256B.4914 HOME AND COMMUNITY-BASED SERVICES WAIVERS; RATE SETTING.
Subdivision 1. Application. The payment methodologies in this section apply to home and
community-based services waivers under sections 256B.092 and 256B.49. This section does not change
existing waiver policies and procedures.
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.
(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:
(1) typical education needed for entry;
(2) work experience in a related occupation; and
(3) typical on-the-job training competency as the most predominant classification for direct care staff.
(d) "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.
(e) "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.
(f) "Direct care staff" means employees providing direct service to people receiving services under this
section. Direct care staff excludes executive, managerial, and administrative staff.
(g) "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.
(h) "Individual direct staffing hours" 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
support plan under section 245D.02, subdivision 4b; any support plan addendum under section 245D.02,
subdivision 4c; and an assessment tool. Provider observation of an individual's needs must also be considered.
(i) "Lead agency" means a county, partnership of counties, or Tribal agency charged with administering
waivered services under sections 256B.092 and 256B.49.
(j) "Payment or rate" means reimbursement to an eligible provider for services provided to a qualified
individual based on an approved service authorization.
(k) "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.
(l) "Recipient" means a person receiving home and community-based services funded under any of the
disability waivers.
(m) "Shared direct staffing hours" means time spent by employees, not defined under paragraph (f),
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
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support individual services; and training to participants, and is based on the requirements in each individual's
support plan under section 245D.02, subdivision 4b; any 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.
(n) "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.
Subd. 3. Applicable services. (a) Applicable services are those authorized under the state's home and
community-based services waivers under sections 256B.092 and 256B.49, including the following, as defined
in the federally approved home and community-based services plan:
(1) 24-hour customized living;
(2) adult day services;
(3) adult day services bath;
(4) community residential services;
(5) customized living;
(6) day support services;
(7) employment development services;
(8) employment exploration services;
(9) employment support services;
(10) family residential services;
(11) individualized home supports;
(12) individualized home supports with family training;
(13) individualized home supports with training;
(14) integrated community supports;
(15) life sharing;
(16) night supervision;
(17) positive support services;
(18) prevocational services;
(19) residential support services;
(20) respite services;
(21) transportation services; and
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(22) other services as approved by the federal government in the state home and community-based
services waiver plan.
(b) Effective January 1, 2024, or upon federal approval, whichever is later, respite services under
paragraph (a), clause (20), are not an applicable service under this section.
[See Note.]
Subd. 4. Data collection for rate determination. (a) Rates for applicable home and community-based
waivered services, including customized rates under subdivision 12, are set by the rates management system.
(b) Data and information in the rates management system must be used to calculate an individual's rate.
(c) Service providers, with information from the support plan and oversight by lead agencies, shall
provide values and information needed to calculate an individual's rate in the rates management system. The
determination of service levels must be part of a discussion with members of the support team as defined
in section 245D.02, subdivision 34. This discussion must occur prior to the final establishment of each
individual's rate. The values and information include:
(1) shared staffing hours;
(2) individual staffing hours;
(3) direct registered nurse hours;
(4) direct licensed practical nurse hours;
(5) staffing ratios;
(6) information to document variable levels of service qualification for variable levels of reimbursement
in each framework;
(7) shared or individualized arrangements for unit-based services, including the staffing ratio;
(8) number of trips and miles for transportation services; and
(9) service hours provided through monitoring technology.
(d) Updates to individual data must include:
(1) data for each individual that is updated annually when renewing service plans; and
(2) requests by individuals or lead agencies to update a rate whenever there is a change in an individual's
service needs, with accompanying documentation.
(e) Lead agencies shall review and approve all services reflecting each individual's needs, and the values
to calculate the final payment rate for services with variables under subdivisions 6 to 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:
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(1) meeting the health and welfare needs of the individual or individuals receiving services by service
site, identified in their support plan under section 245D.02, subdivision 4b, and any addendum under section
245D.02, subdivision 4c;
(2) meeting the requirements for staffing under subdivision 2, paragraphs (h), (n), and (o); and meeting
or exceeding the licensing standards for staffing required under section 245D.09, subdivision 1; and
(3) meeting the staffing ratio requirements under subdivision 2, paragraph (o), and meeting or exceeding
the licensing standards for staffing required under section 245D.31.
[See Note.]
Subd. 5. Base wage index; establishment and updates. (a) The base wage index is established to
determine staffing costs associated with providing services to individuals receiving home and
community-based services. For purposes of calculating the base wage, Minnesota-specific wages taken from
job descriptions and standard occupational classification (SOC) codes from the Bureau of Labor Statistics
as defined in the Occupational Handbook must be used.
(b) The commissioner shall update the base wage index in subdivision 5a, publish these updated values,
and load them into the rate management system as follows:
(1) on January 1, 2022, based on wage data by SOC from the Bureau of Labor Statistics available as of
December 31, 2019;
(2) on January 1, 2024, based on wage data by SOC from the Bureau of Labor Statistics published in
March 2022; and
(3) on January 1, 2026, and every two years thereafter, based on wage data by SOC from the Bureau of
Labor Statistics published in the spring approximately 21 months prior to the scheduled update.
[See Note.]
