Framework rates reenactment for family residential services

A bill for an act

relating to human services; reenacting framework rates for family residential

services; amending Minnesota Statutes 2024, section 256B.4914, subdivisions 6,

19, by adding a subdivision; Minnesota Statutes 2025 Supplement, section

256B.4914, subdivision 5a.

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

Section 1.

Minnesota Statutes 2025 Supplement, section 256B.4914, subdivision 5a, is

amended to read:

Subd. 5a.

Base wage index; calculations.

The base wage index must be calculated as

follows:

(1) for supervisory staff, 100 percent of the median wage for community and social

services specialist (SOC code 21-1099), with the exception of the supervisor of positive

supports professional, positive supports analyst, and positive supports specialist, which is

100 percent of the median wage for clinical counseling and school psychologist (SOC code

19-3031);

(2) for registered nurse staff, 100 percent of the median wage for registered nurses (SOC

code 29-1141);

(3) for licensed practical nurse staff, 100 percent of the median wage for licensed practical

nurses (SOC code 29-2061);

(4)
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effective until the effective date of clause (5),
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for residential asleep-overnight staff,

the minimum wage in Minnesota for large employers;

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(5) effective January 1, 2027, or upon federal approval, whichever is later, for residential

asleep-overnight staff, the minimum wage for Minnesota for large employers, except for

asleep-overnight staff for family residential services, which is 36 percent of the minimum

wage in Minnesota for large employers;

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(5)
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(6)
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for residential direct care staff, the sum of:

(i) 15 percent of the subtotal of 50 percent of the median wage for home health and

personal care aide (SOC code 31-1120); 30 percent of the median wage for nursing assistant

(SOC code 31-1131); and 20 percent of the median wage for social and human services

aide (SOC code 21-1093); and

(ii) 85 percent of the subtotal of 40 percent of the median wage for home health and

personal care aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant

(SOC code 31-1131); 20 percent of the median wage for psychiatric technician (SOC code

29-2053); and 20 percent of the median wage for social and human services aide (SOC code

21-1093);

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(6)
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(7)
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for adult day services staff, 70 percent of the median wage for nursing assistant

(SOC code 31-1131); and 30 percent of the median wage for home health and personal care

aide (SOC code 31-1120);

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(7)
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(8)
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for day support services staff and prevocational services staff, 20 percent of the

median wage for nursing assistant (SOC code 31-1131); 20 percent of the median wage for

psychiatric technician (SOC code 29-2053); and 60 percent of the median wage for social

and human services aide (SOC code 21-1093);

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(8)
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(9)
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for positive supports analyst staff, 100 percent of the median wage for substance

abuse, behavioral disorder, and mental health counselor (SOC code 21-1018);

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(9)
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(10)
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for positive supports professional staff, 100 percent of the median wage for

clinical counseling and school psychologist (SOC code 19-3031);

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(10)
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(11)
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for positive supports specialist staff, 100 percent of the median wage for

psychiatric technicians (SOC code 29-2053);

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(11)
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(12)
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for individualized home supports with family training staff, 20 percent of the

median wage for nursing aide (SOC code 31-1131); 30 percent of the median wage for

community social service specialist (SOC code 21-1099); 40 percent of the median wage

for social and human services aide (SOC code 21-1093); and ten percent of the median

wage for psychiatric technician (SOC code 29-2053);

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(12)
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(13)
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for individualized home supports with training services staff, 40 percent of the

median wage for community social service specialist (SOC code 21-1099); 50 percent of

the median wage for social and human services aide (SOC code 21-1093); and ten percent

of the median wage for psychiatric technician (SOC code 29-2053);

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(13)
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(14)
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for employment support services staff, 50 percent of the median wage for

rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for

community and social services specialist (SOC code 21-1099);

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(14)
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(15)
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for employment exploration services staff, 50 percent of the median wage for

education, guidance, school, and vocational counselor (SOC code 21-1012); and 50 percent

of the median wage for community and social services specialist (SOC code 21-1099);

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(15)
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(16)
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for employment development services staff, 50 percent of the median wage

for education, guidance, school, and vocational counselors (SOC code 21-1012); and 50

percent of the median wage for community and social services specialist (SOC code

21-1099);

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(16)
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(17)
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for individualized home support without training staff, 50 percent of the median

wage for home health and personal care aide (SOC code 31-1120); and 50 percent of the

median wage for nursing assistant (SOC code 31-1131);

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(17)
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(18)
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effective until the effective date of clauses
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(18) and
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(19)
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and (20)
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, for night

supervision staff, 40 percent of the median wage for home health and personal care aide

(SOC code 31-1120); 20 percent of the median wage for nursing assistant (SOC code

31-1131); 20 percent of the median wage for psychiatric technician (SOC code 29-2053);

and 20 percent of the median wage for social and human services aide (SOC code 21-1093);

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(18)
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(19)
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effective January 1, 2026, or upon federal approval, whichever is later, for

awake night supervision staff, 40 percent of the median wage for home health and personal

care aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant (SOC

code 31-1131); 20 of percent the median wage for psychiatric technician (SOC code

29-2053); and 20 percent of the median wage for social and human services aid (SOC code

21-1093); and

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(19)
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(20)
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effective January 1, 2026, or upon federal approval, whichever is later, for

asleep night supervision staff, the minimum wage in Minnesota for large employers.

