SF4698 (Legislative Session 94 (2025-2026))
Community first services and support program modification
AI Generated Summary
Purpose
Clarify and strengthen the Community First Services and Supports (CFSS) program. The bill aims to make CFSS more person-centered, increase accountability for providers, expand monitoring and training requirements, and align financial and administrative practices with state standards. It also adds protections to ensure services are appropriate, properly funded, and delivered by qualified providers.
Main Provisions
CFSS service delivery plan updates
- Plans must be created and reviewed through a person-centered planning process led by the participant or their representative.
- Must reflect what the participant needs and wants, the setting they live in, strengths, goals, and the supports (paid and unpaid) that will help them meet those goals.
- Must specify how much in services is available (units or dollars), how often supports will occur (face-to-face and remote/technology), and include budget details and a plan for worker training per subdivision 18a.
- Must identify risk factors and backup plans, be understandable, finalized in writing, and distributed to the participant and others involved.
- Requires annual review or review when there is significant change in the participant’s condition or needs.
- Requires approval by the lead agency (or case manager/care coordinator for waiver participants) and coordination with the consultation services provider and other parties involved.
Provider qualifications and duties (Agency providers and FMS providers)
- Must enroll as Minnesota Health Care Programs (MA) providers, meet all standards, complete required training, and comply with applicable laws and policies.
- Must pass background checks, maintain service and expenditure records, and document hours worked.
- Prohibited from agency-initiated in-person or electronic marketing to potential participants or their families.
- Must provide direct services (no subcontracting for those services) and meet financial solvency requirements.
- Must have a Minnesota-based office and meet other financial and integrity standards (no fraud history with lead agencies, etc.).
- Must bill based on actual hours, cover training costs, handle payroll taxes, unemployment, workers’ compensation, liability insurance, and other benefits.
- Must enter written agreements with participants or their representatives detailing roles and responsibilities before services begin.
- Must report maltreatment, comply with labor market reporting, and respond to data requests.
- Must maintain documentation to qualify for enhanced rates and request reassessments 60 days before current authorization ends.
- Must notify the commissioner of changes in worker employment status and do so within specified time frames (e.g., six months after a worker leaves; 30 days for workers in training roles).
Enrollment and compliance requirements for CFSS providers
- Enrolling providers must share contact information, proof of surety bonds, fidelity bonds, workers’ compensation, liability insurance, and other financial safeguards.
- Bond requirements scale with current or prior MA revenue (lower revenue → smaller bond; higher revenue → larger bond).
- Must provide an organizational chart and documentation on policies (hiring, training, fraud prevention, billing, safety, grievances, incident response, disease prevention, etc.).
- Must show how 72.5% of CFSS revenue (from those services) will go toward support worker wages and benefits; special treatment for revenue increases due to collective bargaining agreements.
- Must disclose ownership and affiliations, marketing practices, and ensure no participant is coerced into non-competitive agreements.
- Requires self-auditing policies and yearly or periodic reporting to the commissioner; training for leadership and management staff; and compliance with documentation deadlines.
Worker training and development (CFSS staff and consultants)
- Establishes the scope, standards, and limits for worker training and development.
- Costs are added to the participant’s service budget and may be provided by the agency or purchased by the participant’s employer.
- Training must be delivered by qualified personnel and tied to the participant’s assessed needs and CFSS plan.
- Includes tuition for related classes, direct observation and coaching, and documentation of staff skills beyond what the participant or participant’s representative provides.
- Training is generally required at the start of a worker’s service for a participant; general agency training or CFSS self-directed-model training is not included.
- Requires documentation of all training, including the trainer, participant, and staff identifiers, and limits on training expenses.
Consultation services and exemptions
- Consultation services providers must meet specific qualifications and be under contract with the department (not the lead agency or FMS provider).
- Bond requirements and other qualifications apply to consultation services providers as well.
- There is a formal exemption: a participant may be exempt from mandatory consultation services if the same provider is used and there has been no significant change in condition since the last assessment or CFSS plan review. Lead agencies must document when exemption does or does not apply.
Uniformity with state requirements
- Managed care plans and county purchasing plans must not add more restrictive requirements for CFSS than those imposed by the commissioner (e.g., on authorization amounts, provider identifiers, claims, or daily time and activities documentation).
Significant Changes from Current Law
Increased financial oversight and safeguards
- New bonding requirements (surety, fidelity) tied to MA revenue, with annual renewals and debt recovery timelines.
