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S.F. No. 2754 - Health and Human Services Omnibus Bill
 
Author: Senator Tony Lourey
 
Prepared By: Joan White, Senate Counsel (651/296-3814)
 
Date: March 20, 2014



 

Article 1:  Health Department

Section 1 (144A.484) creates a new section, “INTEGRATED LICENSURE; HOME AND COMMUNITY-BASED SERVICES DESIGNATION,” with subdivisions 2 to 8 effective July 1, 2015.

Subdivision 1 requires the Department of Health (MDH) to enforce the home and community-based services (HCBS) standards in Chapter 245D for providers also licensed by MDH as home-care providers, from January 1, 2014, to June 30, 2015; allows home-care providers to apply for an HCBS-designation in lieu of licensure under Chapter 245D, beginning July 1, 2015.

Subdivision 2 outlines the HCBS-designation application process.

Subdivision 3 requires HCBS-designation holders and applicants pay a fee.

Subdivision 4 lists the provisions in Chapter 245D applicable to HCBS-designation holders.

Subdivision 5 requires MDH to monitor HCBS-designation holders’ compliance with the applicable provisions in Chapter 245D; lists the enforcement options available to MDH for noncompliance.

Subdivision 6 specifies that home-care provider license denial also denies an applicant a HCBS-designation; allows for a reconsideration of denial.

Subdivision 7 requires MDH and the Department of Human Services (DHS) to enter into any necessary agreements to implement the integrated licensure system.

Subdivision 8 sets the initial HCBS-designation fee at $155; creates a sliding scale renewal fee system based on annual revenue from HCBS, from $40 for $25,000 or under in HCBS revenue, to $320 for revenue greater than $1.5 million; requires fees and penalties to be credited to the State Government Special Revenue Fund.

Section 2 (256B.04, subdivision 21) requires home-care providers licensed by MDH, with a HCBS-designation, to designate a compliance officer.

Article 2: Health Care

Section 1 (256.01, subdivision 38) authorizes the commissioner to enter into a contract with a national organization that will enable the department to access a national registry of insurance coverage and information.

Sections 2 (256.01) and 3 (256.9685, subdivision 1) remove cross-references to the discontinued General Assistance Medical Care (GAMC) program.

Section 4 (256.9686, subdivision 2) changes the definition of a hospital’s “base year” to include fiscal year “or years;” removes a reference to GAMC.

Section 5 (256.969, subdivision 1) removes language prohibiting automatic annual inflation adjustments for Medical Assistance (MA) hospital payment rates; removes a reference to GAMC.

Section 6 (256.969, subdivision 2) requires DHS to use the all-patient refined diagnosis-related groups (APR-DRGs) diagnostic classification system; allows DHS to supplement APR-DRG data with national averages; removes language requiring DHS on January 1, 2013, to recategorize diagnostic classifications, values, and case mix indices in effect prior to January 1, 2013.

Section 7 (256.969, subdivision 2b) modifies the operating payment rates subdivision by: removing language requiring DHS to obtain operating data to determine rates for admissions on or after January 1, 1991, and every two years after; removing language preventing rates for GAMC, MA, and MinnesotaCare from being rebased beginning January 1, 2009; removing language preventing rate rebasing beginning January 1, 2013; removing language preventing cost and charge data to include property cost and payment outlier information; and requiring rates for admissions between January 1, 2011, through December 31, 2012, to be based on cost-finding methods and allowable costs under Medicare.

Section 8 (256.969, subdivision 2c) modifies the property payment rates subdivisions by: removing language limiting rate increases in fiscal years 1989 and 1990 for certain expenses to the annual growth in the hospital cost index in effect on June 30, 1988; removing language establishing the methodology DHS must use to compute the rate; removing language on how DHS should calculate the rate beginning January 1, 199; removing language on adjusting the rates based on increases in property cost; and removing language requiring DHS to adjust rates beginning January 1, 1991, to ensure all hospitals are subject to the hospital cost index limitation for two years.

Section 9 (256.969) adds a subdivision requiring DHS to apply a budget neutrality factor when rebasing operating and property payment rates, ensuring aggregate hospitals payments under rebasing do not exceed the payments prior to rebasing.

Section 10 (256.969, subdivision 3a) changes the timeline that DHS must notify hospitals of payment rates, from each December 1 of the preceding year to 30 days prior to implementation; removes language relating to GAMC; removes several paragraphs relating to total payment reductions in prior years.

