KEY: stricken = removed, old language.underscored = new language to be added
scs-hhs-contingentreform--art2
A bill for an act
relating to BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:40.4 Section 1. Minnesota Statutes 2012, section 144.0724, subdivision 4, is amended to read:
40.5 Subd. 4. Resident assessment schedule. (a) A facility must conduct and
40.6electronically submit to the commissioner of health case mix assessments that conform
40.7with the assessment schedule defined by Code of Federal Regulations, title 42, section
40.8483.20, and published by the United States Department of Health and Human Services,
40.9Centers for Medicare and Medicaid Services, in the Long Term Care Assessment
40.10Instrument User's Manual, version 3.0, and subsequent updates when issued by the
40.11Centers for Medicare and Medicaid Services. The commissioner of health may substitute
40.12successor manuals or question and answer documents published by the United States
40.13Department of Health and Human Services, Centers for Medicare and Medicaid Services,
40.14to replace or supplement the current version of the manual or document.
40.15(b) The assessments used to determine a case mix classification for reimbursement
40.16include the following:
40.17(1) a new admission assessment must be completed by day 14 following admission;
40.18(2) an annual assessment which must have an assessment reference date (ARD)
40.19within 366 days of the ARD of the last comprehensive assessment;
40.20(3) a significant change assessment must be completed within 14 days of the
40.21identification of a significant change; and
40.22(4) all quarterly assessments must have an assessment reference date (ARD) within
40.2392 days of the ARD of the previous assessment.
40.24(c) In addition to the assessments listed in paragraph (b), the assessments used to
40.25determine nursing facility level of care include the following:
40.26(1) preadmission screening completed under section
40.27
40.28
40.29or other organization under contract with the Minnesota Board on Aging; and
40.30(2) a nursing facility level of care determination as provided for under section
40.31256B.0911, subdivision 4e, as part of a face-to-face long-term care consultation assessment
40.32completed under section
40.33managed care organization under contract with the Department of Human Services.
40.34 Sec. 2. Minnesota Statutes 2012, section 144A.351, is amended to read:
41.1144A.351 BALANCING LONG-TERM CARE SERVICES AND SUPPORTS:
41.2REPORT AND STUDY REQUIRED.
41.3 Subdivision 1. Report requirements. The commissioners of health and human
41.4services, with the cooperation of counties and in consultation with stakeholders, including
41.5persons who need or are using long-term care services and supports, lead agencies,
41.6regional entities, senior, disability, and mental health organization representatives, service
41.7providers, and community members shall prepare a report to the legislature by August 15,
41.82013, and biennially thereafter, regarding the status of the full range of long-term care
41.9services and supports for the elderly and children and adults with disabilities and mental
41.10illnesses in Minnesota. The report shall address:
41.11 (1) demographics and need for long-term care services and supports in Minnesota;
41.12 (2) summary of county and regional reports on long-term care gaps, surpluses,
41.13imbalances, and corrective action plans;
41.14 (3) status of long-term care services and related mental health services, housing
41.15options, and supports by county and region including:
41.16 (i) changes in availability of the range of long-term care services and housing options;
41.17 (ii) access problems, including access to the least restrictive and most integrated
41.18services and settings, regarding long-term care services; and
41.19 (iii) comparative measures of long-term care services availability, including serving
41.20people in their home areas near family, and changes over time; and
41.21 (4) recommendations regarding goals for the future of long-term care services and
41.22supports, policy and fiscal changes, and resource development and transition needs.
41.23 Subd. 2. Critical access study. The commissioner shall conduct a onetime study to
41.24assess local capacity and availability of home and community-based services for older
41.25adults, people with disabilities, and people with mental illnesses. The study must assess
41.26critical access at the community level and identify potential strategies to build home and
41.27community-based service capacity in critical access areas. The report shall be submitted
41.28to the legislature no later than August 15, 2015.
41.29 Sec. 3. Minnesota Statutes 2012, section 148E.065, subdivision 4a, is amended to read:
41.30 Subd. 4a. City, county, and state social workers. (a) Beginning July 1, 2016, the
41.31licensure of city, county, and state agency social workers is voluntary, except an individual
41.32who is newly employed by a city or state agency after July 1, 2016, must be licensed
41.33if the individual who provides social work services, as those services are defined in
41.34section
41.35incorporating the words "social work" or "social worker."
42.1(b) City, county, and state agencies employing social workers and staff who are
42.2designated to perform mandated duties under sections 256.975, subdivisions 7 to 7c and
42.3256.01, subdivision 24, are not required to employ licensed social workers.
42.4 Sec. 4. Minnesota Statutes 2012, section 256.01, subdivision 2, is amended to read:
42.5 Subd. 2. Specific powers. Subject to the provisions of section
42.62
42.7through
42.8 (a) Administer and supervise all forms of public assistance provided for by state law
42.9and other welfare activities or services as are vested in the commissioner. Administration
42.10and supervision of human services activities or services includes, but is not limited to,
42.11assuring timely and accurate distribution of benefits, completeness of service, and quality
42.12program management. In addition to administering and supervising human services
42.13activities vested by law in the department, the commissioner shall have the authority to:
42.14 (1) require county agency participation in training and technical assistance programs
42.15to promote compliance with statutes, rules, federal laws, regulations, and policies
42.16governing human services;
42.17 (2) monitor, on an ongoing basis, the performance of county agencies in the
42.18operation and administration of human services, enforce compliance with statutes, rules,
42.19federal laws, regulations, and policies governing welfare services and promote excellence
42.20of administration and program operation;
42.21 (3) develop a quality control program or other monitoring program to review county
42.22performance and accuracy of benefit determinations;
42.23 (4) require county agencies to make an adjustment to the public assistance benefits
42.24issued to any individual consistent with federal law and regulation and state law and rule
42.25and to issue or recover benefits as appropriate;
42.26 (5) delay or deny payment of all or part of the state and federal share of benefits and
42.27administrative reimbursement according to the procedures set forth in section
42.28 (6) make contracts with and grants to public and private agencies and organizations,
42.29both profit and nonprofit, and individuals, using appropriated funds; and
42.30 (7) enter into contractual agreements with federally recognized Indian tribes with
42.31a reservation in Minnesota to the extent necessary for the tribe to operate a federally
42.32approved family assistance program or any other program under the supervision of the
42.33commissioner. The commissioner shall consult with the affected county or counties in
42.34the contractual agreement negotiations, if the county or counties wish to be included,
42.35in order to avoid the duplication of county and tribal assistance program services. The
43.1commissioner may establish necessary accounts for the purposes of receiving and
43.2disbursing funds as necessary for the operation of the programs.
43.3 (b) Inform county agencies, on a timely basis, of changes in statute, rule, federal law,
43.4regulation, and policy necessary to county agency administration of the programs.
43.5 (c) Administer and supervise all child welfare activities; promote the enforcement of
43.6laws protecting disabled, dependent, neglected and delinquent children, and children born
43.7to mothers who were not married to the children's fathers at the times of the conception
43.8nor at the births of the children; license and supervise child-caring and child-placing
43.9agencies and institutions; supervise the care of children in boarding and foster homes or
43.10in private institutions; and generally perform all functions relating to the field of child
43.11welfare now vested in the State Board of Control.
43.12 (d) Administer and supervise all noninstitutional service to disabled persons,
43.13including those who are visually impaired, hearing impaired, or physically impaired
43.14or otherwise disabled. The commissioner may provide and contract for the care and
43.15treatment of qualified indigent children in facilities other than those located and available
43.16at state hospitals when it is not feasible to provide the service in state hospitals.
43.17 (e) Assist and actively cooperate with other departments, agencies and institutions,
43.18local, state, and federal, by performing services in conformity with the purposes of Laws
43.191939, chapter 431.
43.20 (f) Act as the agent of and cooperate with the federal government in matters of
43.21mutual concern relative to and in conformity with the provisions of Laws 1939, chapter
43.22431, including the administration of any federal funds granted to the state to aid in the
43.23performance of any functions of the commissioner as specified in Laws 1939, chapter 431,
43.24and including the promulgation of rules making uniformly available medical care benefits
43.25to all recipients of public assistance, at such times as the federal government increases its
43.26participation in assistance expenditures for medical care to recipients of public assistance,
43.27the cost thereof to be borne in the same proportion as are grants of aid to said recipients.
43.28 (g) Establish and maintain any administrative units reasonably necessary for the
43.29performance of administrative functions common to all divisions of the department.
43.30 (h) Act as designated guardian of both the estate and the person of all the wards of
43.31the state of Minnesota, whether by operation of law or by an order of court, without any
43.32further act or proceeding whatever, except as to persons committed as developmentally
43.33disabled. For children under the guardianship of the commissioner or a tribe in Minnesota
43.34recognized by the Secretary of the Interior whose interests would be best served by
43.35adoptive placement, the commissioner may contract with a licensed child-placing agency
43.36or a Minnesota tribal social services agency to provide adoption services. A contract
44.1with a licensed child-placing agency must be designed to supplement existing county
44.2efforts and may not replace existing county programs or tribal social services, unless the
44.3replacement is agreed to by the county board and the appropriate exclusive bargaining
44.4representative, tribal governing body, or the commissioner has evidence that child
44.5placements of the county continue to be substantially below that of other counties. Funds
44.6encumbered and obligated under an agreement for a specific child shall remain available
44.7until the terms of the agreement are fulfilled or the agreement is terminated.
44.8 (i) Act as coordinating referral and informational center on requests for service for
44.9newly arrived immigrants coming to Minnesota.
44.10 (j) The specific enumeration of powers and duties as hereinabove set forth shall in no
44.11way be construed to be a limitation upon the general transfer of powers herein contained.
44.12 (k) Establish county, regional, or statewide schedules of maximum fees and charges
44.13which may be paid by county agencies for medical, dental, surgical, hospital, nursing and
44.14nursing home care and medicine and medical supplies under all programs of medical
44.15care provided by the state and for congregate living care under the income maintenance
44.16programs.
44.17 (l) Have the authority to conduct and administer experimental projects to test methods
44.18and procedures of administering assistance and services to recipients or potential recipients
44.19of public welfare. To carry out such experimental projects, it is further provided that the
44.20commissioner of human services is authorized to waive the enforcement of existing specific
44.21statutory program requirements, rules, and standards in one or more counties. The order
44.22establishing the waiver shall provide alternative methods and procedures of administration,
44.23shall not be in conflict with the basic purposes, coverage, or benefits provided by law, and
44.24in no event shall the duration of a project exceed four years. It is further provided that no
44.25order establishing an experimental project as authorized by the provisions of this section
44.26shall become effective until the following conditions have been met:
44.27 (1) the secretary of health and human services of the United States has agreed, for
44.28the same project, to waive state plan requirements relative to statewide uniformity; and
44.29 (2) a comprehensive plan, including estimated project costs, shall be approved by
44.30the Legislative Advisory Commission and filed with the commissioner of administration.
44.31 (m) According to federal requirements, establish procedures to be followed by
44.32local welfare boards in creating citizen advisory committees, including procedures for
44.33selection of committee members.
44.34 (n) Allocate federal fiscal disallowances or sanctions which are based on quality
44.35control error rates for the aid to families with dependent children program formerly
45.1codified in sections
45.2following manner:
45.3 (1) one-half of the total amount of the disallowance shall be borne by the county
45.4boards responsible for administering the programs. For the medical assistance and the
45.5AFDC program formerly codified in sections
45.6shared by each county board in the same proportion as that county's expenditures for the
45.7sanctioned program are to the total of all counties' expenditures for the AFDC program
45.8formerly codified in sections
45.9food stamp program, sanctions shall be shared by each county board, with 50 percent of
45.10the sanction being distributed to each county in the same proportion as that county's
45.11administrative costs for food stamps are to the total of all food stamp administrative costs
45.12for all counties, and 50 percent of the sanctions being distributed to each county in the
45.13same proportion as that county's value of food stamp benefits issued are to the total of
45.14all benefits issued for all counties. Each county shall pay its share of the disallowance
45.15to the state of Minnesota. When a county fails to pay the amount due hereunder, the
45.16commissioner may deduct the amount from reimbursement otherwise due the county, or
45.17the attorney general, upon the request of the commissioner, may institute civil action
45.18to recover the amount due; and
45.19 (2) notwithstanding the provisions of clause (1), if the disallowance results from
45.20knowing noncompliance by one or more counties with a specific program instruction, and
45.21that knowing noncompliance is a matter of official county board record, the commissioner
45.22may require payment or recover from the county or counties, in the manner prescribed in
45.23clause (1), an amount equal to the portion of the total disallowance which resulted from the
45.24noncompliance, and may distribute the balance of the disallowance according to clause (1).
45.25 (o) Develop and implement special projects that maximize reimbursements and
45.26result in the recovery of money to the state. For the purpose of recovering state money,
45.27the commissioner may enter into contracts with third parties. Any recoveries that result
45.28from projects or contracts entered into under this paragraph shall be deposited in the
45.29state treasury and credited to a special account until the balance in the account reaches
45.30$1,000,000. When the balance in the account exceeds $1,000,000, the excess shall be
45.31transferred and credited to the general fund. All money in the account is appropriated to
45.32the commissioner for the purposes of this paragraph.
45.33 (p) Have the authority to make direct payments to facilities providing shelter
45.34to women and their children according to section
45.35the written request of a shelter facility that has been denied payments under section
46.1a determination within 30 days of the request for review regarding issuance of direct
46.2payments to the shelter facility. Failure to act within 30 days shall be considered a
46.3determination not to issue direct payments.
46.4 (q) Have the authority to establish and enforce the following county reporting
46.5requirements:
46.6 (1) the commissioner shall establish fiscal and statistical reporting requirements
46.7necessary to account for the expenditure of funds allocated to counties for human
46.8services programs. When establishing financial and statistical reporting requirements, the
46.9commissioner shall evaluate all reports, in consultation with the counties, to determine if
46.10the reports can be simplified or the number of reports can be reduced;
46.11 (2) the county board shall submit monthly or quarterly reports to the department
46.12as required by the commissioner. Monthly reports are due no later than 15 working days
46.13after the end of the month. Quarterly reports are due no later than 30 calendar days after
46.14the end of the quarter, unless the commissioner determines that the deadline must be
46.15shortened to 20 calendar days to avoid jeopardizing compliance with federal deadlines
46.16or risking a loss of federal funding. Only reports that are complete, legible, and in the
46.17required format shall be accepted by the commissioner;
46.18 (3) if the required reports are not received by the deadlines established in clause (2),
46.19the commissioner may delay payments and withhold funds from the county board until
46.20the next reporting period. When the report is needed to account for the use of federal
46.21funds and the late report results in a reduction in federal funding, the commissioner shall
46.22withhold from the county boards with late reports an amount equal to the reduction in
46.23federal funding until full federal funding is received;
46.24 (4) a county board that submits reports that are late, illegible, incomplete, or not
46.25in the required format for two out of three consecutive reporting periods is considered
46.26noncompliant. When a county board is found to be noncompliant, the commissioner
46.27shall notify the county board of the reason the county board is considered noncompliant
46.28and request that the county board develop a corrective action plan stating how the
46.29county board plans to correct the problem. The corrective action plan must be submitted
46.30to the commissioner within 45 days after the date the county board received notice
46.31of noncompliance;
46.32 (5) the final deadline for fiscal reports or amendments to fiscal reports is one year
46.33after the date the report was originally due. If the commissioner does not receive a report
46.34by the final deadline, the county board forfeits the funding associated with the report for
46.35that reporting period and the county board must repay any funds associated with the
46.36report received for that reporting period;
47.1 (6) the commissioner may not delay payments, withhold funds, or require repayment
47.2under clause (3) or (5) if the county demonstrates that the commissioner failed to
47.3provide appropriate forms, guidelines, and technical assistance to enable the county to
47.4comply with the requirements. If the county board disagrees with an action taken by the
47.5commissioner under clause (3) or (5), the county board may appeal the action according
47.6to sections
47.7 (7) counties subject to withholding of funds under clause (3) or forfeiture or
47.8repayment of funds under clause (5) shall not reduce or withhold benefits or services to
47.9clients to cover costs incurred due to actions taken by the commissioner under clause
47.10(3) or (5).
47.11 (r) Allocate federal fiscal disallowances or sanctions for audit exceptions when
47.12federal fiscal disallowances or sanctions are based on a statewide random sample in direct
47.13proportion to each county's claim for that period.
47.14 (s) Be responsible for ensuring the detection, prevention, investigation, and
47.15resolution of fraudulent activities or behavior by applicants, recipients, and other
47.16participants in the human services programs administered by the department.
47.17 (t) Require county agencies to identify overpayments, establish claims, and utilize
47.18all available and cost-beneficial methodologies to collect and recover these overpayments
47.19in the human services programs administered by the department.
