SF 2786

2nd Engrossment - 92nd Legislature (2021 - 2022) Posted on 06/27/2022 08:44am

A bill for an act
relating to health and human services; establishing grant programs for bonuses to
certain employees of long-term care providers; temporarily permitting retired
nurses to practice in certain long-term care settings; temporarily modifying training
requirements for direct care staff in certain long-term care settings; establishing a
temporary voluntary correction program for nursing homes; modifying payment
rates for certain home and community-based waiver services; appropriating money
for initial planning for establishment of a program for all-inclusive care for the
elderly; appropriating money.

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

Section 1. new text begin DIRECTION TO THE COMMISSIONER; INITIAL PACE
IMPLEMENTATION FINANCING.
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new text begin The commissioner of human services must work with stakeholders to develop
recommendations for financing mechanisms to complete the actuarial work and cover the
administrative costs of a program of all-inclusive care for the elderly (PACE). The
commissioner must recommend a financing mechanism that could begin July 1, 2024. By
December 15, 2023, the commissioner shall inform the chairs and ranking minority members
of the legislative committees with jurisdiction over health care finance on the commissioner's
progress toward developing a recommended financing mechanism.
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new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
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Sec. 2. new text begin LONG-TERM SERVICES AND SUPPORTS WORKFORCE GRANTS.
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new text begin Subdivision 1. new text end

new text begin Grant program established. new text end

new text begin The commissioner shall establish a long-term
services and supports workforce grant program to assist eligible employers with recruiting
and retaining employees.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following terms have the
meanings given.
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new text begin (b) "Allowable education and training costs" means either:
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new text begin (1) incurred costs related to tuition, direct educational expenses, training fees, uniforms,
books, background study fees, and child care and transportation costs incurred as a direct
result of participating in classroom instruction or training; or
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new text begin (2) repayment of student loan debt directly incurred as a result of completing a qualifying
course of study or training. Costs incurred pursuing an incomplete course of study or
participating in classroom instruction or training that has not been completed are not
allowable educational or training costs.
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new text begin (c) "Commissioner" means the commissioner of human services.
new text end

new text begin (d) "Eligible employer" means an employer who is an enrolled medical assistance
provider, meets the requirements of subdivision 5, and is either:
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new text begin (1) a nursing home licensed under Minnesota Statutes, chapter 144A;
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new text begin (2) a boarding care home licensed under Minnesota Statutes, sections 144.50 to 144.56;
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new text begin (3) an assisted living facility licensed under Minnesota Statutes, chapter 144G;
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new text begin (4) a hospice provider, including a licensed residential hospice provider, licensed under
Minnesota Statutes, sections 144A.75 to 144A.755;
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new text begin (5) a provider of home and community-based services licensed under Minnesota Statutes,
chapter 245D;
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new text begin (6) a home care provider licensed under Minnesota Statutes, sections 144A.43 to
144A.482;
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new text begin (7) a facility certified as an intermediate care facility for persons with developmental
disabilities;
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new text begin (8) a provider of home care services as defined under Minnesota Statutes, section
256B.0651, subdivision 1, paragraph (d);
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new text begin (9) an agency as defined under Minnesota Statutes, section 256B.0949, subdivision 2;
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new text begin (10) an agency provider or financial management service provider under Minnesota
Statutes, section 256B.85;
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new text begin (11) an eligible financial management service provider serving people through
consumer-directed community supports under Minnesota Statutes, sections 256B.092 and
256B.49, and chapter 256S, and consumer support grants under Minnesota Statutes, section
256.476; or
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new text begin (12) a provider of customized living services as defined in Minnesota Statutes, section
256S.02, subdivision 12, under the elderly waiver, brain injury waiver, or community access
for disability inclusion waiver.
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new text begin (e) "Eligible employee" means an individual employed by an eligible employer who is
eligible under Minnesota Statutes, chapter 245C, to have access to persons receiving services
without continuous direct supervision, works on average at least 20 hours per week, earns
$30 per hour or less, and has not received a bonus or grant funded under this section from
any other employer.
new text end

