HF3666

Purpose

• Reform how home and community-based services (HCBS) waiver case management works, with a focus on clearer roles, accountability, and quality.
• Create a structure for evaluating and improving waiver case management through a quality working group and required reporting.
• Align case management with person-centered planning and culturally responsive practices, and tighten rules around who can provide case management.

Main provisions

• Case management responsibility and activities

  • Every HCBS waiver recipient must get case management from qualified vendors as described in the federal waiver application.
  • Case management activities include:
  • Developing the person-centered support plan.
  • Informing the person (or guardian/parent if the person is a minor) about all service options under the waiver.
  • Consulting with relevant medical experts or service providers.
  • Helping identify potential service providers, including providers in nondisability-specific settings, employment service providers, settings not controlled by a provider, and providers of financial management services.
  • Assisting access to services and appeals processes.
  • Coordinating services if another provider does not provide coordination.
  • Evaluating and monitoring services, including at least one annual in-person visit with the person.
  • Reviewing the support plan and recommending service authorization based on needs.
  • Assisting and cooperating with facilities licensed under applicable rules.
  • For recipients with developmental disabilities, case management must be provided directly by county agencies or under contract.

• County contracting, oversight, and procurement

  • If a county contracts for case management, they must share grievance contact information with recipients.
  • Counties using contracted case management must use a competitive proposal process at least every two years.
  • Contracts must include oversight to ensure high-quality services.
  • The competitive process must ensure the program is culturally responsive and meets the needs of the county’s population.
  • A “culturally responsive program” must be effective, equitable, comprehensive, respectful, and responsive to language, culture, health literacy, and other needs of individuals sharing a language, racial/ethnic, or social background.

• Future contracting and provider requirements

  • Beginning July 1, 2029, a county agency may not enter into new contracts or renew existing contracts for case management services.
  • Case management services must be provided by a public or private agency enrolled as a medical assistance (MA) provider that meets all federal waiver requirements.
  • Private agencies with a financial interest in other services in the recipient’s plan are not allowed to provide case management.

• Case manager roles and collaboration

  • Case managers are responsible for the listed case management activities (a and b).
  • Case managers must collaborate with consumers, families, legal representatives, and relevant medical experts and service providers in developing and annually reviewing the person-centered support plan and habilitation plan.

• Positive Support Transition Plan (PSTP)

  • For persons needing a PSTP, the case manager must participate in the plan’s development and ongoing evaluation with the expanded support team.
  • At least quarterly, the case manager and expanded team evaluate plan effectiveness using data from the licensed provider.
  • The evaluation must show progress toward phasing out prohibited procedures, acquiring necessary skills, meeting timelines, and achieving outcomes.
  • If progress is not adequate, the case manager must work with the expanded team to modify the plan or obtain additional professional support.

• Education, training, and competency

  • The Department of Human Services (DHS) will provide ongoing education for case managers.
  • Case managers must receive at least 20 hours of case management education and disability-related training each year.
  • Training topics include: service authorization, person-centered planning, informed choice and decision making, cultural competency, employment planning, community living planning, self-direction options, and use of technology supports.
  • Case managers must annually complete an informed choice curriculum and pass a competency evaluation on informed decision making.
  • By August 1, 2024, all case managers must complete an employment support training course identified by DHS.
  • For case managers hired after August 1, 2024, this training must be completed within the first six months of providing case management services.

• Definitions and documentation

  • “Person-centered planning” has the meaning given in Minnesota statute for person-centered planning.
  • Case managers must document completion of training in a system identified by the commissioner.

Significant changes to existing law

• Shifts primary case management delivery to county agencies or MA-enrolled providers and tightens conflict-of-interest rules (no private agency with a financial stake in other plan services can provide case management).
• Introduces a mandatory, recurring competitive procurement process every two years for contracted case management and requires strong oversight to ensure culturally responsive services.
• Establishes a measurable quarterly evaluation framework for PSTPs and overall case management effectiveness, including explicit timelines and outcomes.
• Creates a mandatory, extended education and training regime for case managers, including a defined employment supports component and an annual “informed choice” competency requirement.

Timeline and key deadlines

• July 1, 2029: Counties may not enter into new contracts or renew contracts for case management services (a major transition point toward public/MA-enrolled providers).
• August 1, 2024: All case managers must complete an employment supports training course (for those hired before this date, the requirement applies to prior training; new hires after this date must complete within six months).
• Ongoing: DHS to provide ongoing case management education; at least 20 hours of training per year; quarterly PSTP plan evaluations; annual face-to-face visit requirement for case management.

Oversight and reporting

• Establishes a waiver case management quality working group responsible for reporting on case management quality (specifics to be defined in implementing rules and reports).
• Requires oversight provisions in contracts to ensure high-quality case management services.
• Requires grievance processes enabling recipients to report quality concerns to the county agency.

Definitions and terminology to note

• Home and community-based services (HCBS)
• Case management and case manager
• Waiver case management
• Qualified vendors; MA (medical assistance) provider enrollment
• Person-centered planning; person-centered support plan
• Expanded support team; PSTP (positive support transition plan)
• Prohibited procedures
• Culturally responsive program
• Informed choice and informed decision making
• Competitive proposal/procurement process
• Grievance process
• Lead agency (as referenced in related statute)
• Federal waiver plans; sections cited (e.g., 256B.092, 256B.49)

Potential impacts on recipients

• Greater emphasis on standardized, quality-driven case management and clearer accountability.
• Increased involvement of county agencies and MA-enrolled providers, with stronger safeguards against conflicts of interest.
• A major transition date of 2029 could shift provider arrangements and require adaptation for counties and providers.
• More consistent, culturally responsive services and enhanced training for case managers.

Relevant Terms -HCBS, case management, waiver case management, qualified vendors, person-centered support plan, expanded support team, positive support transition plan, prohibited procedures, culturally responsive program, informed choice, informed decision making, employment planning, community living planning, self-direction, competitive proposal, grievance, MA provider, lead agency, 256B.092, 256B.49, 256S.07, Section 144G, PSTP, person-centered planning.