Payments for residential support services.

(a) deleted text begin Payments for residential support services, as defined in sections 256B.092, subdivision 11 , and 256B.49 , subdivision 22, must be calculated as follows: deleted text end new text begin For purposes of this subdivision, residential support services includes 24-hour customized living services, community residential services, customized living services, family residential services, foster care services, integrated community supports, and supportive living services daily. new text end

new text begin (b) Payments for community residential services, corporate foster care services, corporate supportive living services daily, family residential services, and family foster care services must be calculated as follows: new text end

(1) determine the number of shared staffing and individual direct staff hours to meet a recipient's needs provided on site or through monitoring technology;

(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 5 deleted text begin . This is defined as the direct-care rate deleted text end ;

new text begin (3) except for subdivision 5, paragraph (a), clauses (4) and (21) to (23), multiply the result of clause (2) by the product of one plus the competitive workforce factor in subdivision 5, paragraph (b), clause (1); new text end

deleted text begin (3) deleted text end new text begin (4) new text end for a recipient requiring customization for deaf and hard-of-hearing language accessibility under subdivision 12, add the customization rate provided in subdivision 12 to the result of clause deleted text begin (2) deleted text end new text begin (3) new text end deleted text begin . This is defined as the customized direct-care rate deleted text end ;

deleted text begin (4) deleted text end new text begin (5) new text end multiply the number of shared and individual direct staff hours provided on site or through monitoring technology and nursing hours by the appropriate staff wages deleted text begin in subdivision 5, paragraph (a), or the customized direct-care rate deleted text end ;

deleted text begin (5) deleted text end new text begin (6) new text end multiply the number of shared and individual direct staff hours provided on site or through monitoring technology and nursing hours by the product of the supervision span of control ratio in subdivision 5, paragraph (b), clause deleted text begin (1) deleted text end new text begin (2) new text end , and the appropriate supervision wage in subdivision 5, paragraph (a), clause (21);

deleted text begin (6) deleted text end new text begin (7) new text end combine the results of clauses deleted text begin (4) and deleted text end (5) new text begin and (6) new text end , excluding any shared and individual direct staff hours provided through monitoring technology, and multiply the result by one plus the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (b), clause deleted text begin (2) deleted text end new text begin (3) new text end . This is defined as the direct staffing cost;

deleted text begin (7) deleted text end new text begin (8) new text end for employee-related expenses, multiply the direct staffing cost, excluding any shared and individual direct staff hours provided through monitoring technology, by one plus the employee-related cost ratio in subdivision 5, paragraph (b), clause deleted text begin (3) deleted text end new text begin (4) new text end ;

deleted text begin (8) deleted text end new text begin (9) new text end for client programming and supports, the commissioner shall add $2,179; and

deleted text begin (9) deleted text end new text begin (10) new text end for transportation, if provided, the commissioner shall add $1,680, or $3,000 if customized for adapted transport, based on the resident with the highest assessed need.

deleted text begin (b) deleted text end new text begin (c) new text end The total rate must be calculated using the following steps:

(1) subtotal paragraph deleted text begin (a) deleted text end new text begin (b) new text end , clauses deleted text begin (7) to (9) deleted text end new text begin (8) to (10) new text end , and the direct staffing cost of any shared and individual direct staff hours provided through monitoring technology that was excluded in clause deleted text begin (7) deleted text end new text begin (8) new text end ;

(2) sum the standard general and administrative rate, the program-related expense ratio, and the absence and utilization ratio;

(3) divide the result of clause (1) by one minus the result of clause (2). This is the total payment amount; and

(4) adjust the result of clause (3) by a factor to be determined by the commissioner to adjust for regional differences in the cost of providing services.

deleted text begin (c) deleted text end new text begin (d) new text end The payment methodology for customized living, 24-hour customized living, and residential care services must be the customized living tool. Revisions to the customized living tool must be made to reflect the services and activities unique to disability-related recipient needs.

new text begin (e) Payments for integrated community support services must be calculated as follows: new text end

new text begin (1) the base shared staffing shall be eight hours divided by the number of people receiving support in the integrated community support setting; new text end

new text begin (2) the individual staffing hours shall be the average number of direct support hours provided directly to the service recipient; new text end

new text begin (3) the personnel hourly wage rate must be based on the most recent Bureau of Labor Statistics Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 5; new text end

new text begin (4) except for subdivision 5, paragraph (a), clauses (4) and (21) to (23), multiply the result of clause (3) by the product of one plus the competitive workforce factor in subdivision 5, paragraph (b), clause (1); new text end

new text begin (5) for a recipient requiring customization for deaf and hard-of-hearing language accessibility under subdivision 12, add the customization rate provided in subdivision 12 to the result of clause (4); new text end

new text begin (6) multiply the number of shared and individual direct staff hours in clauses (1) and (2) by the appropriate staff wages; new text end

new text begin (7) multiply the number of shared and individual direct staff hours in clauses (1) and (2) by the product of the supervisory span of control ratio in subdivision 5, paragraph (b), clause (2), and the appropriate supervisory wage in subdivision 5, paragraph (a), clause (21); new text end

new text begin (8) combine the results of clauses (6) and (7) and multiply the result by one plus the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (b), clause (3). This is defined as the direct staffing cost; new text end

new text begin (9) for employee-related expenses, multiply the direct staffing cost by one plus the employee-related cost ratio in subdivision 5, paragraph (b), clause (4); and new text end

new text begin (10) for client programming and supports, the commissioner shall add $2,260.21 divided by 365. new text end

new text begin (f) The total rate must be calculated as follows: new text end

new text begin (1) add the results of paragraph (e), clauses (9) and (10); new text end

new text begin (2) add the standard general and administrative rate, the program-related expense ratio, and the absence and utilization factor ratio; new text end

new text begin (3) divide the result of clause (1) by one minus the result of clause (2). This is the total payment amount; and new text end

new text begin (4) adjust the result of clause (3) by a factor to be determined by the commissioner to adjust for regional differences in the cost of providing services. new text end

new text begin (g) The payment methodology for customized living and 24-hour customized living services must be the customized living tool. The commissioner shall revise the customized living tool to reflect the services and activities unique to disability-related recipient needs and adjust for regional differences in the cost of providing services. new text end

deleted text begin (d) For individuals enrolled prior to January 1, 2014, the days of service authorized must meet or exceed the days of service used to convert service agreements in effect on December 1, 2013, and must not result in a reduction in spending or service utilization due to conversion during the implementation period under section 256B.4913, subdivision 4a . If during the implementation period, an individual's historical rate, including adjustments required under section 256B.4913, subdivision 4a , paragraph (c), is equal to or greater than the rate determined in this subdivision, the number of days authorized for the individual is 365. deleted text end

deleted text begin (e) deleted text end new text begin (h) new text end The number of days authorized for all individuals enrolling deleted text begin after January 1, 2014, deleted text end in residential services must include every day that services start and end.