March 23, 2026 · Human Services · 14,115 words · 13 speakers · 365 segments
Foreign.
First up, we have Senate file 4726. Senator Bolden. Senator Bolden, it sounds like you have an A1 authors amendment.
Thank you, Madam Chair. Yes, I do.
All right.
Senator wickland moves the A1amendment. All those in favor say aye. I all those opposed? The amendment is adopted. Senator Bolden. Thank you, Madam Chair and committee members. Senate File 4726 is the DHS Behavioral
Health Policy bill covering both mental health
and substance use disorder treatment. Given this committee's jurisdictions, today's focus will
be on the SUD provisions.
This bill does not have a fiscal impact.
DHS has worked with providers and advocates
on this bill which focuses on three things. One, technical clarifications and statutory cleanup, Two, improving care delivery and three, strengthening program integrity. Christy Graham, director of state government relations, will walk through the bill and is
available to answer any questions.
Thank you, Ms. Graham.
Thank you, Madam Chair. For the record, my name is Christy Grom and I'm with the Department of Human Services. So I'll do a quick walkthrough. I'll talk a little bit about the amendment and just focus on those sections with an impact on this committee's jurisdiction. So in the amendment, there are some changes related to the tobacco education provision. I'll talk about those as I walk through the bill requiring documentation be kept by programs for that education. There is an effective date change on the treatment coordination education requirement. There was a provision that was meant to be included in the bill, but we inadvertently forgot to flag it for the revisor. So that's related to recovery, community organization, certification timelines. And then there's some cleanup that we're doing in the space of substance use disorders and the interplay there for those services with our 1115 waiver for those services. So I'll start with, and I will say there should be a summary and a bill index for members to look through if that's helpful. I'll start with the first chunk of changes in sections 2, 3, 4 and 7. And these are related to peer recovery services. Primarily these are cleanup changes. So this proposal addresses some issues that after we did. After we moved things around in 2024, I should say the legislature moved things around, not we. In 2024, there were some new statutes created and a lot more program integrity oversight for peer recovery services. So these provisions are just updating citations. There's a Change in section 4 and 7 limitations Removing language that limits supervision of peer recovery services to LADCs. I believe that is now expanded to include LADCs and mental health Professionals. And then in sections Moving to sections 5 and 11, these are the sections I alluded to earlier related to tobacco education. These were provisions that DHS worked on with the Lung Mind alliance and behavioral health programs are required to screen for tobacco use. But it's one of those items that is sometimes unrelated under addressed. So this language would explicitly require SUD facilities to provide tobacco and nicotine educational materials upon admission and programs. And that's the case for both SUD and mental health providers. And as I mentioned the authors amendment just adds the requirement for 245G or SUD programs that those programs and mental health providers actually document that the material was provided so that we can, we can make sure that that's occurring in our licensing check. We've worked on this with providers and we think that there's agreement that this is an important thing to add to statutes. In section 6 there's a change related to treatment coordinator education requirements. This is really just a clarification. Last session the governor had a provision to reduce the qualifications for treatment coordinators. And mental health providers also had some changes. We ended up having a compromise on what that looked like. But the end result was that treatment coordinators only have to have a high school diploma now. And there was language in the statute that still that says that treatment coordinators can have a BA which they wouldn't need to have that if they could have a high school diploma or the equivalent. So we're just cleaning up statute to allow for that. They would still be subject to all the supervision requirements and a significant amount of experiential hours. Moving to. I think there's just one more change that impacts this committee. So the substance use disorder changes are in sections 12, 13, 15, 19, 20 and 27. We've had in Minnesota a section 1115 SUD waiver which allows us to be able to pull down federal dollars even when those treatment services are provided in an imd. And with this waiver we have ensure that programs are meeting the American Society for Addiction Medicine standards and various other requirements. So this is really. All of these sections are basically cleaning up language that has been getting moved around and changes that have been being made over the past year with all of these reforms. So section 12 removes a requirement for utilization management of SUD treatment placements. As a reminder, direct access is a thing now. So we don't actually have placements. So that's why that change is needed. Section 13 is codifying the requirement for providers to do utilization management for up to 10% of all medical assistance or behavioral health claims. So Utilization management is a program integrity tool as well as just a clinical effectiveness tool to make sure that when people are submitting, providers are submitting claims that the services are medically necessary and that providers are doing what they need to do to achieve good outcomes. In the amendment, we do add a couple of programs to be subject to the utilization management review. So those are comprehensive assessments, treatment coordination, as well as adolescent treatment programs, just to make sure we have proper oversight over all of these important services. Sections 19 and 20 consolidate remaining substance use disorder waiver language. So this language retains the requirements for SUD providers to certify ASAM levels of care and then retain certain exemptions for tribal programs and residential programs that are also licensed as a Hospital. Section 14 is related to peer recovery services and vendor clarification for tribally licensed programs. This is not a substantive change. Tribal tribally licensed programs are eligible vendors of peer recovery services. And this just adds adds that applicability back into statute and Madam Chair, I believe. Oh, lastly, the recovery community organization timeline. So this would. Right now, recovery community. Recovery community organizations or RCOs are required to obtain certification from Marco, the Minnesota alliance of Recovery Community Organizations. And they're required to do that by June 30, 2027. This is an important step to make sure that r understand best practices and they have all the technical assistance they need to do well and to serve people well. And these are non clinical peer services. So we want to make sure we have a different kind of structure around them than maybe some other kinds of clinical services. This proposal would change the certification date requirement from June 30, 2027 to June 30, 2026 to just improve program integrity and make sure that all of those RCOs are certified by Marco more quickly. So, Madam Chair, that's the bill and the amendment and I'm happy to answer any questions.
Thank you, Ms. Graham. I'm going to go to Senator Rasselson and then to you, Senator.
Thank you, Madam Chair. Ms. Grom, thank you for the overview. I was wondering if you could just explain one more time. And I'm looking at page nine of the bill, starting at line nine. There's some stricken language around the utilization review process. I was wondering if you could just explain to me one more time why we're taking that requirement out for utilization review. And again, I'm looking at page nine starting at line nine through line 11.
Ms. Graham.
Madam Chair. Senator Rasmussen. Sorry, at page nine, line 33.
You said line nine, Ms. Graham.
Oh, okay. I'm looking at the wrong one. So line nine is stricken, but as you can see, we're moving utilization review requirements further down on line 32 to be more comprehensive. So while we're striking paragraph B, beginning on line nine, we're actually adding more services beginning on 9.33. And I can list what those services are, if that's helpful for you, Senator Rasmussen.
Senator Rasmussen.
Thank you, Madam Chair. And thank you, Ms. Grom. So, to make sure I understand this, this would actually be this bill, as amended, would enhance utilization review and have it be for more services. We're not cutting back on any utilization review. And the reason I bring that up is I just think that's an important piece to program integrity and making sure that the dollars are going in the right spot.
Ms. Gr.
Madam Chair. Senator Rasmussen. That is correct. My understanding is under our 1115 waiver requirements, many of these services are required to do utilization management, even though they're not listed in statute. So this is, in part codifying those requirements, and it is adding three additional services, Comprehensive Assessments, Peer Treatment Coordination, and Adolescent Treatment Services.
Senator Gruenhagen.
Thank you, Madam Chair. Yeah, I think Senator Rasmussen and I are thinking identical. I was going to ask the same question as far as Eunice Lacing, but since he asked it, I'll skip that. You know, I would ask a couple other questions. One is, you know, I see the. You're adding Children's Therapeutic Services and Supports to this. CTSS providers to log temporary service reductions in the patient's case file if desired, for more flexibility and timeliness.
Ms. Graum.
Madam Chair. Senator Gruenhagen, can you refer. First of all, that's not, I didn't cover that because it's not the committee jurisdiction. Those are mental health services.
Oh.
But maybe. And we did discuss that in Senator Wicklin's committee. So do you want to take that offline or would you.
