Engrossments
Introduction		Posted on 03/30/2022
1st Engrossment		Posted on 04/07/2022
2nd Engrossment		Posted on 04/21/2022
3rd Engrossment		Posted on 04/27/2022

Unofficial Engrossments
1st Unofficial Engrossment		Posted on 04/28/2022
2nd Unofficial Engrossment		Posted on 05/03/2022

ARTICLE 1

COMMUNITY SUPPORTS

Section 1.

Minnesota Statutes 2020, section 252.275, subdivision 4c, is amended to read:

Subd. 4c.

Review of funds; reallocation.

new text begin (a) new text end After each quarter, the commissioner shall
review county program expenditures. The commissioner may reallocate unexpended money
at any time among those counties which have earned their full allocation.

new text begin (b) For each fiscal year, the commissioner shall determine if actual statewide expenditures
by county boards are less than the fiscal year appropriation to provide semi-independent
living services under this section. If actual statewide expenditures by county boards are less
than the fiscal year appropriation to provide semi-independent living services under this
section, the unexpended amount must be carried forward to the next fiscal year and allocated
to grants in equal amounts to the eight organizations defined in section 268A.01, subdivision
8, to expand services to support people with disabilities who are ineligible for medical
assistance to live in their own homes and communities by providing accessibility
modifications, independent living services, and public health program facilitation.
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. 2.

Minnesota Statutes 2020, section 252.275, subdivision 8, is amended to read:

Subd. 8.

Use of federal funds and transfer of funds to medical assistance.

deleted text begin (a)deleted text end The
commissioner shall make every reasonable effort to maximize the use of federal funds for
semi-independent living services.

deleted text begin (b) The commissioner shall reduce the payments to be made under this section to each
county from January 1, 1994, to June 30, 1996, by the amount of the state share of medical
assistance reimbursement for services other than residential services provided under the
home and community-based waiver program under section 256B.092 from January 1, 1994
to June 30, 1996, for clients for whom the county is financially responsible and who have
been transferred by the county from the semi-independent living services program to the
home and community-based waiver program. Unless otherwise specified, all reduced amounts
shall be transferred to the medical assistance state account.
deleted text end

deleted text begin (c) For fiscal year 1997, the base appropriation available under this section shall be
reduced by the amount of the state share of medical assistance reimbursement for services
other than residential services provided under the home and community-based waiver
program authorized in section 256B.092 from January 1, 1995, to December 31, 1995, for
persons who have been transferred from the semi-independent living services program to
the home and community-based waiver program. The base appropriation for the medical
assistance state account shall be increased by the same amount.
deleted text end

deleted text begin (d) For purposes of calculating the guaranteed floor under subdivision 4b and to establish
the calendar year 1996 allocations, each county's original allocation for calendar year 1995
shall be reduced by the amount transferred to the state medical assistance account under
paragraph (b) during the six months ending on June 30, 1995. For purposes of calculating
the guaranteed floor under subdivision 4b and to establish the calendar year 1997 allocations,
each county's original allocation for calendar year 1996 shall be reduced by the amount
transferred to the state medical assistance account under paragraph (b) during the six months
ending on December 31, 1995.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 3.

new text begin [256.4791] COMMUNITY ORGANIZATIONS GRANT PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The commissioner of human services shall establish the
community organizations grant program to address violence prevention and provide street
outreach services.
new text end

new text begin Subd. 2. new text end

new text begin Applications. new text end

new text begin Organizations seeking grants under this section shall apply to
the commissioner. The grant applicant must include a description of the project that the
applicant is proposing, the amount of money that the applicant is seeking, and a proposed
budget describing how the applicant will spend the grant money.
new text end

new text begin Subd. 3. new text end

new text begin Eligible applicants. new text end

new text begin To be eligible for a grant under this section, applicants
must address violence prevention, connect with youth and community members, and provide
street outreach services. Applicants must also be focused on prevention, intervention, and
restorative practices within the community, which may include:
new text end

new text begin (1) providing trauma-responsive care; and
new text end

new text begin (2) access to individual and group therapy services or community healing.
new text end

new text begin Subd. 4. new text end

new text begin Use of grant money. new text end

new text begin Grant recipients must use the funds to address violence
prevention, connect with youth and community members, and provide street outreach
services.
new text end

new text begin Subd. 5. new text end

new text begin Reporting. new text end

new text begin Grant recipients must provide an annual report to the commissioner
in a manner specified by the commissioner on the activities and outcomes of the project
funded by the grant program.
new text end

Sec. 4.

new text begin [256.4792] EMPLOYMENT FOR PERSONS EXPERIENCING
HOMELESSNESS OR SUBSTANCE USE DISORDER.
new text end

new text begin (a) Nonprofit organizations, licensed providers, and other entities that receive funding
from the commissioner of human services to address homelessness or provide services to
individuals experiencing homelessness must incorporate into their program the facilitation
of full- or part-time employment and provide or make available employment services for
each client to the extent appropriate for each client.
new text end

new text begin (b) Nonprofit organizations, licensed providers, and other entities that receive funding
from the commissioner of human services to provide substance use disorder services or
treatment must incorporate into their program the facilitation of full- or part-time employment
and provide or make available employment services for each client to the extent appropriate
for each client.
new text end

Sec. 5.

new text begin [256.4795] RESIDENTIAL SETTING CLOSURE PREVENTION GRANTS.
new text end

new text begin Subdivision 1. new text end

new text begin Residential setting closure prevention grants established. new text end

new text begin The
commissioner of human services shall establish a grant program to reduce the risk of
residential settings in financial distress from closing. The commissioner shall limit
expenditures under this subdivision to the amount appropriated for this purpose.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) For the purposes of this section, the terms in this subdivision
have the meaning given them.
new text end

new text begin (b) "At risk of closure" or "at risk of closing" means a residential setting is in significant
financial distress, and, in the judgment of the commissioner, the setting will close without
additional funding from the commissioner.
new text end

new text begin (c) "Residential setting" means any of the following: a nursing facility; an assisted living
facility with a majority of residents receiving services funded by medical assistance; a setting
exempt from assisted living facility licensure under section 144G.08, subdivision 7, clauses
(10) to (13), with a majority of residents receiving services funded by medical assistance;
an intermediate care facility for persons with developmental disabilities; or an adult foster
care setting, a community residential setting, or an integrated community supports setting.
new text end

new text begin Subd. 3. new text end

new text begin Eligibility. new text end

new text begin (a) A license holder operating a residential setting in significant
financial distress may apply to the commissioner for a grant under this section to relieve its
immediate financial distress.
new text end

new text begin (b) Lead agencies that suspect a residential setting is in significant financial distress may
refer the license holder to the commissioner for consideration by the commissioner for grant
funding under this section. Upon a referral from a lead agency under this section, the
commissioner shall immediately solicit an application from the license holder, providing
individualized technical assistance to the license holder regarding the application process.
new text end

new text begin (c) The commissioner must give priority for closure prevention grants to residential
settings that are the most significantly at risk of closing in violation of the applicable notice
requirements prior to the termination of services.
new text end

new text begin Subd. 4. new text end

new text begin Criteria and limitations. new text end

new text begin (a) Within available appropriations for this purpose,
the commissioner must award sufficient funding to a residential setting at risk of closure to
ensure that the residential setting remains open long enough to comply with the applicable
termination of services notification requirements.
new text end

new text begin (b) The commissioner may award additional funding to a residential setting at risk of
closure if, in the judgment of the commissioner, the residential setting is likely to remain
open and financially viable after receiving time-limited additional funding from the
commissioner.
new text end

new text begin (c) Before receiving any additional funding under paragraph (b), grantees must work
with the commissioner to develop a business plan and corrective action plan to reduce the
risk of future financial distress. No residential setting may receive additional funding under
paragraph (b) more than once.
new text end

new text begin Subd. 5. new text end

new text begin Interagency coordination. new text end

new text begin The commissioner must coordinate the grant
activities under this section with any other impacted state agencies and lead agencies.
new text end

new text begin Subd. 6. new text end

new text begin Administrative funding. new text end

new text begin The commissioner may use up to 6.5 percent of the
grant amounts awarded for the commissioner's costs related to administration of this program.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 6.

Minnesota Statutes 2020, 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 within 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. 7.

Minnesota Statutes 2020, 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

Sec. 8.

Minnesota Statutes 2021 Supplement, section 256B.0659, subdivision 17a, is
amended to read:

Subd. 17a.

Enhanced rate.

An enhanced rate of deleted text begin 107.5deleted text end new text begin 143new text end percent of the rate paid for
personal care assistance services shall be paid for services provided to persons who qualify
for ten or more hours of personal care assistance services per day when provided by a
personal care assistant who meets the requirements of subdivision 11, paragraph (d). Any
change in the eligibility criteria for the enhanced rate for personal care assistance services
as described in this subdivision and referenced in subdivision 11, paragraph (d), does not
constitute a change in a term or condition for individual providers as defined in section
256B.0711, and is not subject to the state's obligation to meet and negotiate under chapter
179A.

Sec. 9.

Minnesota Statutes 2020, 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) deleted text begin effective January 1, 2010,deleted text end 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 face-to-face reassessment 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 usednew 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 lawnew 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

Sec. 10.

Minnesota Statutes 2020, 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

Sec. 11.

new text begin [256B.0909] LONG-TERM CARE DECISION REVIEWS.
new text end

new text begin Subdivision 1. new text end

new text begin Notice of intent to deny, reduce, suspend, or terminate required. new text end

new text begin At
least ten calendar days prior to issuing a written notice of action, a lead agency must provide
in a format accessible to the person or the person's legal representative, if any, a notice of
the lead agency's intent to deny, reduce, suspend, or terminate the person's access to or
eligibility for:
new text end

new text begin (1) home and community-based waivers, including level of care determinations, under
sections 256B.092 and 256B.49;
new text end

new text begin (2) specific home and community-based services available under sections 256B.092 and
256B.49;
new text end

new text begin (3) consumer-directed community supports;
new text end

new text begin (4) the following state plan services:
new text end

new text begin (i) personal care assistance services under section 256B.0625, subdivisions 19a and 19c;
new text end

new text begin (ii) consumer support grants under section 256.476; or
new text end

new text begin (iii) community first services and supports under section 256B.85;
new text end

new text begin (5) semi-independent living services under section 252.275;
new text end

new text begin (6) relocation targeted case management services available under section 256B.0621,
subdivision 2, clause (4);
new text end

new text begin (7) case management services targeted to vulnerable adults or people with developmental
disabilities under section 256B.0924;
new text end

new text begin (8) case management services targeted to people with developmental disabilities under
Minnesota Rules, part 9525.0016; and
new text end

new text begin (9) necessary diagnostic information to gain access to or determine eligibility under
clauses (5) to (8).
new text end

new text begin Subd. 2. new text end

new text begin Opportunity to respond required. new text end

new text begin A lead agency must provide the person,
or the person's legal representative, if any, the opportunity to respond to the agency's intent
to deny, reduce, suspend, or terminate eligibility or access to the services described in
subdivision 1. A lead agency must provide the person or the person's legal representative,
if any, ten days to respond. If the person or the person's legal representative, if any, responds,
the agency must initiate a decision review.
new text end

new text begin Subd. 3. new text end

new text begin Decision review. new text end

new text begin (a) A lead agency must initiate a decision review for any
person who responds under subdivision 2.
new text end

new text begin (b) The lead agency must conduct the decision review in a manner that allows an
opportunity for interactive communication between the person and a representative of the
lead agency who has specific knowledge of the proposed decision and the basis for the
decision. The interactive communication must be in a format that is accessible to the recipient,
and may include a phone call, written exchange, in-person meeting, or other format as
chosen by the person or the person's legal representative, if any.
new text end

new text begin (c) During the decision review, the representative of the lead agency must provide a
thorough explanation of the lead agency's intent to deny, reduce, suspend, or terminate
eligibility or access to the services described in subdivision 1 and provide the person or the
person's legal representative, if any, an opportunity to ask questions about the decision. If
the lead agency's explanation of the decision is based on a misunderstanding of the person's
circumstances, incomplete information, missing documentation, or similar missing or
inaccurate information, the lead agency must provide the person or the person's legal
representative, if any, an opportunity to provide clarifying or additional information.
new text end

new text begin (d) A person with a representative is not required to participate in the decision review.
A person may also have someone of the person's choosing participate in the decision review.
new text end

new text begin Subd. 4. new text end

new text begin Continuation of services. new text end

new text begin During the decision review and until the lead agency
issues a written notice of action to deny, reduce, suspend, or terminate the eligibility or
access, the person must continue to receive covered services.
new text end

new text begin Subd. 5. new text end

new text begin Notice of action. new text end

new text begin Following a decision review, a lead agency may issue a notice
of action to deny, reduce, suspend, or terminate the eligibility or access after considering
the discussions and information provided during the decision review.
new text end

new text begin Subd. 6. new text end

new text begin Appeal rights. new text end

new text begin Nothing in this section affects a person's appeal rights under
section 245.045.
new text end

