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S.F. No. 1804 - State Health and Human Services Provisions Modifications and Reforms (First Engrossment)
 
Author: Senator David Hann
 
Prepared By: Joan White, Senate Counsel (651/296-3814)
 
Date: March 9, 2012



 

Article 1 – Continuing Care

Section 1 (144A.071, subdivision 3) allows nursing facilities to receive interim and settle-up operating cost payment rates for beds newly licensed under the hardship provision only if  50 percent or more of the total beds are newly licensed.

Section 2 (144A.071, subdivision 4a) applies previously inapplicable operating cost payment rate determinations to certain nursing facilities.

Section 3 (245A.03, subdivision 7) removes obsolete language related to the child foster care and adult foster care licensing moratorium for providers whose primary residence is not the licensed location. Adds requirements that license applicants and current license holders must inform Department of Human Services (DHS) if the licensed location is the primary residence, and if home and community-based waiver services are provided at the licensed location.

Section 4 (245A.11, subdivision 2a) extends the deadline for the commissioner to issue new adult foster care licenses for up to five people from June 30, 2011, to June 30, 2014.

Section 5 (245A.11, subdivision 8) changes a due date for a licensing report from DHS to the Legislature from January 15, 2011, to January 15, 2012.

Section 6 (252.32, subdivision 1a) add references to specific sections of law regarding home and community-based waivered services, personal care assistance, and consumer support grants.

Section 7 (252.34) requires DHS to submit a biennial report, beginning on January 1, 2013, to the Legislature summarizing the overarching goals, priorities, and status on administering the goals and priorities, for the following programs: home and community-based waiver services, home care services, other relevant programs.

Section 8 (252A.21, subdivision 2) removes rules regarding quarterly review requirements.

Section 9 (256.476, subdivision 11) changes how consumer support grant funds are calculated.

Section 10 (256.9657, subdivision 1) removes a reference being repealed.

Section 11 (256B.0625, subdivision 19c) changes a reference.

Section 12 (256B.0659, subdivision 1) slightly modifies the definition of “extended personal care assistance.”

Section 13 (256B.0659, subdivision 3) makes a language change and removes an obsolete date reference.

Section 14 (256B.0659, subdivision 9) excludes qualified professionals and certain home care provider agency staff to the list of those who are considered a “responsible party” in the personal care assistance (PCA) program.

Section 15 (256B.0659, subdivision 11) changes orientation and training completion time requirements, removes obsolete language, and changes personal care assistant qualifications.

Sections 16 and 17 (256B.0659, subdivisions 13 and 14, respectively) add training requirements for qualified professionals in the PCA program.

Section 18 (256B.0659, subdivision 19) allows PCA provider agencies to be considered a qualified professional.

Section 19 (256B.0659, subdivision 20) excludes revenues and costs associated with the qualified professional from wage and benefit requirements associated with Medical Assistance (MA).

Section 20 (256B.0659, subdivision 21) excludes revenues and costs associated with the qualified professional from wage and benefit requirements associated with MA, and adds the training requirements for Medicare-certified home health agency owners, supervisors, and managers in the PCA program.

Section 21 (256B.0659, subdivision 24) excludes revenues and costs associated with the qualified professional from wage and benefit requirements associated with MA.

Section 22 (256B.0659, subdivision 30) removes DHS notification requirements for PCA service changes, effective July 1, 2012.

Sections 23 and 29 (256B.0916, subdivision 7 and 256B.49, subdivision 21, respectively) eliminate, beginning in 2013, an annual report from DHS to the Legislature on county and state use of available resources for home and community-based waiver services for people with developmental disabilities.

Section 24 (256B.092, subdivision 11) clarifies that certain licensed child foster care and adult foster care providers meet residential support services registration requirements.

Section 25 (256B.096, subdivision 5) eliminates, beginning in 2013, a biennial report from DHS to the Legislature on the development of quality management, assurance, and improvement systems for home and community-based waiver services for people with disabilities.

Section 26 (256B.441, subdivision 13) removes a reference being repealed.

Section 27 (256B.441, subdivision 31) removes a reference being repealed.

Section 28 (256B.441, subdivision 53) removes a reference being repealed.

Section 30 (626.557, subdivision 9) requires the commissioner to maintain the centralized database for Common Point Entry and Adult Protection Investigative data created in 2008.

Section 31 (Laws 2009, chapter 79, article 8, section 81, as amended by Laws 2010, chapter 352, article 1, section 24) exempts customized living services, as service licenses are issued be the Department of Health and not DHS.

