Engrossments
Introduction		Posted on 03/14/2023 , 6 occurences of "finance"
1st Engrossment		Posted on 04/11/2023 , 8 occurences of "finance"
2nd Engrossment		Posted on 04/17/2023 , 9 occurences of "finance"
3rd Engrossment		Posted on 04/18/2023 , 8 occurences of "finance"
4th Engrossment		Posted on 05/21/2023 , 23 occurences of "finance"

Unofficial Engrossments
1st Unofficial Engrossment		Posted on 04/21/2023 , 12 occurences of "finance"
2nd Unofficial Engrossment		Posted on 04/27/2023 , 12 occurences of "finance"

Conference Committee Reports
CCR-SF2934A		Posted on 05/18/2023 , 23 occurences of "finance"

ARTICLE 1

DISABILITY SERVICES

Section 1.

Minnesota Statutes 2022, section 179A.54, is amended by adding a subdivision
to read:

new text begin Subd. 11. new text end

new text begin Home Care Orientation Trust. new text end

new text begin (a) The state and an exclusive representative
certified pursuant to this section may establish a joint labor and management trust, referred
to as the Home Care Orientation Trust, for the exclusive purpose of rendering voluntary
orientation training to individual providers of direct support services who are represented
by the exclusive representative.
new text end

new text begin (b) Financial contributions by the state to the Home Care Orientation Trust must be
made by the state pursuant to a collective bargaining agreement negotiated under this section.
All such financial contributions by the state must be held in trust for the purpose of paying,
from principal, from income, or from both, the costs associated with developing, delivering,
and promoting voluntary orientation training for individual providers of direct support
services working under a collective bargaining agreement and providing services through
a covered program under section 256B.0711. The Home Care Orientation Trust must be
administered, managed, and otherwise controlled jointly by a board of trustees composed
of an equal number of trustees appointed by the state and trustees appointed by the exclusive
representative under this section. The trust shall not be an agent of either the state or of the
exclusive representative.
new text end

new text begin (c) Trust administrative, management, legal, and financial services may be provided to
the board of trustees by a third-party administrator, financial management institution, other
appropriate entity, or any combination thereof, as designated by the board of trustees from
time to time, and those services must be paid from the money held in trust and created by
the state's financial contributions to the Home Care Orientation Trust.
new text end

new text begin (d) The state is authorized to purchase liability insurance for members of the board of
trustees appointed by the state.
new text end

new text begin (e) Financial contributions to or participation in the management or administration of
the Home Care Orientation Trust must not be considered an unfair labor practice under
section 179A.13, or a violation of Minnesota law.
new text end

Sec. 2.

Minnesota Statutes 2022, section 245A.03, subdivision 7, is amended to read:

Subd. 7.

Licensing moratorium.

(a) The commissioner shall not issue an initial license
for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult
foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter
for a physical location that will not be the primary residence of the license holder for the
entire period of licensure. If a family child foster care home or family adult foster care home
license is issued during this moratorium, and the license holder changes the license holder's
primary residence away from the physical location of the foster care license, the
commissioner shall revoke the license according to section 245A.07. The commissioner
shall not issue an initial license for a community residential setting licensed under chapter
245D. When approving an exception under this paragraph, the commissioner shall consider
the resource need determination process in paragraph (h), the availability of foster care
licensed beds in the geographic area in which the licensee seeks to operate, the results of a
person's choices during their annual assessment and service plan review, and the
recommendation of the local county board. The determination by the commissioner is final
and not subject to appeal. Exceptions to the moratorium include:

(1) foster care settings where at least 80 percent of the residents are 55 years of age or
older;

(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
community residential setting licenses replacing adult foster care licenses in existence on
December 31, 2013, and determined to be needed by the commissioner under paragraph
(b);

(3) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD,
or regional treatment center; restructuring of state-operated services that limits the capacity
of state-operated facilities; or allowing movement to the community for people who no
longer require the level of care provided in state-operated facilities as provided under section
256B.092, subdivision 13, or 256B.49, subdivision 24;

(4) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for persons requiring hospital-level care;
or

(5) new foster care licenses or community residential setting licenses for people receiving
customized living or 24-hour customized living services under the brain injury or community
access for disability inclusion waiver plans under section 256B.49new text begin or elderly waiver plan
under chapter 256Snew text end and residing in the customized living setting deleted text begin before July 1, 2022,deleted text end for
which a license is required. A customized living service provider subject to this exception
may rebut the presumption that a license is required by seeking a reconsideration of the
commissioner's determination. The commissioner's disposition of a request for
reconsideration is final and not subject to appeal under chapter 14. The exception is available
until deleted text begin June 30deleted text end new text begin December 31new text end , 2023. This exception is available when:

(i) the person's customized living services are provided in a customized living service
setting serving four or fewer people deleted text begin under the brain injury or community access for disability
inclusion waiver plans under section 256B.49deleted text end in a single-family home operational on or
before June 30, 2021. Operational is defined in section 256B.49, subdivision 28;

(ii) the person's case manager provided the person with information about the choice of
service, service provider, and location of service, including in the person's home, to help
the person make an informed choice; and

(iii) the person's services provided in the licensed foster care or community residential
setting are less than or equal to the cost of the person's services delivered in the customized
living setting as determined by the lead agency.

(b) The commissioner shall determine the need for newly licensed foster care homes or
community residential settings as defined under this subdivision. As part of the determination,
the commissioner shall consider the availability of foster care capacity in the area in which
the licensee seeks to operate, and the recommendation of the local county board. The
determination by the commissioner must be final. A determination of need is not required
for a change in ownership at the same address.

(c) When an adult resident served by the program moves out of a foster home that is not
the primary residence of the license holder according to section 256B.49, subdivision 15,
paragraph (f), or the adult community residential setting, the county shall immediately
inform the Department of Human Services Licensing Division. The department may decrease
the statewide licensed capacity for adult foster care settings.

(d) Residential settings that would otherwise be subject to the decreased license capacity
established in paragraph (c) shall be exempt if the license holder's beds are occupied by
residents whose primary diagnosis is mental illness and the license holder is certified under
the requirements in subdivision 6a or section 245D.33.

(e) A resource need determination process, managed at the state level, using the available
data required by section 144A.351, and other data and information shall be used to determine
where the reduced capacity determined under section 256B.493 will be implemented. The
commissioner shall consult with the stakeholders described in section 144A.351, and employ
a variety of methods to improve the state's capacity to meet the informed decisions of those
people who want to move out of corporate foster care or community residential settings,
long-term service needs within budgetary limits, including seeking proposals from service
providers or lead agencies to change service type, capacity, or location to improve services,
increase the independence of residents, and better meet needs identified by the long-term
services and supports reports and statewide data and information.

(f) At the time of application and reapplication for licensure, the applicant and the license
holder that are subject to the moratorium or an exclusion established in paragraph (a) are
required to inform the commissioner whether the physical location where the foster care
will be provided is or will be the primary residence of the license holder for the entire period
of licensure. If the primary residence of the applicant or license holder changes, the applicant
or license holder must notify the commissioner immediately. The commissioner shall print
on the foster care license certificate whether or not the physical location is the primary
residence of the license holder.

(g) License holders of foster care homes identified under paragraph (f) that are not the
primary residence of the license holder and that also provide services in the foster care home
that are covered by a federally approved home and community-based services waiver, as
authorized under chapter 256S or section 256B.092 or 256B.49, must inform the human
services licensing division that the license holder provides or intends to provide these
waiver-funded services.

(h) The commissioner may adjust capacity to address needs identified in section
144A.351. Under this authority, the commissioner may approve new licensed settings or
delicense existing settings. Delicensing of settings will be accomplished through a process
identified in section 256B.493.

(i) The commissioner must notify a license holder when its corporate foster care or
community residential setting licensed beds are reduced under this section. The notice of
reduction of licensed beds must be in writing and delivered to the license holder by certified
mail or personal service. The notice must state why the licensed beds are reduced and must
inform the license holder of its right to request reconsideration by the commissioner. The
license holder's request for reconsideration must be in writing. If mailed, the request for
reconsideration must be postmarked and sent to the commissioner within 20 calendar days
after the license holder's receipt of the notice of reduction of licensed beds. If a request for
reconsideration is made by personal service, it must be received by the commissioner within
20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.

(j) The commissioner shall not issue an initial license for children's residential treatment
services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter
for a program that Centers for Medicare and Medicaid Services would consider an institution
for mental diseases. Facilities that serve only private pay clients are exempt from the
moratorium described in this paragraph. The commissioner has the authority to manage
existing statewide capacity for children's residential treatment services subject to the
moratorium under this paragraph and may issue an initial license for such facilities if the
initial license would not increase the statewide capacity for children's residential treatment
services subject to the moratorium under this paragraph.

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.

Minnesota Statutes 2022, section 245A.11, subdivision 7, is amended to read:

Subd. 7.

Adult foster care; variance for alternate overnight supervision.

(a) The
commissioner may grant a variance under section 245A.04, subdivision 9, to rule parts
requiring a caregiver to be present in an adult foster care home during normal sleeping hours
to allow for alternative methods of overnight supervision. The commissioner may grant the
variance if the local county licensing agency recommends the variance and the county
recommendation includes documentation verifying that:

(1) the county has approved the license holder's plan for alternative methods of providing
overnight supervision and determined the plan protects the residents' health, safety, and
rights;

(2) the license holder has obtained written and signed informed consent from each
resident or each resident's legal representative documenting the resident's or legal
representative's agreement with the alternative method of overnight supervision; and

(3) the alternative method of providing overnight supervision, which may include the
use of technology, is specified for each resident in the resident's: (i) individualized plan of
care; (ii) individual service plan under section 256B.092, subdivision 1b, if required; or (iii)
individual resident placement agreement under Minnesota Rules, part 9555.5105, subpart
19, if required.

(b) To be eligible for a variance under paragraph (a), the adult foster care license holder
must not have had a conditional license issued under section 245A.06, or any other licensing
sanction issued under section 245A.07 during the prior 24 months based on failure to provide
adequate supervision, health care services, or resident safety in the adult foster care home.

(c) A license holder requesting a variance under this subdivision to utilize technology
as a component of a plan for alternative overnight supervision may request the commissioner's
review in the absence of a county recommendation. Upon receipt of such a request from a
license holder, the commissioner shall review the variance request with the county.

(d) deleted text begin A variance granted by the commissioner according to this subdivision before January
1, 2014, to a license holder for an adult foster care home must transfer with the license when
the license converts to a community residential setting license under chapter 245D. The
terms and conditions of the variance remain in effect as approved at the time the variance
was granteddeleted text end new text begin The variance requirements under this subdivision for alternative overnight
supervision do not apply to community residential settings licensed under chapter 245Dnew text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2024.
new text end

Sec. 4.