Sec. 12.

new text begin [256B.4909] HOME AND COMMUNITY-BASED SERVICES;
HOMEMAKER RATES.
new text end

new text begin Subdivision 1. new text end

new text begin Application. new text end

new text begin (a) Notwithstanding any law to the contrary, the payment
methodologies for homemaker services defined in this section apply to those homemaker
services offered under:
new text end

new text begin (1) home and community-based services waivers under sections 256B.092 and 256B.49;
new text end

new text begin (2) alternative care under section 256B.0913;
new text end

new text begin (3) essential community supports under section 256B.0922; and
new text end

new text begin (4) elderly waiver, elderly waiver customized living, and elderly waiver foster care under
chapter 256S.
new text end

new text begin (b) This section does not change existing waiver policies and procedures.
new text end

new text begin Subd. 2. new text end

new text begin Definition. new text end

new text begin For purposes of this section, "homemaker services" means
homemaker services and assistance with personal care, homemaker services and cleaning,
and homemaker services and home management under chapter 256S and similar services
offered under home and community-based services waivers under sections 256B.092 and
256B.49, alternative care under section 256B.0913, and essential community supports under
section 256B.0922.
new text end

new text begin Subd. 3. new text end

new text begin Rate methodology. new text end

new text begin (a) Beginning January 1, 2023, the rate methodology for
each homemaker service must be determined under sections 256S.211, subdivision 1, and
256S.212 to 256S.215, as adjusted by paragraph (b).
new text end

new text begin (b) As applicable to this section, on November 1, 2024, based on the most recently
available wage data by standard occupational classification (SOC) from the Bureau of Labor
Statistics, the commissioner shall update for each homemaker service the base wage index
in section 256S.212, publish these updated values, and load them into the appropriate rate
system.
new text end

Sec. 13.

Minnesota Statutes 2020, section 256B.4911, subdivision 4, is amended to read:

Subd. 4.

Budget exception for persons leaving institutions and crisis residential
settings.

(a) The commissioner must establish an institutional and crisis bed
consumer-directed community supports budget exception process in the home and
community-based services waivers under sections 256B.092 and 256B.49. This budget
exception process must be available for any individual who:

(1) is not offered available and appropriate services within 60 days since approval for
discharge from the individual's current institutional setting; and

(2) requires services that are more expensive than appropriate services provided in a
noninstitutional setting using the consumer-directed community supports option.

(b) Institutional settings for purposes of deleted text begin this exceptiondeleted text end new text begin paragraph (a)new text end include intermediate
care facilities for persons with developmental disabilities, nursing facilities, acute care
hospitals, Anoka Metro Regional Treatment Center, Minnesota Security Hospital, and crisis
beds.

(c) The budget exception new text begin under paragraph (a) must be renewed each year as necessary
and consistent with the individual's needs and new text end must be limited to no more than the amount
of appropriate services provided in a noninstitutional setting as determined by the lead
agency managing the individual's home and community-based services waiver. The lead
agency must notify the deleted text begin Department of Human Servicesdeleted text end new text begin commissionernew text end of the budget exception.

new text begin (d) Consistent with informed choice and informed decision making, the commissioner
must establish in the home and community-based services waivers under sections 256B.092
and 256B.49, a consumer-directed community supports budget exception process for
individuals living in licensed community residential settings whose cost of residential
services may otherwise exceed their available consumer-directed community supports
budget. The budget exception process must be available to an individual living in licensed
community residential settings.
new text end

new text begin (e) The budget exceptions under paragraph (d) must be renewed each year as necessary
and consistent with the individual's needs and must be limited to no more than the cost of
the community residential services previously authorized for the individual. The lead agency
must notify the commissioner of the budget exception.
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. 14.

Minnesota Statutes 2020, 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) Upon federal approval, 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 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;
new text end

new text begin (6) elderly waiver; and
new text end

new text begin (7) Minnesota senior health option.
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 personal assistance 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 personal assistance services in a seven-day
period regardless of the number of children served.
new text end

new text begin (e) If a spouse is providing personal assistance services, the spouse may provide up to
60 hours of personal assistance 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

new text begin This section is effective July 1, 2022, 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 2020, section 256B.4914, subdivision 3, as amended by Laws
2022, chapter 33, section 1, is amended to read:

Subd. 3.

Applicable services.

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;

(15) night supervision;

(16) positive support services;

(17) prevocational services;

(18) residential support services;

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

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

deleted text begin (21)deleted text end new text begin (20)new text end other services as approved by the federal government in the state home and
community-based services waiver plan.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 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. 16.

Minnesota Statutes 2020, section 256B.4914, subdivision 4, as amended by Laws
2022, chapter 33, section 1, 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 coordinated service and 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 coordinated service and 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. 17.

Minnesota Statutes 2021 Supplement, section 256B.4914, subdivision 5, as
amended by Laws 2022, chapter 33, section 1, 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) new text begin on January 1, 2023, based on wage data by SOC from the Bureau of Labor Statistics
available as of December 31, 2020;
new text end

new text begin (3) new text end on deleted text begin November 1, 2024deleted text end new text begin January 1, 2025new text end , based on wage data by SOC from the Bureau
of Labor Statistics available as of December 31, deleted text begin 2021deleted text end new text begin 2022new text end ; and

deleted text begin (3)deleted text end new text begin (4)new text end on deleted text begin July 1, 2026deleted text end new text begin January 1, 2027new text end , and every two years thereafter, based on wage
data by SOC from the Bureau of Labor Statistics 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

Sec. 18.

Minnesota Statutes 2020, section 256B.4914, subdivision 8, as amended by Laws
2022, chapter 33, section 1, subdivision 8, is amended to read:

Subd. 8.

Unit-based services with programming; component values and calculation
of payment rates.

(a) For the purpose of this section, unit-based services with programming
include employment exploration services, employment development services, employment
support services, individualized home supports with family training, individualized home
supports with training, and positive support services provided to an individual outside of
any service plan for a day program or residential support service.

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

(1) competitive workforce factor: 4.7 percent;

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

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

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

(5) program plan support ratio: 15.5 percent;

(6) client programming and support ratio: 4.7 percent, updated as specified in subdivision
5b;

(7) general administrative support ratio: 13.25 percent;

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

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

(c) A unit of service for unit-based services with programming is 15 minutesnew text begin , except for
individualized home supports with training where a unit of service is one hour or 15 minutesnew text end .

(d) Payments for unit-based services with programming must be calculated as follows,
unless the services are reimbursed separately as part of a residential support services or day
program payment rate:

(1) determine the number of units of service 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;

(4) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (3);

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

(6) multiply the number of 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) this is the subtotal rate;

(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;

(14) for services provided in a shared manner, divide the total payment in clause (13)
as follows:

(i) for employment exploration services, divide by the number of service recipients, not
to exceed five;

(ii) for employment support services, divide by the number of service recipients, not to
exceed six; and

(iii) for individualized home supports with training and individualized home supports
with family training, divide by the number of service recipients, not to exceed deleted text begin twodeleted text end new text begin threenew text end ;
and

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

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, except paragraph (c) is effective July 1, 2022. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 19.

Minnesota Statutes 2020, section 256B.4914, subdivision 9, as amended by Laws
2022, chapter 33, section 1, is amended to read:

Subd. 9.

Unit-based services without programming; component values and
calculation of payment rates.

(a) For the purposes of this section, unit-based services
without programming include individualized home supports without training and night
supervision provided to an individual outside of any service plan for a day program or
residential support service. Unit-based services without programming do not include respite.

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

(1) competitive workforce factor: 4.7 percent;

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

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

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

(5) program plan support ratio: 7.0 percent;

(6) client programming and support ratio: 2.3 percent, updated as specified in subdivision
5b;

(7) general administrative support ratio: 13.25 percent;

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

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

(d) Payments for unit-based services without programming must be calculated as follows
unless the services are reimbursed separately as part of a residential support services or day
program payment rate:

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

(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 to 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 direct staffing hours by the appropriate staff wage;

(6) multiply the number of 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) this is the subtotal rate;

(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;

(14) for individualized home supports without training provided in a shared manner,
divide the total payment amount in clause (13) by the number of service recipients, not to
exceed deleted text begin twodeleted text end new text begin threenew text end ; and

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

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 notify the revisor of
statutes when federal approval is obtained.
new text end

Sec. 20.

Minnesota Statutes 2020, section 256B.4914, subdivision 10, as amended by
Laws 2022, chapter 33, section 1, is amended to read:

Subd. 10.

Evaluation of information and data.

(a) The commissioner shall, within
available resources, conduct research and gather data and information from existing state
systems or other outside sources on the following items:

(1) differences in the underlying cost to provide services and care across the state;

(2) mileage, vehicle type, lift requirements, incidents of individual and shared rides, and
units of transportation for all day services, which must be collected from providers using
the rate management worksheet and entered into the rates management system; and

(3) the distinct underlying costs for services provided by a license holder under sections
245D.05, 245D.06, 245D.07, 245D.071, 245D.081, and 245D.09, and for services provided
by a license holder certified under section 245D.33.

(b) The commissioner, in consultation with stakeholders, shall review and evaluate the
following values already in subdivisions 6 to deleted text begin 9adeleted text end new text begin 9new text end , or issues that impact all services, including,
but not limited to:

(1) values for transportation rates;

(2) values for services where monitoring technology replaces staff time;

(3) values for indirect services;

(4) values for nursing;

(5) values for the facility use rate in day services, and the weightings used in the day
service ratios and adjustments to those weightings;

(6) values for workers' compensation as part of employee-related expenses;

(7) values for unemployment insurance as part of employee-related expenses;

(8) direct care workforce labor market measures;

(9) any changes in state or federal law with a direct impact on the underlying cost of
providing home and community-based services;

(10) outcome measures, determined by the commissioner, for home and community-based
services rates determined under this section; and

(11) different competitive workforce factors by service, as determined under subdivision
10b.

(c) The commissioner shall report to the chairs and the ranking minority members of
the legislative committees and divisions with jurisdiction over health and human services
policy and finance with the information and data gathered under paragraphs (a) and (b) on
January 15, 2021, with a full report, and a full report once every four years thereafter.

(d) Beginning July 1, 2022, the commissioner shall renew analysis and implement
changes to the regional adjustment factors once every six years. Prior to implementation,
the commissioner shall consult with stakeholders on the methodology to calculate the
adjustment.

new text begin EFFECTIVE DATE. new text end

Sec. 21.

Minnesota Statutes 2020, section 256B.4914, subdivision 10a, as amended by
Laws 2022, chapter 33, section 1, is amended to read:

Subd. 10a.

Reporting and analysis of cost data.

(a) The commissioner must ensure
that wage values and component values in subdivisions 5 to deleted text begin 9adeleted text end new text begin 9new text end reflect the cost to provide
the service. As determined by the commissioner, in consultation with stakeholders identified
in subdivision 17, a provider enrolled to provide services with rates determined under this
section must submit requested cost data to the commissioner to support research on the cost
of providing services that have rates determined by the disability waiver rates system.
Requested cost data may include, but is not limited to:

(1) worker wage costs;

(2) benefits paid;

(3) supervisor wage costs;

(4) executive wage costs;

(5) vacation, sick, and training time paid;

(6) taxes, workers' compensation, and unemployment insurance costs paid;

(7) administrative costs paid;

(8) program costs paid;

(9) transportation costs paid;

(10) vacancy rates; and

(11) other data relating to costs required to provide services requested by the
commissioner.

(b) At least once in any five-year period, a provider must submit cost data for a fiscal
year that ended not more than 18 months prior to the submission date. The commissioner
shall provide each provider a 90-day notice prior to its submission due date. If a provider
fails to submit required reporting data, the commissioner shall provide notice to providers
that have not provided required data 30 days after the required submission date, and a second
notice for providers who have not provided required data 60 days after the required
submission date. The commissioner shall temporarily suspend payments to the provider if
cost data is not received 90 days after the required submission date. Withheld payments
shall be made once data is received by the commissioner.

