Community first services and supports program modified.

A bill for an act

relating to human services; modifying the community first services and supports

program; amending Minnesota Statutes 2024, section 256B.85, subdivisions 6,

10, 18a, by adding subdivisions; Minnesota Statutes 2025 Supplement, section

256B.85, subdivisions 12, 17a.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2024, section 256B.85, subdivision 6, is amended to read:

Subd. 6.

Community first services and supports service delivery plan.

(a) The CFSS

service delivery plan must be developed and evaluated through a person-centered planning

process by the participant, or the participant's representative or legal representative who

may be assisted by a consultation services provider. The CFSS service delivery plan must

reflect the services and supports that are important to the participant and for the participant

to meet the needs assessed by the certified assessor and identified in the support plan

identified in sections
256B.092, subdivision 1b
, and
256S.10
. The CFSS service delivery

plan must be reviewed by the participant, the consultation services provider
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when the

participant has utilized one
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, and the agency-provider or FMS provider prior to starting

services and at least annually upon reassessment, or when there is a significant change in

the participant's condition, or a change in the need for services and supports.

(b) The commissioner shall establish the format and criteria for the CFSS service delivery

plan.

(c) The CFSS service delivery plan must be person-centered and:

(1) specify the consultation services provider, agency-provider, or FMS provider selected

by the participant;

(2) reflect the setting in which the participant resides that is chosen by the participant;

(3) reflect the participant's strengths and preferences;

(4) include the methods and supports used to address the needs as identified through an

assessment of functional needs;

(5) include the participant's identified goals and desired outcomes;

(6) reflect the services and supports, paid and unpaid, that will assist the participant to

achieve identified goals, including the costs of the services and supports, and the providers

of those services and supports, including natural supports;

(7) identify the amount and frequency of face-to-face supports and amount and frequency

of remote supports and technology that will be used;

(8) identify risk factors and measures in place to minimize them, including individualized

backup plans;

(9) be understandable to the participant and the individuals providing support;

(10) identify the individual or entity responsible for monitoring the plan;

(11) be finalized and agreed to in writing by the participant and signed by individuals

and providers responsible for its implementation;

(12) be distributed to the participant and other people involved in the plan;

(13) prevent the provision of unnecessary or inappropriate care;

(14) include a detailed budget for expenditures for budget model participants or

participants under the agency-provider model if purchasing goods; and

(15) include a plan for worker training and development provided according to

subdivision 18a detailing what service components will be used, when the service components

will be used, how they will be provided, and how these service components relate to the

participant's individual needs and CFSS support worker services.

(d) The CFSS service delivery plan must describe the units or dollar amount available

to the participant. The total units of agency-provider services or the service budget amount

for the budget model include both annual totals and a monthly average amount that cover

the number of months of the service agreement. The amount used each month may vary,

but additional funds must not be provided above the annual service authorization amount,

determined according to subdivision 8, unless a change in condition is assessed and

authorized by the certified assessor and documented in the support plan and CFSS service

delivery plan.

(e) In assisting with the development or modification of the CFSS service delivery plan

during the authorization time period, the consultation services provider shall:

(1) consult with the FMS provider on the spending budget when applicable; and

(2) consult with the participant or participant's representative, agency-provider, and case

manager or care coordinator.

(f) The CFSS service delivery plan must be approved by the lead agency for participants

without a case manager or care coordinator who is responsible for authorizing services. A

case manager or care coordinator must approve the plan for a waiver or alternative care

program participant.

Sec. 2.

Minnesota Statutes 2024, section 256B.85, subdivision 10, is amended to read:

Subd. 10.

Agency-provider and FMS provider qualifications and duties.

