| 1 | 1 | | 1.1 A bill for an act |
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| 2 | 2 | | 1.2 relating to human services; requiring establishment of certain rates; modifying |
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| 3 | 3 | | 1.3 commissioner duties for certain day services; requiring case manager evaluation |
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| 4 | 4 | | 1.4 on informed decision making; correcting cross-references; amending Minnesota |
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| 5 | 5 | | 1.5 Statutes 2024, sections 252.43; 252.46, subdivision 1a; 256B.092, subdivisions |
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| 6 | 6 | | 1.6 1a, 11a; 256B.49, subdivisions 13, 29. |
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| 7 | 7 | | 1.7BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: |
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| 8 | 8 | | 1.8 Section 1. Minnesota Statutes 2024, section 252.43, is amended to read: |
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| 9 | 9 | | 1.9 252.43 COMMISSIONER'S DUTIES. |
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| 10 | 10 | | 1.10 (a) The commissioner shall supervise lead agencies' provision of day services to adults |
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| 11 | 11 | | 1.11with disabilities. The commissioner shall: |
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| 12 | 12 | | 1.12 (1) determine the need for day programs, except for adult day services, under sections |
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| 13 | 13 | | 1.13256B.4914 and 252.41 to 252.46 operated in a day services facility licensed under sections |
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| 14 | 14 | | 1.14245D.27 to 245D.31; |
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| 15 | 15 | | 1.15 (2) establish payment rates as provided under section 256B.4914; |
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| 16 | 16 | | 1.16 (3) adopt rules for the administration and provision of day services under sections |
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| 17 | 17 | | 1.17245A.01 to 245A.16; 252.28, subdivision 2; or 252.41 to 252.46; or Minnesota Rules, parts |
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| 18 | 18 | | 1.189525.1200 to 9525.1330; |
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| 19 | 19 | | 1.19 (4) enter into interagency agreements necessary to ensure effective coordination and |
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| 20 | 20 | | 1.20provision of day services; |
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| 21 | 21 | | 1.21 (5) monitor and evaluate the costs and effectiveness of day services; and |
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| 22 | 22 | | 1Section 1. |
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| 23 | 23 | | REVISOR EB/BM 25-0034212/31/24 |
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| 24 | 24 | | State of Minnesota |
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| 25 | 25 | | This Document can be made available |
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| 26 | 26 | | in alternative formats upon request |
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| 27 | 27 | | HOUSE OF REPRESENTATIVES |
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| 28 | 28 | | H. F. No. 2160 |
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| 29 | 29 | | NINETY-FOURTH SESSION |
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| 30 | 30 | | Authored by Schomacker03/12/2025 |
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| 31 | 31 | | The bill was read for the first time and referred to the Committee on Human Services Finance and Policy 2.1 (6) provide information and technical help to lead agencies and vendors in their |
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| 32 | 32 | | 2.2administration and provision of day services. |
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| 33 | 33 | | 2.3 (b) A determination of need in paragraph (a), clause (1), shall not be required for a |
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| 34 | 34 | | 2.4change in day service provider name or ownership. |
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| 35 | 35 | | 2.5 EFFECTIVE DATE.This section is effective July 1, 2025. |
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| 36 | 36 | | 2.6 Sec. 2. Minnesota Statutes 2024, section 252.46, subdivision 1a, is amended to read: |
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| 37 | 37 | | 2.7 Subd. 1a.Day training and habilitation rates.The commissioner shall establish a |
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| 38 | 38 | | 2.8statewide rate-setting methodology rates for all day training and habilitation services and |
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| 39 | 39 | | 2.9for transportation delivered as a part of day training and habilitation services as provided |
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| 40 | 40 | | 2.10under section 256B.4914. The rate-setting methodology must abide by the principles of |
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| 41 | 41 | | 2.11transparency and equitability across the state. The methodology must involve a uniform |
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| 42 | 42 | | 2.12process of structuring rates for each service and must promote quality and participant choice. |
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| 43 | 43 | | 2.13 EFFECTIVE DATE.This section is effective January 1, 2026. |
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| 44 | 44 | | 2.14 Sec. 3. Minnesota Statutes 2024, section 256B.092, subdivision 1a, is amended to read: |
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| 45 | 45 | | 2.15 Subd. 1a.Case management services.(a) Each recipient of a home and community-based |
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| 46 | 46 | | 2.16waiver shall be provided case management services by qualified vendors as described in |
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| 47 | 47 | | 2.17the federally approved waiver application. |