(d) The commissioner shall analyze cost data submitted under paragraph (a) and, in
consultation with stakeholders identified in subdivision 17, may submit recommendations
on component values and inflationary factor adjustments to the chairs and ranking minority
members of the legislative committees with jurisdiction over human services once every
four years beginning January 1, 2021. The commissioner shall make recommendations in
conjunction with reports submitted to the legislature according to subdivision 10, paragraph
(c).

(e) The commissioner shall release cost data in an aggregate form, and cost data from
individual providers shall not be released except as provided for in current law.

(f) The commissioner, in consultation with stakeholders identified in subdivision 17,
shall develop and implement a process for providing training and technical assistance
necessary to support provider submission of cost documentation required under paragraph
(a).

new text begin EFFECTIVE DATE. new text end

Sec. 22.

Minnesota Statutes 2020, section 256B.4914, subdivision 12, as amended by
Laws 2022, chapter 33, section 1, is amended to read:

Subd. 12.

Customization of rates for individuals.

(a) For persons determined to have
higher needs based on being deaf or hard-of-hearing, the direct-care costs must be increased
by an adjustment factor prior to calculating the rate under subdivisions 6 to deleted text begin 9adeleted text end new text begin 9new text end . The
customization rate with respect to deaf or hard-of-hearing persons shall be $2.50 per hour
for waiver recipients who meet the respective criteria as determined by the commissioner.

(b) For the purposes of this section, "deaf and hard-of-hearing" means:

(1) the person has a developmental disability and:

(i) an assessment score which indicates a hearing impairment that is severe or that the
person has no useful hearing;

(ii) an expressive communications score that indicates the person uses single signs or
gestures, uses an augmentative communication aid, or does not have functional
communication, or the person's expressive communications is unknown; and

(iii) a communication score which indicates the person comprehends signs, gestures,
and modeling prompts or does not comprehend verbal, visual, or gestural communication,
or that the person's receptive communication score is unknown; or

(2) the person receives long-term care services and has an assessment score that indicates
the person hears only very loud sounds, the person has no useful hearing, or a determination
cannot be made; and the person receives long-term care services and has an assessment that
indicates the person communicates needs with sign language, symbol board, written
messages, gestures, or an interpreter; communicates with inappropriate content, makes
garbled sounds or displays echolalia, or does not communicate needs.

new text begin EFFECTIVE DATE. new text end

Sec. 23.

Minnesota Statutes 2020, section 256B.4914, subdivision 14, as amended by
Laws 2022, chapter 33, section 1, is amended to read:

Subd. 14.

Exceptions.

(a) In a format prescribed by the commissioner, lead agencies
must identify individuals with exceptional needs that cannot be met under the disability
waiver rate system. The commissioner shall use that information to evaluate and, if necessary,
approve an alternative payment rate for those individuals. Whether granted, denied, or
modified, the commissioner shall respond to all exception requests in writing. The
commissioner shall include in the written response the basis for the action and provide
notification of the right to appeal under paragraph (h).

(b) Lead agencies must act on an exception request within 30 days and notify the initiator
of the request of their recommendation in writing. A lead agency shall submit all exception
requests along with its recommendation to the commissioner.

(1) an individual has service needs that cannot be met through additional units of service;

(2) an individual's rate determined under subdivisions 6 to deleted text begin 9adeleted text end new text begin 9new text end is so insufficient that it
has resulted in an individual receiving a notice of discharge from the individual's provider;
or

(3) an individual's service needs, including behavioral changes, require a level of service
which necessitates a change in provider or which requires the current provider to propose
service changes beyond those currently authorized.

(d) Exception requests must include the following information:

(1) the service needs required by each individual that are not accounted for in subdivisions
6 to deleted text begin 9adeleted text end new text begin 9new text end ;

(2) the service rate requested and the difference from the rate determined in subdivisions
6 to deleted text begin 9adeleted text end new text begin 9new text end ;

(3) a basis for the underlying costs used for the rate exception and any accompanying
documentation; and

(4) any contingencies for approval.

(e) Approved rate exceptions shall be managed within lead agency allocations under
sections 256B.092 and 256B.49.

(f) Individual disability waiver recipients, an interested party, or the license holder that
would receive the rate exception increase may request that a lead agency submit an exception
request. A lead agency that denies such a request shall notify the individual waiver recipient,
interested party, or license holder of its decision and the reasons for denying the request in
writing no later than 30 days after the request has been made and shall submit its denial to
the commissioner in accordance with paragraph (b). The reasons for the denial must be
based on the failure to meet the criteria in paragraph (c).

(g) The commissioner shall determine whether to approve or deny an exception request
no more than 30 days after receiving the request. If the commissioner denies the request,
the commissioner shall notify the lead agency and the individual disability waiver recipient,
the interested party, and the license holder in writing of the reasons for the denial.

(h) The individual disability waiver recipient may appeal any denial of an exception
request by either the lead agency or the commissioner, pursuant to sections 256.045 and
256.0451. When the denial of an exception request results in the proposed demission of a
waiver recipient from a residential or day habilitation program, the commissioner shall issue
a temporary stay of demission, when requested by the disability waiver recipient, consistent
with the provisions of section 256.045, subdivisions 4a and 6, paragraph (c). The temporary
stay shall remain in effect until the lead agency can provide an informed choice of
appropriate, alternative services to the disability waiver.

(i) Providers may petition lead agencies to update values that were entered incorrectly
or erroneously into the rate management system, based on past service level discussions
and determination in subdivision 4, without applying for a rate exception.

(j) The starting date for the rate exception will be the later of the date of the recipient's
change in support or the date of the request to the lead agency for an exception.

(k) The commissioner shall track all exception requests received and their dispositions.
The commissioner shall issue quarterly public exceptions statistical reports, including the
number of exception requests received and the numbers granted, denied, withdrawn, and
pending. The report shall include the average amount of time required to process exceptions.

(l) Approved rate exceptions remain in effect in all cases until an individual's needs
change as defined in paragraph (c).

new text begin EFFECTIVE DATE. new text end

Sec. 24.

Minnesota Statutes 2020, section 256B.493, subdivision 4, is amended to read:

Subd. 4.

Review and approval process.

(a) To be considered fornew text begin conditionalnew text end approval,
an application must include:

(1) a description of the proposed closure plan, which must identify the home or homes
and occupied beds for which a planned closure rate adjustment is requested;

(2) the proposed timetable for any proposed closure, including the proposed dates for
notification to residents and the affected lead agencies, commencement of closure, and
completion of closure;

(3) the proposed relocation plan jointly developed by the counties of financial
responsibility, the residents and their legal representatives, if any, who wish to continue to
receive services from the provider, and the providers for current residents of any adult foster
care homenew text begin or community residential settingnew text end designated for closure; and

(4) documentation in a format approved by the commissioner that all the adult foster
care homesnew text begin or community residential settingsnew text end receiving a planned closure rate adjustment
under the plan have accepted joint and several liability for recovery of overpayments under
section 256B.0641, subdivision 2, for the facilities designated for closure under this plan.

(b) In reviewing and approving closure proposals, the commissioner shall give first
priority to proposals that:

(1) target counties and geographic areas which have:

(i) need for other types of services;

(ii) need for specialized services;

(iii) higher than average per capita use of foster care settings where the license holder
does not reside; or

(iv) residents not living in the geographic area of their choice;

(2) demonstrate savings of medical assistance expenditures; deleted text begin and
deleted text end

(3) demonstrate that alternative services are based on the recipient's choice of provider
and are consistent with federal law, state law, and federally approved waiver plansnew text begin ;
new text end

new text begin (4) demonstrate alternative services based on the recipient's choices are available and
secured at time of closure application; and
new text end

new text begin (5) provide proof of referral to the regional Center for Independent Living for resident
transition supportnew text end .

The commissioner shall deleted text begin also considerdeleted text end new text begin prioritize consideration ofnew text end any information provided
by service recipients, their legal representatives, family members, or the lead agency on the
impact of the planned closure on the recipients and the services they need.

(c) The commissioner shall select proposals that best meet the criteria established in this
subdivision for planned closure of adult foster carenew text begin or community residentialnew text end settings. The
commissioner shall notify license holders of the selectionsnew text begin conditionallynew text end approved by the
commissioner.new text begin Approval of closure is obtained following confirmation that every individual
impacted by the planned closure has an established plan to continue services in an equivalent
residential setting or in a less restrictive setting in the community of their choice.
new text end

(d) For each proposalnew text begin conditionallynew text end approved by the commissioner, a contract must be
established between the commissioner, the counties of financial responsibility, and the
participating license holder.

Sec. 25.

Minnesota Statutes 2020, section 256B.493, subdivision 5, is amended to read:

Subd. 5.

Notification ofnew text begin conditionallynew text end approved proposal.

(a) Once the license holder
receives notification from the commissioner that the proposal has beennew text begin conditionallynew text end
approved, the license holder shall provide written notification within five working days to:

(1) the lead agencies responsible for authorizing the licensed services for the residents
of the affected adult foster care settings; and

(2) current and prospective residents, any legal representatives, and family members
involved.

(b) This notification must occur at least deleted text begin 45deleted text end new text begin 90new text end days prior to the implementation of the
closure proposal.

Sec. 26.

Minnesota Statutes 2020, section 256B.493, is amended by adding a subdivision
to read:

new text begin Subd. 5a. new text end

new text begin Notification of conditionally approved proposal to Centers for Independent
Living. new text end

new text begin (a) Once conditional approval has been sent to the license holder, the commissioner
shall provide written notice within five working days to the regional Center for Independent
Living.
new text end

new text begin (b) The commissioner must provide in the written notice the number of persons affected
by closure, location of group homes, provider information, and contact information of
persons or current guardians to coordinate transition support of residents.
new text end

Sec. 27.

Minnesota Statutes 2020, section 256B.493, is amended by adding a subdivision
to read:

new text begin Subd. 5b. new text end

new text begin Approval for planned closure. new text end

new text begin The commissioner may finalize approval of
conditional applications for planned closure after the license holder takes the following
actions and submits proof of documentation to the commissioner:
new text end

new text begin (1) all parties were provided notice within five business days of receiving conditional
approval and residents, support team, and family members were provided 90 days' notice
prior to the implementation of the closure proposal;
new text end

new text begin (2) information regarding rights to appeal service termination and seek a temporary
order to stay the termination of services according to the procedures in section 256.045,
subdivision 4a or 6, paragraph (c), were provided to the resident, family, and support team
at time of closure notice;
new text end

new text begin (3) residents were provided options to live in the geographic community of their own
choice; and
new text end

new text begin (4) residents were provided options to live in a community residential or own-home
setting with the services and supports of their choice.
new text end

Sec. 28.

Minnesota Statutes 2020, section 256B.493, subdivision 6, is amended to read:

Subd. 6.

Adjustment to rates.

(a) For purposes of this section, the commissioner shall
establish enhanced medical assistance payment rates under sections 256B.092 and 256B.49
to facilitate an orderly transition for persons with disabilities from adult foster carenew text begin or
community residential settingsnew text end to other community-based settings.

(b) The enhanced payment rate shall be effective the day after the first resident has
moved until the day the last resident has moved, not to exceed six months.

Sec. 29.

Minnesota Statutes 2020, section 256B.493, is amended by adding a subdivision
to read:

new text begin Subd. 7. new text end

new text begin Termination of license or satellite license upon approved closure
date. new text end

new text begin Following approval of a planned closure, the commissioner shall confirm termination
of licensure for the residence location, whether satellite or home and community-based
license for single residence as referenced in section 245D.23. The commissioner must
provide written notice confirming termination of licensure to the provider.
new text end

Sec. 30.

Minnesota Statutes 2020, section 256B.5012, is amended by adding a subdivision
to read:

new text begin Subd. 19. new text end

new text begin ICF/DD rate increase effective July 1, 2022. new text end

new text begin (a) Effective July 1, 2022, the
daily operating payment rate for a class A intermediate care facility for persons with
developmental disabilities is increased by $50.
new text end

new text begin (b) Effective July 1, 2022, the daily operating payment rate for a class B intermediate
care facility for persons with developmental disabilities is increased by $50.
new text end

new text begin EFFECTIVE DATE. new text end

Sec. 31.

