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S.F. No. 1315 - Payment Methodology for Home and Community-Based Services
 
Author: Senator John A. Hoffman
 
Prepared By:
 
Date: March 18, 2013



 

Section 1 (256B.4912, subdivision 2) adds a cross-reference to the new section of law created in Section 3.

Section 2 (256B.4912, subdivision 3) adds “staff compensation” and “staffing and supervisory patterns” to the list of items the home and community-based services (HCBS) waivers payment methodologies must address.

Section 3 (256B.4913) modifies the Payment Methodology Development section.

Subdivision 1 repeals the obsolete research period and rates subdivision.

Subdivision 1a applies the payment methodologies to the Community Alternative Care (CAC), Community Alternatives for Disabled Individuals (CADI), Developmental Disability (DD) and Brain Injury (BI) waivers.

Subdivision 1b establishes definitions applicable to this section.

Subdivision 1c lists the services under the CAC, CADI, DD and BI waivers applicable to the payment methodologies established in this section.

Subdivision 2 repeals the obsolete framework values subdivision.

Subdivision 3 repeals the obsolete data collection subdivision.

Subdivision 4 repeals the rate stabilization adjustment subdivision (replaced in subdivision 4a).

Subdivision 4a requires the Department of Human Services (DHS) to adjust, with certain exemptions, individual reimbursement rates by no more than one percent annually between calendar years 2014 and 2017, including rates for services in a recipient’s service plan approved prior to calendar 2014.

Subdivision 5 allows DHS to work with other groups, in addition to the existing stakeholder group, to assist in the implementation of the new rate payment system.

Subdivision 6 modifies the implementation of a new payment methodology and directs lead agencies to enter person-specific data into a rate management system developed by DHS. Requires all new services and renewed individual service plans to use the waiver rate system beginning January 1, 2014, and requires all data entered by December 31, 2014. Adjustments to lead agency budgets for HCBS waiver plans must be made by January 1, 2014.

Subdivision 7 requires DHS to determine a uniform payment methodology to meet the individual service plan for HCBS waiver recipients.

Subdivision 8 calculates the payment methodology for residential support services.

Describes how each the payment rate component is established; describes how the total payment rate is calculated; creates a base wage index for determining staffing costs; and lists the component values (i.e., employee vacation and sick allowance) of the payment rates.

Subdivision 9 calculates the payment methodology for day programs, including adult day care, day treatment and rehabilitation, prevocational services and structured day services.

Describes how each the payment rate component is established; creates a base wage index for determining staffing costs; and lists the component values (i.e., employee vacation and sick allowance) of the payment rates.

Subdivision 10 calculates the payment methodology for united-based with program services, including behavior programming, housing access coordination, in-home family support, independent living skills training, hourly supported living services, and supported employment.

Describes how each the payment rate component is established; creates a base wage index for determining staffing costs; and lists the component values (i.e., employee vacation and sick allowance) of the payment rates.

Subdivision 11 calculates the payment methodologies for unit-based without program services, including night supervision, personal support, respite and companion care.

Describes how each the payment rate component is established; creates a base wage index for determining staffing costs; and lists the component values (i.e., employee vacation and sick allowance) of the payment rates.

Subdivision 12 requires DHS to develop and implement uniform procedures to refine terms and update and adjust values used to calculate rate payments. DHS must work with stakeholders to evaluate the efficacy of the component values and payment rates, and report to the legislature with any proposed changes to the component rates and payment rates on February 15, 2014; additional reports are due biennially on each February 15 beginning in 2015 through 2021, when they are due every four years.

Subdivision 13 states that payment rates under the statewide payment methodology created in this section supersede rates established by county contracts for HCBS waivers.

Subdivision 14 requires transportation services to be cost-effective and limited to market rates when the mode is generally available and accessible.

Subdivision 15 creates an enhanced, customized rate for deaf or hard-of-hearing individuals of $2.70 per hour.

Subdivision 16 allows alternative payment rates for individuals with exceptional needs identified by lead agencies, with requests submitted to DHS; specifies the determination and request processes.

Subdivision 17 instructs DHS to calculate rates under both the new payment methodology created in the section and current law, and if forecasted spending under the new methodology is greater than the old methodology, DHS is to adjust the rate for each category accordingly for state fiscal year 2014 in order to maintain budget neutrality.

 
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