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Minnesota Legislature

Office of the Revisor of Statutes

HF 2156

as introduced - 91st Legislature (2019 - 2020) Posted on 03/27/2019 01:25pm

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

Bill Text Versions

Engrossments
Introduction Posted on 03/07/2019

Current Version - as introduced

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A bill for an act
relating to human services; modifying the disability waiver rate system; amending
Minnesota Statutes 2018, section 256B.4914, subdivisions 2, 3, 4, 5, 10, 10a.

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

Section 1.

Minnesota Statutes 2018, section 256B.4914, subdivision 2, is amended to read:


Subd. 2.

Definitions.

(a) For purposes of this section, the following terms have the
meanings given them, unless the context clearly indicates otherwise.

(b) "Commissioner" means the commissioner of human services.

new text begin (c) "Comparable occupations" means the occupations, excluding direct care staff, as
represented by the Bureau of Labor Statistics standard occupational classification codes
that have the same classification for:
new text end

new text begin (1) typical education needed for entry;
new text end

new text begin (2) work experience in a related occupation; and
new text end

new text begin (3) typical on-the-job training competency as the most predominant classification for
direct care staff.
new text end

deleted text begin (c)deleted text endnew text begin (d)new text end "Component value" means underlying factors that are part of the cost of providing
services that are built into the waiver rates methodology to calculate service rates.

deleted text begin (d)deleted text endnew text begin (e)new text end "Customized living tool" means a methodology for setting service rates that
delineates and documents the amount of each component service included in a recipient's
customized living service plan.

new text begin (f) "Direct care staff" means employees providing direct service provision to people
receiving services under this section. Direct care staff does not include executive, managerial,
and administrative staff.
new text end

deleted text begin (e)deleted text endnew text begin (g)new text end "Disability waiver rates system" means a statewide system that establishes rates
that are based on uniform processes and captures the individualized nature of waiver services
and recipient needs.

deleted text begin (f)deleted text endnew text begin (h)new text end "Individual staffing" means the time spent as a one-to-one interaction specific to
an individual recipient by staff to provide direct support and assistance with activities of
daily living, instrumental activities of daily living, and training to participants, and is based
on the requirements in each individual's coordinated service and support plan under section
245D.02, subdivision 4b; any coordinated service and support plan addendum under section
245D.02, subdivision 4c; and an assessment tool. Provider observation of an individual's
needs must also be considered.

deleted text begin (g)deleted text endnew text begin (i)new text end "Lead agency" means a county, partnership of counties, or tribal agency charged
with administering waivered services under sections 256B.092 and 256B.49.

deleted text begin (h)deleted text endnew text begin (j)new text end "Median" means the amount that divides distribution into two equal groups,
one-half above the median and one-half below the median.

deleted text begin (i)deleted text endnew text begin (k)new text end "Payment or rate" means reimbursement to an eligible provider for services
provided to a qualified individual based on an approved service authorization.

deleted text begin (j)deleted text endnew text begin (l)new text end "Rates management system" means a web-based software application that uses a
framework and component values, as determined by the commissioner, to establish service
rates.

deleted text begin (k)deleted text endnew text begin (m)new text end "Recipient" means a person receiving home and community-based services
funded under any of the disability waivers.

deleted text begin (l)deleted text endnew text begin (n)new text end "Shared staffing" means time spent by employees, not defined under paragraph
deleted text begin (f)deleted text endnew text begin (h)new text end, providing or available to provide more than one individual with direct support and
assistance with activities of daily living as defined under section 256B.0659, subdivision
1
, paragraph (b); instrumental activities of daily living as defined under section 256B.0659,
subdivision 1, paragraph (i); ancillary activities needed to support individual services; and
training to participants, and is based on the requirements in each individual's coordinated
service and support plan under section 245D.02, subdivision 4b; any coordinated service
and support plan addendum under section 245D.02, subdivision 4c; an assessment tool; and
provider observation of an individual's service need. Total shared staffing hours are divided
proportionally by the number of individuals who receive the shared service provisions.

deleted text begin (m)deleted text endnew text begin (o)new text end "Staffing ratio" means the number of recipients a service provider employee
supports during a unit of service based on a uniform assessment tool, provider observation,
case history, and the recipient's services of choice, and not based on the staffing ratios under
section 245D.31.

deleted text begin (n)deleted text endnew text begin (p)new text end "Unit of service" means the following:

(1) for residential support services under subdivision 6, a unit of service is a day. Any
portion of any calendar day, within allowable Medicaid rules, where an individual spends
time in a residential setting is billable as a day;

(2) for day services under subdivision 7:

(i) for day training and habilitation services, a unit of service is either:

(A) a day unit of service is defined as six or more hours of time spent providing direct
services and transportation; or

(B) a partial day unit of service is defined as fewer than six hours of time spent providing
direct services and transportation; and

(C) for new day service recipients after January 1, 2014, 15 minute units of service must
be used for fewer than six hours of time spent providing direct services and transportation;

(ii) for adult day and structured day services, a unit of service is a day or 15 minutes. A
day unit of service is six or more hours of time spent providing direct services;

(iii) for prevocational services, a unit of service is a day or an hour. A day unit of service
is six or more hours of time spent providing direct service;

(3) for unit-based services with programming under subdivision 8:

(i) for supported living services, a unit of service is a day or 15 minutes. When a day
rate is authorized, any portion of a calendar day where an individual receives services is
billable as a day; and

(ii) for all other services, a unit of service is 15 minutes; and

(4) for unit-based services without programming under subdivision 9, a unit of service
is 15 minutes.

Sec. 2.

Minnesota Statutes 2018, section 256B.4914, subdivision 3, 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 care;

(3) adult day care bath;

deleted text begin (4) behavioral programming;
deleted text end

deleted text begin (5)deleted text endnew text begin (4)new text end companion services;

deleted text begin (6)deleted text endnew text begin (5)new text end customized living;

deleted text begin (7)deleted text endnew text begin (6)new text end day training and habilitation;

new text begin (7) employment development services;
new text end

new text begin (8) employment exploration services;
new text end

new text begin (9) employment support services;
new text end

deleted text begin (8)deleted text endnew text begin (10)new text end housing access coordination;

deleted text begin (9)deleted text endnew text begin (11)new text end independent living skills;

new text begin (12) independent living skills specialist services;
new text end

new text begin (13) individualized home supports;
new text end

deleted text begin (10)deleted text endnew text begin (14)new text end in-home family support;

deleted text begin (11)deleted text endnew text begin (15)new text end night supervision;

deleted text begin (12)deleted text endnew text begin (16)new text end personal support;

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

deleted text begin (13)deleted text endnew text begin (18)new text end prevocational services;

deleted text begin (14)deleted text endnew text begin (19)new text end residential care services;

deleted text begin (15)deleted text endnew text begin (20)new text end residential support services;

deleted text begin (16)deleted text endnew text begin (21)new text end respite services;

deleted text begin (17)deleted text endnew text begin (22)new text end structured day services;

deleted text begin (18)deleted text endnew text begin (23)new text end supported employment services;

deleted text begin (19)deleted text endnew text begin (24)new text end supported living services;

deleted text begin (20)deleted text endnew text begin (25)new text end transportation services;new text begin and
new text end

deleted text begin (21) individualized home supports;
deleted text end

deleted text begin (22) independent living skills specialist services;
deleted text end

deleted text begin (23) employment exploration services;
deleted text end

deleted text begin (24) employment development services;
deleted text end

deleted text begin (25) employment support services; and
deleted text end

(26) other services as approved by the federal government in the state home and
community-based services plan.

Sec. 3.

Minnesota Statutes 2018, section 256B.4914, subdivision 4, is amended to read:


Subd. 4.

Data collection for rate determination.

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

(b) Data for services under section 256B.4913, subdivision 4a, shall be collected in a
manner prescribed by the commissioner.

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

(d) Service providers, with information from the community support plan and oversight
by lead agencies, shall provide values and information needed to calculate an individual's
rate into 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.

(e) 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.

(f) 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, 7, 8, and 9 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 deleted text begin(f)deleted text endnew text begin (h)new text end, deleted text begin(i)deleted text endnew text begin (n)new text end,
and deleted text begin(m)deleted text endnew text begin (o)new text end; 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 deleted text begin(n)deleted text endnew text begin (p)new text end, and
meeting or exceeding the licensing standards for staffing required under section 245D.31.

Sec. 4.

Minnesota Statutes 2018, section 256B.4914, subdivision 5, is amended to read:


Subd. 5.

Base wage index and standard component values.

