Home and community-based service standards modifications and disability waiver regulations interpretive guidelines issuance by the commissioner requirement provision

A bill for an act

relating to human services; modifying home and community-based service

standards; requiring the commissioner to issue interpretive guidelines for disability

waiver regulations; amending Minnesota Statutes 2024, sections 245D.09,

subdivision 5; 245D.095, subdivision 3; 256B.04, by adding a subdivision;

Minnesota Statutes 2025 Supplement, section 256B.4914, subdivision 14a.

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

Section 1.

Minnesota Statutes 2024, section 245D.09, subdivision 5, is amended to read:

Subd. 5.

Annual training.

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(a)
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A license holder must provide annual training to direct

support staff on the topics identified in subdivision 4, clauses (3) to (11).
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A license holder

may delay annual training up to 90 calendar days following the date by which the direct

care staff would otherwise be required to receive the annual training.

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(b)
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If the direct support staff has a first aid certification, annual training under subdivision

4, clause (9), is not required as long as the certification remains current.

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EFFECTIVE DATE.

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This section is effective August 1, 2026.

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Sec. 2.

Minnesota Statutes 2024, section 245D.095, subdivision 3, is amended to read:

Subd. 3.

Service recipient record.

(a) The license holder must maintain a record of

current services provided to each person on the premises where the services are provided

or coordinated. When the services are provided in a licensed facility, the records must be

maintained at the facility, otherwise the records must be maintained at the license holder's

program office. The license holder must protect service recipient records against loss,

tampering, or unauthorized disclosure according to the requirements in sections
13.01
to

13.10
and
13.46
.

(b) The license holder must maintain the following information for each person:

(1) an admission form signed by the person or the person's legal representative that

includes:

(i) identifying information, including the person's name, date of birth, address, and

telephone number; and

(ii) the name, address, and telephone number of the person's legal representative, if any,

and a primary emergency contact, the case manager, and family members or others as

identified by the person or case manager;

(2) service information, including service initiation information, verification of the

person's eligibility for services, documentation verifying that services have been provided

as identified in the support plan or support plan addendum according to paragraph (a), and

date of admission or readmission;

(3) health information, including medical history, special dietary needs, and allergies,

and when the license holder is assigned responsibility for meeting the person's health service

needs according to section
245D.05
:

(i) current orders for medication, treatments, or medical equipment and a signed

authorization from the person or the person's legal representative to administer or assist in

administering the medication or treatments, if applicable;

(ii) a signed statement authorizing the license holder to act in a medical emergency when

the person's legal representative, if any, cannot be reached or is delayed in arriving;

(iii) medication administration procedures;

(iv) a medication administration record documenting the implementation of the medication

administration procedures, and the medication administration record reviews, including any

agreements for administration of injectable medications by the license holder according to

the requirements in section
245D.05
; and

(v) a medical appointment schedule when the license holder is assigned responsibility

for assisting with medical appointments;

(4) the person's current support plan or that portion of the plan assigned to the license

holder;

(5) copies of the individual abuse prevention plan and assessments as required under

section
245D.071, subdivisions 2
and 3;

(6) a record of other service providers serving the person when the person's support plan

or support plan addendum identifies the need for coordination between the service providers,

that includes a contact person and telephone numbers, services being provided, and names

of staff responsible for coordination;

(7) documentation of orientation to service recipient rights according to section
245D.04,

subdivision 1
, and maltreatment reporting policies and procedures according to section

245A.65, subdivision 1
, paragraph (c);

(8) copies of authorizations to handle a person's funds, according to section
245D.06
,

subdivision 4, paragraph (a);

(9) documentation of complaints received and grievance resolution;

(10) incident reports involving the person, required under section
245D.06
, subdivision

1;

(11) copies of written reports regarding the person's status when requested according to

section
245D.07, subdivision 3
,
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progress review reports as required under section
245D.071,

subdivision 5
, progress or daily log notes that are recorded by the program,
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and reports

received from other agencies involved in providing services or care to the person; and

(12) discharge summary, including service termination notice and related documentation,

when applicable.

