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Tom Bottern
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   Senate   
State of Minnesota
 
 
 
 
 
S.F. No. 825 - Health and Human Services Budget Establishment and Provisions Modifications - the Second Engrossment
 
Author: Senator Tony Lourey
 
Prepared By: Katie Cavanor, Senate Counsel (651/296-3801)
Liam Monahan, Senate Analyst (651/296-1791)
Joan White, Senate Counsel (651/296-3814)
 
Date: April 9, 2015



 

Article 1 – Children and Family Services

            Sections 1 to 3 modify the Child Care Assistance Program (CCAP).  The sections are effective January 1, 2016.

Sections 1 and 2 (119B.07, 119B.10, subd. 1) modify the calculation of authorized CCAP hours for students and employed persons, respectively.  Under certain circumstances, the participant’s activity schedule does not need to be verified.

Section 3 (119B.11, subd. 2a) simplifies the recovery of CCAP overpayments.  This section requires that the overpayment be recovered, regardless of the amount or time period, if it was caused by wrongfully obtaining benefits.  The commissioner will not collect overpayments that are under $500 and overpayments that occurred more than one year prior to the date of the determination, except in cases of fraud or the benefits were received while an action was under appeal.  Overpayments caused by agency error will not be collected, except in cases of fraud.

Section 4 (119B.27) moves the Quality Rating and Improvement System (QRIS) language from the education chapter of law to the child care chapter of law, which is a more appropriate place in statute.  DHS has been and continues to be the lead agency implementing QRIS, and the language builds on the existing program. The old language is repealed at the end of this article. This section is effective the day following final enactment.

Section 5 (124D.165, subd. 4) is technical; updates a cross-reference.

Sections 6 and 7 (245C.03, subd. 10 and 245C.10, subd. 11) amend the background study chapter of law to require background studies for providers of group residential housing (GRH), and allows the commissioner to recover $20 per study.

Section 8 (256.01, subd. 14c) allows the commissioner to authorize grants to tribal child welfare agencies and urban Indian organizations for early intervention support and services to prevent child maltreatment for at-risk American Indian families.

Section 9 (256.017, subd. 1) adds GRH and housing assistance to the Department of Human Services (DHS) compliance system, which permits the commissioner to supervise the administration of public assistance programs.

Sections 10 and 11 (256.741, subd. 1 and 256.741, subd 2.) remove MinnesotaCare from the definition of public assistance for purposes of a child support referral to the county, and the assignment of child support rights to the state.  These modifications are to conform to the Affordable Care Act, consistent with changes in sections 55 to 66.

Section 12 (256D.01, subd. 1b) modifies the general assistance (GA) program to clarify that a person who receives housing assistance under section 256I is not eligible for the full GA grant. 

Sections 13 and 14 (256D.44, subds. 2 and 5) strike references to the MSA shelter needy payment, effective February 1, 2017, consistent with the discontinuation of that program and subsequent merger with GRH. 

Sections 15 to 22 amend the Group Residential Housing (GRH) chapter of law.

Sections 15 and 16 (256I.01 and 256I.02) change group residential housing to “Residential Housing Act.”

Section 17 (256I.03) reorganizes definitions for this chapter in alphabetical order, updates definitions and adds new definitions, which are summarized below.

Subd. 3 amends the definition of GRH to strike obsolete language, and updates references to the staffing and background study requirements.

Subd. 9 modifies the definition of “countable income” to clarify what is counted as income under the GRH program and new housing assistance program. 

Subd. 10 defines the term “direct contact.” 

Subd. 13 defines the term “habitability inspection.”

Subd. 14 defines the term “housing assistance.”

Subd. 15 defines the term “housing costs.” 

Subd. 16 defines the term “institution.”

Subd. 17 defines the term “long-term homelessness.”

Subd. 20 defines the term “own home.”

Subd. 21 defines the term “payment.”

Subd. 22 defines the term “professional certification.”

Subd. 23 defines the term “prospective budgeting.”

Subd. 24 defines the term “qualified professional.”

Subd. 25 modifies the definition of “supplemental services” to include services provided for recipients of housing assistance.

Section 18 (256I.04, subd. 1) modifies the GRH program and creates a new housing assistance program for individuals. This subdivision clarifies eligibility for both programs.

 Subd. 1a provides that the county cannot approve a payment in excess of the MSA equivalent or in excess of the housing assistance payment unless the individual has a professional certification, as defined in this chapter. Also, in order to be eligible for supplementary service payments, providers must enroll in the provider enrollment system, which is part of the MMIS system.

Subd. 2a exempts supportive housing establishments from the licensure requirements and imposes staffing qualifications on GRH providers.

Subd. 2b clarifies that agreements between GRH and supplementary services providers must be in writing, and specifies the minimum requirements that the provider must verify in the agreement.  Agreements may be terminated with or without cause by the commissioner, agency, or provider with two calendar months prior notice.

Subd. 2c imposes background study requirements.

Subd. 2d provides that the GRH or supplementary services must be provided to the satisfaction of the commissioner, and the commissioner has the right to suspend or terminate the agreement immediately if the health or welfare of the recipients is endangered, or when the commissioner has reasonable cause to believe that the provider has breached a material term of the agreement.

Subd. 2e clarifies staffing and background study requirements when there are multiple licenses.

Subd. 2f specifies the minimum requirements for licensed or registered settings, which include food preparation, housekeeping, and maintenance of the building.

