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SF 2771

as introduced - 92nd Legislature (2021 - 2022) Posted on 07/29/2022 09:30am

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - as introduced

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A bill for an act
relating to human services; modifying reimbursement rates for disability waiver
services; amending Minnesota Statutes 2020, section 256B.4914, subdivisions 7,
8, 9; Minnesota Statutes 2021 Supplement, section 256B.4914, subdivisions 5, 6.

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

Section 1.

Minnesota Statutes 2021 Supplement, 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 assistant (SOC
code 31-1014); 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 assistant (SOC code
31-1014); 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 adult day services, 70 percent of the median wage for nursing assistant (SOC
code 31-1014); and 30 percent of the median wage for personal care aide (SOC code
39-9021);

(3) for day services, day support services, and prevocational services, 20 percent of the
median wage for nursing assistant (SOC code 31-1014); 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);

(4) for residential asleep-overnight staff, the wage is the minimum wage in Minnesota
for large employers, except in a family foster care setting, the wage is 36 percent of the
minimum wage in Minnesota for large employers;

(5) for positive supports analyst staff, 100 percent of the median wage for mental health
counselors (SOC code 21-1014);

(6) for positive supports professional staff, 100 percent of the median wage for clinical
counseling and school psychologist (SOC code 19-3031);

(7) for positive supports specialist staff, 100 percent of the median wage for psychiatric
technicians (SOC code 29-2053);

(8) for supportive living services staff, 20 percent of the median wage for nursing assistant
(SOC code 31-1014); 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);

(9) for housing access coordination staff, 100 percent of the median wage for community
and social services specialist (SOC code 21-1099);

(10) for in-home family support and individualized home supports with family training
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);

(11) for individualized home supports with training services 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);

(12) 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);

(13) for employment support 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);

(14) 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);

(15) 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);

(16) for individualized home 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
assistant (SOC code 31-1014);

(17) 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 assistant
(SOC code 31-1014);

(18) 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 assistant (SOC code
31-1014); 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);

(19) 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 assistant (SOC code
31-1014);

(20) 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 assistant
(SOC code 31-1014);

(21) for supervisory staff, 100 percent of the median wage for community and social
services specialist (SOC code 21-1099), with the exception of the supervisor of positive
supports professional, positive supports analyst, and positive supports specialists, which is
100 percent of the median wage for clinical counseling and school psychologist (SOC code
19-3031);

(22) for registered nurse staff, 100 percent of the median wage for registered nurses
(SOC code 29-1141); and

(23) for licensed practical nurse staff, 100 percent of the median wage for licensed
practical nurses (SOC code 29-2061).

(b) Component values for corporate foster care services, corporate supportive living
services daily, community residential services, and integrated community support services
are:

(1) competitive workforce factor: 4.7 percent;

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

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

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

(5) general administrative support ratio: 13.25 percent;

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

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

(c) Component values for family foster care are:

(1) competitive workforce factor: 4.7 percent;

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

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

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

(5) general administrative support ratio: 3.3 percent;

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

(7) absence factor: 1.7 percent.

(d) Component values for day training and habilitation, day support services, and
prevocational services are:

(1) competitive workforce factor: 4.7 percent;

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

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

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

(5) program plan support ratio: 5.6 percent;

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

(7) general administrative support ratio: 13.25 percent;

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

(9) absence and utilization factor ratio: 9.4 percent.

(e) Component values for adult day services are:

(1) competitive workforce factor: 4.7 percent;

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

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

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

(5) program plan support ratio: 5.6 percent;

(6) client programming and support ratio: 7.4 percent;

(7) general administrative support ratio: 13.25 percent;

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

(9) absence and utilization factor ratio: 9.4 percent.

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

(1) competitive workforce factor: 4.7 percent;

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

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

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

(5) program plan supports ratio: 15.5 percent;

(6) client programming and supports ratio: 4.7 percent;

(7) general administrative support ratio: 13.25 percent;

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

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

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

(1) competitive workforce factor: 4.7 percent;

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

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

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

(5) program plan support ratio: 7.0 percent;

(6) client programming and support ratio: 2.3 percent;

(7) general administrative support ratio: 13.25 percent;

(8) program-related expense ratio: 2.9 percent; and

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

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

(1) competitive workforce factor: 4.7 percent;

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

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

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

(5) general administrative support ratio: 13.25 percent;

(6) program-related expense ratio: 2.9 percent; and

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

(i) The commissioner shall update the base wage index in paragraph (a), publish these
updated values, and load them into the rate management system as follows:

(1) on January 1, 2022, based on wage data by SOC from the Bureau of Labor Statistics
available as of December 31, 2019;

(2) on November 1, 2024, based onnew text begin the most recently availablenew text end wage data by SOC from
the Bureau of Labor Statistics deleted text beginavailable as of December 31, 2021deleted text end; and

(3) on July 1, 2026, and every two years thereafter, based onnew text begin the most recently availablenew text end
wage data by SOC from the Bureau of Labor Statistics deleted text beginavailable 30 months and one day
prior to the scheduled update
deleted text end.