- Clear capital requirements for new CFSS agency providers to demonstrate operating capital.
- Detailed organizational structure, policies, and internal controls required for providers.
Enhanced wage and use of funds rules
- A defined portion (72.5%) of CFSS revenue must be used for support worker wages and benefits (with exceptions for wage increases tied to collective bargaining agreements).
Expanded training and workforce requirements
- Mandatory training for management and supervisory staff, with cross-organization transfer provisions for existing staff.
- Formalized worker training and development processes, including direct observation and documentation of skills.
Expanded duties and reporting
- Increased administrative duties for providers, including more frequent reassessments, monitoring of service delivery plans, and stricter reporting to the commissioner.
Participant protections and flexibility
- Maintains option for consultation services exemption under defined conditions to avoid unnecessary service requirements when there is no significant change.
Implementation and Oversight
- The Department and lead agencies will set formats and criteria for CFSS plans and monitoring.
- Lead agencies or case managers will approve CFSS plans for waiver participants; others require lead agency approval.
- The commissioner will oversee provider enrollment, bonding, financial solvency, and data reporting requirements.
- There are defined timelines for notifying changes in worker employment and for submitting required documentation.
Potential Impacts and Considerations
- For participants: stronger protections around service planning, budget transparency, and worker qualifications; potential for more stable service delivery and clearer budgeting.
- For agencies/providers: higher upfront costs to meet bonding, insurance, documentation, and training requirements; greater ongoing administrative workload; need to manage fund allocation toward wages as specified.
- For the system: improved consistency across plans and providers, with stronger safeguards against fraud and mismanagement; possible adjustments in how CFSS services are budgeted and delivered.
Relevant Terms - CFSS (Community First Services and Supports) - service delivery plan - person-centered planning - lead agency - case manager - care coordinator - agency provider - FMS provider - Minnesota Health Care Programs (MA) - medical assistance - service budget - units - face-to-face supports - remote supports - technology - risk factors - backup plans - natural supports - paid and unpaid supports - consultation services provider - lead professional staff - bond (surety bond) - fidelity bond - workers’ compensation - liability insurance - organizational chart - self-auditing - training requirements - data practices - CFSS plan documentation - vendor fiscal-employer agent (FMS) model - self-directed program - uniformity with state requirements - MA revenue - revenue use (wages and benefits) - collective bargaining agreement (CBA) - reassessment - support worker - wages and benefits allocation - exemption from consultation services
Bill text versions
- Introduction PDF PDF file
Actions
| Date | Chamber | Where | Type | Name | Committee Name |
|---|---|---|---|---|---|
| March 23, 2026 | Senate | Action | Introduction and first reading | ||
| March 23, 2026 | Senate | Action | Referred to | Human Services |
Citations
[
{
"analysis": {
"added": [
"Requirement that the CFSS service delivery plan be developed through a person-centered planning process.",
"Plan must reflect services and supports important to the participant, aligned with assessments and identified in the CFSS support plan.",
"Annual review and reassessment or significant change triggers for plan reevaluation.",
"Commissioner to establish format and criteria for the CFSS service delivery plan.",
"Plan must include detailed budget, service components, and training/development plan, with clear responsibility for monitoring and implementation."
],
"removed": [],
"summary": "Amends CFSS to require the CFSS service delivery plan to be developed and evaluated via a person-centered planning process, reflect services important to the participant, be reviewed at specified times, and set format/criteria by the commissioner. The plan must be person-centered, specify providers, and include detailed content elements (setting, strengths, needs, goals, budget, risk factors, monitoring, signing, distribution, and effort to prevent unnecessary care).",
"modified": [
"Substantive expansion of CFSS plan content and review requirements, including alignment with assessments and other plan references (e.g., sections 256B.092, 256S.10)."
]
},
"citation": "256B.85",
"subdivision": "6"
},
{
"analysis": {
"added": [
"Mandatory enrollment as a Minnesota Health Care Programs (MA) provider and adherence to applicable provider standards and required training.",
"Demonstrated compliance with federal and state laws; background study requirements under chapter 245C; and documentation of service expenditures and hours worked.",
"Prohibition on in-person agency-initiated marketing to potential participants, guardians, or representatives.",
"Restriction against subcontracting or reporting agents for direct CFSS services; requirement to meet financial solvency standards."