Yeah, let's just offline if it's outside that jurisdiction. Leave it to me to ask questions outside that jurisdiction. Okay.
It's confusing.
Madam Chair.
Senator Grood Hangingen.
Oh, thank you. Yeah. The other question is, you know, we, when you look at the Tim o' Malley report, you know, on dhs, we see there's a culture of not following what state statute says. So my other question is what you're talking about sounds real good, but I, and again, I just perused the bill, but I don't really see a consequence if they ignore it. And again, we have testimony from whistleblowers and Tim o' Malley's report that the department has had a problem. Well, even the OLA report with kickbacks saying that they didn't have the authority when the OLA report said, well, they do have the authority. Okay, so what's the consequence for not following state statute? That's what I wondered inside this bill, Ms. Grom.
Madam Chair. Senator Gruenhagen. Well, some of the consequences would be that a provider would would receive a penalty of some sort if they don't follow licensing requirements. So a lot of this is adding provider requirements and our licensing area of the department would would review to ensure that they've got the appropriate documentation, they've delivered those services. I can get back to you. But if a provider doesn't submit to, you know, doesn't submit their claims for utilization management, I would assume there would be a significant impact on their ability to bill ma. That is a requirement in our federal waiver plan.
Senator Gruenhagen.
Oh, thank you, Madam Chair. Yeah, I would like if you could get back to me a little bit on that because it seems like it has been a problem in the past. The other thing, is there anything in this bill that is going to satisfy, you know, we're being told that CMS is freezing over $500 million, a quarter of Medicaid funds and you know, due to fraud or whatever? Well, the point is I want to help. I know everybody on this committee wants to help the people that really need help. So to me, anything we do going forward should comply with CMS's requirement to meet the fraud requirement so that we can get that $500 million released and actually meet the needs of the people who actually need it. So does this bill help us in any way with compliance with CMS?
Ms. Graum?
Madam Chair, Senator Gruenhagen, couldn't agree with you more. And CMS has been. We got a response from them finally after about 70 days last week indicating that they've approved our corrective action plan. Most of the components in that corrective action plan were items that the department had been doing before CMS was involved on this matter. So it was a good affirmation to hear that what we are doing is the right course and we will continue to do that. To the t this bill. I would say there are some program integrity elements of it, particularly the recovery community organization changes. There's some also some changes in here related to mental health services not in this jurisdiction that do enhance program integrity, and those are important. And there are other bills. The governor's budget recommendations include a Lot of changes in this. In the behavioral health system space. There is a bill to licensed armed services that's in Senator Wickland's jurisdiction. There is an entire swath of Office of Inspector General policy proposals in Senator Wickland's jurisdiction that we reviewed in that committee as well. So while this bill doesn't have as many program integrity elements, we have a bunch of other provisions that are moving and that are being heard that. That do.
Senator Gruenhagen.
Oh, thank you, Madam Chair. Yeah. So in your opinion, do you think we're closer to getting that 500 million released from CMS, from the feds for Minnesota?
Ms. Graham.
Madam Chair, Senator Gruenhagen. I don't think I can speak to that. I know there are focused reviews that are going on, and those involve not just the Department of Human Services, but also us having to work with the provider community to get the documentation that CMS is requiring for the particular claims that are in those focused reviews. But I will say that we have done everything in our. Everything that we can think of to ensure stronger program integrity across our Medicaid program. We have other states reaching out to us, asking us, you know, what are you doing? How can we use what the tools that you've been implementing to improve our program integrity? We have, you know, one of the lowest error rates in the nation in Minnesota. So certainly the work is never done, but we have made really good progress and will continue to do so.
And, Senator Gurnhagen, I do want to. I want us to stay really focused on this bill. I think the topics that you're bringing up are very important, but I. We do have a number of bills, so.
Yeah, I just have one more question.
Okay, go ahead, Sarah Gurnhangan.
So I'll take that as they haven't quite released the 500 million, but we're getting closer. Sounds like. And the last thing, I just. I'll just make a statement. You know, I haven't read word for word the o' Malley report or the governor's, but I have seen some comparisons, and it seems like a lot of the governor's report wouldn't be implemented till 2032. I mean, we get the problem right now, okay. And I find the o' Malley report, which I wish you would hear here sometime before the end of session, much more prescriptive. And, you know, he has nine points in there that he says really need to be paid attention to, and they could be implemented in a short period of time.
So, Senator Gruenhagen, is that specific to this bill.
Yeah, it is, because she said there were some things in here that applied to. Watching over the fraud. Okay. You said some of this would help, and we want the 500 million released from CMF if at all possible. So, I mean, from my standpoint, I would strongly recommend looking closely. I'm sure there's some good things in the governor's report, too. And the governor appointed Tim o', Malley, but he does seem much more prescriptive as far as what needs to be done in order to address the fraud problem. And I know you said we have a low error rate, but when we have allegations of $9 billion of fraud, it does seem it's a little higher than 2%.
Okay.
Thank you. Madam Chair.
Ms. Graham.
Madam Chair. Senator Gruenhagen, I don't have any evidence that $9 billion of fraud is the number. I know that. That there's. We hear various numbers. 9 billion, 20 billion. You know, they're all over the map. And so I just want to clarify on the record that we're not aware of where that number comes from. I've read Mr. Omalleys report myself. I've met with him. It's great. I do think the governor has very prescriptive recommendations in the budget. So I'm going to work with you offline and send you a link to all of our change pages because there are many provisions that are effective much sooner than 2032, including changes that will, you know, require billing limits and make sure that we've got electronic visit verification. Many of the same ideas that are moving through this body right now to ensure that we've got strong program integrity.
All right, thank you. Senator Bolden, do you have any closing remarks?
All right.
And with that, Senator Wicklin makes a motion that Senate File 4726, as amended, be recommended to pass and re refer to the Committee on Health and Human Services. All those in favor say aye. Aye.
All those Opposed?
Senate File 4726 is on its way to Health and Human Services. Thank you. Senator Bolden,
Can I ask more questions?
Well, Sam, should I stay here?
Okay.
Just. Okay, great. So the next we're going to hear from Ms. Grom. The Department of Human Services Aging and Disability Services policy bill. We don't currently have a Senate file in its possession, so no formal action is going to be taken. But, Ms. Grom, you're going to walk us through it. And members, I'm. We have a. I'm assuming a Senate Council version in our packets. Or how is it The House. No, Senate. Senate version. Got it.
Okay.
Ms. Gr.