(j) Beginning February 1, 2021, and every two years thereafter, the commissioner shall
report to the chairs and ranking minority members of the legislative committees and divisions
with jurisdiction over health and human services policy and finance an analysis of the
competitive workforce factor. The report must include deleted text beginrecommendations to update the
competitive workforce factor using
deleted text end:

(1) the most recently available wage data by SOC code for the weighted average wage
for direct care staff for residential services and direct care staff for day services;

(2) the most recently available wage data by SOC code of the weighted average wage
of comparable occupations; and

(3) workforce data as required under subdivision 10a, paragraph (g).

deleted text begin The commissioner shall not recommend an increase or decrease of the competitive workforce
factor from the current value by more than two percentage points. If, after a biennial analysis
for the next report, the competitive workforce factor is less than or equal to zero, the
commissioner shall recommend a competitive workforce factor of zero.
deleted text end

(k) The commissioner shall update the framework components in paragraph (d), clause
(6); paragraph (e), clause (6); paragraph (f), clause (6); and paragraph (g), clause (6);
subdivision 6, paragraphs (b), clauses (9) and (10), and (e), clause (10); and subdivision 7,
clauses (11), (17), and (18), for changes in the Consumer Price Index. The commissioner
shall adjust these values higher or lower, publish these updated values, and load them into
the rate management system as follows:

(1) on January 1, 2022, by the percentage change in the CPI-U from the date of the
previous update to the data available on December 31, 2019;

(2) on November 1, 2024, by the percentage change in the CPI-U from the date of the
previous update to the data available as of December 31, deleted text begin2021deleted text endnew text begin 2023new text end; and

(3) on July 1, 2026, and every two years thereafter, by the percentage change in the
CPI-U from the date of the previous update to the data available deleted text begin30deleted text endnew text begin sixnew text end months and one day
prior to the scheduled update.

(l) Upon the implementation of the updates under paragraphs (i) and (k), rate adjustments
authorized under section 256B.439, subdivision 7; Laws 2013, chapter 108, article 7, section
60; and Laws 2014, chapter 312, article 27, section 75, shall be removed from service rates
calculated under this section.

(m) Any rate adjustments applied to the service rates calculated under this section outside
of the cost components and rate methodology specified in this section shall be removed
from rate calculations upon implementation of the updates under paragraphs (i) deleted text beginanddeleted text endnew text begin,new text end (k)new text begin,
and (p)
new text end.

(n) In this subdivision, if Bureau of Labor Statistics occupational codes or Consumer
Price Index items are unavailable in the future, the commissioner shall recommend to the
legislature codes or items to update and replace missing component values.

(o) At least 80 percent of the marginal increase in revenue from the rate adjustment
applied to the service rates calculated under this section in paragraphs (i) and (k) beginning
on January 1, 2022, for services rendered between January 1, 2022, and March 31, 2024,
must be used to increase compensation-related costs for employees directly employed by
the program on or after January 1, 2022. For the purposes of this paragraph,
compensation-related costs include:

(1) wages and salaries;

(2) the employer's share of FICA taxes, Medicare taxes, state and federal unemployment
taxes, workers' compensation, and mileage reimbursement;

(3) the employer's paid share of health and dental insurance, life insurance, disability
insurance, long-term care insurance, uniform allowance, pensions, and contributions to
employee retirement accounts; and

(4) benefits that address direct support professional workforce needs above and beyond
what employees were offered prior to January 1, 2022, including retention and recruitment
bonuses and tuition reimbursement.

Compensation-related costs for persons employed in the central office of a corporation or
entity that has an ownership interest in the provider or exercises control over the provider,
or for persons paid by the provider under a management contract, do not count toward the
80 percent requirement under this paragraph. A provider agency or individual provider that
receives a rate subject to the requirements of this paragraph shall prepare, and upon request
submit to the commissioner, a distribution plan that specifies the amount of money the
provider expects to receive that is subject to the requirements of this paragraph, including
how that money was or will be distributed to increase compensation-related costs for
employees. Within 60 days of final implementation of a rate adjustment subject to the
requirements of this paragraph, the provider must post the distribution plan and leave it
posted for a period of at least six months in an area of the provider's operation to which all
direct support professionals have access.

new text begin (p) On November 1, 2024, and July 1, 2026, and then every two years thereafter, the
commissioner shall update the competitive workforce factor to equal the differential between:
new text end

new text begin (1) the most recently available wage data by SOC code for the weighted average wage
for direct care staff for residential services and direct care staff for day services; and
new text end

new text begin (2) the most recently available wage data by SOC code of the weighted average wage
of comparable occupations.
new text end

new text begin For each update of the competitive workforce factor, the update shall not decrease the
competitive workforce factor by more than 2.0. If the competitive workforce factor is less
than or equal to zero, then the competitive workforce factor is zero.
new text end

Sec. 2.

