1.1 A bill for an act
1.2 relating to human services; expanding certain medical assistance services to include
1.3 coverage of care evaluations; modifying medical assistance rates for homemaker
1.4 services, home health agency services, and home care nursing services; establishing
1.5 a home care preceptor grant program; requiring a report; appropriating money;
1.6 amending Minnesota Statutes 2024, sections 256B.0651, subdivisions 1, 2;
1.7 256B.0652, subdivision 11; 256B.0653, subdivisions 1, 6, by adding a subdivision;
1.8 256B.0654, by adding a subdivision.
1.9BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.10 Section 1. Minnesota Statutes 2024, section 256B.0651, subdivision 1, is amended to read:
1.11 Subdivision 1.Definitions.(a) For the purposes of sections 256B.0651 to 256B.0654
1.12and 256B.0659, the terms in paragraphs (b) to (g) this subdivision have the meanings given.
1.13 (b) "Activities of daily living" has the meaning given in section 256B.0659, subdivision
1.141, paragraph (b).
1.15 (c) "Assessment" means a review and evaluation of a recipient's need for home care
1.16services conducted in person.
1.17 (d) "Care evaluation" means a face-to-face evaluation of a person to develop, update,
1.18or review a recipient's plan of care for home care services, except personal care assistance.
1.19 (d) (e) "Home care services" means medical assistance covered services that are home
1.20health agency services, including skilled nurse visits; home health aide visits; physical
1.21therapy, occupational therapy, respiratory therapy, and language-speech pathology therapy;
1.22home care nursing; and personal care assistance.
1.23 (e) (f) "Home residence," effective January 1, 2010, means a residence owned or rented
1.24by the recipient either alone, with roommates of the recipient's choosing, or with an unpaid
1Section 1.
S0476-1 1st EngrossmentSF476 REVISOR AGW
SENATE
STATE OF MINNESOTA
S.F. No. 476NINETY-FOURTH SESSION
(SENATE AUTHORS: HOFFMAN, Utke, Abeler and Boldon)
OFFICIAL STATUSD-PGDATE
Introduction and first reading14101/21/2025
Referred to Human Services
Comm report: To pass as amended04/01/2025
Second reading 2.1responsible party or legal representative; or a family foster home where the license holder
2.2lives with the recipient and is not paid to provide home care services for the recipient except
2.3as allowed under sections 256B.0652, subdivision 10, and 256B.0654, subdivision 4.
2.4 (f) (g) "Medically necessary" has the meaning given in Minnesota Rules, parts 9505.0170
2.5to 9505.0475.
2.6 (g) (h) "Ventilator-dependent" means an individual who receives mechanical ventilation
2.7for life support at least six hours per day and is expected to be or has been dependent on a
2.8ventilator for at least 30 consecutive days.
2.9 EFFECTIVE DATE.This section is effective January 1, 2026, or upon federal approval,
2.10whichever is later. The commissioner of human services shall notify the revisor of statutes
2.11when federal approval is obtained.
2.12 Sec. 2. Minnesota Statutes 2024, section 256B.0651, subdivision 2, is amended to read:
2.13 Subd. 2.Services covered.Home care services covered under this section and sections
2.14256B.0652 to 256B.0654 and 256B.0659 include:
2.15 (1) nursing services under sections 256B.0625, subdivision 6a, and 256B.0653;
2.16 (2) home care nursing services under sections 256B.0625, subdivision 7, and 256B.0654;
2.17 (3) home health services under sections 256B.0625, subdivision 6a, and 256B.0653;
2.18 (4) personal care assistance services under sections 256B.0625, subdivision 19a, and
2.19256B.0659;
2.20 (5) supervision of personal care assistance services provided by a qualified professional
2.21under sections 256B.0625, subdivision 19a, and 256B.0659;
2.22 (6) face-to-face assessments by county public health nurses for personal care assistance
2.23services under sections 256B.0625, subdivision 19a, and 256B.0659; and
2.24 (7) service updates and review reviews by county public health nurses of temporary
2.25increases for personal care assistance services by the county public health nurse for services
2.26under sections 256B.0625, subdivision 19a, and 256B.0659.; and
2.27 (8) care evaluations under sections 256B.0625, subdivisions 6a and 7, 256B.0653, and
2.28256B.0654.
2.29 EFFECTIVE DATE.This section is effective January 1, 2026, or upon federal approval,
2.30whichever is later. The commissioner of human services shall notify the revisor of statutes
2.31when federal approval is obtained.