Subd. 5a. Base wage index; calculations. The base wage index must be calculated as follows:
(1) for supervisory staff, 100 percent of the median wage for community and social services specialist
(SOC code 21-1099), with the exception of the supervisor of positive supports professional, positive supports
analyst, and positive supports specialist, which is 100 percent of the median wage for clinical counseling
and school psychologist (SOC code 19-3031);
(2) for registered nurse staff, 100 percent of the median wage for registered nurses (SOC code 29-1141);
(3) for licensed practical nurse staff, 100 percent of the median wage for licensed practical nurses (SOC
code 29-2061);
(4) for residential asleep-overnight staff, the minimum wage in Minnesota for large employers;
(5) for residential direct care staff, the sum of:
(i) 15 percent of the subtotal of 50 percent of the median wage for home health and personal care aide
(SOC code 31-1120); 30 percent of the median wage for nursing assistant (SOC code 31-1131); and 20
percent of the median wage for social and human services aide (SOC code 21-1093); and
(ii) 85 percent of the subtotal of 40 percent of the median wage for home health and personal care aide
(SOC code 31-1120); 20 percent of the median wage for nursing assistant (SOC code 31-1131); 20 percent
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of the median wage for psychiatric technician (SOC code 29-2053); and 20 percent of the median wage for
social and human services aide (SOC code 21-1093);
(6) for adult day services staff, 70 percent of the median wage for nursing assistant (SOC code 31-1131);
and 30 percent of the median wage for home health and personal care aide (SOC code 31-1120);
(7) for day support services staff and prevocational services staff, 20 percent of the median wage for
nursing assistant (SOC code 31-1131); 20 percent of the median wage for psychiatric technician (SOC code
29-2053); and 60 percent of the median wage for social and human services aide (SOC code 21-1093);
(8) for positive supports analyst staff, 100 percent of the median wage for substance abuse, behavioral
disorder, and mental health counselor (SOC code 21-1018);
(9) for positive supports professional staff, 100 percent of the median wage for clinical counseling and
school psychologist (SOC code 19-3031);
(10) for positive supports specialist staff, 100 percent of the median wage for psychiatric technicians
(SOC code 29-2053);
(11) for individualized home supports with family training staff, 20 percent of the median wage for
nursing aide (SOC code 31-1131); 30 percent of the median wage for community social service specialist
(SOC code 21-1099); 40 percent of the median wage for social and human services aide (SOC code 21-1093);
and ten percent of the median wage for psychiatric technician (SOC code 29-2053);
(12) for individualized home supports with training services staff, 40 percent of the median wage for
community social service specialist (SOC code 21-1099); 50 percent of the median wage for social and
human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric technician
(SOC code 29-2053);
(13) for employment support services staff, 50 percent of the median wage for rehabilitation counselor
(SOC code 21-1015); and 50 percent of the median wage for community and social services specialist (SOC
code 21-1099);
(14) for employment exploration services staff, 50 percent of the median wage for education, guidance,
school, and vocational counselor (SOC code 21-1012); and 50 percent of the median wage for community
and social services specialist (SOC code 21-1099);
(15) for employment development services staff, 50 percent of the median wage for education, guidance,
school, and vocational counselors (SOC code 21-1012); and 50 percent of the median wage for community
and social services specialist (SOC code 21-1099);
(16) for individualized home support without training staff, 50 percent of the median wage for home
health and personal care aide (SOC code 31-1120); and 50 percent of the median wage for nursing assistant
(SOC code 31-1131); and
(17) for night supervision staff, 40 percent of the median wage for home health and personal care aide
(SOC code 31-1120); 20 percent of the median wage for nursing assistant (SOC code 31-1131); 20 percent
of the median wage for psychiatric technician (SOC code 29-2053); and 20 percent of the median wage for
social and human services aide (SOC code 21-1093).
[See Note.]
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Subd. 5b. Standard component value adjustments. The commissioner shall update the client and
programming support, transportation, and program facility cost component values as required in subdivisions
6 to 9 and the rates identified in subdivision 19 for changes in the Consumer Price Index. The commissioner
shall adjust these values higher or lower, publish these updated values, and load them into the rate management
system as follows:
(1) on January 1, 2022, by the percentage change in the CPI-U from the date of the previous update to
the data available on December 31, 2019;
(2) on January 1, 2024, by the percentage change in the CPI-U from the date of the previous update to
the data available as of December 31, 2022; and
(3) on January 1, 2026, and every two years thereafter, by the percentage change in the CPI-U from the
date of the previous update to the data available 24 months and one day prior to the scheduled update.
[See Note.]
Subd. 5c. Removal of after-framework adjustments. Any rate adjustments applied to the service rates
calculated under this section outside of the cost components and rate methodology specified in this section
shall be removed from rate calculations upon implementation of the updates under subdivisions 5 and 5b.
Subd. 5d. Unavailable data for updates and adjustments. If Bureau of Labor Statistics occupational
codes or Consumer Price Index items specified in subdivision 5 or 5b are unavailable in the future, the
commissioner shall recommend to the legislature codes or items to update and replace.
Subd. 5e. Inflationary update spending requirement. (a) At least 80 percent of the marginal increase
in revenue from the rate adjustment applied to the service rates calculated under subdivisions 5 and 5b
beginning on January 1, 2022, for services rendered between January 1, 2022, and March 31, 2024, must
be used to increase compensation-related costs for employees directly employed by the program on or after
January 1, 2022.
(b) For the purposes of this subdivision, compensation-related costs include:
(1) wages and salaries;
(2) the employer's share of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers'
compensation, and mileage reimbursement;
(3) the employer's paid share of health and dental insurance, life insurance, disability insurance, long-term
care insurance, uniform allowance, pensions, and contributions to employee retirement accounts; and
(4) benefits that address direct support professional workforce needs above and beyond what employees
were offered prior to January 1, 2022, including retention and recruitment bonuses and tuition reimbursement.
(c) Compensation-related costs for persons employed in the central office of a corporation or entity that
has an ownership interest in the provider or exercises control over the provider, or for persons paid by the
provider under a management contract, do not count toward the 80 percent requirement under this subdivision.
(d) A provider agency or individual provider that receives a rate subject to the requirements of this
subdivision shall prepare, and upon request submit to the commissioner, a distribution plan that specifies
the amount of money the provider expects to receive that is subject to the requirements of this subdivision,
including how that money was or will be distributed to increase compensation-related costs for employees.
Within 60 days of final implementation of a rate adjustment subject to the requirements of this subdivision,
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the provider must post the distribution plan and leave it posted for a period of at least six months in an area
of the provider's operation to which all direct support professionals have access.
(e) This subdivision expires June 30, 2024.
Subd. 6. Residential support services; generally. (a) For purposes of this section, residential support
services includes 24-hour customized living services, community residential services, customized living
services, and integrated community supports.
(b) A unit of service for residential support services 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. The
number of days authorized for all individuals enrolling in residential support services must include every
day that services start and end.
(c) When the available shared staffing hours in a residential setting are insufficient to meet the needs of
an individual who enrolled in residential support services after January 1, 2014, then individual staffing
hours shall be used.
[See Note.]
Subd. 6a. Community residential services; component values and calculation of payment rates. (a)
Component values for community residential services are:
(1) competitive workforce factor: 6.7 percent;
(2) supervisory span of control ratio: 11 percent;
(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
(4) employee-related cost ratio: 23.6 percent;
(5) general administrative support ratio: 13.25 percent;
(6) program-related expense ratio: 1.3 percent; and
(7) absence and utilization factor ratio: 3.9 percent.