Minnesota Statutes 2022, section 245A.11, subdivision 7a, is amended to read:

Subd. 7a.

Alternate overnight supervision technology; adult foster care deleted text begin and
community residential settingdeleted text end licenses.

(a) The commissioner may grant an applicant or
license holder an adult foster care deleted text begin or community residential settingdeleted text end license for a residence
that does not have a caregiver in the residence during normal sleeping hours as required
under Minnesota Rules, part 9555.5105, subpart 37, item B, or section 245D.02, subdivision
33b, but uses monitoring technology to alert the license holder when an incident occurs that
may jeopardize the health, safety, or rights of a foster care recipient. The applicant or license
holder must comply with all other requirements under Minnesota Rules, parts 9555.5105
to 9555.6265, or applicable requirements under chapter 245D, and the requirements under
this subdivision. The license printed by the commissioner must state in bold and large font:

(1) that the facility is under electronic monitoring; and

(2) the telephone number of the county's common entry point for making reports of
suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.

(b) Applications for a license under this section must be submitted directly to the
Department of Human Services licensing division. The licensing division must immediately
notify the county licensing agency. The licensing division must collaborate with the county
licensing agency in the review of the application and the licensing of the program.

(c) Before a license is issued by the commissioner, and for the duration of the license,
the applicant or license holder must establish, maintain, and document the implementation
of written policies and procedures addressing the requirements in paragraphs (d) through
(f).

(d) The applicant or license holder must have policies and procedures that:

(1) establish characteristics of target populations that will be admitted into the home,
and characteristics of populations that will not be accepted into the home;

(2) explain the discharge process when a resident served by the program requires
overnight supervision or other services that cannot be provided by the license holder due
to the limited hours that the license holder is on site;

(3) describe the types of events to which the program will respond with a physical
presence when those events occur in the home during time when staff are not on site, and
how the license holder's response plan meets the requirements in paragraph (e), clause (1)
or (2);

(4) establish a process for documenting a review of the implementation and effectiveness
of the response protocol for the response required under paragraph (e), clause (1) or (2).
The documentation must include:

(i) a description of the triggering incident;

(ii) the date and time of the triggering incident;

(iii) the time of the response or responses under paragraph (e), clause (1) or (2);

(iv) whether the response met the resident's needs;

(v) whether the existing policies and response protocols were followed; and

(vi) whether the existing policies and protocols are adequate or need modification.

When no physical presence response is completed for a three-month period, the license
holder's written policies and procedures must require a physical presence response drill to
be conducted for which the effectiveness of the response protocol under paragraph (e),
clause (1) or (2), will be reviewed and documented as required under this clause; and

(5) establish that emergency and nonemergency phone numbers are posted in a prominent
location in a common area of the home where they can be easily observed by a person
responding to an incident who is not otherwise affiliated with the home.

(e) The license holder must document and include in the license application which
response alternative under clause (1) or (2) is in place for responding to situations that
present a serious risk to the health, safety, or rights of residents served by the program:

(1) response alternative (1) requires only the technology to provide an electronic
notification or alert to the license holder that an event is underway that requires a response.
Under this alternative, no more than ten minutes will pass before the license holder will be
physically present on site to respond to the situation; or

(2) response alternative (2) requires the electronic notification and alert system under
alternative (1), but more than ten minutes may pass before the license holder is present on
site to respond to the situation. Under alternative (2), all of the following conditions are
met:

(i) the license holder has a written description of the interactive technological applications
that will assist the license holder in communicating with and assessing the needs related to
the care, health, and safety of the foster care recipients. This interactive technology must
permit the license holder to remotely assess the well being of the resident served by the
program without requiring the initiation of the foster care recipient. Requiring the foster
care recipient to initiate a telephone call does not meet this requirement;

(ii) the license holder documents how the remote license holder is qualified and capable
of meeting the needs of the foster care recipients and assessing foster care recipients' needs
under item (i) during the absence of the license holder on site;

(iii) the license holder maintains written procedures to dispatch emergency response
personnel to the site in the event of an identified emergency; and

(iv) each resident's individualized plan of care, support plan under sections 256B.0913,
subdivision 8; 256B.092, subdivision 1b; 256B.49, subdivision 15; and 256S.10, if required,
or individual resident placement agreement under Minnesota Rules, part 9555.5105, subpart
19, if required, identifies the maximum response time, which may be greater than ten minutes,
for the license holder to be on site for that resident.

(f) Each resident's placement agreement, individual service agreement, and plan must
clearly state that the adult foster care deleted text begin or community residential settingdeleted text end license category is
a program without the presence of a caregiver in the residence during normal sleeping hours;
the protocols in place for responding to situations that present a serious risk to the health,
safety, or rights of residents served by the program under paragraph (e), clause (1) or (2);
and a signed informed consent from each resident served by the program or the person's
legal representative documenting the person's or legal representative's agreement with
placement in the program. If electronic monitoring technology is used in the home, the
informed consent form must also explain the following:

(1) how any electronic monitoring is incorporated into the alternative supervision system;

(2) the backup system for any electronic monitoring in times of electrical outages or
other equipment malfunctions;

(3) how the caregivers or direct support staff are trained on the use of the technology;

(4) the event types and license holder response times established under paragraph (e);

(5) how the license holder protects each resident's privacy related to electronic monitoring
and related to any electronically recorded data generated by the monitoring system. A
resident served by the program may not be removed from a program under this subdivision
for failure to consent to electronic monitoring. The consent form must explain where and
how the electronically recorded data is stored, with whom it will be shared, and how long
it is retained; and

(6) the risks and benefits of the alternative overnight supervision system.

The written explanations under clauses (1) to (6) may be accomplished through
cross-references to other policies and procedures as long as they are explained to the person
giving consent, and the person giving consent is offered a copy.

(g) Nothing in this section requires the applicant or license holder to develop or maintain
separate or duplicative policies, procedures, documentation, consent forms, or individual
plans that may be required for other licensing standards, if the requirements of this section
are incorporated into those documents.

(h) The commissioner may grant variances to the requirements of this section according
to section 245A.04, subdivision 9.

(i) For the purposes of paragraphs (d) through (h), "license holder" has the meaning
under section 245A.02, subdivision 9, and additionally includes all staff, volunteers, and
contractors affiliated with the license holder.

(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to remotely
determine what action the license holder needs to take to protect the well-being of the foster
care recipient.

(k) The commissioner shall evaluate license applications using the requirements in
paragraphs (d) to (f). The commissioner shall provide detailed application forms, including
a checklist of criteria needed for approval.

(l) To be eligible for a license under paragraph (a), the adult foster care deleted text begin or community
residential settingdeleted text end license holder must not have had a conditional license issued under section
245A.06 or any licensing sanction under section 245A.07 during the prior 24 months based
on failure to provide adequate supervision, health care services, or resident safety in the
adult foster care home deleted text begin or community residential settingdeleted text end .

(m) The commissioner shall review an application for an alternative overnight supervision
license within 60 days of receipt of the application. When the commissioner receives an
application that is incomplete because the applicant failed to submit required documents or
that is substantially deficient because the documents submitted do not meet licensing
requirements, the commissioner shall provide the applicant written notice that the application
is incomplete or substantially deficient. In the written notice to the applicant, the
commissioner shall identify documents that are missing or deficient and give the applicant
45 days to resubmit a second application that is substantially complete. An applicant's failure
to submit a substantially complete application after receiving notice from the commissioner
is a basis for license denial under section 245A.05. The commissioner shall complete
subsequent review within 30 days.

(n) Once the application is considered complete under paragraph (m), the commissioner
will approve or deny an application for an alternative overnight supervision license within
60 days.

(o) For the purposes of this subdivision, "supervision" means:

(1) oversight by a caregiver or direct support staff as specified in the individual resident's
place agreement or support plan and awareness of the resident's needs and activities; and

(2) the presence of a caregiver or direct support staff in a residence during normal sleeping
hours, unless a determination has been made and documented in the individual's support
plan that the individual does not require the presence of a caregiver or direct support staff
during normal sleeping hours.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2024.
new text end

Sec. 5.

Minnesota Statutes 2022, section 245D.03, subdivision 1, is amended to read:

Subdivision 1.

Applicability.

(a) The commissioner shall regulate the provision of home
and community-based services to persons with disabilities and persons age 65 and older
pursuant to this chapter. The licensing standards in this chapter govern the provision of
basic support services and intensive support services.

(b) Basic support services provide the level of assistance, supervision, and care that is
necessary to ensure the health and welfare of the person and do not include services that
are specifically directed toward the training, treatment, habilitation, or rehabilitation of the
person. Basic support services include:

(1) in-home and out-of-home respite care services as defined in section 245A.02,
subdivision 15, and under the brain injury, community alternative care, community access
for disability inclusion, developmental disabilities, and elderly waiver plans, excluding
out-of-home respite care provided to children in a family child foster care home licensed
under Minnesota Rules, parts 2960.3000 to 2960.3100, when the child foster care license
holder complies with the requirements under section 245D.06, subdivisions 5, 6, 7, and 8,
or successor provisions; and section 245D.061 or successor provisions, which must be
stipulated in the statement of intended use required under Minnesota Rules, part 2960.3000,
subpart 4;

(2) adult companion services as defined under the brain injury, community access for
disability inclusion, community alternative care, and elderly waiver plans, excluding adult
companion services provided under the Corporation for National and Community Services
Senior Companion Program established under the Domestic Volunteer Service Act of 1973,
Public Law 98-288;

(3) personal support as defined under the developmental disabilities waiver plan;

(4) 24-hour emergency assistance, personal emergency response as defined under the
community access for disability inclusion and developmental disabilities waiver plans;

(5) night supervision services as defined under the brain injury, community access for
disability inclusion, community alternative care, and developmental disabilities waiver
plans;

(6) homemaker services as defined under the community access for disability inclusion,
brain injury, community alternative care, developmental disabilities, and elderly waiver
plans, excluding providers licensed by the Department of Health under chapter 144A and
those providers providing cleaning services only;

(7) individual community living support under section 256S.13; and

(8) individualized home supports services as defined under the brain injury, community
alternative care, and community access for disability inclusion, and developmental disabilities
waiver plans.

