2023 Minnesota Statutes › Chapters 245 - 267 — Public Welfare And Related Activities › Chapter 256S — Medical Assistance Elderly Waiver › Section 256S.205 — Customized Living Services; Disproportionate Share Rate Adjustments.

256S.205 CUSTOMIZED LIVING SERVICES; DISPROPORTIONATE SHARE RATE ADJUSTMENTS.
Subdivision 1.
Definitions.
(a) For the purposes of this section, the terms in this subdivision have the meanings given.
(b) "Application year" means a year in which a facility submits an application for designation as a disproportionate share facility.
(c) "Customized living resident" means a resident of a facility who is receiving either 24-hour customized living services or customized living services authorized under the elderly waiver, the brain injury waiver, or the community access for disability inclusion waiver.
(d) "Disproportionate share facility" means a facility designated by the commissioner under subdivision 4.
(e) "Facility" means either an assisted living facility licensed under chapter 144G or a setting that is exempt from assisted living licensure under section 144G.08, subdivision 7, clauses (10) to (13).
(f) "Rate year" means January 1 to December 31 of the year following an application year.
Subd. 2.
Rate adjustment application.
A facility may apply to the commissioner for designation as a disproportionate share facility. Applications must be submitted annually between September 1 and September 30. The applying facility must apply in a manner determined by the commissioner. The applying facility must document each of the following on the application:
(1) the number of customized living residents in the facility on September 1 of the application year, broken out by specific waiver program; and
(2) the total number of people residing in the facility on September 1 of the application year.
Subd. 3.
Rate adjustment eligibility criteria.
Only facilities satisfying all of the following conditions on September 1 of the application year are eligible for designation as a disproportionate share facility:
(1) at least 83.5 percent of the residents of the facility are customized living residents; and
(2) at least 70 percent of the customized living residents are elderly waiver participants.
Subd. 4.
Designation as a disproportionate share facility.
(a) By October 15 of each application year, the commissioner must designate as a disproportionate share facility a facility that complies with the application requirements of subdivision 2 and meets the eligibility criteria of subdivision 3.
(b) An annual designation is effective for one rate year.
Subd. 5.
Rate adjustment; rate floor.
(a) Notwithstanding the 24-hour customized living monthly service rate limits under section 256S.202, subdivision 2, and the component service rates established under section 256S.201, subdivision 4, the commissioner must establish a rate floor equal to $119 per resident per day for 24-hour customized living services provided to an elderly waiver participant in a designated disproportionate share facility.
(b) The commissioner must apply the rate floor to the services described in paragraph (a) provided during the rate year.
(c) The commissioner must adjust the rate floor by the same amount and at the same time as any adjustment to the 24-hour customized living monthly service rate limits under section 256S.202, subdivision 2.
(d) The commissioner shall not implement the rate floor under this section if the customized living rates established under sections 256S.21 to 256S.215 will be implemented at 100 percent on January 1 of the year following an application year.
Subd. 6.
Budget cap disregard.
The value of the rate adjustment under this section must not be included in an elderly waiver client's monthly case mix budget cap.
History:
1Sp2021 c 7 art 13 s 62; 2022 c 98 art 7 s 31
NOTE:
The amendment to this section by Laws 2022, chapter 98, article 7, section 31, applies to services provided on or after January 1, 2023.