1.1 A bill for an act
1.2 relating to human services;
modifying home and community-based services case
1.3 management; establishing a
waiver case management quality working group;
1.4 requiring reports;amending
Minnesota Statutes 2024, section 256S.07, subdivision
1.5 1; Minnesota Statutes 2025
Supplement, sections 256B.092, subdivision 1a;
1.6 256B.49, subdivision 13.
1.7 BE IT ENACTED BY THE
LEGISLATURE OF THE STATE OF MINNESOTA:
1.8 Section 1. Minnesota Statutes
2025 Supplement, section 256B.092, subdivision 1a, is
1.9 amended to read:
1.10 Subd. 1a.Case
management services. (a) Each recipient of a home and community-based
1.11 waiver shall be provided case
management services by qualified vendors as described in
1.12 the federally approved waiver
application.
1.13 (b) Case management service
activities provided to or arranged for a person include:
1.14 (1) development of the
person-centered support plan under subdivision 1b;
1.15 (2) informing the individual or
the individual's legal guardian or conservator, or parent
1.16 if the person is a minor, of
service options, including all service options available under the
1.17 waiver plan;
1.18 (3) consulting with relevant
medical experts or service providers;
1.19 (4) assisting the person in the
identification of potential providers of chosen services,
1.20 including:
1.21 (i) providers of services
provided in a non-disability-specific setting;
1.22 (ii) employment service
providers;
2.1 (iii) providers of services
provided in settings that are not controlled by a provider; and
2.2 (iv) providers of financial
management services;
2.3 (5) assisting the person to
access services and assisting in appeals under section 256.045;
2.4 (6) coordination of services,
if coordination is not provided by another service provider;
2.5 (7) evaluation and monitoring
of the services identified in the support plan, which must
2.6 incorporate at least one
annual face-to-face visit by the case manager with each person;
2.7 (8) reviewing support plans
and providing the lead agency with recommendations for
2.8 service authorization based
upon the individual's needs identified in the support plan; and
2.9 (9) assisting and cooperating
with facilities licensed under chapter 144G with the
2.10 licensee's obligations under
section 144G.55.
2.11 (c) Case management service
activities that are provided to the person with a
2.12 developmental disability shall
be provided directly by county agencies or under contract.
2.13 If a county agency contracts
for case management services, the county agency must provide
2.14 each recipient of home and
community-based services who is receiving contracted case
2.15 management services with the
contact information the recipient may use to file a grievance
2.16 with the county agency about
the quality of the contracted services the recipient is receiving
2.17 from a county-contracted case
manager. If a county agency provides case management
2.18 under contracts with other
individuals or agencies and, the county agency utilizes
must
2.19 utilize a
competitive proposal process for the procurement of contracted case management
2.20 services, the competitive
proposal process must include at least once every two years.
2.21 Contracts must include
provisions for oversight to ensure high-quality case management
2.22 services. The
competitive proposal process must include evaluation criteria to ensure
that
2.23 the county maintains a
culturally responsive program for case management services adequate
2.24 to meet the needs of the
population of the county. For the purposes of this section, "culturally
2.25 responsive program" means
a case management services program that: (1) ensures effective,
2.26 equitable, comprehensive, and
respectful quality care services that are responsive to
2.27 individuals within a specific
population's values, beliefs, practices, health literacy, preferred
2.28 language, and other
communication needs; and (2) is designed to address the unique needs
2.29 of individuals who share a
common language or racial, ethnic, or social background.
2.30 Beginning July 1, 2029,
a county agency must not enter into any new contracts or renew
2.31 contracts for case
management services.
2.32 (d) Case management
services must be provided by a public or private agency that is
2.33 enrolled as a medical
assistance provider determined by the commissioner to meet all of
3.1 the requirements in the
approved federal waiver plans. Case management services must not
3.2 be provided to a recipient by
a private agency that has a financial interest in the provision
3.3 of any other services
included in the recipient's support plan. For purposes of this section,
3.4 "private agency"
means any agency that is not identified as a lead agency under section
3.5 256B.0911, subdivision 10.
3.6 (e) Case managers are
responsible for service provisions listed in paragraphs (a) and
3.7 (b). Case managers shall
collaborate with consumers, families, legal representatives, and
3.8 relevant medical experts and
service providers in the development and annual review of the
3.9 person-centered support plan
and habilitation plan.
3.10 (f) For persons who need a
positive support transition plan as required in chapter 245D,
3.11 the case manager shall
participate in the development and ongoing evaluation of the plan
3.12 with the expanded support team.
At least quarterly, the case manager, in consultation with
3.13 the expanded support team,
shall evaluate the effectiveness of the plan based on progress
3.14 evaluation data submitted by
the licensed provider to the case manager. The evaluation must
3.15 identify whether the plan has
been developed and implemented in a manner to achieve the
3.16 following within the required
timelines:
3.17 (1) phasing out the use of
prohibited procedures;
3.18 (2) acquisition of skills
needed to eliminate the prohibited procedures within the plan's
3.19 timeline; and
3.20 (3) accomplishment of
identified outcomes.