47.20 (u) Have the authority to administer a drug rebate program for drugs purchased
47.21pursuant to the prescription drug program established under section
47.22beneficiary's satisfaction of any deductible established in the program. The commissioner
47.23shall require a rebate agreement from all manufacturers of covered drugs as defined in
47.24section
47.25or after July 1, 2002, must include rebates for individuals covered under the prescription
47.26drug program who are under 65 years of age. For each drug, the amount of the rebate shall
47.27be equal to the rebate as defined for purposes of the federal rebate program in United
47.28States Code, title 42, section 1396r-8. The manufacturers must provide full payment
47.29within 30 days of receipt of the state invoice for the rebate within the terms and conditions
47.30used for the federal rebate program established pursuant to section 1927 of title XIX of
47.31the Social Security Act. The manufacturers must provide the commissioner with any
47.32information necessary to verify the rebate determined per drug. The rebate program shall
47.33utilize the terms and conditions used for the federal rebate program established pursuant to
47.34section 1927 of title XIX of the Social Security Act.
47.35 (v) Have the authority to administer the federal drug rebate program for drugs
47.36purchased under the medical assistance program as allowed by section 1927 of title XIX
48.1of the Social Security Act and according to the terms and conditions of section 1927.
48.2Rebates shall be collected for all drugs that have been dispensed or administered in an
48.3outpatient setting and that are from manufacturers who have signed a rebate agreement
48.4with the United States Department of Health and Human Services.
48.5 (w) Have the authority to administer a supplemental drug rebate program for drugs
48.6purchased under the medical assistance program. The commissioner may enter into
48.7supplemental rebate contracts with pharmaceutical manufacturers and may require prior
48.8authorization for drugs that are from manufacturers that have not signed a supplemental
48.9rebate contract. Prior authorization of drugs shall be subject to the provisions of section
48.11 (x) Operate the department's communication systems account established in Laws
48.121993, First Special Session chapter 1, article 1, section 2, subdivision 2, to manage shared
48.13communication costs necessary for the operation of the programs the commissioner
48.14supervises. A communications account may also be established for each regional
48.15treatment center which operates communications systems. Each account must be used
48.16to manage shared communication costs necessary for the operations of the programs the
48.17commissioner supervises. The commissioner may distribute the costs of operating and
48.18maintaining communication systems to participants in a manner that reflects actual usage.
48.19Costs may include acquisition, licensing, insurance, maintenance, repair, staff time and
48.20other costs as determined by the commissioner. Nonprofit organizations and state, county,
48.21and local government agencies involved in the operation of programs the commissioner
48.22supervises may participate in the use of the department's communications technology and
48.23share in the cost of operation. The commissioner may accept on behalf of the state any
48.24gift, bequest, devise or personal property of any kind, or money tendered to the state for
48.25any lawful purpose pertaining to the communication activities of the department. Any
48.26money received for this purpose must be deposited in the department's communication
48.27systems accounts. Money collected by the commissioner for the use of communication
48.28systems must be deposited in the state communication systems account and is appropriated
48.29to the commissioner for purposes of this section.
48.30 (y) Receive any federal matching money that is made available through the medical
48.31assistance program for the consumer satisfaction survey. Any federal money received for
48.32the survey is appropriated to the commissioner for this purpose. The commissioner may
48.33expend the federal money received for the consumer satisfaction survey in either year of
48.34the biennium.
48.35 (z) Designate community information and referral call centers and incorporate
48.36cost reimbursement claims from the designated community information and referral
49.1call centers into the federal cost reimbursement claiming processes of the department
49.2according to federal law, rule, and regulations. Existing information and referral centers
49.3provided by Greater Twin Cities United Way or existing call centers for which Greater
49.4Twin Cities United Way has legal authority to represent, shall be included in these
49.5designations upon review by the commissioner and assurance that these services are
49.6accredited and in compliance with national standards. Any reimbursement is appropriated
49.7to the commissioner and all designated information and referral centers shall receive
49.8payments according to normal department schedules established by the commissioner
49.9upon final approval of allocation methodologies from the United States Department of
49.10Health and Human Services Division of Cost Allocation or other appropriate authorities.
49.11 (aa) Develop recommended standards for foster care homes that address the
49.12components of specialized therapeutic services to be provided by foster care homes with
49.13those services.
49.14 (bb) Authorize the method of payment to or from the department as part of the
49.15human services programs administered by the department. This authorization includes the
49.16receipt or disbursement of funds held by the department in a fiduciary capacity as part of
49.17the human services programs administered by the department.
49.18 (cc) Have the authority to administer a drug rebate program for drugs purchased for
49.19persons eligible for general assistance medical care under section
49.20For manufacturers that agree to participate in the general assistance medical care rebate
49.21program, the commissioner shall enter into a rebate agreement for covered drugs as
49.22defined in section
49.23rebate shall be equal to the rebate as defined for purposes of the federal rebate program in
49.24United States Code, title 42, section 1396r-8. The manufacturers must provide payment
49.25within the terms and conditions used for the federal rebate program established under
49.26section 1927 of title XIX of the Social Security Act. The rebate program shall utilize
49.27the terms and conditions used for the federal rebate program established under section
49.281927 of title XIX of the Social Security Act.
49.29 Effective January 1, 2006, drug coverage under general assistance medical care shall
49.30be limited to those prescription drugs that:
49.31 (1) are covered under the medical assistance program as described in section
49.33 (2) are provided by manufacturers that have fully executed general assistance
49.34medical care rebate agreements with the commissioner and comply with such agreements.
49.35Prescription drug coverage under general assistance medical care shall conform to
50.1coverage under the medical assistance program according to section
50.2subdivisions 13 to 13g
50.3 The rebate revenues collected under the drug rebate program are deposited in the
50.4general fund.
50.5(dd) Designate the agencies that operate the Senior LinkAge Line under section
50.6256.975, subdivision 7, and the Disability Linkage Line under subdivision 24 as the state
50.7of Minnesota Aging and the Disability Resource Centers under United States Code, title
50.842, section 3001, the Older Americans Act Amendments of 2006 and incorporate cost
50.9reimbursement claims from the designated centers into the federal cost reimbursement
50.10claiming processes of the department according to federal law, rule, and regulations. Any
50.11reimbursement must be appropriated to the commissioner and all Aging and Disability
50.12Resource Center designated agencies shall receive payments of grant funding that supports
50.13the activity and generates the federal financial participation according to Board on Aging
50.14administrative granting mechanisms.
50.15 Sec. 5. Minnesota Statutes 2012, section 256.01, subdivision 24, is amended to read:
50.16 Subd. 24. Disability Linkage Line. The commissioner shall establish the Disability
50.17Linkage Line,
50.18Disability Resource Center under United States Code, title 42, section 3001, the Older
50.19Americans Act Amendments of 2006 in partnership with the Senior LinkAge Line and
50.20shall serve as Minnesota's neutral access point for statewide disability information and
50.21assistance and must be available during business hours through a statewide toll-free
50.22number and the internet. The Disability Linkage Line shall:
50.23(1) deliver information and assistance based on national and state standards;
50.24 (2) provide information about state and federal eligibility requirements, benefits,
50.25and service options;
50.26(3) provide benefits and options counseling;
50.27 (4) make referrals to appropriate support entities;
50.28 (5) educate people on their options so they can make well-informed choices and link
50.29them to quality profiles;
50.30 (6) help support the timely resolution of service access and benefit issues;
50.31(7) inform people of their long-term community services and supports;
50.32(8) provide necessary resources and supports that can lead to employment and
50.33increased economic stability of people with disabilities;
50.34(9) serve as the technical assistance and help center for the Web-based tool,
50.35Minnesota's Disability Benefits 101.org
51.1(10) provide preadmission screening for individuals under 60 years of age using
51.2the procedures as defined in section 256.975, subdivisions 7a to 7c, and 256B.0911,
51.3subdivision 4d.
51.4 Sec. 6. Minnesota Statutes 2012, section 256.975, subdivision 7, is amended to read:
51.5 Subd. 7. Consumer information and assistance and long-term care options
51.6counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a
51.7statewide service to aid older Minnesotans and their families in making informed choices
51.8about long-term care options and health care benefits. Language services to persons
51.9with limited English language skills may be made available. The service, known as
51.10Senior LinkAge Line, shall serve older adults as the designated Aging and Disability
51.11Resource Center under United States Code, title 42, section 3001, the Older Americans
51.12Act Amendments of 2006 in partnership with the Disability LinkAge Line under section
51.13256.01, subdivision 24, and must be available during business hours through a statewide
51.14toll-free number and
51.15on Aging shall consult with, and when appropriate work through, the area agencies on
51.16aging to provide and maintain the telephony infrastructure and related support for the
51.17Aging and Disability Resource Center partners which agree by memorandum to access
51.18the infrastructure, including the designated providers of the Senior LinkAge Line and the
51.19Disability Linkage Line.
51.20 (b) The service must provide long-term care options counseling by assisting older
51.21adults, caregivers, and providers in accessing information and options counseling about
51.22choices in long-term care services that are purchased through private providers or available
51.23through public options. The service must:
51.24 (1) develop a comprehensive database that includes detailed listings in both
51.25consumer- and provider-oriented formats;
51.26 (2) make the database accessible on the Internet and through other telecommunication
51.27and media-related tools;
51.28 (3) link callers to interactive long-term care screening tools and make these tools
51.29available through the Internet by integrating the tools with the database;
51.30 (4) develop community education materials with a focus on planning for long-term
51.31care and evaluating independent living, housing, and service options;
51.32 (5) conduct an outreach campaign to assist older adults and their caregivers in
51.33finding information on the Internet and through other means of communication;
51.34 (6) implement a messaging system for overflow callers and respond to these callers
51.35by the next business day;
52.1 (7) link callers with county human services and other providers to receive more
52.2in-depth assistance and consultation related to long-term care options;
52.3 (8) link callers with quality profiles for nursing facilities and other home and
52.4community-based services providers developed by the
52.5health and human services;
52.6 (9) incorporate information about the availability of housing options, as well as
52.7registered housing with services and consumer rights within the MinnesotaHelp.info
52.8network long-term care database to facilitate consumer comparison of services and costs
52.9among housing with services establishments and with other in-home services and to
52.10support financial self-sufficiency as long as possible. Housing with services establishments
52.11and their arranged home care providers shall provide information that will facilitate price
52.12comparisons, including delineation of charges for rent and for services available. The
52.13commissioners of health and human services shall align the data elements required by
52.14section
52.15consumers standardized information and ease of comparison of long-term care options.
52.16The commissioner of human services shall provide the data to the Minnesota Board on
52.17Aging for inclusion in the MinnesotaHelp.info network long-term care database;
52.18(10) provide long-term care options counseling. Long-term care options counselors
52.19shall:
52.20(i) for individuals not eligible for case management under a public program or public
52.21funding source, provide interactive decision support under which consumers, family
52.22members, or other helpers are supported in their deliberations to determine appropriate
52.23long-term care choices in the context of the consumer's needs, preferences, values, and
52.24individual circumstances, including implementing a community support plan;
52.25(ii) provide Web-based educational information and collateral written materials to
52.26familiarize consumers, family members, or other helpers with the long-term care basics,
52.27issues to be considered, and the range of options available in the community;
52.28(iii) provide long-term care futures planning, which means providing assistance to
52.29individuals who anticipate having long-term care needs to develop a plan for the more
52.30distant future; and
52.31(iv) provide expertise in benefits and financing options for long-term care, including
52.32Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages,
52.33private pay options, and ways to access low or no-cost services or benefits through
52.34volunteer-based or charitable programs;
52.35(11) using risk management and support planning protocols, provide long-term care
52.36options counseling to current residents of nursing homes deemed appropriate for discharge
53.1by the commissioner and older adults who request service after consultation with the
53.2Senior LinkAge Line under clause (12).
53.3LinkAge Line shall also receive referrals from the residents or staff of nursing homes. The
53.4Senior LinkAge Line shall identify and contact residents deemed appropriate for discharge
53.5by developing targeting criteria in consultation with the commissioner who shall provide
53.6designated Senior LinkAge Line contact centers with a list of nursing home residents that
53.7meet the criteria as being appropriate for discharge planning via a secure Web portal.
53.8Senior LinkAge Line shall provide these residents, if they indicate a preference to
53.9receive long-term care options counseling, with initial assessment
53.10
53.11(i) long-term care consultation services under section
53.12(ii) designated care coordinators of contracted entities under section
53.13persons who are enrolled in a managed care plan; or
53.14(iii) the long-term care consultation team for those who are
53.15 for relocation service coordination due to high-risk factors or psychological or physical
53.16disability; and
53.17(12) develop referral protocols and processes that will assist certified health care
53.18homes and hospitals to identify at-risk older adults and determine when to refer these
53.19individuals to the Senior LinkAge Line for long-term care options counseling under this
53.20section. The commissioner is directed to work with the commissioner of health to develop
53.21protocols that would comply with the health care home designation criteria and protocols
53.22available at the time of hospital discharge. The commissioner shall keep a record of the
53.23number of people who choose long-term care options counseling as a result of this section.
53.24 Sec. 7. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
53.25to read:
53.26 Subd. 7a. Preadmission screening activities related to nursing facility
53.27admissions. (a) All individuals seeking admission to Medicaid certified nursing facilities,
53.28including certified boarding care facilities, must be screened prior to admission regardless
53.29of income, assets, or funding sources for nursing facility care, except as described in
53.30subdivision 7b, paragraphs (a) and (b). The purpose of the screening is to determine the
53.31need for nursing facility level of care as described in section 256B.0911, subdivision
53.324e, and to complete activities required under federal law related to mental illness and
53.33developmental disability as outlined in paragraph (b).
53.34(b) A person who has a diagnosis or possible diagnosis of mental illness or
53.35developmental disability must receive a preadmission screening before admission
54.1regardless of the exemptions outlined in subdivision 7b, paragraphs (a) and (b), to identify
54.2the need for further evaluation and specialized services, unless the admission prior to
54.3screening is authorized by the local mental health authority or the local developmental
54.4disabilities case manager, or unless authorized by the county agency according to Public
54.5Law 101-508.
54.6(c) The following criteria apply to the preadmission screening:
54.7(1) requests for preadmission screenings must be submitted via an online form
54.8developed by the commissioner;
54.9(2) the Senior LinkAge Line must use forms and criteria developed by the
54.10commissioner to identify persons who require referral for further evaluation and
54.11determination of the need for specialized services; and
54.12(3) the evaluation and determination of the need for specialized services must be
54.13done by:
54.14(i) a qualified independent mental health professional, for persons with a primary or
54.15secondary diagnosis of a serious mental illness; or
54.16(ii) a qualified developmental disability professional, for persons with a primary or
54.17secondary diagnosis of developmental disability. For purposes of this requirement, a
54.18qualified developmental disability professional must meet the standards for a qualified
54.19developmental disability professional under Code of Federal Regulations, title 42, section
54.20483.430.
54.21(d) The local county mental health authority or the state developmental disability
54.22authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a
54.23nursing facility if the individual does not meet the nursing facility level of care criteria or
54.24needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For
54.25purposes of this section, "specialized services" for a person with developmental disability
54.26means active treatment as that term is defined under Code of Federal Regulations, title
54.2742, section 483.440(a)(1).
54.28(e) In assessing a person's needs, the screener shall:
54.29(1) use an automated system designated by the commissioner;
54.30(2) consult with care transitions coordinators or physician; and
54.31(3) consider the assessment of the individual's physician.
54.32Other personnel may be included in the level of care determination as deemed
54.33necessary by the screener.
54.34EFFECTIVE DATE.This section is effective October 1, 2013.
55.1 Sec. 8. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
55.2to read:
55.3 Subd. 7b. Exemptions and emergency admissions. (a) Exemptions from the federal
55.4screening requirements outlined in subdivision 7a, paragraphs (b) and (c), are limited to:
55.5(1) a person who, having entered an acute care facility from a certified nursing
55.6facility, is returning to a certified nursing facility; or
55.7(2) a person transferring from one certified nursing facility in Minnesota to another
55.8certified nursing facility in Minnesota.
55.9(b) Persons who are exempt from preadmission screening for purposes of level of
55.10care determination include:
55.11(1) persons described in paragraph (a);
55.12(2) an individual who has a contractual right to have nursing facility care paid for
55.13indefinitely by the Veterans' Administration;
55.14(3) an individual enrolled in a demonstration project under section 256B.69,
55.15subdivision 8, at the time of application to a nursing facility; and
55.16(4) an individual currently being served under the alternative care program or under
55.17a home and community-based services waiver authorized under section 1915(c) of the
55.18federal Social Security Act.
55.19(c) Persons admitted to a Medicaid-certified nursing facility from the community
55.20on an emergency basis as described in paragraph (d) or from an acute care facility on a
55.21nonworking day must be screened the first working day after admission.
55.22(d) Emergency admission to a nursing facility prior to screening is permitted when
55.23all of the following conditions are met:
55.24(1) a person is admitted from the community to a certified nursing or certified
55.25boarding care facility during Senior LinkAge Line nonworking hours for ages 60 and
55.26older and Disability Linkage Line nonworking hours for under age 60;
55.27(2) a physician has determined that delaying admission until preadmission screening
55.28is completed would adversely affect the person's health and safety;
55.29(3) there is a recent precipitating event that precludes the client from living safely in
55.30the community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's
55.31inability to continue to provide care;
55.32(4) the attending physician has authorized the emergency placement and has
55.33documented the reason that the emergency placement is recommended; and
55.34(5) the Senior LinkAge Line or Disability Linkage Line is contacted on the first
55.35working day following the emergency admission.
