SF 3195

as introduced - 92nd Legislature (2021 - 2022) Posted on 04/01/2022 10:05am

A bill for an act
relating to human services; modifying nursing facility payment rates; modifying
elderly waiver rates; modifying payment rates for customized living services
provided under certain disability waivers; appropriating money; amending
Minnesota Statutes 2020, sections 256R.02, subdivisions 16, 24, 26, 29, 34, by
adding subdivisions; 256R.23, subdivisions 2, 3; 256R.24, subdivision 1; 256R.25;
256S.201, subdivision 3; 256S.211, by adding a subdivision; 256S.213, subdivision
1; Minnesota Statutes 2021 Supplement, section 256S.21; repealing Minnesota
Statutes 2021 Supplement, section 256S.2101.

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

Section 1.

Minnesota Statutes 2020, section 256R.02, subdivision 16, is amended to read:

Subd. 16.

Dietary costs.

"Dietary costs" means the costs for deleted text begin the salaries and wages of
the dietary supervisor, dietitians, chefs, cooks, dishwashers, and other employees assigned
to the kitchen and dining room, and associated fringe benefits and payroll taxes. Dietary
costs also includes deleted text end the salaries or fees of dietary consultants, dietary supplies, and food
preparation and serving.

new text begin EFFECTIVE DATE. new text end

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

Sec. 2.

Minnesota Statutes 2020, section 256R.02, is amended by adding a subdivision to
read:

new text begin Subd. 16a. new text end

new text begin Dietary labor costs. new text end

new text begin "Dietary labor costs" means the costs for the salaries
and wages of the dietary supervisor, dietitians, chefs, cooks, dishwashers, and other
employees assigned to the kitchen and dining room, and associated fringe benefits and
payroll taxes.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 3.

Minnesota Statutes 2020, section 256R.02, subdivision 24, is amended to read:

Subd. 24.

Housekeeping costs.

"Housekeeping costs" means deleted text begin the costs for the salaries
and wages of the housekeeping supervisor, housekeepers, and other cleaning employees
and associated fringe benefits and payroll taxes. It also includes deleted text end the cost of housekeeping
supplies, including, but not limited to, cleaning and lavatory supplies and contract services.

new text begin EFFECTIVE DATE. new text end

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

Sec. 4.

Minnesota Statutes 2020, section 256R.02, is amended by adding a subdivision to
read:

new text begin Subd. 24a. new text end

new text begin Housekeeping labor costs. new text end

new text begin "Housekeeping labor costs" means the costs for
the salaries and wages of the housekeeping supervisor, housekeepers, and other cleaning
employees, and associated fringe benefits and payroll taxes.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 5.

Minnesota Statutes 2020, section 256R.02, is amended by adding a subdivision to
read:

new text begin Subd. 25b. new text end

new text begin Known cost change factor. new text end

new text begin "Known cost change factor" means 1.00 plus
the forecasted percentage change in the CPI-U index from July 1 of the reporting period to
July 1 of the rate year as determined by the national economic consultant used by the
commissioner of management and budget.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 6.

Minnesota Statutes 2020, section 256R.02, subdivision 26, is amended to read:

Subd. 26.

Laundry costs.

"Laundry costs" means the costs deleted text begin for the salaries and wages
of the laundry supervisor and other laundry employees, associated fringe benefits, and
payroll taxes. It also includes the costs deleted text end of linen and bedding, the laundering of resident
clothing, laundry supplies, and contract services.

new text begin EFFECTIVE DATE. new text end

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

Sec. 7.

Minnesota Statutes 2020, section 256R.02, is amended by adding a subdivision to
read:

new text begin Subd. 26a. new text end

new text begin Laundry labor costs. new text end

new text begin "Laundry labor costs" means the costs for the salaries
and wages of the laundry supervisor and other laundry employees, and associated fringe
benefits and payroll taxes.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 8.

Minnesota Statutes 2020, section 256R.02, subdivision 29, is amended to read:

Subd. 29.

Maintenance and plant operations costs.

"Maintenance and plant operations
costs" means deleted text begin the costs for the salaries and wages of the maintenance supervisor, engineers,
heating-plant employees, and other maintenance employees and associated fringe benefits
and payroll taxes. It also includes deleted text end identifiable costs for maintenance and operation of the
building and grounds, including, but not limited to, fuel, electricity, medical waste and
garbage removal, water, sewer, supplies, tools, and repairs.

new text begin EFFECTIVE DATE. new text end

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

Sec. 9.