3.21 If adequate progress is not
being made, the case manager shall consult with the person's
3.22 expanded support team to
identify needed modifications and whether additional professional
3.23 support is required to provide
consultation.
3.24 (g) The Department of Human
Services shall offer ongoing education in case management
3.25 to case managers. Case managers
shall receive no less than 20 hours of case management
3.26 education and
disability-related training each year. The education and training must include
3.27 appropriate service
authorization, person-centered planning, informed choice, informed
3.28 decision making, cultural
competency, employment planning, community living planning,
3.29 self-direction options, and use
of technology supports. Case managers must annually complete
3.30 an informed choice curriculum
and pass a competency evaluation, in a form determined by
3.31 the commissioner, on informed
decision-making standards. By August 1, 2024, all case
3.32 managers must complete an
employment support training course identified by the
3.33 commissioner of human services.
For case managers hired after August 1, 2024, this training
3.34 must be completed within the
first six months of providing case management services. For
4.1 the purposes of this section,
"person-centered planning" or "person-centered" has the
meaning
4.2 given in section 256B.0911,
subdivision 10. Case managers must document completion of
4.3 training in a system
identified by the commissioner.
4.4 EFFECTIVE DATE.
This section is effective January 1, 2027, and applies to contracts
4.5 entered into or
renewed on or after that date.
4.6 Sec. 2. Minnesota Statutes 2025
Supplement, section 256B.49, subdivision 13, is amended
4.7 to read:
4.8 Subd. 13.Case
management. (a) Each recipient of a home and community-based waiver
4.9 shall be provided case
management services by qualified vendors as described in the federally
4.10 approved waiver application.
The case management service activities provided must include:
4.11 (1) finalizing the
person-centered written support plan within the timelines established
4.12 by the commissioner and section
256B.0911, subdivision 29;
4.13 (2) informing the recipient or
the recipient's legal guardian or conservator of service
4.14 options, including all service
options available under the waiver plans;
4.15 (3) assisting the recipient in
the identification of potential service providers of chosen
4.16 services, including:
4.17 (i) available options for case
management service and providers;
4.18 (ii) providers of services
provided in a non-disability-specific setting;
4.19 (iii) employment service
providers;
4.20 (iv) providers of services
provided in settings that are not community residential settings;
4.21 and
4.22 (v) providers of financial
management services;
4.23 (4) assisting the recipient to
access services and assisting with appeals under section
4.24 256.045;
4.25 (5) coordinating, evaluating,
and monitoring of the services identified in the service
4.26 plan; and
4.27 (6) assisting and cooperating
with facilities licensed under chapter 144G with the
4.28 licensee's obligations under
section 144G.55.
4.29 (b) The case manager may
delegate certain aspects of the case management service
4.30 activities to another
individual provided there is oversight by the case manager. The case
4.31 manager may not delegate those
aspects which require professional judgment including:
5.1 (1) finalizing the
person-centered support plan;
5.2 (2) ongoing assessment and
monitoring of the person's needs and adequacy of the
5.3 approved person-centered
support plan; and
5.4 (3) adjustments to the
person-centered support plan.
5.5 (c) Case management services
must be provided by a public or private agency that is
5.6 enrolled as a medical
assistance provider determined by the commissioner to meet all of
5.7 the requirements in the
approved federal waiver plans. If a county agency provides case
5.8 management under contracts
with other individuals or agencies and, the county agency
5.9 utilizes must
utilize a competitive proposal process for the procurement of contracted
case
5.10 management services, the
competitive proposal process must include at least once every
5.11 two years. Contracts
must include provisions for oversight to ensure high-quality case
5.12 management services. The
competitive proposal process must include evaluation criteria
5.13 to ensure that the county
maintains a culturally responsive program for case management
5.14 services adequate to meet the
needs of the population of the county. For the purposes of
5.15 this section, "culturally
responsive program" means a case management services program
5.16 that: (1) ensures effective,
equitable, comprehensive, and respectful quality care services
5.17 that are responsive to
individuals within a specific population's values, beliefs, practices,
5.18 health literacy, preferred
language, and other communication needs; and (2) is designed to
5.19 address the unique needs of
individuals who share a common language or racial, ethnic, or
5.20 social background. Beginning
July 1, 2029, a county agency must not enter into any new
5.21 contracts or renew
contracts for case management services.
5.22 (d) Case management
services must not be provided to a recipient by a private agency
5.23 that has any financial interest
in the provision of any other services included in the recipient's
5.24 support plan. For purposes of
this section, "private agency" means any agency that is not
5.25 identified as a lead agency
under section 256B.0911, subdivision 10.
