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S.F. No. 668 - Elderly Waiver Program Reform and Appropriation - First Engrossment
 
Author: Senator Karin Housley
 
Prepared By: Liam Monahan, Senate Analyst (651/296-1791)
 
Date: March 13, 2017



 

SF No. 668 modifies the rate methodology for various services, particularly customized living services.

Section 1 [Resident assessment schedule - 144.0724, subdivision 4) clarifies existing law by making explicit in state statute the federal requirements with respect to the frequency of change in status assessments for residents of nursing homes.

Section 2 [Excess income - 256B.056, subdivision 5] requires elderly waiver recipients to pay the amount of their monthly spenddown and waiver obligation directly to their service provider and requires the Department of Human Services or third-party payers to deduct this amount from the monthly amount paid to the provider.

Section 3 [Assessment and support planning - 256B.0911, subdivision 3a] allows persons being assessed for adult day services to grant permission for their current or proposed service provider to submit to the certified assessor the provider’s nursing assessment and recommendations concerning the person’s care needs.  If a provider submits its nursing assessment and recommendations for a person being assessed for elderly waiver services, then the provider must receive a draft of the assessment, be allowed to submit additional information before the assessment is final, and receive a copy of the final community support plan, case mix level and Residential Services Workbook.

In addition, section 2 extends from 60 to 90 days the length of time a face-to-face- assessment may be used to establish service eligibility under the alternative care program, the elderly waiver, and the disability waivers.

Section 4 [Authority - 256B.0915, subdivision 1] makes a structural change to statute.

Section 5 [Elderly waiver cost limits - 256B.0915, subdivision 3a] specifies that if a legislatively authorized rate increase for home and community-based services is service-specific, then the way this increase will be applied to the monthly cost limits under the elderly waiver is by increasing each monthly cost limit by the percent increase in spending for the program that is affected by the service-specific rate increase.

In addition, section 4 aligns the date of future increases in the monthly cost limits for elderly waiver services with the date on which nursing facility rate increases are effective.

Section 6 [Customized living service rates - 256B.0915, subdivision 3e) modifies the language governing the payment rates for customized living services under the elderly waiver by:

(1) directing the commissioner to include a nursing services component rate;

(2) authorizing temporary rate increases to cover the costs incurred to prevent an elderly waiver recipient from being admitted to a hospital;

(3) adding a cognitive and behavioral needs factor to the payment rate;

(4) establishes a new rate for the first 62 days of customized living services that is benchmarked to 120 percent of the state-wide average for 24-hour residential services; and

(5) aligns the date of future increases in the individualized service rate limits for customized living services with the date on which nursing facility rate increases are effective.

Section 7 [Service rate limits; 24-hour customized living - 256B.0915, subdivision 3h] aligns the date of future increases in the individualized service rate limits for 24-hour customized living services with the date on which nursing facility rate increases are effective.

Section 8 [Assessments and reassessments for waiver clients - 256B.0915, subdivision 5] amends the language governing change in status assessments for elderly waiver recipients by specifying the criteria for an assessment, who may request an assessment, and the timing of the assessment.

Section 9 [Payment rates; application - 256B.0915, subdivision 11] specifies that the rate methodology under 256B.0915, subdivision 12 to 256B.0915, subdivision 15 applies to the following services and programs:

(1) Elderly waiver

(2) Elderly waiver customized living

(3) Alternative care

(4) Essential community supports

(6) CADI waiver customized living

(7) BI waiver customized living

(8) Elderly waiver foster care

(9) Elderly waiver residential care

Section 10 [Payment rates; establishment - 256B.0915, subdivision 12] specifies the data sources that will be used to set the wage and component value rates under the proposed rate methodology and outlines the factors included in the methodology.

Section 11 [Payment rates; base wage index - 256B.0915, subdivision 13] specifies the base wage calculations for all the services affected by this rate methodology under the services and programs listed in Minnesota Statutes, section 256B.0915, subdivision 11.

Section 12 [Payment rates; factors - 256B.0915, subdivision 14] specifies how each of the factors outlined in subdivision 12 are calculated.

Section 13 [Payment rates; component rates - 256B.0915, subdivision 15] specifies how the total payment rate is calculated for each of the services available under the programs listed in section 256B.0915, subdivision 11.

Section 14 [Evaluation of rate methodology - 256B.0915, subdivision 16] requires the commissioner, in consultation with stakeholders, to study the appropriateness and effect of the rates established under sections 256B.0915, subdivision 12 to 256B.0915, subdivision 15, and make recommendations to the legislature by January 1, 2019.

Section 15 [Performance measures for elderly waiver customized living - 256B.439, subdivision 2b] requires the commissioner, in consultation with stakeholders and experts, to develop performance measures for housing with services establishments enrolled in the elderly waiver program as providers of 24-hour customized living services.

Section 16 [Adult day services staffing ratios] requires the commissioner to study existing staffing ratio requirements for adult day services and make recommendations to the legislature by January 1, 2018.

Section 17 [Appropriation] appropriates $5 million dollars for the development of performance measures for customized living and 24-hour customized living services under the elderly waiver.

Section 18 [Revisor’s instruction] requires nonpartisan legislative staff and the Department of Human Services to propose a recodification of the language governing the elderly waiver.

 

 

 
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