Subd. 2g is existing language that was moved from a previous subdivision.

Section 19 (256I.05, subd. 1c) changes “county” to “agency” and allows an agency to negotiate a difficulty of care rate for an individual with extraordinary emotional, behavioral, or physical health needs, and if necessary, to secure housing for the individual in a more integrated setting.

Section 20 (256I.05, subd. 1g) allows an agency to negotiate a supplemental services rate for individuals who have experienced long-term homelessness and who live in a supportive housing establishment.

Section 21 (256I.05, subd. 1p) beginning February 1, 2017, an agency may negotiate a supplemental services rate in addition to the maximum rate for individuals receiving housing assistance.

Section 22 (256I.06) requires that housing assistance payments be made in the form of a voucher, unless the individual is receiving SSI or SSDI. Requires recipients to report changes in income every six months, instead of every month under current law. Subdivision 8, paragraph (b) provides the calculation for the amount of housing assistance payment, and paragraph (c) requires that prospective budgeting be used to determine the impact of earned income on the individual’s payment. 

Section 23 to 27 amend the Northstar Care for Children chapter of law.

Sections 22, 24, and 26 (256N.22, subds. 9 and 10, 256N.25, subd. 1) modify language to comply with the federal requirement related successor guardians for children in a custody arrangement with a relative.

Section 25 (256N.24, subd. 4) amends the provision related to extraordinary levels of care for children who have significant physical or mental health care needs, to include “foster care residence setting” to the settings that are eligible for difficulty of care supplemental rate payments.

Section 27 (256N.27, subd. 2) strikes language giving the commissioner authority to transfer funds into the Northstar Care for Children account if a deficit occurs.

Section 28 (259A.75) modifies the reimbursement of tribal contracted adoption placement.  This section removes “tribal social services” from the provision that requires the commissioner to reimburse 100 percent of contracted adoption placement services, and instead requires the commissioner to set aside a certain amount to reimburse tribal social services for child-specific adoption placement, and requires the commissioner to enter into grant contracts with Minnesota tribal social services agencies to provide child-specific recruitment and adoption placement services for Indian children.

Sections 29 to 42 amend the child protection chapter of law.  All modifications in these sections are to conform to federal law.  Generally, the changes expand the definition of relative and add language related to successor custodians, modify provisions so that youth in foster care can be more involved in their permanency planning, and specify requirements for missing and sex trafficked foster care youth.

Section 29 (260C.007, subd. 27) amends the definition of the term “relative.”

Section 30 (260C.007, subd. 32) amends the definition of the term “sibling.”

Section 31 (260C.203) modifies independent living plans so youth in foster care may start the plan at age 14 instead of age 16, updates a cross-reference, and requires the responsible agency to help the child obtain a tribal enrollment identification card prior to leaving foster care. 

Section 32 (260C.212, subd. 1) allows a child in foster care who is 14 years old or older to include two additional individuals on the team preparing the child’s out-of-home placement plan, adds language to reinforce transfer of custody to a relative, if possible, and requires that the independent living plan include objectives that allow for regular opportunities to engage in age appropriate activities typical for the child’s age group.

Section 33 (260C.212, subd. 13) is a new subdivision related to protecting missing and runaway children and youth at risk of sex trafficking. Imposes duties on the local social services agency to report and locate a missing child, determine the primary factors that contributed to the child running away, what the child experienced while absent from foster care, and appropriate services for the child.

Section 34 (260C.212, subd. 14) is a new subdivision requiring that child-placing agencies support a foster child’s emotional and developmental growth by permitting the child to participate in age and developmentally appropriate extracurricular activities.

Section 35 (260C.221) expands who is included in a relative search when a child is placed out of the home.

Sections 36 to 38 (260C.331, subd. 1, 260C.451, subds. 2 and 6) update cross-references.

Section 39 (260C.515, subd. 5) modifies the provision relating to ordering the child into permanent custody of the responsible social services agency.  Under current law, the court may order a child age 12 or older into long-term foster care.  This section changes the age to 16, and requires that the child be asked about his or her desired permanency outcome.

Section 40 (260C.521, subd. 1) requires that the child be asked about his or her desired permanency outcome as part of the agency’s reasonable efforts to finalize a permanent plan for the child.

Section 41 (260C.521, subd. 2) allows an order for permanent legal and physical custody to be modified to name a successor guardian as the custodian if the original relative is incapacitate or dies.

Section 42 (260C.607, subd. 4) makes changes consistent with section 31, changing the age of the child from 16 to 14.

Sections 43 to 54 amend the Child Support chapter of law. Sections 53 and 54 discontinue the $25 application fee for IV-D child support services.  All other modifications in these sections are to conform to the Affordable Care Act.  Generally, the changes allow the modification of a child support order for medical support and remove references to MinnesotaCare as a public assistance program.

Section 43 (518A.32, subd. 2) modifies the determination of potential income by changing full time work at 150 percent of minimum wage to 30 hours per week at 100 percent of the minimum wage.

Section 44 (518A.39, subd. 1) allows a child support order to be modified for medical support.

Section 45 (518A.39, subd. 8) is a new subdivision allowing for a medical support-only modification of a support order.

Section 46 (518A.41, subd. 1) modifies the definition of “public coverage,” with regard to health care benefits.

Section 47 (518A.41, subd. 3) amends the statute in which the court determines if a parent has appropriate health coverage for the child. This section adds language providing that health plans meeting the definition of minimum essential coverage under the ACA meet the definition of comprehensive medical coverage.