Section 11 (256.969, subdivision 3b) replaces references to the old ICD-9-CM codes (International Statistical Classification of Diseases) with the new ICD-10-CM codes; and specifies that the list of hospital-acquired conditions not covered by MA are defined by the Centers for Medicare and Medicaid.

Section 12 (256.969) requires critical access and disproportionate share hospitals file MA cost reports within six months of the hospitals’ fiscal year, and requires DHS to suspend payments if the reports are not filed.

Section 13 (256.969, subdivision 6a) makes a technical cross-reference change.

Section 14 (256.969) requires hospital resident payments be based on the APR-DRG for the first 180 days, then based on the statewide average cost-to-charge ratio multiplied by the usual and customary charges.

Section 15 (256.969, subdivision 9) removes references to GAMC and outdated language related to disproportionate share hospital payments; and excludes critical access hospitals from disproportionate share hospital payments.

Section 16 (256.969, subdivision 10) requires hospitals to exclude certified registered nurse anesthetist costs from the operating payment rate.

Section 17 (256.969, subdivision 14) makes technical cross-reference changes due to subdivisions being repealed.

Section 18 (256.969, subdivision 17) makes a conforming language change; and prevents values of diagnostic categories from being redetermined until required by statute (instead of by rule).

Section 19 (256.969, subdivision 30) specifies the ADR-DRG categories used for payments for births.

Section 20 (256B.0625, subdivision 30) requires the commissioner to notify federally qualified health centers and rural clinics by July 1 of each year of the commissioner’s intent to close out payment rates and claims processing for services provided during the calendar year two years prior to the year in which notification is provided.  If at that time, the commissioner and the FQHCs and RHCs cannot agree to close out the rates and claims processing within 90 days of the notice, the matter shall be submitted for arbitration to determine whether the deadline should be extended.

Section 21 (256B.199) removes outdated language, and references to GAMC.

Section 22 repeals the following subdivisions in Section 256.969:

  • Subdivision 8b – GAMC admissions
  • Subdivision 9a – expired disproportionate share adjustment
  • Subdivision 9b – expired rate reduction
  • Subdivision11 – special rate-setting methodologies
  • Subdivision 13 – neonatal transfers
  • Subdivision 20 – expired MA payment increases
  • Subdivision 21 – GAMC mental health or chemical dependency rates
  • Subdivision 22 – expired hospital payment adjustment
  • Subdivision 25 – long-term hospital rates
  • Subdivision 26 – greater Minnesota payment adjustment
  • Subdivision 27 – quarterly payment adjustment
  • Subdivision 28 – temporary rate increase

Section 256.9695:

  • Subdivision 3 – outdated transition language
  • Subdivision 4 – outdated study language

Article 3: Northstar Care for Children

Sections 1 to 4 (245C.05, subd. 5; 245C.08, subd. 1; 245C.33, subd. 1; 245C.33, subd. 4) modify the Department of Human Services background study chapter of law.  Section 2 requires the commissioner to review information from the child abuse and neglect registry and from the national crime information databases for cases involving a transfer of permanent legal and physical custody.

Section 1 (245C.05, subd. 5) requires that background studies conducted for cases involving a transfer of permanent legal and physical custody of a child, the subject of the background study must provide fingerprints.

Section 3 (245C.33, subd. 1) adds a reference to the adoption statute, and specifies that under certain circumstances, a new background study is not required when a child is being placed in a home.

Section 4 (245C.33, subd. 4) requires the commissioner to review previous background studies of adoptive parents under section 3.

Section 5 (256B.055, subd. 1) inserts a cross-reference in the medical assistance statute to the Northstar Care for Children chapter of law.

Section 6 (256N.02, subd. 14a) defines the term “licensed child foster parent.”

Section 7 (256N.21, subd. 2) clarifies the eligibility criteria for foster care benefits.

Section 8 (256N.21, subd. 7) adds a new subdivision in the foster care benefits section of law, providing that the background checks for purposes of child foster care licensing must meet the requirements in state law under Minnesota Statutes, chapter 245C, and applicable federal law.