5.26 (e) For persons who need a
positive support transition plan as required in chapter 245D,
5.27 the case manager shall
participate in the development and ongoing evaluation of the plan
5.28 with the expanded support team.
At least quarterly, the case manager, in consultation with
5.29 the expanded support team,
shall evaluate the effectiveness of the plan based on progress
5.30 evaluation data submitted by
the licensed provider to the case manager. The evaluation must
5.31 identify whether the plan has
been developed and implemented in a manner to achieve the
5.32 following within the required
timelines:
5.33 (1) phasing out the use of
prohibited procedures;
6.1 (2) acquisition of skills
needed to eliminate the prohibited procedures within the plan's
6.2 timeline; and
6.3 (3) accomplishment of
identified outcomes.
6.4 If adequate progress is not
being made, the case manager shall consult with the person's
6.5 expanded support team to
identify needed modifications and whether additional professional
6.6 support is required to
provide consultation.
6.7 (f) The Department of Human
Services shall offer ongoing education in case management
6.8 to case managers. Case
managers shall receive no less than 20 hours of case management
6.9 education and
disability-related training each year. The education and training must include
6.10 appropriate service
authorization, person-centered planning, informed choice, informed
6.11 decision making, cultural
competency, employment planning, community living planning,
6.12 self-direction options, and use
of technology supports. Case managers must annually complete
6.13 an informed choice curriculum
and pass a competency evaluation, in a form determined by
6.14 the commissioner, on informed
decision-making standards. By August 1, 2024, all case
6.15 managers must complete an
employment support training course identified by the
6.16 commissioner of human services.
For case managers hired after August 1, 2024, this training
6.17 must be completed within the
first six months of providing case management services. For
6.18 the purposes of this section,
"person-centered planning" or "person-centered" has the
meaning
6.19 given in section 256B.0911,
subdivision 10. Case managers shall document completion of
6.20 training in a system identified
by the commissioner.
6.21 EFFECTIVE DATE. This
section is effective January 1, 2027, and applies to contracts
6.22 entered into or renewed
on or after that date.
6.23 Sec. 3. Minnesota Statutes
2024, section 256S.07, subdivision 1, is amended to read:
6.24 Subdivision 1.Elderly
waiver case management provided by counties and tribes. (a)
6.25 For participants not enrolled
in a managed care organization, the county of residence or
6.26 tribe must provide or arrange
to provide elderly waiver case management activities under
6.27 section 256S.09, subdivisions 2
and 3.
6.28 (b) If a county agency provides
case management under contracts with other individuals
6.29 or agencies and,
the county agency utilizes must utilize a competitive proposal
process for
6.30 the procurement of contracted
case management services, the competitive proposal process
6.31 must include at
least once every two years. Contracts must include provisions for oversight
6.32 to ensure high-quality
case management services. The competitive proposal process must
6.33 include evaluation
criteria to ensure that the county maintains a culturally responsive program
7.1 for case management services
adequate to meet the needs of the population of the county.
7.2 For the purposes of this section,
"culturally responsive program" means a case management
7.3 services program that:
7.4 (1) ensures effective,
equitable, comprehensive, and respectful quality care services that
7.5 are responsive to individuals
within a specific population's values, beliefs, practices, health
7.6 literacy, preferred language,
and other communication needs; and
7.7 (2) is designed to address
the unique needs of individuals who share a common language
7.8 or racial, ethnic, or social
background.
7.9 (c) Beginning July 1,
2029, a county agency must not enter into any new contracts or
7.10 renew contracts for case
management services.
7.11 EFFECTIVE DATE. This
section is effective January 1, 2027, and applies to contracts
7.12 entered into or renewed
on or after that date.
7.13 Sec. 4. WAIVER CASE
MANAGEMENT QUALITY WORKING GROUP.
7.14 Subdivision 1.Establishment. The
commissioner of human services shall convene a
7.15 waiver case management
quality working group to develop recommendations related to
7.16 county provision of home
and community-based waiver case management services without
7.17 the use of contractors.
7.18 Subd. 2.Membership.
At a minimum, the working group must include the following
7.19 members:
7.20 (1) two individuals
receiving waiver services or their family members or advocates,
7.21 appointed by the
commissioner, in consultation with organizations representing individuals
7.22 with lived experience of
disability and waiver services;
7.23 (2) three county
representatives, appointed by the Minnesota Association of County
7.24 Social Service
Administrators;
7.25 (3) at least three
representatives of contracted case management agencies, appointed by
7.26 the Minnesota Social
Service Association, including:
7.27 (i) at least one
representative of a contracted case management agency located in a
7.28 metropolitan county, as
defined in Minnesota Statutes, section 473.121, subdivision 4; and
7.29 (ii) at least two
representatives of contracted case management agencies located outside
7.30 of a metropolitan
county;
8.1 (4) one staff member
from the Minnesota Social Service Association, appointed by the
8.2 Minnesota Social
Service Association;
8.3 (5) one member of a
Tribal Nation, appointed by the commissioner;
8.4 (6) two
representatives of disability advocacy organizations, appointed by the
8.5 commissioner; and
8.6 (7) additional
nonvoting participants as determined by the commissioner, which may
8.7 include staff from the
Department of Human Services and other interested parties.
