Human services policy changes

The 2024 human services policy law modifies existing statutes and ushers in new legislation related to disability services; deaf, deafblind, and hard-of-hearing services; aging services; and substance use disorder services.

It also guarantees people with disabilities get to stay in their communities while they live in group homes, provides for increased transparency in nursing home-related party transactions, modifies behavioral health licensing and eligibility, ensures opioid treatment programs are responsive to workforce shortages and availability of counselors, modifies sober home requirements, and prohibits the classification or treatment of recovery peers as independent contractors.

Sponsored by Rep. Peter Fischer (DFL-Maplewood) and Sen. John Hoffman (DFL-Champlin), the law takes effect Aug. 1, 2024, unless otherwise noted.

HF4392/SF4399*/CH108

Disability services

For individuals enrolled in the Medical Assistance for Employed Persons with Disabilities program, the law will require self-employed people to file and pay all applicable taxes and to report income or household size changes within 30 days. It also changes the eligibility review period by which the state determines premium amounts from every six months to every 12 months, and states increased premiums will not take effect until the subsequent 12-month review.

Provisions for assisted living facilities and residential homes for individuals with disabilities include:

• eliminating rental fees charged by any town, municipality, or county if the facility has six or fewer residents (effective May 18, 2024);

• changing the timeline by which the facility must complete client assessments, the type of planning meeting a facility must have with a new client to determine their daily needs and desired outcomes, the timeline by which the facility must develop that service plan, and the education and training requirements for designated coordinators who care for patients, and

• allowing staff under the age of 18 to administer medication.

Provisions for personal care assistants and Community First Services and Support providers include:

• prohibiting the enhanced reimbursement rate of 107.5% to be used for anything other than wages and wage-related costs, which may include any corresponding increase in the employer’s share of taxes and workers’ compensation premiums;

• allowing remote reassessments of clients/patients for two consecutive reassessments if followed by an in-person assessment;

• prohibiting the implementation of additional requirements that could delay a decision on, or implementation of, technology for individuals with developmental disabilities;

• allowing financial management service providers working with Community First Services and Support providers to forgo 30-day written notice before a proposed service termination when the participant’s conduct significantly alters the terms of the service delivery plan or creates an imminent harm risk to support workers and staff; and

• allowing support worker training and development services to be delivered to recipients with chronic health conditions or severely compromised immune systems via interactive telecommunications, except for start-of-services or new support worker training.

Deaf, deafblind, and hard-of-hearing services

The law will modernize the language of the Deaf and Hard-of-Hearing Services Act to rename it the Deaf, DeafBlind, and Hard-of-Hearing Services Act. Other changes include:

• changing the definitions of culturally affirmative, linguistically affirmative, deaf, hard-of-hearing, deafblind, interpreting services, and family and community intervener;

• requiring the Department of Human Services to provide grants for programs, services, and support for individuals who are deaf, deafblind, or hard-of-hearing in deafblind services, family services, interpreting services, and mental health services. Grants to organizations can be used for services and trainings, to develop and administer consumer-directed services, and to develop and provide trainings to counties and service providers on how to meet the needs of individuals who are deafblind;

• changing responsibilities of the Deaf, DeafBlind, and Hard-of-Hearing Services division in the Department of Human Services, to include employing qualified staff to work with individuals who are deaf, deafblind, or hard-of-hearing, and to provide individual culturally and linguistically affirmative assistance with service supports and solutions to individuals who are deaf, deafblind, or hard-of-hearing if adequate or accessible services are unavailable in the region;

• including parents of children who are deafblind on the deaf, deafblind, and hard-of-hearing state advisory committees, and defining that no committee member shall serve more than three consecutive terms and more than nine years;

• changing membership of the Commission of the Deaf, DeafBlind, and Hard-of-Hearing to 10 at-large members, with one member each from up to five advisory committees, further stating that at least 50% of the voting members must be deaf or deafblind or hard-of-hearing and at least one parent or guardian of a person who is deaf, deafblind, or hard-of-hearing must be included;

• defining ex-officio, nonvoting members of the Commission of the Deaf, DeafBlind, and Hard-of-Hearing and stating that the commission may appoint additional ex-officio members; and

• voting members of the commission are governor-appointed for a four-year term and until successors are appointed and qualified.

Aging services

The law will amend provisions for assisted living facilities, including:

• requiring any qualified, eligible person who wishes to be licensed as an assisted living director to apply within 30 days of hire, to have met standards set by the Board of Executives for Long Term Services and Supports, and to be licensed in Minnesota as a nursing home administrator or validated as a qualified health services executive by the National Association of Long-Term Care Administrator Board;

• requiring any assisted living director to receive 30 hours of continuing education every two years on relevant topics; and

• mandating that facilities make available to residents and others any plan of correction issued by the state, including actions taken to comply with correction orders. A paper version of the plan must be provided upon request to residents and others within 30 days.

The availability of long-term care counseling offered by Senior LinkAge Line will be broadened to include any person at a critical care transition, and hospitals will be required to refer older adults to such counseling.

Nursing facilities must provide to the state, no later than Feb. 1 of each year, their working trial balance, audited financial statements, and information if the licensee or general partner, director, or officer controls or owns 5% minimum in an organization that provides services, facilities, or supplies to the nursing facility.

Nursing homes will be mandated to report their lease, rent, land use, or other real property expenses annually to the state.

Substance use disorder services

New substance use disorder service provisions include:

• new recovery peers must be hired and treated as employees, not contractors, as of July 1, 2024, and existing recovery peers must not be classified or treated as independent contractors after Jan. 1, 2025;

• recovery community organizations must be certified or accredited by the Alliance for Recovery Centered Organizations, the Council on Accreditation of Peer Recovery Centered Organizations, or a relevant Minnesota organization identified by the state, by June 30, 2025;

• opioid treatment clients may receive take-home medicine on days the clinic is closed; and

• licensed facilities must ensure one full-time equivalent counselor for every 60 clients.

The law also specifies substance use disorder service base rates according to various service levels. For services offering opioid use disorder medication, rates will increase 20% over the rates in effect on Dec. 31, 2020, until the federal government approves rates established by state law in 2023.

Licensed treatment facilities will be required to provide opioid educational materials to their clients upon client enrollment, as opposed to when a client experiences a substance use disorder.

SF4399* / HF4392 / CH108