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| 48 | 48 | | 2.18 (b) Case management service activities provided to or arranged for a person include: |
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| 49 | 49 | | 2.19 (1) development of the person-centered support plan under subdivision 1b; |
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| 50 | 50 | | 2.20 (2) informing the individual or the individual's legal guardian or conservator, or parent |
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| 51 | 51 | | 2.21if the person is a minor, of service options, including all service options available under the |
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| 52 | 52 | | 2.22waiver plan; |
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| 53 | 53 | | 2.23 (3) consulting with relevant medical experts or service providers; |
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| 54 | 54 | | 2.24 (4) assisting the person in the identification of potential providers of chosen services, |
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| 55 | 55 | | 2.25including: |
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| 56 | 56 | | 2.26 (i) providers of services provided in a non-disability-specific setting; |
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| 57 | 57 | | 2.27 (ii) employment service providers; |
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| 58 | 58 | | 2.28 (iii) providers of services provided in settings that are not controlled by a provider; and |
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| 59 | 59 | | 2.29 (iv) providers of financial management services; |
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| 60 | 60 | | 2Sec. 3. |
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| 61 | 61 | | REVISOR EB/BM 25-0034212/31/24 3.1 (5) assisting the person to access services and assisting in appeals under section 256.045; |
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| 62 | 62 | | 3.2 (6) coordination of services, if coordination is not provided by another service provider; |
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| 63 | 63 | | 3.3 (7) evaluation and monitoring of the services identified in the support plan, which must |
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| 64 | 64 | | 3.4incorporate at least one annual face-to-face visit by the case manager with each person; and |
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| 65 | 65 | | 3.5 (8) reviewing support plans and providing the lead agency with recommendations for |
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| 66 | 66 | | 3.6service authorization based upon the individual's needs identified in the support plan. |
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| 67 | 67 | | 3.7 (c) Case management service activities that are provided to the person with a |
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| 68 | 68 | | 3.8developmental disability shall be provided directly by county agencies or under contract. |
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| 69 | 69 | | 3.9If a county agency contracts for case management services, the county agency must provide |
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| 70 | 70 | | 3.10each recipient of home and community-based services who is receiving contracted case |
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| 71 | 71 | | 3.11management services with the contact information the recipient may use to file a grievance |
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| 72 | 72 | | 3.12with the county agency about the quality of the contracted services the recipient is receiving |
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| 73 | 73 | | 3.13from a county-contracted case manager. If a county agency provides case management |
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| 74 | 74 | | 3.14under contracts with other individuals or agencies and the county agency utilizes a |
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| 75 | 75 | | 3.15competitive proposal process for the procurement of contracted case management services, |
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| 76 | 76 | | 3.16the competitive proposal process must include evaluation criteria to ensure that the county |
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| 77 | 77 | | 3.17maintains a culturally responsive program for case management services adequate to meet |
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| 78 | 78 | | 3.18the needs of the population of the county. For the purposes of this section, "culturally |
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| 79 | 79 | | 3.19responsive program" means a case management services program that: (1) ensures effective, |
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| 80 | 80 | | 3.20equitable, comprehensive, and respectful quality care services that are responsive to |
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| 81 | 81 | | 3.21individuals within a specific population's values, beliefs, practices, health literacy, preferred |
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| 82 | 82 | | 3.22language, and other communication needs; and (2) is designed to address the unique needs |
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| 83 | 83 | | 3.23of individuals who share a common language or racial, ethnic, or social background. |
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| 84 | 84 | | 3.24 (d) Case management services must be provided by a public or private agency that is |
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| 85 | 85 | | 3.25enrolled as a medical assistance provider determined by the commissioner to meet all of |
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| 86 | 86 | | 3.26the requirements in the approved federal waiver plans. Case management services must not |
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| 87 | 87 | | 3.27be provided to a recipient by a private agency that has a financial interest in the provision |