Madam Chair, members, thank you for having me to and making some time to hear this bill. We greatly appreciate it. So you do have a revisor file in your possession as well as a summary and I think an index. I'll walk through the sections and then take questions. So there are maybe about 10 or so main buckets of provisions in the bill. The first is in section one and it's related to the foster care licensing moratorium and exceptions. There are a couple of exceptions in this part of the bill that expired or are no longer needed and so we are removing those as some just technical clarifying clips. Cleanup. It's in section one, Sections two and three. Correct cross reference to update terminology in HCBS Positive supports. So there was an incorrect cross reference to licensed professional clinical counselors or lpcc. And then there was some changes related to the licensing of behavior analysts that happened effective January 1, 2025. So we're just updating some terminology to reflect those changes. Sections 4, 12, 13 and 14 relate to early intensive developmental behavioral intervention. Really adding more program integrity around this service. So one of the changes clarifies that EADBI is a covered service under the Medicaid 256B chapter. There's updating a definition of clinical supervision which basically just adds in more services that are required under EADBI to ensure that supervision is occurring properly under of those services. There's a change related to intervention and observation indicating that only a QSP or qualified supervising professional or provider level one can do the supervision. We want to make sure we have strong supervision in place so that those outcomes are good for for families and children. And then lastly, and maybe most importantly, there's documentation requirements for EIDB EIDBI providers for both the services that are delivered as well as the personnel that are delivering those services, making sure that they've got all the appropriate credentials and training in place. This is particularly important because the license is not yet effective. So they'll be going into a comprehensive licensure. I think this summer is the start date and then at some point thereafter the legislature and the department will work on an ongoing licensure. But for now we want to make sure those requirements are in the clinical statute and the policy statute. Section 5 relates to tribes certifying their own mnchoices assessors. So this is just making sure that tribes. It's clear that tribes can develop education and experiential qualifications for their certified assessors. These are changes that we made in collaboration with our sovereign tribal nations, we want to make sure that they've got all of the tools that they need to serve their members well. Section six includes a change. Looking at Senator Ablor here, don't panic, Senator Ablor, but this is a removing of MnChoice annual trend analysis benchmark data requirement, which we thought was a wonderful idea. And last year's legislature thought it was so good they built on it to create new requirements that DHS collect data and work with counties and actually publish a dashboard so that we've got a live dashboard that you can all click on and see and it's broken down by county what the metrics are. So this is just removing that old reporting requirement since we have a new dashboard that's updated annually and it's live today. Section 7 to 11 and 40 relate to tribal vulnerable adult and developmental disability targeted case management, sometimes called tcm. So this is building off of things that changed related to developing a tribal only TCM benefit in 2024. And it basically clarifies that tribes have the authority to determine eligibility and to credential their own case managers and make sure that they've got the supports that they need and the authority that they need to provide culturally specific services. There's also some kind of technical changes related to encounter rates, not changing actual payment in these sections, but just technical clarifications and requirements that DHS is consulting with tribes ongoing. Section 15 is also related to work that we've been doing with our sovereign tribal nations. So under federal rules, because tribal tribal members are citizens of both a county and a tribal nation, there needs to be more collaboration between the tribe and the county, potentially that's acting as the lead agency to make sure that they've got informed choice in all the services that they're getting for hcbs. And so this just codifies those requirements to make sure that counties and tribes are working together to meet people's culturally specific needs. Section 1618-19 relate to cost reporting for disability waiver services, community fair services and supports, and elderly waiver and alternative care. So right now there are cost reporting requirements for all of these services. And one of the issues that we're finding is some providers, not all and probably not a large majority, but there are some providers that are submitting cost reports that are pretty clearly incomplete, have some questionable data. And so we want to make sure that when that happens, we can reject that incomplete application or that complete document and require the complete form to be submitted within 30 days. There are changes related to primarily cleaning up and Some technical clarifications that align with the conference committee agreement from 2023 on ICF DD rate changes, and those are in section 17 and section 40. There's a bunch of deletion of rates and those are outdated, obsolete, delete rate increases that you see deleted. And then lastly, the big, probably the largest component in this bill is in sections 20 to 39. And this is making changes related to new federal rules around Adult Protective Services, which will impact the Vulnerable Adult Act. So these are changes that are updating definitions, clarifying county and tribal expectations and duties when it comes to adult protective services, making sure that there's timely responses, person centered approach. So it's all aligning with what the federal requirements are. This has been work that the department has been doing for since maybe dating back to even 2019. So we've worked pretty closely with lead agencies on all of this language to make sure we can be in compliance. I think our compliance requirement is 2028. So I'm proud to say it feels like we're ahead on this one. If you all agree and were to pass this and enact it into law. Thank you.
Thank you, Ms. Grom. If we were allowed to clap in the committee, I'd clap. Okay. It looks like we might have two testifiers. Sarah Grafstrom and Tom Gillespie, if you want to come to the table. Miss Grafstrom, please introduce yourself for the record. You may begin your testimony. Welcome to the committee.
Thank you, Madam Chair and members of the Human Services Committee. For the record, my name is Sarah Grafstrom representing ARM and our over 200 home and community based waiver service providers. Thank you for the opportunity to provide testimony to the ADS policy bill. My comments today are focused on section 17 of the bill. Section 17 impacts ICF reimbursement rates. Now, we have not been in front of this committee advocating ICF rates in a couple of years. So as a little refresher, ICF rates are different for each individual ICF. The rates were set back in the year 2000 and were based on the previous year's spending and were frozen. Rates for each ICF have been updated sporadically over the years. When ARM or individual ICF providers advocated for adjustments. During the 2023 legislative session, the legislature did two things to impact ICF reimbursement rates. First, they established rate floors, allowing each ICF that was below the floor to come up to that rate. Second, they passed legislation that allows for annual adjustments for all ICF rates beginning in 2025. This second part is the language in front of you in section 17. Since this legislation has gone into place, the department has not adjusted all ICF rates as written in statute and instead has only applied the adjustments to icfs that were at the rate floor. This led arm to file a lawsuit, which was argued in front of a judge just last week, compelling the department to adjust all ICF rates as written. This language in section 17 would apply the annual adjustment to only ICF rates that are at the rate floor. This language is not policy language and does not belong in a policy bill. This is a cut to future reimbursement rates for ICF services. We encourage the legislature to remove this budget item from this policy bill and reject the proposal altogether. If passed, some ICF homes will not see an adjustment to their reimbursement rates for up to 30 years. Happy to answer any questions and thanks for the opportunity.
Sorry, I forgot I'm in the chair. Mr. Gillespie. Oh, Senator Abelr.
It doesn't sound technical to me, so I presume we'll discuss this some more. It seems like a bad idea. Thanks.
Thank you, senator. Eh Blair. Mr. Gillespie, introduce yourself for the record. Welcome to the committee. You may begin your testimony.
Thank you, Madam Chair. Members of the committee, for the record, my name is Tom Gillespie and I serve as the president and CEO of Living While Disability Services. We're a nonprofit provider of ICF and waivered services in Minnesota, and we've been doing so for over 50 years. First, let me say that in 2023, this committee, along with house and conference committees, did a fantastic thing. You built a more sustainable future for ICF services that currently support thousands of Minnesotans along with their families and their staff. ICF services have traditionally been known for serving people with more intense medical needs. And in recent years, kind of this last decade have become an increasingly important service in our state as people age and develop more intense service and medical needs. Prior to that decision in 2023, ICF services in Minnesota had no predictable system for rate change or rate increase to keep pace with the world around us. And that led to a period of 20 plus years that saw a mere five or six rate increases. And these were not. These were sporadic. They came in clusters. There was no predictability for providers, and more importantly, there was no prediction predictability for families or for staff providing these services. Essentially, we lost significant ground to the world around us, 3 to 7% annually as we weren't seeing any increases. Despite fuel, grocery insurance, medical benefits, all of those things going up in creating rate floors and an annual cost of living increase driven by data, the New system created a path forward for providers like LivingWell to be able to understand the world that we're doing business in, to be able to better communicate that to our staff and family members, and to be able to predict the world ahead of us. However, after communicating and planning on this legislation, providers like LivingWell learned that at the start of 2025, we would not be getting these legislated increases. We have not yet received a 2025 or 2026 increase. It's important to note, I know, that our state has a bit of a credibility issue right now, and we're trying to sort of rise above that and we're trying to figure out what's waste, what's fraud, what's otherwise. It's really important that we understand that these investments in ICF services are not waste, they are not fraud. They are critical investments in the lives of people with disabilities and a critical stop along our state service spectrum that is required. There is no backup. There is no safety net for ICF services. And in a lot of ways, ICF services serve as that backup or that safety net for the rest of the spectrum as people are aging and needs increase. This is critically important work just to underpin what this money means for us. And as a show that this is not wasteful spending, my organization, as a case study, based on 2025 data, our increase would have been less than $200,000 for our organization. Organization. Our medical renewal alone at the end of 2025 was half a million dollars. So this increase that we're talking about doesn't even pay one of our areas of cost increase. And so please, I'm here to beg to you today. Please do not do away with this. Do not reconsider this. This is critical funding. This is not waste. This is not new. Please maintain this. This is not just policy language. I appreciate your time and the ability
to speak to you today.
