HF500

Purpose

• Establish and enforce minimum employment standards for nursing home workers in Minnesota, focused on protecting workers’ health and welfare and ensuring workers are trained and informed about their rights.

Main entity and scope

• Creates a Nursing Home Workforce Standards Board responsible for developing and enforcing minimum nursing home employment standards.
• Standards cover wages, benefits, training, and worker rights related to sections 181.211 to 181.217, with potential references to health and safety standards.

Key provisions and actions

• Board structure and voting requirements

  • The board requires affirmative votes to take action, with a higher threshold (six votes) for actions needed to establish minimum nursing home employment standards.
  • Representation rules require votes from three groups: commissioners (or their designees), nursing home employers (or employer organizations), and nursing home workers (or worker organizations). This ensures input from government, employers, and workers.

• Authority to establish minimum standards

  • The board must adopt rules establishing minimum nursing home employment standards that are reasonably necessary to protect workers’ health and welfare and to inform workers about their rights under the relevant statutes.
  • Standards may include wages and may include recommendations. The board cannot adopt standards that are less protective than existing laws unless certain budget-related exceptions apply (i.e., when existing standards exceed certain payment rate levels in the most recent budget forecast).

• Initial wage standards and consultation

  • The board must establish initial wage standards for nursing home workers by no later than November 1, 2024.
  • The board can use rulemaking authority to set these standards and must consult with the Department in developing them.

• Health and safety considerations

  • If any minimum standards fall within the jurisdiction of occupational health and safety rules, the board may recommend these standards to the commissioner, who would adopt health and safety standards under the relevant statute (with a process for justification if the recommendation is not adopted).

• Market conditions and local implementation

  • The board must investigate market conditions (wages, benefits, working conditions) for nursing home workers by geographic area and occupation.
  • They must aim to set standards that meet or exceed the conditions for a majority of workers in the area and occupation.
  • Initial employment standards become effective January 1, 2025, and stay in effect until updated by subsequent standards.

• Funding impact and legislative oversight

  • The board must consider how wage and benefit increases would affect nursing home operating payment rates (section 256R.21) and the employee benefits portion of the external fixed costs payment rate (section 256R.25).
  • If increases are needed to meet the new standards, the board must report the required funding to the legislature and make implementation contingent on a funded appropriation and federal approval.
  • Forecasts and budget calculations cannot assume these rate increases until the board certifies that increases are needed and funding is appropriated.

• Cost estimation and rate adjustments

  • For any new standard, the Department of Human Services (DHS) must provide facility-specific cost estimates, including:
  • Increased wages and the employer share of payroll taxes, unemployment, workers’ compensation, pensions, and retirement contributions
  • Indirect costs resulting from implementing the standard
  • Rates may be adjusted to reflect these costs, on the first day of the month prior to the standard’s implementation.
  • If the Legislature does not appropriate funds, the new standard does not take effect.

• Rulemaking and review

  • The board must review standards at least every two years and may adopt, amend, or repeal rules accordingly, using expedited rulemaking when appropriate.

• Training and certification of training providers

  • The board will certify worker organizations and employer organizations that provide training to nursing home workers.
  • Certification criteria and renewal processes will be established by rule, ensuring providers can deliver effective training in multiple languages.

• Posting and notice requirements

  • Rules will specify the minimum content and posting requirements for notices related to the standards.
  • The board will provide templates or sample notices to employers to satisfy these requirements.

Significant changes to current law (high-level)

• Creation of a dedicated Nursing Home Workforce Standards Board with explicit authority to set minimum employment standards, including wages and training requirements, linked to funding and rate-setting processes.
• Mandatory wage standards development by a specific date (initial wages by November 1, 2024) and ongoing market-condition-based updates (every two years or as expedited rulemaking allows).
• Connection between workforce standards and Medicaid/operating payment rate funding, requiring legislative appropriation and federal approvals before new standards take effect.
• Expanded governance and accountability through structured representation (government, employers, workers) in board voting to approve standards.
• New processes for certifying training organizations and ensuring training is accessible in workers’ languages.

How this bill would affect nursing homes

• Nursing homes would need to adapt to new minimum wage and workforce standards, potentially increasing labor costs.
• Any wage/benefit increases would be tied to funding in state budgets, with rate adjustments made only after appropriation and approved by authorities.
• Employers would interact with certified training providers and would need to comply with posting and notice requirements.

Related mechanisms and references in the bill

• Operating payment rate (section 256R.21)
• External fixed costs payment rate (section 256R.25)
• Budget and economic forecast (section 16A.103)
• Health and safety standards (section 182.655)
• Occupational health and safety standards (via potential referral to the commissioner)
• Rulemaking authority (section 14.389)
• Expedited rulemaking process (section 14.389)

Timeline snapshot

• Initial wage standards: by November 1, 2024
• First set of minimum wage/standards effective: January 1, 2025
• Ongoing: biennial review and potential updates; funding-dependent implementation

Potential implementation conditions

• Standards take effect only if the legislature appropriates funding and, where required, if federal approval is obtained.
• Budget forecasts will not assume increases unless the board certifies rate needs and funding is available.

Relevant Terms - minimum nursing home employment standards - Nursing Home Workforce Standards Board - wages and benefits (wage rates, benefits) - health and welfare of nursing home workers - training and certification - operating payment rate (256R.21) - external fixed costs payment rate (256R.25) - budget and economic forecast (16A.103) - occupational health and safety standards - health and safety standards (section 182.655) - rulemaking (section 14.389) - expedited rulemaking - geographic areas and nursing home occupations - collective bargaining agreements - posting requirements - notice templates - funding/appropriation - federal approval