as introduced - 92nd Legislature (2021 - 2022) Posted on 03/25/2021 04:31pm
A bill for an act
relating to human services; modifying rates for services provided under elderly
waiver; modifying rates for certain services provided under disability waiver;
requiring a report; amending Minnesota Statutes 2020, sections 256S.21;
256S.2101; 256S.211, subdivision 1; 256S.212; 256S.213; 256S.214; 256S.215.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Minnesota Statutes 2020, section 256S.21, is amended to read:
The payment methodologies in sections 256S.2101 to 256S.215 apply tonew text begin :
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new text begin (1) thenew text end elderly waiver, elderly waiver customized living, elderly waiver foster care, and
elderly waiver residential care under this chapterdeleted text begin ,deleted text end new text begin ;
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new text begin (2)new text end alternative care under section 256B.0913deleted text begin ,deleted text end new text begin ;
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new text begin (3)new text end essential community supports under section 256B.0922deleted text begin ,deleted text end new text begin ;new text end and deleted text begin community access for
disability inclusion customized living and brain injury customized living under section
256B.49.
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(4) the following services, to the extent these services are covered under the home and
community-based services waivers under sections 256B.092 and 256B.49:
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(i) customized living;
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(ii) chore services;
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(iii) home-delivered meals;
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(iv) homemaker/assistance with personal care;
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(v) homemaker/cleaning; and
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(vi) homemaker/home management.
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This section is effective January 1, 2022.
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Minnesota Statutes 2020, section 256S.2101, is amended to read:
new text begin (a) new text end All rates and rate components for services listed in section 256S.21 shall be deleted text begin the sum
of ten percent ofdeleted text end the rates calculated under sections 256S.211 to 256S.215 deleted text begin and 90 percent
of the rates calculated using the rate methodology in effect as of June 30, 2017deleted text end .
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(b) On January 1 of each odd-numbered year, the commissioner shall update the base
wage index in section 256S.212 based on the most recently available Bureau of Labor
Statistics Minneapolis-St. Paul-Bloomington, MN-WI MetroSA data.
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(c) On January 1 of each odd-numbered year, the commissioner shall update the payroll
taxes and benefits factor in section 256S.213, subdivision 1, based on the most recently
available nursing facility cost report data.
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This section is effective January 1, 2022.
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Minnesota Statutes 2020, section 256S.211, subdivision 1, is amended to read:
When establishing the base wages according
to section 256S.212, the commissioner shall use standard occupational classification (SOC)
codes from the Bureau of Labor Statistics as defined in the edition of the Occupational
Handbook published immediately prior to deleted text begin January 1, 2019,deleted text end new text begin the implementation or
recalculation of rates new text end using Minnesota-specific wages taken from job descriptions.
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This section is effective January 1, 2022.
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Minnesota Statutes 2020, section 256S.212, is amended to read:
If any of the SOC codes and positions used in
this section are no longer available, the commissioner shall, in consultation with stakeholders,
select a new SOC code and position that is the closest match to the previously used SOC
position.
For customized livingdeleted text begin ,deleted text end new text begin
andnew text end foster caredeleted text begin , and residential caredeleted text end component services, the home management and support
services base wage equals 33.33 percent of the Minneapolis-St. Paul-Bloomington, MN-WI
MetroSA average wage for personal and home care aide (SOC code 39-9021); 33.33 percent
of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for food
preparation workers (SOC code 35-2021); and 33.34 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for maids and housekeeping cleaners
(SOC code 37-2012).
For customized livingdeleted text begin ,deleted text end new text begin andnew text end foster caredeleted text begin , and
residential caredeleted text end component services, the home care aide base wage equals deleted text begin 50deleted text end new text begin 75new text end percent of
the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for home health
aides (SOC code 31-1011); and deleted text begin 50deleted text end new text begin 25new text end percent of the Minneapolis-St. Paul-Bloomington,
MN-WI MetroSA average wage for nursing assistants (SOC code 31-1014).
For customized livingdeleted text begin ,deleted text end new text begin andnew text end foster caredeleted text begin , and
residential caredeleted text end component services, the home health aide base wage equals deleted text begin 20deleted text end new text begin 33.33new text end percent
of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for licensed
practical and licensed vocational nurses (SOC code 29-2061); deleted text begin and 80deleted text end new text begin 33.33new text end percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants
(SOC code 31-1014)new text begin ; and 33.34 percent of the Minneapolis-St. Paul-Bloomington, MN-WI
MetroSA average wage for home health aides (SOC code 31-1011)new text end .