Thank you, Mr. Gillespie. And I see that Senator Abel is probably meeting with constituents, but I do think this is worthy of a conversation. Senator Rasison.
Thank you, Madam Chair. And I guess I'm just going to hold my further comments until we have the bill actually in front of us. But I appreciate the department and the testifiers coming to share comments today.
Thank you, sir. Asm Senator Gruenhagen.
Oh, thank you, Madam Chair. Yeah, I can't remember a name from the department, but based on their testimony, what do you any response?
Ms. Graham?
Madam Chair. Senator Gruenhagen, this matter is under active litigation. I did reach out to Ms. Grafstrom last week and didn't hear back, so. So it's good to hear in testimony today what the position is of arm. So I'll have to be limited in what I say, but when in 2023, the governor brought forward the proposal to increase the ICFDD rates as a workforce measure, it's something that we have been trying to work with ARM on for many years. There were two provisions. You can't see both of them in this bill, but I just was looking it up on my phone, identifying the risk, the rate changes, as well as the CPIU adjustment. And there were assumptions that we made when the legislature decided they wanted to fund this. And those assumptions assumed the current funding mechanism that we have implemented that CMS has approved. So if the legislature wished to increase the appropriation, I don't think we're saying providers shouldn't get higher rates if they want, but I think what we're saying is we assumed that this is how the rates would work, and that's what CMS has approved. That's what the appropriation was in law. And so happy to chat with you more if you would like to increase rates.
Senator Gruenhagen.
Yeah. Madam Chair. Thank you. It sounds like they didn't get the rate increase that was approved by the legislature. Or did I misunderstand?
Ms. Grom.
Senator Gruenhagen. I would defer to the provider community if they would like to respond to that.
Ms. Grabstrom.
Madam Chair. Senator Gruenhagen. Correct. So rates that were above the rate floor beginning in 2025 have not seen an adjustment as written.
Sarah Gruenhagen.
Oh, thank you, Ben. So that adjustment was passed by the legislature? Correct.
Ms. Grafstrom.
Senator Gruenhagen. Madam Chair.
That's correct, Senator Gruenhagen.
So I'm back to the department. So why didn't that get passed on?
Ms. Grum.
Madam Chair. Senator Gruenhagen, My understanding was if you were above the. That there is a rate floor and that the increase is going to providers that are below the rate floor right now.
Senator Gruenhagen.
Yeah. I'm trying to not be confused.
May I?
Sure.
I mean, I think I have similar questions. Senator Gruenhagen. So I think if the language that the legislature passed doesn't do what is in this bill, then wouldn't you have to give an increase to all providers? Otherwise, this change wouldn't be necessary. Because I. What I'm seeing is that this is the change that you're suggesting we make in law to match what we intended to do. In 2023. Am I correct in that, Ms. Graham?
Madam Chair that's correct. I'm not certain about I know that there was that the mechanism for this in 2023 was to establish a rate floor. There were some providers that were going to be above that rate floor floor, and there was testimony from ARM at that time that that was a concern of theirs. So there's an acknowledgement that not all providers were going to be getting a rate increase. And I would have to follow up on the specific inflationary adjustment and how that applies in this, in this instance.
Mr. Gillespie, do you want to so
there, as I understand it, there's two provisions. There's the rate floors, those, those were paid the annual inflationary adjustments for anybody who's above those rate floors. So basically it created a system where those are who are at the minimum, that minimum raises anybody who's above that minimum. The way that the wording is set today, regardless of intent, the way that the wording is documented, calls for a cost of living increase for all rates. That was not implemented. That second portion was not implemented. The cost scores were and that's the source of the confusion. Half was implemented, half was not. And that's what brings us here today, sir.
Ms. Grom, can I ask, would there be a fiscal note if we just passed lines 22.12 and to 22.16 as its own bill? Ms. Gr.
Madam Chair not to my knowledge, no. This is a clarification. We're not trying to change the current funding.
So, Ms. Grom, just to be clear that the way that the law currently
is
doesn't match what you're doing, and so this is an attempt to do that, to make the law match what you're currently doing for funding, not match your funding to what the current law is.
Madam Chair, we are implement. Yes, we are. I mean, this is a clarification. This was an assume. This, this clarification of the minimum daily operating rate was assumed when we drafted this language as well as the preceding section in law, and there are now claims being made that we are not implementing it as was required. So we are trying to clarify how we are implementing it based on the funding that we received.
Senator Abel, we are on the 22.13 to 22.16 piece that you had said you wanted to have a conversation on. Did you mean today?
Well, no, I. Thank you. It seems like we're discussing it quite a bit, so not right now. I mean, would you want to do
more of it or.
We're A little bit vamping for time till Senator Hoffman comes back from ag. So we have time.
Okay. Well, I missed all the discussion so but I, you know, Ms. Grafstrom, I heard her comments. We have struggled to pay icfs anything that they can stay in business at. They've been like the kind of the forgotten child, as it were. But the people there should not be forgotten and they're lucky.
They're open.
Their daily rates are horrible and you have to kind of be wanting to be a volunteer worker to do that. And was that the summary of your statement, Mr. Kolesky? And so just if I can, I feel bad making you repeat things, but if you're trying to, don't mind since I was out there. It's SEIU day here, by the way, so there's a whole bunch of them and they have other challenges for other committees and some of it's ours.
So.
Ms. Grom, are you I just heard came in, you were saying you're trying to is this can you just tell me why this is anything that's something that we should do.
Ms. Graham, Madam Chair, Senator Abeler, There is active litigation on this and basically 2023, the legislature passed a rate increase based on, you know, how we described it in the governor's change page, how we described it in committee. There were fiscal assumptions around that. The department went and sought federal approval and we've implemented accordingly. And now there is it was brought to our attention that there's disagreement on how that's being implemented. So at the end of the day, if, you know, the legislature doesn't want to pass this change, we can wait for the courts and come back and ask either clarify it or ask for an additional appropriation.
Senator Abelor well, thanks. That's interesting. Well, I appreciate the explanation, Mr. Gillespie. How is the court thing going to go? Are you part of that suit, Mr. Gillespie?
ARM is representing the industry. My organization is helping provide data and backup. I'm not sure frankly exactly how it's going to go. We thought we had clear language. I think just to clarify, we've been trying to work on this language, I think since very early 25, maybe even back into 24, trying to figure out why this was interpreted differently than how it's written. So I don't have a great idea how the court case is going to go. I'm not sure why we're here in the middle of a court case and I'd love to understand a little bit more.
Madam Chair, Ms. Grassrom, I have sat through a number of times we thought we had it pretty clear and, you know, using, you know, the, not the king's English, maybe the, the rebel country's English, and it just didn't go well. Do you, do you want to comment? So if you said it already, just a comment since. Especially since we're enjoying our company here, Ms. Rostrom.
Sure.
Senator Abler. Madam Chair. Yeah. I think as we read the language in section 17, it states that beginning 24, 25-1-1, and every other, every year thereafter, the rates under this section, that is every ICF rate, not just rates at the minimum, daily floor, which is, again, why we've been in these conversations with the department, as Mr. Gillespie said, since early 2025, when the rates under this section, all rates were not adjusted. You asked about the court case. We did have a hearing on Friday, and the judge has up to 90 days to issue a ruling. So that's kind of where we're at with that.
All right.
Sarah Abelr.
Well, thanks. I was just reading this. I mean, it seems like if you wanted to raise rates, we'd say starting sometime, the rates must be updated for the percentage change. Ms. Grammer, are you a lawyer? You just play one on tv. But I would think if they had. We had a bunch of students in the Education Committee, I bet most of those students that read this to say you have to give them a rate increase. Starting when it says you have to give them a rate increase. Some of your attorneys, Ms. Grom. Not you, but some of them, I think, have a hard time keeping track of what we intended. And so I have another question on a different page on the EIDBI thing, and I'm not really prepared to go into too much detail, but I know there was a snag.
