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HF 3722

1st Engrossment - 90th Legislature (2017 - 2018) Posted on 05/20/2018 02:32am

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Current Version - 1st Engrossment

A bill for an act
relating to human services; requiring commissioner of human services to seek a
federal waiver to establish a work and community engagement requirement for
certain medical assistance enrollees.

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

Section 1. MEDICAL ASSISTANCE WORK AND COMMUNITY ENGAGEMENT
REQUIREMENT FOR ABLE-BODIED INDIVIDUALS.

Subdivision 1.

Waiver request.

(a) By October 1, 2018, the commissioner of human
services shall apply to the Centers for Medicare and Medicaid Services for a section 1115
waiver to allow the state to implement a medical assistance work and community engagement
requirement for able-bodied adults who meet the definition of "qualified individual," in
order to improve enrollee health and well-being. The waiver proposal must meet the criteria
specified in this section, be consistent with the work requirements of the Supplemental
Nutrition Assistance Program (SNAP) as specified in Code of Federal Regulations, title 7,
parts 273.24 and 273.7, and be consistent with the guidance issued by the Centers for
Medicare and Medicaid Services on January 11, 2018, Opportunities to Promote Work and
Community Engagement Among Medicaid Beneficiaries.

(b) The commissioner, at least 60 days prior to submittal of the waiver application to
the federal government, shall report to the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services policy and finance,
on the specific strategies, criteria, requirements, and procedures the commissioner proposes
to use to implement subdivision 3, paragraphs (a) and (b), and to comply with subdivision
4. The commissioner shall make the report available to the public on the agency's Web site.
The commissioner shall consider input from the legislature and the public on these strategies,
criteria, requirements, and procedures when developing the final waiver application.

(c) The commissioner shall make the waiver application available on the agency's Web
site. The commissioner shall notify the chairs and ranking minority members of the legislative
committees with jurisdiction over health and human services policy and finance of any
federal action related to the waiver request.

(d) Following federal waiver approval, the commissioner shall submit to the legislature
draft legislation proposing any statutory changes necessary to implement the approved
waiver.

Subd. 2.

Qualified individuals.

(a) The following persons shall be considered qualified
individuals and shall be subject to the work and community engagement requirement, except
as provided under paragraph (c):

(1) parents and caretakers eligible under Minnesota Statutes, section 256B.055,
subdivision 3a;

(2) adults without children eligible under Minnesota Statutes, section 256B.055,
subdivision 15; and

(3) children ages 19 and 20, eligible under Minnesota Statutes, section 256B.055,
subdivision 16.

(b) Persons eligible for medical assistance under provisions of Minnesota Statutes,
chapter 256B, who are not listed in paragraph (a), clauses (1) to (3), are not qualified
individuals, and are not subject to the work and community engagement requirement.

(c) A person is exempt from the work and community engagement requirement if a
county human services agency, in accordance with criteria established by the commissioner,
determines that the person is:

(1) pregnant;

(2) age 18 or younger or age 60 or older;

(3) working a minimum of 30 hours per week or earning weekly wages at least equal to
the federal minimum wage multiplied by 30 hours;

(4) a student enrolled at least half time in any recognized school, training program, or
institution of higher education;

(5) the sole or primary caregiver of a family member who is younger than 18 years of
age or a family member who is incapacitated;

(6) receiving temporary or permanent disability benefits from a private insurer or under
a state or federal program;

(7) medically frail based on criteria established by the commissioner;

(8) physically or mentally unfit for employment, as determined by a health care
professional based on criteria established by the commissioner;

(9) subject to and complying with the work requirements of the Minnesota Family
Investment Program or the Supplemental Nutrition Assistance Program; or

(10) receiving treatment for a substance abuse disorder in a residential or inpatient setting,
or receiving treatment for a substance use disorder for at least ten hours per week in an
outpatient setting.

(d) The commissioner shall develop standard exemption forms that health care
professionals must complete, in order for a person to apply for an exemption from the work
and community engagement requirement on the basis of being medically frail or physically
or mentally unfit for employment. A person seeking these exemptions must submit a
completed form to the county human services agency.