Section 48 (518A.41, subd. 4) modifies what a court may order related to a parent’s contribution for health care coverage in a child support case, if neither parent has appropriate health care coverage.

Section 49 (518A.41, subd. 14) requires the public authority to assist with modifying a medical support order.

Section 50 (518A.41, subd. 15) amends the remedies available for the enforcement of a child support order.  New language provides that failure to provide court-ordered coverage or provide medical support is a basis for a modification, unless it meets a presumption.

Section 51 (518A.46, subd. 3) strikes reference to MinnesotaCare as a public assistance program.

Section 52 (518A.46, subd. 3a) specifies the contents of pleadings for medical support modifications.

Section 53 (518A.51) discontinues the $25 application fee for child support IV-D services. Federal conformity part of this section strikes reference to MinnesotaCare.

Section 54 (518A.53, subd. 4) strikes reference to $25 application fee.

Sections 55 to 71 (518C.802, Laws 2014, chapter 189, sections 5, 10, 11, 16, 17, 18, 19, 23, 24, 27,28, 29, 31, 43, 50, 51) amend the Uniform Interstate Family Support Act (UIFSA), to conform to the verbatim language requirement for a Uniform Act.

Section 72 (Laws 2014, chapter 189, section 73) makes the UIFSA changes effective July 1, 2015.

Section 73 repeals the old Child Care Quality rating and improvement system language effective the day following final enactment.

 Article 2 – Chemical and Mental Health Services

Sections 1 to 4 are technical; update references to intensive residential treatment services (IRTS) consistent with other changes in this article.

Section 2 (245.735, subd. 1) requires the Commissioner of Human services to develop and execute projects to reform the mental health system by participating in the federal Excellence in Mental Health demonstration project. 

Subd. 2 requires the commissioner to submit a proposal to the federal Department of Health and Human Services for the demonstration project.

Subd. 3 gives the commissioner rulemaking authority to establish standards for reform projects under subdivision 4.

Subd. 4 requires the commissioner to establish standards for state certification of   certified community behavioral health clinics, and specifies what the certification standards must include. The commissioner is also required to establish standards and methodologies for a prospective payment system for MA payments for mental health services delivered in the clinics. 

Subd. 5 requires the commissioner to consult with mental health providers, and others in developing the projects under subdivision 4.

Subd. 6 requires the commissioner and the state chief information officer to provider information systems support to the projects as necessary to comply with federal requirements and deadlines.

Section 3 (254B.05, subd. 5) makes providers of integrated dual diagnosis treatment eligible for the consolidated chemical dependency treatment fund. Clients are individuals who have co-occurring disorders, are civilly committed to the commissioner, and are a potential threat to the community.  This modification is effective January 1, 2016, or upon federal approval, whichever is later. 

Sections 5 to 12 modify assertive community treatment (ACT) and intensive residential treatment services (IRTS).

Section 5 (256B.0622, subd. 1) updates the name of the service to “assertive community treatment” (ACT) and intensive residential rehabilitative mental health service to be consistent with the state plan.

Section 6 (256B.0622, subd. 2) strikes an old reference and adds a definition for ACT and strikes outdated language.

Section 7 (256B.0622, subd. 3) changes eligibility for services for programs under section 5, changing reference to “two or more” inpatient hospitalizations in the past year, to “recurring or prolonged” inpatient hospitalizations in the past year.

Section 8 (256B.0622, subd. 4) updates references to ACT and IRTS.

Section 9 (256B.0622, subd. 5) amends the standards for ACT and residential providers by modifying when the functional assessment must be updated, and when the individual treatment plan must be completed and refined.

Section 10, 11, 12, and 13 (256B.0622, subds. 7, 8, 9, and 10) update references to ACT and IRTS, make changes to align with state plan, allow physician services to be delivered by telemedicine, strike obsolete references related to county rate setting due to the implementation of the statewide rate methodology, and add rate language for new programs.

Section 14 (256B.0622, subd. 11) allows the commissioner to disburse grants directly to providers ACT and IRTS.

Section 15 (256B.0624, subd. 7) clarifies staffing requirements for adult crisis services.

Section 16 (256B.0625, subd. 45a) adds psychiatric residential treatment facility services for persons under 21 years of age to the services eligible for medical assistance coverage.  The commissioner is required to develop admissions and discharge procedures and establish rates consistent with the guidelines from Centers for Medicare and Medicaid Services (CMS). The commissioner is required to enroll 150 certified psychiatric residential treatment facility services beds at up to six sites. The commissioner shall select the providers though a request for proposals (RFP) process. This section is effective July 1, 2017, or upon federal approval, whichever is later.

Section 17 requires the commissioner to conduct a comprehensive analysis of the current rate-setting methodology for community-based mental health services for adults and children.  The report must include alternative payment structures, and recommendations for establishing pay-for-performance measures for providers delivering services consistent with evidence-based practices. The commissioner shall consult with stakeholders and experts in Medicaid financing. The report is due January 1, 2017.

Section 18 requires the commissioner to report to legislative committees on the progress of the Excellence in Mental Health demonstration project under section 245.735, and include any recommendations for legislative changes necessary to implement the reform projects.

Article 3 – Withdrawal Management

Article 3 establishes a new model for detoxification programs, called Withdrawal Management. The article establishes the comprehensive program in a new chapter of law, Minnesota Statutes, chapter 245G, and the commissioner is required to develop a payment methodology for services provided under this chapter, and seek federal approval for the rate methodology, and obtain legislative approval before implementing the program. 