Where did I write that?
Where's the EIDBI part with this QSPS and all that? I marked it.
There's section 4, 12, 13 and 14. Sorry, Madam Chair.
Yeah,
Scribble down.
Try 7.177 Center.
Well, it talked about.
Well, I actually was in your summary. That's what I was reading. When I was talking to Representative Hicks, and she was frustrated. We fully intended that you had to have these credentials for people to do stuff, and pretty much the janitor can do stuff from how your lawyers interpret. And I was very frustrated about that. Nothing against janitors, and actually they're here today with SCIU day custodians. But I just. We were just really frustrated about. We sat in the room together, I think, working on some of this stuff, and we thought it was very clear that you had to have this elevated credential to do it. And so the definition of clinical supervision, who can do the intervention, observation and direction by a QSP or a level one provider? Are we just restating what we thought we said, Ms. Graham? And where is that in the bill,
Madam Chair, Senator Ablor, I think you're referring. You're referring to the definition of clinical supervision, is that right, Senator Ablor? Yes, yes, that's on page 14, beginning on line 15. And so this is kind of. This is a cleanup that I think a lot of these provisions were written in haste last session and that's. That sometimes happens, as you know, to my dismay. But so we're just adding observation and direction, coordinated care conference, family training and counseling and clarifying that for individual treatment planning. It's actually the development and progress of the monitoring for treatment. You might be referring to, Senator Abler, because I heard you mention credentialing. Are you referring to the change around observation and direction?
Third bullet points on your senator?
Yes, yes, Ms. Graham.
Madam Chair. Senator Abeler, that requirement was not clear in law last session and we should have drafted it clearer. And so this just clarifies that a QSP or Level 1 provider is the one doing that oversight, I would say. I know. I've spoken with Representative Hicks and the department agrees with a change to even it just being overseen by a QSP.
Senator.
Madam Chair. Ms. Graham. I was going to say, Senator Graham, I wouldn't do that to you. What page in line is that change in the definitions of QSP? But who can do what.
17.15.
Thank you. That's why you're the chair, Madam Chair.
Yes.
So it really was that vague. Madam Chair. Poo's left the word the off. That's probably the reason on line 17.15. That's supposed to be a joke. Madam Chair, Senator Hoffman would have liked that if you were here.
Who's to say I didn't like it? Senator Abel left it.
But you could like it as well as the other chair. All right, so. Because we were trying to crack down on some of this stuff, but that was our full intention. But we were frustrated with your lawyers that they were letting people get away with a lower bar. So that's all lawyer jokes are always. They always work many places. With all respect to the attorneys,
Madam Chair, Senator Abel, our general counsel is astounding and they are doing amazing work right now to deal with some very, very serious threats to our program. And of course, we have attorneys for a reason they are a little bit more risk averse than maybe we would like to be, but they help keep us in line and make sure that our laws are that we're staying within the confines of our authority. So apologies that we didn't get that perfectly last session, but hopefully we'll get it right this time around.
Center Aert do you have more?
I just have one more thing. Where was that thing that we were looking at with the ICS
line 12 or 22.13.
So at some point, just back to the lawyer thing, I just don't know why I couldn't read that as the plain English that it says. So that's my frustration. So maybe we didn't do as well on the other part. But you know, there's legislative intent, there's discussions in a room, there's intent on the floor stated, there's clear intent. And you know, I think part of the deal that I'm struggling with as we deal with fraud and people that are making just errors that they're being cracked down on as though they're some kind of criminal, that has to go both ways, I guess. You know, if they interpret somehow that this means you don't get a raise and they were going to drag providers off to court who have no money working at MA rates that anyway there should be a fair due process through the oversight thing, which we're still working on this year. And a thought of fairness and I'll be done in a second. Mr. O' Malley said in his comments that 10% of the people are honest, 10% are grossly dishonest and 80% would be dishonest if you gave them a chance. And I totally disagree with that stigmatization of the workers in this arena that I can give you that 10% could be dishonest if you give them a chance. Maybe 5% would take every chance you could give them. But I in an agency where we're trusting people with their lives and legacy providers who are doing the very best they can to deal with lousy rates, including the ICF people, to treat them as though they're just waiting to steal something as a philosophy is wrong. I know fraud is a problem, but Madam Chair, as the face of the department for the moment, you know this already, Ms. Graham, that most of the people that serve our very challenged clients have the best of the best of thoughts and the best of intent. So as we go forward, I'll keep working with you on that. And I don't think that you disagree with anything I just said so thank you, Madam Chair.
Thank you. Senator Fateh.
Yeah, thank you so much. And I also stepped away for another zoom meeting. I'm trying to balance the. At the same time. So if you already answered this question, I apologize. But I had a question around the changes around ics also going from the daily rate model to the unit based model. How is that change going to be, I guess, implemented and then what sort of impacts you might be foreseeing going from that model and if you can also touch on the type of level of care that clients can expect in that transition also.
Ms. Graham, Madam Chair. Senator Fatah, I believe the changes that you're referencing are in the governor's supplemental budget, which isn't before us today. This is just the policy bill. So maybe can we put a pin in that and talk about it when that bill comes before this committee? Or we. I'd also be willing to meet with you outside of committee and talk more.
I think both. Ms. Grom, that sounds good and right on time. We have Senator Hoffman. So thank you for that walk through Ms. Grom. Of this policy proposal. And it's not a bill. So, Senator Hoffman, it is your turn.
You visit the ICF paragraph.
Thank you, Madam Chair. Well, Mr.
Chair.
Senator.
Absolute. So just just to catch him up to the.
Do you have an amendment for this?
I do eventually. But just when you sit down on the way, I just want to remind you of where the conversation. We spent most of the time on the section about the ICF pay. Oh yeah.
Are you guys okay?
Yeah. Your chair, Mr. Committee.
Anyway, so Senator Hoffman. So Senator Hoffman, the. The part about that ICF minimum rate thing is very problematic. Apparently. We just. Maybe she has a lawyer come and tell us how they couldn't read it. That was plain English. It says the rate should go up at this time and it did not. And now DHS refuses to pay and the lawyers are defending them. So anyway, that's just of the. The flashpoint in this, in this legislation is that point, I think. Yeah. And I think it shouldn't be there. But we'll. We'll talk about that later and you can talk to Ms. Grafstrom and other people. Okay, thank you. That's the highlights.
Do you have other. Madam Chair, If I may, Mr.
Chair, it's all you.
Oh, you got. Okay. So Senator Abler, is there. Do you have something in mind that you want to do? Is this something we can get marked up or.
Mr. Chair, Madam Chair, that bill, that wasn't a bill. It was just a policy proposal before us. So we have time before we get a Senate file to okay. Figure out what we're gonna do.
All right, good. Yeah, that was just that wasn't that was they got it dropped it's or they got it. So we're good. All right, so let's hear the we're gonna do the Housing Stabilization Services Program, which we're changing that. The committee had previously heard the bill in the form of Senate File 3755, right. Since the other body had already passed the companion, we're going to proceed using the House file. Are you all okay with that? That would have been my you would have asked the same question. You're right, Paul or Senator Utke. So to, to that effect, there's an A1amendment to House File 3379 and that A1amendment replaces the language of the bill file with the language from the second engrossment that we all did from Senate File 3755, except that it excludes a section from Senator Abler that carried a fiscal cost. Imagine that you had an amendment that
was added that you're blaming me for spending money. Mr.