Section 32 requires the commissioner to seek federal approval to the home and community-based services waivers to allow adult foster care homes for up to five people.

Section 33 requires private duty nursing (PDN) service providers to submit to the commissioner an hourly nursing determination matrix for each PDN service recipient.

Section 34 repeals obsolete Minnesota Statutes related to nursing facilities, and a Minnesota Rule related to the reporting of abuse and neglect.

Article 2 – Telephone Equipment Program

Section 1 (237.50) updates definitions within the Telephone Equipment Distribution (TED) program.

Section 2 (237.51) updates terminology within the Telecommunications Access Minnesota program, provides devices based on assessed need, and requires any advisory board to have at least one member who has a physical disability making access to telecommunication services difficult.

Section 3 (237.52) updates terminology within the Telecommunications Access Minnesota fund and clarifies a reference to the Public Utilities Commission (PUC).

Section 4 (237.53) updates terminology regarding telecommunication devices, removes requirement for telephone companies to install outside wiring to certain households, and requires the establishment of policies and procedures for the return of equipment once recipients are ineligible for the program.

Section 5 (237.54) updated terminology regarding telecommunications rely services (TRS) and requires TRS providers to comply with FCC regulations and inform persons with communication disabilities and the public on the availability and use of TRS.

Section 6 (237.55) updates terminology and clarifies a reference to the PUC.

Section 7 (237.56) updates terminology and clarifies who may participate in the consumer protection process.

Article 3 – Comprehensive Assessment and Case Management Reform

Section 1 (256B.0625, subdivision 56) requires in-reach community-based service coordination to connect frequent users with existing, available services.

Section 2 (256B.0659, subdivision 1) adds a nebulizer to the definition of “self-administered medication.”

Section 3 (256B.0659, subdivision 2) adds a nebulizer to the definition of “self-administered medication” and specifies that a PCA cannot determine the timing or dosage of medication. 

Section 4 (256B.0659, subdivision 3a) clarifies who can do PCA assessments and adds a sunset date to the subdivision. Makes timelines for completing assessments consistent with all assessments identified in the long-term care statute.

Section 5 (256B.0659, subdivision 4) modifies the list of limitations that apply to PCA assessments.

Section 6 (256B.0911, subdivision 1) makes technical and clarifying changes to the purpose and goal of long-term care consultation services.

Section 7 (256B.0911, subdivision 1a) modifies the definition of "long-term care consultation services."

Section 8 (256B.0911, subdivision 2b) removes language requiring assessors to be part of a multidisciplinary team and removes requirements related to assessments for persons with complex health care needs.

Section 9 (256B.0911, subdivision 2c) sets the timeline for required training and certification for certified assessors.

Section 10 (256B.0911, subdivision 3) continues the requirement that counties must have long-term care consultation teams, and specifies that certified assessors must be part of a multidisciplinary team and specifies the other professionals that must be part of the team. Adds a reference to tribes.

Section 11 (256B.0911, subdivision 3a) specifies who must be consulted for persons with complex health care needs. Adds language specifying the information that must be included in the written community support plan. Modifies the list of information that must be provided to the person receiving the assessment. Makes technical changes.

Section 12 (256B.0911, subdivision 3b) makes technical and conforming changes and modifies lead agency duties related to transition assistance.

Section 13 (256B.0911, subdivision 4a) makes technical and conforming changes.

Section 14 (256B.0911, subdivision 4c) makes technical and conforming changes.

Section 15 (256B.0911, subdivision 6) makes cross-reference changes, clarifies that until a new payment methodology is implemented, payment for assessments will continue to be billed as it is currently, and directs the commissioner to consider and maximize all funding sources when developing the methodology.

Section 16 (256B.0913, subdivision 7) makes technical and conforming changes and specifies case manager responsibilities.

Section 17 (256B.0913, subdivision 8) makes technical and conforming changes. Specifies the requirements the coordinated services and support plan must meet.

Section 18 (256B.0915, subdivision 1a) modifies the activities included in case management services. Requires case managers to collaborate with specified persons in the development and review of the coordinated services and support plan. Requires case management services to be provided by either a public or private agency. Defines "private agency." Lists the activities included under case management services. Requires the health plan to provide or arrange to provider EW case management services for certain enrollees of prepaid MA programs.