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| 88 | 88 | | 3.28of any other services included in the recipient's support plan. For purposes of this section, |
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| 89 | 89 | | 3.29"private agency" means any agency that is not identified as a lead agency under section |
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| 90 | 90 | | 3.30256B.0911, subdivision 10. |
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| 91 | 91 | | 3.31 (e) Case managers are responsible for service provisions listed in paragraphs (a) and |
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| 92 | 92 | | 3.32(b). Case managers shall collaborate with consumers, families, legal representatives, and |
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| 93 | 93 | | 3.33relevant medical experts and service providers in the development and annual review of the |
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| 94 | 94 | | 3.34person-centered support plan and habilitation plan. |
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| 95 | 95 | | 3Sec. 3. |
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| 96 | 96 | | REVISOR EB/BM 25-0034212/31/24 4.1 (f) For persons who need a positive support transition plan as required in chapter 245D, |
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| 97 | 97 | | 4.2the case manager shall participate in the development and ongoing evaluation of the plan |
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| 98 | 98 | | 4.3with the expanded support team. At least quarterly, the case manager, in consultation with |
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| 99 | 99 | | 4.4the expanded support team, shall evaluate the effectiveness of the plan based on progress |
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| 100 | 100 | | 4.5evaluation data submitted by the licensed provider to the case manager. The evaluation must |
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| 101 | 101 | | 4.6identify whether the plan has been developed and implemented in a manner to achieve the |
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| 102 | 102 | | 4.7following within the required timelines: |
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| 103 | 103 | | 4.8 (1) phasing out the use of prohibited procedures; |
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| 104 | 104 | | 4.9 (2) acquisition of skills needed to eliminate the prohibited procedures within the plan's |
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| 105 | 105 | | 4.10timeline; and |
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| 106 | 106 | | 4.11 (3) accomplishment of identified outcomes. |
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| 107 | 107 | | 4.12If adequate progress is not being made, the case manager shall consult with the person's |
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| 108 | 108 | | 4.13expanded support team to identify needed modifications and whether additional professional |
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| 109 | 109 | | 4.14support is required to provide consultation. |
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| 110 | 110 | | 4.15 (g) The Department of Human Services shall offer ongoing education in case management |
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| 111 | 111 | | 4.16to case managers. Case managers shall receive no less than 20 hours of case management |
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| 112 | 112 | | 4.17education and disability-related training each year. The education and training must include |
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| 113 | 113 | | 4.18person-centered planning, informed choice, informed decision making, cultural competency, |
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| 114 | 114 | | 4.19employment planning, community living planning, self-direction options, and use of |
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| 115 | 115 | | 4.20technology supports. Case managers must annually pass a competency evaluation, in a form |
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| 116 | 116 | | 4.21determined by the commissioner, on informed decision-making topics. By August 1, 2024, |
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| 117 | 117 | | 4.22all case managers must complete an employment support training course identified by the |
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| 118 | 118 | | 4.23commissioner of human services. For case managers hired after August 1, 2024, this training |
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| 119 | 119 | | 4.24must be completed within the first six months of providing case management services. For |
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| 120 | 120 | | 4.25the purposes of this section, "person-centered planning" or "person-centered" has the meaning |
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| 121 | 121 | | 4.26given in section 256B.0911, subdivision 10. Case managers must document completion of |
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| 122 | 122 | | 4.27training in a system identified by the commissioner. |
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| 123 | 123 | | 4.28 EFFECTIVE DATE.This section is effective August 1, 2025. |
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| 124 | 124 | | 4.29 Sec. 4. Minnesota Statutes 2024, section 256B.092, subdivision 11a, is amended to read: |
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| 125 | 125 | | 4.30 Subd. 11a.Residential support services criteria.(a) For the purposes of this subdivision, |
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| 126 | 126 | | 4.31"residential support services" means the following residential support services reimbursed |
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| 127 | 127 | | 4.32under section 256B.4914: community residential services, customized living services, and |
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| 128 | 128 | | 4.3324-hour customized living services. |
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| 129 | 129 | | 4Sec. 4. |