(c) Intensive support services provide assistance, supervision, and care that is necessary
to ensure the health and welfare of the person and services specifically directed toward the
training, habilitation, or rehabilitation of the person. Intensive support services include:

(1) intervention services, including:

(i) positive support services as defined under the brain injury and community access for
disability inclusion, community alternative care, and developmental disabilities waiver
plans;

(ii) in-home or out-of-home crisis respite services as defined under the brain injury,
community access for disability inclusion, community alternative care, and developmental
disabilities waiver plans; and

(iii) specialist services as defined under the current brain injury, community access for
disability inclusion, community alternative care, and developmental disabilities waiver
plans;

(2) in-home support services, including:

(i) in-home family support and supported living services as defined under the
developmental disabilities waiver plan;

(ii) independent living services training as defined under the brain injury and community
access for disability inclusion waiver plans;

(iii) semi-independent living services;

(iv) individualized home support with training services as defined under the brain injury,
community alternative care, community access for disability inclusion, and developmental
disabilities waiver plans; and

(v) individualized home support with family training services as defined under the brain
injury, community alternative care, community access for disability inclusion, and
developmental disabilities waiver plans;

(3) residential supports and services, including:

(i) supported living services as defined under the developmental disabilities waiver plan
provided in a family or corporate child foster care residence, a family adult foster care
residence, a community residential setting, or a supervised living facility;

(ii) foster care services as defined in the brain injury, community alternative care, and
community access for disability inclusion waiver plans provided in a family or corporate
child foster care residence, a family adult foster care residence, or a community residential
setting;

(iii) community residential services as defined under the brain injury, community
alternative care, community access for disability inclusion, and developmental disabilities
waiver plans provided in a corporate child foster care residence, a community residential
setting, or a supervised living facility;

(iv) family residential services as defined in the brain injury, community alternative
care, community access for disability inclusion, and developmental disabilities waiver plans
provided in a family child foster care residence or a family adult foster care residence; deleted text begin and
deleted text end

(v) residential services provided to more than four persons with developmental disabilities
in a supervised living facility, including ICFs/DD;new text begin and
new text end

new text begin (vi) life sharing as defined in the brain injury, community alternative care, community
access for disability inclusion, and developmental disabilities waiver plans;
new text end

(4) day services, including:

(i) structured day services as defined under the brain injury waiver plan;

(ii) day services under sections 252.41 to 252.46, and as defined under the brain injury,
community alternative care, community access for disability inclusion, and developmental
disabilities waiver plans;

(iii) day training and habilitation services under sections 252.41 to 252.46, and as defined
under the developmental disabilities waiver plan; and

(iv) prevocational services as defined under the brain injury, community alternative care,
community access for disability inclusion, and developmental disabilities waiver plans; and

(5) employment exploration services as defined under the brain injury, community
alternative care, community access for disability inclusion, and developmental disabilities
waiver plans;

(6) employment development services as defined under the brain injury, community
alternative care, community access for disability inclusion, and developmental disabilities
waiver plans;

(7) employment support services as defined under the brain injury, community alternative
care, community access for disability inclusion, and developmental disabilities waiver plans;
and

(8) integrated community support as defined under the brain injury and community
access for disability inclusion waiver plans beginning January 1, 2021, and community
alternative care and developmental disabilities waiver plans beginning January 1, 2023.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 6.

new text begin [245D.261] COMMUNITY RESIDENTIAL SETTINGS; REMOTE
OVERNIGHT SUPERVISION.
new text end

new text begin Subdivision 1. 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, unless otherwise specified.
new text end

new text begin (b) "Resident" means an adult residing in a community residential setting.
new text end

new text begin (c) "Technology" means:
new text end

new text begin (1) enabling technology, which is a device capable of live two-way communication or
engagement between a resident and direct support staff at a remote location; or
new text end

new text begin (2) monitoring technology, which is the use of equipment to oversee, monitor, and
supervise an individual who receives medical assistance waiver or alternative care services
under section 256B.0913, 256B.092, or 256B.49 or chapter 256S.
new text end

new text begin Subd. 2. new text end

new text begin Documentation of permissible remote overnight supervision. new text end

new text begin A license
holder providing remote overnight supervision in a community residential setting in lieu of
on-site direct support staff must comply with the requirements of this chapter, including
the requirement under section 245D.02, subdivision 33b, paragraph (a), clause (3), that the
absence of direct support staff from the community residential setting while services are
being delivered must be documented in the resident's support plan or support plan addendum.
new text end

new text begin Subd. 3. new text end

new text begin Provider requirements for remote overnight supervision; commissioner
notification. new text end

new text begin (a) A license holder providing remote overnight supervision in a community
residential setting must:
new text end

new text begin (1) use technology;
new text end

new text begin (2) notify the commissioner of the community residential setting's intent to use technology
in lieu of on-site staff. The notification must:
new text end

new text begin (i) indicate a start date for the use of technology; and
new text end

new text begin (ii) attest that all requirements under this section are met and policies required under
subdivision 4 are available upon request;
new text end

new text begin (3) clearly state in each person's support plan addendum that the community residential
setting is a program without the in-person presence of overnight direct support;
new text end

new text begin (4) include with each person's support plan addendum the license holder's protocols for
responding to situations that present a serious risk to the health, safety, or rights of residents
served by the program; and
new text end

new text begin (5) include in each person's support plan addendum the person's maximum permissible
response time as determined by the person's support team.
new text end

new text begin (b) Upon being notified via technology that an incident has occurred that may jeopardize
the health, safety, or rights of a resident, the license holder must document an evaluation
of the need for the physical presence of a staff member. If a physical presence is needed, a
staff person, volunteer, or contractor must be on site to respond to the situation within the
resident's maximum permissible response time.
new text end

new text begin (c) A license holder must notify the commissioner if remote overnight supervision
technology will no longer be used by the license holder.
new text end

new text begin (d) Upon receipt of notification of use of remote overnight supervision or discontinuation
of use of remote overnight supervision by a license holder, the commissioner shall notify
the county licensing agency and update the license.
new text end

new text begin Subd. 4. new text end

new text begin Required policies and procedures for remote overnight supervision. new text end

new text begin (a) A
license holder providing remote overnight supervision must have policies and procedures
that:
new text end

new text begin (1) protect the residents' health, safety, and rights;
new text end

new text begin (2) explain the discharge process if a person served by the program requires in-person
supervision or other services that cannot be provided by the license holder due to the limited
hours that direct support staff are on site, including information explaining that if a resident
provides informed consent to the use of monitoring technology but later revokes their
consent, the resident may be subject to a service termination in accordance with section
245D.10, subdivision 3a;
new text end

new text begin (3) ensure that services may not be terminated for any person or resident currently served
by the program and receiving in-person services solely because the person declines to
provide informed consent to the initial change to the use of monitoring technology as required
under subdivision 5;
new text end

new text begin (4) explain the backup system for technology in times of electrical outages or other
equipment malfunctions;
new text end

new text begin (5) explain how the license holder trains the direct support staff on the use of the
technology; and
new text end

new text begin (6) establish a plan for dispatching emergency response personnel to the site in the event
of an identified emergency.
new text end

new text begin (b) Nothing in this section requires the license holder to develop or maintain separate
or duplicative policies, procedures, documentation, consent forms, or individual plans that
may be required for other licensing standards if the requirements of this section are
incorporated into those documents.
new text end

new text begin (c) When no physical presence response is completed for a three-month period, the
license holder must conduct a physical presence response drill. The effectiveness of the
response protocol must be reviewed and documented.
new text end

new text begin Subd. 5. new text end

new text begin Consent to use of monitoring technology. new text end

new text begin If a license holder uses monitoring
technology in a community residential setting, the license holder must obtain a signed
informed consent form from each resident served by the program or the resident's legal
representative documenting the resident's or legal representative's agreement to use of the
specific monitoring technology used in the setting. The informed consent form documenting
this agreement must also explain:
new text end

new text begin (1) how the license holder uses monitoring technology to provide remote supervision;
new text end

new text begin (2) the risks and benefits of using monitoring technology;
new text end

new text begin (3) how the license holder protects each resident's privacy while monitoring technology
is being used in the setting; and
new text end

new text begin (4) how the license holder protects each resident's privacy when the monitoring
technology system electronically records personally identifying data.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2024.
new text end

Sec. 7.

new text begin [252.54] STATEWIDE DISABILITY EMPLOYMENT TECHNICAL
ASSISTANCE CENTER.
new text end

new text begin The commissioner must establish a statewide technical assistance center to provide
resources and assistance to programs, people, and families to support individuals with
disabilities to achieve meaningful and competitive employment in integrated settings. Duties
of the technical assistance center include but are not limited to:
new text end

new text begin (1) offering provider business model transition support to ensure ongoing access to
employment and day services;
new text end

new text begin (2) identifying and providing training on innovative, promising, and emerging practices;
new text end

new text begin (3) maintaining a resource clearinghouse to serve as a hub of information to ensure
programs, people, and families have access to high-quality materials and information;
new text end

new text begin (4) fostering innovation and actionable progress by providing direct technical assistance
to programs; and
new text end

new text begin (5) cultivating partnerships and mentorship across support programs, people, and families
in the exploration of and successful transition to competitive, integrated employment.
new text end

Sec. 8.

new text begin [252.55] LEAD AGENCY EMPLOYMENT FIRST CAPACITY BUILDING
GRANTS.
new text end

new text begin The commissioner shall establish a grant program to expand lead agency capacity to
support people with disabilities to contemplate, explore, and maintain competitive, integrated
employment options. Allowable uses of money include:
new text end

new text begin (1) enhancing resources and staffing to support people and families in understanding
employment options and navigating service options;
new text end

new text begin (2) implementing and testing innovative approaches to better support people with
disabilities and their families in achieving competitive, integrated employment; and
new text end

new text begin (3) other activities approved by the commissioner.
new text end

Sec. 9.

Minnesota Statutes 2022, section 256.01, subdivision 19, is amended to read:

Subd. 19.

Grants for deleted text begin case managementdeleted text end new text begin supportivenew text end services to persons with HIV or
AIDS.

The commissioner may award grants to eligible vendors for the development,
implementation, and evaluation of deleted text begin case managementdeleted text end new text begin supportivenew text end services for individuals
infected with the human immunodeficiency virus. HIV/AIDS deleted text begin case managementdeleted text end new text begin supportivenew text end
services will be provided to increase access to cost effective health care services, to reduce
the risk of HIV transmission, to ensure that basic client needs are met, and to increase client
access to needed community supports or services.

