Minnesota 2025-2026 Regular Session

Minnesota Senate Bill SF2876 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	1.1 A bill for an act
2	2	1.2 relating to human services; establishing a coordinated services organization
3	3	1.3 demonstration project; appropriating money; proposing coding for new law in
4	4	1.4 Minnesota Statutes, chapter 256B.
5	5	1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
6	6	1.6 Section 1. [256B.7705] COORDINATED SERVICES ORGANIZATION
7	7	1.7DEMONSTRATION PROJECT.
8	8	1.8 Subdivision 1.Purpose.The commissioner shall establish a demonstration project to
9	9	1.9test a provider-led coordinated service model, implemented by disability services providers
10	10	1.10for people with disabilities, that coordinates services across the continuum of covered
11	11	1.11services under medical assistance and Medicare, addresses health-related social needs, and
12	12	1.12prioritizes enrollee choice.
13	13	1.13 Subd. 2.Application.The commissioner shall develop a request for applications for
14	14	1.14participation in the coordinated services organization demonstration project. In developing
15	15	1.15the request for applications, the commissioner shall:
16	16	1.16 (1) identify, in consultation with interested parties, key indicators of well-being, quality,
17	17	1.17access, satisfaction, and other performance indicators;
18	18	1.18 (2) identify, in consultation with interested parties, indicators for measuring cost savings;
19	19	1.19 (3) establish quality standards for the coordinated service organization that are appropriate
20	20	1.20for the populations served;
21	21	1.21 (4) encourage the coordination of services across home and community-based services,
22	22	1.22crisis services, primary care, dental care, and pharmacy;
23	23	1Section 1.
24	24	25-04566 as introduced03/11/25 REVISOR AGW/HL
25	25	SENATE
26	26	STATE OF MINNESOTA
27	27	S.F. No. 2876NINETY-FOURTH SESSION
28	28	(SENATE AUTHORS: HOFFMAN, Abeler, Gruenhagen, Utke and Maye Quade)
29	29	OFFICIAL STATUSD-PGDATE
30	30	Introduction and first reading03/24/2025
31	31	Referred to Human Services 2.1 (5) allow flexibility in the application evaluation methodology to encourage applicants
32	32	2.2to propose innovation and disability services provider collaborations that may be customized
33	33	2.3for the special needs and barriers of patient populations receiving home and community-based
34	34	2.4waiver services and dual-eligible populations; and
35	35	2.5 (6) allow flexibility in the application evaluation methodology to facilitate the delivery
36	36	2.6of eligibility and claims data to the coordinated services organization, including collaborating
37	37	2.7on data use agreements with the Centers for Medicare & Medicaid Services for dual-eligible
38	38	2.8Medicare claims and eligibility data.
39	39	2.9 Subd. 3.Eligibility.(a) To be eligible to participate in the coordinated services
40	40	2.10organization demonstration project an applicant must demonstrate in its application that it
41	41	2.11will:
42	42	2.12 (1) include providers of home and community-based services and long-term services
43	43	2.13and supports;
44	44	2.14 (2) have partnership or joint venture arrangements between home and community-based
45	45	2.15providers and health care providers;
46	46	2.16 (3) have partnership or joint venture agreements with managed care plans serving people
47	47	2.17enrolled in special needs basic care programs to improve the coordination and integration
48	48	2.18of medical, behavioral health, and long-term services and supports for enrollees served by
49	49	2.19the coordinated services organization;
50	50	2.20 (4) have an established, nonprofit, shared governance structure;
51	51	2.21 (5) develop a process for enrollees to opt into the coordinated service organization and
52	52	2.22establish a mechanism to monitor enrollment;
53	53	2.23 (6) establish a process to ensure the quality of care and services provided;
54	54	2.24 (7) have the capacity to provide care coordination and population health activities for
55	55	2.25enrollees;
56	56	2.26 (8) have the capacity to provide community intervention programming, including
57	57	2.27upstream early identification and enhanced care to reduce preventable emergency department
58	58	2.28use, services to reduce avoidable hospitalization and readmission, transitions of care,
59	59	2.29enhanced primary care, medication therapy management, in-home technology, and specialized
60	60	2.30dental coordination and services;
61	61	2.31 (9) in cooperation with counties and community social service agencies, coordinate the
62	62	2.32delivery of health care services with existing social services programs;
63	63	2Section 1.
64	64	25-04566 as introduced03/11/25 REVISOR AGW/HL 3.1 (10) have a mechanism to ensure compliance with conflict-free case management
65	65	3.2requirements;
66	66	3.3 (11) have the ability to provide population health analysis, risk stratification, and quality
67	67	3.4and performance reporting to its participating providers for the purposes of meeting cost
68	68	3.5and quality measures; and
69	69	3.6 (12) adopt innovative and cost-effective methods of care delivery and coordination,
70	70	3.7which may include the use of telehealth, care coordinators, community health workers, and
71	71	3.8peer support.