(b) Payments for community residential services must be calculated as follows:
(1) determine the number of shared direct staffing and individual direct staffing hours to meet a recipient's
needs provided on site or through monitoring technology;
(2) determine the appropriate hourly staff wage rates derived by the commissioner as provided in
subdivisions 5 and 5a;
(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the product of one
plus the competitive workforce factor;
(4) for a recipient requiring customization for deaf and hard-of-hearing language accessibility under
subdivision 12, add the customization rate provided in subdivision 12 to the result of clause (3);
(5) multiply the number of shared direct staffing and individual direct staffing hours provided on site
or through monitoring technology and nursing hours by the appropriate staff wages;
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(6) multiply the number of shared direct staffing and individual direct staffing hours provided on site
or through monitoring technology and nursing hours by the product of the supervision span of control ratio
and the appropriate supervisory staff wage in subdivision 5a, clause (1);
(7) combine the results of clauses (5) and (6), excluding any shared direct staffing and individual direct
staffing hours provided through monitoring technology, and multiply the result by one plus the employee
vacation, sick, and training allowance ratio. This is defined as the direct staffing cost;
(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared direct staffing
and individual hours provided through monitoring technology, by one plus the employee-related cost ratio;
(9) for client programming and supports, add $2,260.21 divided by 365. The commissioner shall update
the amount in this clause as specified in subdivision 5b;
(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided by 365 if
customized for adapted transport, based on the resident with the highest assessed need. The commissioner
shall update the amounts in this clause as specified in subdivision 5b;
(11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing and individual
direct staffing hours provided through monitoring technology that was excluded in clause (8);
(12) sum the standard general administrative support ratio, the program-related expense ratio, and the
absence and utilization factor ratio;
(13) divide the result of clause (11) by one minus the result of clause (12). This is the total payment
amount; and
(14) adjust the result of clause (13) by a factor to be determined by the commissioner to adjust for
regional differences in the cost of providing services.
[See Note.]
Subd. 6b. Family residential services; component values and calculation of payment rates. (a)
Component values for family residential services are:
(1) competitive workforce factor: 6.7 percent;
(2) supervisory span of control ratio: 11 percent;
(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
(4) employee-related cost ratio: 23.6 percent;
(5) general administrative support ratio: 3.3 percent;
(6) program-related expense ratio: 1.3 percent; and
(7) absence factor: 1.7 percent.
(b) Payments for family residential services must be calculated as follows:
(1) determine the number of shared direct staffing and individual direct staffing hours to meet a recipient's
needs provided on site or through monitoring technology;
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(2) determine the appropriate hourly staff wage rates derived by the commissioner as provided in
subdivisions 5 and 5a;
(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the product of one
plus the competitive workforce factor;
(4) for a recipient requiring customization for deaf and hard-of-hearing language accessibility under
subdivision 12, add the customization rate provided in subdivision 12 to the result of clause (3);
(5) multiply the number of shared direct staffing and individual direct staffing hours provided on site
or through monitoring technology and nursing hours by the appropriate staff wages;
(6) multiply the number of shared direct staffing and individual direct staffing hours provided on site
or through monitoring technology and nursing hours by the product of the supervisory span of control ratio
and the appropriate supervisory staff wage in subdivision 5a, clause (1);
(7) combine the results of clauses (5) and (6), excluding any shared direct staffing and individual direct
staffing hours provided through monitoring technology, and multiply the result by one plus the employee
vacation, sick, and training allowance ratio. This is defined as the direct staffing cost;
(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared and individual
direct staffing hours provided through monitoring technology, by one plus the employee-related cost ratio;
(9) for client programming and supports, add $2,260.21 divided by 365. The commissioner shall update
the amount in this clause as specified in subdivision 5b;
(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided by 365 if
customized for adapted transport, based on the resident with the highest assessed need. The commissioner
shall update the amounts in this clause as specified in subdivision 5b;
(11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing and individual
direct staffing hours provided through monitoring technology that was excluded in clause (8);
(12) sum the standard general administrative support ratio, the program-related expense ratio, and the
absence and utilization factor ratio;
(13) divide the result of clause (11) by one minus the result of clause (12). This is the total payment
rate; and
(14) adjust the result of clause (13) by a factor to be determined by the commissioner to adjust for
regional differences in the cost of providing services.
[See Note.]
Subd. 6c. Integrated community supports; component values and calculation of payment rates. (a)
Component values for integrated community supports are:
(1) competitive workforce factor: 6.7 percent;
(2) supervisory span of control ratio: 11 percent;
(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
(4) employee-related cost ratio: 23.6 percent;
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(5) general administrative support ratio: 13.25 percent;
(6) program-related expense ratio: 1.3 percent; and
(7) absence and utilization factor ratio: 3.9 percent.
(b) Payments for integrated community supports must be calculated as follows:
(1) determine the number of shared direct staffing and individual direct staffing hours to meet a recipient's
needs. The base shared direct staffing hours must be eight hours divided by the number of people receiving
support in the integrated community support setting, and the individual direct staffing hours must be the
average number of direct support hours provided directly to the service recipient;
(2) determine the appropriate hourly staff wage rates derived by the commissioner as provided in
subdivisions 5 and 5a;
(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the product of one
plus the competitive workforce factor;
(4) for a recipient requiring customization for deaf and hard-of-hearing language accessibility under
subdivision 12, add the customization rate provided in subdivision 12 to the result of clause (3);
(5) multiply the number of shared direct staffing and individual direct staffing hours in clause (1) by
the appropriate staff wages;
(6) multiply the number of shared direct staffing and individual direct staffing hours in clause (1) by
the product of the supervisory span of control ratio and the appropriate supervisory staff wage in subdivision
5a, clause (1);
(7) combine the results of clauses (5) and (6) and multiply the result by one plus the employee vacation,
sick, and training allowance ratio. This is defined as the direct staffing cost;
(8) for employee-related expenses, multiply the direct staffing cost by one plus the employee-related
cost ratio;
(9) for client programming and supports, add $2,260.21 divided by 365. The commissioner shall update
the amount in this clause as specified in subdivision 5b;
(10) add the results of clauses (8) and (9);
(11) add the standard general administrative support ratio, the program-related expense ratio, and the
absence and utilization factor ratio;
(12) divide the result of clause (10) by one minus the result of clause (11). This is the total payment
amount; and
(13) adjust the result of clause (12) by a factor to be determined by the commissioner to adjust for
regional differences in the cost of providing services.
[See Note.]
Subd. 6d. Payment for customized living. (a) The payment methodology for customized living and
24-hour customized living must be the customized living tool. The commissioner shall revise the customized
living tool to reflect the services and activities unique to disability-related recipient needs and adjust for
regional differences in the cost of providing services.
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(b) The rate adjustments described in section 256S.205 do not apply to rates paid under this section.
(c) Customized living and 24-hour customized living rates determined under this section shall not include
more than 24 hours of support in a daily unit.