(a) The base wage index
is established to determine staffing costs associated with providing services to individuals
receiving home and community-based services. For purposes of developing and calculating
the proposed base wage, Minnesota-specific wages taken from job descriptions and standard
occupational classification (SOC) codes from the Bureau of Labor Statistics as defined in
the most recent edition of the Occupational Handbook must be used. The base wage index
must be calculated as follows:

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

(i) 15 percent of the subtotal of 50 percent of the median wage for personal and home
health aide (SOC code 39-9021); 30 percent of the median wage for nursing assistant (SOC
code 31-1014); and 20 percent of the median wage for social and human services aide (SOC
code 21-1093); and

(ii) 85 percent of the subtotal of 20 percent of the median wage for home health aide
(SOC code 31-1011); 20 percent of the median wage for personal and home health aide
(SOC code 39-9021); 20 percent of the median wage for nursing assistant (SOC code
31-1014); 20 percent of the median wage for psychiatric technician (SOC code 29-2053);
and 20 percent of the median wage for social and human services aide (SOC code 21-1093);

(2) for day services, 20 percent of the median wage for nursing assistant (SOC code
31-1014); 20 percent of the median wage for psychiatric technician (SOC code 29-2053);
and 60 percent of the median wage for social and human services aide (SOC code 21-1093);

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

(4) for behavior program analyst staff, 100 percent of the median wage for mental health
counselors (SOC code 21-1014);

(5) for behavior program professional staff, 100 percent of the median wage for clinical
counseling and school psychologist (SOC code 19-3031);

(6) for behavior program specialist staff, 100 percent of the median wage for psychiatric
technicians (SOC code 29-2053);

(7) for supportive living services staff, 20 percent of the median wage for nursing assistant
(SOC code 31-1014); 20 percent of the median wage for psychiatric technician (SOC code
29-2053); and 60 percent of the median wage for social and human services aide (SOC code
21-1093);

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

(9) for in-home family support staff, 20 percent of the median wage for nursing aide
(SOC code 31-1012); 30 percent of the median wage for community social service specialist
(SOC code 21-1099); 40 percent of the median wage for social and human services aide
(SOC code 21-1093); and ten percent of the median wage for psychiatric technician (SOC
code 29-2053);

(10) for individualized home supports 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);

(11) for independent living skills staff, 40 percent of the median wage for community
social service specialist (SOC code 21-1099); 50 percent of the median wage for social and
human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric
technician (SOC code 29-2053);

(12) for independent living skills specialist staff, 100 percent of mental health and
substance abuse social worker (SOC code 21-1023);

(13) for supported employment staff, 20 percent of the median wage for nursing assistant
(SOC code 31-1014); 20 percent of the median wage for psychiatric technician (SOC code
29-2053); and 60 percent of the median wage for social and human services aide (SOC code
21-1093);

(14) 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);

(15) for employment exploration services staff, 50 percent of the median wage for
rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for
community and social services specialist (SOC code 21-1099);

(16) 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);

(17) for adult companion staff, 50 percent of the median wage for personal and home
care aide (SOC code 39-9021); and 50 percent of the median wage for nursing assistant
(SOC code 31-1014);

(18) for night supervision staff, 20 percent of the median wage for home health aide
(SOC code 31-1011); 20 percent of the median wage for personal and home health aide
(SOC code 39-9021); 20 percent of the median wage for nursing assistant (SOC code
31-1014); 20 percent of the median wage for psychiatric technician (SOC code 29-2053);
and 20 percent of the median wage for social and human services aide (SOC code 21-1093);

(19) for respite staff, 50 percent of the median wage for personal and home care aide
(SOC code 39-9021); and 50 percent of the median wage for nursing assistant (SOC code
31-1014);

(20) for personal support staff, 50 percent of the median wage for personal and home
care aide (SOC code 39-9021); and 50 percent of the median wage for nursing assistant
(SOC code 31-1014);

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

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

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

(b) Component values for residential support services are:

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

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

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

(4) general administrative support ratio: 13.25 percent;

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

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

(c) Component values for family foster care are:

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

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

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

(4) general administrative support ratio: 3.3 percent;

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

(6) absence factor: 1.7 percent.