56.1Transfer of a patient from an acute care hospital to a nursing facility is not considered
56.2an emergency except for a person who has received hospital services in the following
56.3situations: hospital admission for observation, care in an emergency room without hospital
56.4admission, or following hospital 24-hour bed care and from whom admission is being
56.5sought on a nonworking day.
56.6(e) A nursing facility must provide written information to all persons admitted
56.7regarding the person's right to request and receive long-term care consultation services as
56.8defined in section 256B.0911, subdivision 1a. The information must be provided prior to
56.9the person's discharge from the facility and in a format specified by the commissioner.
56.10EFFECTIVE DATE.This section is effective October 1, 2013.
56.11 Sec. 9. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
56.12to read:
56.13 Subd. 7c. Screening requirements. (a) A person may be screened for nursing
56.14facility admission by telephone or in a face-to-face screening interview. The Senior
56.15LinkAge Line shall identify each individual's needs using the following categories:
56.16(1) the person needs no face-to-face long-term care consultation assessment
56.17completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or
56.18managed care organization under contract with the Department of Human Services to
56.19determine the need for nursing facility level of care based on information obtained from
56.20other health care professionals;
56.21(2) the person needs an immediate face-to-face long-term care consultation
56.22assessment completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county,
56.23tribe, or managed care organization under contract with the Department of Human
56.24Services to determine the need for nursing facility level of care and complete activities
56.25required under subdivision 7a; or
56.26(3) the person may be exempt from screening requirements as outlined in subdivision
56.277b, but will need transitional assistance after admission or in-person follow-along after
56.28a return home.
56.29(b) Individuals between the ages of 60 and 64 who are admitted to nursing facilities
56.30with only a telephone screening must receive a face-to-face assessment from the long-term
56.31care consultation team member of the county in which the facility is located or from the
56.32recipient's county case manager within 40 calendar days of admission as described in
56.33section 256B.0911, subdivision 4d, paragraph (c).
56.34(c) Persons admitted on a nonemergency basis to a Medicaid-certified nursing
56.35facility must be screened prior to admission.
57.1(d) Screenings provided by the Senior LinkAge Line must include processes
57.2to identify persons who may require transition assistance described in subdivision 7,
57.3paragraph (b), clause (12), and section 256B.0911, subdivision 3b.
57.4EFFECTIVE DATE.This section is effective October 1, 2013.
57.5 Sec. 10. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
57.6to read:
57.7 Subd. 7d. Payment for preadmission screening. Funding for preadmission
57.8screening shall be provided to the Minnesota Board on Aging for the population 60
57.9years of age and older by the Department of Human Services to cover screener salaries
57.10and expenses to provide the services described in subdivisions 7a to 7c. The Minnesota
57.11Board on Aging shall employ, or contract with other agencies to employ, within the limits
57.12of available funding, sufficient personnel to provide preadmission screening and level of
57.13care determination services and shall seek to maximize federal funding for the service as
57.14provided under section 256.01, subdivision 2, paragraph (dd).
57.15EFFECTIVE DATE.This section is effective October 1, 2013.
57.16 Sec. 11. Minnesota Statutes 2012, section 256.9754, is amended by adding a
57.17subdivision to read:
57.18 Subd. 3a. Priority for other grants. The commissioner of health shall give
57.19priority to a grantee selected under subdivision 3 when awarding technology-related
57.20grants, if the grantee is using technology as a part of a proposal, unless that priority
57.21conflicts with existing state or federal guidance related to grant awards by the Department
57.22of Health. The commissioner of transportation shall give priority to a grantee selected
57.23under subdivision 3 when distributing transportation-related funds to create transportation
57.24options for older adults.
57.25 Sec. 12. Minnesota Statutes 2012, section 256.9754, is amended by adding a
57.26subdivision to read:
57.27 Subd. 3b. State waivers. The commissioner of health may waive applicable state
57.28laws and rules on a time-limited basis if the commissioner of health determines that a
57.29participating grantee requires a waiver in order to achieve demonstration project goals.
57.30 Sec. 13. Minnesota Statutes 2012, section 256.9754, subdivision 5, is amended to read:
58.1 Subd. 5. Grant preference. The commissioner of human services shall give
58.2preference when awarding grants under this section to areas where nursing facility
58.3closures have occurred or are occurring or areas with service needs identified by section
58.4144A.351. The commissioner may award grants to the extent grant funds are available
58.5and to the extent applications are approved by the commissioner. Denial of approval of an
58.6application in one year does not preclude submission of an application in a subsequent
58.7year. The maximum grant amount is limited to $750,000.
58.8 Sec. 14. Minnesota Statutes 2012, section 256B.021, is amended by adding a
58.9subdivision to read:
58.10 Subd. 4a. Evaluation. The commissioner shall evaluate the projects contained in
58.11subdivision 4, paragraphs (f), clauses (2) and (12), and (h). The evaluation must include:
58.12(1) an impact assessment focusing on program outcomes, especially those
58.13experienced directly by the person receiving services;
58.14(2) study samples drawn from the population of interest for each project; and
58.15(3) a time series analysis to examine aggregate trends in average monthly
58.16utilization, expenditures, and other outcomes in the targeted populations before and after
58.17implementation of the initiatives.
58.18 Sec. 15. Minnesota Statutes 2012, section 256B.021, is amended by adding a
58.19subdivision to read:
58.20 Subd. 6. Work, empower, and encourage independence. As provided under
58.21subdivision 4, paragraph (e), upon federal approval, the commissioner shall establish a
58.22demonstration project to provide navigation, employment supports, and benefits planning
58.23services to a targeted group of federally funded Medicaid recipients to begin July 1, 2014.
58.24This demonstration shall promote economic stability, increase independence, and reduce
58.25applications for disability benefits while providing a positive impact on the health and
58.26future of participants.
58.27 Sec. 16. Minnesota Statutes 2012, section 256B.021, is amended by adding a
58.28subdivision to read:
58.29 Subd. 7. Housing stabilization. As provided under subdivision 4, paragraph (e),
58.30upon federal approval, the commissioner shall establish a demonstration project to provide
58.31service coordination, outreach, in-reach, tenancy support, and community living assistance
58.32to a targeted group of federally funded Medicaid recipients to begin January 1, 2014. This
59.1demonstration shall promote housing stability, reduce costly medical interventions, and
59.2increase opportunities for independent community living.
59.3 Sec. 17. Minnesota Statutes 2012, section 256B.0911, subdivision 1, is amended to read:
59.4 Subdivision 1. Purpose and goal. (a) The purpose of long-term care consultation
59.5services is to assist persons with long-term or chronic care needs in making care
59.6decisions and selecting support and service options that meet their needs and reflect
59.7their preferences. The availability of, and access to, information and other types of
59.8assistance, including assessment and support planning, is also intended to prevent or delay
59.9institutional placements and to provide access to transition assistance after admission.
59.10Further, the goal of these services is to contain costs associated with unnecessary
59.11institutional admissions. Long-term consultation services must be available to any person
59.12regardless of public program eligibility. The commissioner of human services shall seek
59.13to maximize use of available federal and state funds and establish the broadest program
59.14possible within the funding available.
59.15(b) These services must be coordinated with long-term care options counseling
59.16provided under subdivision 4d, section
59.17section
59.18services shall encourage the use of volunteers from families, religious organizations, social
59.19clubs, and similar civic and service organizations to provide community-based services.
59.20 Sec. 18. Minnesota Statutes 2012, section 256B.0911, subdivision 1a, is amended to
59.21read:
59.22 Subd. 1a. Definitions. For purposes of this section, the following definitions apply:
59.23 (a) Until additional requirements apply under paragraph (b), "long-term care
59.24consultation services" means:
59.25 (1) intake for and access to assistance in identifying services needed to maintain an
59.26individual in the most inclusive environment;
59.27 (2) providing recommendations for and referrals to cost-effective community
59.28services that are available to the individual;
59.29 (3) development of an individual's person-centered community support plan;
59.30 (4) providing information regarding eligibility for Minnesota health care programs;
59.31 (5) face-to-face long-term care consultation assessments, which may be completed
59.32in a hospital, nursing facility, intermediate care facility for persons with developmental
59.33disabilities (ICF/DDs), regional treatment centers, or the person's current or planned
59.34residence;
60.1
60.2
60.3
60.4eligibility as required under sections
60.5of care determination for individuals who need an institutional level of care as determined
60.6under section
60.7community support plan development, appropriate referrals to obtain necessary diagnostic
60.8information, and including an eligibility determination for consumer-directed community
60.9supports;
60.10
60.11cost-effective community services available;
60.12
60.13after institutional admission; and
60.14
60.15supports, for school-age youth and working-age adults and referrals to the Disability
60.16Linkage Line and Disability Benefits 101 to ensure that an informed choice about
60.17competitive employment can be made. For the purposes of this subdivision, "competitive
60.18employment" means work in the competitive labor market that is performed on a full-time
60.19or part-time basis in an integrated setting, and for which an individual is compensated at or
60.20above the minimum wage, but not less than the customary wage and level of benefits paid
60.21by the employer for the same or similar work performed by individuals without disabilities.
60.22(b) Upon statewide implementation of lead agency requirements in subdivisions 2b,
60.232c, and 3a, "long-term care consultation services" also means:
60.24(1) service eligibility determination for state plan home care services identified in:
60.25(i) section
60.26(ii) section
60.27(iii) consumer support grants under section
60.28(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024,
60.29determination of eligibility for case management services available under sections
60.319525.0016;
60.32(3) determination of institutional level of care, home and community-based service
60.33waiver, and other service eligibility as required under section
60.34of eligibility for family support grants under section
60.35services under section
61.1(4) obtaining necessary diagnostic information to determine eligibility under clauses
61.2(2) and (3).
61.3 (c) "Long-term care options counseling" means the services provided by the linkage
61.4lines as mandated by sections
61.5also includes telephone assistance and follow up once a long-term care consultation
61.6assessment has been completed.
61.7 (d) "Minnesota health care programs" means the medical assistance program under
61.8chapter 256B and the alternative care program under section
61.9 (e) "Lead agencies" means counties administering or tribes and health plans under
61.10contract with the commissioner to administer long-term care consultation assessment and
61.11support planning services.
61.12 Sec. 19. Minnesota Statutes 2012, section 256B.0911, subdivision 3a, is amended to
61.13read:
61.14 Subd. 3a. Assessment and support planning. (a) Persons requesting assessment,
61.15services planning, or other assistance intended to support community-based living,
61.16including persons who need assessment in order to determine waiver or alternative care
61.17program eligibility, must be visited by a long-term care consultation team within 20
61.18calendar days after the date on which an assessment was requested or recommended.
61.19Upon statewide implementation of subdivisions 2b, 2c, and 5, this requirement also
61.20applies to an assessment of a person requesting personal care assistance services and
61.21private duty nursing. The commissioner shall provide at least a 90-day notice to lead
61.22agencies prior to the effective date of this requirement. Face-to-face assessments must be
61.23conducted according to paragraphs (b) to (i).
61.24 (b) The lead agency may utilize a team of either the social worker or public health
61.25nurse, or both. Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall
61.26use certified assessors to conduct the assessment. The consultation team members must
61.27confer regarding the most appropriate care for each individual screened or assessed. For
61.28a person with complex health care needs, a public health or registered nurse from the
61.29team must be consulted.
61.30 (c) The assessment must be comprehensive and include a person-centered assessment
61.31of the health, psychological, functional, environmental, and social needs of referred
61.32individuals and provide information necessary to develop a community support plan that
61.33meets the consumers needs, using an assessment form provided by the commissioner.
61.34 (d) The assessment must be conducted in a face-to-face interview with the person
61.35being assessed and the person's legal representative, and other individuals as requested by
62.1the person, who can provide information on the needs, strengths, and preferences of the
62.2person necessary to develop a community support plan that ensures the person's health and
62.3safety, but who is not a provider of service or has any financial interest in the provision
62.4of services. For persons who are to be assessed for elderly waiver customized living
62.5services under section
62.6the person's designated or legal representative, the client's current or proposed provider
62.7of services may submit a copy of the provider's nursing assessment or written report
62.8outlining its recommendations regarding the client's care needs. The person conducting
62.9the assessment will notify the provider of the date by which this information is to be
62.10submitted. This information shall be provided to the person conducting the assessment
62.11prior to the assessment.
62.12 (e) If the person chooses to use community-based services, the person or the person's
62.13legal representative must be provided with a written community support plan within 40
62.14calendar days of the assessment visit, regardless of whether the individual is eligible for
62.15Minnesota health care programs. The written community support plan must include:
62.16(1) a summary of assessed needs as defined in paragraphs (c) and (d);
62.17(2) the individual's options and choices to meet identified needs, including all
62.18available options for case management services and providers;
62.19(3) identification of health and safety risks and how those risks will be addressed,
62.20including personal risk management strategies;
62.21(4) referral information; and
62.22(5) informal caregiver supports, if applicable.
62.23For a person determined eligible for state plan home care under subdivision 1a,
62.24paragraph (b), clause (1), the person or person's representative must also receive a copy of
62.25the home care service plan developed by the certified assessor.
62.26(f) A person may request assistance in identifying community supports without
62.27participating in a complete assessment. Upon a request for assistance identifying
62.28community support, the person must be transferred or referred to long-term care options
62.29counseling services available under sections
62.30subdivision 24, for telephone assistance and follow up.
62.31 (g) The person has the right to make the final decision between institutional
62.32placement and community placement after the recommendations have been provided,
62.33except as provided in section 256.975, subdivision
62.34 (h) The lead agency must give the person receiving assessment or support planning,
62.35or the person's legal representative, materials, and forms supplied by the commissioner
62.36containing the following information:
63.1 (1) written recommendations for community-based services and consumer-directed
63.2options;
63.3(2) documentation that the most cost-effective alternatives available were offered to
63.4the individual. For purposes of this clause, "cost-effective" means community services and
63.5living arrangements that cost the same as or less than institutional care. For an individual
63.6found to meet eligibility criteria for home and community-based service programs under
63.7section
63.8approved waiver plan for each program;
63.9(3) the need for and purpose of preadmission screening conducted by long-term
63.10care options counselors according to section 256.975, subdivisions 7a to 7c, and section
63.11256.01, subdivision 24, if the person selects nursing facility placement. If the individual
63.12selects nursing facility placement, the lead agency shall forward information needed to
63.13complete the level of care determinations and screening for developmental disability and
63.14mental illness collected during the assessment to the long-term care options counselor
63.15using forms provided by the commissioner;
63.16 (4) the role of long-term care consultation assessment and support planning in
63.17eligibility determination for waiver and alternative care programs, and state plan home
63.18care, case management, and other services as defined in subdivision 1a, paragraphs (a),
63.19clause (7), and (b);
63.20 (5) information about Minnesota health care programs;
63.21 (6) the person's freedom to accept or reject the recommendations of the team;
63.22 (7) the person's right to confidentiality under the Minnesota Government Data
63.23Practices Act, chapter 13;
63.24 (8) the certified assessor's decision regarding the person's need for institutional level
63.25of care as determined under criteria established in section 256B.0911, subdivision
63.26
63.27and programs as defined in subdivision 1a, paragraphs (a), clause (7), and (b); and
63.28 (9) the person's right to appeal the certified assessor's decision regarding eligibility
63.29for all services and programs as defined in subdivision 1a, paragraphs (a), clause (7), and
63.30(b), and incorporating the decision regarding the need for institutional level of care or the
63.31lead agency's final decisions regarding public programs eligibility according to section
63.33 (i) Face-to-face assessment completed as part of eligibility determination for
63.34the alternative care, elderly waiver, community alternatives for disabled individuals,
63.35community alternative care, and brain injury waiver programs under sections
64.2calendar days after the date of assessment.
64.3(j) The effective eligibility start date for programs in paragraph (i) can never be
64.4prior to the date of assessment. If an assessment was completed more than 60 days
64.5before the effective waiver or alternative care program eligibility start date, assessment
64.6and support plan information must be updated in a face-to-face visit and documented in
64.7the department's Medicaid Management Information System (MMIS). Notwithstanding
64.8retroactive medical assistance coverage of state plan services, the effective date of
64.9eligibility for programs included in paragraph (i) cannot be prior to the date the most
64.10recent updated assessment is completed.
64.11 Sec. 20. Minnesota Statutes 2012, section 256B.0911, subdivision 4d, is amended to
64.12read:
64.13 Subd. 4d. Preadmission screening of individuals under
64.14It is the policy of the state of Minnesota to ensure that individuals with disabilities or
64.15chronic illness are served in the most integrated setting appropriate to their needs and have
64.16the necessary information to make informed choices about home and community-based
64.17service options.
64.18 (b) Individuals under
64.19 nursing facility
64.20
64.21subdivisions 7a to 7c. This shall be provided by the Disability Linkage Line as required
64.22under section 256.01, subdivision 24.