(d) The commissioner shall establish the following acuity-based customized living tool input limits,
based on case mix, for customized living and 24-hour customized living rates determined under this section:
(1) no more than two hours of mental health management per day for people assessed for case mixes
A, D, and G;
(2) no more than four hours of activities of daily living assistance per day for people assessed for case
mix B; and
(3) no more than six hours of activities of daily living assistance per day for people assessed for case
mix D.
Subd. 7. Day programs; generally. (a) For the purposes of this section, day programs include adult
day services, day support services, and prevocational services.
(b) The staffing ratios for the units of service provided by a day program to a recipient in a typical week
must be averaged to determine an individual's staffing ratio.
(c) The commissioner, in consultation with service providers, shall develop a uniform staffing ratio
worksheet to be used by day programs to determine staffing ratios for day programs.
Subd. 7a. Adult day services; component values and calculation of payment rates. (a) Component
values for adult day services are:
(1) competitive workforce factor: 6.7 percent;
(2) supervisory span of control ratio: 11 percent;
(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
(4) employee-related cost ratio: 23.6 percent;
(5) program plan support ratio: 5.6 percent;
(6) client programming and support ratio: 7.4 percent, updated as specified in subdivision 5b;
(7) general administrative support ratio: 13.25 percent;
(8) program-related expense ratio: 1.8 percent; and
(9) absence and utilization factor ratio: 9.4 percent.
(b) A unit of service for adult day services is either a day or 15 minutes. A day unit of service is six or
more hours of time spent providing direct service.
(c) Payments for adult day services must be calculated as follows:
(1) determine the number of units of service and the staffing ratio to meet a recipient's needs;
(2) determine the appropriate hourly staff wage rates derived by the commissioner as provided in
subdivisions 5 and 5a;
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(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the product of one
plus the competitive workforce factor;
(4) for a recipient requiring customization for deaf and hard-of-hearing language accessibility under
subdivision 12, add the customization rate provided in subdivision 12 to the result of clause (3);
(5) multiply the number of day program direct staffing hours and nursing hours by the appropriate staff
wage;
(6) multiply the number of day program direct staffing hours by the product of the supervisory span of
control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);
(7) combine the results of clauses (5) and (6), and multiply the result by one plus the employee vacation,
sick, and training allowance ratio. This is defined as the direct staffing rate;
(8) for program plan support, multiply the result of clause (7) by one plus the program plan support
ratio;
(9) for employee-related expenses, multiply the result of clause (8) by one plus the employee-related
cost ratio;
(10) for client programming and supports, multiply the result of clause (9) by one plus the client
programming and support ratio;
(11) for program facility costs, add $19.30 per week with consideration of staffing ratios to meet individual
needs, updated as specified in subdivision 5b;
(12) for adult day bath services, add $7.01 per 15 minute unit;
(13) this is the subtotal rate;
(14) sum the standard general administrative rate support ratio, the program-related expense ratio, and
the absence and utilization factor ratio;
(15) divide the result of clause (13) by one minus the result of clause (14). This is the total payment
amount; and
(16) adjust the result of clause (15) by a factor to be determined by the commissioner to adjust for
regional differences in the cost of providing services.
[See Note.]
Subd. 7b. Day support services; component values and calculation of payment rates. (a) Component
values for day support services are:
(1) competitive workforce factor: 6.7 percent;
(2) supervisory span of control ratio: 11 percent;
(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
(4) employee-related cost ratio: 23.6 percent;
(5) program plan support ratio: 5.6 percent;
(6) client programming and support ratio: 10.37 percent, updated as specified in subdivision 5b;
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(7) general administrative support ratio: 13.25 percent;
(8) program-related expense ratio: 1.8 percent; and
(9) absence and utilization factor ratio: 9.4 percent.
(b) A unit of service for day support services is 15 minutes.
(c) Payments for day support services must be calculated as follows:
(1) determine the number of units of service and the staffing ratio to meet a recipient's needs;
(2) determine the appropriate hourly staff wage rates derived by the commissioner as provided in
subdivisions 5 and 5a;
(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the product of one
plus the competitive workforce factor;
(4) for a recipient requiring customization for deaf and hard-of-hearing language accessibility under
subdivision 12, add the customization rate provided in subdivision 12 to the result of clause (3);
(5) multiply the number of day program direct staffing hours and nursing hours by the appropriate staff
wage;
(6) multiply the number of day program direct staffing hours by the product of the supervisory span of
control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);
(7) combine the results of clauses (5) and (6), and multiply the result by one plus the employee vacation,
sick, and training allowance ratio. This is defined as the direct staffing rate;
(8) for program plan support, multiply the result of clause (7) by one plus the program plan support
ratio;
(9) for employee-related expenses, multiply the result of clause (8) by one plus the employee-related
cost ratio;
(10) for client programming and supports, multiply the result of clause (9) by one plus the client
programming and support ratio;
(11) for program facility costs, add $19.30 per week with consideration of staffing ratios to meet individual
needs, updated as specified in subdivision 5b;
(12) this is the subtotal rate;
(13) sum the standard general administrative rate support ratio, the program-related expense ratio, and
the absence and utilization factor ratio;
(14) divide the result of clause (12) by one minus the result of clause (13). This is the total payment
amount; and
(15) adjust the result of clause (14) by a factor to be determined by the commissioner to adjust for
regional differences in the cost of providing services.
[See Note.]
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Subd. 7c. Prevocational services; component values and calculation of payment rates. (a) Component
values for prevocational services are:
(1) competitive workforce factor: 6.7 percent;
(2) supervisory span of control ratio: 11 percent;
(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
(4) employee-related cost ratio: 23.6 percent;
(5) program plan support ratio: 5.6 percent;
(6) client programming and support ratio: 10.37 percent, updated as specified in subdivision 5b;
(7) general administrative support ratio: 13.25 percent;
(8) program-related expense ratio: 1.8 percent; and
(9) absence and utilization factor ratio: 9.4 percent.
(b) A unit of service for prevocational services is either a day or 15 minutes. A day unit of service is six
or more hours of time spent providing direct service.