Sections 9 and 10 (256N.22, subd. 1; 256N.22, subd. 2) modify guardianship assistance provisions.  Section 9 adds language regarding the requirements for guardian assistance. Section 10 requires the legally responsible agency to document the determinations the eligibility requirements in the federal adoption and guardianship assistance law in the kinship placement agreement.

Section 11 (256N.22, subd. 4) provides that a background study completed under section 245C.33 meets the federal requirements. Specifies when a previous study is sufficient under this section.

Section 12 (256N.22, subd. 6) clarifies that the commissioner shall not enter into a guardianship assistance agreement with a stepparent.

Section 13 (256N.23, subd. 1) clarifies the general eligibility requirements for adoption assistance related to American Indian children, and adds a new paragraph providing that a child receiving Northstar kinship assistance is eligible for adoption assistance under certain circumstances.           

Section 14 (256N.23, subd. 4) requires a background study on all adults in a prospective adoptive parent’s home, and allows a previously completed study to meet this requirement, under certain circumstances.

Section 15 (256N.24, subd. 9) clarifies when reassessments for a child in continuous foster care must be completed.

Section 16 (256N.24, subd. 10) strikes language allowing a foster parent to request a reassessment due to a significant change in the child’s needs, and adds a new paragraph stating that no reassessment can be requested or conducted if the agreement has been signed by all parties, but has not been approved by the court.

Sections 17-19 (256N.25, subds. 2 and 3; 256N.26, subd. 1) eliminate the at-risk benefit level for children eligible for guardianship (kinship) assistance and eliminate the special at-risk monthly payment for adoption assistance.

Section 20 (256N.27, subd. 4clarifies the federal, state, and local shares, aligning this subdivision with subdivision 5 so that the local share is consistent with what the county or tribe would have spent had Northstar Care for Children not been enacted.

Section 21 (257.85, subd. 11) provides that payments to counties for relative custody assistance after January 1, 2015, when Northstar becomes effective, are reimbursed under the fiscal reconciliation process under the Northstar chapter of law

Sections 22 to 24 amend the child protection chapter of law.

Section 22 (260C.212, subd. 1) modifies the out-of-home placement plan to require documentation of steps to finalize the permanency plan for a child who cannot return to or be in the care of either parent. 

Section 23 (260C.515, subd. 4) relates to the court ordering custody to a relative, by adding that the relative must be “fit and willing,” and modifies the best interests of the child requirements under this section.

Section 24 (260C.611) amends adoption study requirements, providing that a foster home study may suffice if it meets the requirements in this section. 

Section 25 is a revisor instruction to change all “guardian assistance” references to “Northstar kinship assistance” in chapter 256N.

Section 26 repeals Minnesota Statutes, section 256N.26, subd. 7. Special at-risk monthly payment for at-risk children in guardianship assistance and adoption assistance.

Article 4:  Community First Services and Supports (CFSS)

Sections 1, 2, and 3 amend the DHS background study chapter of law.

Section 1(245C.03, subdivision 8) requires the commissioner to conduct background studies on Community First Services and Supports providers and support workers, as required under Minnesota Statutes, section 256B.85.  

Section 2 (245C.04, subdivision 7) requires the commissioner to conduct a background study of the individuals under section 1 at least upon application for initial enrollment. Prior to the individual beginning direct contact services, the organization must receive a notification from the commissioner that the support worker is not disqualified from direct services, or is disqualified, but received a set-aside of the disqualification. 

Section 3 (245C.10, subdivision 10) adds a new subdivision requiring the commissioner to recover the cost of background studies initialed by an agency-provider delivering community first services and supports.  The fee must not be more than $20 per study, charged to the organization responsible for submitting the background study form.  The fees collected are appropriated to the commissioner for conducting background studies. 

Section 4 (256B.85 subdivision 2) modifies the definitions for “Budget model,” “Community first services and supports service delivery plan,” “Financial management services contractor or vendor,” (FMS contractor) and “Support worker;” adds definitions for “Consultation services” and “Worker training and development;” and removes “Support specialist” from the definitions list.

Section 5 (256B.85, subdivision 3) removes the word “recipient” throughout the list of individuals eligible for CFSS, replacing the term with either “enrollee” or “participant” where applicable; and removes the eligibility requirement that a person cannot live in corporate foster care, a noncertified boarding home, or a boarding and lodging establishment.

