Disability waiver rate system unit-based services with programming limits modification

A bill for an act

relating to human services; modifying disability waiver rate system unit-based

services with programming limits; amending Minnesota Statutes 2025 Supplement,

section 256B.4914, subdivision 8.

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

Section 1.

Minnesota Statutes 2025 Supplement, section 256B.4914, subdivision 8, is

amended to read:

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;

(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.

(e) Effective January 1,
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2026
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2027
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, or upon federal approval, whichever is later, a

provider must not bill more than
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three consecutive hours and not more than six total hours

per day
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2,190 hours per service authorization year
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for individualized home supports with

training and
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not more than six total hours per day for
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individualized home supports with

family training.
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This daily limit does
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These limits do
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not
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:
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(1)
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limit a person's use of other disability waiver services, including individualized home

supports, which may be provided on the same day by the same provider providing

individualized home supports with training or individualized home supports with family

training
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.
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; or
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(2) apply to individuals who meet the residential support services criteria under sections

256B.092, subdivision 11a, and 256B.49, subdivision 29.

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