(c) Payments for prevocational services must be calculated as follows:
(1) determine the number of units of service and the staffing ratio to meet a recipient's needs;
(2) determine the appropriate hourly staff wage rates derived by the commissioner as provided in
subdivisions 5 and 5a;
(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the product of one
plus the competitive workforce factor;
(4) for a recipient requiring customization for deaf and hard-of-hearing language accessibility under
subdivision 12, add the customization rate provided in subdivision 12 to the result of clause (3);
(5) multiply the number of day program direct staffing hours and nursing hours by the appropriate staff
wage;
(6) multiply the number of day program direct staffing hours by the product of the supervisory span of
control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);
(7) combine the results of clauses (5) and (6), and multiply the result by one plus the employee vacation,
sick, and training allowance ratio. This is defined as the direct staffing rate;
(8) for program plan support, multiply the result of clause (7) by one plus the program plan support
ratio;
(9) for employee-related expenses, multiply the result of clause (8) by one plus the employee-related
cost ratio;
(10) for client programming and supports, multiply the result of clause (9) by one plus the client
programming and support ratio;
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(11) for program facility costs, add $19.30 per week with consideration of staffing ratios to meet individual
needs, updated as specified in subdivision 5b;
(12) this is the subtotal rate;
(13) sum the standard general administrative rate support ratio, the program-related expense ratio, and
the absence and utilization factor ratio;
(14) divide the result of clause (12) by one minus the result of clause (13). This is the total payment
amount; and
(15) adjust the result of clause (14) by a factor to be determined by the commissioner to adjust for
regional differences in the cost of providing services.
[See Note.]
Subd. 8. Unit-based services with programming; component values and calculation of payment
rates. (a) For the purpose of this section, unit-based services with programming include employment
exploration services, employment development services, employment support services, individualized home
supports with family training, individualized home supports with training, and positive support services
provided to an individual outside of any service plan for a day program or residential support service.
(b) Component values for unit-based services with programming are:
(1) competitive workforce factor: 6.7 percent;
(2) supervisory span of control ratio: 11 percent;
(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
(4) employee-related cost ratio: 23.6 percent;
(5) program plan support ratio: 15.5 percent;
(6) client programming and support ratio: 4.7 percent, updated as specified in subdivision 5b;
(7) general administrative support ratio: 13.25 percent;
(8) program-related expense ratio: 6.1 percent; and
(9) absence and utilization factor ratio: 3.9 percent.
(c) A unit of service for unit-based services with programming is 15 minutes.
(d) Payments for unit-based services with programming must be calculated as follows, unless the services
are reimbursed separately as part of a residential support services or day program payment rate:
(1) determine the number of units of service to meet a recipient's needs;
(2) determine the appropriate hourly staff wage rates derived by the commissioner as provided in
subdivisions 5 and 5a;
(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the product of one
plus the competitive workforce factor;
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(4) for a recipient requiring customization for deaf and hard-of-hearing language accessibility under
subdivision 12, add the customization rate provided in subdivision 12 to the result of clause (3);
(5) multiply the number of direct staffing hours by the appropriate staff wage;
(6) multiply the number of direct staffing hours by the product of the supervisory span of control ratio
and the appropriate supervisory staff wage in subdivision 5a, clause (1);
(7) combine the results of clauses (5) and (6), and multiply the result by one plus the employee vacation,
sick, and training allowance ratio. This is defined as the direct staffing rate;
(8) for program plan support, multiply the result of clause (7) by one plus the program plan support
ratio;
(9) for employee-related expenses, multiply the result of clause (8) by one plus the employee-related
cost ratio;
(10) for client programming and supports, multiply the result of clause (9) by one plus the client
programming and support ratio;
(11) this is the subtotal rate;
(12) sum the standard general administrative support ratio, the program-related expense ratio, and the
absence and utilization factor ratio;
(13) divide the result of clause (11) by one minus the result of clause (12). This is the total payment
amount;
(14) for services provided in a shared manner, divide the total payment in clause (13) as follows:
(i) for employment exploration services, divide by the number of service recipients, not to exceed five;
(ii) for employment support services, divide by the number of service recipients, not to exceed six;
(iii) for individualized home supports with training and individualized home supports with family
training, divide by the number of service recipients, not to exceed three; and
(iv) for night supervision, divide by the number of service recipients, not to exceed two; and
(15) adjust the result of clause (14) by a factor to be determined by the commissioner to adjust for
regional differences in the cost of providing services.
[See Note.]
Subd. 9. Unit-based services without programming; component values and calculation of payment
rates. (a) For the purposes of this section, unit-based services without programming include individualized
home supports without training and night supervision provided to an individual outside of any service plan
for a day program or residential support service. Unit-based services without programming do not include
respite.
(b) Component values for unit-based services without programming are:
(1) competitive workforce factor: 6.7 percent;
(2) supervisory span of control ratio: 11 percent;
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(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
(4) employee-related cost ratio: 23.6 percent;
(5) program plan support ratio: 7.0 percent;
(6) client programming and support ratio: 2.3 percent, updated as specified in subdivision 5b;
(7) general administrative support ratio: 13.25 percent;
(8) program-related expense ratio: 2.9 percent; and
(9) absence and utilization factor ratio: 3.9 percent.
(c) A unit of service for unit-based services without programming is 15 minutes.
(d) Payments for unit-based services without programming must be calculated as follows unless the
services are reimbursed separately as part of a residential support services or day program payment rate:
(1) determine the number of units of service to meet a recipient's needs;
(2) determine the appropriate hourly staff wage rates derived by the commissioner as provided in
subdivisions 5 to 5a;
(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the product of one
plus the competitive workforce factor;
(4) for a recipient requiring customization for deaf and hard-of-hearing language accessibility under
subdivision 12, add the customization rate provided in subdivision 12 to the result of clause (3);
(5) multiply the number of direct staffing hours by the appropriate staff wage;
(6) multiply the number of direct staffing hours by the product of the supervisory span of control ratio
and the appropriate supervisory staff wage in subdivision 5a, clause (1);
(7) combine the results of clauses (5) and (6), and multiply the result by one plus the employee vacation,
sick, and training allowance ratio. This is defined as the direct staffing rate;
(8) for program plan support, multiply the result of clause (7) by one plus the program plan support
ratio;
(9) for employee-related expenses, multiply the result of clause (8) by one plus the employee-related
cost ratio;
(10) for client programming and supports, multiply the result of clause (9) by one plus the client
programming and support ratio;
(11) this is the subtotal rate;
(12) sum the standard general administrative support ratio, the program-related expense ratio, and the
absence and utilization factor ratio;
(13) divide the result of clause (11) by one minus the result of clause (12). This is the total payment
amount;
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(14) for individualized home supports without training provided in a shared manner, divide the total
payment amount in clause (13) by the number of service recipients, not to exceed three; and
(15) adjust the result of clause (14) by a factor to be determined by the commissioner to adjust for
regional differences in the cost of providing services.
[See Note.]