8.8 Subd.
3.Duties. (a) The working group shall make recommendations to
ensure that
8.9 clients are receiving
high-quality case management services, including but not limited to:
8.10 (1) requiring written
documentation of visits with clients in order to receive payment;
8.11 (2) requiring initial
and annual case management training conducted by the Department
8.12 of Human Services, with
input from the counties related to core competencies and the
8.13 training curriculum;
8.14 (3) requiring a county
to accept a client transfer and continue services at the level provided
8.15 by the previous county
without the client reapplying for services;
8.16 (4) prohibiting a county
from arbitrarily reducing the level and type of services a client
8.17 receives;
8.18 (5) requiring case
management service providers to submit to a yearly financial audit
8.19 and random inspections
of files and documentation;
8.20 (6) requiring counties
that contract for case management services to utilize a competitive
8.21 process for the
procurement of contracted case management services at least once every
8.22 three years;
8.23 (7) requiring case
management service providers to implement a grievance process for
8.24 clients that must
document all complaints and responses to and resolutions of complaints;
8.25 and
8.26 (8) requiring contracted
case management service providers to annually report to the
8.27 county their case load
numbers and staff turnover rates.
8.28 (b) The working group
shall make recommendations to transition from a contract-based
8.29 case management services
system to a system in which counties provide case management
8.30 services without
contracting for those services. The recommendations must include but are
8.31 not limited to:
9.1 (1) ways to reduce
complaints and improve quality of waiver case management services;
9.2 (2) an evaluation of
the impact of current funding levels, administrative structures, and
9.3 workforce capacity on
case management service delivery;
9.4 (3) an examination of
alternative accountability and oversight models that protect access,
9.5 provider flexibility,
and case management service quality;
9.6 (4) creation of a
variance process, including county oversight and contractor site visits,
9.7 to allow a county to
continue to use contracted case management services; and
9.8 (5) legislative or administrative
changes to strengthen the waiver case management
9.9 services system.
9.10 Subd. 4.Compensation;
expenses. Members of the working group may receive
9.11 compensation and expense
reimbursement as provided in Minnesota Statutes, section 15.059,
9.12 subdivision 3.
9.13 Subd. 5.Meetings;
administrative support. (a) The first meeting of the working group
9.14 must be convened no
later than August 1, 2026. The working group must meet at least
9.15 monthly. Meetings are
subject to Minnesota Statutes, chapter 13D. The working group may
9.16 meet by telephone or
interactive technology consistent with Minnesota Statutes, section
9.17 13D.015.
9.18 (b) The Department of
Human Services shall provide staff and administrative support
9.19 to convene the working
group, facilitate working group meetings, and prepare the final
9.20 report.
9.21 Subd. 6.Report.
By September 1, 2027, the commissioner shall submit a report of the
9.22 working group's findings
and recommendations, including any legislative language necessary
9.23 to implement the
recommendations, to the chairs and ranking minority members of the
9.24 legislative committees
with jurisdiction over human services policy and finance.
9.25 Subd. 7.Expiration.
The working group expires upon submission of the report required
9.26 under subdivision 6.
9.27 Sec. 5. DIRECTION TO
COMMISSIONER; CASE MANAGEMENT AND HOME
9.28 AND
COMMUNITY-BASED SERVICES RATES STUDY.
9.29 (a) The commissioner of human services shall analyze the
current rate-setting
9.30 methodology for all case
management and medical assistance home and community-based
9.31 services waivers and
make recommendations to improve rate-setting methodologies to more
9.32 accurately reflect
service costs. By January 1, 2027, the commissioner shall issue a request
10.1 for proposals to analyze
the rate frameworks and current rate-setting practices. The
10.2 commissioner must
consult with lead agencies and providers across the spectrum of services
10.3 and regions of the state
and with culturally responsive providers in the development of the
10.4 request for proposals
and for the duration of the contract.
10.5 (b) By January 15, 2028,
the commissioner must submit a report to the chairs and ranking
10.6 minority members of the
legislative committees with jurisdiction over human services policy
10.7 and finance on the
initial results of the analysis required under this section. By January 15,
10.8 2029, the commissioner
must submit a final report to the chairs and ranking minority
10.9 members of the
legislative committees with jurisdiction over human services policy and
10.10 finance that includes
legislative language necessary to modify existing or implement new
10.11 rate methodologies and a
detailed fiscal analysis.