Section 6 (256B.85, subdivision 5) allows CFSS participants to be assessed upon request; removes language  allowing institutional residents to be assessed and choose CFSS when transitioning to the community; specifies that temporary authorization for CFSS services must be provided under the agency-provider model; and makes terminology changes.

Section 7 (256B.85, subdivision 6) makes modifications to the CFSS service delivery plan.

Paragraph (a) specifies that consultation services providers and FMS contractors must review the CFSS service delivery plan before services begin; and makes terminology changes.

Paragraph (c) requires the CFSS service delivery plan to:  specify the consultation service provider and FMS contractor, include the cost of the services and supports, include a detailed budget for expenditures, and include a plan for worker training and development; and makes terminology changes.

Paragraph (d) makes terminology changes.

Paragraph (e) outlines the requirements consultation services providers must meet when assisting in the development and modification of the CFSS service delivery plan.

Section 8 (256B.85, subdivision 7)  removes transition costs from the list of services and supports covered under the CFSS service unit authorization; specifies that services provided by consultation service providers under contract with DHS are covered; and adds to the list of covered services: the services of a FMS contractor under contract with DHS, the services of parents, stepparents, or legal guardians for participants under 18 and participants’ spouses; and worker training and development services; makes terminology changes.

Section 9 (256B.85, subdivision 8) requires the service budget for budget model participants be based on assessed units determined by a home care rating, along with a factor for administrative costs; makes terminology changes.

Section 10 (256B.85, subdivision 9) modifies the list of noncovered CFSS services by: removing references to transition costs and training-related expenses for caregivers; and by adding:

  • instrumental activities of daily living for people under 18, with some exceptions
  • services provided by a non-enrolled CFSS provider
  • services provided by a CFSS participant’s representative or paid legal guardian
  • services solely for child care or babysitting
  • services  provided by a residential or program license holder under the terms of a service agreement or administrative rules
  • sterile procedures
  • injections
  • non-CFSS assessed homemaker services
  • home maintenance or chore services
  • home care services, including hospice, covered by Medicare or other insurance
  • services to other members of the household
  • services not covered under MA as CFSS
  • use of restraints or implementation of deprivation procedures
  • assessments by CFSS providers or independently-enrolled registered nurses
  • services provided in lieu of legally required staffing in a residential or child care setting
  • services provided by a residential or program license holder in a residence with more than four people

Section 11(256B.85, subdivision 10) modifies agency-provider and FMS contractor qualifications, requirements, and duties.

Paragraph (a) consolidates repetitive clauses; and requires agency-providers and FMS contractors to: demonstrate compliance with federal and state laws, maintain background study documentation, directly provide services and not subcontract, meet certain financial requirements, never have had committed fraud that resulted in a contract being discontinued, or have had an owner, board member, or manager fail a background check, have established business practices, and have an office in Minnesota.

Paragraph (b) requires agency-providers and vendor fiscal/employer agent FMS contractors to pay for worker training and development services based on actual hours or unit cost of training sessions, and comply with DHS data requests.

Section 12  (256B.85, subdivision 11) allows the agency-provider model to include worker training and development services, and excludes the revenue generated by these services from the requirement that 72.5 percent of MA revenue be used to pay for support worker wages and benefits; and specifies the process for purchasing goods under the agency-provider model.

Section 13 (256B.85, subdivision 12) changes the term “provider agency” to “agency-provider;” requires DHS to send annual enrollment renewal notifications to agency-providers 30 days prior to renewal, with the agency-providers required to submit enrollment renewal documentation to DHS within 30 days of receiving the notifications.

Section 14 (256B.85, subdivision 13) modifies the CFSS budget model.

Paragraph (a) requires budget model participants to use an FMS contractor; specifies that participants must directly pay wages and related costs to their support workers; and removes language related to participants choosing a range of FMS contractor services.

Paragraph (c) lists the circumstances that require DHS to disenroll or exclude individuals from the budget model; this replaces the deleted paragraph (g).

Paragraph (d) provides an appeals process for individuals disenrolled or excluded from the budget model.

Paragraph (f) modifies the list of the services FMS contractors must provide to budget model participants by: removing information and consultation about CFSS from the list, specifying the budget expenditures portion of the service delivery plan and assisting with payroll taxes is a function of the FMS contractor, and adding billing, payment, and accounting of approved expenditures for goods is a function of the FMS contractor.