Article 4 – Direct Care and Treatment
 

Section 1 (246.54, subd. 1) modifies the county portion of the cost of care for the Anoka Metro Regional Treatment Center (AMRTC).  Currently, the county pays zero percent of the cost of care for the first 30 days; 20 percent for days 31 to 60; and 75 percent for over 60 days.  The proposal changes the cost of care to 20 percent for 31 days or more, provided the stay at the AMRTC is determined to be clinically appropriate for the client; and 100 percent for each day the facility determines that it is clinically appropriate to discharge the client.

 Sections 2 to 4 relate to the Minnesota Sex Offender Program.

Section 2 (246B.01, subd. 2b) expands the definition of “cost of care” to include aftercare services and supervision.

Section 3 (246B.033) is a new section of law requiring biennial evaluations of civilly committed sex offenders.

Subd. 1 requires the executive director of MSOP to ensure that each civilly committed sex offender is evaluated not less than once every two years.

Subd. 2 requires that a copy of the report be provided to the civilly committed sex offender and the civilly committed sex offender's attorney, with a blank petition for a reduction in custody and instructions on completing and filing the petition.

Subd. 3 suspends the duty to evaluate the civilly committed sex offender if the individual is in a correctional facility.

Subd. 4 clarifies that this section does not impair or restrict the civilly committed sex offender's right to petition for a reduction in custody.

This section is effective July 1, 2015.  The executive director is not required to begin the evaluations until January 4, 2016.

Section 4 (246B.10) requires the counties to pay either ten percent or 25 percent of the cost of care for civilly committed sex offenders who are discharged or provisionally discharged from MSOP.

Article 5 – Operations

Section 1 (144.057, subd. 1) requires DHS, when conducting background studies of non-Minnesota residents who provide direct-care services in nursing homes, home care agencies, or boarding care homes, to (1) check for substantiated findings of maltreatment in the individual’s state of residence when that information is available, and (2) check the national Crime Information Center database.

Section 2 (174.30, subd. 10) Paragraphs (a) and (b) require a provider of special transportation services (STS) to initiate background studies on its employees using the online NETStudy system operated by the Commissioner of Human Services.

Paragraph (c) prohibits an STS provider from allowing an employee to provide services unless the employee passes a background study.

Paragraph (d) permits a local or contracting agency to initiate background studies of volunteer drivers who provide nonemergency medical transportation services.

Section 3 (245C.03, subd. 10) requires DHS to conduct background studies for providers of special transportation services who initiate the studies of their employees, as they are required to do under Minnesota Statutes, section 174.30, subdivision 10.

Section 4 (245C.03, subd. 1) requires DHS to conduct background studies on consumer assistance partners (entities certified by MNsure to serve as navigators, in-person assisters, and certified application counselors).

Section 5 (245C.08, subd. 1) provides a cross-reference to section144.057, subdivision 1, which requires DHS to review information from the national Crime Information System when conducting background studies of any non-Minnesota resident who performs direct-care services in a nursing home, home care agency, or boarding care home.

Section 6 (245C.10, subd. 11) imposes on special transportation providers a fee of no more than $20 per background study.  Appropriates the fee to the commissioner to conduct the background studies.

Section 7 (245C.10, subd. 12) requires the commissioner to recover the cost of the background studies on consumer assistance partners through a fee of no more than $20 per study.  Appropriates the fee to the commissioner to conduct the background studies.

Section 8 (245C.12) requires DHS, when it contracts with Tribes to conduct background studies for staff working in Tribal nursing homes, to obtain data from the National Criminal Records Repository. 

Section 9 (256.962, subd. 9) requires all consumer assistance partners to undergo a background study under chapter 245C.

Section 10 (Repealer) repeals rules requiring providers of special transportation services to conduct driver and criminal record checks.

Article 6:  Health Care

Section 1 (62A.045) requires a health insurer to process a claim from a state agency for covered expenses paid under state medical programs within 90 business days.  Authorizes the state agency to grant the health insurer an additional 30 business days to process the claim if the request is submitted within 30 business days after the insurer received the claim. 

Also authorizes a health insurer to request a refund of a claim paid in error to DHS within two years of the date the payment was made.  States that a request for a refund received after this time period will not be honored.

Section 2 (62V.06, subd. 6) specifies the appeals process for an appellant aggrieved by an order of the executive director of MNsure.

Section 3 (256.015, subd. 7) requires an employer or third-party payer to provide DHS, within 60 days of a request, the following information as part of the data file:  name, date of birth, Social Security number, employer names, policy identification number, group identification number, and plan or coverage type.

Section 4 (256.969, subd. 1) eliminates the requirement that MMB submit budget change requests for annual adjustments to hospital payment rates.

Section 5 (256.969, subd 2b) grants DHS the authority to determine a new methodology for determining a cost-based final payment rate for critical access hospitals.

 Section 6 (256.969, subd. 9) grants DHS the authority to determine a new methodology for determining the disproportionate share hospital payment rate.

Section 7 (256B.059, subd. 5) removes language that prohibits under any circumstances a married couple from converting assets to income in order to avoid being subject to the asset limit for the purposes of determining an institutionalized spouse’s eligibility for long-term care under medical assistance.