Sec. 10.

new text begin [256.4764] LONG-TERM SERVICES AND SUPPORTS WORKFORCE
INCENTIVE GRANTS.
new text end

new text begin Subdivision 1. new text end

new text begin Grant program established. new text end

new text begin The commissioner of human services shall
establish grants for long-term services and supports providers and facilities to assist with
recruiting and retaining direct support professionals.
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.
new text end

new text begin (b) "Commissioner" means the commissioner of human services.
new text end

new text begin (c) "Eligible employer" means an organization enrolled in a Minnesota health care
program that is:
new text end

new text begin (1) a provider of home and community-based services under Minnesota Statutes, chapter
245D;
new text end

new text begin (2) a facility certified as an intermediate care facility for persons with developmental
disabilities;
new text end

new text begin (3) a nursing facility under section 256R.02, subdivision 33;
new text end

new text begin (4) a provider of personal care assistance services under section 256B.0659;
new text end

new text begin (5) a provider of community first services and supports under section 256B.85;
new text end

new text begin (6) a provider of early intensive developmental and behavioral intervention services
under section 256B.0949;
new text end

new text begin (7) a provider of home care services as defined under section 256B.0651, subdivision
1, paragraph (d);
new text end

new text begin (8) an eligible financial management services provider serving people through
consumer-directed community supports under chapter 256S and sections 256B.092 and
256B.49, or consumer support grants under section 256.476; or
new text end

new text begin (9) a provider of customized living services as defined in section 256S.02.
new text end

new text begin (d) "Eligible worker" means a worker who earns $30 per hour or less and is currently
employed or recruited to be employed by an eligible employer.
new text end

new text begin Subd. 3. new text end

new text begin Allowable uses of grant money. new text end

new text begin (a) Grantees must use grant money to provide
payments to eligible workers for the following purposes:
new text end

new text begin (1) retention, recruitment, and incentive payments;
new text end

new text begin (2) postsecondary loan and tuition payments;
new text end

new text begin (3) child care costs;
new text end

new text begin (4) transportation-related costs;
new text end

new text begin (5) personal care assistant background study costs; and
new text end

new text begin (6) other costs associated with retaining and recruiting workers, as approved by the
commissioner.
new text end

new text begin (b) Eligible workers may receive cumulative payments up to $1,000 per year from the
workforce incentive grant account and all other state money intended for the same purpose.
new text end

new text begin (c) The commissioner must develop a grant cycle distribution plan that allows for
equitable distribution of money among eligible employers. The commissioner's determination
of the grant awards and amounts is final and is not subject to appeal.
new text end

new text begin Subd. 4. new text end

new text begin Attestation. new text end

new text begin As a condition of obtaining grant payments under this section, an
eligible employer must attest and agree to the following:
new text end

new text begin (1) the employer is an eligible employer;
new text end

new text begin (2) the total number of eligible employees;
new text end

new text begin (3) the employer will distribute the entire value of the grant to eligible workers allowed
under this section;
new text end

new text begin (4) the employer will create and maintain records under subdivision 6;
new text end

new text begin (5) the employer will not use the money appropriated under this section for any purpose
other than the purposes permitted under this section; and
new text end

new text begin (6) the entire value of any grant amounts will be distributed to eligible workers identified
by the employer.
new text end

new text begin Subd. 5. new text end

new text begin Distribution plan; report. new text end

new text begin (a) Each grantee shall prepare, and upon request
submit to the commissioner, a distribution plan that specifies the amount of money the
grantee expects to receive and how that money will be distributed for recruitment and
retention purposes for eligible employees. Within 60 days of receiving the grant, the grantee
must post the distribution plan and leave it posted for a period of at least six months in an
area of the grantee's operation to which all direct support professionals have access.
new text end

new text begin (b) Within 12 months of receiving a grant under this section, each grantee that receives
a grant shall submit a report to the commissioner that includes the following information:
new text end

new text begin (1) a description of how grant money was distributed to eligible employees; and
new text end

new text begin (2) the total dollar amount distributed.
new text end

new text begin (c) Failure to submit the report under paragraph (b) may result in recoupment of grant
money.
new text end

new text begin Subd. 6. new text end

new text begin Audits and recoupment. new text end

new text begin (a) The commissioner may perform an audit under
this section up to six years after a grant is awarded to ensure:
new text end

new text begin (1) the grantee used the money solely for allowable purposes under subdivision 3;
new text end

new text begin (2) the grantee was truthful when making attestations under subdivision 4; and
new text end

new text begin (3) the grantee 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 grant money for purposes not
authorized under this section, the commissioner must treat any amount used for a purpose
not authorized under this section as an overpayment. The commissioner must recover any
overpayment.
new text end

new text begin Subd. 7. new text end

new text begin Grants not to be considered income. new text end

new text begin (a) Notwithstanding any law to the
contrary, grant awards under this section must not be considered income, assets, or personal
property for purposes of determining eligibility or recertifying eligibility for:
new text end

new text begin (1) child care assistance programs under chapter 119B;
new text end

new text begin (2) general assistance, Minnesota supplemental aid, and food support under chapter
256D;
new text end

new text begin (3) housing support under chapter 256I;
new text end

new text begin (4) the Minnesota family investment program and diversionary work program under
chapter 256J; and
new text end

new text begin (5) economic assistance programs under chapter 256P.
new text end

new text begin (b) The commissioner must not consider grant awards under this section as income or
assets under section 256B.056, subdivision 1a, paragraph (a), 3, or 3c, or for persons with
eligibility determined under section 256B.057, subdivision 3, 3a, 3b, 4, or 9.
new text end

new text begin Subd. 8. new text end

new text begin Income tax subtractions. new text end

new text begin (a) For the purposes of this section, "subtraction"
has the meaning given in section 290.0132, subdivision 1, and the rules in that subdivision
apply for this section. The definitions in section 290.01 apply to this section.
new text end

new text begin (b) The amount of a payment received under this section is a subtraction.
new text end

new text begin (c) Payments under this section and Laws 2021, First Special Session chapter 7, article
17, section 20, as amended, are excluded from income as defined in sections 290.0674,
subdivision 2a, and 290A.03, subdivision 3.
new text end

new text begin Subd. 9. new text end

new text begin Account created. new text end

new text begin A workforce incentive grant account is created in the special
revenue fund. Appropriations made for grants and payments administered under this section
may be transferred to this account. Amounts in the account are appropriated to the
commissioner of human services. Appropriations transferred to this account cancel and are
returned to the fund of origin on the date the original appropriations would have lapsed.
new text end

new text begin Subd. 10. new text end

new text begin Nursing facilities; applicable credit. new text end

new text begin The commissioner must treat grant
payments awarded under this section as an applicable credit as defined under section 256R.10,
subdivision 6.
new text end

new text begin Subd. 11. new text end

new text begin Self-directed services workforce. new text end

new text begin Payments administered under this section,
including reimbursements for paid family medical leave premiums, do not constitute a
change in a term or condition for individual providers as defined in section 256B.0711 in
covered programs and are not subject to the state's obligation to meet and negotiate under
chapter 179A.
new text end

Sec. 11.

new text begin [256.4773] TECHNOLOGY FOR HOME GRANT.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The commissioner must establish a technology for home
grant program that provides assistive technology consultations and resources for people
with disabilities who want to stay in their own home, move to their own home, or remain
in a less restrictive residential setting. The grant program may be administered using a team
approach that allows multiple professionals to assess and meet a person's assistive technology
needs. The team may include but is not limited to occupational therapists, physical therapists,
speech therapists, nurses, and engineers.
new text end

new text begin Subd. 2. new text end

new text begin Eligible applicants. new text end

new text begin An eligible applicant is a person who uses or is eligible
for home care services under section 256B.0651, home and community-based services under
section 256B.092 or 256B.49, personal care assistance under section 256B.0659, or
community first services and supports under section 256B.85, and who meets one of the
following conditions:
new text end

new text begin (1) lives in the applicant's own home and may benefit from assistive technology for
safety, communication, community engagement, or independence;
new text end

new text begin (2) is currently seeking to live in the applicant's own home and needs assistive technology
to meet that goal; or
new text end

new text begin (3) resides in a residential setting under section 256B.4914, subdivision 3, and is seeking
to reduce reliance on paid staff to live more independently in the setting.
new text end

new text begin Subd. 3. new text end

new text begin Allowable grant activities. new text end

new text begin The technology for home grant program must
provide at-home, in-person assistive technology consultation and technical assistance to
help people with disabilities live more independently. Allowable activities include but are
not limited to:
new text end

new text begin (1) consultations in people's homes, workplaces, or community locations;
new text end

new text begin (2) connecting people to resources to help them live in their own homes, transition to
their own homes, or live more independently in residential settings;
new text end

new text begin (3) conducting training for and set up and installation of assistive technology; and
new text end

new text begin (4) participating on a person's care team to develop a plan to ensure assistive technology
goals are met.
new text end

new text begin Subd. 4. new text end

new text begin Data collection and outcomes. new text end

new text begin Grantees must provide data summaries to the
commissioner for the purpose of evaluating the effectiveness of the grant program. The
commissioner must identify outcome measures to evaluate program activities to assess
whether the grant programs help people transition to or remain in the least restrictive setting.
new text end

Sec. 12.

Minnesota Statutes 2022, section 256B.0659, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

(a) For the purposes of this section, the terms defined in
paragraphs (b) to (r) have the meanings given unless otherwise provided in text.

(b) "Activities of daily living" means grooming, dressing, bathing, transferring, mobility,
positioning, eating, and toileting.

(c) "Behavior," effective January 1, 2010, means a category to determine the home care
rating and is based on the criteria found in this section. "Level I behavior" means physical
aggression deleted text begin towardsdeleted text end new text begin towardnew text end self, others, or destruction of property that requires the immediate
response of another person.

(d) "Complex health-related needs," effective January 1, 2010, means a category to
determine the home care rating and is based on the criteria found in this section.

(e) "Critical activities of daily living," effective January 1, 2010, means transferring,
mobility, eating, and toileting.

(f) "Dependency in activities of daily living" means a person requires assistance to begin
and complete one or more of the activities of daily living.

(g) "Extended personal care assistance service" means personal care assistance services
included in a service plan under one of the home and community-based services waivers
authorized under chapter 256S and sections 256B.092, subdivision 5, and 256B.49, which
exceed the amount, duration, and frequency of the state plan personal care assistance services
for participants who:

(1) need assistance provided periodically during a week, but less than daily will not be
able to remain in their homes without the assistance, and other replacement services are
more expensive or are not available when personal care assistance services are to be reduced;
or

(2) need additional personal care assistance services beyond the amount authorized by
the state plan personal care assistance assessment in order to ensure that their safety, health,
and welfare are provided for in their homes.

(h) "Health-related procedures and tasks" means procedures and tasks that can be
delegated or assigned by a licensed health care professional under state law to be performed
by a personal care assistant.

(i) "Instrumental activities of daily living" means activities to include meal planning and
preparation; basic assistance with paying bills; shopping for food, clothing, and other
essential items; performing household tasks integral to the personal care assistance services;
communication by telephone and other media; and traveling, including to medical
appointments and to participate in the community.new text begin For purposes of this paragraph, traveling
includes driving and accompanying the recipient in the recipient's chosen mode of
transportation and according to the recipient's personal care assistance care plan.
new text end

(j) "Managing employee" has the same definition as Code of Federal Regulations, title
42, section 455.

