Individual authorized budget reduction limit on reductions resulting from implementation of waiver reimagine phase II establishment

A bill for an act

relating to human services; establishing an individual authorized budget reduction

limit on reductions resulting from implementation of waiver reimagine phase II;

requiring a cost-of-living adjustment in the waiver reimagine phase II methodology;

amending Laws 2021, First Special Session chapter 7, article 13, section 73, as

amended.

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

Section 1.

Laws 2021, First Special Session chapter 7, article 13, section 73, as amended

by Laws 2025, First Special Session chapter 9, article 2, section 56, is amended to read:

Sec. 73.
WAIVER REIMAGINE PHASE II.

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

commissioner of human services must implement a two-home and community-based services

waiver program structure, as authorized under section 1915(c) of the federal Social Security

Act, that serves persons who are determined by a certified assessor to require the levels of

care provided in a nursing home, a hospital, a neurobehavioral hospital, or an intermediate

care facility for persons with developmental disabilities.

(b) The commissioner of human services must implement an individualized budget

methodology, as authorized under section 1915(c) of the federal Social Security Act, that

serves persons who are determined by a certified assessor to require the levels of care

provided in a nursing home, a hospital, a neurobehavioral hospital, or an intermediate care

facility for persons with developmental disabilities.

(c) The commissioner must develop an individualized budget methodology exception

to support access to self-directed home care nursing services. Lead agencies must submit

budget exception requests to the commissioner in a manner identified by the commissioner.

Eligibility for the budget exception in this paragraph is limited to persons meeting all of the

following criteria in the person's most recent assessment:

(1) the person is assessed to need the level of care delivered in a hospital setting as

evidenced by the submission of the Department of Human Services form 7096, primary

medical provider's documentation of medical monitoring and treatment needs;

(2) the person is assessed to receive a support range budget of E or H; and

(3) the person does not receive community residential services, family residential services,

integrated community supports services, or customized living services.

(d) Home care nursing services funded through the budget exception developed under

paragraph (c) must be ordered by a physician, physician assistant, or advanced practice

registered nurse. If the participant chooses home care nursing, the home care nursing services

must be performed by a registered nurse or licensed practical nurse practicing within the

registered nurse's or licensed practical nurse's scope of practice as defined under Minnesota

Statutes, sections
148.171
to
148.285
. If after a person's annual reassessment under Minnesota

Statutes, section
256B.0911
, any requirements of this paragraph or paragraph (c) are no

longer met, the commissioner must terminate the budget exception.

(e) The commissioner of human services may seek all federal authority necessary to

implement this section.

(f) The commissioner must ensure that the new waiver service menu and individual

budgets allow people to live in their own home, family home, or any home and

community-based setting of their choice. The commissioner must ensure, within available

resources and subject to state and federal regulations and law, that waiver reimagine does

not result in unintended service disruptions.

(g) No later than July 1, 2026, the commissioner must:

(1) develop and implement an online support planning and tracking tool to provide

information in an accessible format to support informed choice for people using disability

waiver services that allows access to the total budget available to a person, the services for

which they are eligible, and the services they have chosen and used;

(2) explore operability options that facilitate real-time tracking of a person's remaining

available budget throughout the service year; and

(3) seek input from people with disabilities about the online support planning and tracking

tool prior to the tool's implementation.

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(h) When implementing waiver reimagine phase II, the commissioner of human services

must not reduce the individual authorized budget amount of any waiver services recipient

by more than ten percent unless there is a decrease in need documented in the recipient's

MnCHOICES assessment.

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(i) When determining whether a reduction in a recipient's authorized budget amount

violates paragraph (h), the commissioner must use:

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(1) the recipient's authorized budget amount most recently approved by the recipient's

case manager prior to waiver reimagine phase II implementation; and

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(2) the documented needs in the recipient's most recent MnCHOICES assessment prior

to waiver reimagine phase II implementation.

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(j) If a recipient's documented needs in the MnCHOICES assessments completed after

waiver reimagine phase II implementation remain the same as or exceed the level of needs

documented in paragraph (i), clause (2), the reduction limit in paragraph (h) continues to

apply to every subsequent determination of that recipient's individual authorized budget

amount.

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(k) If a recipient's documented needs in a MnCHOICES assessment completed after

implementation of waiver reimagine phase II decrease from the level of needs documented

in paragraph (i), clause (2), the reduction limit in paragraph (h) no longer applies to that

recipient's individual authorized budget amount and the commissioner must determine the

budget amount based on the methodology established by waiver reimagine phase II for

every subsequent determination of that recipient's individual authorized budget amount.

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(l) The commissioner must incorporate into the methodology established in waiver

reimagine phase II a cost-of-living adjustment for all waiver recipient individual authorized

budgets.

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(m) The commissioner must include the reduction limits and cost-of-living adjustment

in this section in any proposed statutory language codifying the implementation and

methodology of waiver reimagine phase II.

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