So our goal members, our goal is to send this bill as amended to general orders, right, so we can find agreement with the other body to get this to the governor's desk as soon as possible. So this is just, this is all of our work that we put together. And so please, if you guys are finding, if folks are finding some, some gaps or stuff in there, you know, get rid, you know, let's do it. But this is our work that we did. So does that make sense? So before we adopt vote on the adoption of the amendment, I just want to briefly remind members what the language does. It repeals the Housing Stabilization Services Program. If you all remember, somebody had concluded had stopped this program and they didn't have legislative authority to do that. So we are actually doing that. We are requiring the department to post all public comments that are received for the proposed waiver plan. Amendments prohibit the executive branch. This is one that I think we all, no matter who's in charge of the other body and the other body body, it prohibits the executive branch from unilaterally terminating a state statutory program without the assent of the legislature. I think we're all in agreement, right? We direct DHS development recommendation to the legislature for redesigning a new medical assistance housing support benefit. So House File 3379, as amended, should be recommended to pass and sent to general orders. But with that, everything I just went through members, the Microphones are open. The A1amendment. If all. If you guys are okay with the A1amendment. What I just said. All those in favor say aye. Aye. Opposed? Same sign. It goes. So, Senator Rasmussen, two hour work.
Thank you. Mr. Chair, I'd like to offer the A3amendment. I'm happy to describe it.
Yep. Do you want to pause while we pass it out? Unless you already sent it to everybody, please, prior to.
I will pause.
Is there a fiscal note to it?
There shouldn't be.
No.
Okay, then you're not.
We haven't learned. Well, we, we always had. Do you guys all have the amendment that Senator Rasmussen. No,
I can describe it.
Just describe it. Go ahead. We'll wait till it passes. I'll go ahead and describe it.
Thank you, Mr.
Chair.
So this A3amendment is the language that passed the other body on the floor with wide bipartisan support to unredact the Optum report. And this would make it available to the chairs and ranking minority members of a legislative committee with jurisdiction over human services policy and finance. And so this is the language that every House Democrat voted for. Most House Republicans voted for in identical form. So I'd like to attach this, but I also want to make sure members have a chance to.
Let's have a discussion.
Look at the language and discuss it. But this is identical language that pass the other body. So that's what I'm using.
Thank you. I knew that was coming. So the language, Senator Fatah and Senator Rasmussen, if you guys. Is that language, it would have to go to Judiciary. If that language is current how we sent it before. So have you had that discussion and that it's not going to have to go to Judiciary because of the changes in there? That's the question.
Thank you, Mr. Chair. You know, it'd be up to Senator Latz if you wanted to do it.
But there,
you know, again, this is the language that passed the Minnesota House. And if Senator Latz wanted to pull it in because it's referencing chapter 13, he could. But as I'm looking through here. Yeah. So it'd be up to Senator Latz if he wanted to.
So to the point. It's the same language, Senator Fatah, to that.
Thank you, Mr.
Chair.
And thank you, Senator Rasmussen. I'm looking at line 1.9, 1.10. It says upon a joint request. Wait, is it only going to go to committee members or the chairs and ranking members? I'd like an oral amendment to add vice chairs. Mr. Chair,
Senator, Senator, I don't. It was the House one, Senator Wickland? I think they said it was just for the as soon as we can keep talking while we get this. But it was to the legislature, period is what I believe passed on the House floor. But anyway, to your Senator Wickland, it's your mic.
Thank you, Mr.
Chair.
I thought that the House language it was that it had to be requested by the chair and the ranking member, but then it was the committee members were able to view it. I don't know. I don't have the amendment in front
of me, so I don't know.
But I did want to say that we amended Senator Muhammad's bill in my committee with which came into the committee with the original language of your bill, Senator Rasmussen. We amended it with the House language that you have said that your amendment is and we were told that it, it needed to go to Judiciary. So that's where we referred the bill. And so that language is already in I don't remember the number of that bill but it is sitting in Judiciary.
So that actually answers the question that I had to those guys then that if that's the exact same language then it has to go to Judiciary. So Senator Aber.
Well, thanks.
And then go to Ian.
The status of the Muhammad though, is it awaiting a hearing in Judiciary? Is it going to go into the ether instead of being heard there? Does anybody, Senator Mahonga is gone, but does anybody know this if they're planning to take it out?
Which committee was that in? Senator Ehler?
Judiciary. Her bill went to Judiciary.
Does anybody, do you know, did you hear anything on Senator Mohammad's bill in Judiciary?
It wasn't one of the 42 bills they did on Thursday.
Yeah, no, it's in there. I just, I don't know. I don't know what his, I don't serve on Judiciary. I don't know what that is.
Thanks.
You want to clarify and then we go to Aaron Mae Quaid or do you want to go to Aaron May, Senator Aaron May Quaid first and then you clarify what do you want to do? Okay, thank you.
Mr. Chair. I just wanted to clarify because I misspoke earlier, the language that passed the other body and that's in front of us in the A3amendment states that upon a joint request by both the chairs and ranking minority members of a legislative committee with jurisdiction over human services policy and finance, the commissioner of Human Services must immediately release the initial optum reports to the members of that legislative committee in the report's entirety without redactions or edits except for redactions, requests by option to protect proprietary information. So that if, Mr. Chair, if this were to become law and you and I were to agree that this committee should have access to the report, the members of this committee would be able to see an unredacted report.
Is there anything that says, except for Senator Fatah,
that could be an amendment? Mr. Chair, I would be opposed to that.
Thank you for clarifying. I still do. I think it's still. Yeah, this is good. Senator quaid.
Thank you, Mr. Chair. I. I want to state up front that I like the amendment and I very much want to see this report. And, and then, of course, whenever you're talking process, you're boring everybody to tears.
I know. Sorry.
I. What I don't want to do is send. Because this seems like a bill. We have to pass the underlying bill now. How. The other body already did.
Yep.
And I. What I don't want to do is get this hung up in Judiciary that has so many bills, including one that already has this provision in it. But I also support the outcome of it. So I just, I want to. I just want to note that I don't know how I feel about the amendment, not because of the content of it, but because the path it sends it on. I struggle with that out loud.
Then that's the articulated argument right here, right now. Senator abel.
Well, thanks, Mr.
Chair.
And I think the concern is valid, but I have advice. Perhaps if we would create a placeholder saying something like optum shall provide periodic reports on the status of the prepayment program, that would then when we get to the floor, then we could delete that and then put in this version, which would then be Jermaine, to the bill.
So go ahead, Senator, make.
I think Senator Abler is publicly proposing a way around the path that this amendment would send the bill down.
Hi. Welcome to the Human Services Committee. You got a forecast grab in your mind at all?
So the reason, I think expediting this.
Yeah.
So if there's, If Judiciary is cleared by the time you get to the floor, then you can simply substitute the language that Judiciary has approved over this optimum report, and then it's germane to the bill. If we don't put the word optum and report in the bill now, it will not be germane. And anybody could challenge it, and they would be correct.
Senator Mae Quaid and then Senator Fatah, I think you're onto something in there.
You, too.
Well, M. Mr. Chair and Senator Abel, you could also just keep the language that you're talking
about
because if we change this bill in any way then it goes to conference anyway and so then that could be the place they like. We wouldn't have to amend it on the floor. We could amend it in conference if that makes sense.
So the amendment members is in front of you now as we're talking. There was actually two that was sent out. The one was my was the A2 that I believe somebody is probably going to add to this anyway the happy hour to some other bill. But that optum one is there is there where would you insert in what language would be Senator Rasmussen to the, to the amendment, Mr.
Chair and I'm, you know comfortable proceeding how committee members want to but I think adopting the A3 is, is the clearest and if this bill does go judiciary, it's a House file, it can be heard this week. There's a floor session tomorrow and I think my hope would be that we'd have the support in the Judiciary Committee for this provision and then members of the legislature can have a vote on it. My concern with the other bills like for example the other House file that was sent over on this, it has not received a hearing yet and I worry that it won't be able to before deadline. And so that's why this is a House file. It's relevant. The Optum report was about one of the 14 programs it looked at was housing stabilization services. So I do think it's relevant good faith amendment to try to get this passed in the law as soon as possible because every day we're not receiving this optimal report, it diminishes its ability for us as policymakers to take into account those considerations. So I'm not trying to skirt any process. I just want to make sure that as this bill which I think is really important comes through that we mark this important policy on there as well. And I would hope that Senator Latz would give us a hearing if we needed that.