Minnesota Statutes 2020, section 256B.5012, is amended by adding a subdivision
to read:

new text begin Subd. 20. new text end

new text begin ICF/DD minimum daily operating payment rates. new text end

new text begin (a) The minimum daily
operating payment rate for a class A intermediate care facility for persons with developmental
disabilities is $300.
new text end

new text begin (b) The minimum daily operating payment rate for a class B intermediate care facility
for persons with developmental disabilities is $400.
new text end

new text begin EFFECTIVE DATE. new text end

Sec. 32.

Minnesota Statutes 2021 Supplement, section 256B.85, subdivision 7, is amended
to read:

Subd. 7.

Community first services and supports; covered services.

Services and
supports covered under CFSS include:

(1) assistance to accomplish activities of daily living (ADLs), instrumental activities of
daily living (IADLs), and health-related procedures and tasks through hands-on assistance
to accomplish the task or constant supervision and cueing to accomplish the task;

(2) assistance to acquire, maintain, or enhance the skills necessary for the participant to
accomplish activities of daily living, instrumental activities of daily living, or health-related
tasks;

(3) expenditures for items, services, supports, environmental modifications, or goods,
including assistive technology. These expenditures must:

(i) relate to a need identified in a participant's CFSS service delivery plan; and

(ii) increase independence or substitute for human assistance, to the extent that
expenditures would otherwise be made for human assistance for the participant's assessed
needs;

(4) observation and redirection for behavior or symptoms where there is a need for
assistance;

(5) back-up systems or mechanisms, such as the use of pagers or other electronic devices,
to ensure continuity of the participant's services and supports;

(6) services provided by a consultation services provider as defined under subdivision
17, that is under contract with the department and enrolled as a Minnesota health care
program provider;

(7) services provided by an FMS provider as defined under subdivision 13a, that is an
enrolled provider with the department;

(8) CFSS services provided by a support worker who is a parent, stepparent, or legal
guardian of a participant under age 18, or who is the participant's spouse. deleted text begin These support
workers shall not:deleted text end new text begin Covered services under this clause are subject to the limitations described
in subdivision 7b; and
new text end

deleted text begin (i) provide any medical assistance home and community-based services in excess of 40
hours per seven-day period regardless of the number of parents providing services,
combination of parents and spouses providing services, or number of children who receive
medical assistance services; and
deleted text end

deleted text begin (ii) have a wage that exceeds the current rate for a CFSS support worker including the
wage, benefits, and payroll taxes; and
deleted text end

(9) worker training and development services as described in subdivision 18a.

new text begin EFFECTIVE DATE. new text end

Sec. 33.

Minnesota Statutes 2021 Supplement, section 256B.85, subdivision 7a, is amended
to read:

Subd. 7a.

Enhanced rate.

An enhanced rate of deleted text begin 107.5deleted text end new text begin 143new text end percent of the rate paid for
CFSS must be paid for services provided to persons who qualify for ten or more hours of
CFSS per day when provided by a support worker who meets the requirements of subdivision
16, paragraph (e). Any change in the eligibility criteria for the enhanced rate for CFSS as
described in this subdivision and referenced in subdivision 16, paragraph (e), does not
constitute a change in a term or condition for individual providers as defined in section
256B.0711, and is not subject to the state's obligation to meet and negotiate under chapter
179A.

Sec. 34.

Minnesota Statutes 2020, section 256B.85, is amended by adding a subdivision
to read:

new text begin Subd. 7b. new text end

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

new text begin (a) This subdivision applies to
services and supports described in subdivision 7, clause (8).
new text end

new text begin (b) If multiple parents are support workers providing CFSS services to their minor child
or children, each parent may provide up to 40 hours of medical assistance home and
community-based 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 (c) If only one parent is a support worker providing CFSS services to the parent's 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 (d) If a spouse is a support worker providing CFSS 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 (e) Paragraphs (b) to (d) must not be construed to permit an increase in either the total
authorized service budget for an individual or the total number of authorized service units.
new text end

new text begin (f) A parent or spouse must not receive a wage that exceeds the current rate for a CFSS
support worker, including the wage, benefits, and payroll taxes.
new text end

new text begin EFFECTIVE DATE. new text end

Sec. 35.

Minnesota Statutes 2021 Supplement, section 256B.851, subdivision 5, is amended
to read:

Subd. 5.

Payment rates; component values.

(a) The commissioner must use the
following component values:

(1) employee vacation, sick, and training factor, 8.71 percent;

(2) employer taxes and workers' compensation factor, 11.56 percent;

(3) employee benefits factor, 12.04 percent;

(4) client programming and supports factor, 2.30 percent;

(5) program plan support factor, 7.00 percent;

(6) general business and administrative expenses factor, 13.25 percent;

(7) program administration expenses factor, 2.90 percent; and

(8) absence and utilization factor, 3.90 percent.

(b) For purposes of implementation, the commissioner shall use the following
implementation components:

(1) personal care assistance services and CFSS: deleted text begin 75.45deleted text end new text begin 83.5new text end percent;

(2) enhanced rate personal care assistance services and enhanced rate CFSS: deleted text begin 75.45deleted text end new text begin 83.5new text end
percent; and

(3) qualified professional services and CFSS worker training and development: deleted text begin 75.45deleted text end new text begin
83.5new text end percent.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, or 60 days following
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. 36.

Minnesota Statutes 2020, section 256I.04, subdivision 3, is amended to read:

Subd. 3.

Moratorium on development of housing support beds.

(a) Agencies shall
not enter into agreements for new housing support beds with total rates in excess of the
MSA equivalent rate except:

(1) for establishments licensed under chapter 245D provided the facility is needed to
meet the census reduction targets for persons with developmental disabilities at regional
treatment centers;

(2) up to 80 beds in a single, specialized facility located in Hennepin County that will
provide housing for chronic inebriates who are repetitive users of detoxification centers and
are refused placement in emergency shelters because of their state of intoxication, and
planning for the specialized facility must have been initiated before July 1, 1991, in
anticipation of receiving a grant from the Housing Finance Agency under section 462A.05,
subdivision 20a, paragraph (b);

(3) notwithstanding the provisions of subdivision 2a, for up to 226 supportive housing
units in Anoka, new text begin Carver, new text end Dakota, Hennepin, deleted text begin ordeleted text end Ramseynew text begin , Scott, or Washingtonnew text end County for
homeless adults with a new text begin disability, including but not limited to new text end mental illness, a history of
substance abuse, or human immunodeficiency virus or acquired immunodeficiency syndrome.
For purposes of this deleted text begin sectiondeleted text end new text begin clausenew text end , "homeless adult" means a person who is new text begin (i) new text end living on
the street or in a shelter or new text begin (ii) new text end discharged from a regional treatment center, community
hospital, or residential treatment program and has no appropriate housing available and
lacks the resources and support necessary to access appropriate housing. deleted text begin At least 70 percent
of the supportive housing units must serve homeless adults with mental illness, substance
abuse problems, or human immunodeficiency virus or acquired immunodeficiency syndrome
who are about to be or, within the previous six months, have been discharged from a regional
treatment center, or a state-contracted psychiatric bed in a community hospital, or a residential
mental health or chemical dependency treatment program.deleted text end If a person meets the requirements
of subdivision 1, paragraph (a)new text begin or (b)new text end , and receives a federal or state housing subsidy, the
housing support rate for that person is limited to the supplementary rate under section
256I.05, subdivision 1adeleted text begin , and is determined by subtracting the amount of the person's
countable income that exceeds the MSA equivalent rate from the housing support
supplementary service ratedeleted text end . A resident in a demonstration project site who no longer
participates in the demonstration program shall retain eligibility for a housing support
payment in an amount determined under section 256I.06, subdivision 8, using the MSA
equivalent rate. deleted text begin Service funding under section 256I.05, subdivision 1a, will end June 30,
1997, if federal matching funds are available and the services can be provided through a
managed care entity. If federal matching funds are not available, then service funding will
continue under section 256I.05, subdivision 1adeleted text end ;

(4) for an additional two beds, resulting in a total of 32 beds, for a facility located in
Hennepin County providing services for recovering and chemically dependent men that has
had a housing support contract with the county and has been licensed as a board and lodge
facility with special services since 1980;

(5) for a housing support provider located in the city of St. Cloud, or a county contiguous
to the city of St. Cloud, that operates a 40-bed facility, that received financing through the
Minnesota Housing Finance Agency Ending Long-Term Homelessness Initiative and serves
chemically dependent clientele, providing 24-hour-a-day supervision;

(6) for a new 65-bed facility in Crow Wing County that will serve chemically dependent
persons, operated by a housing support provider that currently operates a 304-bed facility
in Minneapolis, and a 44-bed facility in Duluth;

(7) for a housing support provider that operates two ten-bed facilities, one located in
Hennepin County and one located in Ramsey County, that provide community support and
24-hour-a-day supervision to serve the mental health needs of individuals who have
chronically lived unsheltered; and

(8) for a facility authorized for recipients of housing support in Hennepin County with
a capacity of up to 48 beds that has been licensed since 1978 as a board and lodging facility
and that until August 1, 2007, operated as a licensed chemical dependency treatment program.

(b) An agency may enter into a housing support agreement for beds with rates in excess
of the MSA equivalent rate in addition to those currently covered under a housing support
agreement if the additional beds are only a replacement of beds with rates in excess of the
MSA equivalent rate which have been made available due to closure of a setting, a change
of licensure or certification which removes the beds from housing support payment, or as
a result of the downsizing of a setting authorized for recipients of housing support. The
transfer of available beds from one agency to another can only occur by the agreement of
both agencies.

Sec. 37.

Minnesota Statutes 2020, section 256I.05, is amended by adding a subdivision
to read:

new text begin Subd. 1s. new text end

new text begin Supplemental rate; Douglas County. new text end

new text begin Notwithstanding the provisions in this
section, a county agency shall negotiate a supplemental rate for up to 20 beds in addition
to the rate specified in subdivision 1, not to exceed the maximum rate allowed under
subdivision 1a, including any legislatively authorized inflationary adjustments, for a housing
support provider located in Douglas County that operates two facilities and provides room
and board and supplementary services to adult males recovering from substance use disorder,
mental illness, or housing instability.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 38.

Laws 2014, chapter 312, article 27, section 75, is amended to read:

Sec. 75. PROVIDER RATE AND GRANT INCREASES EFFECTIVE JULY 1, 2014.

(a) The commissioner of human services shall increase reimbursement rates, grants,
allocations, individual limits, and rate limits, as applicable, by five percent for the rate period
beginning July 1, 2014, for services rendered on or after July 1, 2014. County or tribal
contracts for services, grants, and programs under paragraph (b) must be amended to pass
through these rate increases by September 1, 2014.

(b) The rate changes described in this section must be provided to:

(1) home and community-based waivered services for persons with developmental
disabilities, including consumer-directed community supports, under Minnesota Statutes,
section 256B.092;

(2) waivered services under community alternatives for disabled individuals, including
consumer-directed community supports, under Minnesota Statutes, section 256B.49;

(3) community alternative care waivered services, including consumer-directed
community supports, under Minnesota Statutes, section 256B.49;

(4) brain injury waivered services, including consumer-directed community supports,
under Minnesota Statutes, section 256B.49;

(5) home and community-based waivered services for the elderly under Minnesota
Statutes, section 256B.0915;

(6) nursing services and home health services under Minnesota Statutes, section
256B.0625, subdivision 6a;

(7) personal care services and qualified professional supervision of personal care services
under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;

(8) private duty nursing services under Minnesota Statutes, section 256B.0625,
subdivision 7;

(9) community first services and supports under Minnesota Statutes, section 256B.85;

(10) essential community supports under Minnesota Statutes, section 256B.0922;

(11) day training and habilitation services for adults with developmental disabilities
under Minnesota Statutes, sections 252.41 to 252.46deleted text begin , including the additional cost to counties
deleted text end deleted text begin of the rate adjustments on day training and habilitation services, provided as a social servicedeleted text end ;

(12) alternative care services under Minnesota Statutes, section 256B.0913;

(13) living skills training programs for persons with intractable epilepsy who need
assistance in the transition to independent living under Laws 1988, chapter 689;

(14) semi-independent living services (SILS) under Minnesota Statutes, section 252.275;

(15) consumer support grants under Minnesota Statutes, section 256.476;

(16) family support grants under Minnesota Statutes, section 252.32;

(17) housing access grants under Minnesota Statutes, section 256B.0658;

(18) self-advocacy grants under Laws 2009, chapter 101;

(19) technology grants under Laws 2009, chapter 79;

(20) aging grants under Minnesota Statutes, sections 256.975 to 256.977 and 256B.0917;

(21) deaf and hard-of-hearing grants, including community support services for deaf
and hard-of-hearing adults with mental illness who use or wish to use sign language as their
primary means of communication under Minnesota Statutes, section 256.01, subdivision 2;

(22) deaf and hard-of-hearing grants under Minnesota Statutes, sections 256C.233,
256C.25, and 256C.261;

(23) Disability Linkage Line grants under Minnesota Statutes, section 256.01, subdivision
24;

(24) transition initiative grants under Minnesota Statutes, section 256.478;

(25) employment support grants under Minnesota Statutes, section 256B.021, subdivision
6; and

(26) grants provided to people who are eligible for the Housing Opportunities for Persons
with AIDS program under Minnesota Statutes, section 256B.492.

