Purpose

• This bill updates Minnesota law to clarify how community first services and supports (CFSS) can be provided when multiple recipients share a single personal care assistant.
• It creates rules for shared services, requires wage increases for staff involved in shared services, and updates definitions and payment structures to reflect these shared arrangements.
• The goal is to maintain health and safety while expanding options for delivering CFSS.

Key Provisions (What the bill does)

• Defines and governs shared services for CFSS as two or three recipients receiving care from one personal care assistant at the same time and in the same setting.
• Requires daily documentation of personal care assistance (PCA) on a time sheet approved by the commissioner, with options for web-based, electronic, or paper formats.
• Establishes when and how shared services may be authorized, including recipient consent and professional oversight, and ensures the total hours for an individual recipient aren’t reduced.
• Requires a qualified professional to evaluate the shared setting, visit at least every six months, monitor effectiveness, and develop contingency plans for absences.
• Sets wage and wage-related cost expectations to fund shared services, and limits how the additional revenue can be used (primarily for wages and related costs; not for mileage, certain insurance, or non-wage benefits).
• Creates rate caps for shared services: for two recipients, the rate cannot exceed 1.5 times the single-recipient rate; for three recipients, up to 2 times the single-recipient rate.
• Requires agency providers to offer shared services as an option, with the choice staying with the recipient or representative, and allows withdrawal from shared services at any time.
• Adds training requirements for PCA staff in shared settings and requires documentation of training.
• Introduces passthrough and budget-savings concepts to fund shared services, including how funds are allocated to wages and related costs.

Shared Services Details

• What counts as a shared service: two or three eligible CFSS recipients receiving PCA services at the same time and in the same location.
• Settings for shared services: homes, foster care, child care programs, and certain school or district-operated facilities.
• Roles involved: recipients or their representatives (assessing and approving), a PCA, an assessor, and a qualified professional who oversees the arrangement.
• Oversight: the qualified professional must evaluate capability, observe the shared setting, and ensure ongoing suitability; a contingency plan is created for illness or other interruptions.

Payment and Rates

• Additional revenue: the difference between the rate for a single recipient and the rate for shared services.
• Wage-related costs: include higher wages, payroll taxes, unemployment taxes, workers’ compensation, and retirement contributions tied to wages.
• Rate caps:
  • Two recipients: shared services rate ≤ 1.5 × single-recipient rate.
  • Three recipients: shared services rate ≤ 2.0 × single-recipient rate.
• Use of funds: agency providers must allocate most of the shared-services revenue to wages and wage-related costs; cannot use shared-services revenue for mileage, uniform allowances, or certain non-wage benefits.
• Passthrough and budget-savings concepts: specify how much of the additional revenue or budget savings must be directed to wages and related costs, with some portions reserved for particular purposes.

Administration and Oversight

• Authorization: the commissioner determines when shared services are appropriate for meeting all participants’ needs and maintaining health and safety, and this decision is included in the CFSS authorization process.
• Participant choice: participants or their representatives can choose shared services, one-on-one services, or a mix, and may switch or withdraw.
• Documentation: requires comprehensive time-tracking details (including provider and recipient information, dates, times, signatures, hospital stays, travel, and shared-service specifics).
• Training and background checks: agencies must ensure staff training and complete background studies for personal care assistants and qualified professionals.
• Professional visits: a qualified professional must visit the shared setting at least every six months or as needed, and monitor effectiveness.

CFSS Coverage Changes

• Expands CFSS covered services to include:
  • ADLs and IADLs with hands-on help or cueing.
  • Skills training to maintain or improve daily living activities.
  • Environmental modifications and assistive technology.
  • Observation/behavior guidance and backup systems to ensure continuity of services.
  • Swimming lessons for participants under age 12 if needed for safety.
  • Services provided by authorized consultants and family management services (FMS) providers.
  • Shared services as described, including those provided by a parent, stepparent, guardian, or spouse in certain cases.
• Maintains service delivery coverage while incorporating shared-service options and related requirements.
• Adds definitions and cross-references to support the shared-service framework (including how “additional revenue” and “budget savings” are calculated and used).

Effects and Practical Implications

• For recipients: more flexibility to share a PCA with others, potentially increasing access to services and allowing more efficient use of staff time, while preserving health and safety.
• For agencies and providers: new rate structures and reporting requirements, plus a stronger emphasis on wages and staff training to support shared arrangements.
• For the state: updated statutes to codify shared-service options, oversight, and funding mechanics; includes a reorganization/renumbering step to align definitions.

Significant Changes to Existing Law

• Adds substantial provisions for shared CFSS, including a formal rate system, passthrough and budget-savings models, and enhanced documentation and oversight.
• Expands and renumbers CFSS definitions and related terms.
• Introduces agency-provider and budget models for shared services, with specific requirements on how funds may be used and how services are delivered.
• Requires revisor actions to renumber and reorganize related definitions in the statutes.

Relevant Terms - CFSS (Community First Services and Supports) - shared services - two recipients - three recipients - personal care assistant (PCA) - personal care assistance services (PCAS) - qualified professional - assessor - agency-provider model - budget model - additional revenue - wages and wage-related costs - rate system - passthrough - contingency plan - time sheet - documentation - health and safety - activities of daily living (ADLs) - instrumental activities of daily living (IADLs) - environmental modifications - assistive technology - FMS provider - CFSS service delivery plan - authorization - crossreferences - renumbering

(Note: Some values and percentages are indicated as placeholders in the text; the final law may specify exact percentages or figures.)