Minnesota Statutes 2020, section 256R.02, is amended by adding a subdivision to
read:

new text begin Subd. 29a. new text end

new text begin Maintenance and plant operations labor costs. new text end

new text begin "Maintenance and plant
operations labor costs" means the costs for the salaries and wages of the maintenance
supervisor, engineers, heating-plant employees, and other maintenance employees, and
associated fringe benefits and payroll taxes.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 10.

Minnesota Statutes 2020, section 256R.02, subdivision 34, is amended to read:

Subd. 34.

Other care-related costs.

"Other care-related costs" means the sum of activities
costs, other direct care costs, raw food costs, new text begin dietary labor costs, housekeeping labor costs,
laundry labor costs, maintenance and plant operations labor costs, new text end therapy costs, and social
services costs.

new text begin EFFECTIVE DATE. new text end

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

Sec. 11.

Minnesota Statutes 2020, section 256R.23, subdivision 2, is amended to read:

Subd. 2.

Calculation of direct care cost per standardized day.

Each facility's direct
care cost per standardized day is new text begin the product of new text end the facility's direct care costs new text begin and the known
cost change factor, new text end divided by the sum of the facility's standardized days. A facility's direct
care cost per standardized day is the facility's cost per day for direct care services associated
with a case mix index of 1.00.

new text begin EFFECTIVE DATE. new text end

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

Sec. 12.

Minnesota Statutes 2020, section 256R.23, subdivision 3, is amended to read:

Subd. 3.

Calculation of other care-related cost per resident day.

Each facility's other
care-related cost per resident day is new text begin the product of new text end its other care-related costs new text begin and the known
cost change factor new text end , divided by the sum of the facility's resident days.

new text begin EFFECTIVE DATE. new text end

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

Sec. 13.

Minnesota Statutes 2020, section 256R.24, subdivision 1, is amended to read:

Subdivision 1.

Determination of other operating cost per day.

Each facility's other
operating cost per day is new text begin the product of new text end its other operating costs new text begin and the known cost change
factor, new text end divided by the sum of the facility's resident days.

new text begin EFFECTIVE DATE. new text end

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

Sec. 14.

Minnesota Statutes 2020, section 256R.25, is amended to read:

256R.25 EXTERNAL FIXED COSTS PAYMENT RATE.

(a) The payment rate for external fixed costs is the sum of the amounts in paragraphs
(b) to (o).

(b) For a facility licensed as a nursing home, the portion related to the provider surcharge
under section 256.9657 is equal to $8.86 per resident day. For a facility licensed as both a
nursing home and a boarding care home, the portion related to the provider surcharge under
section 256.9657 is equal to $8.86 per resident day multiplied by the result of its number
of nursing home beds divided by its total number of licensed beds.

(c) The portion related to the licensure fee under section 144.122, paragraph (d), is the
amount of the fee divided by the sum of the facility's resident days.

(d) The portion related to development and education of resident and family advisory
councils under section 144A.33 is $5 per resident day divided by 365.

(e) The portion related to scholarships is determined under section 256R.37.

(f) The portion related to planned closure rate adjustments is as determined under section
256R.40, subdivision 5, and Minnesota Statutes 2010, section 256B.436.

(g) The portion related to consolidation rate adjustments shall be as determined under
section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d.

(h) The portion related to single-bed room incentives is as determined under section
256R.41.

(i) The portions related to real estate taxes, special assessments, and payments made in
lieu of real estate taxes directly identified or allocated to the nursing facility are the allowable
amounts divided by the sum of the facility's resident days. Allowable costs under this
paragraph for payments made by a nonprofit nursing facility that are in lieu of real estate
taxes shall not exceed the amount which the nursing facility would have paid to a city or
township and county for fire, police, sanitation services, and road maintenance costs had
real estate taxes been levied on that property for those purposes.

(j) The portion related to employer health insurance costs is new text begin the product of new text end the allowable
costs new text begin and the known cost change factor, new text end divided by the sum of the facility's resident days.

(k) The portion related to the Public Employees Retirement Association is the allowable
costs divided by the sum of the facility's resident days.

(l) The portion related to quality improvement incentive payment rate adjustments is
the amount determined under section 256R.39.

(m) The portion related to performance-based incentive payments is the amount
determined under section 256R.38.

(n) The portion related to special dietary needs is the amount determined under section
256R.51.

(o) The portion related to the rate adjustments for border city facilities is the amount
determined under section 256R.481.

new text begin EFFECTIVE DATE. new text end

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

Sec. 15.

Minnesota Statutes 2020, section 256S.201, subdivision 3, is amended to read:

Subd. 3.

Customized living service rates.

The authorized rates for customized living
services and 24-hour customized living services must be based on the amount of component
services to be provided utilizing component rates established deleted text begin by the commissioner deleted text end new text begin in section
256S.215 new text end . Counties and tribes shall use tools issued by the commissioner to develop and
document customized living service plans and rates.

new text begin EFFECTIVE DATE. new text end

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

Sec. 16.