Yeah, I don't, I don't know if we would get a hearing. That's just the timeline stuff. So I'm hearing what these two maybe we should recess and we should go in the back and work work something out. Senator Rasmussen because my concern is if we throw this on here and it gets it has to go to Judiciary. Now we're lined up where I like what Senator Mae Quaid and Senator Abel are started talking about. It's starting that I don't want to lose the fact that I believe we should see this unredacted report. Right. We all this whole committee believes that, right? We do. There you go. Senator rasmussen.
Mr. Chair, I would. Yep. Mr. Chair, I would move to divide the amendment between page one, line eight, and page one, line nine. And I'd like to offer the first part of that amendment.
So.
Give me one second, Mr. Monahan. If that has divided like that, would that keep. Would that language in the top part necessarily have to go to Judiciary? Would that stop, in your opinion,
Mr. Chair. Members.
I don't.
All you're doing is putting a definition out there.
Is that what you two want? So will you two validate with him what's going on? I'm just gonna.
No, I. Mr. Chair, I understand what they're doing.
I know that.
What I love. What I love about it's when you got quiet, I just. I could hear the happening, the processing, and that was like.
I.
So I just wanted to step back to say, okay. Get clarity from them on what. You know, they're shaking their head yes when you said that. So.
Mr. Chair,
Mr. Moni.
The committee, of course, is free to do whatever it wants. Perhaps a recess to discuss the implications of.
This committee is in recession,
Like we talked about. The good of the community when it
comes to things like this.
We don't have to see an agriculture, so obviously.
Sa.
Sa.
Okay. Senator Rasselson.
Thank you, Madam Chair. I would withdraw the A3.
Senator Rasselson withdraws the A3amendment. Senator Rasselson.
Thank you, Madam Chair. I would like to re. Offer the A3.
Senator Rasselson re. Offers the A3amendment. Senator Ason.
Thank you, Madam Chair. I would like to divide the amendment between page one, line 17 and page one, line 18. And I would like to move the adoption of the second part of that amendment, starting on line 18.
Mr. Monahan, would you mind repeating that for the record?
Madam Chair. Members.
First.
Senator Rasmussen moves to amend the A3amendment to House File 3379. The first part would be lines 1.4 through 1.17. The second part would be lines 1.18 through 1.22. And he further moves to adopt the second part.
Thank you, Mr. Monahan. Members to the divided amendment to the A3. Senator Esselson.
Thank you, Madam Chair. The second part would prohibit Optum from disseminating private data that is a part of their contract or engagement with the Department of Human Services pursuant to the Governor's executive order that established that relationship.
Thank you, members. Before we vote, any other questions?
Okay.
All those in favor of the A3amendment? Divided at 1.17 and 1.18. And the second part offered. All those in favor say aye.
Aye.
All Those opposed? The A3 is adopted. Senator Rosterson.
Thank you, Madam Chair. And I would withdraw the balance of the amendment.
Balance of the amendment is withdrawn.
Madam Chair.
Senator Abelor.
Well, I think that, you know, it's been a long. It's been a long session so far, Madam Chair. And we've. People have suffered so much harm. You've had just the challenges. Spring is here and I think our seniors in their, in their challenge times just need a little relief. And so I'd like to move the A2amendment.
Senator Aber. Moves the A2amendment, Senator Aber. To your amendment.
Senator Hoffman's still here.
Senator Hoffman is, I believe, in transportation.
Okay.
When I chatted with him, he. We thought this would be a good idea. This is the nursing home happy hour language which has been, which has really been agreed on. It's on the floor anyway, I think, and I believe in terms of trying to pass the bill, that this would actually increase the chances of the bill passing. So I just urge people to vote for it. And Senator Hoffman earlier said that he was okay, but I won't speak for him and he can come back and speak for himself.
Okay.
Any other member questions for Senator Ablor's A2amendment? Senator Oetke?
Thank you, Madam Chair. And my question would be, as we had with the last amendment, were it would cause the bill to have to make additional stops because this is liquor. Is that going to take add another stop in Commerce and maybe beyond.
Madam Chair, Senator Abelor and Senator Utke. It's already been there. It's clear the, the bar is closed in the Commerce Committee on this. So it's been sent out, I think to the floor or somewhere. So Senator Hoffman didn't know that, but it's cleared that no more hurdles.
Sarah Gruenhagen.
Oh, thank you, Madam Chair. Yeah. Just a quick question for Senator Ablor. You know, I do have customers through my insurance agency who are in the nursing home. They have liquor in their room. Okay. They didn't have to buy it through the nursing home. So my question is, is there going to be a markup by the nursing home or tax or are they going to make money on this or, I mean they can get the liquor now is my understanding, Senator Abel.
Well, thank you. And Senator Hoffman, it's his bill. I just thought this was a great place to do it because this is one of the few bills that's actually going to move And I think if people can have this in time for May Day and April Fool's Day and so the parties there. But I believe it's just allows them to have it in public on the patio compared which I do believe is not allowed right now. So I just know it's very popular with the people. But I thought let's just get something done. So anyway, that's my point.
Thank you, Senator Blair to Senator Gruenhagen. I think this allows the assisted living facilities to serve it. And so it wouldn't require somebody to go out and purchase it and store it. They could just consume it outside their room.
Yes, Senator, because I know there's some residents that can already consume it in their room. But you're right, I never see them outside their room consuming it.
So it's a pro socialization bill.
Any other member?
Questions to A2. So the answer to the question I'm going to look at counsel here is because this language has cleared another committee, it wouldn't get pulled into that committee for hearing. Mr. Monahan.
Madam Chair, members, A member on the floor could always make a Rule 21. Objection. But the language, as has been heard multiple times, I believe in the Commerce Committee.
Okay, thank you, Mr. Monahan.
Okay.
Any other member? Senator Ecke.
Thank you, Madam Chair. An additional question along those lines is, and I was looking through here quick, and I didn't see it, but how do the nursing homes attain the liquor? I know this is actually something that came up a few weeks ago when I had people in my office. Are they going to a liquor store to buy it or is it being delivered by a wholesaler?
Senator, you're seeing me look around for the very people who have left the room.
Went out for happy hour.
I thought she was. Oh, I see you back there. Ms. Hubbard, would you be willing to come down to the testifying table and answer the question? Miss Hubbard, if you want to introduce yourself for the record and answer the question.
Madam Chair, for the record, my name is Erin Hubert and I am here on behalf of the long term care imperative. And I regret that I missed the question.
Senator Akey, do you want to re. Ask your question?
Sure.
Thank you. Madam Chair, my question was how would the liquor get to the nursing home? Would they go to an off sale and purchase it or would a wholesale distributor drop it off? Are they going to get into the three tier system that we operate under alcohol And I mean, it opens up a whole new can of worms from what I'm hearing.
Yeah.
Wondering how that goes. Plus you, the Fact, if they're handling or in so called owning this alcohol, then you get into the insurance and the liability side of it. So what do you know about all those things?
Ms. Hubert?
Madam Chair, Senator AKEE I have learned a lot about the three tier system this year. The bill that was heard in this committee and passed just last week provides a limited exemption for nursing homes, assisted living and boarding care homes to be able to coordinate a social event, including a happy hour for residents. That limited license also permits the Department of Public Safety to do oversight and enforcement, which includes some of the provisions around overserving safe consumption, safe food, handling things of that nature. Because we are in the position now where some of our communities were unable to, to provide happy hour, they're not purchasing it from anyone at the moment. But it is my understanding that for those who thought that they could always do this, we're talking a very limited volume of alcohol and most were probably just purchasing it from their local commercial retailer of choice.