For customized livingdeleted text begin ,deleted text end new text begin andnew text end
foster caredeleted text begin , and residential caredeleted text end component services, the medication setups by licensed nurse
base wage equals deleted text begin tendeleted text end new text begin 25new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA
average wage for licensed practical and licensed vocational nurses (SOC code 29-2061);
and deleted text begin 90deleted text end new text begin 75new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average
wage for registered nurses (SOC code 29-1141).
The chore services base wage equals deleted text begin 100deleted text end new text begin 50new text end percent
of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for landscaping
and groundskeeping workers (SOC code 37-3011)new text begin ; and 50 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for maids and housekeeping cleaners
(SOC code 37-2012)new text end .
The companion services base wage equals
deleted text begin 50deleted text end new text begin 80new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage
for personal and home care aides (SOC code 39-9021); and deleted text begin 50deleted text end new text begin 20new text end percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for maids and
housekeeping cleaners (SOC code 37-2012).
The deleted text begin homemaker services and assistancedeleted text end new text begin homemaker/assistancenew text end with
personal care base wage equals deleted text begin 60deleted text end new text begin 50new text end percent of the Minneapolis-St. Paul-Bloomington,
MN-WI MetroSA average wage for personal and home care aide (SOC code 39-9021); deleted text begin 20deleted text end new text begin
and 50new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage
for nursing assistants (SOC code 31-1014)deleted text begin ; and 20 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for maids and housekeeping cleaners
(SOC code 37-2012)deleted text end .
The
deleted text begin homemaker services and cleaningdeleted text end new text begin homemaker/cleaningnew text end base wage equals deleted text begin 60 percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for personal and home
care aide (SOC code 39-9021); 20 percent of the Minneapolis-St. Paul-Bloomington, MN-WI
MetroSA average wage for nursing assistants (SOC code 31-1014); and 20deleted text end new text begin 100new text end percent of
the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for maids and
housekeeping cleaners (SOC code 37-2012).
The deleted text begin homemaker services and homedeleted text end new text begin homemaker/homenew text end management base wage equals
deleted text begin 60deleted text end new text begin 50new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage
for personal and home care aide (SOC code 39-9021); deleted text begin 20deleted text end new text begin and 50new text end percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants
(SOC code 31-1014)deleted text begin ; and 20 percent of the Minneapolis-St. Paul-Bloomington, MN-WI
MetroSA average wage for maids and housekeeping cleaners (SOC code 37-2012)deleted text end .
The in-home respite care services
base wage equals deleted text begin fivedeleted text end new text begin 15new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA
average wage for registered nurses (SOC code 29-1141); 75 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for deleted text begin nursing assistantsdeleted text end new text begin home health aidesnew text end
(SOC code deleted text begin 31-1014deleted text end new text begin 31-1011new text end ); and deleted text begin 20deleted text end new text begin tennew text end percent of the Minneapolis-St. Paul-Bloomington,
MN-WI MetroSA average wage for licensed practical and licensed vocational nurses (SOC
code 29-2061).
The out-of-home respite care
services base wage equals deleted text begin fivedeleted text end new text begin 15new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI
MetroSA average wage for registered nurses (SOC code 29-1141); 75 percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for deleted text begin nursing assistantsdeleted text end new text begin
home health aidesnew text end (SOC code deleted text begin 31-1014deleted text end new text begin 31-1011new text end ); and deleted text begin 20deleted text end new text begin tennew text end percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for licensed practical and licensed
vocational nurses (SOC code 29-2061).
The individual community
living support base wage equals deleted text begin 20deleted text end new text begin 60new text end percent of the Minneapolis-St. Paul-Bloomington,
MN-WI MetroSA average wage for deleted text begin licensed practical and licensed vocational nursesdeleted text end new text begin social
and human services aidesnew text end (SOC code deleted text begin 29-2061deleted text end new text begin 21-1093new text end ); and deleted text begin 80deleted text end new text begin 40new text end percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants
(SOC code 31-1014).
The registered nurse base wage equals 100
percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for
registered nurses (SOC code 29-1141).