Paragraph (g) requires FMS contractors to:  be knowledgeable about certain federal tax laws, be held liable for overpayments or violations of applicable statutes or rules, and provide information determined by DHS when submitting claims for payment.

Section 15 (256B.85, subdivision 15) changes when daily documentation by the support worker must be submitted to the provider, or participant and FMS contractor, from “monthly” to “regular;” and makes terminology changes.

Section 16 (256B.85, subdivision 16) prohibits a CFSS support worker from working, and being paid for, more than 275 hours per month, with no prohibition on the number of work hours in a day (unless it violates other law); makes a terminology change.

Section 17 (256B.85) adds a subdivision establishing the requirements for support workers enrolling with a different CFSS agency-provider or FMS contractor.

Section 18 (256B.85, subdivision 17) establishes, defines, describes, and outlines the duties of consultation services.

Section 19 (256B.85, subdivision 17a) adds a new subdivision requiring DHS to develop qualifications and requirements for consultation services providers.

Section 20 (256B.85, subdivision 17b) adds a new subdivision requiring DHS to establish a cost-neutral funding mechanism for FMS and consultation services.

Section 21 (256B.85, subdivision 18) changes the service budget allocation by referencing subdivision 8.

Section 22 (256B.85) is amended by adding requires that DHS establish support worker training and development service standards and limits.

Section 23 (256B.85, subdivision 23) makes a terminology change.

Section 24 (256B.85, subdivision 24) 

Section 25 (Laws 2013, chapter 108, article 7, section 49) amends the CFFS effective date.

Article 5: Continuing Care

Section 1 (13.46, subdivision 4) amends the data practices act by adding cross-references to Minnesota Statutes, chapter 245D.  Paragraph (d) makes the names of reporters of alleged violations of licensing standards under chapter 245D confidential data, which may be disclosed only as provided in this paragraph.  Under paragraph (i), data on individuals collected according to investigations under chapter 245D may be shared with the Department of Human Rights, Health, Corrections, the ombudsman (ombudsman) for mental health and developmental disabilities, and the individual’s professional regulatory board under certain circumstances.

Section 2 (245.8251) modifies the human services chapter of law, specifically the statute governing positive support strategies and emergency manual restraint.  Subdivision 1 requires the commissioner, by August 31, 2015, to adopt rules restricting or prohibiting the use of aversive and deprivation procedures in all facilities.  Subdivision 2 requires the commissioner to identify data specific to incidents of restraint, and licensed facilities shall report that data to the commissioner and ombudsman.  New subdivision 3 requires that rules adopted according to this section establish requirements for an external program review committee appointed by the commissioner.  New subdivision 4 requires the commissioner to establish an interim review panel by August 15, 2014, to review requests for emergency use procedures.  The panel must make recommendations to the commissioner to approve or deny the requests.  This committee must operate until the committee under subdivision 3 is established.  This paragraph specifies membership qualifications for the interim review panel.

Section 3 (245A.042, subdivision 3) amends the Department of Human Services licensing chapter of law related to home and community-based services by specifying that license holders must ensure compliance with the requirements under this section, within the stated timelines.  The requirements relate primarily to service initiation and planning for the recipient, staff orientation, development of policy and procedures, and staff training.

Sections 4 to 40 modify chapter 245D.

Sections 4-12 amend the “definitions” section of law.

Section 4 (245D.02, subdivision 3) modifies the definition of “case manager,” to include case management services defined in rule.

Section 5 (245D.02, subdivision 4b) modifies the definition of “coordinated service and support plan” to include the individual program plan or treatment plan as defined in rule.

Section 6 (245D.02, subdivision 8b) is technical, corrects a cross-reference.

Section 7 (245D.02, subdivision 11) amends the definition of “incident” to include a mental health crisis that requires a mental health response team or service when available and appropriate.

Section 8 (245D.02, subdivision 15b) modifies the definition of “mechanical restraint” by clarifying what devices do not fall under this definition.

Section 9 (245D.02, subdivision 29) clarifies the definition of “seclusion.”

Section 10 (245D.02, subdivision 34) provides that the support team includes the case management team as defined in rule.

Section 11 (245D.02, subdivision 34a) reworks the definition of the term “time out.”

Section 12 (245D.02, subdivision 35b) defines the term “unlicensed staff.”

