S.F. No. 654 Summary

• Creates a new shared services framework allowing one direct care worker to provide services simultaneously to up to three individuals who have agreed to share home and community-based services, with services limited to chore, extended home care, homemaker, individualized home supports, integrated community supports, night supervision, and other appropriate supports.

• Requires development of a shared services agreement between individuals and providers that includes names of participants and their representatives, case managers, service provider, schedule, location, training requirements, documentation instructions, contingency plans for absences, and signatures from all parties.

• Establishes payment rate adjustments for shared services, allowing providers to bill up to 1.5 times the single individual rate for two-person sharing and up to 2 times the rate for three-person sharing, but only when all shared service criteria are met.

• Directs the commissioner to submit federal amendments to Centers for Medicare and Medicaid Services by September 30, 2023, and develop guidance including payment recommendations and a shared services agreement template.

• Authorizes indirect billing for individualized home supports with training for health provider coordination and care coordination, and allows services to be provided to participants temporarily traveling or attending out-of-state postsecondary schools, with federal submissions required by December 1, 2023.