Section 19 (256B.0915, subdivision 1b) makes a conforming change and requires health plans to provide or coordinate elderly waiver case management services to comply with the provider standards and qualifications created by the commissioner.

Section 20 (256B.0915, subdivision 3c) makes a conforming change.

Section 21 (256B.0915, subdivision 6) lists the requirements related to coordinated services and support plan.

Section 22 (256B.0915, subdivision 10) makes technical and conforming changes.

Section 23 (256B.092, subdivision 1) requires a certified assessor to conduct needs assessments for people diagnosed as having a developmental disability.

Section 24 (256B.092, subdivision 1a) removes language related to the administrative functions of case management. Requires home and community-based waiver recipients to be provided case management services by qualified vendors as described in the federally approved waiver application. Modifies the list of case management service activities. Requires case management services to be provided by a public or private agency enrolled as an MA provider, and defines "private agency." Makes technical and conforming changes.

Section 25 (256B.092, subdivision 1b) requires each recipient of case management services to be provided a written copy of the coordinated service and support plan, specifies requirements of the plans, and encourages the case manager to utilize various community resources (religious groups, civic organizations, etc.) to support the individual in the community.

Section 26 (256B.092, subdivision 1e) makes technical and conforming changes.

Section 27 (256B.092, subdivision 1g) makes technical and conforming changes.

Section 28 (256B.092, subdivision 2) makes a conforming language change.

Section 29 (256B.092, subdivision 3) makes technical and conforming changes.

Section 30 (256B.092, subdivision 5) makes technical and conforming changes.

Section 31 (256B.092, subdivision 7) requires assessments and reassessments to be conducted by certified assessors according to the long-term care consultation services statute, and requires assessments and reassessments to incorporate appropriate referrals to determine eligibility for case management. Makes technical and conforming changes. Removes language related to screening teams and case manager responsibilities.

Section 32 (256B.092, subdivision 8) modifies the certified assessor's duties for persons with developmental disabilities.

Section 33 (256B.092, subdivision 8a) modifies the procedure by which a county of financial responsibility places a person in another county for services, and specifies that this procedure also applies to the CAC, CADI, and BI waiver programs.

Section 34 (256B.092, subdivision 9) makes technical and conforming changes related to changes in terminology.

Section 35 (256B.092, subdivision 11) makes technical and conforming changes related to changes in terminology.

Section 36 (256B.15, subdivision 1c) requires only the last four digits of the Social Security Number on notices of potential claims against estates for medical assistance.

Section 37 (256B.15, subdivision 1f) requires only the last four digits of the Social Security Number on notices of liens for medical assistance.

Section 38 (256B.49, subdivision 13) removes a needs assessment within 20 days from the list of case management service activities. Modifies the list of case management service activities for the CAC, CADI, and BI waivers. Prohibits the case manager from delegating certain duties. Requires case management services to be provided by a public or private agency enrolled as an MA provider, and defines "private agency."

 Section 39 (256B.49, subdivision 14) requires assessments and reassessments for CAC, CADI, and BI services to be conducted by certified assessors according to the long-term care consultation statute.

Section 40 (256B.49, subdivision 15) aligns the coordinated service and support plan requirements for CAC, CADI and BI waiver recipients with requirements for DD waiver recipients.

Section 41 (256G.02, subdivision 6) removes a reference to the PCA program from the definition of "excluded time.”

Section 42 requires the commissioner to develop by February 1, 2013, a legislative report with specific recommendations and language for proposed legislation for further case management redesign. Specifies what must be included in the recommendations and proposed legislation.

Also requires DHS to evaluate, and report to the Legislature by February 1, 2013, county and tribal administrative functions, processes, and reimbursement methodologies for home and community-based services. Specific requirements to the Legislature is due July 1, 2013.

Article 4 - Chemical and Mental Health

Sections 1 and 3 (24.461, subdivision 6; 245.487, subdivision 7) amend the Adult and Children’s Mental Health Acts, respectively, by requiring the commissioner to develop a list of diagnostic codes that define emotional disturbance and mental illness for the statewide mental health system.

 Section 2 (245.462, subdivision 20) modifies the definition of mental illness by referencing the diagnostic codes list published by the commissioner, and striking language referencing specific manuals.

 Section 4 (245.4871, subdivision 15) modifies the definition of emotional disturbance by referencing the diagnostic codes list published by the commissioner, and striking language referencing specific manuals.

 Section 5 (245.4932, subdivision 1) amends the children’s mental health collaborative section of law by striking the maintenance of effort requirements.