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| 130 | 130 | | REVISOR EB/BM 25-0034212/31/24 5.1 (b) In order to increase independent living options for people with disabilities and in |
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| 131 | 131 | | 5.2accordance with section 256B.4905, subdivisions 3 and 4 7 and 8, and consistent with |
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| 132 | 132 | | 5.3section 245A.03, subdivision 7, the commissioner must establish and implement criteria to |
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| 133 | 133 | | 5.4access residential support services. The criteria for accessing residential support services |
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| 134 | 134 | | 5.5must prohibit the commissioner from authorizing residential support services unless at least |
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| 135 | 135 | | 5.6all of the following conditions are met: |
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| 136 | 136 | | 5.7 (1) the individual has complex behavioral health or complex medical needs; and |
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| 137 | 137 | | 5.8 (2) the individual's service planning team has considered all other available residential |
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| 138 | 138 | | 5.9service options and determined that those options are inappropriate to meet the individual's |
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| 139 | 139 | | 5.10support needs. |
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| 140 | 140 | | 5.11 (c) Nothing in this subdivision shall be construed as permitting the commissioner to |
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| 141 | 141 | | 5.12establish criteria prohibiting the authorization of residential support services for individuals |
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| 142 | 142 | | 5.13described in the statewide priorities established in subdivision 12, the transition populations |
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| 143 | 143 | | 5.14in subdivision 13, and the licensing moratorium exception criteria under section 245A.03, |
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| 144 | 144 | | 5.15subdivision 7, paragraph (a). |
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| 145 | 145 | | 5.16 (d) Individuals with active service agreements for residential support services on the |
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| 146 | 146 | | 5.17date that the criteria for accessing residential support services become effective are exempt |
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| 147 | 147 | | 5.18from the requirements of this subdivision, and the exemption from the criteria for accessing |
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| 148 | 148 | | 5.19residential support services continues to apply for renewals of those service agreements. |
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| 149 | 149 | | 5.20 EFFECTIVE DATE.This section is effective 90 days following federal approval of |
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| 150 | 150 | | 5.21Laws 2021, First Special Session chapter 7, article 13, section 18. |
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| 151 | 151 | | 5.22 Sec. 5. Minnesota Statutes 2024, section 256B.49, subdivision 13, is amended to read: |
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| 152 | 152 | | 5.23 Subd. 13.Case management.(a) Each recipient of a home and community-based waiver |
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| 153 | 153 | | 5.24shall be provided case management services by qualified vendors as described in the federally |
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| 154 | 154 | | 5.25approved waiver application. The case management service activities provided must include: |
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| 155 | 155 | | 5.26 (1) finalizing the person-centered written support plan within the timelines established |
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| 156 | 156 | | 5.27by the commissioner and section 256B.0911, subdivision 29; |
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| 157 | 157 | | 5.28 (2) informing the recipient or the recipient's legal guardian or conservator of service |
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| 158 | 158 | | 5.29options, including all service options available under the waiver plans; |
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| 159 | 159 | | 5.30 (3) assisting the recipient in the identification of potential service providers of chosen |
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| 160 | 160 | | 5.31services, including: |
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| 161 | 161 | | 5.32 (i) available options for case management service and providers; |
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| 162 | 162 | | 5Sec. 5. |
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| 163 | 163 | | REVISOR EB/BM 25-0034212/31/24 6.1 (ii) providers of services provided in a non-disability-specific setting; |
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| 164 | 164 | | 6.2 (iii) employment service providers; |
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| 165 | 165 | | 6.3 (iv) providers of services provided in settings that are not community residential settings; |
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| 166 | 166 | | 6.4and |
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| 167 | 167 | | 6.5 (v) providers of financial management services; |
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| 168 | 168 | | 6.6 (4) assisting the recipient to access services and assisting with appeals under section |
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| 169 | 169 | | 6.7256.045; and |
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| 170 | 170 | | 6.8 (5) coordinating, evaluating, and monitoring of the services identified in the service |
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| 171 | 171 | | 6.9plan. |
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| 172 | 172 | | 6.10 (b) The case manager may delegate certain aspects of the case management service |