Section 8 (256B.0625, subd. 9) adds to the dental services covered under MA and MinnesotaCare for nonpregnant adults nonsurgical treatment for periodontal disease limited to once per quadrant per year.

Section 9 (256B.0625, subd. 13h) expands medication therapy services covered by MA to recipients taking prescriptions to treat or prevent one or more chronic medical conditions.  Also permits medication therapy management services to be delivered into patient’s residence via secure interactive video if the services are performed electronically during a covered home visit by an enrolled provider.  States that reimbursement shall be at the same rate and same condition as would otherwise apply and the pharmacist providing the services must be located within an ambulatory setting that meets specified requirements.

Section 10 (256B.0625, subd. 58) specifies that payment for providing an EPSDT screening shall not include charges for health care services and products that are available to the provider at no cost.

Section 11 (256B.0631) makes changes to the MA co-payments to conform to changes in federal regulations.

Subd. 1 modifies the family deductible amount to keep the deductible at $2.75 per month per family and permits it to be adjusted annually by the percentage in the medical care component of the CPI-U.  Also specifies that family deductible does not apply to premiums charged to individuals enrolled in MA-EPD.

Subd. 2 exempts from co-payments and deductibles: American Indians who are enrolled in a federally recognized tribe; individuals eligible for MA through the breast and cervical cancer control program; and preventive health services recommended by the U.S. Preventive Services Task Force.

Subd. 3 caps cost sharing for all MA recipients at five percent of the family’s income.

Section 12 (256B.0638) creates the opioid prescribing improvement program.

Subd.1 requires the Commissioners of Human Services, in conjunction with the Commissioner of Health, to establish a statewide opioid prescribing program to reduce opioid dependency and substance use due to the prescribing of opioid analgesics by health care providers.

Subd. 2 defines terms.

Subd. 3 requires the Commissioner of Human Services, in consultation with the Commissioner of Health, to establish an opioid prescribing work group.

Subd. 4 requires the work group to recommend to the commissioners the components of the statewide opioid prescribing improvement program, including criteria for opioid prescribing protocols; developing sentinel measures; educational resources for opioid prescribers about pain management and the use of opioids to treat pain; opioid quality improvement standard thresholds and opioid disenrollment standards for opioid prescribers and provider groups; and other program issues as determined by the commissioners.

Subd. 5.  Paragraph (a) requires the Commissioner of Human Services to implement the program and to annually collect and report to opioid prescribers data showing the sentinel measures of their opioid prescribing patterns compared to their anonymized peers.

Paragraph (b) requires the commissioner to notify the prescriber and all provider groups with which the prescriber is employed or affiliated when the prescriber’s prescribing pattern exceeds the opioid quality improvement standards thresholds.  If notified by the commissioner, the prescriber is required to submit to the commissioner a quality improvement plan for review and approval.

Paragraph (c) specifies that if after one year the prescriber’s prescribing practices are not consistent with community standards, the commissioner may take certain steps.

Paragraph (d) requires the commissioner to disenroll from the Minnesota health care programs all prescribers and provider groups whose prescribing practices fall within the applicable opioid disenrollment standards.

 Subd. 6 classifies the reports and data identifying an opioid prescriber as private data on individuals until the prescriber is subject to disenrollment as a MA provider, then permits the commissioner to share with all the provider groups with which the prescriber is employed or affiliated a report identifying the prescriber.  Specifies that data and reports identifying a provider group are nonpublic data until the provider group is subject to disenrollment.  At that time the data and reports are public, except that any identifying information of enrollees must be redacted by the commissioner.

Subd. 7 requires the commissioner to annually report to the legislature on the status of the implementation of the program, including data on utilization of opioids in the Minnesota health care programs.

Section 13 (256B.0757) expands the certification of health homes to include behavioral health homes.

Subd. 1 requires the commissioner to establish behavioral health homes to serve individuals with serious mental illness.  Requires the services provided by these behavioral health homes to focus on both behavioral and physical health.

Subd. 2 expands who is eligible for health home services to include individuals who have been diagnosed with a mental illness.

Subd. 4 specifies that health home services are voluntary and that an eligible individual may choose any designated provider.  Defines a designated provider as a clinical practice or clinical group practice, rural clinic, community health center, community mental health center, or another entity that is determined by the commissioner to be qualified to be a health home.

Subd. 5 clarifies that the commissioner shall make payments to each designated provider for the provision of health home services.

Subd. 6 changes terminology to refer to designated providers.

Subd. 8 requires health homes to meet process, outcome, and quality standards developed and specified by the commissioner.  Requires the commissioner to collect data from health homes to monitor compliance with certification standards. Permits the commissioner to contract with a private entity to evaluate patient and family experiences, health care utilization, and costs.  Requires the commissioners to utilize findings from the utilization of health homes to determine populations to serve under subsequent health home models for individuals with chronic conditions.

Section 14 (256B.76, subd. 2) specifies that beginning July 1, 2015, payments to critical access hospitals for outpatient, emergency, and ambulatory surgery hospital facility fee services will be final payments and will not be settled to actual costs.

Section 15 (256B.76, subd. 2)  increases payment rates for dental services rendered on or after January 1, 2016,  to an amount equal to a 15 percent increase in the aggregate payment for dental services from the rates in effect on December 31, 2015.  (Uses 2012 submitted charges.)