new text begin Subd. 3. new text end

new text begin Allowable uses of funds. new text end

new text begin Grantees must use funds awarded under this section
for any combination of the following purposes:
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new text begin (1) retention bonuses of $1,000, inclusive of applicable payroll taxes, paid to eligible
employees who are continuously employed by the same employer between February 28,
2022, and August 31, 2022;
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new text begin (2) signing bonuses of $750, inclusive of applicable payroll taxes, paid to newly hired
eligible employees hired on or after March 1, 2022, and who are continuously employed
by the same employer for 30 days;
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new text begin (3) retention bonuses of $750, inclusive of applicable payroll taxes, paid to recipients
of bonuses under clause (2) who remain continuously employed as eligible employees with
the same eligible employer for six months; or
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new text begin (4) education and training grants of up to $1,500, inclusive of applicable taxes, paid to
eligible employees to cover allowable education and training costs related to a recently
completed course of study or training that is expected to lead to employment or career
advancement with any eligible provider as defined in subdivision 2.
new text end

new text begin Subd. 4. new text end

new text begin Grant request. new text end

new text begin Within 30 days of final enactment of this section, the
commissioner shall develop an expedited request process that includes a form allowing
providers to meet the requirements of subdivision 5 in as timely and simple a manner as
possible. Eligible employers may begin requesting grants 30 days following final enactment
of this section. The commissioner shall allow the use of electronic submission of request
forms and accept electronic signatures.
new text end

new text begin Subd. 5. new text end

new text begin Attestation and agreement. new text end

new text begin As a condition of obtaining funds under this
section, an eligible employer must attest and agree to the following on the grant request
form:
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new text begin (1) the employer is an eligible provider;
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new text begin (2) the total number of eligible employees for whom the employer is requesting grant
funding;
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new text begin (3) the total amount the eligible employer is requesting;
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new text begin (4) the employer will distribute the entire value of the grant award as required under this
section;
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new text begin (5) the employer will create and maintain the records required under subdivision 6;
new text end

new text begin (6) the employer will create and post the distribution plan required under subdivision 8;
and
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new text begin (7) the employer will segregate funds received under this section from other sources of
revenue and will not use the funds for any purpose other than the purposes permitted under
this section.
new text end

new text begin Subd. 6. new text end

new text begin Record keeping requirements. new text end

new text begin (a) As a condition of obtaining funds under
this section, an eligible employer must create and retain until December 31, 2028, records
containing sufficient evidence to determine:
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new text begin (1) the number of eligible employees that received bonuses;
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new text begin (2) that the individuals who received bonuses or grants from the grantee under this
section were eligible employees, including attestations by each individual that the individual
has not received from any other employer a bonus or grant funded under this section;
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new text begin (3) that the bonuses were for allowable uses and allowable education and training costs;
and
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new text begin (4) that the awarded funds were distributed as required under this section.
new text end

new text begin (b) Upon request of the commissioner or the commissioner's designee, a grantee must
immediately produce for inspection the records required under this subdivision.
new text end

new text begin Subd. 7. new text end

new text begin Workforce grants. new text end

new text begin (a) For the purpose of this section, the commissioner and
the commissioner of management and budget are not subject to Minnesota Statutes, sections
16B.97; 16B.98, subdivisions 5 to 7; and the express audit clause requirement in section
16B.98, subdivision 8.
new text end

new text begin (b) No later than 60 days following final enactment of this section, the commissioner
shall begin issuing long-term services and supports workforce grants to eligible employers.
Within the appropriation for this purpose, the commissioner shall award grants under this
section on a rolling basis and in the order in which the grant requests are received.
new text end

new text begin (c) By accepting a grant under this subdivision, the grantee attests and agrees to the
conditions specified in subdivision 5.
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new text begin (d) By accepting a bonus or education and training grant from an employer, an individual
attests that the individual is an eligible employee.
new text end

new text begin (e) The commissioner's determination of the grant amount determined under this
subdivision is final and is not subject to appeal. This paragraph does not apply to recoupment
by the commissioner under subdivision 10.
new text end

new text begin Subd. 8. new text end

new text begin Distribution plan. new text end

new text begin (a) An eligible employer must develop a plan to distribute
the entire value of any grant amounts as bonuses and grants, inclusive of applicable payroll
taxes, to eligible employees for whom the employer requested funds.
new text end