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| 173 | 173 | | 6.11activities to another individual provided there is oversight by the case manager. The case |
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| 174 | 174 | | 6.12manager may not delegate those aspects which require professional judgment including: |
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| 175 | 175 | | 6.13 (1) finalizing the person-centered support plan; |
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| 176 | 176 | | 6.14 (2) ongoing assessment and monitoring of the person's needs and adequacy of the |
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| 177 | 177 | | 6.15approved person-centered support plan; and |
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| 178 | 178 | | 6.16 (3) adjustments to the person-centered support plan. |
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| 179 | 179 | | 6.17 (c) Case management services must be provided by a public or private agency that is |
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| 180 | 180 | | 6.18enrolled as a medical assistance provider determined by the commissioner to meet all of |
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| 181 | 181 | | 6.19the requirements in the approved federal waiver plans. If a county agency provides case |
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| 182 | 182 | | 6.20management under contracts with other individuals or agencies and the county agency |
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| 183 | 183 | | 6.21utilizes a competitive proposal process for the procurement of contracted case management |
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| 184 | 184 | | 6.22services, the competitive proposal process must include evaluation criteria to ensure that |
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| 185 | 185 | | 6.23the county maintains a culturally responsive program for case management services adequate |
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| 186 | 186 | | 6.24to meet the needs of the population of the county. For the purposes of this section, "culturally |
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| 187 | 187 | | 6.25responsive program" means a case management services program that: (1) ensures effective, |
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| 188 | 188 | | 6.26equitable, comprehensive, and respectful quality care services that are responsive to |
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| 189 | 189 | | 6.27individuals within a specific population's values, beliefs, practices, health literacy, preferred |
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| 190 | 190 | | 6.28language, and other communication needs; and (2) is designed to address the unique needs |
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| 191 | 191 | | 6.29of individuals who share a common language or racial, ethnic, or social background. |
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| 192 | 192 | | 6.30 (d) Case management services must not be provided to a recipient by a private agency |
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| 193 | 193 | | 6.31that has any financial interest in the provision of any other services included in the recipient's |
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| 194 | 194 | | 6Sec. 5. |
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| 195 | 195 | | REVISOR EB/BM 25-0034212/31/24 7.1support plan. For purposes of this section, "private agency" means any agency that is not |
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| 196 | 196 | | 7.2identified as a lead agency under section 256B.0911, subdivision 10. |
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| 197 | 197 | | 7.3 (e) For persons who need a positive support transition plan as required in chapter 245D, |
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| 198 | 198 | | 7.4the case manager shall participate in the development and ongoing evaluation of the plan |
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| 199 | 199 | | 7.5with the expanded support team. At least quarterly, the case manager, in consultation with |
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| 200 | 200 | | 7.6the expanded support team, shall evaluate the effectiveness of the plan based on progress |
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| 201 | 201 | | 7.7evaluation data submitted by the licensed provider to the case manager. The evaluation must |
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| 202 | 202 | | 7.8identify whether the plan has been developed and implemented in a manner to achieve the |
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| 203 | 203 | | 7.9following within the required timelines: |
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| 204 | 204 | | 7.10 (1) phasing out the use of prohibited procedures; |
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| 205 | 205 | | 7.11 (2) acquisition of skills needed to eliminate the prohibited procedures within the plan's |
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| 206 | 206 | | 7.12timeline; and |
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| 207 | 207 | | 7.13 (3) accomplishment of identified outcomes. |
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| 208 | 208 | | 7.14If adequate progress is not being made, the case manager shall consult with the person's |
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| 209 | 209 | | 7.15expanded support team to identify needed modifications and whether additional professional |
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| 210 | 210 | | 7.16support is required to provide consultation. |
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| 211 | 211 | | 7.17 (f) The Department of Human Services shall offer ongoing education in case management |
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| 212 | 212 | | 7.18to case managers. Case managers shall receive no less than 20 hours of case management |