(a)

Agency-providers identified in subdivision 11 and FMS providers identified in subdivision

13a
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shall
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must
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:

(1) enroll as a medical assistance Minnesota health care programs provider and meet all

applicable provider standards and requirements including completion of required provider

training as determined by the commissioner;

(2) demonstrate compliance with federal and state laws and policies for CFSS as

determined by the commissioner;

(3) comply with background study requirements under chapter 245C and maintain

documentation of background study requests and results;

(4) verify and maintain records of all services and expenditures by the participant,

including hours worked by support workers;

(5) not engage in any agency-initiated direct contact or marketing in person, by telephone,

or other electronic means to potential participants, guardians, family members, or participants'

representatives;

(6) directly provide services and not use a subcontractor or reporting agent;

(7) meet the financial requirements established by the commissioner for financial

solvency;

(8) have never had a lead agency contract or provider agreement discontinued due to

fraud, or have never had an owner, board member, or manager fail a state or FBI-based

criminal background check while enrolled or seeking enrollment as a Minnesota health care

programs provider; and

(9) have an office located in Minnesota.

(b) In conducting general duties, agency-providers and FMS providers
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shall
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must
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:

(1)
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bill for and
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pay support workers based upon actual hours of services provided;

(2)
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bill for and
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pay for worker training and development services based
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upon actual

hours of services provided or
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on
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the unit cost of the training session purchased
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or in the

manner defined by the commissioner
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;

(3) withhold and pay all applicable federal and state payroll taxes;

(4) make arrangements and pay unemployment insurance, taxes, workers' compensation,

liability insurance, and other benefits, if any;

(5) enter into a written agreement with the participant, participant's representative, or

legal representative that assigns roles and responsibilities to be performed before services,

supports, or goods are provided and that meets the requirements of subdivisions 20a, 20b,

and 20c for agency-providers;

(6) report maltreatment as required under section
626.557
and chapter 260E;

(7) comply with the labor market reporting requirements described in section
256B.4912
,

subdivision 1a;

(8) comply with any data requests from the department consistent with the Minnesota

Government Data Practices Act under chapter 13;
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and
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(9) maintain documentation for the requirements under subdivision 16, paragraph (e),

clause (2), to qualify for an enhanced rate under this section
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; and
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.
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(10) request reassessments 60 days before the end of the current authorization for CFSS

on forms provided by the commissioner.

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(c) Agency-providers and FMS providers must inform the commissioner of changes in

the employment status and affiliation of support workers and of individuals providing worker

training and development. Agency-providers and FMS providers must notify the

commissioner on a form prescribed by the commissioner:

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(1) within six months following the date upon which a support worker is no longer

employed by or otherwise affiliated with the CFSS agency-provider or participant employer

for whom the support worker previously provided CFSS services; and

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(2) within 30 days following the date upon which an individual providing worker training

and development is no longer employed by or otherwise affiliated with the CFSS

agency-provider or participant employer for whom the individual previously provided

worker training and development services.

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Sec. 3.

Minnesota Statutes 2025 Supplement, section 256B.85, subdivision 12, is amended

to read:

Subd. 12.

Requirements for enrollment of CFSS agency-providers.

(a)
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Except as

provided in paragraph (b),
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all CFSS agency-providers must provide
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to the commissioner
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,

at the time of enrollment, reenrollment, and revalidation as a CFSS agency-provider in a

format determined by the commissioner, information and documentation that includes but

is not limited to the following:

(1) the CFSS agency-provider's current contact information including address, telephone

number, and email address;

(2) proof of surety bond coverage. Upon new enrollment
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,
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or if the agency-provider's

Medicaid revenue in the previous calendar year is less than or equal to $300,000, the

agency-provider must purchase a surety bond of
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$50,000
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$100,000
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. If the agency-provider's

Medicaid revenue in the previous calendar year is greater than $300,000
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but less than or

equal to $750,000
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, the agency-provider must purchase a surety bond of
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$100,000
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$200,000
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.
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If the agency-provider's Medicaid revenue in the previous calendar year is greater than

$750,000, the agency-provider must purchase a surety bond of $300,000.
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The surety bond

must be in a form approved by the commissioner, must be renewed annually, and must

allow for recovery of costs and fees in pursuing a claim on the bond. Any action to obtain

monetary recovery or sanctions from a surety bond must occur within six years from the

date the debt is affirmed by a final agency decision. An agency decision is final when the

right to appeal the debt has been exhausted or the time to appeal has expired under section

256B.064
;

(3) proof of fidelity bond coverage in the amount of
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$20,000
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$50,000
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per provider

location;

(4) proof of workers' compensation insurance coverage;