2Sec. 2.
S0476-1 1st EngrossmentSF476 REVISOR AGW 3.1 Sec. 3. Minnesota Statutes 2024, section 256B.0652, subdivision 11, is amended to read:
3.2 Subd. 11.Limits on services without authorization.During a calendar year, a recipient
3.3may receive the following home care services during a calendar year without authorization:
3.4 (1) up to two face-to-face assessments to determine a recipient's need for personal care
3.5assistance services;
3.6 (2) one service update done to determine a recipient's need for personal care assistance
3.7services; and
3.8 (3) up to nine face-to-face visits that must include only skilled nurse visits or care
3.9evaluations.
3.10 EFFECTIVE DATE.This section is effective January 1, 2026, or upon federal approval,
3.11whichever is later. The commissioner of human services shall notify the revisor of statutes
3.12when federal approval is obtained.
3.13 Sec. 4. Minnesota Statutes 2024, section 256B.0653, subdivision 1, is amended to read:
3.14 Subdivision 1.Scope.This section applies to home health agency services including
3.15home health aide, skilled nursing visits, physical therapy, occupational therapy, respiratory
3.16therapy, and speech-language pathology therapy, and care evaluations.
3.17 EFFECTIVE DATE.This section is effective January 1, 2026, or upon federal approval,
3.18whichever is later. The commissioner of human services shall notify the revisor of statutes
3.19when federal approval is obtained.
3.20 Sec. 5. Minnesota Statutes 2024, section 256B.0653, subdivision 6, is amended to read:
3.21 Subd. 6.Noncovered home health agency services.The following are not eligible for
3.22payment under medical assistance as a home health agency service:
3.23 (1) telehomecare skilled nurses services that is communication between the home care
3.24nurse and recipient that consists solely of a telephone conversation, facsimile, electronic
3.25mail, or a consultation between two health care practitioners;
3.26 (2) the following skilled nurse visits:
3.27 (i) for the purpose of monitoring medication compliance with an established medication
3.28program for a recipient;
3.29 (ii) administering or assisting with medication administration, including injections,
3.30prefilling syringes for injections, or oral medication setup of an adult recipient, when, as
3Sec. 5.
S0476-1 1st EngrossmentSF476 REVISOR AGW 4.1determined and documented by the registered nurse, the need can be met by an available
4.2pharmacy or the recipient or a family member is physically and mentally able to
4.3self-administer or prefill a medication;
4.4 (iii) services done for the sole purpose of supervision of the home health aide or personal
4.5care assistant;
4.6 (iv) services done for the sole purpose to train other home health agency workers;
4.7 (v) services done for the sole purpose of blood samples or lab draw when the recipient
4.8is able to access these services outside the home; and
4.9 (vi) Medicare evaluation or administrative nursing visits required by Medicare, except
4.10as provided in subdivision 9, paragraph (a);
4.11 (3) home health aide visits when the following activities are the sole purpose for the
4.12visit: companionship, socialization, household tasks, transportation, and education;
4.13 (4) home care therapies provided in other settings such as a clinic or as an inpatient or
4.14when the recipient can access therapy outside of the recipient's residence; and
4.15 (5) home health agency services without qualifying documentation of a face-to-face
4.16encounter as specified in subdivision 7.
4.17 EFFECTIVE DATE.This section is effective January 1, 2026, or upon federal approval,
4.18whichever is later. The commissioner of human services shall notify the revisor of statutes
4.19when federal approval is obtained.
4.20 Sec. 6. Minnesota Statutes 2024, section 256B.0653, is amended by adding a subdivision
4.21to read:
4.22 Subd. 9.Care evaluations.(a) Notwithstanding the coverage limitation in subdivision
4.236, clause (2), item (vi), medical assistance covers care evaluations as a home health service
4.24under section 256B.0625, subdivision 6a, provided that the recipient's home health services
4.25are not covered under the Medicare program or any other insurance held by the recipient.
4.26 (b) The reimbursement rate for care evaluations under this section must equal 300 percent
4.27of the medical assistance reimbursement rate for a skilled nursing visit.
4.28 (c) Care evaluations under this section must occur during a start-of-care visit, a
4.29resumption-of-care visit, or a recertification visit. Care evaluations under this section must
4.30be provided by a registered nurse whenever the recipient's plan of care involves nursing
4.31tasks or medically oriented tasks requiring skilled nursing visits or home health aide visits.