64.23 (c) Individuals under 65 years of age who are admitted to nursing facilities with
64.24only a telephone screening must receive a face-to-face assessment from the long-term
64.25care consultation team member of the county in which the facility is located or from the
64.26recipient's county case manager within 40 calendar days of admission.
64.27
64.28
64.29
64.30
64.31
64.32or county case manager must perform the activities required under subdivision 3b.
64.33
64.34recommends nursing facility admission must be face-to-face and approved by the
64.35commissioner before the individual is admitted to the nursing facility.
65.1
65.2nursing facility on an emergency basis, the
65.3notified of the admission on the next working day, and a face-to-face assessment as
65.4described in paragraph (c) must be conducted within 40 calendar days of admission.
65.5
65.6or the case manager must present information about home and community-based options,
65.7including consumer-directed options, so the individual can make informed choices. If the
65.8individual chooses home and community-based services, the long-term care consultation
65.9team member or case manager must complete a written relocation plan within 20 working
65.10days of the visit. The plan shall describe the services needed to move out of the facility
65.11and a time line for the move which is designed to ensure a smooth transition to the
65.12individual's home and community.
65.13
65.14a face-to-face assessment at least every 12 months to review the person's service choices
65.15and available alternatives unless the individual indicates, in writing, that annual visits are
65.16not desired. In this case, the individual must receive a face-to-face assessment at least
65.17once every 36 months for the same purposes.
65.18
65.19county agencies directly for face-to-face assessments for individuals under 65 years of age
65.20who are being considered for placement or residing in a nursing facility.
65.21(j) Funding for preadmission screening shall be provided to the Disability Linkage
65.22Line for the under 60 population by the Department of Human Services to cover screener
65.23salaries and expenses to provide the services described in subdivisions 7a to 7c. The
65.24Disability Linkage Line shall employ, or contract with other agencies to employ, within
65.25the limits of available funding, sufficient personnel to provider preadmission screening
65.26and level of care determination services and shall seek to maximize federal funding for the
65.27service as provided under section 256.01, subdivision 2, paragraph (dd).
65.28EFFECTIVE DATE.This section is effective October 1, 2013.
65.29 Sec. 21. Minnesota Statutes 2012, section 256B.0911, subdivision 4d, is amended to
65.30read:
65.31 Subd. 4d. Preadmission screening of individuals under 65 years of age. (a)
65.32It is the policy of the state of Minnesota to ensure that individuals with disabilities or
65.33chronic illness are served in the most integrated setting appropriate to their needs and have
65.34the necessary information to make informed choices about home and community-based
65.35service options.
66.1 (b) Individuals under 65 years of age who are admitted to a nursing facility from a
66.2hospital must be screened prior to admission as outlined in subdivisions 4a through 4c.
66.3 (c) Individuals under 65 years of age who are admitted to nursing facilities with
66.4only a telephone screening must receive a face-to-face assessment from the long-term
66.5care consultation team member of the county in which the facility is located or from the
66.6recipient's county case manager within 40 calendar days of admission.
66.7 (d) Individuals under 65 years of age who are admitted to a nursing facility
66.8without preadmission screening according to the exemption described in subdivision 4b,
66.9paragraph (a), clause (3), and who remain in the facility longer than 30 days must receive
66.10a face-to-face assessment within 40 days of admission.
66.11 (e) At the face-to-face assessment, the long-term care consultation team member or
66.12county case manager must perform the activities required under subdivision 3b.
66.13 (f) For individuals under 21 years of age, a screening interview which recommends
66.14nursing facility admission must be face-to-face and approved by the commissioner before
66.15the individual is admitted to the nursing facility.
66.16 (g) In the event that an individual under 65 years of age is admitted to a nursing
66.17facility on an emergency basis, the county must be notified of the admission on the
66.18next working day, and a face-to-face assessment as described in paragraph (c) must be
66.19conducted within 40 calendar days of admission.
66.20 (h) At the face-to-face assessment, the long-term care consultation team member or
66.21the case manager must present information about home and community-based options,
66.22including consumer-directed options, so the individual can make informed choices. If the
66.23individual chooses home and community-based services, the long-term care consultation
66.24team member or case manager must complete a written relocation plan within 20 working
66.25days of the visit. The plan shall describe the services needed to move out of the facility
66.26and a time line for the move which is designed to ensure a smooth transition to the
66.27individual's home and community.
66.28 (i) An individual under 65 years of age residing in a nursing facility shall receive a
66.29face-to-face assessment at least every 12 months to review the person's service choices
66.30and available alternatives unless the individual indicates, in writing, that annual visits are
66.31not desired. In this case, the individual must receive a face-to-face assessment at least
66.32once every 36 months for the same purposes.
66.33 (j) Notwithstanding the provisions of subdivision 6, the commissioner may pay
66.34county agencies directly for face-to-face assessments for individuals under 65 years of age
66.35who are being considered for placement or residing in a nursing facility. Until September
67.130, 2013, payments for individuals under 65 years of age shall be made as described
67.2in this subdivision.
67.3 Sec. 22. Minnesota Statutes 2012, section 256B.0911, is amended by adding a
67.4subdivision to read:
67.5 Subd. 4e. Determination of institutional level of care. The determination of the
67.6need for nursing facility, hospital, and intermediate care facility levels of care must be
67.7made according to criteria developed by the commissioner, and in section 256B.092,
67.8using forms developed by the commissioner. Effective January 1, 2014, for individuals
67.9age 21 and older, the determination of need for nursing facility level of care shall be
67.10based on criteria in section 144.0724, subdivision 11. For individuals under age 21, the
67.11determination of the need for nursing facility level of care must be made according to
67.12criteria developed by the commissioner until criteria in section 144.0724, subdivision 11,
67.13becomes effective on or after October 1, 2019.
67.14 Sec. 23. Minnesota Statutes 2012, section 256B.0911, subdivision 6, is amended to read:
67.15 Subd. 6. Payment for long-term care consultation services. (a) Until September
67.1630, 2013, payment for long-term care consultation face-to-face assessment shall be made
67.17as described in this subdivision.
67.18 (b) The total payment for each county must be paid monthly by certified nursing
67.19facilities in the county. The monthly amount to be paid by each nursing facility for each
67.20fiscal year must be determined by dividing the county's annual allocation for long-term
67.21care consultation services by 12 to determine the monthly payment and allocating the
67.22monthly payment to each nursing facility based on the number of licensed beds in the
67.23nursing facility. Payments to counties in which there is no certified nursing facility must be
67.24made by increasing the payment rate of the two facilities located nearest to the county seat.
67.25
67.26paragraph (a) for each nursing facility reimbursed under section
67.27or
67.28
67.29layaway of 25 percent or more of the beds in a facility, the commissioner may adjust the
67.30per diem payment amount in paragraph
67.31amount in paragraph (a). The effective date of an adjustment made under this paragraph
67.32shall be on or after the first day of the month following the effective date of the layaway,
67.33delicensure and decertification, or removal from layaway.
68.1
68.2or counties to cover staff salaries and expenses to provide the services described in
68.3subdivision 1a. The county shall employ, or contract with other agencies to employ,
68.4within the limits of available funding, sufficient personnel to provide long-term care
68.5consultation services while meeting the state's long-term care outcomes and objectives as
68.6defined in subdivision 1. The county shall be accountable for meeting local objectives
68.7as approved by the commissioner in the biennial home and community-based services
68.8quality assurance plan on a form provided by the commissioner.
68.9
68.10of the screening costs under the medical assistance program may not be recovered from
68.11a facility.
68.12
68.13assistance plan to include reimbursement for the local consultation teams.
68.14
68.15the county may bill, as case management services, assessments, support planning, and
68.16follow-along provided to persons determined to be eligible for case management under
68.17Minnesota health care programs. No individual or family member shall be charged for an
68.18initial assessment or initial support plan development provided under subdivision 3a or 3b.
68.19
68.20effective on October 1, 2013, for long-term care consultation services that includes
68.21the funding available under this subdivision, and for assessments authorized under
68.22sections
68.23commissioner shall consider the maximization of other funding sources, including federal
68.24administrative reimbursement through federal financial participation funding, for all
68.25long-term care consultation
68.26methodology shall include the use of the appropriate time studies and the state financing
68.27of nonfederal share as part of the state's medical assistance program.
68.28 Sec. 24. Minnesota Statutes 2012, section 256B.0911, subdivision 7, is amended to read:
68.29 Subd. 7. Reimbursement for certified nursing facilities. (a) Medical assistance
68.30reimbursement for nursing facilities shall be authorized for a medical assistance recipient
68.31only if a preadmission screening has been conducted prior to admission or the county has
68.32authorized an exemption. Medical assistance reimbursement for nursing facilities shall
68.33not be provided for any recipient who the local screener has determined does not meet the
68.34level of care criteria for nursing facility placement in section
68.35if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus
69.1Budget Reconciliation Act of 1987 completed unless an admission for a recipient with
69.2mental illness is approved by the local mental health authority or an admission for a
69.3recipient with developmental disability is approved by the state developmental disability
69.4authority.
69.5 (b) The nursing facility must not bill a person who is not a medical assistance
69.6recipient for resident days that preceded the date of completion of screening activities
69.7as required under section 256.975, subdivisions
69.8facility must include unreimbursed resident days in the nursing facility resident day totals
69.9reported to the commissioner.
69.10 Sec. 25. Minnesota Statutes 2012, section 256B.0913, subdivision 4, is amended to read:
69.11 Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.
69.12 (a) Funding for services under the alternative care program is available to persons who
69.13meet the following criteria:
69.14 (1) the person has been determined by a community assessment under section
69.16facility, as determined under section 256B.0911, subdivision
69.17the provision of services under the alternative care program;
69.18 (2) the person is age 65 or older;
69.19 (3) the person would be eligible for medical assistance within 135 days of admission
69.20to a nursing facility;
69.21 (4) the person is not ineligible for the payment of long-term care services by the
69.22medical assistance program due to an asset transfer penalty under section
69.23equity interest in the home exceeding $500,000 as stated in section
69.24 (5) the person needs long-term care services that are not funded through other
69.25state or federal funding, or other health insurance or other third-party insurance such as
69.26long-term care insurance;
69.27 (6) except for individuals described in clause (7), the monthly cost of the alternative
69.28care services funded by the program for this person does not exceed 75 percent of the
69.29monthly limit described under section
69.30does not prohibit the alternative care client from payment for additional services, but in no
69.31case may the cost of additional services purchased under this section exceed the difference
69.32between the client's monthly service limit defined under section
69.333
69.34care-related supplies and equipment or environmental modifications and adaptations are or
69.35will be purchased for an alternative care services recipient, the costs may be prorated on a
70.1monthly basis for up to 12 consecutive months beginning with the month of purchase.
70.2If the monthly cost of a recipient's other alternative care services exceeds the monthly
70.3limit established in this paragraph, the annual cost of the alternative care services shall be
70.4determined. In this event, the annual cost of alternative care services shall not exceed 12
70.5times the monthly limit described in this paragraph;
70.6 (7) for individuals assigned a case mix classification A as described under section
70.8living, or (ii) up to two dependencies in bathing, dressing, grooming, walking, and eating
70.9when the dependency score in eating is three or greater as determined by an assessment
70.10performed under section
70.11by the program cannot exceed $593 per month for all new participants enrolled in
70.12the program on or after July 1, 2011. This monthly limit shall be applied to all other
70.13participants who meet this criteria at reassessment. This monthly limit shall be increased
70.14annually as described in section
70.15limit does not prohibit the alternative care client from payment for additional services, but
70.16in no case may the cost of additional services purchased exceed the difference between the
70.17client's monthly service limit defined in this clause and the limit described in clause (6)
70.18for case mix classification A; and
70.19(8) the person is making timely payments of the assessed monthly fee.
70.20A person is ineligible if payment of the fee is over 60 days past due, unless the person
70.21agrees to:
70.22 (i) the appointment of a representative payee;
70.23 (ii) automatic payment from a financial account;
70.24 (iii) the establishment of greater family involvement in the financial management of
70.25payments; or
70.26 (iv) another method acceptable to the lead agency to ensure prompt fee payments.
70.27 The lead agency may extend the client's eligibility as necessary while making
70.28arrangements to facilitate payment of past-due amounts and future premium payments.
70.29Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
70.30reinstated for a period of 30 days.
70.31 (b) Alternative care funding under this subdivision is not available for a person who
70.32is a medical assistance recipient or who would be eligible for medical assistance without a
70.33spenddown or waiver obligation. A person whose initial application for medical assistance
70.34and the elderly waiver program is being processed may be served under the alternative care
70.35program for a period up to 60 days. If the individual is found to be eligible for medical
70.36assistance, medical assistance must be billed for services payable under the federally
71.1approved elderly waiver plan and delivered from the date the individual was found eligible
71.2for the federally approved elderly waiver plan. Notwithstanding this provision, alternative
71.3care funds may not be used to pay for any service the cost of which: (i) is payable by
71.4medical assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to
71.5pay a medical assistance income spenddown for a person who is eligible to participate in the
71.6federally approved elderly waiver program under the special income standard provision.
71.7 (c) Alternative care funding is not available for a person who resides in a licensed
71.8nursing home, certified boarding care home, hospital, or intermediate care facility, except
71.9for case management services which are provided in support of the discharge planning
71.10process for a nursing home resident or certified boarding care home resident to assist with
71.11a relocation process to a community-based setting.
71.12 (d) Alternative care funding is not available for a person whose income is greater
71.13than the maintenance needs allowance under section
71.14to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
71.15year for which alternative care eligibility is determined, who would be eligible for the
71.16elderly waiver with a waiver obligation.
71.17 Sec. 26. Minnesota Statutes 2012, section 256B.0913, is amended by adding a
71.18subdivision to read:
71.19 Subd. 17. Essential community supports grants. (a) Notwithstanding subdivisions
71.201 to 14, the purpose of the essential community supports grant program is to provide
71.21targeted services to persons age 65 and older who need essential community support, but
71.22whose needs do not meet the level of care required for nursing facility placement under
71.23section 144.0724, subdivision 11.
71.24(b) Essential community supports grants are available not to exceed $400 per person
71.25per month. Essential community supports service grants may be used as authorized within
71.26an authorization period not to exceed 12 months. Grants must be available to a person who:
71.27(1) is age 65 or older;
71.28(2) is not eligible for medical assistance;
71.29(3) would otherwise be financially eligible for the alternative care program under
71.30subdivision 4;
71.31(4) has received a community assessment under section 256B.0911, subdivision 3a
71.32or 3b, and does not require the level of care provided in a nursing facility;
71.33(5) has a community support plan; and
71.34(6) has been determined by a community assessment under section 256B.0911,
71.35subdivision 3a or 3b, to be a person who would require provision of at least one of the
72.1following services, as defined in the approved elderly waiver plan, in order to maintain
72.2their community residence:
72.3(i) caregiver support;
72.4(ii) homemaker support;
72.5(iii) chores; or
72.6(iv) a personal emergency response device or system.
72.7(c) The person receiving any of the essential community supports in this subdivision
72.8must also receive service coordination, not to exceed $600 in a 12-month authorization
72.9period, as part of their community support plan.
72.10(d) A person who has been determined to be eligible for an essential community
72.11supports grant must be reassessed at least annually and continue to meet the criteria in
72.12paragraph (b) to remain eligible for an essential community supports grant.
72.13(e) The commissioner is authorized to use federal matching funds for essential
72.14community supports as necessary and to meet demand for essential community supports
72.15grants as outlined in paragraphs (f) and (g), and that amount of federal funds is
72.16appropriated to the commissioner for this purpose.
72.17(f) Upon federal approval and following a reasonable implementation period
72.18determined by the commissioner, essential community supports are available to an
72.19individual who:
72.20(1) is receiving nursing facility services or home and community-based long-term
72.21services and supports under section 256B.0915 or 256B.49 on the effective date of
72.22implementation of the revised nursing facility level of care under section 144.0724,
72.23subdivision 11;
72.24(2) meets one of the following criteria:
72.25(i) due to the implementation of the revised nursing facility level of care, loses
72.26eligibility for continuing medical assistance payment of nursing facility services at the
72.27first reassessment under section 144.0724, subdivision 11, paragraph (b), that occurs on or
72.28after the effective date of the revised nursing facility level of care criteria under section
72.29144.0724, subdivision 11; or
72.30(ii) due to the implementation of the revised nursing facility level of care, loses
72.31eligibility for continuing medical assistance payment of home and community-based
72.32long-term services and supports under section 256B.0915 or 256B.49 at the first
72.33reassessment required under those sections that occurs on or after the effective date of
72.34implementation of the revised nursing facility level of care under section 144.0724,
72.35subdivision 11;
72.36(3) is not eligible for personal care attendant services; and
73.1(4) has an assessed need for one or more of the supportive services offered under
73.2essential community supports.
73.3Individuals eligible under this paragraph includes individuals who continue to be
73.4eligible for medical assistance state plan benefits and those who are not or are no longer
73.5financially eligible for medical assistance.