The deleted text begin social workerdeleted text end new text begin
unlicensed supervisornew text end base wage equals 100 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for deleted text begin medical and public health socialdeleted text end new text begin
supervisor of personal servicenew text end workers (SOC code deleted text begin 21-1022deleted text end new text begin 39-1021new text end ).
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The adult day services base wage equals 75
percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for home
health aides (SOC code 31-1011); and 25 percent of the Minneapolis-St. Paul-Bloomington,
MN-WI MetroSA average wage for nursing assistants (SOC code 31-1014).
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This section is effective January 1, 2022.
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Minnesota Statutes 2020, section 256S.213, is amended to read:
The payroll taxes and benefits factor
is the sum of net payroll taxes and benefits, divided by the sum of all salaries for all nursing
facilities on the most recent and available cost report.
The general and administrative factor is
deleted text begin the difference of net general and administrative expenses and administrative salaries, divided
by total operating expenses for all nursing facilities on the most recent and available cost
reportdeleted text end new text begin 14.4 percentnew text end .
new text begin (a) new text end The program plan support factor is deleted text begin 12.8deleted text end new text begin tennew text end
percentnew text begin for the following servicesnew text end to cover the cost of direct service staff needed to provide
support for deleted text begin home and community-baseddeleted text end new text begin thenew text end service when not engaged in direct contact with
participantsdeleted text begin .deleted text end new text begin :
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(1) adult day services;
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(2) customized living; and
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(3) foster care.
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(b) The program plan support factor is 15.5 percent for the following services to cover
the cost of direct service staff needed to provide support for the service when not engaged
in direct contact with participants:
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(1) chore services;
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(2) companion services;
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(3) homemaker/assistance with personal care;
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(4) homemaker/cleaning;
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(5) homemaker/home management;
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(6) in-home respite care;
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(7) individual community living support; and
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(8) out-of-home respite care.
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The registered nurse
management and supervision factor equals 15 percent of the registered nurse adjusted base
wage as defined in section 256S.214.
The deleted text begin social workerdeleted text end new text begin
unlicensed supervisornew text end supervision factor equals 15 percent of the deleted text begin social workerdeleted text end new text begin position'snew text end
adjusted base wage as defined in section 256S.214.
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The facility and equipment factor for adult
day services is 16.2 percent.
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The food, supplies, and
transportation factor for adult day services is 24 percent.
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The supplies and transportation factor
for the following services is 1.56 percent:
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(1) chore services;
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(2) companion services;
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(3) homemaker/assistance with personal care;
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(4) homemaker/cleaning;
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(5) homemaker/home management;
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(6) in-home respite care;
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(7) individual community support services; and
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(8) out-of-home respite care.
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The absence factor for the following services is 4.5 percent:
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(1) adult day services;
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(2) chore services;
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(3) companion services;
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(4) homemaker/assistance with personal care;
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(5) homemaker/cleaning;
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(6) homemaker/home management;
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(7) in-home respite care;
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(8) individual community living support; and
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(9) out-of-home respite care.
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This section is effective January 1, 2022.
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Minnesota Statutes 2020, section 256S.214, is amended to read:
For the purposes of section 256S.215, the adjusted base wage for each position equals
the position's base wage under section 256S.212 plus:
(1) the position's base wage multiplied by the payroll taxes and benefits factor under
section 256S.213, subdivision 1;
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(2) the position's base wage multiplied by the general and administrative factor under
section 256S.213, subdivision 2; and
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deleted text begin (3)deleted text end new text begin (2)new text end the position's base wage multiplied by thenew text begin applicablenew text end program plan support factor
under section 256S.213, subdivision 3deleted text begin .deleted text end new text begin ; and
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(3) the position's base wage multiplied by the absence factor, if applicable.
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This section is effective January 1, 2022.
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Minnesota Statutes 2020, section 256S.215, is amended to read:
The component
ratenew text begin or factor valuenew text end for medication setups by a licensed nursenew text begin , the registered nurse
management and supervision factor, and the unlicensed supervisor supervision factornew text end equals
the deleted text begin medication setups by licensed nursedeleted text end new text begin respective position'snew text end adjusted base wage.
The component
rate for home management and support services is the home management and support
services adjusted base wage plus the registered nurse management and supervision factornew text begin
multiplied by the general and administrative factor and by the applicable factors in section
256S.213, subdivisions 6 to 8new text end .