Minnesota Statutes 2021 Supplement, section 256S.21, is amended to read:

256S.21 RATE SETTING; APPLICATION.

The payment methodologies in sections deleted text begin 256S.2101 deleted text end new text begin 256S.211 new text end to 256S.215 apply to
elderly waiver, elderly waiver customized living, and elderly waiver foster care under this
chapter; alternative care under section 256B.0913; essential community supports under
section 256B.0922; and community access for disability inclusion customized living and
brain injury customized living under section 256B.49.

new text begin EFFECTIVE DATE. new text end

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

Sec. 17.

Minnesota Statutes 2020, section 256S.211, is amended by adding a subdivision
to read:

new text begin Subd. 1a. new text end

new text begin Updating base wages. new text end

new text begin Each January 1, the commissioner must update the
base wages under section 256S.212 based on the most recently available Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage data from the Bureau of Labor Statistics.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 18.

Minnesota Statutes 2020, section 256S.213, subdivision 1, is amended to read:

Subdivision 1.

Payroll taxes and benefits factor.

The payroll taxes and benefits factor
is the sum of net payroll taxes and benefits, divided by the sum of all salaries for all nursing
facilities on the most recent and available cost report. new text begin The commissioner must update the
payroll tax and benefit factor each January 1.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 19. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
PARTIAL YEAR RATE ADJUSTMENTS.
new text end

new text begin (a) On July 1, 2022, the commissioner shall update the base wage indices in Minnesota
Statutes, section 256S.212, based on the most recently available Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage data from the Bureau of Labor Statistics.
new text end

new text begin (b) On July 1, 2022, the commissioner shall update the payroll tax and benefit factor in
Minnesota Statutes, section 256S.213, subdivision 1, based on the most recently available
nursing facility cost report data.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever occurs later. The commissioner of human services shall inform the revisor of
statutes when federal approval is obtained.
new text end

Sec. 20. new text begin APPROPRIATION; NURSING FACILITY FUNDING.
new text end

new text begin (a) $....... in fiscal year 2022 and $....... in fiscal year 2023 are appropriated from the
general fund to the commissioner of human services for payments to nursing facilities in
the amount of $....... per bed per quarter. The commissioner shall make payments for each
quarter of calendar years 2022 and 2023. The general fund base for this appropriation is
$....... in fiscal year 2024 and $0 in fiscal year 2025.
new text end

new text begin (b) To be eligible to receive a payment under this section, a nursing facility must attest
to the commissioner of human services that the additional revenue will be used exclusively
to increase compensation-related costs for employees directly employed by the facility on
or after January 1, 2022. For the purposes of this paragraph, compensation-related costs
include:
new text end

new text begin (1) wages and salaries;
new text end

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

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

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

new text begin (c) A facility that receives a payment under this section must prepare, and submit to the
commissioner upon request, a distribution plan that specifies the total amount of money the
facility expects to receive and how that money will be distributed to increase
compensation-related costs for employees. Within 60 days after receiving the first payment
under this section, a facility must post the distribution plan and leave it posted for a period
of at least six months in an area of the facility to which all employees have access.
new text end

new text begin (d) The commissioner shall not treat payments received under this section as an applicable
credit for the purposes of setting total payment rates under Minnesota Statutes, chapter
256R.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 21. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2021 Supplement, section 256S.2101, new text end new text begin is repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever occurs later. The commissioner of human services shall inform the revisor of
statutes when federal approval is obtained.
new text end

APPENDIX

Repealed Minnesota Statutes: 22-05649

256S.2101 RATE SETTING; PHASE-IN.

Subdivision 1.

Phase-in for disability waiver customized living rates.

All rates and rate components for community access for disability inclusion customized living and brain injury customized living under section 256B.4914 shall be the sum of ten percent of the rates calculated under sections 256S.211 to 256S.215 and 90 percent of the rates calculated using the rate methodology in effect as of June 30, 2017.

Subd. 2.

Phase-in for elderly waiver rates.

Except for home-delivered meals as described in section 256S.215, subdivision 15, all rates and rate components for elderly waiver, elderly waiver customized living, and elderly waiver foster care under this chapter; alternative care under section 256B.0913; and essential community supports under section 256B.0922 shall be the sum of 18.8 percent of the rates calculated under sections 256S.211 to 256S.215, and 81.2 percent of the rates calculated using the rate methodology in effect as of June 30, 2017. The rate for home-delivered meals shall be the sum of the service rate in effect as of January 1, 2019, and the increases described in section 256S.215, subdivision 15.