Purpose of the Bill

The bill aims to establish a demonstration project for a new model of coordinated healthcare services for people with disabilities in Minnesota. This project is led by disability services providers and will integrate various services including those offered under medical assistance and Medicare. The goal is to enhance service coordination, address health-related social needs, and prioritize the choices of enrollees.

Main Provisions

1. Demonstration Project Setup: The commissioner will establish the project, which tests a coordinated services organization model, working with providers across medical and social services.

2. Application Process: Interested providers must apply to participate. The application will focus on measuring well-being, access, satisfaction, cost savings, and meeting quality standards. It will encourage innovation and collaborations among disability service providers.

3. Eligibility and Enrollment:

   • To qualify, entities must demonstrate integration of home and community services with health care.
   • Individuals eligible under the program include those receiving both medical assistance and Medicare, and those in special needs basic care who receive waiver services.

4. Accountability and Evaluation:

   • Participating organizations will be accountable for the quality and costs of care.
   • They will demonstrate coordination of health and social services in the community.
   • Future contracts may expand to include additional activities related to long-term care and support services.

5. Payment System:

   • Establishes a per-member per-month payment model that reflects activities and metrics of the organizations.
   • Payments will be risk-adjusted based on the complexity of care needs.
   • Incentives may be provided for meeting quality and performance targets.
   • Providers will continue receiving existing service rates under Medicaid.

6. Federal Approval: The project will seek necessary federal approval to maximize funding.

7. Innovation Grants: The bill proposes establishing grants to support initial setup costs and encourage integration and innovation among organizations.

8. Appropriations: Funds are allocated for fiscal years 2026 and 2027 to support these innovation and capacity-building grants, with a cap of $2,000,000 per organization during the biennium.

Significant Changes

• Introduces a new pilot model to coordinate disability services with health services, shifting from traditional single-service models to a more integrated approach.
• Encourages a partnership model between home-based and health care providers to foster better service delivery and outcomes.

Relevant Terms

coordinated services organization, disability services, medical assistance, Medicare, waiver services, special needs basic care, provider-led model, demonstration project, innovation grants, integrated health partnerships, population health.