73.6(g) Upon federal approval and following a reasonable implementation period
73.7determined by the commissioner, the services available through essential community
73.8supports include the services and grants provided in paragraphs (b) and (c), home-delivered
73.9meals, and community living assistance as defined by the commissioner. These services
73.10are available to all eligible recipients including those outlined in paragraphs (b) and (f).
73.11Recipients are eligible if they have a need for any of these services and meet all other
73.12eligibility criteria.
73.13 Sec. 27. Minnesota Statutes 2012, section 256B.0915, subdivision 5, is amended to read:
73.14 Subd. 5. Assessments and reassessments for waiver clients. (a) Each client
73.15shall receive an initial assessment of strengths, informal supports, and need for services
73.16in accordance with section
73.17client served under the elderly waiver must be conducted at least every 12 months and at
73.18other times when the case manager determines that there has been significant change in
73.19the client's functioning. This may include instances where the client is discharged from
73.20the hospital. There must be a determination that the client requires nursing facility level
73.21of care as defined in section 256B.0911, subdivision
73.22subsequent assessments to initiate and maintain participation in the waiver program.
73.23(b) Regardless of other assessments identified in section
73.244, as appropriate to determine nursing facility level of care for purposes of medical
73.25assistance payment for nursing facility services, only face-to-face assessments conducted
73.26according to section
73.27level of care determination will be accepted for purposes of initial and ongoing access to
73.28waiver service payment.
73.29 Sec. 28. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
73.30subdivision to read:
73.31 Subd. 1a. Home and community-based services for older adults. (a) The purpose
73.32of projects selected by the commissioner of human services under this section is to
73.33make strategic changes in the long-term services and supports system for older adults
73.34including statewide capacity for local service development and technical assistance, and
74.1statewide availability of home and community-based services for older adult services,
74.2caregiver support and respite care services, and other supports in the state of Minnesota.
74.3These projects are intended to create incentives for new and expanded home and
74.4community-based services in Minnesota in order to:
74.5(1) reach older adults early in the progression of their need for long-term services
74.6and supports, providing them with low-cost, high-impact services that will prevent or
74.7delay the use of more costly services;
74.8(2) support older adults to live in the most integrated, least restrictive community
74.9setting;
74.10(3) support the informal caregivers of older adults;
74.11(4) develop and implement strategies to integrate long-term services and supports
74.12with health care services, in order to improve the quality of care and enhance the quality
74.13of life of older adults and their informal caregivers;
74.14(5) ensure cost-effective use of financial and human resources;
74.15(6) build community-based approaches and community commitment to delivering
74.16long-term services and supports for older adults in their own homes;
74.17(7) achieve a broad awareness and use of lower-cost in-home services as an
74.18alternative to nursing homes and other residential services;
74.19(8) strengthen and develop additional home and community-based services and
74.20alternatives to nursing homes and other residential services; and
74.21(9) strengthen programs that use volunteers.
74.22(b) The services provided by these projects are available to older adults who are
74.23eligible for medical assistance and the elderly waiver under section 256B.0915, the
74.24alternative care program under section 256B.0913, or essential community supports grant
74.25under subdivision 14, paragraph (b), and to persons who have their own funds to pay for
74.26services.
74.27 Sec. 29. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
74.28subdivision to read:
74.29 Subd. 1b. Definitions. (a) For purposes of this section, the following terms have
74.30the meanings given.
74.31(b) "Community" means a town; township; city; or targeted neighborhood within a
74.32city; or a consortium of towns, townships, cities, or specific neighborhoods within a city.
74.33(c) "Core home and community-based services provider" means a Faith in Action,
74.34Living at Home Block Nurse, Congregational Nurse, or similar community-based
74.35program governed by a board, the majority of whose members reside within the program's
75.1service area, that organizes and uses volunteers and paid staff to deliver nonmedical
75.2services intended to assist older adults to identify and manage risks and to maintain their
75.3community living and integration in the community.
75.4(d) "Eldercare development partnership" means a team of representatives of county
75.5social service and public health agencies, the area agency on aging, local nursing home
75.6providers, local home care providers, and other appropriate home and community-based
75.7providers in the area agency's planning and service area.
75.8(e) "Long-term services and supports" means any service available under the
75.9elderly waiver program or alternative care grant programs; nursing facility services;
75.10transportation services; caregiver support and respite care services; and other home and
75.11community-based services identified as necessary either to maintain lifestyle choices for
75.12older adults or to support them to remain in their own home.
75.13(f) "Older adult" refers to an individual who is 65 years of age or older.
75.14 Sec. 30. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
75.15subdivision to read:
75.16 Subd. 1c. Eldercare development partnerships. The commissioner of human
75.17services shall select and contract with eldercare development partnerships sufficient to
75.18provide statewide availability of service development and technical assistance using a
75.19request for proposals process. Eldercare development partnerships shall:
75.20(1) develop a local long-term services and supports strategy consistent with state
75.21goals and objectives;
75.22(2) identify and use existing local skills, knowledge and relationships, and build
75.23on these assets;
75.24(3) coordinate planning for funds to provide services to older adults, including funds
75.25received under Title III of the Older Americans Act, Title XX of the Social Security Act,
75.26and the Local Public Health Act;
75.27(4) target service development and technical assistance where nursing facility
75.28closures have occurred or are occurring or in areas where service needs have been
75.29identified through activities under section 144A.351;
75.30(5) provide sufficient staff for development and technical support in its designated
75.31area; and
75.32(6) designate a single public or nonprofit member of the eldercare development
75.33partnerships to apply grant funding and manage the project.
75.34 Sec. 31. Minnesota Statutes 2012, section 256B.0917, subdivision 6, is amended to read:
76.1 Subd. 6. Caregiver support and respite care projects. (a) The commissioner
76.2shall establish
76.3
76.4
76.5caregivers. The commissioner shall use a request for proposals to select nonprofit entities
76.6to administer the projects. Projects shall:
76.7(1) establish a local coordinated network of volunteer and paid respite workers;
76.8(2) coordinate assignment of respite
76.9
76.10
76.11
76.12(3) assure the health and safety of the older adults;
76.13(4) identify at-risk caregivers;
76.14(5) provide information, education, and training for caregivers in the designated
76.15community; and
76.16(6) demonstrate the need in the proposed service area particularly where nursing
76.17facility closures have occurred or are occurring or areas with service needs identified
76.18by section 144A.351. Preference must be given for projects that reach underserved
76.19populations.
76.20
76.21
76.22
76.23
76.24
76.25
76.26
76.27
76.28
76.29
76.30
76.31Projects must clearly describe:
76.32
76.33
76.34
76.35achieve
76.36
77.1
77.2
77.3
77.4
77.5training, and retraining volunteers; and
77.6
77.7designated community, including outreach to persons needing the services.
77.8
77.9(1) hire a coordinator to develop a coordinated network of volunteer and paid respite
77.10care services and assign workers to clients;
77.11(2) recruit and train volunteer providers;
77.12(3)
77.13
77.14
77.15
77.16
77.17 Sec. 32. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
77.18subdivision to read:
77.19 Subd. 7a. Core home and community-based services. The commissioner shall
77.20select and contract with core home and community-based services providers for projects
77.21to provide services and supports to older adults both with and without family and other
77.22informal caregivers using a request for proposals process. Projects must:
77.23(1) have a credible, public, or private nonprofit sponsor providing ongoing financial
77.24support;
77.25(2) have a specific, clearly defined geographic service area;
77.26(3) use a practice framework designed to identify high-risk older adults and help them
77.27take action to better manage their chronic conditions and maintain their community living;
77.28(4) have a team approach to coordination and care, ensuring that the older adult
77.29participants, their families, and the formal and informal providers are all part of planning
77.30and providing services;
77.31(5) provide information, support services, homemaking services, counseling, and
77.32training for the older adults and family caregivers;
77.33(6) encourage service area or neighborhood residents and local organizations to
77.34collaborate in meeting the needs of older adults in their geographic service areas;
78.1(7) recruit, train, and direct the use of volunteers to provide informal services and
78.2other appropriate support to older adults and their caregivers; and
78.3(8) provide coordination and management of formal and informal services to older
78.4adults and their families using less expensive alternatives.
78.5 Sec. 33. Minnesota Statutes 2012, section 256B.0917, subdivision 13, is amended to
78.6read:
78.7 Subd. 13. Community service grants. The commissioner shall award contracts
78.8for grants to public and private nonprofit agencies to establish services that strengthen
78.9a community's ability to provide a system of home and community-based services
78.10for elderly persons. The commissioner shall use a request for proposal process. The
78.11commissioner shall give preference when awarding grants under this section to areas
78.12where nursing facility closures have occurred or are occurring or to areas with service
78.13needs identified under section 144A.351.
78.14
78.15
78.16
78.17 Sec. 34. Minnesota Statutes 2012, section 256B.439, subdivision 1, is amended to read:
78.18 Subdivision 1. Development and implementation of quality profiles. (a) The
78.19commissioner of human services, in cooperation with the commissioner of health,
78.20shall develop and implement
78.21beginning not later than July 1,
78.22except when the quality profile system would duplicate requirements under section
78.24
78.25
78.26commissioners of health and human services to the extent possible. The profiles must
78.27incorporate or be coordinated with information on quality maintained by area agencies on
78.28aging, long-term care trade associations, the ombudsman offices, counties, tribes, health
78.29plans, and other entities and the long-term care database maintained under section 256.975,
78.30subdivision 7. The
78.31(1) consumers and their families to facilitate informed choices of service providers;
78.32(2) providers to enable them to measure the results of their quality improvement
78.33efforts and compare quality achievements with other service providers; and
79.1(3) public and private purchasers of long-term care services to enable them to
79.2purchase high-quality care.
79.3(b) The
79.4task force, area agencies on aging, and representatives of consumers, providers, and labor
79.5unions. Within the limits of available appropriations, the commissioners may employ
79.6consultants to assist with this project.
79.7 Sec. 35. Minnesota Statutes 2012, section 256B.439, subdivision 2, is amended to read:
79.8 Subd. 2. Quality measurement tools. The commissioners shall identify and apply
79.9existing quality measurement tools to:
79.10(1) emphasize quality of care and its relationship to quality of life; and
79.11(2) address the needs of various users of long-term care services, including, but not
79.12limited to, short-stay residents, persons with behavioral problems, persons with dementia,
79.13and persons who are members of minority groups.
79.14 The tools must be identified and applied, to the extent possible, without requiring
79.15providers to supply information beyond
79.16 Sec. 36. Minnesota Statutes 2012, section 256B.439, subdivision 3, is amended to read:
79.17 Subd. 3. Consumer surveys of nursing facilities residents. Following
79.18identification of the quality measurement tool, the commissioners shall conduct surveys
79.19of long-term care service consumers of nursing facilities to develop quality profiles
79.20of providers. To the extent possible, surveys must be conducted face-to-face by state
79.21employees or contractors. At the discretion of the commissioners, surveys may be
79.22conducted by telephone or by provider staff. Surveys must be conducted periodically to
79.23update quality profiles of individual
79.24 Sec. 37. Minnesota Statutes 2012, section 256B.439, is amended by adding a
79.25subdivision to read:
79.26 Subd. 3a. Home and community-based services report card in cooperation with
79.27the commissioner of health. The profiles developed for home and community-based
79.28services providers under this section shall be incorporated into a report card and
79.29maintained by the Minnesota Board on Aging pursuant to section 256.975, subdivision
79.307, paragraph (b), clause (2), as data becomes available. The commissioner, in
79.31cooperation with the commissioner of health, shall use consumer choice, quality of life,
79.32care approaches, and cost or flexible purchasing categories to organize the consumer
79.33information in the profiles. The final categories used shall include consumer input and
80.1survey data to the extent that is available through the state agencies. The commissioner
80.2shall develop and disseminate the qualify profiles for a limited number of provider types
80.3initially, and develop quality profiles for additional provider types as measurement tools
80.4are developed and data becomes available. This includes providers of services to older
80.5adults and people with disabilities, regardless of payor source.
80.6 Sec. 38. Minnesota Statutes 2012, section 256B.439, subdivision 4, is amended to read:
80.7 Subd. 4. Dissemination of quality profiles. By July 1,
80.8commissioners shall implement a
80.9profiles
80.10may be disseminated
80.11to consumers, providers, and purchasers of long-term care services
80.12
80.13
80.14 Sec. 39. Minnesota Statutes 2012, section 256B.441, subdivision 13, is amended to read:
80.15 Subd. 13. External fixed costs. "External fixed costs" means costs related to the
80.16nursing home surcharge under section
80.17section
80.18section
80.19scholarships under section
80.20under section
80.21subdivision 42
80.22 Sec. 40. Minnesota Statutes 2012, section 256B.441, subdivision 53, is amended to read:
80.23 Subd. 53. Calculation of payment rate for external fixed costs. The commissioner
80.24shall calculate a payment rate for external fixed costs.
80.25 (a) For a facility licensed as a nursing home, the portion related to section
80.27home, the portion related to section
80.28result of its number of nursing home beds divided by its total number of licensed beds.
80.29 (b) The portion related to the licensure fee under section
80.30shall be the amount of the fee divided by actual resident days.
80.31 (c) The portion related to scholarships shall be determined under section
80.32subdivision 36.
81.1 (d) Until September 30, 2013, the portion related to long-term care consultation shall
81.2be determined according to section
81.3 (e) The portion related to development and education of resident and family advisory
81.4councils under section
81.5 (f) The portion related to planned closure rate adjustments shall be as determined
81.6under section
81.7Planned closure rate adjustments that take effect before October 1, 2014, shall no longer
81.8be included in the payment rate for external fixed costs beginning October 1, 2016.
81.9Planned closure rate adjustments that take effect on or after October 1, 2014, shall no
81.10longer be included in the payment rate for external fixed costs beginning on October 1 of
81.11the first year not less than two years after their effective date.
81.12 (g) The portions related to property insurance, real estate taxes, special assessments,
81.13and payments made in lieu of real estate taxes directly identified or allocated to the nursing
81.14facility shall be the actual amounts divided by actual resident days.
81.15 (h) The portion related to the Public Employees Retirement Association shall be
81.16actual costs divided by resident days.
81.17 (i) The single bed room incentives shall be as determined under section
81.18subdivision 42. Single bed room incentives that take effect before October 1, 2014, shall
81.19no longer be included in the payment rate for external fixed costs beginning October 1,
81.202016. Single bed room incentives that take effect on or after October 1, 2014, shall no
81.21longer be included in the payment rate for external fixed costs beginning on October 1 of
81.22the first year not less than two years after their effective date.
81.23 (j) The payment rate for external fixed costs shall be the sum of the amounts in
81.24paragraphs (a) to (i).
81.25 Sec. 41. Minnesota Statutes 2012, section 256B.49, subdivision 12, is amended to read:
81.26 Subd. 12. Informed choice. Persons who are determined likely to require the level
81.27of care provided in a nursing facility as determined under section 256B.0911, subdivision
81.284e, or a hospital shall be informed of the home and community-based support alternatives
81.29to the provision of inpatient hospital services or nursing facility services. Each person
81.30must be given the choice of either institutional or home and community-based services
81.31using the provisions described in section
81.32 Sec. 42. Minnesota Statutes 2012, section 256B.49, subdivision 14, is amended to read:
81.33 Subd. 14. Assessment and reassessment. (a) Assessments and reassessments
81.34shall be conducted by certified assessors according to section 256B.0911, subdivision 2b.
82.1With the permission of the recipient or the recipient's designated legal representative,
82.2the recipient's current provider of services may submit a written report outlining their
82.3recommendations regarding the recipient's care needs prepared by a direct service
82.4employee with at least 20 hours of service to that client. The person conducting the
82.5assessment or reassessment must notify the provider of the date by which this information
82.6is to be submitted. This information shall be provided to the person conducting the
82.7assessment and the person or the person's legal representative and must be considered
82.8prior to the finalization of the assessment or reassessment.
82.9(b) There must be a determination that the client requires a hospital level of care or a
82.10nursing facility level of care as defined in section
82.11
82.12waiver program.
82.13(c) Regardless of other assessments identified in section
82.14appropriate to determine nursing facility level of care for purposes of medical assistance
82.15payment for nursing facility services, only face-to-face assessments conducted according
82.16to section
82.17determination or a nursing facility level of care determination must be accepted for
82.18purposes of initial and ongoing access to waiver services payment.
82.19(d) Recipients who are found eligible for home and community-based services under
82.20this section before their 65th birthday may remain eligible for these services after their
82.2165th birthday if they continue to meet all other eligibility factors.
82.22(e) The commissioner shall develop criteria to identify recipients whose level of
82.23functioning is reasonably expected to improve and reassess these recipients to establish
82.24a baseline assessment. Recipients who meet these criteria must have a comprehensive
82.25transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be
82.26reassessed every six months until there has been no significant change in the recipient's
82.27functioning for at least 12 months. After there has been no significant change in the
82.28recipient's functioning for at least 12 months, reassessments of the recipient's strengths,
82.29informal support systems, and need for services shall be conducted at least every 12
82.30months and at other times when there has been a significant change in the recipient's
82.31functioning. Counties, case managers, and service providers are responsible for
82.32conducting these reassessments and shall complete the reassessments out of existing funds.