Minnesota Statutes 2021 Supplement, 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)new text begin, (22),new text end and deleted text begin(21) todeleted text end (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 shall add $2,179; and

(10) for transportation, if provided, the commissioner shall 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 and 24-hour customized living
must be the customized living tool. The commissioner shall 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. The rate adjustments
described in section 256S.205 do not apply to rates paid under this section. Customized
living and 24-hour customized living rates determined under this section shall not include
more than 24 hours of support in a daily unit. The commissioner shall establish the following
acuity-based customized living tool input limits, based on case mix, for customized living
and 24-hour customized living rates determined under this section:

(1) no more than two hours of mental health management per day for people assessed
for case mixes A, D, and G;

(2) no more than four hours of activities of daily living assistance per day for people
assessed for case mix B; and

(3) no more than six hours of activities of daily living assistance per day for people
assessed for case mix D.

(e) Payments for integrated community support services must be calculated as follows:

(1) the base shared staffing must be eight hours divided by the number of people receiving
support in the integrated community support setting;

(2) the individual staffing hours must 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)new text begin, (22),new text end and deleted text begin(21) todeleted text end (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 shall 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 number of days authorized for all individuals enrolling in residential services
must include every day that services start and end.

Sec. 3.

Minnesota Statutes 2020, section 256B.4914, subdivision 7, is amended to read:


Subd. 7.

Payments for day programs.

Payments for services with day programs
including adult day services, day treatment and habilitation, day support services,
prevocational services, and structured day services must be calculated as follows:

(1) determine the number of units of service and staffing ratio to meet a recipient's needs:

(i) the staffing ratios for the units of service provided to a recipient in a typical week
must be averaged to determine an individual's staffing ratio; and

(ii) the commissioner, in consultation with service providers, shall develop a uniform
staffing ratio worksheet to be used to determine staffing ratios under this subdivision;

(2) personnel hourly wage rates 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)new text begin, (22),new text end and deleted text begin(21) todeleted text end (23), multiply
the result of clause (2) by the product of one plus the competitive workforce factor in
subdivision 5, paragraph (d), 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 day program direct staff hours and nursing hours by the
appropriate staff wage;

(6) multiply the number of day direct staff hours by the product of the supervision span
of control ratio in subdivision 5, paragraph (d), clause (2), and the appropriate supervision
wage in subdivision 5, paragraph (a), clause (21);

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

(8) for program plan support, multiply the result of clause (7) by one plus the program
plan support ratio in subdivision 5, paragraph (d), clause (5);

(9) for employee-related expenses, multiply the result of clause (8) by one plus the
employee-related cost ratio in subdivision 5, paragraph (d), clause (4);

(10) for client programming and supports, multiply the result of clause (9) by one plus
the client programming and support ratio in subdivision 5, paragraph (d), clause (6);

(11) for program facility costs, add $19.30 per week with consideration of staffing ratios
to meet individual needs;

(12) for adult day bath services, add $7.01 per 15 minute unit;

(13) this is the subtotal rate;

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

(15) divide the result of clause (13) by one minus the result of clause (14). This is the
total payment amount;

(16) adjust the result of clause (15) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services;

(17) for transportation provided as part of day training and habilitation for an individual
who does not require a lift, add:

(i) $10.50 for a trip between zero and ten miles for a nonshared ride in a vehicle without
a lift, $8.83 for a shared ride in a vehicle without a lift, and $9.25 for a shared ride in a
vehicle with a lift;

(ii) $15.75 for a trip between 11 and 20 miles for a nonshared ride in a vehicle without
a lift, $10.58 for a shared ride in a vehicle without a lift, and $11.88 for a shared ride in a
vehicle with a lift;

(iii) $25.75 for a trip between 21 and 50 miles for a nonshared ride in a vehicle without
a lift, $13.92 for a shared ride in a vehicle without a lift, and $16.88 for a shared ride in a
vehicle with a lift; or

(iv) $33.50 for a trip of 51 miles or more for a nonshared ride in a vehicle without a lift,
$16.50 for a shared ride in a vehicle without a lift, and $20.75 for a shared ride in a vehicle
with a lift;

(18) for transportation provided as part of day training and habilitation for an individual
who does require a lift, add:

(i) $19.05 for a trip between zero and ten miles for a nonshared ride in a vehicle with a
lift, and $15.05 for a shared ride in a vehicle with a lift;

(ii) $32.16 for a trip between 11 and 20 miles for a nonshared ride in a vehicle with a
lift, and $28.16 for a shared ride in a vehicle with a lift;

(iii) $58.76 for a trip between 21 and 50 miles for a nonshared ride in a vehicle with a
lift, and $58.76 for a shared ride in a vehicle with a lift; or

(iv) $80.93 for a trip of 51 miles or more for a nonshared ride in a vehicle with a lift,
and $80.93 for a shared ride in a vehicle with a lift.

