2025 Legislative Agenda

The Residential Providers Association of Minnesota (RPAMN) is a nonprofit trade association that represents small, residential, customized living, and waiver service providers in Minnesota. We seek to represent all providers, with a particular focus on engaging BIPOC-owned, culturally specific service providers who may not otherwise be involved in policy development and legislative processes.

Unintended Impact of 2023 Direct Care Staff Requirements

As of January 1, 2025, all providers delivering services reimbursed under the Disability Waiver Rate System (DWRS) will be required to use a certain percentage of Medical Assistance (MA) dollars toward the wages and benefits of direct care workers. For residential providers, this requirement is 66%. However, this new mandate does not treat all residential provider equitably and uses a one-size-fits-all approach.

The 66% requirement extends to assisted living providers licensed by the Minnesota

Department of Health (under Chapter 144G) while relying on data and cost-reporting
methodologies developed for home and community-based services (HCBS) services
providers licensed by the Minnesota Department of Human Services (under Chapter 245D) It fails to account for the various assisted living licensing costs (ex. licensed AL Director, certified food protection manager, etc.) that are not required of any other DWRS providers.

It disproportionately impacts small, often BIPOC-owned, service providers who historically struggled to get housing support contracts from counties and have had to draw on all available resources to make rent/mortgage payments.

RPAMN proposes legislation that would clarify that this requirement does not to apply to
licensed assisted living facilities and a delay in implementation in order to work on
improvements and clarity on the cost reporting process.

Integrated Community Supports (ICS) Improvements

For the past few years, small assisted living providers have been encouraged to transition to the Integrated Community Supports (ICS) program. However, the program’s implementation has been chaotic, and providers face obstacles in making the transition or navigating the new program as an ICS provider.

Codification of the ICS Program
The ICS program is a creation of DHS and providers struggle to navigate the program requirements because there are no statutory guidelines. Codifying the program in statute would create transparency about the program’s functionality and its processes. It will also allow for provider input in the program so that improvements can be made during future legislative sessions.

ICS Licensing Issues
Providers who are actively transitioning to providing ICS services are facing months of delays in licensing and approval processes and there is no clear process or timeline for ICS licensing approval. Providers are frequently forced to pay for apartments where they cannot provide services while they wait for the settings to be approved. More importantly, the clients who are transitioning to the new settings are in limbo as they wait to move to a new setting. RPAMN seeks legislative support for the licensing process changes, review timelines, and state resources needed to address these untenable administrative delays.

Assisted Living Licensing Service Termination Changes

Since the implementation of the state’s new assisted living licensure law in 2021, providers have had time to assess the need for updates or changes to the licensing. One major issue is the inability of assisted living facilities to transition clients who they can no longer safely serve to facilities where their care needs can be better met.

As Minnesota prioritizes hospital decompression, RPAMN’s members are often a part of the solution by taking in clients experiencing serious and persistent mental illness. However, if the setting is found to not be the right level of care for the client due to behavioral health needs, providers do not have access to a process to support that individual in transitioning to a new setting that best fits their needs. Further, physical safety issues are more pronounced in small facilities and providers have fewer tools available to minimize their impact on their residents and staff. RPAMN supports a proposal that would streamline the service termination process in limited, emergent circumstances to ensure the health and safety of the individual, the other residents, and the staff.

Greater Access to Housing Support for People with Disabilities

While Medicaid waiver programs fund the cost of services, these dollars cannot be used to support the cost of room and board, even when a client is receiving services in a provider-controlled setting like ICS. Many RPAMN clients struggle to stay current with their housing-related expenses. RPAMN seeks a legislative change that would ensure providers can contract with counties so that residents eligible for Housing Support can use it toward their room and board costs. This will ensure the financial stability of both the residents and providers.

Thank you to our Associate Members!