82.33 Sec. 43. [256B.85] COMMUNITY FIRST SERVICES AND SUPPORTS.
82.34 Subdivision 1. Basis and scope. (a) Upon federal approval, the commissioner
82.35shall establish a medical assistance state plan option for the provision of home and
83.1community-based personal assistance service and supports called "community first
83.2services and supports (CFSS)."
83.3(b) CFSS is a participant-controlled method of selecting and providing services
83.4and supports that allows the participant maximum control of the services and supports.
83.5Participants may choose the degree to which they direct and manage their supports by
83.6choosing to have a significant and meaningful role in the management of services and
83.7supports including by directly employing support workers with the necessary supports
83.8to perform that function.
83.9(c) CFSS is available statewide to eligible individuals to assist with accomplishing
83.10activities of daily living (ADLs), instrumental activities of daily living (IADLs), and
83.11health-related procedures and tasks through hands-on assistance to complete the task or
83.12supervision and cueing to complete the task; and to assist with acquiring, maintaining, and
83.13enhancing the skills necessary to accomplish ADLs, IADLs, and health-related procedures
83.14and tasks. CFSS allows payment for certain supports and goods such as environmental
83.15modifications and technology that are intended to replace or decrease the need for human
83.16assistance.
83.17(d) Upon federal approval, CFSS will replace the personal care assistance program
83.18under sections 256.476, 256B.0625, subdivisions 19a and 19c, and 256B.0659.
83.19 Subd. 2. Definitions. (a) For the purposes of this section, the terms defined in
83.20this subdivision have the meanings given.
83.21(b) "Activities of daily living" or "ADLs" means eating, toileting, grooming,
83.22dressing, bathing, mobility, positioning, and transferring.
83.23(c) "Agency-provider model" means a method of CFSS under which a qualified
83.24agency provides services and supports through the agency's own employees and policies.
83.25The agency must allow the participant to have a significant role in the selection and
83.26dismissal of support workers of their choice for the delivery of their specific services
83.27and supports.
83.28(d) "Behavior" means a category to determine the home care rating and is based on the
83.29criteria in section 256B.0659. "Level I behavior" means physical aggression towards self,
83.30others, or destruction of property that requires the immediate response of another person.
83.31(e) "Complex health-related needs" means a category to determine the home care
83.32rating and is based on the criteria in section 256B.0659.
83.33(f) "Community first services and supports" or "CFSS" means the assistance and
83.34supports program under this section needed for accomplishing activities of daily living,
83.35instrumental activities of daily living, and health-related tasks through hands-on assistance
83.36to complete the task or supervision and cueing to complete the task, or the purchase of
84.1goods as defined in subdivision 7, paragraph (a), clause (2), that replace the need for
84.2human assistance.
84.3(g) "Community first services and supports service delivery plan" or "service delivery
84.4plan" means a written summary of the services and supports, that is based on the community
84.5support plan identified in section 256B.0911 and coordinated services and support plan
84.6and budget identified in section 256B.0915, subdivision 6, if applicable, that is determined
84.7by the participant to meet the assessed needs, using a person-centered planning process.
84.8(h) "Critical activities of daily living" means transferring, mobility, eating, and
84.9toileting.
84.10(i) "Dependency" in activities of daily living means a person requires assistance to
84.11begin and complete one or more of the activities of daily living.
84.12(j) "Financial management services contractor or vendor" means a qualified
84.13organization having a written contract with the department to provide services necessary to
84.14use the budget model under subdivision 13, that include but are not limited to: participant
84.15education and technical assistance; CFSS service delivery planning and budgeting; billing,
84.16making payments, and monitoring of spending; and assisting the participant in fulfilling
84.17employer-related requirements in accordance with Section 3504 of the IRS code and
84.18the IRS Revenue Procedure 70-6.
84.19(k) "Budget model" means a service delivery method of CFSS that uses an
84.20individualized CFSS service delivery plan and service budget and assistance from the
84.21financial management services contractor to facilitate participant employment of support
84.22workers and the acquisition of supports and goods.
84.23(l) "Health-related procedures and tasks" means procedures and tasks related to
84.24the specific needs of an individual that can be delegated or assigned by a state-licensed
84.25healthcare or behavioral health professional and performed by a support worker.
84.26(m) "Instrumental activities of daily living" means activities related to living
84.27independently in the community, including but not limited to: meal planning, preparation,
84.28and cooking; shopping for food, clothing, or other essential items; laundry; housecleaning;
84.29assistance with medications; managing money; communicating needs, preferences, and
84.30activities; arranging supports; and assistance with traveling around and participating
84.31in the community.
84.32(n) "Legal representative" means parent of a minor, a court-appointed guardian, or
84.33another representative with legal authority to make decisions about services and supports
84.34for the participant. Other representatives with legal authority to make decisions include
84.35but are not limited to a health care agent or an attorney-in-fact authorized through a health
84.36care directive or power of attorney.
85.1(o) "Medication assistance" means providing verbal or visual reminders to take
85.2regularly scheduled medication and includes any of the following supports:
85.3(1) under the direction of the participant or the participant's representative, bringing
85.4medications to the participant including medications given through a nebulizer, opening a
85.5container of previously set up medications, emptying the container into the participant's
85.6hand, opening and giving the medication in the original container to the participant, or
85.7bringing to the participant liquids or food to accompany the medication;
85.8(2) organizing medications as directed by the participant or the participant's
85.9representative; and
85.10(3) providing verbal or visual reminders to perform regularly scheduled medications.
85.11(p) "Participant's representative" means a parent, family member, advocate, or
85.12other adult authorized by the participant to serve as a representative in connection with
85.13the provision of CFSS. This authorization must be in writing or by another method
85.14that clearly indicates the participant's free choice. The participant's representative must
85.15have no financial interest in the provision of any services included in the participant's
85.16service delivery plan and must be capable of providing the support necessary to assist
85.17the participant in the use of CFSS. If through the assessment process described in
85.18subdivision 5 a participant is determined to be in need of a participant's representative, one
85.19must be selected. If the participant is unable to assist in the selection of a participant's
85.20representative, the legal representative shall appoint one. Two persons may be designated
85.21as a participant's representative for reasons such as divided households and court-ordered
85.22custodies. Duties of a participant's representatives may include:
85.23(1) being available while care is provided in a method agreed upon by the participant
85.24or the participant's legal representative and documented in the participant's CFSS service
85.25delivery plan;
85.26(2) monitoring CFSS services to ensure the participant's CFSS service delivery
85.27plan is being followed; and
85.28(3) reviewing and signing CFSS time sheets after services are provided to provide
85.29verification of the CFSS services.
85.30(q) "Person-centered planning process" means a process that is driven by the
85.31participant for discovering and planning services and supports that ensures the participant
85.32makes informed choices and decisions. The person-centered planning process must:
85.33(1) include people chosen by the participant;
85.34(2) provide necessary information and support to ensure that the participant directs
85.35the process to the maximum extent possible, and is enabled to make informed choices
85.36and decisions;
86.1(3) be timely and occur at time and locations of convenience to the participant;
86.2(4) reflect cultural considerations of the participant;
86.3(5) include strategies for solving conflict or disagreement within the process,
86.4including clear conflict-of-interest guidelines for all planning;
86.5(6) offers choices to the participant regarding the services and supports they receive
86.6and from whom;
86.7(7) include a method for the participant to request updates to the plan; and
86.8(8) record the alternative home and community-based settings that were considered
86.9by the participant.
86.10(r) "Shared services" means the provision of CFSS services by the same CFSS
86.11support worker to two or three participants who voluntarily enter into an agreement to
86.12receive services at the same time and in the same setting by the same provider.
86.13(s) "Support specialist" means a professional with the skills and ability to assist the
86.14participant using either the agency provider model under subdivision 11 or the flexible
86.15spending model under subdivision 13, in services including, but not limited to assistance
86.16regarding:
86.17(1) the development, implementation, and evaluation of the CFSS service delivery
86.18plan under subdivision 6;
86.19(2) recruitment, training, or supervision, including supervision of health-related
86.20tasks or behavioral supports appropriately delegated by a health care professional, and
86.21evaluation of support workers; and
86.22(3) facilitating the use of informal and community supports, goods, or resources.
86.23(t) "Support worker" means an employee of the agency provider or of the participant
86.24who has direct contact with the participant and provides services as specified within the
86.25participant's service delivery plan.
86.26(u) "Wages and benefits" means the hourly wages and salaries, the employer's
86.27share of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers'
86.28compensation, mileage reimbursement, health and dental insurance, life insurance,
86.29disability insurance, long-term care insurance, uniform allowance, contributions to
86.30employee retirement accounts, or other forms of employee compensation and benefits.
86.31 Subd. 3. Eligibility. (a) CFSS is available to a person who meets one of the
86.32following:
86.33(1) is a recipient of medical assistance as determined under section 256B.055,
86.34256B.056, or 256B.057, subdivisions 5 and 9;
86.35(2) is a recipient of the alternative care program under section 256B.0913;
87.1(3) is a waiver recipient as defined under section 256B.0915, 256B.092, 256B.093,
87.2or 256B.49; or
87.3(4) has medical services identified in a participant's individualized education
87.4program and is eligible for services as determined in section 256B.0625, subdivision 26.
87.5(b) In addition to meeting the eligibility criteria in paragraph (a), a person must also
87.6meet all of the following:
87.7(1) require assistance and be determined dependent in one activity of daily living or
87.8Level I behavior based on assessment under section 256B.0911;
87.9(2) is not a recipient under the family support grant under section 252.32;
87.10(3) lives in the person's own apartment or home including a family foster care setting
87.11licensed under chapter 245A, but not in corporate foster care under chapter 245A; or a
87.12noncertified boarding care or boarding and lodging establishments under chapter 157;
87.13unless transitioning into the community from an institution; and
87.14(4) has not been excluded or disenrolled from the budget model.
87.15(c) The commissioner shall disenroll or exclude participants from the budget model
87.16and transfer them to the agency-provider model under the following circumstances that
87.17include but are not limited to:
87.18(1) when a participant has been restricted by the Minnesota restricted recipient
87.19program, the participant may be excluded for a specified time period;
87.20(2) when a participant exits the budget service delivery model during the participant's
87.21service plan year. Upon transfer, the participant shall not access the budget model for
87.22the remainder of that service plan year; or
87.23(3) when the department determines that the participant or participant's representative
87.24or legal representative cannot manage participant responsibilities under the service
87.25delivery model. The commissioner must develop policies for determining if a participant
87.26is unable to manage responsibilities under a service model.
87.27(d) A participant may appeal in writing to the department to contest the department's
87.28decision under paragraph (c), clause (3), to remove or exclude the participant from the
87.29budget model.
87.30 Subd. 4. Eligibility for other services. Selection of CFSS by a participant must not
87.31restrict access to other medically necessary care and services furnished under the state
87.32plan medical assistance benefit or other services available through alternative care.
87.33 Subd. 5. Assessment requirements. (a) The assessment of functional need must:
87.34(1) be conducted by a certified assessor according to the criteria established in
87.35section 256B.0911;
88.1(2) be conducted face-to-face, initially and at least annually thereafter, or when there
88.2is a significant change in the participant's condition or a change in the need for services
88.3and supports; and
88.4(3) be completed using the format established by the commissioner.
88.5(b) A participant who is residing in a facility may be assessed and choose CFSS for
88.6the purpose of using CFSS to return to the community as described in subdivisions 3
88.7and 7, paragraph (a), clause (5).
88.8(c) The results of the assessment and any recommendations and authorizations for
88.9CFSS must be determined and communicated in writing by the lead agency's certified
88.10assessor as defined in section 256B.0911 to the participant and the agency-provider or
88.11financial management services provider chosen by the participant within 40 calendar days
88.12and must include the participant's right to appeal under section 256.045.
88.13 Subd. 6. Community first services and support service delivery plan. (a) The
88.14CFSS service delivery plan must be developed, implemented, and evaluated through a
88.15person-centered planning process by the participant, or the participant's representative
88.16or legal representative who may be assisted by a support specialist. The CFSS service
88.17delivery plan must reflect the services and supports that are important to the participant
88.18and for the participant to meet the needs assessed by the certified assessor and identified
88.19in the community support plan under section 256B.0911 or the coordinated services and
88.20support plan identified in section 256B.0915, subdivision 6, if applicable. The CFSS
88.21service delivery plan must be reviewed by the participant and the agency-provider or
88.22financial management services contractor at least annually upon reassessment, or when
88.23there is a significant change in the participant's condition, or a change in the need for
88.24services and supports.
88.25(b) The commissioner shall establish the format and criteria for the CFSS service
88.26delivery plan.
88.27(c) The CFSS service delivery plan must be person-centered and:
88.28(1) specify the agency-provider or financial management services contractor selected
88.29by the participant;
88.30(2) reflect the setting in which the participant resides that is chosen by the participant;
88.31(3) reflect the participant's strengths and preferences;
88.32(4) include the means to address the clinical and support needs as identified through
88.33an assessment of functional needs;
88.34(5) include individually identified goals and desired outcomes;
89.1(6) reflect the services and supports, paid and unpaid, that will assist the participant
89.2to achieve identified goals, and the providers of those services and supports, including
89.3natural supports;
89.4(7) identify the amount and frequency of face-to-face supports and amount and
89.5frequency of remote supports and technology that will be used;
89.6(8) identify risk factors and measures in place to minimize them, including
89.7individualized backup plans;
89.8(9) be understandable to the participant and the individuals providing support;
89.9(10) identify the individual or entity responsible for monitoring the plan;
89.10(11) be finalized and agreed to in writing by the participant and signed by all
89.11individuals and providers responsible for its implementation;
89.12(12) be distributed to the participant and other people involved in the plan; and
89.13(13) prevent the provision of unnecessary or inappropriate care.
89.14(d) The total units of agency-provider services or the budget allocation amount for
89.15the budget model include both annual totals and a monthly average amount that cover
89.16the number of months of the service authorization. The amount used each month may
89.17vary, but additional funds must not be provided above the annual service authorization
89.18amount unless a change in condition is assessed and authorized by the certified assessor
89.19and documented in the community support plan, coordinated services and supports plan,
89.20and service delivery plan.
89.21 Subd. 7. Community first services and supports; covered services. Services
89.22and supports covered under CFSS include:
89.23(1) assistance to accomplish activities of daily living (ADLs), instrumental activities
89.24of daily living (IADLs), and health-related procedures and tasks through hands-on
89.25assistance to complete the task or supervision and cueing to complete the task;
89.26(2) assistance to acquire, maintain, or enhance the skills necessary for the participant
89.27to accomplish activities of daily living, instrumental activities of daily living, or
89.28health-related tasks;
89.29(3) expenditures for items, services, supports, environmental modifications, or
89.30goods, including assistive technology. These expenditures must:
89.31(i) relate to a need identified in a participant's CFSS service delivery plan;
89.32(ii) increase independence or substitute for human assistance to the extent that
89.33expenditures would otherwise be made for human assistance for the participant's assessed
89.34needs; and
89.35(iii) fit within the annual limit of the participant's approved service allocation
89.36or budget;
90.1(4) observation and redirection for episodes where there is a need for redirection
90.2due to participant behaviors or intervention needed due to a participant's symptoms. An
90.3assessment of behaviors must meet the criteria in this clause. A recipient qualifies as
90.4having a need for assistance due to behaviors if the recipient's behavior requires assistance
90.5at least four times per week and shows one or more of the following behaviors:
90.6(i) physical aggression towards self or others, or destruction of property that requires
90.7the immediate response of another person;
90.8(ii) increased vulnerability due to cognitive deficits or socially inappropriate
90.9behavior; or
90.10(iii) increased need for assistance for recipients who are verbally aggressive or
90.11resistive to care so that time needed to perform activities of daily living is increased;
90.12(5) back-up systems or mechanisms, such as the use of pagers or other electronic
90.13devices, to ensure continuity of the participant's services and supports;
90.14(6) transition costs, including:
90.15(i) deposits for rent and utilities;
90.16(ii) first month's rent and utilities;
90.17(iii) bedding;
90.18(iv) basic kitchen supplies;
90.19(v) other necessities, to the extent that these necessities are not otherwise covered
90.20under any other funding that the participant is eligible to receive; and
90.21(vi) other required necessities for an individual to make the transition from a nursing
90.22facility, institution for mental diseases, or intermediate care facility for persons with
90.23developmental disabilities to a community-based home setting where the participant
90.24resides; and
90.25(7) services by a support specialist defined under subdivision 2 that are chosen
90.26by the participant.
90.27 Subd. 8. Determination of CFSS service methodology. (a) All community first
90.28services and supports must be authorized by the commissioner or the commissioner's
90.29designee before services begin except for the assessments established in section
90.30256B.0911. The authorization for CFSS must be completed within 30 days after receiving
90.31a complete request.
90.32(b) The amount of CFSS authorized must be based on the recipient's home
90.33care rating. The home care rating shall be determined by the commissioner or the
90.34commissioner's designee based on information submitted to the commissioner identifying
90.35the following for a recipient:
91.1(1) the total number of dependencies of activities of daily living as defined in
91.2subdivision 2;
91.3(2) the presence of complex health-related needs as defined in subdivision 2; and
91.4(3) the presence of Level I behavior as defined in subdivision 2.
