2025 Legislative Agenda
The Residential Providers Association of Minnesota (RPAMN) is a non-profit trade association
that represents small, residential customized living and waiver service providers in Minnesota.
We seek to represent all providers, but with a particular focus on engaging BIPOC-owned,
culturally-specific service providers who might not otherwise be engaged in the 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 providers
equitably and uses a one-size-fits-all approach.
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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.
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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.