 Section 6 (246.53, subdivision 4) modifies the state-operated services section of law, negating any statute of limitation provision that limits the commissioner’s ability to recover the cost of care obligation incurred by a client for any claim against an estate made under this section to recover the cost of care.

 Section 7 (245B.04, subdivision 2a) corrects a provision passed last year, that limits services with a room and board component to individuals who score severity of 4 in either relapse and continued use "or" recovery environment, instead of "and."

Section 8 (256B.0625, subdivision 42) corrects a cross-reference in the Adult Mental Health Act.

 Section 9 (256F.13, subdivision 1) strikes the maintenance of effort language in the children’s mental health collaboratives section of law.

Section 10 requires DHS to collaborate with individuals with disabilities, their families, advocates, and other government agencies on identifying inappropriate and insensitive terminology, and recommend changes during the 2013 legislative session.

Article 5 – Health Care

 Section 1 (125A.21, subdivision 7) strikes a reference to parental consent given to a school district as part of the application process for MA or MinnesotaCare. 

Section 2 (256B.04, subdivision 14) specifies that a recipient’s cost sharing requirement does not affect the contract payments for items purchased through volume purchasing.

Sections 3, 4, and 5 (256B.056 and 256B.057) clarify that under the American Recovery and Reinvestment Act of 2009, certain assets owned by American Indians are exempt from the asset limitations of the MA program and are exempt from paying premiums under the medical assistance employed persons with disabilities (MA-EPD).

Section 6 (256B.0595, subdivision 2) makes changes to the period of ineligibility due to transferring assets for less than market value if the assets are returned.

Sections 7, 8, and 9 (256B.0625, subdivision 13) define an “active pharmaceutical ingredient” and “excipient” and specify that certain active pharmaceutical ingredients are not included in the drug formulary. 

Section 7 also specifies that over-the-counter medications when prescribed must be dispensed in a quantity that is the lower of: (1) the number of dosage units contained in the manufacturer’s original package; or (2) the number of dosage units required to complete the patient’s course of therapy.

Section 10 (256B.0625, subdivision 13h) specifies that to be reimbursed for medication therapy management services under MA , a pharmacist must have a valid license issued by the Board of Pharmacy of the state in which the service is being performed.  (Currently, the pharmacist must have a Minnesota license.)

Section 11(256B.0625, subdivision 14) changes a reference from fluoride treatment to fluoride varnish.

Section 12 (256B.0631, subdivision 1) removes the co-payment for eyeglasses.

Section 13 (256B.0631, subdivision 2) specifies that co-payments and deductibles do not apply to services that are paid for by fee-for-service payments subject to volume purchasing through competitive bidding. 

Section 14 (256B.19, subdivision 1c) makes a conforming change to an existing intergovernmental transfer arrangement with Hennepin County in recognition of higher than average medical education costs by changing the reference to a demonstration provider serving eligible individuals in Hennepin County instead of a specific reference to metropolitan health plan. (Metropolitan Health Plan was not awarded a contract to deliver PMAP services to Hennepin County through the competitive bidding process.)

Section 15 (256B.69, subdivision 5) makes changes to the timing of payments for elderly waiver services.

Section 16 (256B.69, subdivision 5a) clarifies the base year for emergency room utilization rate performance withhold as 2009.  (This was inadvertently changed last session.)

Section 17 (256B.69, subdivision 28) clarifies that the department may contract with demonstration providers and current or former sponsors of qualified Medicare-approved special needs plans to provide MA basic health care services to persons with disabilities.

Section 18 (256L.05, subdivision 3) specifies that the MinnesotaCare premium exemption for American Indians is the first day of the month following the month in which verification of American Indian status is received or eligibility is approved, whichever is later.

Section 19 (256L.15, subdivision 1) exempts American Indians from having to pay MinnesotaCare premiums in accordance with the American Recovery and Reinvestment Act of 2009.

Section 20 (514.982, subdivision 1) specifies that only the last four digits of a MA recipient’s Social Security Number must be on the MA lien notice.

Section 21 requires the Health Services Advisory Council to review available literature on the efficacy of various treatments for autism spectrum disorder and make a recommendation to the Commissioner of Human Services on authorization criteria for services based on existing evidence by December 31, 2012.

Section 22 repeals Minnesota Statutes, section 256.01, subdivision 18b (requires the commissioner to comply with the American Recovery and Reinvestment Act of 2009 regarding American Indians).

 
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