72	72	3.9 (b) A successful applicant may contract with a third party, including for the administration
73	73	3.10of a payment system using the payment methods established by the commissioner for
74	74	3.11integrated health partnerships.
75	75	3.12 Subd. 4.Enrollment.(a) An individual is eligible to enroll with a coordinated services
76	76	3.13organization if the individual is either dually eligible for medical assistance and Medicare
77	77	3.14and eligible to receive waiver services under section 256B.49 or enrolled in medical
78	78	3.15assistance special needs basic care and receiving waiver services under section 256B.49.
79	79	3.16 (b) An individual eligible under paragraph (a) may enroll in a coordinated services
80	80	3.17organization if the organization and its participating providers serve the county in which
81	81	3.18the eligible individual resides.
82	82	3.19 Subd. 5.Accountability.(a) A coordinated services organization must accept
83	83	3.20responsibility for the quality of care and services based on standards established under
84	84	3.21subdivision 2 and the cost of care or utilization of services provided to its enrollees.
85	85	3.22Accountability standards must be appropriate to people with disabilities and specific
86	86	3.23subpopulations served.
87	87	3.24 (b) A coordinated services organization must demonstrate to the commissioner how it
88	88	3.25coordinates services affecting its enrollees' health, quality of care, and cost of care that are
89	89	3.26provided by other providers, county agencies, and other organizations in the local service
90	90	3.27area.
91	91	3.28 (c) After the expiration of an initial contract term under this section, the commissioner
92	92	3.29may evaluate additional activities for inclusion in coordinated services organization contracts.
93	93	3.30Additional activities the commissioner may include in the contract include but are not limited
94	94	3.31to long-term care consultation services assessments under section 256B.0911, community
95	95	3.32first services and supports consultative services under section 256B.85, waiver case
96	96	3Section 1.
97	97	25-04566 as introduced03/11/25 REVISOR AGW/HL 4.1management under sections 256B.092 and 256B.49, and financial management services
98	98	4.2under chapter 256B.
99	99	4.3 Subd. 6.Payments.(a) The commissioner shall establish a per member, per month
100	100	4.4population-based payment that reflects the ongoing activities, scope, and metrics of the
101	101	4.5coordinated services organization. The payment must be risk-adjusted to reflect varying
102	102	4.6levels of care and case management intensiveness for enrollees with chronic conditions,
103	103	4.7dependencies in activities of daily living, need for assistance due to behaviors, and other
104	104	4.8factors that recognize the medical complexity of the populations served. The payment must
105	105	4.9be paid at least on a quarterly basis.
106	106	4.10 (b) The commissioner shall collaborate with the coordinated services organization in
107	107	4.11developing a total cost of care risk-gain sharing payment model.
108	108	4.12 (c) The commissioner may include in the payment system incentive payments to the
109	109	4.13coordinated services organization that meet or exceed annual quality and performance targets
110	110	4.14realized through the coordination of care.
111	111	4.15 (d) The population-based payment must not duplicate services under already existing
112	112	4.16special need basic care coordination delegation agreements.
113	113	4.17 (e) The coordinated services organization must develop a value-based arrangement
114	114	4.18between the parties participating in its approved demonstration project, including the
115	115	4.19Department of Human Services, and establish a shared risk-savings distribution agreement
116	116	4.20among parties.
117	117	4.21 (f) The commissioner must continue to pay providers participating in an approved
118	118	4.22coordinated services organization demonstration project contractual or fee-for-service rates
119	119	4.23for individual services covered by medical assistance.
120	120	4.24 (g) A coordinated services organization receiving this payment must continue to meet
121	121	4.25cost and quality metrics under the program to maintain eligibility for the population-based
122	122	4.26payment.
123	123	4.27 Subd. 7.Federal approval.The commissioner shall apply for any federal approval
124	124	4.28required to implement this project and seek to maximize federal financial participation.
125	125	4.29 Subd. 8.Innovation grants.The commissioner shall, from within appropriations
126	126	4.30available for this purpose, establish coordinated service organization innovation and
127	127	4.31capacity-building grants. The commissioner shall award grants to assist approved coordinated
128	128	4.32services organizations in covering initial start-up costs and maximizing the coordination
129	129	4.33and integration of the organization and its partners.
130	130	4Section 1.
131	131	25-04566 as introduced03/11/25 REVISOR AGW/HL 5.1 Sec. 2. APPROPRIATION; COORDINATED SERVICE ORGANIZATION
132	132	5.2INNOVATION AND CAPACITY-BUILDING GRANTS.
133	133	5.3 $....... in fiscal year 2026 and $....... in fiscal year 2027 are appropriated from the general
134	134	5.4fund to the commissioner of human services for coordinated service organization innovation
135	135	5.5and capacity-building grants under Minnesota Statutes, section 256B.7705. The commissioner
136	136	5.6must not award a grant exceeding $2,000,000 to a coordinated service organization during
137	137	5.7the biennium.
138	138	5Sec. 2.
139	139	25-04566 as introduced03/11/25 REVISOR AGW/HL