost by one plus the
employee-related cost ratio in subdivision 5, paragraph (b), clause (4); and
(10) for client programming and supports, the commissioner deleted text begin shalldeleted text end new text begin mustnew text end add $2,260.21
divided by 365.
(f) The total rate must be calculated as follows:
(1) add the results of paragraph (e), clauses (9) and (10);
(2) add the standard general and administrative rate, the program-related expense ratio,
and the absence and utilization factor ratio;
(3) divide the result of clause (1) by one minus the result of clause (2). This is the total
payment amount; and
(4) adjust the result of clause (3) by a factor to be determined by the commissioner to
adjust for regional differences in the cost of providing services.
(g) The payment methodology for customized living and 24-hour customized living
services must be the customized living tool. The commissioner deleted text begin shalldeleted text end new text begin mustnew text end revise the
customized living tool to reflect the services and activities unique to disability-related
recipient needs and adjust for regional differences in the cost of providing services.new text begin The
commissioner must revise the customized living tool to incorporate the rate adjustment
described in section 256S.205.
new text end
(h) The number of days authorized for all individuals enrolling in residential services
must include every day that services start and end.
Sec. 2.
Minnesota Statutes 2020, section 256S.203, is amended to read:
256S.203 CUSTOMIZED LIVING SERVICES; MANAGED CARE RATES.
Subdivision 1.
Capitation payments.
The commissioner deleted text begin shalldeleted text end new text begin mustnew text end adjust the elderly
waiver capitation payment rates for managed care organizations paid to reflect the monthly
service rate limits for customized living services and 24-hour customized living services
established under section 256S.202new text begin and the rate adjustments for disproportionate share
facilities under section 256S.205new text end .
Subd. 2.
Reimbursement rates.
Medical assistance rates paid to customized living
providers by managed care organizations under this chapter deleted text begin shalldeleted text end new text begin mustnew text end not exceed the
monthly service rate limits and component rates as determined by the commissioner under
sections 256S.15 and 256S.20 to 256S.202new text begin , plus any rate adjustment under section 256S.205new text end .
Sec. 3.
new text begin
[256S.205] CUSTOMIZED LIVING SERVICES; DISPROPORTIONATE
SHARE RATE ADJUSTMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
(a) For the purposes of this section, the terms in this
subdivision have the meanings given.
new text end
new text begin
(b) "Assisted living facility" or "facility" means either a housing with services
establishment registered under chapter 144D and operating under title protection under
sections 144G.01 to 144G.07 or an assisted living facility licensed under chapter 144G.
new text end
new text begin
(c) "Disproportionate share facility" means an assisted living facility designated by the
commissioner under subdivision 4.
new text end
new text begin Subd. 2. new text end
new text begin Rate adjustment application. new text end
new text begin
An assisted living facility may apply to the
commissioner for designation as a disproportionate share facility. Applications must be
submitted annually between June 1 and June 15. The applying facility must apply in a
manner determined by the commissioner. The applying facility must document as a
percentage the census of elderly waiver participants residing in the facility on May 1 of the
year of application.
new text end
new text begin Subd. 3. new text end
new text begin Rate adjustment eligibility criteria. new text end
new text begin
(a) Only facilities with a census of at
least 80 percent elderly waiver participants on May 1 of the application year are eligible
for designation as a disproportionate share facility.
new text end
new text begin
(b) Only the following facilities are eligible for designation as a disproportionate share
facility:
new text end
new text begin
(1) facilities located in Brooklyn Center, Hennepin County, with 158 living units and
originally registered on March 14, 2018;
new text end
new text begin
(2) facilities in West St. Paul, Dakota County, with 164 living units and originally
registered on August 29, 2016; or
new text end
new text begin
(3) facilities in St. Cloud, Sherburne County, with 137 living units and originally
registered on December 21, 2017.
new text end
new text begin Subd. 4. new text end
new text begin Designation as a disproportionate share facility. new text end
new text begin
By June 30 of each year,
the commissioner must designate as a disproportionate share facility a facility that complies
with the application requirements of subdivision 2 and meets the eligibility criteria of
subdivision 3.
new text end
new text begin Subd. 5. new text end
new text begin Rate adjustment; rate floor. new text end
new text begin
(a) Notwithstanding the 24-hour customized
living monthly service rate limits under section 256S.202, subdivision 2, and the component
service rates established under section 256S.201, subdivision 4, the commissioner must
establish a rate floor equal to $119 for 24-hour customized living services provided in a
designated disproportionate share facility.
new text end
new text begin
(b) The commissioner must adjust the rate floor at least annually in the manner described
under section 256S.18, subdivisions 5 and 6.
new text end
new text begin Subd. 6. new text end
new text begin Budget cap disregard. new text end
new text begin
The value of the rate adjustment under this section
must not be included in an elderly waiver client's monthly case mix budget cap.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2021, or upon federal approval,
whichever is later, and applies to services provided on or after July 1, 2021, or on or after
the date upon which federal approval is obtained, whichever is later. The commissioner of
human services must inform the revisor of statutes when federal approval is obtained.
new text end