Section 13 (245D.03, subdivision 1) adds “adult” to clarify that this law applies to “adult” companion services, and modifies “intensive support services” to include residential services provided to more than four persons with developmental disabilities in a supervised living facility.

Section 14 (245D.03, 1a) adds a subdivision stating the effect of the home and community-based standards, which are established to protect the health, safety, welfare, and rights of persons receiving home and community-based services.

Section 15 (245D.03, subdivision 2) modifies the subdivision regarding the relationship to other standards governing H&CBS, by striking language related to corporate or family foster care, and striking cross-references to sections of law that are modified later in the bill.

Section 16 (245D.03, subdivision 3) amends the variance statue by striking a reference to a subdivision related to restrictions when implementing emergency use of manual restraint, and adds a reference to restricted procedures.

Section 17 (245D.04, subdivision 3) amends the protection-related rights of a person, to include that the person has a right to be free from any aversive, deprivation, or other prohibited procedures, except for the use of safety interventions, and strikes a nonexistent cross-reference.

Section 18 (245D.05, subdivision 1) provides that unlicensed staff responsible for medication setup or medication administration must complete training.

Section 19 (245D.05, subdivision 1a) clarifies that if the license holder is responsible for medication setup, or if the license holder provides medication setup as part of medication assistance, the license holder must document the information listed in this section related to the type of medication, quantity, and times administered. 

Section 20 (245D.05, subdivision 1b) clarifies the definition of “medication assistance” and moves existing language regarding medication assistance within the subdivision.

Section 21 (245D.05, subdivision 2) clarifies medication administration responsibilities and procedures.

Section 22 (245D.05, subdivision 4) relates to reviewing and reporting medication and treatment issues, by striking language that required certain reports to the person’s physician or prescriber.

Section 23 (245D.05, subdivision 5) amends the injectable medications subdivision by striking the terms “subcutaneous” and “intramuscular” when describing injections.

Section 24 (245D.051) amends the psychotropic medication use and monitoring provision.  This section strikes language that requires the use of medication be in the person’s coordinated services and support plan and based on a prescriber’s prescription.  Subdivision 2 prohibits the license holder from administering the medication if the person refuses, and the refusal must be reported to the prescriber as expediently as possible. Clarifies that the refusal may not be overridden without a court order.

Section 25 (245D.06, subdivision 2) provides that toxic substances or dangerous items must be inaccessible when a known safety risk exists, and makes other clarifying changes.

Section 26 (245D.06, subdivision 4) specifies the circumstances under which a license holder or staff person is restricted from accepting an appointment as guardian.

Section 27 (245D.06, subdivision 6) amends the restricted procedures subdivision, by adding language clarifying what a restricted procedure does not include. This language is moved from 245D.061, subdivision 3.

Section 28 (245D.06, subdivision 7) provides that physical contact or instructional techniques must use the lease restrictive alternative.  This section permits physical contact to redirect a person’s behavior when applied for less than 60 seconds and allows for the use of an auxiliary device to ensure that a person does not unfasten a seatbelt in accordance with other law.

Section 29 (245D.06, subdivision 8) provides that the commissioner has limited authority to grant approval for the emergency use of manual restraint. The commissioner may grant approval when the person is at imminent risk of serious injury due to self-injurious behavior, provided the conditions in this paragraph are also met, which include approval by the person’s support team and the interim review panel. Written requests for emergency use of procedures must be developed and submitted to the commissioner for a determination.

Section 30 (245D.071, subdivision 3) reworks and clarifies the assessment and initial service planning section of law.

Section 31 (245D.071, subdivision 4) amends the service outcomes and supports statute, by clarifying the time lines and duties related to developing a services plan and documentation of service outcomes.  This section also makes other clarifying language changes.

Section 32 (245D.071, subdivision 5) changes “progress reviews” to “service plan review and evaluation”, and adds that the purpose of the service plan is to determine if changes are needed based on new information.

Section 33 (245D.081, subdivision 2) modifies the designated coordinator’s training requirements, in order to ensure that the designated coordinator is competent to perform the duties under this section.

Section 34 (245D.09, subdivision 3) modifies direct care staffing qualifications by allowing the license holder to determine competency of staff by either knowledge testing or observed skill assessment.   Existing law requires both.

Section 35 (245D.09, subdivision 4a) requires staff to review and receive instruction on mental health crisis response, de-escalation techniques, and suicide intervention, when providing direct care to person with a serious mental illness.