(5) proof of liability insurance;

(6) a copy of the CFSS agency-provider's organizational chart identifying the names

and roles of all owners, managing employees, staff, board of directors, and additional

documentation reporting any affiliations of the directors and owners to other service

providers;

(7) proof that the CFSS agency-provider has written policies and procedures including:

hiring of employees; training requirements; service delivery;
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identification, prevention,

detection, and reporting of fraud or any billing, record keeping, or other administrative

noncompliance;
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and employee and consumer safety, including the process for notification

and resolution of participant grievances, incident response, identification and prevention of

communicable diseases, and employee misconduct;

(8) proof that the CFSS agency-provider has all of the following forms and documents:

(i) a copy of the CFSS agency-provider's time sheet; and

(ii) a copy of the participant's individual CFSS service delivery plan;

(9) a list of all training and classes that the CFSS agency-provider requires of its staff

providing CFSS services;

(10) documentation that the CFSS agency-provider and staff have successfully completed

all the training required by this section;

(11) documentation of the agency-provider's marketing practices;

(12) disclosure of ownership, leasing, or management of all residential properties that

are used or could be used for providing home care services;

(13) documentation that the agency-provider will use at least the following percentages

of revenue generated from the medical assistance rate paid for CFSS services for CFSS

support worker wages and benefits: 72.5 percent of revenue from CFSS providers, except

100 percent of the revenue generated by a medical assistance rate increase due to a collective

bargaining agreement under section
179A.54
must be used for support worker wages and

benefits. The revenue generated by the worker training and development services and the

reasonable costs associated with the worker training and development services shall not be

used in making this calculation;
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and
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(14) documentation that the agency-provider does not burden participants' free exercise

of their right to choose service providers by requiring CFSS support workers to sign an

agreement not to work with any particular CFSS participant or for another CFSS

agency-provider after leaving the agency and that the agency is not taking action on any

such agreements or requirements regardless of the date signed
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.
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;
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(15) a copy of the CFSS agency-provider's self-auditing policy and other materials

demonstrating the CFSS agency-provider's internal program integrity procedures;

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(16) a copy of the CFSS agency-provider's policy for notifying individuals providing

worker training and development of the individual's obligation to notify the commissioner

within 30 days that the individual is no longer employed by or affiliated with the CFSS

agency-provider;

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(17) a copy of the CFSS agency-provider's policy for notifying support workers of the

support worker's obligation to notify the commissioner within six months that the support

worker is no longer employed by or affiliated with the CFSS agency-provider;

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(18) a copy of the CFSS agency-provider's policy for notifying the commissioner within

30 days that an individual providing worker training and development is no longer employed

by or affiliated with the CFSS agency-provider; and

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(19) a copy of the CFSS agency-provider's policy for notifying the commissioner within

six months that a support worker is no longer employed by or affiliated with the CFSS

agency-provider.

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(b) CFSS agency-providers
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shall provide to the commissioner the information specified

in paragraph (a)
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must annually provide to the commissioner the information described in

paragraph (a), clauses (2) to (5)
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.

(c) All CFSS agency-providers
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shall
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must
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require all employees in management and

supervisory positions and owners of the agency who are active in the day-to-day management

and operations of the agency to complete mandatory training as determined by the

commissioner. Employees in management and supervisory positions and owners who are

active in the day-to-day operations of an agency who have completed the required training

as an employee with a CFSS agency-provider do not need to repeat the required training if

they are hired by another agency and they have completed the training within the past
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three
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two
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years. CFSS agency-provider billing staff
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shall
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must
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complete training about CFSS

program financial management. Any new owners or employees in management and

supervisory positions involved in the day-to-day operations
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are required to
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must
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complete

mandatory training as a requisite of working for the agency.

(d) Agency-providers
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shall
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must
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submit all required documentation in this section within

30 days of notification from the commissioner. If an agency-provider fails to submit all the

required documentation, the commissioner may take action under subdivision 23a.