Sec. 4.

Minnesota Statutes 2020, 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 employment exploration services, employment
development services, housing access coordination, individualized home supports with
family training, individualized home supports with training, in-home family support,
independent living skills training, and hourly supported living services 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 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)new text begin, (22),new text end and deleted text begin(21) todeleted text end (23), multiply
the result of clause (2) by the product of one plus the competitive workforce factor in
subdivision 5, paragraph (f), 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 direct staff hours by the appropriate staff wage;

(6) multiply the number of direct staff hours by the product of the supervision span of
control ratio in subdivision 5, paragraph (f), clause (2), and the appropriate supervision
wage in subdivision 5, paragraph (a), clause (21);

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

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

(9) for employee-related expenses, multiply the result of clause (8) by one plus the
employee-related cost ratio in subdivision 5, paragraph (f), clause (4);

(10) for client programming and supports, multiply the result of clause (9) by one plus
the client programming and supports ratio in subdivision 5, paragraph (f), clause (6);

(11) this is the subtotal rate;

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

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

(14) for employment exploration services provided in a shared manner, divide the total
payment amount in clause (13) by the number of service recipients, not to exceed five. For
employment support services provided in a shared manner, divide the total payment amount
in clause (13) by the number of service recipients, not to exceed six. For independent living
skills training, individualized home supports with training, and individualized home supports
with family training provided in a shared manner, divide the total payment amount in clause
(13) by the number of service recipients, not to exceed two; and

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

Sec. 5.

Minnesota Statutes 2020, section 256B.4914, subdivision 9, is amended to read:


Subd. 9.

Payments for unit-based services without programming.

Payments for
unit-based services without programming, including individualized home supports, night
supervision, personal support, respite, and companion care 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) for all services except respite, determine the number of units of service to meet a
recipient's needs;

(2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics
Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5;

(3) except for subdivision 5, paragraph (a), clauses (4)new text begin, (22),new text end and deleted text begin(21) todeleted text end (23), multiply
the result of clause (2) by the product of one plus the competitive workforce factor in
subdivision 5, paragraph (g), 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 direct staff hours by the appropriate staff wage;

(6) multiply the number of direct staff hours by the product of the supervision span of
control ratio in subdivision 5, paragraph (g), clause (2), and the appropriate supervision
wage in subdivision 5, paragraph (a), clause (21);

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

(8) for program plan support, multiply the result of clause (7) by one plus the program
plan support ratio in subdivision 5, paragraph (g), clause (5);

(9) for employee-related expenses, multiply the result of clause (8) by one plus the
employee-related cost ratio in subdivision 5, paragraph (g), clause (4);

(10) for client programming and supports, multiply the result of clause (9) by one plus
the client programming and support ratio in subdivision 5, paragraph (g), clause (6);

(11) this is the subtotal rate;

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

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

(14) for respite services, determine the number of day units of service to meet an
individual's needs;

(15) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics
Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5;

(16) except for subdivision 5, paragraph (a), clauses (4)new text begin, (22),new text end and deleted text begin(21) todeleted text end (23), multiply
the result of clause (15) by the product of one plus the competitive workforce factor in
subdivision 5, paragraph (h), clause (1);

(17) for a recipient requiring deaf and hard-of-hearing customization under subdivision
12, add the customization rate provided in subdivision 12 to the result of clause (16);

(18) multiply the number of direct staff hours by the appropriate staff wage;

(19) multiply the number of direct staff hours by the product of the supervisory span of
control ratio in subdivision 5, paragraph (h), clause (2), and the appropriate supervision
wage in subdivision 5, paragraph (a), clause (21);

(20) combine the results of clauses (18) and (19), and multiply the result by one plus
the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (h),
clause (3). This is defined as the direct staffing rate;

(21) for employee-related expenses, multiply the result of clause (20) by one plus the
employee-related cost ratio in subdivision 5, paragraph (h), clause (4);

(22) this is the subtotal rate;

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

(24) divide the result of clause (22) by one minus the result of clause (23). This is the
total payment amount;

(25) for individualized home supports provided in a shared manner, divide the total
payment amount in clause (13) by the number of service recipients, not to exceed two;

(26) for respite care services provided in a shared manner, divide the total payment
amount in clause (24) by the number of service recipients, not to exceed three; and

(27) adjust the result of clauses (13), (25), and (26) by a factor to be determined by the
commissioner to adjust for regional differences in the cost of providing services.