91.5(c) For purposes meeting the criteria in paragraph (b), the methodology to determine
91.6the total minutes for CFSS for each home care rating is based on the median paid units
91.7per day for each home care rating from fiscal year 2007 data for the PCA program. Each
91.8home care rating has a base number of minutes assigned. Additional minutes are added
91.9through the assessment and identification of the following:
91.10(1) 30 additional minutes per day for a dependency in each critical activity of daily
91.11living as defined in subdivision 2;
91.12(2) 30 additional minutes per day for each complex health-related function as
91.13defined in subdivision 2; and
91.14(3) 30 additional minutes per day for each behavior issue as defined in subdivision 2.
91.15 Subd. 9. Noncovered services. (a) Services or supports that are not eligible for
91.16payment under this section include those that:
91.17(1) are not authorized by the certified assessor or included in the written service
91.18delivery plan;
91.19(2) are provided prior to the authorization of services and the approval of the written
91.20CFSS service delivery plan;
91.21(3) are duplicative of other paid services in the written service delivery plan;
91.22(4) supplant natural unpaid supports that are provided voluntarily to the participant
91.23and are selected by the participant in lieu of a support worker and appropriately meeting
91.24the participant's needs;
91.25(5) are not effective means to meet the participant's needs; and
91.26(6) are available through other funding sources, including, but not limited to, funding
91.27through Title IV-E of the Social Security Act.
91.28(b) Additional services, goods, or supports that are not covered include:
91.29(1) those that are not for the direct benefit of the participant;
91.30(2) any fees incurred by the participant, such as Minnesota health care programs fees
91.31and co-pays, legal fees, or costs related to advocate agencies;
91.32(3) insurance, except for insurance costs related to employee coverage;
91.33(4) room and board costs for the participant with the exception of allowable
91.34transition costs in subdivision 7, clause (6);
91.35(5) services, supports, or goods that are not related to the assessed needs;
92.1(6) special education and related services provided under the Individuals with
92.2Disabilities Education Act and vocational rehabilitation services provided under the
92.3Rehabilitation Act of 1973;
92.4(7) assistive technology devices and assistive technology services other than those
92.5for back-up systems or mechanisms to ensure continuity of service and supports listed in
92.6subdivision 7;
92.7(8) medical supplies and equipment;
92.8(9) environmental modifications, except as specified in subdivision 7;
92.9(10) expenses for travel, lodging, or meals related to training the participant, the
92.10participant's representative, legal representative, or paid or unpaid caregivers that exceed
92.11$500 in a 12-month period;
92.12(11) experimental treatments;
92.13(12) any service or good covered by other medical assistance state plan services,
92.14including prescription and over-the-counter medications, compounds, and solutions and
92.15related fees, including premiums and co-payments;
92.16(13) membership dues or costs, except when the service is necessary and appropriate
92.17to treat a physical condition or to improve or maintain the participant's physical condition.
92.18The condition must be identified in the participant's CFSS plan and monitored by a
92.19physician enrolled in a Minnesota health care program;
92.20(14) vacation expenses other than the cost of direct services;
92.21(15) vehicle maintenance or modifications not related to the disability, health
92.22condition, or physical need; and
92.23(16) tickets and related costs to attend sporting or other recreational or entertainment
92.24events.
92.25 Subd. 10. Provider qualifications and general requirements. (a)
92.26Agency-providers delivering services under the agency-provider model under subdivision
92.2711 or financial management service (FMS) contractors under subdivision 13 shall:
92.28(1) enroll as a medical assistance Minnesota health care programs provider and meet
92.29all applicable provider standards;
92.30(2) comply with medical assistance provider enrollment requirements;
92.31(3) demonstrate compliance with law and policies of CFSS as determined by the
92.32commissioner;
92.33(4) comply with background study requirements under chapter 245C;
92.34(5) verify and maintain records of all services and expenditures by the participant,
92.35including hours worked by support workers and support specialists;
93.1(6) not engage in any agency-initiated direct contact or marketing in person, by
93.2telephone, or other electronic means to potential participants, guardians, family member
93.3or participants' representatives;
93.4(7) pay support workers and support specialists based upon actual hours of services
93.5provided;
93.6(8) withhold and pay all applicable federal and state payroll taxes;
93.7(9) make arrangements and pay unemployment insurance, taxes, workers'
93.8compensation, liability insurance, and other benefits, if any;
93.9(10) enter into a written agreement with the participant, participant's representative,
93.10or legal representative that assigns roles and responsibilities to be performed before
93.11services, supports, or goods are provided using a format established by the commissioner;
93.12(11) report suspected neglect and abuse to the common entry point according to
93.13sections 256B.0651 and 626.557; and
93.14(12) provide the participant with a copy of the service-related rights under
93.15subdivision 19 at the start of services and supports.
93.16(b) The commissioner shall develop policies and procedures designed to ensure
93.17program integrity and fiscal accountability for goods and services provided in this section
93.18in consultation with the implementation council described in subdivision 21.
93.19 Subd. 11. Agency-provider model. (a) The agency-provider model is limited to
93.20the services provided by support workers and support specialists who are employed by
93.21an agency-provider that is licensed according to chapter 245A or meets other criteria
93.22established by the commissioner, including required training.
93.23(b) The agency-provider shall allow the participant to have a significant role in the
93.24selection and dismissal of the support workers for the delivery of the services and supports
93.25specified in the participant's service delivery plan.
93.26(c) A participant may use authorized units of CFSS services as needed within a
93.27service authorization that is not greater than 12 months. Using authorized units in a
93.28flexible manner in either the agency-provider model or the budget model does not increase
93.29the total amount of services and supports authorized for a participant or included in the
93.30participant's service delivery plan.
93.31(d) A participant may share CFSS services. Two or three CFSS participants may
93.32share services at the same time provided by the same support worker.
93.33(e) The agency-provider must use a minimum of 72.5 percent of the revenue
93.34generated by the medical assistance payment for CFSS for support worker wages and
93.35benefits. The agency-provider must document how this requirement is being met. The
94.1revenue generated by the support specialist and the reasonable costs associated with the
94.2support specialist must not be used in making this calculation.
94.3(f) The agency-provider model must be used by individuals who have been restricted
94.4by the Minnesota restricted recipient program under MN Rules parts 9505.2160 to
94.59505.2245.
94.6 Subd. 12. Requirements for initial enrollment of CFSS provider agencies. (a)
94.7All CFSS provider agencies must provide, at the time of enrollment as a CFSS provider
94.8agency in a format determined by the commissioner, information and documentation that
94.9includes, but is not limited to, the following:
94.10(1) the CFSS provider agency's current contact information including address,
94.11telephone number, and e-mail address;
94.12(2) proof of surety bond coverage in the amount of $50,000 or ten percent of the
94.13provider's payments from Medicaid in the previous year, whichever is less;
94.14(3) proof of fidelity bond coverage in the amount of $20,000;
94.15(4) proof of workers' compensation insurance coverage;
94.16(5) proof of liability insurance;
94.17(6) a description of the CFSS provider agency's organization identifying the names
94.18or all owners, managing employees, staff, board of directors, and the affiliations of the
94.19directors, owners, or staff to other service providers;
94.20(7) a copy of the CFSS provider agency's written policies and procedures including:
94.21hiring of employees; training requirements; service delivery; and employee and consumer
94.22safety including process for notification and resolution of consumer grievances,
94.23identification and prevention of communicable diseases, and employee misconduct;
94.24(8) copies of all other forms the CFSS provider agency uses in the course of daily
94.25business including, but not limited to:
94.26(i) a copy of the CFSS provider agency's time sheet if the time sheet varies from
94.27the standard time sheet for CFSS services approved by the commissioner, and a letter
94.28requesting approval of the CFSS provider agency's nonstandard time sheet;
94.29(ii) the CFSS provider agency's template for the CFSS care plan; and
94.30(iii) the CFSS provider agency's template for the written agreement in subdivision
94.3121 for recipients using the CFSS choice option, if applicable;
94.32(9) a list of all training and classes that the CFSS provider agency requires of its
94.33staff providing CFSS services;
94.34(10) documentation that the CFSS provider agency and staff have successfully
94.35completed all the training required by this section;
94.36(11) documentation of the agency's marketing practices;
95.1(12) disclosure of ownership, leasing, or management of all residential properties
95.2that is used or could be used for providing home care services;
95.3(13) documentation that the agency will use the following percentages of revenue
95.4generated from the medical assistance rate paid for CFSS services for employee personal
95.5care assistant wages and benefits: 72.5 percent of revenue from CFSS providers. The
95.6revenue generated by the support specialist and the reasonable costs associated with the
95.7support specialist shall not be used in making this calculation; and
95.8(14) documentation that the agency does not burden recipients' free exercise of their
95.9right to choose service providers by requiring personal care assistants to sign an agreement
95.10not to work with any particular CFSS recipient or for another CFSS provider agency after
95.11leaving the agency and that the agency is not taking action on any such agreements or
95.12requirements regardless of the date signed.
95.13(b) CFSS provider agencies shall provide the information specified in paragraph
95.14(a) to the commissioner.
95.15 (c) All CFSS provider agencies shall require all employees in management and
95.16supervisory positions and owners of the agency who are active in the day-to-day
95.17management and operations of the agency to complete mandatory training as determined
95.18by the commissioner. Employees in management and supervisory positions and owners
95.19who are active in the day-to-day operations of an agency who have completed the required
95.20training as an employee with a CFSS provider agency do not need to repeat the required
95.21training if they are hired by another agency, if they have completed the training within
95.22the past three years. CFSS provider agency billing staff shall complete training about
95.23CFSS program financial management. Any new owners or employees in management
95.24and supervisory positions involved in the day-to-day operations are required to complete
95.25mandatory training as a requisite of working for the agency. CFSS provider agencies
95.26certified for participation in Medicare as home health agencies are exempt from the
95.27training required in this subdivision.
95.28 Subd. 13. Budget model. (a) Under the budget model participants can exercise
95.29more responsibility and control over the services and supports described and budgeted
95.30within the CFSS service delivery plan. Under this model, participants may use their
95.31budget allocation to:
95.32(1) directly employ support workers;
95.33(2) obtain supports and goods as defined in subdivision 7; and
95.34(3) choose a range of support assistance services from the financial management
95.35services (FMS) contractor related to:
96.1(i) assistance in managing the budget to meet the service delivery plan needs,
96.2consistent with federal and state laws and regulations;
96.3(ii) the employment, training, supervision, and evaluation of workers by the
96.4participant;
96.5(iii) acquisition and payment for supports and goods; and
96.6(iv) evaluation of individual service outcomes as needed for the scope of the
96.7participant's degree of control and responsibility.
96.8(b) Participants who are unable to fulfill any of the functions listed in paragraph (a)
96.9may authorize a legal representative or participant's representative to do so on their behalf.
96.10(c) The FMS contractor shall not provide CFSS services and supports under the
96.11agency-provider service model. The FMS contractor shall provide service functions as
96.12determined by the commissioner that include but are not limited to:
96.13(1) information and consultation about CFSS;
96.14(2) assistance with the development of the service delivery plan and budget model
96.15as requested by the participant;
96.16(3) billing and making payments for budget model expenditures;
96.17(4) assisting participants in fulfilling employer-related requirements according to
96.18Internal Revenue Code Procedure 70-6, section 3504, Agency Employer Tax Liability,
96.19regulation 137036-08, which includes assistance with filing and paying payroll taxes, and
96.20obtaining worker compensation coverage;
96.21(5) data recording and reporting of participant spending; and
96.22(6) other duties established in the contract with the department.
96.23(d) A participant who requests to purchase goods and supports along with support
96.24worker services under the agency-provider model must use the budget model with
96.25a service delivery plan that specifies the amount of services to be authorized to the
96.26agency-provider and the expenditures to be paid by the FMS contractor.
96.27(e) The FMS contractor shall:
96.28(1) not limit or restrict the participant's choice of service or support providers or
96.29service delivery models consistent with any applicable state and federal requirements;
96.30(2) provide the participant and the targeted case manager, if applicable, with a
96.31monthly written summary of the spending for services and supports that were billed
96.32against the spending budget;
96.33(3) be knowledgeable of state and federal employment regulations under the Fair
96.34Labor Standards Act of 1938, and comply with the requirements under the Internal
96.35Revenue Service Revenue Code Procedure 70-6, Section 35-4, Agency Employer Tax
96.36Liability for vendor or fiscal employer agent, and any requirements necessary to process
97.1employer and employee deductions, provide appropriate and timely submission of
97.2employer tax liabilities, and maintain documentation to support medical assistance claims;
97.3(4) have current and adequate liability insurance and bonding and sufficient cash
97.4flow as determined by the commission and have on staff or under contract a certified
97.5public accountant or an individual with a baccalaureate degree in accounting;
97.6(5) assume fiscal accountability for state funds designated for the program; and
97.7(6) maintain documentation of receipts, invoices, and bills to track all services and
97.8supports expenditures for any goods purchased and maintain time records of support
97.9workers. The documentation and time records must be maintained for a minimum of
97.10five years from the claim date and be available for audit or review upon request by the
97.11commissioner. Claims submitted by the FMS contractor to the commissioner for payment
97.12must correspond with services, amounts, and time periods as authorized in the participant's
97.13spending budget and service plan.
97.14(f) The commissioner of human services shall:
97.15(1) establish rates and payment methodology for the FMS contractor;
97.16(2) identify a process to ensure quality and performance standards for the FMS
97.17contractor and ensure statewide access to FMS contractors; and
97.18(3) establish a uniform protocol for delivering and administering CFSS services
97.19to be used by eligible FMS contractors.
97.20(g) The commissioner of human services shall disenroll or exclude participants from
97.21the budget model and transfer them to the agency-provider model under the following
97.22circumstances that include but are not limited to:
97.23(1) when a participant has been restricted by the Minnesota restricted recipient
97.24program, the participant may be excluded for a specified time period under Minnesota
97.25Rules, parts 9505.2160 to 9505.2245;
97.26(2) when a participant exits the budget model during the participant's service plan
97.27year. Upon transfer, the participant shall not access the budget model for the remainder of
97.28that service plan year; or
97.29(3) when the department determines that the participant or participant's representative
97.30or legal representative cannot manage participant responsibilities under the budget model.
97.31The commissioner must develop policies for determining if a participant is unable to
97.32manage responsibilities under a budget model.
97.33(h) A participant may appeal under 256.045 subdivision 3 in writing to the
97.34department to contest the department's decision under paragraph (c), clause (3), to remove
97.35or exclude the participant from the budget model.
98.1 Subd. 14. Participant's responsibilities under budget model. (a) A participant
98.2using the budget model must use an FMS contractor or vendor that is under contract with
98.3the department. Upon a determination of eligibility and completion of the assessment and
98.4community support plan, the participant shall choose a FMS contractor from a list of
98.5eligible vendors maintained by the department.
98.6(b) When the participant, participant's representative, or legal representative chooses
98.7to be the employer of the support worker, they are responsible for the hiring and supervision
98.8of the support worker, including, but not limited to, recruiting, interviewing, training, and
98.9discharging the support worker consistent with federal and state laws and regulations.
98.10(c) In addition to the employer responsibilities in paragraph (b), the participant,
98.11participant's representative, or legal representative is responsible for:
98.12(1) tracking the services provided and all expenditures for goods or other supports;
98.13(2) preparing and submitting time sheets, signed by both the participant and support
98.14worker, to the FMS contractor on a regular basis and in a timely manner according to
98.15the FMS contractor's procedures;
98.16(3) notifying the FMS contractor within ten days of any changes in circumstances
98.17affecting the CFSS service plan or in the participant's place of residence including, but
98.18not limited to, any hospitalization of the participant or change in the participant's address,
98.19telephone number, or employment;
98.20(4) notifying the FMS contractor of any changes in the employment status of each
98.21participant support worker; and
98.22(5) reporting any problems resulting from the quality of services rendered by the
98.23support worker to the FMS contractor. If the participant is unable to resolve any problems
98.24resulting from the quality of service rendered by the support worker with the assistance of
98.25the FMS contractor, the participant shall report the situation to the department.
98.26 Subd. 15. Documentation of support services provided. (a) Support services
98.27provided to a participant by a support worker employed by either an agency-provider
98.28or the participant acting as the employer must be documented daily by each support
98.29worker, on a time sheet form approved by the commissioner. All documentation may be
98.30Web-based, electronic, or paper documentation. The completed form must be submitted
98.31on a monthly basis to the provider or the participant and the FMS contractor selected by
98.32the participant to provide assistance with meeting the participant's employer obligations
98.33and kept in the recipient's health record.
98.34(b) The activity documentation must correspond to the written service delivery plan
98.35and be reviewed by the agency provider or the participant and the FMS contractor when
98.36the participant is acting as the employer of the support worker.