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(e) In addition to the other requirements of this subdivision, a CFSS agency-provider

enrolling for the first time must provide, at the time of initial enrollment as a CFSS

agency-provider and in a format determined by the commissioner, proof of sufficient initial

operating capital to support the infrastructure necessary for ongoing compliance with the

requirements of this section. A CFSS agency-provider may demonstrate sufficient operating

capital by submitting:

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(1) copies of business bank account statements showing at least $5,000 in cash reserves;

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(2) proof of a cash reserve or business line of credit sufficient to equal two payrolls of

the agency-provider's current or projected business; or

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(3) any other information as determined by the commissioner.

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(f) In addition to the other requirements of this subdivision, a CFSS agency-provider

must provide the following to the commissioner at the time of revalidation as a CFSS

agency-provider in a format determined by the commissioner:

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(1) documentation of the payroll paid for the preceding 12 months or other time period

as prescribed by the commissioner; and

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(2) financial statements demonstrating compliance with the use of revenue requirements

of subdivision 11, paragraph (e).

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Sec. 4.

Minnesota Statutes 2024, section 256B.85, is amended by adding a subdivision to

read:

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Subd. 16b.

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Support workers; notice of change of employment required.

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Within six

months of ceasing employment as a support worker with a CFSS agency-provider or

participant employer, the support worker must notify the commissioner on a form prescribed

by the commissioner that the support worker is no longer employed by or otherwise affiliated

with the CFSS agency-provider or participant employer for whom the support worker was

previously providing CFSS services.

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Sec. 5.

Minnesota Statutes 2025 Supplement, section 256B.85, subdivision 17a, is amended

to read:

Subd. 17a.

Consultation services provider qualifications and

requirements.

Consultation services providers must meet the following qualifications and

requirements:

(1) meet the requirements under subdivision 10, paragraph (a), excluding clauses (4)

and (5);

(2) be under contract with the department and enrolled as a Minnesota health care program

provider;

(3) not be the FMS provider, the lead agency, or the CFSS or home and community-based

services waiver vendor or agency-provider to the participant;

(4) meet the service standards as established by the commissioner;

(5) have proof of surety bond coverage. Upon new enrollment
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,
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or if the consultation

service provider's Medicaid revenue in the previous calendar year is less than or equal to

$300,000, the consultation service provider must purchase a surety bond of
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$50,000
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$100,000
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.

If the agency-provider's Medicaid revenue in the previous calendar year is greater than

$300,000
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but less than or equal to $750,000
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, the consultation service provider must purchase

a surety bond of
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$100,000
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$200,000
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.
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If the consultation service provider's Medicaid revenue

in the previous calendar year is greater than $750,000, the consultation service provider

must purchase a surety bond of $300,000.
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The surety bond must be in a form approved by

the commissioner, must be renewed annually, and must allow for recovery of costs and fees

in pursuing a claim on the bond;

(6) employ lead professional staff with a minimum of two years of experience in

providing services such as support planning, support broker, case management or care

coordination, or consultation services and consumer education to participants using a

self-directed program using FMS under medical assistance;

(7) report maltreatment as required under chapter 260E and section
626.557
;

(8) comply with medical assistance provider requirements;

(9) understand the CFSS program and its policies;

(10) be knowledgeable about self-directed principles and the application of the

person-centered planning process;

(11) have general knowledge of the FMS provider duties and the vendor fiscal/employer

agent model, including all applicable federal, state, and local laws and regulations regarding

tax, labor, employment, and liability and workers' compensation coverage for household

workers; and

(12) have all employees, including lead professional staff, staff in management and

supervisory positions, and owners of the agency who are active in the day-to-day management

and operations of the agency, complete training as specified in the contract with the

department.

Sec. 6.

Minnesota Statutes 2024, section 256B.85, is amended by adding a subdivision to

read:

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Subd. 17b.

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Exemption from consultation services.

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(a) Notwithstanding any provision

of this section to the contrary, except subdivision 5a, a participant is exempt from the

requirement to obtain consultation services if the participant is receiving CFSS services

from an agency-provider, the participant is not changing the CFSS agency-provider, and

one of the following additional conditions are met:

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(1) if the participant has received consultation services in the past, the participant's

condition has not changed significantly since the participant most recently received

consultation services; or

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(2) if the participant has not received consultation services, the participant's condition

has not changed significantly since the participant's most recent assessment, most recent

reassessment, or most recent CFSS service delivery plan review.