(k) "Qualified professional" means a professional providing supervision of personal care
assistance services and staff as defined in section 256B.0625, subdivision 19c.

(l) "Personal care assistance provider agency" means a medical assistance enrolled
provider that provides or assists with providing personal care assistance services and includes
a personal care assistance provider organization, personal care assistance choice agency,
class A licensed nursing agency, and Medicare-certified home health agency.

(m) "Personal care assistant" or "PCA" means an individual employed by a personal
care assistance agency who provides personal care assistance services.

(n) "Personal care assistance care plan" means a written description of personal care
assistance services developed by the personal care assistance provider according to the
service plan.

(o) "Responsible party" means an individual who is capable of providing the support
necessary to assist the recipient to live in the community.

(p) "Self-administered medication" means medication taken orally, by injection, nebulizer,
or insertion, or applied topically without the need for assistance.

(q) "Service plan" means a written summary of the assessment and description of the
services needed by the recipient.

(r) "Wages and benefits" means wages and salaries, the employer's share of FICA taxes,
Medicare taxes, state and federal unemployment taxes, workers' compensation, mileage
reimbursement, health and dental insurance, life insurance, disability insurance, long-term
care insurance, uniform allowance, and contributions to employee retirement accounts.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective 90 days following federal approval. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

Sec. 13.

Minnesota Statutes 2022, section 256B.0659, subdivision 12, is amended to read:

Subd. 12.

Documentation of personal care assistance services provided.

(a) Personal
care assistance services for a recipient must be documented daily by each personal care
assistant, on a time sheet form approved by the commissioner. All documentation may be
web-based, electronic, or paper documentation. The completed form must be submitted on
a monthly basis to the provider and kept in the recipient's health record.

(b) The activity documentation must correspond to the personal care assistance care plan
and be reviewed by the qualified professional.

(c) The personal care assistant time sheet must be on a form approved by the
commissioner documenting time the personal care assistant provides services in the home.
The following criteria must be included in the time sheet:

(1) full name of personal care assistant and individual provider number;

(2) provider name and telephone numbers;

(3) full name of recipient and either the recipient's medical assistance identification
number or date of birth;

(4) consecutive dates, including month, day, and year, and arrival and departure times
with a.m. or p.m. notations;

(5) signatures of recipient or the responsible party;

(6) personal signature of the personal care assistant;

(7) any shared care provided, if applicable;

(8) a statement that it is a federal crime to provide false information on personal care
service billings for medical assistance payments; deleted text begin and
deleted text end

(9) dates and location of recipient stays in a hospital, care facility, or incarcerationnew text begin ; and
new text end

new text begin (10) any time spent traveling, as described in subdivision 1, paragraph (i), including
start and stop times with a.m. and p.m. designations, the origination site, and the destination
sitenew text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective 90 days following federal approval. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

Sec. 14.

Minnesota Statutes 2022, section 256B.0659, is amended by adding a subdivision
to read:

new text begin Subd. 14a. new text end

new text begin Qualified professional; remote supervision. new text end

new text begin (a) For recipients with chronic
health conditions or severely compromised immune systems, a qualified professional may
conduct the supervision required under subdivision 14 via two-way interactive audio and
visual telecommunication if, at the recipient's request, the recipient's primary health care
provider:
new text end

new text begin (1) determines that remote supervision is appropriate; and
new text end

new text begin (2) documents the determination under clause (1) in a statement of need or other document
that is subsequently included in the recipient's personal care assistance care plan.
new text end

new text begin (b) Notwithstanding any other provision of law, a care plan developed or amended via
remote supervision may be executed by electronic signature.
new text end

new text begin (c) A personal care assistance provider agency must not conduct its first supervisory
visit for a recipient or complete its initial personal care assistance care plan via a remote
visit.
new text end

new text begin (d) A recipient may request to return to in-person supervisory visits at any time.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 15.

Minnesota Statutes 2022, section 256B.0659, subdivision 19, is amended to read:

Subd. 19.

Personal care assistance choice option; qualifications; duties.

(a) Under
personal care assistance choice, the recipient or responsible party shall:

(1) recruit, hire, schedule, and terminate personal care assistants according to the terms
of the written agreement required under subdivision 20, paragraph (a);

(2) develop a personal care assistance care plan based on the assessed needs and
addressing the health and safety of the recipient with the assistance of a qualified professional
as needed;

(3) orient and train the personal care assistant with assistance as needed from the qualified
professional;

(4) supervise and evaluate the personal care assistant with the qualified professional,
who is required to visit the recipient at least every 180 days;

(5) monitor and verify in writing and report to the personal care assistance choice agency
the number of hours worked by the personal care assistant and the qualified professional;

(6) engage in an annual reassessment as required in subdivision 3a to determine
continuing eligibility and service authorization; deleted text begin and
deleted text end

(7) use the same personal care assistance choice provider agency if shared personal
assistance care is being useddeleted text begin .deleted text end new text begin ; and
new text end

new text begin (8) ensure that a personal care assistant driving the recipient under subdivision 1,
paragraph (i), has a valid driver's license and the vehicle used is registered and insured
according to Minnesota law.
new text end

(b) The personal care assistance choice provider agency shall:

(1) meet all personal care assistance provider agency standards;

(2) enter into a written agreement with the recipient, responsible party, and personal
care assistants;

(3) not be related as a parent, child, sibling, or spouse to the recipient or the personal
care assistant; and

(4) ensure arm's-length transactions without undue influence or coercion with the recipient
and personal care assistant.

(1) be the employer of the personal care assistant and the qualified professional for
employment law and related regulations including but not limited to purchasing and
maintaining workers' compensation, unemployment insurance, surety and fidelity bonds,
and liability insurance, and submit any or all necessary documentation including but not
limited to workers' compensation, unemployment insurance, and labor market data required
under section 256B.4912, subdivision 1a;

(2) bill the medical assistance program for personal care assistance services and qualified
professional services;

(3) request and complete background studies that comply with the requirements for
personal care assistants and qualified professionals;

(4) pay the personal care assistant and qualified professional based on actual hours of
services provided;

(5) withhold and pay all applicable federal and state taxes;

(6) verify and keep records of hours worked by the personal care assistant and qualified
professional;

(7) make the arrangements and pay taxes and other benefits, if any, and comply with
any legal requirements for a Minnesota employer;

(8) enroll in the medical assistance program as a personal care assistance choice agency;
and

(9) enter into a written agreement as specified in subdivision 20 before services are
provided.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective 90 days following federal approval. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

Sec. 16.

Minnesota Statutes 2022, section 256B.0659, subdivision 24, is amended to read:

Subd. 24.

Personal care assistance provider agency; general duties.

A personal care
assistance provider agency shall:

(1) enroll as a Medicaid provider meeting all provider standards, including completion
of the required provider training;

(2) comply with general medical assistance coverage requirements;

(3) demonstrate compliance with law and policies of the personal care assistance program
to be determined by the commissioner;

(4) comply with background study requirements;

(5) verify and keep records of hours worked by the personal care assistant and qualified
professional;

(6) not engage in any agency-initiated direct contact or marketing in person, by phone,
or other electronic means to potential recipients, guardians, or family members;

(7) pay the personal care assistant and qualified professional based on actual hours of
services provided;

(8) withhold and pay all applicable federal and state taxes;

(9) document that the agency uses a minimum of 72.5 percent of the revenue generated
by the medical assistance rate for personal care assistance services for employee personal
care assistant wages and benefits. The revenue generated by the qualified professional and
the reasonable costs associated with the qualified professional shall not be used in making
this calculation;

(10) make the arrangements and pay unemployment insurance, taxes, workers'
compensation, liability insurance, and other benefits, if any;

(11) enter into a written agreement under subdivision 20 before services are provided;

(12) report suspected neglect and abuse to the common entry point according to section
256B.0651;

(13) provide the recipient with a copy of the home care bill of rights at start of service;

(14) request reassessments at least 60 days prior to the end of the current authorization
for personal care assistance services, on forms provided by the commissioner;

(15) comply with the labor market reporting requirements described in section 256B.4912,
subdivision 1a; deleted text begin and
deleted text end

(16) document that the agency uses the additional revenue due to the enhanced rate under
subdivision 17a for the wages and benefits of the PCAs whose services meet the requirements
under subdivision 11, paragraph (d)new text begin ; and
new text end

new text begin (17) ensure that a personal care assistant driving a recipient under subdivision 1,
paragraph (i), has a valid driver's license and the vehicle used is registered and insured
according to Minnesota lawnew text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective 90 days following federal approval. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

Sec. 17.

Minnesota Statutes 2022, section 256B.0911, subdivision 13, is amended to read:

Subd. 13.

MnCHOICES assessor qualifications, training, and certification.

(a) The
commissioner shall develop and implement a curriculum and an assessor certification
process.

(b) MnCHOICES certified assessors must:

(1) either have a bachelor's degree in social work, nursing with a public health nursing
certificate, or other closely related field deleted text begin with at least one year of home and community-based
experiencedeleted text end or be a registered nurse with at least two years of home and community-based
experience; and

(2) have received training and certification specific to assessment and consultation for
long-term care services in the state.

(c) Certified assessors shall demonstrate best practices in assessment and support
planning, including person-centered planning principles, and have a common set of skills
that ensures consistency and equitable access to services statewide.

(d) Certified assessors must be recertified every three years.

Sec. 18.

Minnesota Statutes 2022, section 256B.092, subdivision 1a, is amended to read:

Subd. 1a.

Case management services.

(a) Each recipient of a home and community-based
waiver shall be provided case management services by qualified vendors as described in
the federally approved waiver application.

(b) Case management service activities provided to or arranged for a person include:

(1) development of the person-centered support plan under subdivision 1b;

(2) informing the individual or the individual's legal guardian or conservator, or parent
if the person is a minor, of service options, including all service options available under the
waiver plan;

(3) consulting with relevant medical experts or service providers;

(4) assisting the person in the identification of potential providers of chosen services,
including:

(i) providers of services provided in a non-disability-specific setting;

(ii) employment service providers;

(iii) providers of services provided in settings that are not controlled by a provider; and

(iv) providers of financial management services;

(5) assisting the person to access services and assisting in appeals under section 256.045;

(6) coordination of services, if coordination is not provided by another service provider;

(7) evaluation and monitoring of the services identified in the support plan, which must
incorporate at least one annual face-to-face visit by the case manager with each person; and

(8) reviewing support plans and providing the lead agency with recommendations for
service authorization based upon the individual's needs identified in the support plan.