Section 16 (256B.76, subd. 4) modifies the critical access dental supplemental rates effective for services rendered on or after January 1, 2016, for critical access providers that are not community health clinics to an additional 20 percent above the basic payment rate, and for critical access providers that are community health clinics to an additional 17.4 percent above the basic payment rate.

Section 17 (256B.79) establishes integrated care for high-risk pregnant women.

Subd. 1 defines terms.

Subd. 2 requires the commissioner to implement a pilot program to improve birth outcomes and strengthen early parental resilience for pregnant women who are receiving MA, are at a significantly elevated risk for adverse outcomes of pregnancy, and are in targeted populations.

Subd. 3 requires the commissioner to award grants to qualifying applicants to support interdisciplinary, integrated perinatal care. Requires the grants to be distributed through a request for proposals (RFP) process to a designated lead agency within an entity that has been determined to be a qualified integrated perinatal care collaborative or an entity in the process of meeting the qualifications to become a collaborative.

Subd. 4 specifies that to be eligible for a grant, an entity must show that the entity meets or is in the process of meeting the qualifications established by the commissioner to be a qualified perinatal care collaborative.  Specifies the policies, services, and partnerships that an entity must have in place to meet the qualifications to be a collaborative.

Subd. 5 requires a collaborative receiving a grant to develop means to identify and report gaps in the  communication, administrative support, and direct care that must be remedied for the collaborative to provide integrated care and enhanced services to targeted populations.

Subd. 6 requires the commissioner to report to the legislature on the status and progress of the pilot program by January 31, 2019.

Subd. 7 specifies that this section expires June 30, 2019.

Sections 18 to 31 make changes to the MinnesotaCare program to comply with federal requirements.

Section 18 (256L.01, subd.3a) defines family in the MinnesotaCare program to comply with federal requirements for the basic health plan (BHP).

Section 19 (256L.01, subd. 5) clarifies the definition of income to mean a household’s projected annual income for the applicable year.

Section 20 (256L.03, subd. 5) updates the family deductible cost-sharing requirement by specifying that the family deductible is equal to $2.75 per month per family, and that it will be annually adjusted by the increase in the medical care component of the CPI-U. Also specifies that cost-sharing requirements do not apply to American Indians.  The section also gives the commissioner authority to increase co-payments to reduce the actuarial value of the MinnesotaCare benefits to 94 percent.

Section 21 (256L.04, subd. 1a) specifies that a Social Security number is required when applying for MinnesotaCare if required under federal regulations.

Section 22 (256L.04, subd. 1c) clarifies eligibility requirements for MinnesotaCare.

Section 23 (256L.04, subd. 7b) requires the commissioner to adjust the income limits annually on January 1 as provided in federal regulations.

Section 24 (256L.04, subd. 10) updates a cross-reference to the federal regulations.

Section 25 (256L.05, subd. 2a) specifies that the commissioner must determine eligibility for each applicable period of eligibility, and if the individual is required to pay a premium, that coverage is only available in each month for which a premium has been paid.

Section 26 (256L.05, subd. 3) clarifies that coverage for American Indians begins the first day of the month following the month in which eligibility is approved.

Section 27 (256L.05, subd. 3a) clarifies that eligibility must be redetermined on an annual basis and that the period of eligibility is the entire calendar year following the year in which eligibility is redetermined.  Specifies that beginning in calendar year 2015, eligibility redeterminations shall occur during open enrollment periods for qualified health plans.

Section 28 (256L.05, subd. 4) requires the commissioner to determine an applicant’s eligibility for MinnesotaCare no more than 45 days from the date the application was received by the department.

Section 29 (256L.06, subd. 3) specifies that disenrollment for nonpayment of the premium is effective for the calendar month following the months the premium was due, and if disenrolled, an individual may not reenroll prior to the first day of the month following payment of an amount equal to two months’ premiums.

Section 30 (256L.11, subd. 7) eliminates critical access dental payments for services provided on or after January 1, 2016, in the MinnesotaCare program.

Section 31 (256L.121, subd. 1) clarifies a cross-reference.

Section 32 (256L.15, subd. 2) modifies the MinnesotaCare premiums to comply with federal regulations.  Specifies that individuals with household incomes below 35 percent of federal poverty guidelines are not required to pay premiums.

Section 33 (282.241, subd. 1) clarifies that if after a parcel of land has been forfeited for taxes it is repurchased by certain individuals associated with the original owner, all MA liens will remain in place.  

Section 34 (297A.70, subd. 7) makes a conforming change to a cross-reference.

Section 35 (514.73, subd.1) clarifies that the state may transfer its interest in any medical assistance lien.

Subd. 2 allows the state, as a holder of an MA lien, to transfer to a third party its redemption right, which is the right of a creditor to gain possession of a property after foreclosure by paying a price the creditor negotiates with the bank.

Subd. 3 allows DHS to disclose its financial interest in any MA liens when it transfers that interest or transfers its redemption rights.

Section 36 (514.981, subd. 2) allows DHS, for the purposes of filing an MA lien notice, to presume that MA recipients will not return home if they have resided in a long-term care facility for six months or longer.

Section 37 (580.032, subd. 1) allows a recorded MA lien to constitute a request for notice of a mortgage foreclosure, provided the lien includes a legal description of the real property and the department’s mailing address.

Section 38 (Statewide Opioid Prescribing Improvement Program) requires the Commissioner of Human Services to report to the legislature by December 1, 2015, any recommendations made by the opioid prescribing work group and steps taken to implement the opioid prescribing improvement program.