Section 36, 37, and 38 (245D.091, subdivision 2; 245D.091, subdivision 3; 245D.091, subdivision 4) modify behavior professional qualifications, behavior analyst qualifications, and behavior specialist qualifications, respectively.

Section 39 (245D.10, subdivision 3) allows the notice of proposed termination of service to be given in conjunction with the notice of temporary service suspension.   This section also requires the license holder to work with the support team or expanded support team, instead of the appropriate county agency, during the temporary service suspension or service termination notice period.

Section 40 (245D.11, subdivision 2) adds that a mental health response team or service must be contacted when an incident occurs, if available and appropriate.

Section 41 (252.451, subdivision 2) provides that notwithstanding the requirements in chapter 245D, a day training and habilitation vendor may enter into written agreements with a business to provide training and supervision needed by individuals to maintain their employment.

Section 42 (256B.439, subdivision 1) adds home health services, private duty nursing services, personal care services, and Community First Services and Supports to the list of home and community-based services required to have quality profiles developed by the Department of Human Services (DHS) and Health.

Section 43 (256B.439, subdivision 7) requires quality add-on payment rate adjustments to become part of home and community-based (HCBS) providers’ ongoing rate; requires all HCBS providers to receive a minimum quality add-on rate increase, with additional quality add-on payments to providers meeting certain measurements and outcomes. 

Section 44 (256B.4912, subdivision 1) requires that home and communitiy-based providers meet the requirements of chapter 245C prior to the revalidation of a license.

Section 45 (section 256B.5012) provides a four percent rate increase to intermediate care facilities for individuals with developmental disabilities (ICF/DDs), effective July 1, 2014, with one percent of the increase reduced on January 1, 2015, for facilities that do not submit quality improvement plans to DHS; requires 75 percent of the rate increase to go towards direct care employee wages and benefits, when applicable.

Section 46 (Laws 2013, chapter 108, article 14, section 2, subdivision 6) modifies an aging and adult services grant appropriation made in 2013.

Section 47 provides a four percent rate increase to a variety of home and community-based services providers, grants, and programs, with one percent of the increase reduced on January 1, 2015, for providers that do not submit quality improvement plans to DHS; requires 75 percent of the rate increase to go towards direct care employee wages and benefits.

Section 48 directs the Revisor of Statutes to change the term “defective persons” in the statutes to “persons with intellectual disabilities.”

Section 49 repeals the following:

  1. Minnesota Statutes 2013 Supplement, section 245D.061, subdivision 3.
  2. Minnesota Statutes 2012, section 245.825, subdivisions 1 and 1b, are repealed upon the effective date of rules adopted according to Minnesota Statutes, section 245.8251. The commissioner of human services shall notify the Revisor of Statutes when this occurs.
  3. Minnesota Statutes 2013 Supplement, sections 245D.02, subdivisions 2b, 2c, 3b, 5a, 8a, 15a, 15b, 23b, 28, 29, and 34a; 245D.06, subdivisions 5, 6, 7, and 8; and 245D.061, subdivisions 1, 2, 4, 5, 6, 7, 8, and 9 are repealed upon the effective date of rules adopted according to Minnesota Statutes, section 245.8251. The commissioner of human services shall notify the Revisor of Statutes when this occurs.
  4. Minnesota Rules, parts 9525.2700; and 9525.2810, are repealed upon the effective date of rules adopted according to Minnesota Statutes, section 245.8251. The commissioner of human services shall notify the Revisor of Statutes when this occurs.

Article 6:  Miscellaneous

Section 1 (254B.12) modifies the consolidated chemical dependency treatment fund methodology, to allow the commissioner to seek federal authority to develop a separate payment methodology for chemical dependency treatment services provided by a state-operated vendor.  This is effective for service provided on or after October 1, 2015, or after federal approval, whichever is later.  Before implementing the methodology, the commissioner must receive any necessary legislative approval of required changes to state law or funding.  

Section 2 (256I.05, subd. 2) modifies a group residential housing (GRH) rate.  New language states that the rate paid to this facility shall also include adjustments to the GRH rate according to subdivision 1, which sets the maximum rates, and any adjustments applicable to supplemental service rates statewide. The facility is Andrew Residence that cares for approximately 200 people with serious and persistent mental illness who also need a nursing home level of care.

 
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