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S.F. No. 1062 - Modifying the Disability Waiver System - the First Engrossment
Author: Senator John A. Hoffman
Prepared By: Liam Monahan, Senate Analyst (651/296-1791)
Date: April 15, 2015


SF 1062 modifies the disability waiver system by:

  1. altering procedures to prevent overspend of available funding for disability waiver services;
  2. creating procedures to prevent underspending of available funding for disability waiver services;
  3. reviving and expanding reporting requirements that expired in 2013;
  4. creating a Home and Community-Based Waiver Services Reserve Fund; and
  5. modifying various components of the payment rates for certain services, strengthening the rate setting training requirements for employees of lead agencies, expanding required analysis and reporting by the commissioner, and modifying the procedures governing the approval of alternative payment plans for individuals with exceptional needs.

Section 1 (256B.0916, subdivision 2) adds language clarifying that the commissioner must manage developmental disability (DD) waiver allocations in a manner that will maximize the use of all available waiver funding.

Section 2 (256B.0916, subdivision 4) sets an expiration date for the allowed reserves allowed under the DD waiver.

Section 3 (256B.0916, subdivision 7a) revives and expands the requirement that the commissioner issue an annual report on county and state use of available DD waiver funds.

Section 4 (256B.0916, subdivision 11) modifies the existing provisions governing the consequences for lead agencies if they overspend their DD waiver allocation.  Under the proposed language, if a lead agency over spends its allocation for DD waiver services, it must submit a corrective action plan for approval.  The lead agency will have 2 years to successfully implement the plan.  If the agency fails to comply with its approved action plan, then the commissioner may assume or reassign the agency’s responsibility to spend DD waiver funds or the commissioner may recoup spending in excess of the allocation to the agency, but only if the statewide appropriation dedicated to DD waiver services is overspent.

Section 5 (256B.0916, subdivision 12) introduces new language to control underspending of DD waiver funds. Depending on the extent of the underspending, a lead agency that underspends it allocation must either explain to the commissioner why the underspending occurred or submit a corrective action plan for approval.

Section 6 (256B.49, subdivision 26) applies to over-authorizations under the community alternatives for disabled individuals (CADI), community alternative care (CAC), and brain injury (BI) waivers provisions similar to the overspending provisions under the DD waiver.

Section 7 (256B.49, subdivision 27) applies to underauthorizations under the CADI, CAC and BI waivers provisions similar to the underspending provisions under the DD waiver.

Section 8 (256B.49, subdivision 28) creates a reporting requirement for CADI, CAC, and BI waiver funding utilization similar to the reporting requirement for DD waiver funding.

Section 9 [256B.4911] creates the Home and Community-based Waiver Services Reserve Account in the general fund.  At the end of each biennium, any unspent portion of the medical assistance appropriation dedicated to disability waiver services is deposited in the reserve account.  The language provides a method of estimating how much of the unspent appropriation can be attributed to each lead agency. During each biennium, the funds in the reserve account may be distributed to lead agencies to off-set costs arising from crises or unmet needs of current wavier recipients.  At the end of each biennium, if the balance of the fund exceeds five percent of the appropriation dedicated to waiver services in the subsequent biennium, then the excess amount may to transferred out of the reserve account, but only to either off-set any overspending of the appropriation dedicated to waiver services or supplement the appropriation dedicated for waiver services.

Section 10 (Section 256B.4913, subdivision 4a) creates a rate adjustment moratorium during the 12-month period following the end of the banding period.

Section 11 (Section 256B.4913, subdivision 5) increases the training of and resources available to county personnel responsible for administering the rate setting framework so that the framework is properly implemented.

Section 12 (Section 256B.4914, subdivision 2) strikes the definition of shared staffing and adds a definition by cross reference for person-centered staffing environment.

Section 13 (Section 256B.4914, subdivision 7) adjusts components of the payment rate for day programs.

Section 14 (Section 256B.4914, subdivision 8) adjusts components of the payment rate for unit-based services with programming.

Section 15 (Section 256B.4914, subdivision 10) expands the range of providers the costs of whom the commissioner must research and analyze. Section 15 also requires the commissioner to consult with specified stakeholders when developing person-centered staffing environments.

Section 16 (Section 256B.4914, subdivision 14) makes extensive revisions to the procedures and policies governing the approval of alternative payment plans for individuals with exceptional needs.

Section 17 (Section 256B.4914, subdivision 15) strikes language that provided for an alternative policy with respect to overspending during the first two years of implementation of the new rate-setting framework.  The new language inserts a cross-reference to the relevant under and overspending or under and over-authorization provisions found earlier in the bill.

Section 18 (Section 256B.4914, subdivision 16) changes the budget neutrality adjustment for unit-based services with programs and requires the commissioner to report annually during the banding period on the comparison of estimated spending for all home and community-based waiver services under the new rate setting framework and the estimated spending on the same recipients and services under the old payment system.


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