(c) Case management service activities that are provided to the person with a
developmental disability shall be provided directly by county agencies or under contract.
If a county agency contracts for case management services, the county agency must provide
each recipient of home and community-based services who is receiving contracted case
management services with the contact information the recipient may use to file a grievance
with the county agency about the quality of the contracted services the recipient is receiving
from a county-contracted case manager. Case management services must be provided by a
public or private agency that is enrolled as a medical assistance provider determined by the
commissioner to meet all of the requirements in the approved federal waiver plans. Case
management services must not be provided to a recipient by a private agency that has a
financial interest in the provision of any other services included in the recipient's support
plan. For purposes of this section, "private agency" means any agency that is not identified
as a lead agency under section 256B.0911, subdivision 10.

(d) Case managers are responsible for service provisions listed in paragraphs (a) and
(b). Case managers shall collaborate with consumers, families, legal representatives, and
relevant medical experts and service providers in the development and annual review of the
person-centered support plan and habilitation plan.

(e) For persons who need a positive support transition plan as required in chapter 245D,
the case manager shall participate in the development and ongoing evaluation of the plan
with the expanded support team. At least quarterly, the case manager, in consultation with
the expanded support team, shall evaluate the effectiveness of the plan based on progress
evaluation data submitted by the licensed provider to the case manager. The evaluation must
identify whether the plan has been developed and implemented in a manner to achieve the
following within the required timelines:

(1) phasing out the use of prohibited procedures;

(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's
timeline; and

(3) accomplishment of identified outcomes.

If adequate progress is not being made, the case manager shall consult with the person's
expanded support team to identify needed modifications and whether additional professional
support is required to provide consultation.

(f) The Department of Human Services shall offer ongoing education in case management
to case managers. Case managers shall receive no less than deleted text begin tendeleted text end new text begin 20new text end hours of case management
education and disability-related training each year. The education and training must include
person-centered planningnew text begin , informed choice, cultural competency, employment planning,
community living planning, self-direction options, and use of technology supportsnew text end . new text begin By
August 1, 2024, all case managers must complete an employment support training course
identified by the commissioner of human services. For case managers hired after August
1, 2024, this training must be completed within the first six months of providing case
management services.new text end For the purposes of this section, "person-centered planning" or
"person-centered" has the meaning given in section 256B.0911, subdivision 10.new text begin Case
managers must document completion of training in a system identified by the commissioner.
new text end

Sec. 19.

Minnesota Statutes 2022, section 256B.0949, subdivision 15, is amended to read:

Subd. 15.

EIDBI provider qualifications.

(a) A QSP must be employed by an agency
and be:

(1) a licensed mental health professional who has at least 2,000 hours of supervised
clinical experience or training in examining or treating people with ASD or a related condition
or equivalent documented coursework at the graduate level by an accredited university in
ASD diagnostics, ASD developmental and behavioral treatment strategies, and typical child
development; or

(2) a developmental or behavioral pediatrician who has at least 2,000 hours of supervised
clinical experience or training in examining or treating people with ASD or a related condition
or equivalent documented coursework at the graduate level by an accredited university in
the areas of ASD diagnostics, ASD developmental and behavioral treatment strategies, and
typical child development.

(b) A level I treatment provider must be employed by an agency and:

(1) have at least 2,000 hours of supervised clinical experience or training in examining
or treating people with ASD or a related condition or equivalent documented coursework
at the graduate level by an accredited university in ASD diagnostics, ASD developmental
and behavioral treatment strategies, and typical child development or an equivalent
combination of documented coursework or hours of experience; and

(2) have or be at least one of the following:

(i) a master's degree in behavioral health or child development or related fields including,
but not limited to, mental health, special education, social work, psychology, speech
pathology, or occupational therapy from an accredited college or university;

(ii) a bachelor's degree in a behavioral health, child development, or related field
including, but not limited to, mental health, special education, social work, psychology,
speech pathology, or occupational therapy, from an accredited college or university, and
advanced certification in a treatment modality recognized by the department;

(iii) a board-certified behavior analyst; or

(iv) a board-certified assistant behavior analyst with 4,000 hours of supervised clinical
experience that meets all registration, supervision, and continuing education requirements
of the certification.

(1) a person who has a bachelor's degree from an accredited college or university in a
behavioral or child development science or related field including, but not limited to, mental
health, special education, social work, psychology, speech pathology, or occupational
therapy; and meets at least one of the following:

(i) has at least 1,000 hours of supervised clinical experience or training in examining or
treating people with ASD or a related condition or equivalent documented coursework at
the graduate level by an accredited university in ASD diagnostics, ASD developmental and
behavioral treatment strategies, and typical child development or a combination of
coursework or hours of experience;

(ii) has certification as a board-certified assistant behavior analyst from the Behavior
Analyst Certification Board;

(iii) is a registered behavior technician as defined by the Behavior Analyst Certification
Board; or

(iv) is certified in one of the other treatment modalities recognized by the department;
or

(2) a person who has:

(i) an associate's degree in a behavioral or child development science or related field
including, but not limited to, mental health, special education, social work, psychology,
speech pathology, or occupational therapy from an accredited college or university; and

(ii) at least 2,000 hours of supervised clinical experience in delivering treatment to people
with ASD or a related condition. Hours worked as a mental health behavioral aide or level
III treatment provider may be included in the required hours of experience; or

(3) a person who has at least 4,000 hours of supervised clinical experience in delivering
treatment to people with ASD or a related condition. Hours worked as a mental health
behavioral aide or level III treatment provider may be included in the required hours of
experience; or

(4) a person who is a graduate student in a behavioral science, child development science,
or related field and is receiving clinical supervision by a QSP affiliated with an agency to
meet the clinical training requirements for experience and training with people with ASD
or a related condition; or

(5) a person who is at least 18 years of age and who:

(i) is fluent in a non-English languagenew text begin or is an individual certified by a Tribal Nationnew text end ;

(ii) completed the level III EIDBI training requirements; and

(iii) receives observation and direction from a QSP or level I treatment provider at least
once a week until the person meets 1,000 hours of supervised clinical experience.

(d) A level III treatment provider must be employed by an agency, have completed the
level III training requirement, be at least 18 years of age, and have at least one of the
following:

(1) a high school diploma or commissioner of education-selected high school equivalency
certification;

(2) fluency in a non-English languagenew text begin or Tribal Nation certificationnew text end ;

(3) one year of experience as a primary personal care assistant, community health worker,
waiver service provider, or special education assistant to a person with ASD or a related
condition within the previous five years; or

(4) completion of all required EIDBI training within six months of employment.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2024, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 20.

Minnesota Statutes 2022, section 256B.49, subdivision 13, is amended to read:

Subd. 13.

Case management.

(a) Each recipient of a home and community-based waiver
shall be provided case management services by qualified vendors as described in the federally
approved waiver application. The case management service activities provided must include:

(1) finalizing the person-centered written support plan within the timelines established
by the commissioner and section 256B.0911, subdivision 29;

(2) informing the recipient or the recipient's legal guardian or conservator of service
options, including all service options available under the waiver plans;

(3) assisting the recipient in the identification of potential service providers of chosen
services, including:

(i) available options for case management service and providers;

(ii) providers of services provided in a non-disability-specific setting;

(iii) employment service providers;

(iv) providers of services provided in settings that are not community residential settings;
and

(v) providers of financial management services;

(4) assisting the recipient to access services and assisting with appeals under section
256.045; and

(5) coordinating, evaluating, and monitoring of the services identified in the service
plan.

(b) The case manager may delegate certain aspects of the case management service
activities to another individual provided there is oversight by the case manager. The case
manager may not delegate those aspects which require professional judgment including:

(1) finalizing the person-centered support plan;

(2) ongoing assessment and monitoring of the person's needs and adequacy of the
approved person-centered support plan; and

(3) adjustments to the person-centered support plan.

(c) Case management services must be provided by a public or private agency that is
enrolled as a medical assistance provider determined by the commissioner to meet all of
the requirements in the approved federal waiver plans. Case management services must not
be provided to a recipient by a private agency that has any financial interest in the provision
of any other services included in the recipient's support plan. For purposes of this section,
"private agency" means any agency that is not identified as a lead agency under section
256B.0911, subdivision 10.

(d) For persons who need a positive support transition plan as required in chapter 245D,
the case manager shall participate in the development and ongoing evaluation of the plan
with the expanded support team. At least quarterly, the case manager, in consultation with
the expanded support team, shall evaluate the effectiveness of the plan based on progress
evaluation data submitted by the licensed provider to the case manager. The evaluation must
identify whether the plan has been developed and implemented in a manner to achieve the
following within the required timelines:

(1) phasing out the use of prohibited procedures;

(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's
timeline; and

(3) accomplishment of identified outcomes.

(e) The Department of Human Services shall offer ongoing education in case management
to case managers. Case managers shall receive no less than deleted text begin tendeleted text end new text begin 20new text end hours of case management
education and disability-related training each year. The education and training must include
person-centered planningnew text begin , informed choice, cultural competency, employment planning,
community living planning, self-direction options, and use of technology supportsnew text end . new text begin By
August 1, 2024, all case managers must complete an employment support training course
identified by the commissioner of human services. For case managers hired after August
1, 2024, this training must be completed within the first six months of providing case
management services.new text end For the purposes of this section, "person-centered planning" or
"person-centered" has the meaning given in section 256B.0911, subdivision 10.new text begin Case
managers shall document completion of training in a system identified by the commissioner.
new text end

Sec. 21.

Minnesota Statutes 2022, section 256B.4905, subdivision 4a, is amended to read:

Subd. 4a.

Informed choice in employment policy.