(c) A managed care plan or county-based purchasing plan receiving state payments for
the services grants and programs in paragraph (b) must include these increases in their
payments to providers. To implement the rate increase in paragraph (a), capitation rates
paid by the commissioner to managed care plans and county-based purchasing plans under
Minnesota Statutes, section 256B.69, shall reflect a five percent increase for the services
and programs specified in paragraph (b) for the period beginning July 1, 2014.

(d) Counties shall increase the budget for each recipient of consumer-directed community
supports by the amount in paragraph (a) on July 1, 2014.

(e) To receive the rate increase described in this section, providers under paragraphs (a)
and (b) must submit to the commissioner documentation that identifies a quality improvement
project that the provider will implement by June 30, 2015. Documentation must be provided
in a format specified by the commissioner. Projects must:

(1) improve the quality of life of home and community-based services recipients in a
meaningful way;

(2) improve the quality of services in a measurable way; or

(3) deliver good quality service more efficiently while using the savings to enhance
services for the participants served.

Providers listed in paragraph (b), clauses (7), (9), (10), and (13) to (26), are not subject to
this requirement.

(f) For a provider that fails to submit documentation described in paragraph (e) by a date
or in a format specified by the commissioner, the commissioner shall reduce the provider's
rate by one percent effective January 1, 2015.

(g) Providers that receive a rate increase under paragraph (a) shall use 80 percent of the
additional revenue to increase compensation-related costs for employees directly employed
by the program on or after July 1, 2014, except:

(1) persons employed in the central office of a corporation or entity that has an ownership
interest in the provider or exercises control over the provider; and

(2) persons paid by the provider under a management contract.

This requirement is subject to audit by the commissioner.

(h) Compensation-related costs include:

(1) wages and salaries;

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

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

(4) other benefits provided and workforce needs, including the recruiting and training
of employees as specified in the distribution plan required under paragraph (m).

(i) For public employees under a collective bargaining agreement, the increase for wages
and benefits is available and pay rates must be increased only to the extent that the increases
comply with laws governing public employees' collective bargaining. Money received by
a provider for pay increases for public employees under paragraph (g) must be used only
for pay increases implemented between July 1, 2014, and August 1, 2014.

(j) For a provider that has employees that are represented by an exclusive bargaining
representative, the provider shall obtain a letter of acceptance of the distribution plan required
under paragraph (m), in regard to the members of the bargaining unit, signed by the exclusive
bargaining agent. Upon receipt of the letter of acceptance, the provider shall be deemed to
have met all the requirements of this section in regard to the members of the bargaining
unit. Upon request, the provider shall produce the letter of acceptance for the commissioner.

(k) The commissioner shall amend state grant contracts that include direct
personnel-related grant expenditures to include the allocation for the portion of the contract
related to employee compensation. Grant contracts for compensation-related services must
be amended to pass through these adjustments by September 1, 2014, and must be retroactive
to July 1, 2014.

(l) The Board on Aging and its area agencies on aging shall amend their grants that
include direct personnel-related grant expenditures to include the rate adjustment for the
portion of the grant related to employee compensation. Grants for compensation-related
services must be amended to pass through these adjustments by September 1, 2014, and
must be retroactive to July 1, 2014.

(m) A provider that receives a rate adjustment under paragraph (a) that is subject to
paragraph (g) shall prepare, and upon request submit to the commissioner, a distribution
plan that specifies the amount of money the provider expects to receive that is subject to
the requirements of paragraph (g), including how that money will be distributed to increase
compensation for employees. The commissioner may recover funds from a provider that
fails to comply with this requirement.

(n) By January 1, 2015, the provider shall post the distribution plan required under
paragraph (m) for a period of at least six weeks in an area of the provider's operation to
which all eligible employees have access and shall provide instructions for employees who
do not believe they have received the wage and other compensation-related increases
specified in the distribution plan. The instructions must include a mailing address, e-mail
address, and telephone number that the employee may use to contact the commissioner or
the commissioner's representative.

(o) For providers with rates established under Minnesota Statutes, section 256B.4914,
and with a historical rate established under Minnesota Statutes, section 256B.4913,
subdivision 4a, paragraph (b), that is greater than the rate established under Minnesota
Statutes, section 256B.4914, the requirements in paragraph (g) must only apply to the portion
of the rate increase that exceeds the difference between the rate established under Minnesota
Statutes, section 256B.4914, and the banding value established under Minnesota Statutes,
section 256B.4913, subdivision 4a, paragraph (b).

Sec. 39.

Laws 2021, First Special Session chapter 7, article 17, section 14, is amended to
read:

Sec. 14. TASK FORCE ON deleted text begin ELIMINATINGdeleted text end SUBMINIMUM WAGES.

Subdivision 1.

Establishment; purpose.

The Task Force on deleted text begin Eliminatingdeleted text end Subminimum
Wages is established to develop a plan and make recommendations to deleted text begin phase out payment
of subminimum wages to people with disabilities on or before August 1, 2025deleted text end new text begin promote
independence and increase opportunities for people with disabilities to earn competitive
wagesnew text end .

Subd. 2.

Definitions.

For the purposes of this section, "subminimum wage" means wages
authorized under section 14(c) of the federal Fair Labor Standards Act, Minnesota Statutes,
section 177.28, subdivision 5, or Minnesota Rules, parts 5200.0030 and 5200.0040.

Subd. 3.

Membership.

(a) The task force consists of deleted text begin 16deleted text end new text begin 20new text end members, appointed as
follows:

(1) the commissioner of human services or a designee;

(2) the commissioner of labor and industry or a designee;

(3) the commissioner of education or a designee;

(4) the commissioner of employment and economic development or a designee;

(5) a representative of the Department of Employment and Economic Development's
Vocational Rehabilitation Services Division appointed by the commissioner of employment
and economic development;

(6) one member appointed by the Minnesota Disability Law Center;

(7) one member appointed by The Arc of Minnesota;

(8) deleted text begin threedeleted text end new text begin fournew text end members who are persons with disabilities appointed by the commissioner
of human services, at least one of whom deleted text begin must bedeleted text end new text begin isnew text end neurodiverse, deleted text begin anddeleted text end at least one of whom
deleted text begin must havedeleted text end new text begin hasnew text end a significant physical disabilitynew text begin , and at least one of whom at the time of the
appointment is being paid a subminimum wagenew text end ;

(9) two representatives of employers authorized to pay subminimum wage and one
representative of an employer who successfully transitioned away from payment of
subminimum wages to people with disabilities, appointed by the commissioner of human
services;

(10) one member appointed by the Minnesota Organization for Habilitation and
Rehabilitation;

(11) one member appointed by ARRM;deleted text begin and
deleted text end

(12) one member appointed by the State Rehabilitation Councilnew text begin ; and
new text end

new text begin (13) three members who are parents or guardians of persons with disabilities appointed
by the commissioner of human services, at least one of whom is a parent or guardian of a
person who is neurodiverse, at least one of whom is a parent or guardian of a person with
a significant physical disability, and at least one of whom is a parent or guardian of a person
being paid a subminimum wage as of the date of the appointmentnew text end .

(b) To the extent possible, membership on the task force under paragraph (a) shall reflect
geographic parity throughout the state and representation from Black, Indigenous, and
communities of color.

Subd. 4.

Appointment deadline; first meeting; chair.

Appointing authorities must
complete member selections by January 1, 2022. The commissioner of human services shall
convene the first meeting of the task force by February 15, 2022. The task force shall select
a chair from among its members at its first meeting.

Subd. 5.

Compensation.

Members shall be compensated and may be reimbursed for
expenses as provided in Minnesota Statutes, section 15.059, subdivision 3.

Subd. 6.

Duties; plan and recommendations.

The task force shall:

(1) develop a plan to deleted text begin phase out the payment of subminimum wages to people with
disabilities by August 1, 2025deleted text end new text begin promote independence and increase opportunities for people
with disabilities to earn competitive wagesnew text end ;

(2) consult with and advise the commissioner of human services on statewide plans for
deleted text begin limitingdeleted text end new text begin reducing reliance onnew text end subminimum wages in medical assistance home and
community-based services waivers under Minnesota Statutes, sections 256B.092 and
256B.49;

(3) engage with employees with disabilities paid subminimum wages and conduct
community education on the payment of subminimum wages to people with disabilities in
Minnesota;

(4) identify and collaborate with employees, employers, businesses, organizations,
agencies, and stakeholders deleted text begin impacted by the phase out of subminimum wagedeleted text end on how to
implement the plan and create sustainable work opportunities for employees with disabilities;

(5) propose a plan to establish and evaluate benchmarks for measuring annual progress
toward deleted text begin eliminatingdeleted text end new text begin reducing reliance onnew text end subminimum wages;

(6) propose a plan to monitor and track outcomes of employees with disabilitiesnew text begin , including
those who transition to competitive employmentnew text end ;

(7) identify initiatives, investment, training, and services designed to improve wages,
reduce unemployment rates, and provide support and sustainable work opportunities for
persons with disabilities;

(8) identify benefits to the state deleted text begin in eliminatingdeleted text end new text begin in reducing reliance onnew text end subminimum deleted text begin wage
by August 1, 2025deleted text end new text begin wagesnew text end ;

(9) identify barriers to eliminating subminimum deleted text begin wage by August 1, 2025deleted text end new text begin wagesnew text end , including
the cost of implementing and providing ongoing employment services, training, and support
for employees with disabilities deleted text begin anddeleted text end new text begin ,new text end the cost of paying minimum deleted text begin wagedeleted text end new text begin wagesnew text end to employees
with disabilitiesnew text begin , and the potential impact on persons with disabilities who would be unable
to find sustainable employment in the absence of a subminimum wage or who would not
choose competitive employmentnew text end ;

(10) make recommendations to eliminate the barriers identified in clause (9); and

(11) identify and make recommendations for sustainable financial support, funding, and
resources for deleted text begin eliminatingdeleted text end new text begin reducing reliance onnew text end subminimum deleted text begin wage by August 1, 2025deleted text end new text begin wagesnew text end .

Subd. 7.

Duties; provider reinvention grants.

(a) The commissioner of human services
shall establish a provider reinvention grant program to promote independence and increase
opportunities for people with disabilities to earn competitive wages. The commissioner
shall make the grants available to at least the following:

(1) providers of disability services under Minnesota Statutes, sections 256B.092 and
256B.49, for developing and implementing a business plan to shift the providers' business
models away from paying waiver participants subminimum wages;

(2) organizations to develop peer-to-peer mentoring for people with disabilities who
have successfully transitioned to earning competitive wages;

(3) organizations to facilitate provider-to-provider mentoring to promote shifting away
from paying employees with disabilities a subminimum wage; and

(4) organizations to conduct family outreach and education on working with people with
disabilities who are transitioning from subminimum wage employment to competitive
employment.

(b) The provider reinvention grant program must be competitive. The commissioner of
human services must develop criteria for evaluating responses to requests for proposals.
Criteria for evaluating grant applications must be finalized no later than November 1, 2021.
The commissioner of human services shall administer grants in compliance with Minnesota
Statutes, sections 16B.97 and 16B.98, and related policies set forth by the Department of
Administration's Office of Grants Management.

(c) Grantees must work with the commissioner to develop their business model and, as
a condition of receiving grant funds, grantees must fully phase out the use of subminimum
wage by April 1, 2024, unless the grantee receives a waiver from the commissioner of
human services for a demonstrated need.