new text begin (b) Within 30 calendar days following receipt of a grant award under this section, the
grantee must distribute the entire value of the grant amount according to the grantee's
distribution plan.
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new text begin (c) Within 30 days of receiving a grant award under this section, the grantee must post
both the distribution plan and the grant application submitted to the commissioner and leave
both documents posted for a period of six months in an area of the facility or on a secure
website to which all eligible employees have access. The grantee must provide instructions
for employees who do not believe they have received the bonuses or grants specified in the
distribution plan. The instructions must include a mailing address, e-mail address, and
telephone number that an employee may use to contact the employer's management. If an
employee is unable to resolve the problem with the employer's management, the employee
may contact the commissioner or the commissioner's representative. The commissioner
must provide grantees a mailing address, e-mail address, and telephone number for this
purpose and the grantee must include them in the distribution plan.
new text end

new text begin (d) Upon request of the commissioner, the grantee must submit the distribution plan to
the commissioner.
new text end

new text begin Subd. 9. new text end

new text begin Effect of grants on reimbursement rates. new text end

new text begin (a) Costs associated with the
purposes described in this section that are funded under this section are not allowable costs
under Minnesota Statutes, chapter 256R. Grants provided under this section are not applicable
credits under Minnesota Statutes, chapter 256R.
new text end

new text begin (b) Money received by a facility under this section must not be used to supplant funding
available under Minnesota Statutes, section 144.1503, or to supplant the portion of a nursing
facility's total payment rate attributable to scholarships under Minnesota Statutes, section
256R.37.
new text end

new text begin Subd. 10. new text end

new text begin Recoupment. new text end

new text begin (a) The commissioner may perform an audit under this section
up to six years after the grant is awarded to ensure the grantee used the funds solely for the
purposes stated in subdivision 3, was truthful when making attestations under subdivision
5, and complied with the conditions of receiving a grant under this section.
new text end

new text begin (b) If the commissioner determines that a grantee used awarded funds for purposes not
authorized under this section, the commissioner shall treat any amount used for a purpose
not authorized under this section as an overpayment. The commissioner shall recover any
overpayment.
new text end

new text begin Subd. 11. new text end

new text begin Treble damages. new text end

new text begin Any grantee who willfully submits a grant application,
invoice, cost report, or claim for reimbursement for grant funds which the grantee knows
is a false representation and which results in the payment of public funds for which the
grantee is ineligible shall, in addition to other provisions of Minnesota law, be subject to
an action by the state of Minnesota or any of its subdivisions or agencies for civil damages.
The damages awarded shall include three times the payments which result from the false
representation, together with costs and disbursements, including reasonable attorney fees
or their equivalent.
new text end

new text begin Subd. 12. new text end

new text begin Fraud. new text end

new text begin A person who obtains or tries to obtain, or aids or abets any person
in obtaining funds available under this section for which the person is not eligible by a
willfully false statement or representation, or by the intentional withholding or concealment
of a material fact, or by impersonation, or other fraudulent device, violates Minnesota
Statutes, section 256.98, and is subject to both the criminal and civil penalties in that section.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 3. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
TEMPORARY DWRS PAYMENT ADJUSTMENT.
new text end

new text begin Effective on the effective date of this section, the commissioner must implement a
temporary claims adjustment of 13.3 percent for service rates paid under Minnesota Statutes,
section 256B.4914. This adjustment is in effect for services provided during the 90 days
following the effective date of this section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective April 1, 2022, or upon federal approval,
whichever is later.
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Sec. 4. new text begin EXPEDITED REREGISTRATION FOR LAPSED NURSING LICENSES.
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new text begin (a) Notwithstanding Minnesota Statutes, section 148.231, a nurse who desires to resume
the practice of professional or practical nursing at a licensed nursing facility or licensed
assisted living facility but whose license to practice nursing has lapsed effective on or after
January 1, 2019, may submit an application to the Board of Nursing for reregistration. The
application must be submitted and received by the board between March 31, 2022, and
March 31, 2023, and must be accompanied with the reregistration fee specified in Minnesota
Statutes, section 148.243, subdivision 5. The applicant must include with the application
the name and location of the facility where the nurse is or will be employed.
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new text begin (b) The board shall issue a current registration if upon a licensure history review, the
board determines that at the time the nurse's license lapsed:
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new text begin (1) the nurse's license was in good standing; and
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new text begin (2) the nurse was not the subject of any pending investigations or disciplinary actions
or was not disqualified to practice in any way.
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new text begin The board shall waive any other requirements for reregistration including any continuing
education requirements.
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new text begin (c) The registration issued under this section shall remain valid until the nurse's next
registration period. If the nurse desires to continue to practice after that date, the nurse must
meet the reregistration requirements under Minnesota Statutes, section 148.231, including
any penalty fees required.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 5. new text begin TEMPORARY ASSISTED LIVING STAFF TRAINING REQUIREMENTS.
new text end