Section 39 (Payment System for Critical Access Dental Providers) requires the Commissioner of Human Services, in collaboration with the Dental Services Advisory Committee, to make recommendations on modifications to the critical access program so that 50 percent of the payment is based on measures of quality and outcome measures, to the legislature by January 15, 2017.

Section 40 (Repealer) repeals the following:

(a) Minnesota Statutes, sections 256.969, subd. 30 (payment for births); and 256B.69, subd. 32 (initiatives to reduce incidence of low birth weight).

(b) Minnesota Statutes, sections 256L.02, subd. 3 (financial management for MinnesotaCare); and 256L.05, subd. 1b (MinnesotaCare enrollment by counties), 1c (open enrollment and streamlined application), 3c (retroactive coverage), and 5 (availability of private insurance).

Article 7 – Continuing Care

Section 1 (256.478) repeals the authority of the Commissioner of Human Services to transfer funds between the MA account and the home and community-based services transitions grant account. 

Section 2 (256.975, subd. 8) establishes through the Senior LinkAge Line a long-term care call center.

Sections 3 and 4 (256B.092, subd. 13; 256B.49, subd. 24) modify the provisions relating to increasing MA waiver allocations to transition individuals from the Anoka Metro RTC and the MN Security Hospital to the community by providing “resources,” in addition to waiver allocations.

Section 5 (Development of Long-Term Care; Life Stage Planning Insurance Product) requires the Commissioner of Human Services to work with stakeholders and other state agencies to research, develop, and investigate the marketability of a new long-term care insurance product.

 Section 6 (Rate Increase for Self-Directed Workforce Negotiations) increases the reimbursement rate by 1.53 percent on July 1, 2015, and by an additional 0.2 percent on July 1, 2016, for direct support services provided through a covered program if the legislature ratifies the contract negotiated between the state and SEIU Healthcare Minnesota.  Covered programs include PCA Choice, Consumer-Directed Community Supports, home and community-based waivered services, alternative care, consumer support grant, and Community First Services and Supports. 

 Section 7 (Home and Community-Based Services Incentive Pool) grants authority to DHS to create a home and community-based services incentive pool to allow DHS to contract with providers and provide incentive payments to those providers to meet outcomes to be determined by DHS.

Article 8 – Health Department

 Section 1 (15.445) creates a new unified licensing structure for retail food handlers and food and beverage services establishments regulated by the Department of Health and Department of Agriculture.

            Sections 2 to 5 modify the health information exchange oversight.

 Section 2 (62J.498) updates definitions and specifies that portions of the application for certification classified as public data shall be made available to the public for at least ten days while an application is under consideration and upon the request of the commissioner.  The applicant must participate in a public hearing by presenting an overview of the application and responding to questions from the public.

 Section 3 (62J.4981) modifies the certificate of authority requirements for health data intermediaries and health information organizations.

 Section 4 (62J.4982, subd. 4) strikes obsolete language.

Section 5 (62J.4982, subd. 5) modifies the fee structure for health information exchange service providers.

Sections 6 to 9 (144.291; 144.293; 144.298) add a definition and references to a patient information service within the Health Records Act.

 Section 10 (144.3831, subd. 1) increases the public water services annual connection fee from $6.36 to $8.28 for every service connection.

 Section 11 (144.4961) establishes the Minnesota Radon Licensing Act.

          Subd. 1 permits this section to be cited as the Minnesota Radon Licensing Act.

Subd. 2 defines terms.

 Subd. 3 authorizes the Commissioner of Health to adopt rules relating to licensure and enforcement of laws and rules relating to indoor radon in dwellings and other buildings, with the exception of newly constructed homes.

 Subd. 4 requires all radon mitigation systems installed in Minnesota on or after October 1, 2017, to have a radon mitigation system tag provided by the commissioner.  The tag must be attached by a radon mitigation professional and must be in a visible location.

Subd. 5 requires that every person, firm, or corporation that sells or performs a service for compensation to detect the presence of radon in the indoor atmosphere, performs laboratory analysis, or performs a service to mitigate radon in the indoor atmosphere be licensed on an annual basis.  Specifies that this does not apply to retail stores that only sell or distribute radon sampling and are not engaged in the manufacture of radon sampling devices.

Subd. 6 specifies that radon systems installed in newly constructed homes prior to the issuance of a certificate of occupancy are exempt from this section.

Subd. 7 requires that applications for licensure, system tags, and other reporting requirements be submitted on forms prescribed by the commissioner.

 Subd. 8 establishes radon license fees.

Subd. 9 states that the commissioner shall enforce this section under Minnesota Statutes, sections 144.989 to 144.993.

Sections 12 to 18 modify the lead statutes.

Sections 12 to 16 (144.9501, subd. 22b; 144.9501, subd. 26b; 144.9501, subd. 26c) make changes to the definitions for lead sampling technician and renovation, and adds a definition for “lead renovator.”

Section 17 (144.9505) modifies the credentialing requirements for lead firms and professionals.  Requires renovation firms to be licensed by the commissioner.  Requires a person that employs an individual to perform regulated lead work outside the person’s property to obtain certification as a certified lead firm or a certified renovation firm. Clarifies that an individual who performs lead hazard reduction, lead hazard screens, lead inspections, lead risk assessment, lead project designer services, lead sampling technician services, swab team services, and activities performed to comply with lead orders must be employed by a certified lead firm.  Specifies that the fees are annual fees.  Specifies that a person who employs individuals to perform renovation activities outside the person’s property must obtain certification as a renovation firm.  Requires a person who provides training to lead workers, supervisors, inspectors, assessors, project designers, technicians, and lead renovators to obtain a permit from the commissioner.