Senator Ecke thank you, Madam Chair. And I think did I hear you just at the end comment that it would be a very limited amount potentially? Because you know, when it was first, when I first heard about it a number of weeks ago, I'm thinking, you know, assisted livings and nursing homes, people that are in particularly nursing homes are there for a reason. They need a lot of help, they need a lot of care, usually with health and medications and all this. And so to me, the alcohol just didn't seem to be a mix or it wouldn't be a big deal. But, but I would just be interested in hearing from, because you deal with all the nursing homes and such, do they anticipate this being something that really gets used?
I do want to Note, Senator Ricky Ms. Hubert did help us clarify that. We did hear this language in this committee, I think, last week. So we have heard this language before. But since we're feeling in chorus today, Ms. Hubert, Madam Chair, Senator Utke. Yes. The language that we worked on with
the Department of Public Safety and the Department of Health put this in the right regulatory framework in that assisted living board and care homes, nursing homes already have health and safety oversight through the Department of Health. So they already have to understand the residents, their medical needs, their social needs, et cetera. And so in this case we feel, and I think MDH didn't take issue with our proposal, that because we are under the Health Department's licensing framework, that the language that you passed last week accommodated both their needs and the Department of Public Safety's needs. And in terms of the amount. I think what I would just say is, practically speaking, most of the residents that we're talking about are not consuming large amounts of social libations. This is really about community building, social activities and things like that.
Senator Ocke.
Thank you, Madam Chair. That's all. Appreciate it.
Thank. Thank you. Senator Gruenhagen.
Yeah, Just for my own clarification, Senator Utke's comments about liability, to me, if the nursing home gets involved, whether they give it away free or whatever, you know, a lot of these residents have physical health problems. If they fall and hurt themselves, who's going to be liable?
Ms. Hubert?
I mean, there's a difference between if the family brings it to them and then they can drink. I'm sorry? You know, if the family brings it to them and they can drink outside their room, that's one thing. But if the nursing home gets involved, to me, if the resident falls, and there's already a lot of falls in nursing homes sometimes, who's liable?
Ms. Hubert or Mr. Bergman? No, I didn't get that right. Bern. Mr. Burnt, go ahead.
Thank you, Madam Chair, members of the committee, my name is Kyle Burnt with the long term care imperative here today. Thank you, Senator, for the question I would want to direct to just generally, these facilities carry a substantial amount of liability insurance and things like that already. That's what we hear from our members. Obviously those acuity aspects are part of the reality of being in a nursing facility. So I don't know that that creates any new liabilities that don't already exist. It would just be being aware of them and functioning within that regulatory framework that already exists.
Senator Gruenhagen.
Oh, thank you, Madam Chair. Yeah, so. But I mean, you start drinking alcohol, you can get a little tipsy. So maybe we should all have a drink before we vote on this bill.
That's just a thought.
Thanks, Senator. I wouldn't turn it down. Senator Abel.
Well, thanks. And I don't know if the vote was divided in commerce, but it just seems like a really simple bill. I think they're going to buy like two bottles of wine. They're going to get some kind of rose wine, which rose. But anyway, kind of that pink stuff. And so they're going to sit on a sunny afternoon in their little common area, and they might get some of those little frozen, you know, the little barley ones that are kind of beer based or those little packets that are frozen. It's going to be just little. And that's all. I just. I think we're overthinking This, I just thought it'd be. I mean, I think some people would enjoy this and I just, it's. I don't see that they're going to set up a whole bar and have martinis and which kind you want to make it dirty for me and all that. But I anyway, just hope we can pass this, so. Thank you, Madam Chair.
I'll just, I'll speak, I'll speak it just in favor of the amendment. You know, there's a lot of autonomy that you lose when you are become an older adult and. But you don't stop being an adult with decision making capabilities and wanting to be able to retain some semblance of your adult life. And so I think I trust older adults to make responsible decisions and then the facilities where they live and people who care for them. So I'm happy to support the amendment. I was proud to sign onto the clone bill. And so with that, Senator Aylor renews his motion to pass the A2amendment. Senator Abel, can I just point out that you have a typo on 1.21. You're missing the word B after the word may.
I'll be happy to incorporate that if Mr. Monahan, or.
Sorry, the word B after the word not. Excuse me.
I'm happy to incorporate that.
Okay. Mr. Monahan.
The Senate grammarian agrees.
Madam Chair, members. So you want to make an oral amendment?
Yes, Mr. Monahan.
Madam Chair, members, Senator Abler moves to amend the A2amendment to House File 3379 as follows. Page 1, line 21 after not insert B.
Sure. But all those in favor of the Oral Amendment as described by Mr. Monahan, please say aye. Aye.
Those opposed?
The Oral Amendment is adopted. Senator Ablor, do you want to say anything else before we go to your A2 as amended?
I'm excited for the opportunity to give some of these folks a nice spring afternoon.
All right, all those in favor of the A2 as amended, please say aye.
Aye. All those opposed?
Aye.
All right, the amendment is adopted.
Thank you.
I appreciate it.
Thank you, Senator Abler. So before us we have House File 3379 as amended. I don't have the sheet in front of me, but it is being recommended to pass and sent to general orders. Senator Rasmussen?
Yes, thank you, Madam Chair. And I appreciate the conversation today. And I think there's a lot, a lot of good things in this bill. I did just want to point out that there are two meaningful differences in the DE versus the language that passed the other body and that would be section 6 on page 7 and then also section 10 on page 9. And so I just wanted to let members know that I do have some concerns around these sections being included. Even though I would agree that there was, you know, some questions over what authority DHS acted under, I worry about the alternative would have been to continue to have money go out to bad actors within the program. So those would just be some questions I'll be asking the department about. And then also in section 10 for the housing Stabilization Service redesign, I don't know if that will come with a cost for including that language. And so I'm not going to make any motions today to remove those sections, but just wanted to express that I'll be continuing to think about those sections as this bill comes to the floor. Thank you, Madam Chair.
Thank you, Senator A.S.M. i will. I mean, so this is not in response to what you said, Senator Ashwin, but thank you for reminding me for us to talk about the bill as amended. You know, I do like this language in Section 6, and I do hope that we can be really clear in this committee and on the floor that there is a difference between payment withholds, prepayment reviews, and unilaterally terminating a program, because the people who create programs is the legislature and the people who can terminate programs, the legislature. And so I do want us, you know, it is odd to me that we would have to clarify that in statute because that's how their government is set up. But if we have to do that, then I suppose we have to do that. Senator Gruenhagen Yes.
Just a real quick question on that comment. So can the governor pause it if he thinks there's fraud subject to what the legislature does or not?
Senator Gruenhagen, that's a great question. I don't know if I'm the final authority on that, but I will say I did ask the OIG that exact question, or I offered that as something they could have done. And he said, oh, I don't think we have the authority to pause a pro. To pause a program. And I said, but you had the authority to terminate it, so it's a good question. I think you could probably effectively pause a program through payment withholds.
Senator Grinhein well, Madam Chair, that's been part of the excuse for not addressing the fraud is that, well, we didn't have the legal authority to pause it or stop it. And of course, Ola said the DHS did in the, in the one case,
but
appreciate getting that clarified somehow.
So thanks.
Okay. Senator Abeler.
I just did some research in the back of the room. Section 10 has no cost. The redesign does not part of what they're going to do. They gave TA to make it without a cost. And Madam Chair, I agree with you about the language about making sure that the executive branch knows there's a legislature here. So I like that.
Thank you.
Thank you. Any other comments on Senate file? House file 3379 as amended. Okay, so Senator Hoffman renews his motion that House File 3379 as amended. Be. Wait, can I do that? He's not here. Senator Fate. We use this motion that House about 3379 as amended be recommended to pass and sent to general orders. All those in favor say aye. Aye. All those opposed?
All right.
House 3379 is amended is on general orders. And with that, members, we are adjourned.
Sa.