Subd. 9a. Respite services; component values and calculation of payment rates. (a) For the purposes
of this section, respite services include respite services provided to an individual outside of any service plan
for a day program or residential support service.
(b) Component values for respite services are:
(1) competitive workforce factor: 4.7 percent;
(2) supervisory span of control ratio: 11 percent;
(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
(4) employee-related cost ratio: 23.6 percent;
(5) general administrative support ratio: 13.25 percent;
(6) program-related expense ratio: 2.9 percent; and
(7) absence and utilization factor ratio: 3.9 percent.
(c) A unit of service for respite services is 15 minutes.
(d) Payments for respite services must be calculated as follows unless the service is reimbursed separately
as part of a residential support services or day program payment rate:
(1) determine the number of units of service to meet an individual's needs;
(2) determine the appropriate hourly staff wage rates derived by the commissioner as provided in
subdivisions 5 and 5a;
(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the product of one
plus the competitive workforce factor;
(4) for a recipient requiring deaf and hard-of-hearing customization under subdivision 12, add the
customization rate provided in subdivision 12 to the result of clause (3);
(5) multiply the number of direct staffing hours by the appropriate staff wage;
(6) multiply the number of direct staffing hours by the product of the supervisory span of control ratio
and the appropriate supervisory staff wage in subdivision 5a, clause (1);
(7) combine the results of clauses (5) and (6), and multiply the result by one plus the employee vacation,
sick, and training allowance ratio. This is defined as the direct staffing rate;
(8) for employee-related expenses, multiply the result of clause (7) by one plus the employee-related
cost ratio;
(9) this is the subtotal rate;
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(10) sum the standard general administrative support ratio, the program-related expense ratio, and the
absence and utilization factor ratio;
(11) divide the result of clause (9) by one minus the result of clause (10). This is the total payment
amount;
(12) for respite services provided in a shared manner, divide the total payment amount in clause (11)
by the number of service recipients, not to exceed three; and
(13) adjust the result of clause (12) by a factor to be determined by the commissioner to adjust for
regional differences in the cost of providing services.
[See Note.]
Subd. 10. Evaluation of information and data. (a) The commissioner shall, within available resources,
conduct research and gather data and information from existing state systems or other outside sources on
the following items:
(1) differences in the underlying cost to provide services and care across the state;
(2) mileage, vehicle type, lift requirements, incidents of individual and shared rides, and units of
transportation for all day services, which must be collected from providers using the rate management
worksheet and entered into the rates management system; and
(3) the distinct underlying costs for services provided by a license holder under sections 245D.05,
245D.06, 245D.07, 245D.071, 245D.081, and 245D.09, and for services provided by a license holder certified
under section 245D.33.
(b) The commissioner, in consultation with stakeholders, shall review and evaluate the following values
already in subdivisions 6 to 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) direct care workforce labor market measures;
(9) any changes in state or federal law with a direct impact on the underlying cost of providing home
and community-based services;
(10) outcome measures, determined by the commissioner, for home and community-based services rates
determined under this section; and
(11) different competitive workforce factors by service, as determined under subdivision 10b.
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(c) The commissioner shall report to the chairs and the ranking minority members of the legislative
committees and divisions with jurisdiction over health and human services policy and finance with the
information and data gathered under paragraphs (a) and (b) on January 15, 2021, with a full report, and a
full report once every four years thereafter.
(d) Beginning July 1, 2022, the commissioner shall renew analysis and implement changes to the regional
adjustment factors once every six years. Prior to implementation, the commissioner shall consult with
stakeholders on the methodology to calculate the adjustment.
[See Note.]
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 subdivision 17, a provider enrolled to provide
services with rates determined under this section must submit requested cost data to the commissioner to
support research on the cost of providing services that have rates determined by the disability waiver rates
system. Requested cost data may include, but is not limited to:
(1) worker wage costs;
(2) benefits paid;
(3) supervisor wage costs;
(4) executive wage costs;
(5) vacation, sick, and training time paid;
(6) taxes, workers' compensation, and unemployment insurance costs paid;
(7) administrative costs paid;
(8) program costs paid;
(9) transportation costs paid;
(10) vacancy rates; and
(11) other data relating to costs required to provide services requested by the commissioner.
(b) At least once in any five-year period, a provider must submit cost data for a fiscal year that ended
not more than 18 months prior to the submission date. The commissioner shall provide each provider a
90-day notice prior to its submission due date. If a provider fails to submit required reporting data, the
commissioner shall provide notice to providers that have not provided required data 30 days after the required
submission date, and a second notice for providers who have not provided required data 60 days after the
required submission date. The commissioner shall temporarily suspend payments to the provider if cost data
is not received 90 days after the required submission date. Withheld payments shall be made once data is
received by the commissioner.
(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.
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(d) The commissioner shall analyze cost data submitted under paragraph (a) and, in consultation with
stakeholders identified in subdivision 17, may submit recommendations on component values and inflationary
factor adjustments to the chairs and ranking minority members of the legislative committees with jurisdiction
over human services once every four years beginning January 1, 2021. The commissioner shall make
recommendations in conjunction with reports submitted to the legislature according to subdivision 10,
paragraph (c). The commissioner shall release cost data in an aggregate form. Cost data from individual
providers must not be released except as provided for in current law.
(e) The commissioner shall use data collected in paragraph (a) to determine the compliance with
requirements identified under subdivision 10d. The commissioner shall identify providers who have not met
the thresholds identified under subdivision 10d on the Department of Human Services website for the year
for which the providers reported their costs.
[See Note.]
Subd. 10b. Provider submission of labor market data. (a) Providers enrolled to provide services with
rates determined under section 256B.4914, subdivision 3, shall submit labor market data to the commissioner
annually on or before November 1, including but not limited to:
(1) number of direct care staff;
(2) wages of direct care staff;
(3) overtime wages of direct care staff;
(4) hours worked by direct care staff;
(5) overtime hours worked by direct care staff;
(6) benefits provided to direct care staff;
(7) direct care staff job vacancies; and
(8) direct care staff retention rates.
(b) The commissioner shall publish annual reports on provider and state-level labor market data, including
but not limited to the data obtained under paragraph (a).
(c) The commissioner may temporarily suspend payments to the provider if data requested under
paragraph (a) is not received 90 days after the required submission date. Withheld payments shall be made
once data is received by the commissioner.
(d) Providers who receive payment under this section for less than 25 percent of their clients in the year
prior to the report may attest to the commissioner in a manner determined by the commissioner that they
are declining to provide the data required under paragraph (a) and will not be subject to the payment
suspension in paragraph (c).