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(b) A lead agency that determines the exemption from consultation services under this

subdivision does not apply must document in the participant's case record the basis for

determining that the participant is required to obtain consultation services.

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(c) Nothing in this subdivision prevents a participant, participant's legal representative,

or lead agency from requesting consultation services at any time.

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(d) Nothing in this subdivision requires a lead agency to forego requiring a participant

receive consultation services when documentation indicates a significant change in the

participant's condition.

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Sec. 7.

Minnesota Statutes 2024, section 256B.85, subdivision 18a, is amended to read:

Subd. 18a.

Worker training and development services.

(a) The commissioner
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shall
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must
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develop the scope of tasks and functions, service standards, and service limits for

worker training and development services.

(b) Worker training and development costs are in addition to the participant's assessed

service units or service budget. Services provided according to this subdivision must:

(1) help support workers obtain and expand the skills and knowledge necessary to ensure

competency in providing quality services as needed and defined in the participant's CFSS

service delivery plan and as required under subdivisions 11b and 14;

(2) be provided or arranged for by the agency-provider under subdivision 11, or purchased

by the participant employer under the budget model as identified in subdivision 13;

(3) be delivered by an individual competent to perform, teach, or assign the tasks,

including health-related tasks, identified in the plan through education, training, and work

experience relevant to the person's assessed needs; and

(4) be described in the participant's CFSS service delivery plan and documented in the

participant's file.

(c) Services covered under worker training and development
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shall
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must
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include:

(1) support worker training on the participant's individual assessed needs and condition,

provided individually or in a group setting by a skilled and knowledgeable trainer beyond

any training the participant or participant's representative provides;

(2) tuition for professional classes and workshops for the participant's support workers

that relate to the participant's assessed needs and condition;

(3) direct observation, monitoring, coaching, and documentation of support worker job

skills and tasks, beyond any training the participant or participant's representative provides,

including supervision of health-related tasks or behavioral supports that is conducted by an

appropriate professional based on the participant's assessed needs. These services must be

provided at the start of services or the start of a new support worker except as provided in

paragraph (d) and must be specified in the participant's CFSS service delivery plan; and

(4) the activities to evaluate CFSS services and ensure support worker competency

described in subdivisions 11a and 11b.

(d) The services in paragraph (c), clause (3), are not required to be provided for a new

support worker providing services for a participant due to staffing failures, unless the support

worker is expected to provide ongoing backup staffing coverage.

(e) Worker training and development services shall not include:

(1) general agency training, worker orientation, or training on CFSS self-directed models;

(2) payment for preparation or development time for the trainer or presenter;

(3) payment of the support worker's salary or compensation during the training;

(4) training or supervision provided by the participant, the participant's support worker,

or the participant's informal supports, including the participant's representative; or

(5) services in excess of the limit set by the commissioner per annual service agreement,

unless approved by the department.

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(f) Worker training and development for a recipient must be documented in a manner

determined by the commissioner and must include the full name and individual provider

identifier of the individual providing worker training and development.

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Sec. 8.

Minnesota Statutes 2024, section 256B.85, is amended by adding a subdivision to

read:

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Subd. 18c.

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Worker training and development; notice of change of employment

required.

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Within 30 days of ceasing employment providing worker training and development

on behalf of a CFSS agency-provider or a participant employer, the individual providing

worker training and development must notify the commissioner on a form prescribed by

the commissioner that the individual is no longer providing worker training and development

on behalf of the CFSS agency-provider or the participant employer.

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Sec. 9.

Minnesota Statutes 2024, section 256B.85, is amended by adding a subdivision to

read:

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Subd. 27.

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Uniformity with state requirements.

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Managed care plans and county-based

purchasing plans must not impose requirements on CFSS services that are more restrictive

or otherwise exceed the requirements imposed by the commissioner with respect to:

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(1) determining CFSS service authorization amounts under subdivision 8;

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(2) assigning unique Minnesota provider identifiers;

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(3) submitting claims; or

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(4) documenting daily time and activities.

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EFFECTIVE DATE.

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This section is effective January 1, 2027.

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