Section 18 (144.9508) specifies that the authority to adopt rules consistent with the Toxic Substance Control Act do not expire.

Sections 19 to 23 strengthen the regulation of supplemental nursing services agencies in order to protect vulnerable adults and increases the registration fee for such agencies. 

Section 19 (144A.70, subd. 6) expands the list of temporary employees placed by supplemental nursing services agencies to include any licensed health professional.

Section 20 (144A.70, subd. 7) requires annual unannounced inspections of supplemental nursing services agencies to ensure compliance with the sections of statute regulating supplemental nursing services agencies.

Section 21 (144A.71, subd. 1) requires supplemental nursing agencies to register annually with DHS and requires DHS to deposit registration fees in the special revenue fund.

Subd. 2 requires registration applications to include a policy for making a supplemental nursing services agency’s records immediately available at all times to DHS and increases an annual registration fee from $891 to $2,035.  If the agency fails to provide all the required parts of the registration application, DHS must refuse to issue the registration, subject to an appeals process.

Section 22 (144A.72, subd. 1)  adds a requirement that supplemental nursing services agencies retain for five years all records pertaining to their registration, including those records related to an agency’s insurance and bonding and its employees’ education, training, and licensing. Agencies must make these documents immediately available to DHS. Subdivision 1 also adds a requirement that in order to retain their registration, agencies provide services to a health care facility during the year prior to the date of their registration renewal.

Subd. 2 removes the requirement that an agency must engage in a pattern of failure to comply with the provision of the section before it is subject to revocation or nonrenewal of its registration; a single instance of failure to comply is sufficient.

 Subd. 4 requires a hearing involving an administrative law judge prior to the revocation or rejection of an agency’s registration or renewal of registration.

Section 23 (144A.73) requires the Office of Health Facility Complaints to investigate complaints against supplemental nursing services agencies.

Sections 24 and 25 expand and strengthen the enforcement of dementia care training in housing with services establishments.

Section 24 (144D.01) adds the definition of “direct-care staff” to the housing with services chapter.

Section 25 (144D.066, sub. 1) requires DHS to enforce dementia care training among the staff of housing with services establishments, including direct-care staff, supervisors of direct-care staff, maintenance staff, housekeeping staff, food service staff, and housing managers.

Subd. 2 permits DHS to impose fines for failure to comply with required dementia care training, but the fines are subject to an appeals process; requires that employees be permitted to complete the training as part of their duties; does not allow payment of a fine to substitute for completion of the required training; permits the revocation or nonrenewal of registration for continued noncompliance with the requirement to receive the required training; and requires DHS to make public a list of all housing with services establishments that have complied with the training requirements.

Subd. 3 requires DHS, in lieu of imposing fines between January 1, 2016, and December 31, 2016, to offer technical assistance to help providers come into compliance with the dementia care training requirements.

Section 26 (145A.131, subd. 1) provides an increase in the local public health grant for community health boards that are all or a portion is located outside of the counties of Anoka, Chisago, Carver, Dakota, Hennepin, Isanti, Ramsey, Scott, Sherburne, Washington, and Wright equal to ten percent of the grant award to the community health board.  The amount distributed shall be adjusted each year based on available funding and the number of eligible community health boards. 

Sections 27 to 32 modify the mortuary science chapter.

Section 27 (149A.20, subd. 5) specifies that if a passing score is not attained on the state examination, the individual must wait two weeks before retaking the examination.

Section 28 (149A.20, subd. 6) requires that an internship shall at a minimum be 2,080 hours completed within a three-year period, and that the commissioner may waive up to 520 hours upon the satisfactory completion of a clinical or practicum in mortuary science through a program approved by the commissioner.  Requires an intern to complete 25 case reports in the areas of embalming arrangements and services.  Requires case reports be completed by the intern and filed with the commissioner before completion of the internship.

Section 29 (149A.10, subd. 11) requires 18 continuing education hours for license renewal to practice mortuary science.  Specifies the areas that these hours must cover.

Section 30 (149A.65) increases mortuary science fees.

Section 31 (149A.92, subd. 1)  eliminates a grandfather clause for minimum standards for preparation and embalming rooms that had not been used for the preparation or embalming of a dead human body in the 12 months prior to July 1, 1997.

Section 32 (149A.97, subd. 7) requires funeral providers reporting preneed trust accounts to complete an independent audit by an independent third-party auditing firm every other year, and report the findings to the commissioner by March 31 of that calendar year.  This is in addition to the annual report that is required to be submitted.

Section 33 (157.16) modifies the food and beverage services establishment fees to coordinate with the fees established under section 15.445 (section 1 of this article). 

Article 9 – Health Licensing Board Fee Modifications

Sections 1, 2, and 3 (148.57, subd. 1, subd. 2; 148.59) modify fees established under the Board of Optometry.

Sections 4 and 5 (148D.180, subd. 2; subd. 5) modify fees established under the Board of Social Work.

Sections 6 to 11 (150A.091, subds. 4, 5, 11, 17, 18; 150A.31) modify fees established by the Board of Dentistry.

Sections 12 to 15 (151.065, subds. 1, 2, 3 and 4) modify fees established by the Board of Pharmacy.

 

 

 
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