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(c) A license holder providing intensive support services identified in section 245D.03,

subdivision 1, paragraph (c), must maintain copies of progress review reports for each person

as required under section 245D.071, subdivision 5, and copies of progress or daily log notes

recorded by the program for each person.

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EFFECTIVE DATE.

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This section is effective August 1, 2026.

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Sec. 3.

Minnesota Statutes 2024, section 256B.04, is amended by adding a subdivision to

read:

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Subd. 28.

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Interpretive guidelines for disability waiver regulation.

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(a) The

commissioner of human services must develop and publish interpretive guidelines within

120 calendar days of the effective date of any statutory changes, waiver plan amendments,

state or federal administrative ruling, or state or federal court decisions that affect policies

or reimbursement for services licensed under chapter 245D, authorized under section

256B.092 or 256B.49, or reimbursed under section 256B.4914.

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(b) Interpretive guidelines issued by the commissioner under this subdivision do not

have the force and effect of law and have no precedential effect but may be relied on by

consumers, providers of service, county agencies, the Department of Human Services, and

others concerned until revoked or modified. An interpretive guideline may be expressly

revoked or modified by the commissioner or by the issuance of another interpretive guideline

but may not be revoked or modified retroactively to the detriment of consumers, providers

of service, county agencies, the Department of Human Services, or others concerned. A

change in the law or an interpretation of the law occurring after the interpretive guidelines

are issued, whether in the form of a statute, court decision, administrative ruling, or

subsequent interpretive guideline, results in the revocation or modification of the previously

adopted guidelines to the extent that the change affects the guidelines.

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EFFECTIVE DATE.

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This section is effective the day following final enactment and

applies to statutory changes, waiver plan amendments, state or federal administrative rulings,

or state or federal court decisions effective or issued on or after that date.

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Sec. 4.

Minnesota Statutes 2025 Supplement, section 256B.4914, subdivision 14a, is

amended to read:

Subd. 14a.

Limitations on rate exceptions for residential services.

(a) Effective July

1, 2026, the commissioner must implement limitations on the rate exceptions for community

residential services, customized living services, family residential services, and integrated

community supports.

(b) The commissioner must restrict rate exceptions to the absence and utilization factor

ratio to people temporarily receiving hospital or crisis respite services.

(c) For rate exceptions related to behavioral needs, the lead agency must include:

(1) a documented behavioral diagnosis; or

(2) determined assessed needs for behavioral supports as identified in the person's most

recent assessment or reassessment under section
256B.0911
.

(d) Community residential services rate exceptions must not include positive support

services costs.

(e) The commissioner must not approve rate exception requests related to increased

community time or transportation.

(f) For the commissioner to approve a rate exception annual renewal, the person's most

recent assessment must indicate continued extraordinary needs in the areas cited in the

exception request. If a person's assessment continues to identify these extraordinary needs,
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a
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lead
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agencies
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agency
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requesting an annual renewal of rate exceptions must submit

documentation supporting the continuation of the exception.
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At a minimum,
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Documentation
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submitted by the lead agency
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must include:

(1) payroll records for direct care wages cited in the request;

(2) payment records or receipts for other costs cited in the request; and

(3) documentation of expenses paid that were identified as necessary for the initial rate

exception.

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(g) For purposes of requesting an annual renewal of a rate exception under paragraph

(f), a lead agency may not require the provider of the service for which the annual renewal

of a rate exception is requested to submit to the lead agency any documentation in addition

to the documentation required to be submitted by the lead agency under paragraph (f).

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(g)
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(h)
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The commissioner must not increase rate exception annual renewals that request

an exception to direct care or supervision wages more than the most recently implemented

update to the base wage index under subdivision 5b.

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(h)
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(i)
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The commissioner must publish online an annual report detailing the impact of

the limitations under this subdivision on home and community-based services spending,

including but not limited to:

(1) the number and percentage of rate exceptions granted and denied;

(2) total spending on community residential setting services and rate exceptions;

(3) trends in the percentage of spending attributable to rate exceptions; and

(4) an evaluation of the effectiveness of the limitations in controlling spending growth.

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EFFECTIVE DATE.

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This section is effective the day following final enactment.

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