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EFFECTIVE DATE.

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This section is effective the day following final enactment.

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Sec. 2.

Minnesota Statutes 2024, section 256B.4914, subdivision 6, is amended to read:

Subd. 6.

Residential support services; generally.

(a) For purposes of this section,

residential support services includes 24-hour customized living services, community

residential services, customized living services, and integrated community supports.
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This

paragraph expires on the effective date of paragraph (b).
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(b) Effective January 1, 2027, or upon federal approval, whichever is later, for purposes

of this section, residential support services includes 24-hour customized living services,

community residential services, customized living services, integrated community supports,

and family residential services.

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(b)
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(c)
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A unit of service for residential support services is a day. Any portion of any

calendar day, within allowable Medicaid rules, where an individual spends time in a

residential setting is billable as a day. The number of days authorized for all individuals

enrolling in residential support services must include every day that services start and end.

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(c)
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(d)
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When the available shared staffing hours in a residential setting are insufficient

to meet the needs of an individual who enrolled in residential support services after January

1, 2014, then individual staffing hours shall be used.

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EFFECTIVE DATE.

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This section is effective the day following final enactment.

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Sec. 3.

Minnesota Statutes 2024, section 256B.4914, is amended by adding a subdivision

to read:

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Subd. 6e.

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Family residential services; component values and calculation of payment

rates.

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(a) Effective January 1, 2027, or upon federal approval, component values for family

residential services are:

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(1) competitive workforce factor: 6.7 percent;

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(2) supervisory span of control ratio: 11 percent;

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(3) employee vacation, sick, and training allowance ratio: 8.71 percent;

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(4) employee-related cost ratio: 23.6 percent;

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(5) general administrative support ratio: 3.3 percent;

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(6) program-related expense ratio: 1.3 percent; and

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(7) absence factor: 1.7 percent.

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(b) Payments for family residential services must be calculated as follows:

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(1) determine the number of shared direct staffing and individual direct staffing hours

to meet a recipient's needs provided on site or through monitoring technology;

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(2) determine the appropriate hourly staff wage rates derived by the commissioner as

provided in subdivisions 5 and 5a;

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(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;

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(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);

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(5) multiply the number of shared direct staffing and individual direct staffing hours

provided on site or through monitoring technology and nursing hours by the appropriate

staff wages;

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(6) multiply the number of shared direct staffing and individual direct staffing hours

provided on site or through monitoring technology and nursing hours by the product of the

supervisory span of control ratio and the appropriate supervisory staff wage in subdivision

5a, clause (1);

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(7) combine the results of clauses (5) and (6), excluding any shared direct staffing and

individual direct staffing hours provided through monitoring technology, and multiply the

result by one plus the employee vacation, sick, and training allowance ratio. This is defined

as the direct staffing cost;

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(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared

and individual direct staffing hours provided through monitoring technology, by one plus

the employee-related cost ratio;

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(9) for client programming and supports, add $2,260.21 divided by 365. The

commissioner shall update the amount in this clause as specified in subdivision 5b;

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(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided

by 365 if customized for adapted transport, based on the resident with the highest assessed

need. The commissioner shall update the amounts in this clause as specified in subdivision

5b;

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(11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing

and individual direct staffing hours provided through monitoring technology that was

excluded in clause (8);

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(12) sum the standard general administrative support ratio, the program-related expense

ratio, and the absence and utilization factor ratio;

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(13) divide the result of clause (11) by one minus the result of clause (12). This is the

total payment rate; and

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(14) adjust the result of clause (13) by a factor to be determined by the commissioner

to adjust for regional differences in the cost of providing services.

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EFFECTIVE DATE.

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This section is effective the day following final enactment.

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Sec. 4.

Minnesota Statutes 2024, section 256B.4914, subdivision 19, is amended to read:

Subd. 19.

Payments for family residential and life sharing services.

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(a)
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The

commissioner shall establish rates for family residential services and life sharing services

based on a person's assessed need, as described in the federally-approved waiver plans.

Rates for life sharing services must be ten percent higher than the corresponding family

residential services rate.
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This paragraph expires on the effective date of paragraph (b).
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(b) Effective January 1, 2027, or upon federal approval, whichever is later, the

commissioner shall establish rates for life sharing services based on a person's assessed

need, as described in the federally approved waiver plans.

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EFFECTIVE DATE.

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This section is effective the day following final enactment.

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