Subd. 10c. Reporting and analysis of competitive workforce factor. (a) Beginning February 1, 2025,
and every two years thereafter, the commissioner shall report to the chairs and ranking minority members
of the legislative committees and divisions with jurisdiction over health and human services policy and
finance an analysis of the competitive workforce factor.
(b) The report must include:
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(1) the most recently available wage data by SOC code for the weighted average wage for direct care
staff for residential services and direct care staff for day services;
(2) the most recently available wage data by SOC code of the weighted average wage of comparable
occupations; and
(3) workforce data as required under subdivision 10b.
(c) This subdivision expires June 30, 2031.
Subd. 10d. Direct care staff; compensation. (a) A provider paid with rates determined under subdivision
6 must use a minimum of 66 percent of the revenue generated by rates determined under that subdivision
for direct care staff compensation.
(b) A provider paid with rates determined under subdivision 7 must use a minimum of 45 percent of the
revenue generated by rates determined under that subdivision for direct care staff compensation.
(c) A provider paid with rates determined under subdivision 8 or 9 must use a minimum of 60 percent
of the revenue generated by rates determined under those subdivisions for direct care staff compensation.
(d) Compensation under this subdivision includes:
(1) wages;
(2) taxes and workers' compensation;
(3) health insurance;
(4) dental insurance;
(5) vision insurance;
(6) life insurance;
(7) short-term disability insurance;
(8) long-term disability insurance;
(9) retirement spending;
(10) tuition reimbursement;
(11) wellness programs;
(12) paid vacation time;
(13) paid sick time; or
(14) other items of monetary value provided to direct care staff.
[See Note.]
Subd. 11. MS 2020 [Repealed by amendment, 2022 c 33 s 1]
Subd. 12. Customization of rates for individuals. (a) For persons determined to have higher needs
based on being deaf or hard-of-hearing, the direct-care costs must be increased by an adjustment factor prior
to calculating the rate under subdivisions 6 to 9. The customization rate with respect to deaf or hard-of-hearing
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persons shall be $2.50 per hour for waiver recipients who meet the respective criteria as determined by the
commissioner.
(b) For the purposes of this section, "deaf and hard-of-hearing" means:
(1) the person has a developmental disability and:
(i) an assessment score which indicates a hearing impairment that is severe or that the person has no
useful hearing;
(ii) an expressive communications score that indicates the person uses single signs or gestures, uses an
augmentative communication aid, or does not have functional communication, or the person's expressive
communications is unknown; and
(iii) a communication score which indicates the person comprehends signs, gestures, and modeling
prompts or does not comprehend verbal, visual, or gestural communication, or that the person's receptive
communication score is unknown; or
(2) the person receives long-term care services and has an assessment score that indicates the person
hears only very loud sounds, the person has no useful hearing, or a determination cannot be made; and the
person receives long-term care services and has an assessment that indicates the person communicates needs
with sign language, symbol board, written messages, gestures, or an interpreter; communicates with
inappropriate content, makes garbled sounds or displays echolalia, or does not communicate needs.
[See Note.]
Subd. 13. Transportation. The commissioner shall require that the purchase of transportation services
be cost-effective and be limited to market rates where the transportation mode is generally available and
accessible.
Subd. 14. Exceptions. (a) In a format prescribed by the commissioner, lead agencies must identify
individuals with exceptional needs that cannot be met under the disability waiver rate system. The
commissioner shall use that information to evaluate and, if necessary, approve an alternative payment rate
for those individuals. Whether granted, denied, or modified, the commissioner shall respond to all exception
requests in writing. The commissioner shall include in the written response the basis for the action and
provide notification of the right to appeal under paragraph (h).
(b) Lead agencies must act on an exception request within 30 days and notify the initiator of the request
of their recommendation in writing. A lead agency shall submit all exception requests along with its
recommendation to the commissioner.
(c) An application for a rate exception may be submitted for the following criteria:
(1) an individual has service needs that cannot be met through additional units of service;
(2) an individual's rate determined under subdivisions 6 to 9 is so insufficient that it has resulted in an
individual receiving a notice of discharge from the individual's provider; or
(3) an individual's service needs, including behavioral changes, require a level of service which
necessitates a change in provider or which requires the current provider to propose service changes beyond
those currently authorized.
(d) Exception requests must include the following information:
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(1) the service needs required by each individual that are not accounted for in subdivisions 6 to 9;
(2) the service rate requested and the difference from the rate determined in subdivisions 6 to 9;
(3) a basis for the underlying costs used for the rate exception and any accompanying documentation;
and
(4) any contingencies for approval.
(e) Approved rate exceptions shall be managed within lead agency allocations under sections 256B.092
and 256B.49.
(f) Individual disability waiver recipients, an interested party, or the license holder that would receive
the rate exception increase may request that a lead agency submit an exception request. A lead agency that
denies such a request shall notify the individual waiver recipient, interested party, or license holder of its
decision and the reasons for denying the request in writing no later than 30 days after the request has been
made and shall submit its denial to the commissioner in accordance with paragraph (b). The reasons for the
denial must be based on the failure to meet the criteria in paragraph (c).
(g) The commissioner shall determine whether to approve or deny an exception request no more than
30 days after receiving the request. If the commissioner denies the request, the commissioner shall notify
the lead agency and the individual disability waiver recipient, the interested party, and the license holder in
writing of the reasons for the denial.
(h) The individual disability waiver recipient may appeal any denial of an exception request by either
the lead agency or the commissioner, pursuant to sections 256.045 and 256.0451. When the denial of an
exception request results in the proposed demission of a waiver recipient from a residential or day habilitation
program, the commissioner shall issue a temporary stay of demission, when requested by the disability
waiver recipient, consistent with the provisions of section 256.045, subdivisions 4a and 6, paragraph (c).
The temporary stay shall remain in effect until the lead agency can provide an informed choice of appropriate,
alternative services to the disability waiver.
(i) Providers may petition lead agencies to update values that were entered incorrectly or erroneously
into the rate management system, based on past service level discussions and determination in subdivision
4, without applying for a rate exception.
(j) The starting date for the rate exception will be the later of the date of the recipient's change in support
or the date of the request to the lead agency for an exception.
(k) The commissioner shall track all exception requests received and their dispositions. The commissioner
shall issue quarterly public exceptions statistical reports, including the number of exception requests received
and the numbers granted, denied, withdrawn, and pending. The report shall include the average amount of
time required to process exceptions.
(l) Approved rate exceptions remain in effect in all cases until an individual's needs change as defined
in paragraph (c).