(e) Enrollees who are exempt from the work and community engagement requirement
due to receiving an exemption under this subdivision shall report any changes related to
their exemption status within ten days of the change to the county human services agency.
The agency must redetermine eligibility for the exemption when a change in exemption
status is reported, and at the time of the enrollee's annual renewal.

Subd. 3.

Work and community engagement activities.

(a) The commissioner shall
require qualified individuals to meet the work and community engagement requirement,
beginning three months after medical assistance eligibility is approved. The commissioner
may provide one or more 30-day extensions from the requirement that an individual must
meet the work and community engagement requirement beginning three months after medical
assistance eligibility is approved, if the commissioner determines that the individual is
making a good faith effort to establish an exemption. The commissioner shall consider a
qualified individual as having satisfied the work and community engagement requirement
if the qualified individual meets the requirement in paragraph (b) and engages in any one,
or a combination of, the following activities for at least 80 hours per month:

(1) is employed, engaged in community or public service, or a combination of these
activities;

(2) is actively seeking employment; engaged in career planning, job training, referral,
or job support services; or a combination of these activities; or

(3) participates in a workfare program if assigned by a state agency.

(b) To satisfy the work and community engagement requirement, a qualified individual
must also accept any bona fide offer of suitable employment.

(c) The commissioner shall establish criteria to determine whether a qualified individual
is in compliance with the requirements of paragraphs (a) and (b), and shall require qualified
individuals to verify to the commissioner, on a monthly basis, compliance with the
requirements of paragraphs (a) and (b).

Subd. 4.

Additional requirements for commissioner.

(a) The commissioner, through
county human services agencies, shall implement strategies to assist persons in meeting the
work and community engagement requirement and link persons to additional resources for
job training or other employment services, child care assistance, transportation, or other
work supports to help persons prepare for work, maintain employment, or increase their
earnings.

(b) The commissioner shall ensure that each enrollee's due process rights are protected.
The commissioner must assess each person's disabilities, medical diagnoses, the presence
of opioid addiction and other substance use disorders, and other barriers to employment
and self-sufficiency. The commissioner, based on the results of the assessment, shall identify
appropriate work and community engagement activities and services, determine the need
for any exemptions from the work and community engagement requirement, and identify
any reasonable modifications and supports necessary for persons to participate in work and
community engagement activities and attain long-term employment and self-sufficiency.

(c) The commissioner shall modify and may temporarily suspend the work and
community engagement requirement in order to respond to the local employment market
and other circumstances that may prevent persons from complying with the work and
community engagement requirement.

(d) The commissioner shall administer the work and community engagement requirement
in a manner that complies with state and federal civil rights laws, and shall exempt from
the work and community engagement requirement persons considered to have disabilities
under the definitions of the Americans with Disabilities Act, section 504 of the Rehabilitation
Act of 1973, or section 1557 of the Affordable Care Act, or shall provide these persons with
reasonable modifications to the work and community engagement requirement.

(e) The commissioner shall develop a good cause exemption process for qualified
individuals who do not satisfy the work and community engagement requirement.

Subd. 5.

Failure to satisfy work and community engagement requirement.

The
commissioner shall suspend medical assistance benefits for qualified individuals who do
not satisfy the work and community engagement requirement. The commissioner shall
reinstate medical assistance benefits once the qualified individual satisfies the work and
community engagement requirement for a calendar month. Medical assistance benefits shall
be reinstated the first day of the month following the month for which the individual has
satisfied the work and community engagement requirement.

EFFECTIVE DATE.

Subdivision 1 is effective the day following final enactment.
Subdivisions 2 to 5 are effective January 1, 2020, or upon federal approval of the waiver
requested under subdivision 1, whichever is later. The commissioner of human services
shall notify the revisor of statutes when federal approval is obtained.

Sec. 2. DETERMINATION OF COMPLIANCE; CONTINGENT TRANSFER.

The commissioner of management and budget shall determine whether the commissioner
of human services has submitted a medical assistance work and community engagement
waiver by October 1, 2018, as required by section 1, subdivision 1. If the commissioner of
management and budget determines that the commissioner of human services fails to meet
this deadline for waiver submittal, the commissioner of management and budget for each
business day of noncompliance shall transfer $5,000 from the central office operations
account of the Department of Human Services to the general fund.

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