It is the policy of this state that
working-age individuals who have disabilities:

(1) can work and achieve competitive integrated employment with appropriate services
and supports, as needed;

(2) make informed choices about their postsecondary education, work, and career goals;
deleted text begin and
deleted text end

(3) will be offered the opportunity to make an informed choice, at least annually, to
pursue postsecondary education or to work and earn a competitive wagedeleted text begin .deleted text end new text begin ; and
new text end

new text begin (4) will be offered benefits planning assistance and supports to understand available
work incentive programs and to understand the impact of work on benefits.
new text end

Sec. 22.

new text begin [256B.4906] SUBMINIMUM WAGES IN HOME AND
COMMUNITY-BASED SERVICES REPORTING.
new text end

new text begin (a) A provider of home and community-based services for people with developmental
disabilities under section 256B.092 or home and community-based services for people with
disabilities under section 256B.49 that holds a credential listed in clause (1) or (2) as of
August 1, 2023, must submit to the commissioner of human services data on individuals
who are currently being paid subminimum wages or were being paid subminimum wages
by the provider organization as of August 1, 2023:
new text end

new text begin (1) a certificate through the United States Department of Labor under United States
Code, title 29, section 214(c), of the Fair Labor Standards Act authorizing the payment of
subminimum wages to workers with disabilities; or
new text end

new text begin (2) a permit by the Minnesota Department of Labor and Industry under section 177.28.
new text end

new text begin (b) The report required under paragraph (a) must include the following data about each
individual being paid subminimum wages:
new text end

new text begin (1) name;
new text end

new text begin (2) date of birth;
new text end

new text begin (3) identified race and ethnicity;
new text end

new text begin (4) disability type;
new text end

new text begin (5) key employment status measures as determined by the commissioner; and
new text end

new text begin (6) key community-life engagement measures as determined by the commissioner.
new text end

new text begin (c) The information in paragraph (b) must be submitted in a format determined by the
commissioner.
new text end

new text begin (d) A provider must submit the data required under this section annually on a date
specified by the commissioner. The commissioner must give a provider at least 30 calendar
days to submit the data following notice of the due date. If a provider fails to submit the
requested data by the date specified by the commissioner, the commissioner may delay
medical assistance reimbursement until the requested data is submitted.
new text end

new text begin (e) Individually identifiable data submitted to the commissioner under this section are
considered private data on individuals as defined by section 13.02, subdivision 12.
new text end

new text begin (f) The commissioner must analyze data annually for tracking employment and
community-life engagement outcomes.
new text end

Sec. 23.

Minnesota Statutes 2022, section 256B.4911, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin Services provided by parents and spouses. new text end

new text begin (a) This subdivision limits medical
assistance payments under the consumer-directed community supports option for personal
assistance services provided by a parent to the parent's minor child or by a participant's
spouse. This subdivision applies to the consumer-directed community supports option
available under all of the following:
new text end

new text begin (1) alternative care program;
new text end

new text begin (2) brain injury waiver;
new text end

new text begin (3) community alternative care waiver;
new text end

new text begin (4) community access for disability inclusion waiver;
new text end

new text begin (5) developmental disabilities waiver; and
new text end

new text begin (6) elderly waiver.
new text end

new text begin (b) For the purposes of this subdivision, "parent" means a parent, stepparent, or legal
guardian of a minor.
new text end

new text begin (c) If multiple parents are providing personal assistance services to their minor child or
children, each parent may provide up to 40 hours of personal assistance services in any
seven-day period regardless of the number of children served. The total number of hours
of medical assistance home and community-based services provided by all of the parents
must not exceed 80 hours in a seven-day period regardless of the number of children served.
new text end

new text begin (d) If only one parent is providing personal assistance services to a minor child or
children, the parent may provide up to 60 hours of medical assistance home and
community-based services in a seven-day period regardless of the number of children served.
new text end

new text begin (e) If a participant's spouse is providing personal assistance services, the spouse may
provide up to 60 hours of medical assistance home and community-based services in a
seven-day period.
new text end

new text begin (f) This subdivision must not be construed to permit an increase in the total authorized
consumer-directed community supports budget for an individual.
new text end

new text begin EFFECTIVE DATE. new text end

Sec. 24.

Minnesota Statutes 2022, section 256B.4912, is amended by adding a subdivision
to read:

new text begin Subd. 1b. new text end

new text begin Direct support professional annual labor market survey. new text end

new text begin (a) The
commissioner shall develop and administer a survey of direct care staff who work for
organizations that provide services under the following programs:
new text end

new text begin (1) home and community-based services for seniors under chapter 256S and section
256B.0913, home and community-based services for people with developmental disabilities
under section 256B.092, and home and community-based services for people with disabilities
under section 256B.49;
new text end

new text begin (2) personal care assistance services under section 256B.0625, subdivision 19a;
community first services and supports under section 256B.85; nursing services and home
health services under section 256B.0625, subdivision 6a; home care nursing services under
section 256B.0625, subdivision 7; and
new text end

new text begin (3) financial management services for participants who directly employ direct-care staff
through consumer support grants under section 256.476; the personal care assistance choice
program under section 256B.0659, subdivisions 18 to 20; community first services and
supports under section 256B.85; and the consumer-directed community supports option
available under the alternative care program, the brain injury waiver, the community
alternative care waiver, the community access for disability inclusion waiver, the
developmental disabilities waiver, the elderly waiver, and the Minnesota senior health
option, except financial management services providers are not required to submit the data
listed in subdivision 1a, clauses (7) to (11).
new text end

new text begin (b) The survey must collect information about the individual experience of the direct-care
staff and any other information necessary to assess the overall economic viability and
well-being of the workforce.
new text end

new text begin (c) For purposes of this subdivision, "direct-care staff" means employees, including
self-employed individuals and individuals directly employed by a participant in a
consumer-directed service delivery option, providing direct service to participants under
this section. Direct-care staff does not include executive, managerial, or administrative staff.
new text end

new text begin (d) Individually identifiable data submitted to the commissioner under this section are
considered private data on individuals as defined by section 13.02, subdivision 12.
new text end

new text begin (e) The commissioner shall analyze data submitted under this section annually to assess
the overall economic viability and well-being of the workforce and the impact of the state
of the workforce on access to services.
new text end

Sec. 25.

Minnesota Statutes 2022, section 256B.4912, is amended by adding a subdivision
to read:

new text begin Subd. 1c. new text end

new text begin Annual labor market report. new text end

new text begin The commissioner shall publish annual reports
on provider and state-level labor market data, including but not limited to the data outlined
in subdivisions 1a and 1b.
new text end

Sec. 26.

Minnesota Statutes 2022, section 256B.4912, is amended by adding a subdivision
to read:

new text begin Subd. 16. new text end

new text begin Rates established by the commissioner. new text end

new text begin For homemaker services eligible
for reimbursement under the developmental disabilities waiver, the brain injury waiver, the
community alternative care waiver, and the community access for disability inclusion waiver,
the commissioner must establish rates equal to the rates established under sections 256S.21
to 256S.215 for the corresponding homemaker services.
new text end

new text begin EFFECTIVE DATE. new text end

Sec. 27.

Minnesota Statutes 2022, section 256B.4914, subdivision 3, is amended to read:

Subd. 3.

Applicable services.

new text begin (a) new text end Applicable services are those authorized under the
state's home and community-based services waivers under sections 256B.092 and 256B.49,
including the following, as defined in the federally approved home and community-based
services plan:

(1) 24-hour customized living;

(2) adult day services;

(3) adult day services bath;

(4) community residential services;

(5) customized living;

(6) day support services;

(7) employment development services;

(8) employment exploration services;

(9) employment support services;

(10) family residential services;

(11) individualized home supports;

(12) individualized home supports with family training;

(13) individualized home supports with training;

(14) integrated community supports;

new text begin (15) life sharing;
new text end

deleted text begin (15)deleted text end new text begin (16)new text end night supervision;

deleted text begin (16)deleted text end new text begin (17)new text end positive support services;

deleted text begin (17)deleted text end new text begin (18)new text end prevocational services;

deleted text begin (18)deleted text end new text begin (19)new text end residential support services;

deleted text begin (19)deleted text end new text begin (20)new text end respite services;

deleted text begin (20)deleted text end new text begin (21)new text end transportation services; and

deleted text begin (21)deleted text end new text begin (22)new text end other services as approved by the federal government in the state home and
community-based services waiver plan.

new text begin (b) Effective January 1, 2024, or upon federal approval, whichever is later, respite
services under paragraph (a), clause (20), are not an applicable service under this section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2026, or upon federal approval,
whichever is later, except that paragraph (b) is effective the day following final enactment.
The commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

Sec. 28.

Minnesota Statutes 2022, section 256B.4914, subdivision 4, is amended to read:

Subd. 4.

Data collection for rate determination.

(a) Rates for applicable home and
community-based waivered services, including customized rates under subdivision 12, are
set by the rates management system.

(b) Data and information in the rates management system must be used to calculate an
individual's rate.

(c) Service providers, with information from the support plan and oversight by lead
agencies, shall provide values and information needed to calculate an individual's rate in
the rates management system. The determination of service levels must be part of a discussion
with members of the support team as defined in section 245D.02, subdivision 34. This
discussion must occur prior to the final establishment of each individual's rate. The values
and information include:

(1) shared staffing hours;

(2) individual staffing hours;

(3) direct registered nurse hours;

(4) direct licensed practical nurse hours;

(5) staffing ratios;

(6) information to document variable levels of service qualification for variable levels
of reimbursement in each framework;

(7) shared or individualized arrangements for unit-based services, including the staffing
ratio;

(8) number of trips and miles for transportation services; and

(9) service hours provided through monitoring technology.

(d) Updates to individual data must include:

(1) data for each individual that is updated annually when renewing service plans; and

(2) requests by individuals or lead agencies to update a rate whenever there is a change
in an individual's service needs, with accompanying documentation.

(e) Lead agencies shall review and approve all services reflecting each individual's needs,
and the values to calculate the final payment rate for services with variables under
subdivisions 6 to deleted text begin 9adeleted text end new text begin 9new text end for each individual. Lead agencies must notify the individual and the
service provider of the final agreed-upon values and rate, and provide information that is
identical to what was entered into the rates management system. If a value used was
mistakenly or erroneously entered and used to calculate a rate, a provider may petition lead
agencies to correct it. Lead agencies must respond to these requests. When responding to
the request, the lead agency must consider:

(1) meeting the health and welfare needs of the individual or individuals receiving
services by service site, identified in their support plan under section 245D.02, subdivision
4b, and any addendum under section 245D.02, subdivision 4c;

(2) meeting the requirements for staffing under subdivision 2, paragraphs (h), (n), and
(o); and meeting or exceeding the licensing standards for staffing required under section
245D.09, subdivision 1; and

(3) meeting the staffing ratio requirements under subdivision 2, paragraph (o), and
meeting or exceeding the licensing standards for staffing required under section 245D.31.

new text begin EFFECTIVE DATE. new text end

Sec. 29.

Minnesota Statutes 2022, section 256B.4914, subdivision 5, is amended to read:

Subd. 5.

Base wage index; establishment and updates.

(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 calculating the 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 Occupational
Handbook must be used.

(b) The commissioner shall update the base wage index in subdivision 5a, 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 deleted text begin Novemberdeleted text end new text begin Januarynew text end 1, 2024, based on wage data by SOC from the Bureau of Labor
Statistics deleted text begin available as of December 31, 2021deleted text end new text begin published in March 2022new text end ; and

(3) on deleted text begin Julydeleted text end new text begin Januarynew text end 1, 2026, and every two years thereafter, based on wage data by SOC
from the Bureau of Labor Statistics deleted text begin available 30 months and one daydeleted text end new text begin published in the spring
approximately 21 monthsnew text end prior to the scheduled update.

new text begin EFFECTIVE DATE. new text end

Sec. 30.