],
"removed": [],
"summary": "Adds and clarifies agency/provider qualifications and duties for CFSS providers, including MA enrollment, standards, training, compliance, and prohibited practices.",
"modified": [
"Consolidates and codifies multiple provider duties into a single subdivision, clarifying expectations for CFSS agencyproviders and FMS providers."
]
},
"citation": "256B.85",
"subdivision": "10"
},
{
"analysis": {
"added": [
"Mandatory surety bond depending on Medicaid revenue levels (tiered thresholds: ≤$300,000; >$300,000 to $750,000; >$750,000). Bond forms approved by the commissioner and renewals every year with recovery rights.",
"Fidelity bond, workers' compensation, and liability insurance requirements.",
"Organizational chart showing owners, managers, directors, and affiliations; written policies and procedures for fraud prevention, record-keeping, safety, grievances, and incident response.",
"Documentation of revenue allocation toward CFSS worker wages and benefits (including specific percentage rules and exclusions for wage increases tied to CBAs).",
"List of required forms and documents (time sheets, CFSS service delivery plan, training lists, marketing practices, and disclosures of ownership/property management).",
"Requirements that CFSS providers disclose affiliations and ensure non-restrictive practices (not forcing exclusive provider arrangements).",
"Annual self-auditing policy and ongoing program integrity materials; notification policies for worker changes and other staffing events."
],
"removed": [],
"summary": "Imposes comprehensive enrollment requirements for CFSS agencyproviders, detailing bonding, insurance, organizational, governance, and documentation standards.",
"modified": [
"Significant expansion of enrollment prerequisites to improve provider integrity, financial solvency, governance transparency, and compliance controls."
]
},
"citation": "256B.85",
"subdivision": "12"
},
{
"analysis": {
"added": [
"CSPs must meet requirements of subdivision 10 (excluding certain clauses), be under contract with the Department, and be enrolled as MA providers (not be FMS providers, lead agencies, or CFSS/HCBS waiver vendors).",
"Bonding requirements (surety bond tiers) and proof of lead professional staff with relevant experience (minimum two years).",
"Mandatory maltreatment reporting, MA provider compliance, and CFSS policy knowledge.",
"Staff including lead professionals must be trained; knowledge of self-directed concepts and vendor/employee relations."
],
"removed": [],
"summary": "Defines qualifications and requirements for Consultation Services Providers (CSPs) who work with CFSS, including bond requirements, staffing, maltreatment reporting, MA provider requirements, and knowledge of CFSS and related laws.",
"modified": [
"Adds CSP-specific qualifications and cross-references to other CFSS requirements (e.g., service standards, bond coverage, reporting)."
]
},
"citation": "256B.85",
"subdivision": "17a"
},
{
"analysis": {
"added": [
"Exemption from CSP consultation if participant has previously received consultation services and condition has not significantly changed, or has not previously received consultation services but condition has not changed significantly since last assessment or CFSS plan review.",
"Lead agency must document exemption basis in the participant's case record.",
"Explicit allowance for requests for CSP consultation at any time; no obligation to provide exemption even if documentation indicates significant change."
],
"removed": [],
"summary": "Exemption from consultation services; specifies when participants may be exempt from requiring CSP consultation if conditions of stability and consistency are met.",
"modified": [
"Introduces a conditional exemption framework to allow flexibility in CSP consultation while preserving documentation requirements."
]
},
"citation": "256B.85",
"subdivision": "17b"
},
{
"analysis": {
"added": [
"Commissioner to develop scope of tasks, service standards, and service limits for worker training and development.",
"Costs for worker training and development are in addition to the participant's service units/budget; services can be provided by agencyproviders or purchased by the participant employer.",
"Training components include direct instruction, tuition, observation, coaching, and documentation of competencies; start at service start or new worker start; must be described in the CFSS plan and participant file.",
"Specific training activities to improve worker skills and comply with CFSS plan; continuous competency evaluation."
],
"removed": [],
"summary": "Establishes the scope, standards, and limits for Worker Training and Development services; defines delivery methods, cost structure, and required documentation.",
"modified": [
"Broadens and formalizes worker training and development as a distinct service line with standards, costs, and documentation requirements."
]
},
"citation": "256B.85",
"subdivision": "18a"
},
{
"analysis": {
"added": [
"Notice requirement within 30 days of ceasing employment of an individual providing worker training and development on behalf of CFSS agencyproviders or participant employers."