(d) Of the total amount available for provider reinvention grants, the commissioner may
award up to 25 percent of the grant funds to providers who have already successfully shifted
their business model away from paying employees with disabilities subminimum wages to
provide provider-to-provider mentoring to providers receiving a provider reinvention grant.

Subd. 8.

Report.

By February 15, 2023, the task force shall submit to the chairs and
ranking minority members of the committees and divisions in the senate and house of
representatives with jurisdiction over employment and wages and over health and human
services a report with recommendations to deleted text begin eliminate by August 1, 2025, the payment of
subminimum wagedeleted text end new text begin increase opportunities for people with disabilities to earn competitive
wagesnew text end , and any changes to statutes, laws, or rules required to implement the recommendations
of the task force. The task force must include in the report a recommendation concerning
continuing the task force beyond its scheduled expiration.

Subd. 9.

Administrative support.

The commissioner of human services shall provide
meeting space and administrative services to the task force.

Subd. 10.

Expiration.

The task force shall conclude their duties and expire on March
31, 2024.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment. The
commissioner of human services must make the additional appointments required under
this section within 30 days following final enactment.
new text end

Sec. 40.

Laws 2022, chapter 33, section 1, 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
employers, with the exception of asleep-overnight staff for family residential services, which
is 36 percent of the minimum wage in Minnesota for large employers;

(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 31-1014); 20 percent of the median wage for psychiatric technician (SOC code
29-2053); and 20 percent of the median wage for social and human services aide (SOC code
21-1093);

(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
counselors (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 ; and
deleted 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

Sec. 41.

Laws 2022, chapter 33, section 1, 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 9new 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) new text begin on January 1, 2023, by the percentage change in the CPI-U from the date of previous
update to the data available on December 31, 2021;
new text end

new text begin (3) new text end on deleted text begin November 1, 2024deleted text end new text begin January 1, 2025new text end , 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 2023new text end ; and

deleted text begin (3)deleted text end new text begin (4)new text end on deleted text begin July 1, 2026deleted text end new text begin January 1, 2027new text end , 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 12new text end months
and one day prior to the scheduled update.

new text begin EFFECTIVE DATE. new text end

Sec. 42.

Laws 2022, chapter 33, section 1, subdivision 5c, is amended to read:

Subd. 5c.

Removal of after-framework adjustments.

Any rate adjustments applied to
the service rates calculated under this section outside of the cost components and rate
methodology specified in this section shall be removed from rate calculations upon
implementation of the updates under subdivisions 5 deleted text begin anddeleted text end new text begin ,new text end 5bnew text begin , and 5fnew text end .

new text begin EFFECTIVE DATE. new text end

Sec. 43.

Laws 2022, chapter 33, section 1, subdivision 5d, is amended to read:

Subd. 5d.

Unavailable data for updates and adjustments.

If Bureau of Labor Statistics
occupational codes or Consumer Price Index items specified in subdivisions 5 deleted text begin ordeleted text end new text begin ,new text end 5bnew text begin , or 5fnew text end
are unavailable in the future, the commissioner shall recommend to the legislature codes or
items to update and replace.

new text begin EFFECTIVE DATE. new text end

Sec. 44.

Laws 2022, chapter 33, section 1, is amended by adding a subdivision to read:

new text begin Subd. 5f. new text end

new text begin Competitive workforce factor adjustments. new text end

new text begin (a) On January 1, 2023, and
every two years thereafter, the commissioner shall update the competitive workforce factor
to equal the differential between:
new text end

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

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

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

new text begin EFFECTIVE DATE. new text end

Sec. 45.

Laws 2022, chapter 33, section 1, subdivision 10c, is amended to read:

Subd. 10c.

Reporting and analysis of competitive workforce factor.

(a) Beginning
February 1, deleted text begin 2021deleted text end new text begin 2024new text end , and every two years thereafter, the commissioner shall report to the
chairs and ranking minority members of the legislative committees and divisions with
jurisdiction over health and human services policy and finance an analysis of the competitive
workforce factor.

(b) The report must include deleted text begin recommendations to update the competitive workforce factor
usingdeleted text end :

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

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

(3) workforce data as required under subdivision 10b.

(c) deleted text begin The commissioner shall not recommend an increase or decrease of the competitive
deleted text end deleted text begin workforce factor from the current value by more than two percentage points. If, after a
deleted text end deleted text begin biennial analysis for the next report, the competitive workforce factor is less than or equal
deleted text end deleted text begin to zero, the commissioner shall recommend a competitive workforce factor of zerodeleted text end new text begin This
subdivision expires upon submission of the calendar year 2030 reportnew text end .

new text begin EFFECTIVE DATE. new text end

Sec. 46.

Laws 2022, chapter 40, section 6, is amended to read:

Sec. 6. COMMISSIONER OF HUMAN SERVICES; TEMPORARY STAFFING
POOLdeleted text begin ; APPROPRIATIONdeleted text end .

(a) The commissioner of human services shall establish a temporary emergency staffing
pool for congregate settingsnew text begin and for providers or recipients of home- and community-based
servicesnew text end experiencing staffing crises. Vendor contracts may include retention bonuses,
sign-on bonuses, and payment for hours on call. The commissioner may pay for necessary
training, travel, and lodging expenses of the temporary staff. Contracts for temporary staffing
executed under this section: (1) should minimize the recruitment away from providers'
current workforces; and (2) may not be executed with an individual until at least 30 days
since the individual was last employed in Minnesota by one of the types of facilitiesnew text begin ,
providers, or individualsnew text end listed in paragraph (g).

(b) Temporary staff, at the request of the commissioner, may be deployed tonew text begin providers
of home- and community-based services, individual recipients of home- and
community-based services, andnew text end long-term care facilities and other congregate care residential
facilities and programs experiencing an emergency staffing crisis on or after the effective
date of this section. Temporary staff must be provided at no cost to thenew text begin provider, individual
recipient,new text end facilitynew text begin ,new text end or program receiving the temporary staff.

(d) The commissioner must coordinate the activities under this section with any other
impacted state agencies, to appropriately prioritize locations to deploy contracted temporary
staff.

(e) The commissioner must give priority for deploying staff tonew text begin providers, individual
recipients,new text end facilitiesnew text begin ,new text end and programs with the most significant staffing crises and where, but
for this assistance, residentsnew text begin or service recipientsnew text end would be at significant risk of injury due
to the need to transfer to deleted text begin anotherdeleted text end new text begin anew text end facility or a hospital for adequately staffed care.

(f) Anew text begin provider, individual recipient,new text end facilitynew text begin ,new text end or program may seek onetime assistance
per settingnew text begin or individual service recipientnew text end from the temporary staffing pool only after thenew text begin
provider, individual recipient,new text end facilitynew text begin ,new text end or program has used all resources available to obtain
temporary staff but is unable to meet thenew text begin provider's, individual's,new text end facility'snew text begin ,new text end or program's
temporary staffing needs. Anew text begin provider, individual,new text end facilitynew text begin ,new text end or program may apply for
temporary staff for up to 21 days. Applicants must submit a proposed plan for ensuring
resident safety at the end of that time period.

(g)new text begin Providers, individuals,new text end facilitiesnew text begin ,new text end and programs eligible to obtain temporary staff
from the temporary staffing pool include:

(1) nursing facilities;

(2) assisted living facilities;

(3) intermediate care facilities for persons with developmental disabilities;

(4) adult foster care deleted text begin ordeleted text end new text begin ,new text end community residential settingsnew text begin , or integrated community supports
settingsnew text end ;

(5) licensed substance use disorder treatment facilities;

(6) unlicensed county-based substance use disorder treatment facilities;

(7) licensed facilities for adults with mental illness;

(8) licensed detoxification programs;

(9) licensed withdrawal management programs;

(10) licensed children's residential facilities;

(11) licensed child foster residence settings;

(12) unlicensed, Tribal-certified facilities that perform functions similar to the licensed
facilities listed in this paragraph;

(13) boarding care homes;

(14) board and lodging establishments serving people with disabilities or disabling
conditions;

(15) board and lodging establishments with special services;

(16) supervised living facilities;

(17) supportive housing;

(18) sober homes;

(19) community-based halfway houses for people exiting the correctional system;

(20) shelters serving people experiencing homelessness;

(21) drop-in centers for people experiencing homelessness;

(22) homeless outreach services for unsheltered individuals;

(23) shelters for people experiencing domestic violence; deleted text begin and
deleted text end

(24) temporary isolation spaces for people who test positive for COVID-19new text begin ;
new text end

new text begin (25) individuals who use consumer-directed community supports;
new text end

new text begin (26) individuals who use the personal care assistance choice program;
new text end

new text begin (27) personal care assistance provider agencies;
new text end

new text begin (28) individuals who use the community first services and supports budget model;
new text end

new text begin (29) agency-providers of community first services and supports; and
new text end

new text begin (30) providers of individualized home supportsnew text end .

(h) Notwithstanding Minnesota Statutes, chapter 16C, the commissioner may maintain,
extend, or renew contracts for temporary staffing entered into on or after September 1, 2020.
The commissioner may also enter into new contracts with eligible entities for temporary
staff deployed in the temporary staffing pool. The commissioner may use up to 6.5 percent
of this funding for the commissioner's costs related to administration of this program.

(i) The commissioner shall seek all allowable FEMA reimbursement for the costs of this
activity.

Sec. 47. new text begin PERSONAL CARE ASSISTANCE ENHANCED RATE FOR PERSONS
WHO USE CONSUMER-DIRECTED COMMUNITY SUPPORTS.
new text end

new text begin The commissioner of human services shall increase the annual budgets for participants
who use consumer-directed community supports under Minnesota Statutes, sections
256B.0913, subdivision 5, clause (17); 256B.092, subdivision 1b, paragraph (a), clause (4);
256B.49, subdivision 16, paragraph (c); and chapter 256S, by 43 percent for participants
who are determined by assessment to be eligible for ten or more hours of personal care
assistance services or community first services and supports per day when the participant
uses direct support services provided by a worker employed by the participant who has
completed training identified in Minnesota Statutes, section 256B.0659, subdivision 11,
paragraph (d), or 256B.85, subdivision 16, paragraph (e).
new text end

new text begin EFFECTIVE DATE. new text end

Sec. 48. new text begin RATE INCREASE FOR CERTAIN HOME CARE SERVICES.
new text end

new text begin (a) Effective January 1, 2023, or upon federal approval, whichever is later, the
commissioner of human services shall increase payment rates for home health aide visits
by 14 percent from the rates in effect on December 31, 2022. The commissioner must apply
the annual rate increases under Minnesota Statutes, section 256B.0653, subdivision 8, to
the rates resulting from the application of the rate increases under this paragraph.
new text end

new text begin (b) Effective January 1, 2023, or upon federal approval, whichever is later, the
commissioner shall increase payment rates for respiratory therapy under Minnesota Rules,
part 9505.0295, subpart 2, item E, and for home health services and home care nursing
services under Minnesota Statutes, section 256B.0651, subdivision 2, clauses (1) to (3),
except home health aide visits, by 38.8 percent from the rates in effect on December 31,
2022. The commissioner must apply the annual rate increases under Minnesota Statutes,
sections 256B.0653, subdivision 8, and 256B.0654, subdivision 5, to the rates resulting
from the application of the rate increase under this paragraph.
new text end