4Sec. 6.
S0476-1 1st EngrossmentSF476 REVISOR AGW 5.1If the service recipient's plan of care involves only home care therapy, an appropriate therapist
5.2may conduct a care evaluation under this section.
5.3 EFFECTIVE DATE.This section is effective January 1, 2026, or upon federal approval,
5.4whichever is later. The commissioner of human services shall notify the revisor of statutes
5.5when federal approval is obtained.
5.6 Sec. 7. Minnesota Statutes 2024, section 256B.0654, is amended by adding a subdivision
5.7to read:
5.8 Subd. 6.Care evaluations.(a) Medical assistance covers care evaluations as a home
5.9care nursing service under section 256B.0625, subdivision 7, provided the recipient's home
5.10care nursing services are not covered by the Medicare program or any other insurance held
5.11by the recipient.
5.12 (b) The reimbursement rate for care evaluations under this section must equal 300 percent
5.13of the medical assistance reimbursement rate for a skilled nursing visit.
5.14 (c) Care evaluations under this section must occur during a start-of-care visit, a
5.15resumption-of-care visit, or a recertification visit. Care evaluations under this section must
5.16be provided by a registered nurse.
5.17 EFFECTIVE DATE.This section is effective January 1, 2026, or upon federal approval,
5.18whichever is later. The commissioner of human services shall notify the revisor of statutes
5.19when federal approval is obtained.
5.20 Sec. 8. RATE INCREASE FOR CERTAIN HOME CARE SERVICES.
5.21 (a) The commissioner of human services shall increase payment rates for home health
5.22agency services under Minnesota Statutes, section 256B.0653, by ... percent from the rates
5.23in effect on December 31, 2025.
5.24 (b) The commissioner of human services shall increase payment rates for home care
5.25nursing under Minnesota Statutes, section 256B.0651, subdivision 2, clause (2), by ... percent
5.26from the rates in effect on December 31, 2025.
5.27 (c) The commissioner of human services shall increase payment rates established under
5.28Minnesota Statutes, sections 256S.21 to 256S.215, for homemaker assistance with personal
5.29care, homemaker cleaning, and homemaker home management by ... percent from the rates
5.30in effect on December 31, 2025.
5Sec. 8.
S0476-1 1st EngrossmentSF476 REVISOR AGW 6.1 EFFECTIVE DATE.This section is effective January 1, 2026, or upon federal approval,
6.2whichever is later. The commissioner of human services shall notify the revisor of statutes
6.3when federal approval is obtained.
6.4 Sec. 9. HOME CARE PRECEPTOR GRANT PROGRAM.
6.5 Subdivision 1.Establishment.The commissioner of human services must establish a
6.6onetime grant program for incentive compensation and benefits for home care nurse
6.7employees who serve as a preceptor of a nursing student.
6.8 Subd. 2.Eligible grant recipients.Only home care providers licensed under Minnesota
6.9Statutes, chapter 144A, are eligible grant recipients under this section.
6.10 Subd. 3.Allowable uses.Grant money must be directed toward employees providing
6.11home care services licensed under Minnesota Statutes, chapter 144A. The only allowable
6.12use of grant money is incentive compensation and benefits for home care nurse employees
6.13who serve as a preceptor of a nursing student.
6.14 Subd. 4.Selection process.The commissioner shall select grantees based on information
6.15submitted in a grant proposal in a format as determined by the commissioner. The
6.16commissioner shall take into account relevant factors including the demonstrated need for
6.17an award for preceptors, the percentage of an organization's clients that are enrolled in
6.18medical assistance and MinnesotaCare, statewide geographical distribution of awarded
6.19grants, and other criteria as determined by the commissioner.
6.20 Subd. 5.Report.By July 1, 2028, each grant recipient must submit a report to the
6.21commissioner that includes details of how the grant money was distributed.
6.22 Subd. 6.Expiration.Subdivisions 1 to 4 expire January 1, 2028. This subdivision and
6.23subdivision 5 expire July 1, 2028.
6.24 Sec. 10. APPROPRIATION; HOME CARE PRECEPTOR GRANT PROGRAM.
6.25 $....... in fiscal year 2026 is appropriated from the general fund to the commissioner of
6.26human services for the home care preceptor grant program. This is a onetime appropriation
6.27and is available until June 30, 2028.
6Sec. 10.
S0476-1 1st EngrossmentSF476 REVISOR AGW