(d) Component values for day services for all services are:

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

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

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

(4) program plan support ratio: 5.6 percent;

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

(6) general administrative support ratio: 13.25 percent;

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

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

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

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

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

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

(4) program plan supports ratio: 15.5 percent;

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

(6) general administrative support ratio: 13.25 percent;

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

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

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

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

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

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

(4) program plan support ratio: 7.0 percent;

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

(6) general administrative support ratio: 13.25 percent;

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

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

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

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

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

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

(4) general administrative support ratio: 13.25 percent;

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

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

(h) On July 1, 2017, the commissioner shall update the base wage index in paragraph
(a) based on the wage data by standard occupational code (SOC) from the Bureau of Labor
Statistics available on December 31, 2016. The commissioner shall publish these updated
values and load them into the rate management system. On July 1, 2022, and every deleted text beginfivedeleted text endnew text begin twonew text end
years thereafter, the commissioner shall update the base wage index in paragraph (a) based
on the most recently available wage data by SOC from the Bureau of Labor Statistics. The
commissioner shall publish these updated values and load them into the rate management
system.

(i) On July 1, 2017, the commissioner shall update the framework components in
paragraph (d), clause (5); paragraph (e), clause (5); and paragraph (f), clause (5); subdivision
6, clauses (8) and (9); and subdivision 7, clauses (10), (16), and (17), for changes in the
Consumer Price Index. The commissioner will adjust these values higher or lower by the
percentage change in the Consumer Price Index-All Items, United States city average
(CPI-U) from January 1, 2014, to January 1, 2017. The commissioner shall publish these
updated values and load them into the rate management system. On July 1, 2022, and every
deleted text begin fivedeleted text endnew text begin twonew text end years thereafter, the commissioner shall update the framework components in
paragraph (d), clause (5); paragraph (e), clause (5); and paragraph (f), clause (5); subdivision
6, clauses (8) and (9); and subdivision 7, clauses (10), (16), and (17), for changes in the
Consumer Price Index. The commissioner shall adjust these values higher or lower by the
percentage change in the CPI-U from the date of the previous update to the date of the data
most recently available prior to the scheduled update. The commissioner shall publish these
updated values and load them into the rate management system.

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

new text begin (k) The commissioner shall increase the updated base wage index in paragraph (h) with
a competitive workforce factor as follows:
new text end

new text begin (1) effective July 1, 2019, or upon federal approval, whichever is later, the competitive
workforce factor is 8.35 percent; and
new text end

new text begin (2) effective July 1, 2022, and every two years thereafter, the commissioner shall update
the competitive workforce factor using the most recently available data prior to the scheduled
update. The commissioner shall adjust the competitive workforce factor to equal the
differential between:
new text end

new text begin (i) 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 (ii) the weighted average wage of the comparable occupations.
new text end

new text begin For each adjustment of the competitive workforce factor, the adjustment must not increase
or 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. The lead
agencies must implement the competitive workforce factor on the dates listed in clause (1)
and not as reassessments, reauthorizations, or service plan renewals occur. Lead agencies
must implement adjustments to the competitive workforce factor in clause (2) in conjunction
with the base wage index updates required in paragraph (h) as reassessments, reauthorizations,
or service plan renewals occur.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin (a) The amendments to paragraphs (h) and (i) are effective July
1, 2022, or upon federal approval, whichever is later. The commissioner shall inform the
revisor of statutes when federal approval is obtained.
new text end

new text begin (b) Paragraph (k) is effective July 1, 2019, or upon federal approval, whichever is later.
The commissioner shall inform the revisor of statutes when federal approval is obtained.
new text end

Sec. 5.

Minnesota Statutes 2018, section 256B.4914, subdivision 10, is amended to read:


Subd. 10.

Updating payment values and additional information.

(a) From January
1, 2014, through December 31, 2017, the commissioner shall develop and implement uniform
procedures to refine terms and adjust values used to calculate payment rates in this section.

(b) No later than July 1, 2014, the commissioner shall, within available resources, begin
to 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; and

(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.

(c) Beginning January 1, 2014, through December 31, 2018, using a statistically valid
set of rates management system data, the commissioner, in consultation with stakeholders,
shall analyze for each service the average difference in the rate on December 31, 2013, and
the framework rate at the individual, provider, lead agency, and state levels. The
commissioner shall issue semiannual reports to the stakeholders on the difference in rates
by service and by county during the banding period under section 256B.4913, subdivision
4a
. The commissioner shall issue the first report by October 1, 2014, and the final report
shall be issued by December 31, 2018.