Sec. 49. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES;
ADDITIONAL DWRS RATE INCREASES.
new text end

new text begin (a) In addition to the rate increases described in the amendments contained in this act
to Minnesota Statutes, section 256B.4914, the commissioner shall further adjust the rates
as described in paragraphs (b) to (f) until the net increase in the rates established under
Minnesota Statutes, section 256B.4914, as amended in this act, and under this section are
equivalent to a three-year appropriation of $253,001,000 for fiscal years 2023, 2024, and
2025. The commissioner shall apply the rate changes in this section after applying other
changes contained in this act. The commissioner shall apply the rate changes in this section
in the order presented in the following paragraphs. If the three-year appropriation target is
reached after applying the provisions of a paragraph, the commissioner shall not apply the
provisions in the remaining paragraphs.
new text end

new text begin (b) Notwithstanding Minnesota Statutes, section 256B.4914, subdivision 5, paragraph
(b), clause (2), as added by amendment in this act, on January 1, 2023, the commissioner
shall adjust the data used to update the base wage index by using up to the most recently
available wage data by SOC code from the Bureau of Labor Statistics. If the estimated cost
of fully implementing the rate adjustment in this paragraph exceeds the three-year
appropriation target, the commissioner shall proportionately reduce the estimated change
to the wage index to reach the target.
new text end

new text begin (c) Notwithstanding Minnesota Statutes, section 256B.4914, subdivision 5b, clause (2),
as added by amendment in this act, on January 1, 2023, the commissioner shall adjust the
data used to update the client and programming support, transportation, and program facility
cost component values by using up to the most recently available data. If the estimated cost
of fully implementing the rate adjustment in this paragraph exceeds the three-year
appropriation target, the commissioner shall proportionately reduce the estimated change
to component values to reach the target.
new text end

new text begin (d) Notwithstanding the provision in Minnesota Statutes, section 256B.4914, subdivision
5f, paragraph (a), as added by amendment in this act, requiring a biennial update of the
competitive workforce factor, on January 1, 2024, the commissioner shall update the
competitive workforce factor. If the estimated cost of fully implementing the rate adjustment
in this paragraph exceeds the three-year appropriation target, the commissioner shall cap
the increase in the competitive workforce factor to reach the target.
new text end

new text begin (e) Notwithstanding the provision in Minnesota Statutes, section 256B.4914, subdivision
5, paragraph (b), as amended in this act, on January 1, 2024, the commissioner shall update
the base wage index in Minnesota Statutes, section 256B.4914, subdivision 5a, based on
the most recently available wage data by SOC from the Bureau of Labor Statistics. If the
estimated cost of fully implementing the rate adjustment in this paragraph exceeds the
three-year appropriation target, the commissioner shall proportionately reduce the estimated
change to component values to reach the target.
new text end

new text begin (f) Notwithstanding the provision in Minnesota Statutes, section 256B.4914, subdivision
5b, as amended in this act, on January 1, 2024, the commissioner shall update the client and
programming support, transportation, and program facility cost component values based
on the most recently available wage data by SOC from the Bureau of Labor Statistics. If
the estimated cost of fully implementing the rate adjustment in this paragraph exceeds the
three-year appropriation target, the commissioner shall proportionately reduce the estimated
change to component values to reach the target.
new text end

Sec. 50. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES;
APPLICATION OF ICF/DD RATE INCREASES.
new text end

new text begin The commissioner of human services shall apply the rate increases under Minnesota
Statutes, section 256B.5012, subdivisions 19 and 20, as follows:
new text end

new text begin (1) apply Minnesota Statutes, section 256B.5012, subdivision 19; and
new text end

new text begin (2) apply any required rate increase as required under Minnesota Statutes, section
256B.5012, subdivision 20, to the results of clause (1).
new text end

Sec. 51. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; BUDGET
EXCEPTIONS FOR COMMUNITY RESIDENTIAL SETTINGS.
new text end

new text begin The commissioner of human services must take steps to inform individuals, families,
and lead agencies of the amendments to Minnesota Statutes, section 256B.4911, subdivision
4, and widely disseminate easily understood instructions for quickly applying for a budget
exception under that section.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 52. new text begin DIRECTION TO COMMISSIONER; DISABILITY WAIVER SHARED
SERVICES RATES.
new text end

new text begin The commissioner of human services shall establish a rate system for shared homemaker
services and shared chore services provided under Minnesota Statutes, sections 256B.092
and 256B.49. For two persons sharing services, the rate paid to a provider must not exceed
1-1/2 times the rate paid for serving a single individual, and for three persons sharing
services, the rate paid to a provider must not exceed two times the rate paid for serving a
single individual. These rates apply only when all of the criteria for the shared service have
been met.
new text end

Sec. 53. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; SHARED
SERVICES.
new text end

new text begin (a) By December 1, 2022, the commissioner of human services shall seek any necessary
changes to home and community-based services waiver plans regarding sharing services in
order to:
new text end

new text begin (1) permit shared services for more services, including chore, homemaker, and night
supervision;
new text end

new text begin (2) permit shared services for some services for higher ratios, including individualized
home supports without training, individualized home supports with training, and
individualized home supports with family training for a ratio of one staff person to three
recipients;
new text end

new text begin (3) ensure that individuals who are seeking to share services permitted under the waiver
plans in an own-home setting are not required to live in a licensed setting in order to share
services so long as all other requirements are met; and
new text end

new text begin (4) issue guidance for shared services, including:
new text end

new text begin (i) informed choice for all individuals sharing the services;
new text end

new text begin (ii) guidance for when multiple shared services by different providers occur in one home
and how lead agencies and individuals shall determine that shared service is appropriate to
meet the needs, health, and safety of each individual for whom the lead agency provides
case management or care coordination; and
new text end

new text begin (iii) guidance clarifying that an individual's decision to share services does not reduce
any determination of the individual's overall or assessed needs for services.
new text end

new text begin (b) The commissioner shall develop or provide guidance outlining:
new text end

new text begin (1) instructions for shared services support planning;
new text end

new text begin (2) person-centered approaches and informed choice in shared services support planning;
and
new text end

new text begin (3) required contents of shared services agreements.
new text end

new text begin (c) The commissioner shall seek and utilize stakeholder input for any proposed changes
to waiver plans and any shared services guidance.
new text end

Sec. 54. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES;
LIFE-SHARING SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Recommendations required. new text end

new text begin The commissioner of human services shall
develop recommendations for establishing life sharing as a covered medical assistance
waiver service.
new text end

new text begin Subd. 2. new text end

new text begin Definition. new text end

new text begin For the purposes of this section, "life sharing" means a
relationship-based living arrangement between an adult with a disability and an individual
or family in which they share their lives and experiences while the adult with a disability
receives support from the individual or family using person-centered practices.
new text end

new text begin Subd. 3. new text end

new text begin Stakeholder engagement and consultation. new text end

new text begin (a) The commissioner must
proactively solicit participation in the development of the life-sharing medical assistance
service through a robust stakeholder engagement process that results in the inclusion of a
racially, culturally, and geographically diverse group of interested stakeholders from each
of the following groups:
new text end

new text begin (1) providers currently providing or interested in providing life-sharing services;
new text end

new text begin (2) people with disabilities accessing or interested in accessing life-sharing services;
new text end

new text begin (3) disability advocacy organizations; and
new text end

new text begin (4) lead agencies.
new text end

new text begin (b) The commissioner must proactively seek input into and assistance with the
development of recommendations for establishing the life-sharing service from interested
stakeholders.
new text end

new text begin (c) The commissioner must provide a method for the commissioner and interested
stakeholders to cofacilitate public meetings. The first meeting must occur before January
31, 2023. The commissioner must host the cofacilitated meetings at least monthly through
December 31, 2023. All meetings must be accessible to all interested stakeholders, recorded,
and posted online within one week of the meeting date.
new text end

new text begin Subd. 4. new text end

new text begin Required topics to be discussed during development of the
recommendations. new text end

new text begin The commissioner and the interested stakeholders must discuss the
following topics:
new text end

new text begin (1) the distinction between life sharing and adult family foster care;
new text end

new text begin (2) successful life-sharing models used in other states;
new text end

new text begin (3) services and supports that could be included in a life-sharing service;
new text end

new text begin (4) potential barriers to providing or accessing life-sharing services;
new text end

new text begin (5) solutions to remove identified barriers to providing or accessing life-sharing services;
new text end

new text begin (6) potential medical assistance payment methodologies for life-sharing services;
new text end

new text begin (7) expanding awareness of the life-sharing model; and
new text end

new text begin (8) draft language for legislation necessary to define and implement life-sharing services.
new text end

new text begin Subd. 5. new text end

new text begin Report to the legislature. new text end

new text begin By December 31, 2023, the commissioner must
provide to the chairs and ranking minority members of the house of representatives and
senate committees and divisions with jurisdiction over direct care services a report
summarizing the discussions between the commissioner and the interested stakeholders and
the commissioner's recommendations. The report must also include any draft legislation
necessary to define and implement life-sharing services.
new text end

Sec. 55. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
REASSESSMENT FREQUENCY.
new text end

new text begin By January 1, 2023, the commissioner of human services shall seek federal approval to
streamline medical assistance service eligibility determinations for people with disabilities
by using less-frequent disability service needs assessments or streamlined annual
reevaluations for people whose disability-related needs are not likely to change and
less-frequent or streamlined reassessment is chosen by the participant.
new text end

Sec. 56. new text begin REPEALER.
new text end

new text begin Laws 2022, chapter 33, section 1, subdivision 9a, new text end new text begin is repealed.
new text end

new text begin EFFECTIVE DATE. new text end

ARTICLE 2

CONTINUING CARE FOR OLDER ADULTS

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 includesdeleted 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 notify 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

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 includesdeleted 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

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

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

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 costsdeleted text end of linen and bedding, the laundering of resident
clothing, laundry supplies, and contract services.

new text begin EFFECTIVE DATE. 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

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 includesdeleted 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

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

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

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 isnew text begin the product ofnew text end the facility's direct care costsnew 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

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 isnew text begin the product ofnew text end its other care-related costsnew text begin and the known
cost change factornew text end , divided by the sum of the facility's resident days.

new text begin EFFECTIVE DATE. 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 isnew text begin the product ofnew text end its other operating costsnew 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

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 isnew text begin the product ofnew text end the allowable
costsnew 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

Sec. 15.

Minnesota Statutes 2020, section 256S.16, is amended to read:

256S.16 AUTHORIZATION OF ELDERLY WAIVER SERVICES AND SERVICE
RATES.

new text begin Subdivision 1. new text end

new text begin Service rates; generally. new text end

A lead agency must use the service rates and
service rate limits published by the commissioner to authorize services.

new text begin Subd. 2. new text end

new text begin Shared services; rates. new text end

new text begin The commissioner shall establish a rate system for
shared homemaker services and shared chore services, based on homemaker rates for a
single individual under section 256S.215, subdivisions 9 to 11, and the chore rate for a
single individual under section 256S.215, subdivision 7. For two persons sharing services,
the rate paid to a provider must not exceed 1-1/2 times the rate paid for serving a single
individual, and for three persons sharing services, the rate paid to a provider must not exceed
two times the rate paid for serving a single individual. These rates apply only when all of
the criteria for the shared service have been met.
new text end

Sec. 16.

Minnesota Statutes 2021 Supplement, section 256S.205, is amended to read:

256S.205 CUSTOMIZED LIVING SERVICES; DISPROPORTIONATE SHARE
RATE ADJUSTMENTS.

Subdivision 1.

Definitions.

(a) For the purposes of this section, the terms in this
subdivision have the meanings given.

(b) "Application year" means a year in which a facility submits an application for
designation as a disproportionate share facility.

(c) deleted text begin "Assisted living facility" or "facility" means an assisted living facility licensed under
chapter 144Gdeleted text end new text begin "Customized living resident" means a resident of a facility who is receiving
either 24-hour customized living services or customized living services authorized under
the elderly waiver, the brain injury waiver, or the community access for disability inclusion
waivernew text end .

(d) "Disproportionate share facility" means deleted text begin an assisted livingdeleted text end new text begin anew text end facility designated by
the commissioner under subdivision 4.

new text begin (e) "Facility" means either an assisted living facility licensed under chapter 144G or a
setting that is exempt from assisted living licensure under section 144G.08, subdivision 7,
clauses (10) to (13).
new text end

new text begin (f) "Rate year" means January 1 to December 31 of the year following an application
year.
new text end

Subd. 2.

Rate adjustment application.

deleted text begin An assisted livingdeleted text end new text begin Anew text end facility may apply to the
commissioner for designation as a disproportionate share facility. Applications must be
submitted annually between deleted text begin Octoberdeleted text end new text begin Septembernew text end 1 and deleted text begin October 31deleted text end new text begin September 30new text end . The
applying facility must apply in a manner determined by the commissioner. The applying
facility must document deleted text begin as a percentage the census of elderly waiver participantsdeleted text end new text begin each of the
following on the application:
new text end

new text begin (1) the number of customized living residents in the facility on September 1 of the
application year, broken out by specific waiver program; and
new text end

new text begin (2) the total number of peoplenew text end residing in the facility on deleted text begin Octoberdeleted text end new text begin Septembernew text end 1 of the
application year.

Subd. 3.

Rate adjustment eligibility criteria.