Minnesota Statutes 2022, section 256B.4914, subdivision 5a, is amended to read:

Subd. 5a.

Base wage index; calculations.

The base wage index must be calculated as
follows:

(1) 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 specialist, which is
100 percent of the median wage for clinical counseling and school psychologist (SOC code
19-3031);

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

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

(4) for residential asleep-overnight staff, the minimum wage in Minnesota for large
employersdeleted text begin , with the exception of asleep-overnight staff for family residential services, which
is 36 percent of the minimum wage in Minnesota for large employersdeleted text end ;

(5) for residential direct care staff, the sum of:

(i) 15 percent of the subtotal of 50 percent of the median wage for home health and
personal care aide (SOC code 31-1120); 30 percent of the median wage for nursing assistant
(SOC code 31-1131); 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 40 percent of the median wage for home health and
personal care aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant
(SOC code deleted text begin 31-1014deleted text end new text begin 31-1131new text end ); 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);

(6) for adult day services staff, 70 percent of the median wage for nursing assistant (SOC
code 31-1131); and 30 percent of the median wage for home health and personal care aide
(SOC code 31-1120);

(7) for day support services staff and prevocational services staff, 20 percent of the
median wage for nursing assistant (SOC code 31-1131); 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);

(8) for positive supports analyst staff, 100 percent of the median wage for substance
abuse, behavioral disorder, and mental health counselor (SOC code 21-1018);

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

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

(11) for individualized home supports with family training staff, 20 percent of the median
wage for nursing aide (SOC code 31-1131); 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);

(12) 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);

(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
deleted text begin rehabilitation counselor (SOC code 21-1015)deleted text end new text begin education, guidance, school, and vocational
counselor (SOC code 21-1012)new text end ; 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 without training staff, 50 percent of the median
wage for home health and personal care aide (SOC code 31-1120); and 50 percent of the
median wage for nursing assistant (SOC code 31-1131);new text begin and
new text end

(17) for night supervision staff, 40 percent of the median wage for home health and
personal care aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant
(SOC code 31-1131); 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)deleted text begin ; anddeleted text end new text begin .
new text end

deleted text begin (18) for respite staff, 50 percent of the median wage for home health and personal care
aide (SOC code 31-1131); and 50 percent of the median wage for nursing assistant (SOC
code 31-1014).
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin The amendment to clause (5), item (ii), the amendment to clause
(14), and the amendment striking clause (18) are effective January 1, 2024, or upon federal
approval, whichever is later. The amendment to clause (4) is effective January 1, 2026, or
upon federal approval, whichever is later. The commissioner of human services shall notify
the revisor of statutes when federal approval is obtained.
new text end

Sec. 31.

Minnesota Statutes 2022, section 256B.4914, subdivision 5b, is amended to read:

Subd. 5b.

Standard component value adjustments.

The commissioner shall update
the client and programming support, transportation, and program facility cost component
values as required in subdivisions 6 to deleted text begin 9adeleted text end new text begin 9 and the rates identified in subdivision 19new text end 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 deleted text begin Novemberdeleted text end new text begin Januarynew text end 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 begin 2021deleted text end new text begin 2022new text end ; and

(3) on deleted text begin Julydeleted text end new text begin Januarynew text end 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 begin 30deleted text end new text begin 24new text end months and
one day prior to the scheduled update.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2026, or upon federal approval,
whichever is later, except that the amendment striking the cross-reference to subdivision
9a and the amendments to clauses (2) and (3) are effective January 1, 2024, or upon federal
approval, whichever is later. The commissioner of human services shall notify the revisor
of statutes when federal approval is obtained.
new text end

Sec. 32.

Minnesota Statutes 2022, section 256B.4914, subdivision 6, is amended to read:

Subd. 6.

Residential support services; generally.

(a) For purposes of this section,
residential support services includes 24-hour customized living services, community
residential services, customized living services, deleted text begin family residential services,deleted text end and integrated
community supports.

(b) A unit of service for residential support services is a day. Any portion of any calendar
day, within allowable Medicaid rules, where an individual spends time in a residential setting
is billable as a day. The number of days authorized for all individuals enrolling in residential
support services must include every day that services start and end.

(c) When the available shared staffing hours in a residential setting are insufficient to
meet the needs of an individual who enrolled in residential support services after January
1, 2014, then individual staffing hours shall be used.

new text begin EFFECTIVE DATE. new text end

Sec. 33.

Minnesota Statutes 2022, section 256B.4914, subdivision 6a, is amended to read:

Subd. 6a.

Community residential services; component values and calculation of
payment rates.

(a) Component values for community residential services are:

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 6.7new text end 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.

(b) Payments for community residential services must be calculated as follows:

(1) determine the number of shared direct staffing and individual direct staffing hours
to meet a recipient's needs provided on site or through monitoring technology;

(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 and 5a;

(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;

(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 direct staffing and individual direct staffing hours
provided on site or through monitoring technology and nursing hours by the appropriate
staff wages;

(6) multiply the number of shared direct staffing and individual direct staffing hours
provided on site or through monitoring technology and nursing hours by the product of the
supervision span of control ratio and the appropriate supervisory staff wage in subdivision
5a, clause (1);

(7) combine the results of clauses (5) and (6), excluding any shared direct staffing and
individual direct staffing hours provided through monitoring technology, and multiply the
result by one plus the employee vacation, sick, and training allowance ratio. This is defined
as the direct staffing cost;

(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared
direct staffing and individual hours provided through monitoring technology, by one plus
the employee-related cost ratio;

(9) for client programming and supports, add $2,260.21 divided by 365. The
commissioner shall update the amount in this clause as specified in subdivision 5b;

(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided
by 365 if customized for adapted transport, based on the resident with the highest assessed
need. The commissioner shall update the amounts in this clause as specified in subdivision
5b;

(11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing
and individual direct staffing hours provided through monitoring technology that was
excluded in clause (8);

(12) sum the standard general administrative support ratio, 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; and

(14) adjust the result of clause (13) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.

new text begin EFFECTIVE DATE. new text end

Sec. 34.

Minnesota Statutes 2022, section 256B.4914, subdivision 6b, is amended to read:

Subd. 6b.

Family residential services; component values and calculation of payment
rates.

(a) Component values for family residential services are:

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 6.7new text end 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.

(b) Payments for family residential services must be calculated as follows:

(1) determine the number of shared direct staffing and individual direct staffing hours
to meet a recipient's needs provided on site or through monitoring technology;

(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 and 5a;

(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;

(5) multiply the number of shared direct staffing and individual direct staffing hours
provided on site or through monitoring technology and nursing hours by the appropriate
staff wages;

(6) multiply the number of shared direct staffing and individual direct staffing hours
provided on site or through monitoring technology and nursing hours by the product of the
supervisory span of control ratio and the appropriate supervisory staff wage in subdivision
5a, clause (1);

(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared
and individual direct staffing hours provided through monitoring technology, by one plus
the employee-related cost ratio;

(9) for client programming and supports, add $2,260.21 divided by 365. The
commissioner shall update the amount in this clause as specified in subdivision 5b;

(12) sum the standard general administrative support ratio, 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 rate; and

(14) adjust the result of clause (13) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.

new text begin EFFECTIVE DATE. new text end

Sec. 35.

Minnesota Statutes 2022, section 256B.4914, subdivision 6c, is amended to read:

Subd. 6c.

Integrated community supports; component values and calculation of
payment rates.

(a) Component values for integrated community supports are:

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 6.7new text end 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.

(b) Payments for integrated community supports must be calculated as follows:

(1) determine the number of shared direct staffing and individual direct staffing hours
to meet a recipient's needs. The base shared direct staffing hours must be eight hours divided
by the number of people receiving support in the integrated community support setting, and
the individual direct staffing hours must be the average number of direct support hours
provided directly to the service recipient;

(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 and 5a;

(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;

(5) multiply the number of shared direct staffing and individual direct staffing hours in
clause (1) by the appropriate staff wages;

(6) multiply the number of shared direct staffing and individual direct staffing hours in
clause (1) by the product of the supervisory span of control ratio and the appropriate
supervisory staff wage in subdivision 5a, clause (1);

(7) combine the results of clauses (5) and (6) and multiply the result by one plus the
employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
cost;

(8) for employee-related expenses, multiply the direct staffing cost by one plus the
employee-related cost ratio;

(9) for client programming and supports, add $2,260.21 divided by 365. The
commissioner shall update the amount in this clause as specified in subdivision 5b;

(10) add the results of clauses (8) and (9);

(11) add the standard general administrative support ratio, the program-related expense
ratio, and the absence and utilization factor ratio;

(12) divide the result of clause (10) by one minus the result of clause (11). This is the
total payment amount; and

(13) adjust the result of clause (12) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.

new text begin EFFECTIVE DATE. new text end

Sec. 36.

Minnesota Statutes 2022, section 256B.4914, subdivision 7a, is amended to read:

Subd. 7a.

Adult day services; component values and calculation of payment rates.

(a)
Component values for adult day services are:

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 6.7new text end 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, updated as specified in subdivision
5b;

(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.

(b) A unit of service for adult day services is either a day or 15 minutes. A day unit of
service is six or more hours of time spent providing direct service.

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

(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 and 5a;

(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;

(5) multiply the number of day program direct staffing hours and nursing hours by the
appropriate staff wage;

(6) multiply the number of day program direct staffing hours by the product of the
supervisory span of control ratio and the appropriate supervisory staff wage in subdivision
5a, clause (1);

(7) combine the results of clauses (5) and (6), and multiply the result by one plus the
employee vacation, sick, and training allowance ratio. 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;

(9) for employee-related expenses, multiply the result of clause (8) by one plus the
employee-related cost ratio;

(10) for client programming and supports, multiply the result of clause (9) by one plus
the client programming and support ratio;

(11) for program facility costs, add $19.30 per week with consideration of staffing ratios
to meet individual needs, updated as specified in subdivision 5b;

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

(13) this is the subtotal rate;

(14) sum the standard general administrative rate support ratio, 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; and

(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.

new text begin EFFECTIVE DATE. new text end

Sec. 37.

Minnesota Statutes 2022, section 256B.4914, subdivision 7b, is amended to read:

Subd. 7b.

Day support services; component values and calculation of payment
rates.

(a) Component values for day support services are:

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 6.7new text end 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: 10.37 percent, updated as specified in
subdivision 5b;

(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.

(b) A unit of service for day support services is 15 minutes.