],
"removed": [],
"summary": "Worker training and development notice of change of employment; requires timely notification when individuals providing worker training and development cease employment.",
"modified": [
"Adds explicit notice obligations to ensure continuity and accountability for training services."
]
},
"citation": "256B.85",
"subdivision": "18c"
},
{
"analysis": {
"added": [
"Within six months after a CFSS support worker is no longer employed or affiliated, the agency/provider must notify the commissioner.",
"Within 30 days after the date an individual providing worker training and development ceases employment or affiliation, notice to the commissioner is required."
],
"removed": [],
"summary": "Notice of change of employment for CFSS workforce; establishes reporting deadlines for CFSS agencyproviders and related personnel.",
"modified": [
"Adds formalized notification timelines to improve workforce tracking and program integrity."
]
},
"citation": "256B.85",
"subdivision": "16b"
},
{
"analysis": {
"added": [
"Prohibits more restrictive requirements on CFSS service authorization amounts, provider identifiers, claims submission, and time/activity documentation by managed care and county-based purchasing plans."
],
"removed": [],
"summary": "Uniformity with state requirements; ensures managed care and county-based purchasing do not impose more restrictive CFSS requirements than those set by the commissioner.",
"modified": [
"Clarifies that state-level standards control CFSS requirements, preventing overly burdensome local variations."
]
},
"citation": "256B.85",
"subdivision": "27"
},
{
"analysis": {
"added": [
"Referencing that final agency decisions occur after exhaustion of appeal rights or expiration of appeal period under 256B.064."
],
"removed": [],
"summary": "Provides for finality of agency decisions, particularly in relation to debts or sanctions under CFSS-related provisions.",
"modified": [
"Connects CFSS enforcement actions to established debt/appeal procedures."
]
},
"citation": "256B.064",
"subdivision": ""
},
{
"analysis": {
"added": [
"Compliance with Minn. Gen. Data Practices Act (chapter 13) when handling data requests or disclosures related to CFSS providers and participants."
],
"removed": [],
"summary": "References the Minnesota Government Data Practices Act (chapter 13) in relation to data requests and privacy considerations for CFSS providers.",
"modified": [
"Integrates data practices requirements into CFSS oversight and reporting."
]
},
"citation": "13",
"subdivision": ""
},
{
"analysis": {
"added": [
"Reference to complying with labor market reporting described in 256B.4912."
],
"removed": [],
"summary": "Cites labor market reporting requirements related to CFSS and the obligations for providers under state reporting laws.",
"modified": [
"Anchors CFSS provider reporting obligations to existing labor market reporting statutes."
]
},
"citation": "256B.4912",
"subdivision": ""
},
{
"analysis": {
"added": [
"Direct citation to background study requirements governing CFSS agencyproviders and providers (245C)."
],
"removed": [],
"summary": "Background study requirements; references to 245C in relation to CFSS provider background checks.",
"modified": [
"Ensures CFSS-related providers adhere to mandated background checks."
]
},
"citation": "245C",
"subdivision": ""
},
{
"analysis": {
"added": [
"Cross-reference to section 179A.54 for application of CBAs and related wage provisions to CFSS funding and provider compensation."
],
"removed": [],
"summary": "References to CPSS-related collective bargaining and wage provisions (CBAs) as they relate to funding and wage allocations.",
"modified": [
"Links CFSS provider wage allocations to state collective bargaining framework."
]
},
"citation": "179A.54",
"subdivision": ""
},
{
"analysis": {
"added": [
"Mandates reporting of maltreatment as required by 626.557."
],
"removed": [],
"summary": "Maltreatment reporting requirements; CFSS provider duties to report maltreatment under statute 626.557.",
"modified": [
"Reinforces child/adult maltreatment reporting obligations for CFSS providers."
]
},
"citation": "626.557",
"subdivision": ""
},
{
"analysis": {
"added": [
"Cites compliance with Chapter 260E for reporting and related protections."
],
"removed": [],
"summary": "References to Chapter 260E for maltreatment reporting and related protections, aligning CFSS with elder/ vulnerable adult protections.",
"modified": [
"Integrates CFSS reporting obligations with established Chapter 260E frameworks."
]
},
"citation": "260E",
"subdivision": ""
}
]Progress through the legislative process
In Committee