99.1(c) The time sheet must be on a form approved by the commissioner documenting
99.2time the support worker provides services in the home. The following criteria must be
99.3included in the time sheet:
99.4(1) full name of the support worker and individual provider number;
99.5(2) provider name and telephone numbers, if an agency-provider is responsible for
99.6delivery services under the written service plan;
99.7(3) full name of the participant;
99.8(4) consecutive dates, including month, day, and year, and arrival and departure
99.9times with a.m. or p.m. notations;
99.10(5) signatures of the participant or the participant's representative;
99.11(6) personal signature of the support worker;
99.12(7) any shared care provided, if applicable;
99.13(8) a statement that it is a federal crime to provide false information on CFSS
99.14billings for medical assistance payments; and
99.15(9) dates and location of recipient stays in a hospital, care facility, or incarceration.
99.16 Subd. 16. Support workers requirements. (a) Support workers shall:
99.17(1) enroll with the department as a support worker after a background study under
99.18chapter 245C has been completed and the support worker has received a notice from the
99.19commissioner that:
99.20 (i) the support worker is not disqualified under section 245C.14; or
99.21(ii) is disqualified, but the support worker has received a set-aside of the
99.22disqualification under section 245C.22;
99.23(2) have the ability to effectively communicate with the participant or the
99.24participant's representative;
99.25(3) have the skills and ability to provide the services and supports according to the
99.26person's CFSS service delivery plan and respond appropriately to the participant's needs;
99.27(4) not be a participant of CFSS, unless the support services provided by the support
99.28worker differ from those provided to the support worker;
99.29(5) complete the basic standardized training as determined by the commissioner
99.30before completing enrollment. The training must be available in languages other than
99.31English and to those who need accommodations due to disabilities. Support worker
99.32training must include successful completion of the following training components: basic
99.33first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic roles
99.34and responsibilities of support workers including information about basic body mechanics,
99.35emergency preparedness, orientation to positive behavioral practices, orientation to
99.36responding to a mental health crisis, fraud issues, time cards and documentation, and an
100.1overview of person-centered planning and self-direction. Upon completion of the training
100.2components, the support worker must pass the certification test to provide assistance
100.3to participants;
100.4(6) complete training and orientation on the participant's individual needs; and
100.5(7) maintain the privacy and confidentiality of the participant, and not independently
100.6determine the medication dose or time for medications for the participant.
100.7(b) The commissioner may deny or terminate a support worker's provider enrollment
100.8and provider number if the support worker:
100.9(1) lacks the skills, knowledge, or ability to adequately or safely perform the
100.10required work;
100.11(2) fails to provide the authorized services required by the participant employer;
100.12(3) has been intoxicated by alcohol or drugs while providing authorized services to
100.13the participant or while in the participant's home;
100.14(4) has manufactured or distributed drugs while providing authorized services to the
100.15participant or while in the participant's home; or
100.16(5) has been excluded as a provider by the commissioner of human services, or the
100.17United States Department of Health and Human Services, Office of Inspector General,
100.18from participation in Medicaid, Medicare, or any other federal health care program.
100.19(c) A support worker may appeal in writing to the commissioner to contest the
100.20decision to terminate the support worker's provider enrollment and provider number.
100.21 Subd. 17. Support specialist requirements and payments. The commissioner
100.22shall develop qualifications, scope of functions, and payment rates and service limits for a
100.23support specialist that may provide additional or specialized assistance necessary to plan,
100.24implement, arrange, augment, or evaluate services and supports.
100.25 Subd. 18. Service unit and budget allocation requirements and limits. (a) For the
100.26agency-provider model, services will be authorized in units of service. The total service
100.27unit amount must be established based upon the assessed need for CFSS services, and must
100.28not exceed the maximum number of units available as determined under subdivision 8.
100.29(b) For the budget model, the budget allocation allowed for services and supports
100.30is established by multiplying the number of units authorized under subdivision 8 by the
100.31payment rate established by the commissioner.
100.32 Subd. 19. Support system. (a) The commissioner shall provide information,
100.33consultation, training, and assistance to ensure the participant is able to manage the
100.34services and supports and budgets, if applicable. This support shall include individual
100.35consultation on how to select and employ workers, manage responsibilities under CFSS,
100.36and evaluate personal outcomes.
101.1(b) The commissioner shall provide assistance with the development of risk
101.2management agreements.
101.3 Subd. 20. Service-related rights. (a) Participants must be provided with adequate
101.4information, counseling, training, and assistance, as needed, to ensure that the participant
101.5is able to choose and manage services, models, and budgets. This support shall include
101.6information regarding:
101.7(1) person-centered planning;
101.8(2) the range and scope of individual choices;
101.9(3) the process for changing plans, services and budgets;
101.10(4) the grievance process;
101.11(5) individual rights;
101.12(6) identifying and assessing appropriate services;
101.13(7) risks and responsibilities; and
101.14(8) risk management.
101.15(b) The commissioner must ensure that the participant has a copy of the most recent
101.16community support plan and service delivery plan.
101.17(c) A participant who appeals a reduction in previously authorized CFSS services
101.18may continue previously authorized services pending an appeal in accordance with section
101.19256.045.
101.20(d) if the units of service or budget allocation for CFSS are reduced, denied,
101.21terminated, the commissioner must provide notice of the reasons for the reduction in the
101.22participant's notice of denial, termination, or reduction.
101.23(e) If all or part of a service delivery plan is denied approval, the commissioner must
101.24provide a notice that describes the basis of the denial.
101.25 Subd. 21. Development and Implementation Council. The commissioner
101.26shall establish a Development and Implementation Council of which the majority of
101.27members are individuals with disabilities, elderly individuals, and their representatives.
101.28The commissioner shall consult and collaborate with the council when developing and
101.29implementing this section for at least the first five years of operation. The commissioner,
101.30in consultation with the council, shall provide recommendations on how to improve the
101.31quality and integrity of CFSS, reduce the paper documentation required in subdivisions
101.3210, 12, and 15, make use of electronic means of documentation and online reporting in
101.33order reduce administrative costs and improve training to the legislative chairs of the
101.34Health and Human Service Policy and Finance Committees by February 1, 2014.
101.35 Subd. 22. Quality assurance and risk management system. (a) The commissioner
101.36shall establish quality assurance and risk management measures for use in developing and
102.1implementing CFSS, including those that (1) recognize the roles and responsibilities of
102.2those involved in obtaining CFSS, and (2) ensure the appropriateness of such plans and
102.3budgets based upon a recipient's resources and capabilities. Risk management measures
102.4must include background studies, and backup and emergency plans, including disaster
102.5planning.
102.6(b) The commissioner shall provide ongoing technical assistance and resource and
102.7educational materials for CFSS participants.
102.8(c) Performance assessment measures, such as a participant's satisfaction with the
102.9services and supports, and ongoing monitoring of health and well-being shall be identified
102.10in consultation with the council established in subdivision 21.
102.11(d) Data reporting requirements will be developed in consultation with the council
102.12established in subdivision 21.
102.13 Subd. 23. Commissioner's access. When the commissioner is investigating a
102.14possible overpayment of Medicaid funds, the commissioner must be given immediate
102.15access without prior notice to the agency provider or FMS contractor's office during
102.16regular business hours and to documentation and records related to services provided and
102.17submission of claims for services provided. Denying the commissioner access to records
102.18is cause for immediate suspension of payment and terminating the agency provider's
102.19enrollment according to section 256B.064 or terminating the FMS contract.
102.20 Subd. 24. CFSS agency-providers; background studies. CFSS agency-providers
102.21enrolled to provide personal care assistance services under the medical assistance program
102.22shall comply with the following:
102.23(1) owners who have a five percent interest or more and all managing employees
102.24are subject to a background study as provided in chapter 245C. This applies to currently
102.25enrolled CFSS agency-providers and those agencies seeking enrollment as a CFSS
102.26agency-provider. "Managing employee" has the same meaning as Code of Federal
102.27Regulations, title 42, section 455. An organization is barred from enrollment if:
102.28(i) the organization has not initiated background studies on owners managing
102.29employees; or
102.30(ii) the organization has initiated background studies on owners and managing
102.31employees, but the commissioner has sent the organization a notice that an owner or
102.32managing employee of the organization has been disqualified under section 245C.14, and
102.33the owner or managing employee has not received a set-aside of the disqualification
102.34under section 245C.22;
102.35(2) a background study must be initiated and completed for all support specialists; and
102.36(3) a background study must be initiated and completed for all support workers.
103.1EFFECTIVE DATE.This section is effective upon federal approval but no earlier
103.2than January 1, 2014. The service will begin 90 days after federal approval or January 1,
103.32014 whichever is later. The commissioner of human services shall notify the revisor of
103.4statutes when this occurs.
103.5 Sec. 44. Minnesota Statutes 2012, section 256I.05, is amended by adding a subdivision
103.6to read:
103.7 Subd. 1o. Supplementary service rate; exemptions. A county agency shall not
103.8negotiate a supplementary service rate under this section for any individual that has been
103.9determined to be eligible for Housing Stability Services as approved by the Centers
103.10for Medicare and Medicaid Services, and who resides in an establishment voluntarily
103.11registered under section 144D.025, as a supportive housing establishment or participates
103.12in the Minnesota supportive housing demonstration program under section 256I.04,
103.13subdivision 3, paragraph (a), clause (4).
103.14 Sec. 45. Minnesota Statutes 2012, section 626.557, subdivision 4, is amended to read:
103.15 Subd. 4. Reporting. (a) Except as provided in paragraph (b), a mandated reporter
103.16shall immediately make an oral report to the common entry point. The common entry
103.17point may accept electronic reports submitted through a Web-based reporting system
103.18established by the commissioner. Use of a telecommunications device for the deaf or other
103.19similar device shall be considered an oral report. The common entry point may not require
103.20written reports. To the extent possible, the report must be of sufficient content to identify
103.21the vulnerable adult, the caregiver, the nature and extent of the suspected maltreatment,
103.22any evidence of previous maltreatment, the name and address of the reporter, the time,
103.23date, and location of the incident, and any other information that the reporter believes
103.24might be helpful in investigating the suspected maltreatment. A mandated reporter may
103.25disclose not public data, as defined in section
103.27(b) A boarding care home that is licensed under sections
103.28certified under Title 19 of the Social Security Act, a nursing home that is licensed under
103.29section
103.30hospital that is licensed under sections
103.31Code of Federal Regulations, title 42, section
103.32to the common entry point instead of submitting an oral report. The report may be a
103.33duplicate of the initial report the facility submits electronically to the commissioner of
103.34health to comply with the reporting requirements under Code of Federal Regulations, title
104.142, section
104.2to include items required under paragraph (a) that are not currently included in the
104.3electronic reporting form.
104.4EFFECTIVE DATE.This section is effective July 1, 2014.
104.5 Sec. 46. Minnesota Statutes 2012, section 626.557, subdivision 9, is amended to read:
104.6 Subd. 9. Common entry point designation. (a)
104.7
104.8
104.9 common entry point effective July 1, 2014. The common entry point is the unit responsible
104.10for receiving the report of suspected maltreatment under this section.
104.11(b) The common entry point must be available 24 hours per day to take calls from
104.12reporters of suspected maltreatment. The common entry point shall use a standard intake
104.13form that includes:
104.14(1) the time and date of the report;
104.15(2) the name, address, and telephone number of the person reporting;
104.16(3) the time, date, and location of the incident;
104.17(4) the names of the persons involved, including but not limited to, perpetrators,
104.18alleged victims, and witnesses;
104.19(5) whether there was a risk of imminent danger to the alleged victim;
104.20(6) a description of the suspected maltreatment;
104.21(7) the disability, if any, of the alleged victim;
104.22(8) the relationship of the alleged perpetrator to the alleged victim;
104.23(9) whether a facility was involved and, if so, which agency licenses the facility;
104.24(10) any action taken by the common entry point;
104.25(11) whether law enforcement has been notified;
104.26(12) whether the reporter wishes to receive notification of the initial and final
104.27reports; and
104.28(13) if the report is from a facility with an internal reporting procedure, the name,
104.29mailing address, and telephone number of the person who initiated the report internally.
104.30(c) The common entry point is not required to complete each item on the form prior
104.31to dispatching the report to the appropriate lead investigative agency.
104.32(d) The common entry point shall immediately report to a law enforcement agency
104.33any incident in which there is reason to believe a crime has been committed.
105.1(e) If a report is initially made to a law enforcement agency or a lead investigative
105.2agency, those agencies shall take the report on the appropriate common entry point intake
105.3forms and immediately forward a copy to the common entry point.
105.4(f) The common entry point staff must receive training on how to screen and
105.5dispatch reports efficiently and in accordance with this section.
105.6(g) The commissioner of human services shall maintain a centralized database
105.7for the collection of common entry point data, lead investigative agency data including
105.8maltreatment report disposition, and appeals data. The common entry point shall
105.9have access to the centralized database and must log the reports into the database and
105.10immediately identify and locate prior reports of abuse, neglect, or exploitation.
105.11(h) When appropriate, the common entry point staff must refer calls that do not
105.12allege the abuse, neglect, or exploitation of a vulnerable adult to other organizations
105.13that might resolve the reporter's concerns.
105.14(i) a common entry point must be operated in a manner that enables the
105.15commissioner of human services to:
105.16(1) track critical steps in the reporting, evaluation, referral, response, disposition,
105.17and investigative process to ensure compliance with all requirements for all reports;
105.18(2) maintain data to facilitate the production of aggregate statistical reports for
105.19monitoring patterns of abuse, neglect, or exploitation;
105.20(3) serve as a resource for the evaluation, management, and planning of preventative
105.21and remedial services for vulnerable adults who have been subject to abuse, neglect,
105.22or exploitation;
105.23(4) set standards, priorities, and policies to maximize the efficiency and effectiveness
105.24of the common entry point; and
105.25(5) track and manage consumer complaints related to the common entry point.
105.26(j) The commissioners of human services and health shall collaborate on the
105.27creation of a system for referring reports to the lead investigative agencies. This system
105.28shall enable the commissioner of human services to track critical steps in the reporting,
105.29evaluation, referral, response, disposition, investigation, notification, determination, and
105.30appeal processes.
105.31 Sec. 47. Minnesota Statutes 2012, section 626.557, subdivision 9e, is amended to read:
105.32 Subd. 9e. Education requirements. (a) The commissioners of health, human
105.33services, and public safety shall cooperate in the development of a joint program for
105.34education of lead investigative agency investigators in the appropriate techniques for
105.35investigation of complaints of maltreatment. This program must be developed by July
106.11, 1996. The program must include but need not be limited to the following areas: (1)
106.2information collection and preservation; (2) analysis of facts; (3) levels of evidence; (4)
106.3conclusions based on evidence; (5) interviewing skills, including specialized training to
106.4interview people with unique needs; (6) report writing; (7) coordination and referral
106.5to other necessary agencies such as law enforcement and judicial agencies; (8) human
106.6relations and cultural diversity; (9) the dynamics of adult abuse and neglect within family
106.7systems and the appropriate methods for interviewing relatives in the course of the
106.8assessment or investigation; (10) the protective social services that are available to protect
106.9alleged victims from further abuse, neglect, or financial exploitation; (11) the methods by
106.10which lead investigative agency investigators and law enforcement workers cooperate in
106.11conducting assessments and investigations in order to avoid duplication of efforts; and
106.12(12) data practices laws and procedures, including provisions for sharing data.
106.13(b) The commissioner of human services shall conduct an outreach campaign to
106.14promote the common entry point for reporting vulnerable adult maltreatment. This
106.15campaign shall use the Internet and other means of communication.
106.16
106.17least annual education to others on the requirements of this section, on how this section is
106.18implemented, and investigation techniques.
106.19
106.20of public safety shall provide training for the common entry point staff as required in this
106.21subdivision and the program courses described in this subdivision, at least four times
106.22per year. At a minimum, the training shall be held twice annually in the seven-county
106.23metropolitan area and twice annually outside the seven-county metropolitan area. The
106.24commissioners shall give priority in the program areas cited in paragraph (a) to persons
106.25currently performing assessments and investigations pursuant to this section.
106.26
106.27personnel of any new requirements under this section. The commissioner of public
106.28safety shall conduct regional training for law enforcement personnel regarding their
106.29responsibility under this section.
106.30
106.31program specified by this subdivision within the first 12 months of work as a lead
106.32investigative agency investigator.
106.33A lead investigative agency investigator employed when these requirements take
106.34effect must complete the program within the first year after training is available or as soon
106.35as training is available.
107.1All lead investigative agency investigators having responsibility for investigation
107.2duties under this section must receive a minimum of eight hours of continuing education
107.3or in-service training each year specific to their duties under this section.
107.4 Sec. 48. FEDERAL APPROVAL.
107.5This article is contingent on federal approval.
107.6 Sec. 49. REPEALER.
107.7(a) Minnesota Statutes 2012, sections 245A.655; and 256B.0917, subdivisions 1, 2,
107.83, 4, 5, 7, 8, 9, 10, 11, 12, and 14, are repealed.
107.9(b) Minnesota Statutes 2012, section 256B.0911, subdivisions 4a, 4b, and 4c, are
107.10repealed effective October 1, 2013.