(d) No later than July 1, 2014, the commissioner, in consultation with stakeholders, shall
begin the review and evaluation of the following values already in subdivisions 6 to 9, 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) any changes in state or federal law with a direct impact on the underlying cost of
providing home and community-based services; deleted text beginand
deleted text end

(9) new text begindirect care staff labor market measures; and
new text end

new text begin (10) new text endoutcome measures, determined by the commissioner, for home and community-based
services rates determined under this section.

(e) 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 (b) to (d) on
the following dates:

(1) January 15, 2015, with preliminary results and data;

(2) January 15, 2016, with a status implementation update, and additional data and
summary information;

(3) January 15, 2017, with the full report; and

(4) January 15, 2020, with another full report, and a full report once every four years
thereafter.

(f) The commissioner shall implement a regional adjustment factor to all rate calculations
in subdivisions 6 to 9, effective no later than January 1, 2015. Beginning July 1, 2017, the
commissioner shall renew analysis and implement changes to the regional adjustment factors
when adjustments required under subdivision 5, paragraph (h), occur. Prior to
implementation, the commissioner shall consult with stakeholders on the methodology to
calculate the adjustment.

(g) The commissioner shall provide a public notice via LISTSERV in October of each
year beginning October 1, 2014, containing information detailing legislatively approved
changes in:

(1) calculation values including derived wage rates and related employee and
administrative factors;

(2) service utilization;

(3) county and tribal allocation changes; and

(4) information on adjustments made to calculation values and the timing of those
adjustments.

The information in this notice must be effective January 1 of the following year.

(h) When the available shared staffing hours in a residential setting are insufficient to
meet the needs of an individual who enrolled in residential services after January 1, 2014,
or insufficient to meet the needs of an individual with a service agreement adjustment
described in section 256B.4913, subdivision 4a, paragraph (f), then individual staffing hours
shall be used.

(i) The commissioner shall study the underlying cost of absence and utilization for day
services. Based on the commissioner's evaluation of the data collected under this paragraph,
the commissioner shall make recommendations to the legislature by January 15, 2018, for
changes, if any, to the absence and utilization factor ratio component value for day services.

(j) Beginning July 1, 2017, the commissioner shall collect transportation and trip
information for all day services through the rates management system.

Sec. 6.

Minnesota Statutes 2018, section 256B.4914, subdivision 10a, 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 9 reflect the cost to provide the
service. As determined by the commissioner, in consultation with stakeholders identified
in section 256B.4913, subdivision 5, 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.

(c) The commissioner shall conduct a random validation of data submitted under
paragraph (a) to ensure data accuracy. The commissioner shall analyze cost documentation
in paragraph (a) and provide recommendations for adjustments to cost components.

(d) The commissioner shall analyze cost documentation in paragraph (a) and, in
consultation with stakeholders identified in section 256B.4913, subdivision 5, 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 every four years beginning January 1, 2020. The commissioner shall make
recommendations in conjunction with reports submitted to the legislature according to
subdivision 10, paragraph deleted text begin(e)deleted text endnew text begin (c)new text end. 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.

(e) The commissioner, in consultation with stakeholders identified in section 256B.4913,
subdivision 5, 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 (f) Beginning November 1, 2019, providers enrolled to provide services with rates
determined under this section shall submit labor market data to the commissioner annually,
including, but not limited to:
new text end

new text begin (1) number of direct care staff;
new text end

new text begin (2) wages of direct care staff;
new text end

new text begin (3) overtime wages of direct care staff;
new text end

new text begin (4) hours worked by direct care staff;
new text end

new text begin (5) overtime hours worked by direct care staff;
new text end

new text begin (6) benefits provided to direct care staff;
new text end

new text begin (7) direct care staff job vacancies; and
new text end

new text begin (8) direct care staff retention rates.
new text end

new text begin (g) Beginning February 1, 2020, the commissioner shall publish annual reports on
provider and state-level labor market data, including, but not limited to:
new text end

new text begin (1) number of direct care staff;
new text end

new text begin (2) wages of direct care staff;
new text end

new text begin (3) overtime wages of direct care staff;
new text end

new text begin (4) hours worked by direct care staff;
new text end

new text begin (5) overtime hours worked by direct care staff;
new text end

new text begin (6) benefits provided to direct care staff;
new text end

new text begin (7) direct care staff job vacancies; and
new text end

new text begin (8) direct care staff retention rates.
new text end