(m) Rates determined under subdivision 19 are ineligible for rate exceptions.
[See Note.]
Subd. 15. County or Tribal allocations. (a) The commissioner shall establish a method of tracking and
reporting the fiscal impact of the disability waiver rates management system on individual lead agencies.
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(b) The commissioner shall make annual adjustments to lead agencies' home and community-based
waivered service budget allocations to adjust for rate differences and the resulting impact on county allocations
upon implementation of the disability waiver rates system.
(c) Lead agencies exceeding their allocations shall be subject to the provisions under sections 256B.0916,
subdivision 11, and 256B.49, subdivision 26.
Subd. 16. [Repealed, 1Sp2017 c 6 art 1 s 54]
Subd. 17. Stakeholder consultation and county training. (a) The commissioner shall continue
consultation at regular intervals with the existing stakeholder group established as part of the rate-setting
methodology process and others, to gather input, concerns, and data, to assist in the implementation of the
rate payment system, and to make pertinent information available to the public through the department's
website.
(b) The commissioner shall offer training at least annually for county personnel responsible for
administering the rate-setting framework in a manner consistent with this section.
(c) The commissioner shall maintain an online instruction manual explaining the rate-setting framework.
The manual shall be consistent with this section, and shall be accessible to all stakeholders including recipients,
representatives of recipients, county or Tribal agencies, and license holders.
(d) The commissioner shall not defer to the county or Tribal agency on matters of technical application
of the rate-setting framework, and a county or Tribal agency shall not set rates in a manner that conflicts
with this section.
Subd. 18. Legislatively approved changes; public notice. (a) The commissioner shall provide a public
notice via LISTSERV in October of each year 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.
(b) The information in this notice must be effective January 1 of the following year.
Subd. 19. Payments for family residential and life sharing services. The commissioner shall establish
rates for family residential services and life sharing services based on a person's assessed need, as described
in the federally-approved waiver plans. Rates for life sharing services must be ten percent higher than the
corresponding family residential services rate.
[See Note.]
History: 2013 c 108 art 13 s 12; 2014 c 312 art 27 s 62-69; 2015 c 71 art 7 s 37-42; 2016 c 158 art 1
s 126; 2017 c 90 s 21-24; 1Sp2017 c 6 art 1 s 22-31; 2019 c 50 art 2 s 1; 1Sp2019 c 9 art 5 s 56-68; 1Sp2021
c 7 art 13 s 42,43; 2022 c 33 s 1; 2022 c 98 art 17 s 26; 2023 c 50 art 4 s 6; 2023 c 61 art 1 s 27-47
NOTE: The amendment to subdivision 3, paragraph (a), by Laws 2023, chapter 61, article 1, section
27, is effective January 1, 2026, or upon federal approval, whichever is later. The commissioner of human
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services shall notify the revisor of statutes when federal approval is obtained. Laws 2023, chapter 61, article
1, section 27, the effective date.
NOTE: The amendments to subdivision 4, 5, 6a, 6b, 6c, 7a, 7b, 7c, 8, 9, 10, and 12, by Laws 2023,
chapter 61, article 1, sections 28, 29, 33 to 41, and 45, are effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained. Laws 2023, chapter
61, article 1, sections 28, 29, 33 to 41, and 45, the effective dates.
NOTE: The service name changes in subdivisions 5a, clauses (7), (11), and (12); 6a; 6c; 7b; and 7c,
made by Laws 2019, First Special Session chapter 9, article 5, section 59, are effective upon federal approval.
The commissioner of human services shall notify the revisor of statutes when federal approval is obtained.
Laws 2019, First Special Session chapter 9, article 5, section 59, the effective date.
NOTE: The amendments to subdivision 5a, clauses (5), item (ii); (14); and (18), by Laws 2023, chapter
61, article 1, section 30, are effective upon federal approval. The amendment to clause (4) by Laws 2023,
chapter 61, article 1, section 30, is effective January 1, 2026, or upon federal approval, whichever is later.
The commissioner of human services shall notify the revisor of statutes when federal approval is obtained.
Laws 2023, chapter 61, article 1, section 30, the effective date.
NOTE: The amendments to subdivision 5b by Laws 2023, chapter 61, article 1, section 31, are effective
January 1, 2026, or upon federal approval, whichever is later, except that the amendment striking the
cross-reference to subdivision 9a and the amendments to clauses (2) and (3) are effective upon federal
approval. The commissioner of human services shall notify the revisor of statutes when federal approval is
obtained. Laws 2023, chapter 61, article 1, section 31, the effective date.
NOTE: The amendment to subdivision 6 by Laws 2023, chapter 61, article 1, section 32, is effective
January 1, 2026, or upon federal approval, whichever is later. The commissioner of human services shall
notify the revisor of statutes when federal approval is obtained. Laws 2023, chapter 61, article 1, section
32, the effective date.
NOTE: Subdivision 6b is repealed by Laws 2023, chapter 61, article 1, section 85, effective January 1,
2026, or upon federal approval, whichever is later. The commissioner of human services shall notify the
revisor of statutes when federal approval is obtained. Laws 2023, chapter 61, article 1, section 85, the effective
date.
NOTE: Subdivision 9a is repealed by Laws 2023, chapter 61, article 1, section 85, effective upon federal
approval. The commissioner of human services shall notify the revisor of statutes when federal approval is
obtained. Laws 2023, chapter 61, article 1, section 85, the effective date.
NOTE: The amendments to subdivision 10a by Laws 2023, chapter 61, article 1, section 42, are effective
January 1, 2025, except that the amendment striking the cross-reference to subdivision 9a is effective upon
federal approval. The commissioner of human services shall notify the revisor of statutes when federal
approval is obtained. Laws 2023, chapter 61, article 1, section 42, the effective date.
NOTE: Subdivision 10d, as added by Laws 2023, chapter 61, article 1, section 44, is effective January
1, 2025. Laws 2023, chapter 61, article 1, section 44, the effective date.
NOTE: The amendments to subdivision 14 by Laws 2023, chapter 61, article 1, section 46, are effective
upon federal approval, except that paragraph (m) is effective January 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes when federal
approval is obtained. Laws 2023, chapter 61, article 1, section 46, the effective date.
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NOTE: Subdivision 19, as added by Laws 2023, chapter 61, article 1, section 47, is effective January
1, 2026, or upon federal approval, whichever is later. The commissioner of human services shall notify the
revisor of statutes when federal approval is obtained. Laws 2023, chapter 61, article 1, section 47, the effective
date.
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