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| 213 | 213 | | 7.19education and disability-related training each year. The education and training must include |
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| 214 | 214 | | 7.20person-centered planning, informed choice, informed decision making, cultural competency, |
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| 215 | 215 | | 7.21employment planning, community living planning, self-direction options, and use of |
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| 216 | 216 | | 7.22technology supports. Case managers must annually pass a competency evaluation, in a form |
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| 217 | 217 | | 7.23determined by the commissioner, on informed decision-making topics. By August 1, 2024, |
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| 218 | 218 | | 7.24all case managers must complete an employment support training course identified by the |
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| 219 | 219 | | 7.25commissioner of human services. For case managers hired after August 1, 2024, this training |
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| 220 | 220 | | 7.26must be completed within the first six months of providing case management services. For |
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| 221 | 221 | | 7.27the purposes of this section, "person-centered planning" or "person-centered" has the meaning |
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| 222 | 222 | | 7.28given in section 256B.0911, subdivision 10. Case managers shall document completion of |
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| 223 | 223 | | 7.29training in a system identified by the commissioner. |
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| 224 | 224 | | 7.30 EFFECTIVE DATE.This section is effective August 1, 2025. |
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| 225 | 225 | | 7.31 Sec. 6. Minnesota Statutes 2024, section 256B.49, subdivision 29, is amended to read: |
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| 226 | 226 | | 7.32 Subd. 29.Residential support services criteria.(a) For the purposes of this subdivision, |
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| 227 | 227 | | 7.33"residential support services" means the following residential support services reimbursed |
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| 228 | 228 | | 7Sec. 6. |
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| 229 | 229 | | REVISOR EB/BM 25-0034212/31/24 8.1under section 256B.4914: community residential services, customized living services, and |
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| 230 | 230 | | 8.224-hour customized living services. |
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| 231 | 231 | | 8.3 (b) In order to increase independent living options for people with disabilities and in |
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| 232 | 232 | | 8.4accordance with section 256B.4905, subdivisions 3 and 4 7 and 8, and consistent with |
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| 233 | 233 | | 8.5section 245A.03, subdivision 7, the commissioner must establish and implement criteria to |
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| 234 | 234 | | 8.6access residential support services. The criteria for accessing residential support services |
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| 235 | 235 | | 8.7must prohibit the commissioner from authorizing residential support services unless at least |
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| 236 | 236 | | 8.8all of the following conditions are met: |
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| 237 | 237 | | 8.9 (1) the individual has complex behavioral health or complex medical needs; and |
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| 238 | 238 | | 8.10 (2) the individual's service planning team has considered all other available residential |
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| 239 | 239 | | 8.11service options and determined that those options are inappropriate to meet the individual's |
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| 240 | 240 | | 8.12support needs. |
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| 241 | 241 | | 8.13 (c) Nothing in this subdivision shall be construed as permitting the commissioner to |
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| 242 | 242 | | 8.14establish criteria prohibiting the authorization of residential support services for individuals |
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| 243 | 243 | | 8.15described in the statewide priorities established in subdivision 12 11a, the transition |
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| 244 | 244 | | 8.16populations in subdivision 13 24, and the licensing moratorium exception criteria under |
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| 245 | 245 | | 8.17section 245A.03, subdivision 7, paragraph (a). |
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| 246 | 246 | | 8.18 (c) (d) Individuals with active service agreements for residential support services on the |
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| 247 | 247 | | 8.19date that the criteria for accessing residential support services become effective are exempt |
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| 248 | 248 | | 8.20from the requirements of this subdivision, and the exemption from the criteria for accessing |
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| 249 | 249 | | 8.21residential support services continues to apply for renewals of those service agreements. |
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| 250 | 250 | | 8.22 EFFECTIVE DATE.This section is effective 90 days following federal approval of |
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| 251 | 251 | | 8.23Laws 2021, First Special Session chapter 7, article 13, section 30. |
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| 252 | 252 | | 8Sec. 6. |
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| 253 | 253 | | REVISOR EB/BM 25-0034212/31/24 |
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