WeVote
Log In

Bill

Bill

SF 5019

Human services provisions modification

2025-2026 Regular Session Introduced by Melissa Wiklund

Minnesota SF 5019 introduces sliding-scale parental contributions for long-term care and home-and-community waivers, effective 1/1/2027, based on adjusted gross income and househol

Referred to Health and Human Services
#healthandhealthdepartment #humanservicesandhumanservicesdepartment
0
WeVote Research Nonpartisan
Bill Summary · SF 5019

Summary of SF 5019 (2025-2026) – Minnesota

Title: Human services provisions modification

Jurisdiction: Minnesota Senate

Author: Sen. Wiklund

Status: Referred to Health and Human Services (as of 4/9/2026)

Purpose (overall): The bill amends a broad set of human services provisions, with a focus on aging and health care, behavioral health, housing, licensing, program integrity, mental health licensing, background studies, and forecasted program appropriations. It introduces new definitions, procedures, and cost-sharing structures, and aligns several statutes with federal requirements and ongoing program integrity efforts. Many changes are effective January 1, 2027, with some provisions tied to specific federal triggers or phased in over time.

Key Provisions and Changes

  • Health Care Records and Access (Sec. 1)

    • Revisions to cost rules for providing copies of patient records.
    • Providers may charge specified fees for paper, electronic, and x-ray copies, with caps.
    • Special exemptions for record requests related to Social Security disability appeals and certain public assistance scenarios.
    • Up to two updates to medical records may be provided without charge for appeals purposes.
    • Certain exemptions apply to public/legal aid contexts; explicit conditions for when fees do not apply.

  • Adult and Child Mental Health Case Management (Secs. 2–4)

    • Coordination requirements between case managers and community support services.
    • Minimum monthly in-person or video contact with documented core service components for adult mental health targeted case management (at least one documented contact per period, not by telephone alone for more than two consecutive months).
    • Similar coordination and contact requirements for family/child community support services.

  • Case Management Contact Definition (Sec. 4)

    • Adds a formal definition of “Case management contact” including in-person, interactive video, or telephone contacts with applicable parties for minors and adults.

  • Parental Financial Contributions for Children's Services (Secs. 5–9, 12–15)

    • Introduces a sliding-scale parental contribution for certain long-term care and home-and-community-based waivers, effective 1/1/2027.
    • Defines income (adjusted gross income, with home equity considerations) and contribution rates by tier:
    • For higher-income households, contributions range from roughly 4.5% to 7.49% of adjusted gross income, with adjustments for household size and certain exemptions.
    • Caps and adjustments:
    • Allows reductions for household adjustments, special needs, and shared custody scenarios (e.g., court-ordered payments deducted before calculating contributions).
    • Requires annual adjustments tied to federal poverty guidelines.
    • Written explanations and appeals:
    • The commissioner must explain contributions in writing at eligibility determination and provide for redetermination/appeal rights.
    • Reimbursement of any overpayment and tax notice considerations included.
    • Enforcement and enforcement-related provisions:
    • Civil actions by Attorney General or county attorneys to recover reimbursements as needed.
    • Order of payment directs proceeds to the applicable accounts.

  • Health Care Eligibility Oversight (Sec. 19)

    • Creates a Health Care Eligibility Oversight Unit to ensure consistent Medicaid eligibility processing across regions.
    • Unit monitors compliance, provides guidance, and supports corrective action planning.

  • Hospital Assessments and Directed Payments (Secs. 20–21)

    • Establishes hospital assessments for the directed payment program (as part of 256B.1974), with annual amounts defined by days and net outpatient revenue.
    • Data-driven method for 2026–2027 using cost reports from prior years; ongoing assessments for subsequent years based on most recent cost reports.
    • Allows adjustments to comply with federal law and to maintain consistent funding levels.
    • Discounts applied to inpatient and outpatient portions for certain hospitals; special considerations for large hospitals and those with significant MA impact.
    • Provisions for invoicing, payment schedules, and handling of mergers, deficiencies, or overpayments.

  • Medical Assistance Residency and Citizenship (Secs. 23–31)

    • Adjustments to residency rules and handling of absences from the state for MA eligibility; treatment of services when a recipient is absent but deemed a Minnesota resident.
    • Changes to long-term care home equity limits (increasing to $1,000,000 effective 1/1/2028) and related hardship waivers.
    • Revisions to asset transfer rules, spend-down options, and periodic renewal considerations.
    • Strengthened disenrollment processes and data matching with stronger protections and timeframes (with exemptions and appeal rights).

  • Work or Community Engagement for MA Eligibility (Sec. 29)

    • Adds a work/community engagement requirement for MA eligibility under section 256B.055, subdivision 15, with exemptions and short-term hardship exceptions.
    • Defines acceptable forms of engagement (work, community service, education, minimum wage-based income calculations, etc.) and enumerates exemptions (e.g., American Indian/Alaska Native, veterans with disability, medical frailty, SNAP participants, incarceration, etc.).
    • Allows expedited rulemaking for implementing this section and sets an 18-month non-application rulemaking clock.

  • Other Provisions

    • Residency and auto-renewal provisions (Sec. 27–28) for MA eligibility data matching and renewals, including six-month reinvestment or exemption cycles for certain populations.
    • Provisions related to cost-sharing and deductibles (Sec. 34) with phased effective date (October 1, 2028) for certain MA populations above 100% FPL.
    • Various conforming amendments to 2024/2025 Minnesota Statutes and supplements to align with the new requirements.

Effective Dates and Implementation

  • Many sections become effective January 1, 2027 (Secs. 5–15, 18–19, 23–34, in various subsections).
  • Some sections hinge on federal approvals or specific triggers (e.g., Section 20, hospital assessment, contingent on applicable laws becoming effective).
  • Certain long-term care provisions (home equity cap, income-based contributions) have phased increases, with a notable increase in the home equity limit to $1,000,000 effective January 1, 2028.

Who Would Be Affected

  • Medical assistance (MA) enrollees, including children and adults, particularly those with long-term care needs or disabilities.
  • Parents/c guardians responsible for child MA costs and parental contributions.
  • Hospitals, particularly those in the hospital-directed payment programs, and their financing via assessments.
  • Lead agencies and county-based agencies implementing MA eligibility, renewals, and data matching.
  • Mental health providers and families receiving mental health case management services.
  • Individuals subject to work/community engagement requirements for MA eligibility.

Procedural/Timeline Aspects

  • Revisions require ongoing monthly or annual processes (case management contacts, monthly MA renewals, annual data matching, quarterly hospital assessments).
  • Appeals processes for parental contributions and MA eligibility decisions are codified, with specified timelines.
  • Establishment of new oversight unit to standardize eligibility processing.
  • Expansions to cost-sharing and assets are staged, with phased effective dates through 2028.

Notes

  • The bill is comprehensive and alters numerous program rules, funding streams, and eligibility criteria. Readers should reference the specific statute sections for exact language and transition rules.

Compiled from official sources — confirm details with the bill’s official record.

Sign in to ask a question.