Only facilities deleted text begin with a census of at least
80 percent elderly waiver participantsdeleted text end new text begin satisfying all of the following conditionsnew text end on deleted text begin Octoberdeleted text end new text begin
Septembernew text end 1 of the application year are eligible for designation as a disproportionate share
facilitynew text begin :
new text end

new text begin (1) at least 80 percent of the residents of the facility are customized living residents; and
new text end

new text begin (2) at least 50 percent of the customized living residents are elderly waiver participantsnew text end .

Subd. 4.

Designation as a disproportionate share facility.

new text begin (a) new text end By deleted text begin Novemberdeleted text end new text begin Octobernew text end
15 of each application year, the commissioner must designate as a disproportionate share
facility a facility that complies with the application requirements of subdivision 2 and meets
the eligibility criteria of subdivision 3.

new text begin (b) An annual designation is effective for one rate year.
new text end

Subd. 5.

Rate adjustment; rate floor.

(a) Notwithstanding the 24-hour customized
living monthly service rate limits under section 256S.202, subdivision 2, and the component
service rates established under section 256S.201, subdivision 4, the commissioner must
establish a rate floor equal to deleted text begin $119deleted text end new text begin $139new text end per resident per day for 24-hour customized living
services providednew text begin to an elderly waiver participantnew text end in a designated disproportionate share
facility deleted text begin for the purpose of ensuring the minimal level of staffing required to meet the health
and safety needs of elderly waiver participantsdeleted text end .

new text begin (b) The commissioner must apply the rate floor to the services described in paragraph
(a) provided during the rate year.
new text end

deleted text begin (b)deleted text end new text begin (c)new text end The commissioner must adjust the rate floor at least annually in the manner
described under section 256S.18, subdivisions 5 and 6.

deleted text begin (c)deleted text end new text begin (d)new text end The commissioner shall not implement the rate floor under this section if the
customized living rates established under sections 256S.21 to 256S.215 will be implemented
at 100 percent on January 1 of the year following an application year.

Subd. 6.

Budget cap disregard.

The value of the rate adjustment under this section
must not be included in an elderly waiver client's monthly case mix budget cap.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later, and applies to services provided on or after October 1, 2022, or on or
after the date upon which federal approval is obtained, whichever is later. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 17.

Minnesota Statutes 2021 Supplement, section 256S.2101, is amended to read:

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 deleted text begin tendeleted text end new text begin 27.2new text end percent of
the rates calculated under sections 256S.211 to 256S.215 and deleted text begin 90deleted text end new text begin 72.8new text end 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 deleted text begin 18.8deleted text end new text begin 27.2new text end percent of the rates calculated under sections
256S.211 to 256S.215, and deleted text begin 81.2deleted text end new text begin 72.8new text end 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.

new text begin EFFECTIVE DATE. new text end

Sec. 18. new text begin NURSING FACILITY FUNDING.
new text end

new text begin (a) Effective July 1, 2022, through December 31, 2024, the total payment rate for all
facilities reimbursed under this section must be increased by $28.65 per resident day.
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 July 1, 2022, excluding:
new text end

new text begin (1) owners of the building and operation;
new text end

new text begin (2) persons employed in the central office of an entity that has any ownership interest
in the nursing facility or exercises control over the nursing facility;
new text end

new text begin (3) persons paid by the nursing facility under a management contract; and
new text end

new text begin (4) persons providing separately billable services.
new text end

new text begin (c) Contracted housekeeping, dietary, and laundry employees providing services on site
at the nursing facility are eligible for compensation-related cost increases under this section,
provided the agency that employs them submits to the nursing facility proof of the costs of
the increases provided to those employees.
new text end

new text begin (d) For purposes of this section, compensation-related costs include:
new text end

new text begin (1) permanent new increases to wages and salaries implemented on or after July 1, 2022,
and before September 1, 2022, for nursing facility employees;
new text end

new text begin (2) permanent new increases to wages and salaries implemented on or after July 1, 2022,
and before September 1, 2022, for employees in the organization's shared services
departments of hospital-attached nursing facilities for the nursing facility allocated share
of wages; and
new text end

new text begin (3) the employer's share of FICA taxes, Medicare taxes, state and federal unemployment
taxes, PERA, workers' compensation, and pension and employee retirement accounts directly
associated with the wage and salary increases in clauses (1) and (2) incurred no later than
December 31, 2024, and paid for no later than June 30, 2025.
new text end

new text begin (e) A facility that receives a rate increase under this section must complete a distribution
plan in the form and manner determined by the commissioner. This plan must specify the
total amount of money the facility is estimated to receive from this rate increase and how
that money will be distributed to increase the allowable compensation-related costs described
in paragraph (d) for employees described in paragraphs (b) and (c). This estimate must be
computed by multiplying $28.65 by the sum of the medical assistance and private pay
resident days as defined in Minnesota Statutes, section 256R.02, subdivision 45, for the
period beginning October 1, 2020, through September 30, 2021, dividing this sum by 365
and multiplying the result by 915. A facility must submit its distribution plan to the
commissioner by October 1, 2022. The commissioner may review the distribution plan to
ensure that the payment rate adjustment per resident day is used in accordance with this
section. The commissioner may allow for a distribution plan amendment under exceptional
circumstances to be determined at the sole discretion of the commissioner.
new text end

new text begin (f) By September 1, 2022, a facility must post the distribution plan summary and leave
it posted for a period of at least six months in an area of the facility to which all employees
have access. The posted distribution plan summary must be in the form and manner
determined by the commissioner. The distribution plan summary must include instructions
regarding how to contact the commissioner or the commissioner's representative if an
employee believes the employee is covered by paragraph (b) or (c) and has not received the
compensation-related increases described in paragraph (d). The instruction to such employees
must include the e-mail address and telephone number that may be used by the employee
to contact the commissioner's representative. The posted distribution plan summary must
demonstrate how the increase in paragraph (a) received by the nursing facility from July 1,
2022, through December 1, 2024, will be used in full to pay the compensation-related costs
in paragraph (d) for employees described in paragraphs (b) and (c).
new text end

new text begin (g) If the nursing facility expends less on new compensation-related costs than the amount
that was made available by the rate increase in this section for that purpose, the amount of
this rate adjustment must be reduced to equal the amount utilized by the facility for purposes
authorized under this section. If the facility fails to post the distribution plan summary in
its facility as required, fails to submit its distribution plan to the commissioner by the due
date, or uses these funds for unauthorized purposes, these rate increases must be treated as
an overpayment and subsequently recovered.
new text end

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

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

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin For the purposes of this section, the definitions in Minnesota
Statutes, section 256S.205, apply.
new text end

new text begin Subd. 2. new text end

new text begin Partial year implementation. new text end

new text begin (a) Notwithstanding the provisions of Minnesota
Statutes, section 256S.205, subdivisions 2 to 5, regarding application dates, eligibility dates,
designation dates, and payment adjustment dates, during the first partial year of
implementation of the amendments in this act to Minnesota Statutes, section 256S.205, a
facility may apply between July 1, 2022, and July 31, 2022, to be designated a
disproportionate share facility on the basis of the conditions outlined in Minnesota Statutes,
section 256S.205, subdivision 3, as of July 1, 2022. The commissioner shall designate
disproportionate share facilities by August 15, 2022. Between October 1, 2022, and December
31, 2022, the commissioner shall apply the rate floor under Minnesota Statutes, section
256S.205, as amended in this act, to eligible customized living services provided in
disproportionate share facilities between those dates.
new text end

new text begin Subd. 3. new text end

new text begin Rate year 2023. new text end

new text begin Beginning September 1, 2022, the timelines and dates described
in Minnesota Statutes, section 256S.205, subdivisions 2 to 4, apply for the purposes of rate
year 2023.
new text end

new text begin Subd. 4. new text end

new text begin Treatment of prior rate adjustments. new text end

new text begin (a) The commissioner shall apply rate
adjustments required under Minnesota Statutes 2021 Supplement, section 256S.205, until
September 30, 2022. Beginning October 1, 2022, the commissioner shall remove all rate
adjustments required under Minnesota Statutes 2021 Supplement, section 256S.205.
new text end

new text begin (b) A disproportionate share facility receiving a rate adjustment under Minnesota Statutes
2021 Supplement, section 256S.205, as of July 1, 2022, may apply for an adjustment under
this section.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin (a) Subdivisions 1 to 3 are effective July 1, 2022, or upon federal
approval, whichever is later, and apply to services provided on or after October 1, 2022, or
on or after the date upon which federal approval is obtained, whichever is later. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

new text begin (b) Subdivision 4 is effective July 1, 2022.
new text end

Sec. 20. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; ELDERLY
WAIVER BASE WAGE INDEX ADJUSTMENTS.
new text end

new text begin On January 1, 2023, 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 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

SF 4410

Bill Text Versions

ARTICLE 1

COMMUNITY SUPPORTS

Section 1.

Subd. 4c.

Review of funds; reallocation.

new text begin EFFECTIVE DATE. new text end

Sec. 2.

Subd. 8.

Use of federal funds and transfer of funds to medical assistance.

new text begin EFFECTIVE DATE. new text end

Sec. 3.

new text begin [256.4791] COMMUNITY ORGANIZATIONS GRANT PROGRAM. new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin Subd. 2. new text end

new text begin Applications. new text end

new text begin Subd. 3. new text end

new text begin Eligible applicants. new text end

new text begin Subd. 4. new text end

new text begin Use of grant money. new text end

new text begin Subd. 5. new text end

new text begin Reporting. new text end

Sec. 4.

new text begin [256.4792] EMPLOYMENT FOR PERSONS EXPERIENCING HOMELESSNESS OR SUBSTANCE USE DISORDER. new text end

Sec. 5.

new text begin [256.4795] RESIDENTIAL SETTING CLOSURE PREVENTION GRANTS. new text end

new text begin Subdivision 1. new text end

new text begin Residential setting closure prevention grants established. new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin Subd. 3. new text end

new text begin Eligibility. new text end

new text begin Subd. 4. new text end

new text begin Criteria and limitations. new text end

new text begin Subd. 5. new text end

new text begin Interagency coordination. new text end

new text begin Subd. 6. new text end

new text begin Administrative funding. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 6.

Subdivision 1.

Definitions.

new text begin EFFECTIVE DATE. new text end

Sec. 7.

Subd. 12.

Documentation of personal care assistance services provided.

new text begin EFFECTIVE DATE. new text end

Sec. 8.

Subd. 17a.

Enhanced rate.

Sec. 9.

Subd. 19.

Personal care assistance choice option; qualifications; duties.

new text begin EFFECTIVE DATE. new text end

Sec. 10.

Subd. 24.

Personal care assistance provider agency; general duties.

new text begin EFFECTIVE DATE. new text end

Sec. 11.

new text begin [256B.0909] LONG-TERM CARE DECISION REVIEWS. new text end

new text begin Subdivision 1. new text end

new text begin Notice of intent to deny, reduce, suspend, or terminate required. new text end

new text begin Subd. 2. new text end

new text begin Opportunity to respond required. new text end

new text begin Subd. 3. new text end

new text begin Decision review. new text end

new text begin Subd. 4. new text end

new text begin Continuation of services. new text end

new text begin Subd. 5. new text end

new text begin Notice of action. new text end

new text begin Subd. 6. new text end

new text begin Appeal rights. new text end

Sec. 12.

new text begin [256B.4909] HOME AND COMMUNITY-BASED SERVICES; HOMEMAKER RATES. new text end

new text begin Subdivision 1. new text end

new text begin Application. new text end

new text begin Subd. 2. new text end

new text begin Definition. new text end

new text begin [256.4791] COMMUNITY ORGANIZATIONS GRANT PROGRAM.
new text end

new text begin [256.4792] EMPLOYMENT FOR PERSONS EXPERIENCING
HOMELESSNESS OR SUBSTANCE USE DISORDER.
new text end

new text begin [256.4795] RESIDENTIAL SETTING CLOSURE PREVENTION GRANTS.
new text end

new text begin [256B.0909] LONG-TERM CARE DECISION REVIEWS.
new text end

new text begin [256B.4909] HOME AND COMMUNITY-BASED SERVICES;
HOMEMAKER RATES.
new text end

Budget exception for persons leaving institutions and crisis residential
settings.

Unit-based services with programming; component values and calculation
of payment rates.

Unit-based services without programming; component values and
calculation of payment rates.

new text begin Notification of conditionally approved proposal to Centers for Independent
Living. new text end

new text begin Termination of license or satellite license upon approved closure
date. new text end