The component rate for home care
aide services is the home health aide services adjusted base wage plus the registered nurse
management and supervision factornew text begin multiplied by the general and administrative factor and
by the applicable factors in section 256S.213, subdivisions 6 to 8new text end .
The component rate for home
health aide services is the home health aide services adjusted base wage plus the registered
nurse management and supervision factornew text begin multiplied by the general and administrative factor
and by the applicable factors in section 256S.213, subdivisions 6 to 8new text end .
The component rate under elderly waiver
customized living for one-to-one socialization equals the home management and support
services component rate.
The component rate under elderly waiver
customized living for one-to-one transportation equals the home management and support
services component rate.
The 15-minute unit rate for chore services is calculated
as follows:
(1) deleted text begin sumdeleted text end new text begin addnew text end the chore services adjusted base wage and the deleted text begin social workerdeleted text end new text begin unlicensed
supervisornew text end supervision factor;
new text begin (2) multiply the result of clause (1) by the general and administrative factor and by the
applicable factors in section 256S.213, subdivisions 6 to 8; new text end and
deleted text begin (2)deleted text end new text begin (3)new text end divide the result of clause deleted text begin (1)deleted text end new text begin (2)new text end by four.
The 15-minute unit rate for companion services is
calculated as follows:
(1) deleted text begin sumdeleted text end new text begin addnew text end the companion services adjusted base wage and the social worker supervision
factor;
new text begin (2) multiply the result of clause (1) by the general and administrative factor and by the
applicable factors in section 256S.213, subdivisions 6 to 8; new text end and
deleted text begin (2)deleted text end new text begin (3)new text end divide the result of clause deleted text begin (1)deleted text end new text begin (2)new text end by four.
The 15-minute unit rate for deleted text begin homemaker services and assistancedeleted text end new text begin
homemaker/assistancenew text end with personal care is calculated as follows:
(1) deleted text begin sumdeleted text end new text begin addnew text end the deleted text begin homemaker services and assistancedeleted text end new text begin homemaker/assistancenew text end with personal
care adjusted base wage and the registered nurse management and supervision factor;
new text begin (2) multiply the result of clause (1) by the general and administrative factor and by the
applicable factors in section 256S.213, subdivisions 6 to 8; new text end and
deleted text begin (2)deleted text end new text begin (3)new text end divide the result of clause deleted text begin (1)deleted text end new text begin (2)new text end by four.
The
15-minute unit rate for deleted text begin homemaker services and cleaningdeleted text end new text begin homemaker/cleaningnew text end is calculated
as follows:
(1) deleted text begin sumdeleted text end new text begin addnew text end the deleted text begin homemaker services and cleaningdeleted text end new text begin homemaker/cleaningnew text end adjusted base
wage and the registered nurse management and supervision factor;
new text begin (2) multiply the result of clause (1) by the general and administrative factor and by the
applicable factors in section 256S.213, subdivisions 6 to 8; new text end and
deleted text begin (2)deleted text end new text begin (3)new text end divide the result of clause deleted text begin (1)deleted text end new text begin (2)new text end by four.
The
15-minute unit rate for deleted text begin homemaker services and homedeleted text end new text begin homemaker/homenew text end management is
calculated as follows:
(1) deleted text begin sumdeleted text end new text begin addnew text end the deleted text begin homemaker services and homedeleted text end new text begin homemaker/homenew text end management adjusted
base wage and the registered nurse management and supervision factor;
new text begin (2) multiply the result of clause (1) by the general and administrative factor and by the
applicable factors in section 256S.213, subdivisions 6 to 8; new text end and
deleted text begin (2)deleted text end new text begin (3)new text end divide the result of clause deleted text begin (1)deleted text end new text begin (2)new text end by four.
(a) The 15-minute unit rate for in-home
respite care services is calculated as follows:
(1) deleted text begin sumdeleted text end new text begin addnew text end the in-home respite care services adjusted base wage and the registered
nurse management and supervision factor;
new text begin (2) multiply the result of clause (1) by the general and administrative factor and by the
applicable factors in section 256S.213, subdivisions 6 to 8; new text end and
deleted text begin (2)deleted text end new text begin (3)new text end divide the result of clause deleted text begin (1)deleted text end new text begin (2)new text end by four.