new text begin (a) Notwithstanding Minnesota Statutes, section 144G.60, subdivision 4, paragraphs (a)
and (b), a person who registers, completes, and passes the American Health Care
Association's eight-hour online temporary nurse aide training course may be employed by
a licensed assisted living facility to provide assisted living services or perform delegated
nursing tasks. Assisted living facilities must maintain documentation that a person employed
under the authority of this section to provide assisted living services or perform delegated
nursing tasks completed the required training program.
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new text begin (b) Whenever providing assisted living services, a person employed under the authority
of this section must be directly supervised by another employee who meets the requirements
of Minnesota Statutes, section 144G.60, subdivision 4, paragraph (a). If, during employment,
the person meets the requirements of Minnesota Statutes, section 144G.60, subdivision 4,
paragraph (a), the supervision described in this paragraph is no longer required.
new text end

new text begin (c) Whenever performing delegated nursing tasks, a person employed under the authority
of this section must be directly supervised by another employee who meets the requirements
of Minnesota Statutes, section 144G.60, subdivision 4, paragraph (b). If, during employment,
the person meets the requirements of Minnesota Statutes, section 144G.60, subdivision 4,
paragraph (b), the supervision described in this paragraph is no longer required.
new text end

new text begin (d) This section expires four months after the expiration of the blanket federal waiver
of the nurse aides training and certification requirements under Code of Federal Regulations,
title 42, section 483.35(d), by the Centers for Medicare and Medicaid Services as authorized
by section 1135 of the Social Security Act.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 6. new text begin DIRECTION TO COMMISSIONER OF HEALTH.
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new text begin (a) The commissioner of health shall develop a plan to implement a voluntary technical
assistance program for nursing facilities licensed under Minnesota Statutes, chapter 144A,
and assisted living facilities licensed under Minnesota Statutes, chapter 144G. The program
shall operate separately from current regulatory activities of the department and offer
participating facilities the ability to receive consultation related to compliance with federal
or state licensure or certification standards.
new text end

new text begin (b) By December 15, 2022, the commissioner shall provide to the chairs and ranking
minority members of the legislative committees with jurisdiction over health and human
services recommendations and legislative language for resources needed to establish and
implement the program.
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new text begin (c) This section expires on December 15, 2023.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 7. new text begin APPROPRIATION; INITIAL PACE IMPLEMENTATION FUNDING.
new text end

new text begin $390,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
of human services to complete the initial actuarial and administrative work necessary to
recommend a financing mechanism for the operation of PACE under Minnesota Statutes,
section 256B.69, subdivision 23, paragraph (e).
new text end

Sec. 8. new text begin APPROPRIATION; LONG-TERM SERVICES AND SUPPORTS
WORKFORCE GRANTS.
new text end

new text begin $269,265,000 in fiscal year 2022 is appropriated from the general fund to the
commissioner of human services for grants to eligible employers for long-term services and
supports workforce grants. Of this amount, $259,063,000 is for grants and $10,202,000 is
for administration of the grants. The amount for administration is eligible to claim federal
financial participation of $3,265,000. This is a onetime appropriation and is available until
June 30, 2025.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 9. new text begin APPROPRIATION; DWRS AFTER-MODEL ADJUSTMENT.
new text end

new text begin $54,465,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
of human services for a temporary DWRS after-model adjustment and $15,000 is
appropriated from the general fund to the commissioner of human services for systems costs
for the DWRS after-model adjustment. These are onetime appropriations.
new text end

Sec. 10. new text begin APPROPRIATION; VOLUNTARY TECHNICAL ASSISTANCE
PROGRAM FOR NURSING FACILITIES.
new text end

new text begin $47,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
of health to implement a voluntary technical assistance program for nursing facilities. This
is a onetime appropriation.
new text end