(b) The in-home respite care services daily rate equals the in-home respite care services
15-minute unit rate multiplied by 18.
(a) The 15-minute unit rate for
out-of-home respite care is calculated as follows:
(1) deleted text begin sumdeleted text end new text begin addnew text end the out-of-home respite care services adjusted base wage and the registered
nurse management and supervision factor;
new text begin (2) multiply the result of clause (1) by the general and administrative factor and by the
applicable factors in section 256S.213, subdivisions 6 to 8;new text end and
deleted text begin (2)deleted text end new text begin (3)new text end divide the result of clause deleted text begin (1)deleted text end new text begin (2)new text end by four.
(b) The out-of-home respite care services daily rate equals the 15-minute unit rate for
out-of-home respite care services multiplied by 18.
The individual community living
support rate is calculated as follows:
(1) deleted text begin sumdeleted text end new text begin addnew text end the deleted text begin home care aidedeleted text end new text begin individual community living supportnew text end adjusted base wage
and the deleted text begin social workerdeleted text end new text begin registered nurse management andnew text end supervision factor;
new text begin (2) multiply the result of clause (1) by the general and administrative factor and by the
applicable factors in section 256S.213, subdivisions 6 to 8; new text end and
deleted text begin (2)deleted text end new text begin (3)new text end divide the result of clause deleted text begin (1)deleted text end new text begin (2)new text end by four.
The home-delivered meals rate equals deleted text begin $9.30deleted text end new text begin
$8.17new text end . The commissioner shall increase the home delivered meals rate deleted text begin every Julydeleted text end new text begin January new text end
1new text begin of each odd-numbered yearnew text end by the percent increase in the nursing facility dietary per diem
using the two most recent and available nursing facility cost reports.
The 15-minute unit rate for adult day servicesdeleted text begin , with
an assumed staffing ratio of one staff person to four participants, is the sum ofdeleted text end new text begin is calculated
as followsnew text end :
(1) deleted text begin one-sixteenth of the home care aide servicesdeleted text end new text begin divide the adult day servicesnew text end adjusted
base wagedeleted text begin , except that the general and administrative factor used to determine the home
care aide services adjusted base wage is 20 percentdeleted text end new text begin by five to reflect an assumed staffing
ratio of one to fivenew text end ;
(2) deleted text begin one-fourth of the registered nurse management and supervision factordeleted text end new text begin add the result
of clause (1) and the registered nurse management and supervision factornew text end ;
new text begin (3) multiply the result of clause (2) by the general and administrative factor and by the
applicable factors in section 256S.213, subdivisions 6 to 8; new text end and
deleted text begin
(3) $0.63 to cover the cost of meals.
deleted text end
new text begin
(4) divide the result of clause (3) by four.
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The 15-minute unit rate for adult day services
bath is deleted text begin the sum ofdeleted text end new text begin calculated as followsnew text end :
(1) deleted text begin one-fourth of the home care aidedeleted text end new text begin add the adult daynew text end services adjusted base wagedeleted text begin ,
except that the general and administrative factor used to determine the home care aide
services adjusted base wage is 20 percentdeleted text end new text begin and the registered nurse management and
supervision factornew text end ;
(2) deleted text begin one-fourth of the registered nurse management and supervision factordeleted text end new text begin multiply the
result of clause (1) by the general and administrative factor and the applicable factors in
section 256S.213, subdivisions 6 to 8new text end ; and
(3) deleted text begin $0.63 to cover the cost of mealsdeleted text end new text begin divide the result of clause (2) by fournew text end .
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This section is effective January 1, 2022.
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(a) The commissioner of human services, in consultation with stakeholders, shall conduct
a study to evaluate:
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(1) elderly waiver rate methodology base wage values compared to wages paid by service
providers;
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(2) elderly waiver rate methodology nonwage cost factor values compared to nonwage
costs of service providers; and
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(3) the extent to which nonwage cost factors and factor values should vary by service.
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(b) By January 1, 2024, the commissioner of human services shall submit a report to the
chairs and ranking minority members of the legislative committees and divisions with
jurisdiction over the elderly waiver program with recommended adjustments to the rate
methodologies in Minnesota Statutes, sections 256S.21 to 256S.215, based on the results
of the evaluation in paragraph (a). The report must comply with Minnesota Statutes, sections
3.195 and 3.197.
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This section is effective July 1, 2021.
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