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S.F. No. 74 - Human Services Policy
 
Author: Senator Jerry Relph
 
Prepared By: Liam Monahan, Senate Analyst (651/296-1791)
Joan White, Senate Counsel (651/296-3814)
Patrick Hauswald, Senate Counsel (651/296-5079)
 
Date: January 11, 2019



 

Article 1 - Health Care

Section 1 (Pain Management) requires the Health Services Policy Committee, established by the Commissioner of Human Services, to evaluate the integration and make recommendations based on best practices for effective treatment for musculoskeletal pain provided by certain health practitioners and covered by Medical Assistance.  Requires the commissioner to consult with certain health practitioners and report to the Legislature by August 1, 2020, on the commissioner's recommendations. The final report to the Legislature must include a pilot program to assess integrated nonpharmacologic, multidisciplinary treatments for managing musculoskeletal pain.

Article 2 - Home Care Licensing

Section 1 (144A.43, subdivision 11) modifies the definition of “medication administration.”

Section 2 (144A.43, subdivision 12a) adds a new definition for “medication reconciliation.”

Section 3 (144A.43, subdivision 27) replaces the term “service plan” with “service agreement.” Conforming changes appear throughout the bill.

Section 4 (144A.43, subdivision 30) modifies the definition of “standby assistance.”

Section 5 (144A.472, subdivision 5, paragraph (a)) clarifies the meaning of a change of ownership.

Paragraphs (b) and (c) clarify that when a change of ownership occurs, employees who are continuously employed in the same capacity during the transition are not required to repeat various training, testing, and background studies, unless the new owner adopts new policies and procedures.

Section 6 (144A.472, subdivision 7) imposes a new $1,000 fee on a home care provider with a temporary license who fails to notify the commissioner within five days that the provider has begun to provide service to clients.

Section 7 (144A.473, subdivisions 1 to 3) allows temporary licenses to be extended for up to an additional 90 days while the temporary licensee tries to come into compliance with the home care licensing requirements.

Subdivision 2, paragraph (b), requires an initial survey to be completed within 90 days of the provider beginning to provide services.

Subdivision 3, paragraph (e), also specifies limited circumstances under which a home care provider whose license was denied can continue to operate.

Section 8 (144A.474, subdivision 2) adds a definition of “change of ownership survey" and makes conforming changes.

Section 9 (144A.475, subdivision 1) makes conforming changes.

Section 10 (144A.475, subdivision 2) clarifies that a home care provider whose license is suspended or conditional may continue to provide services to clients while clients are transferred to other providers.

Section 11 (144A.475, subdivision 5) allows a provider with a suspended or revoked license to continue operating while its clients are transferred to other providers.

Sections 12 and 13 (144A.476, subdivision 1; 144A.479, subdivision 7) make conforming changes.

Sections 14 to 19 make conforming changes, clarify the meaning of “initiation of services,” and require disclosure regarding how staff will be supervised.

Section 20 (144A.4792, subdivision 1) requires home care providers that store controlled substances to have policies and procedures to ensure the security of those substances within state and federal requirements.

Section 21 (144A.4792, subdivision 2) requires any assessment for medication management services to include providing a client with instructions on how to manage medications and prevent medication diversion.

Section 22 (144A.4792, subdivision 5) makes conforming changes and requires medication reconciliation to be completed whenever medication management services are provided.

Section 23 (144A.4792, subdivision 10) modifies the medication management standards when a client is away from home.

Section 24 (144A.4793, subdivision 6) clarifies the required elements of a treatment or therapy order and requires such orders to be renewed at least every 12 months.

Section 25 (144A.4796, subdivision 2) clarifies which policies and procedures must be reviewed during an employee’s orientation.

Section 26 (144A.4797, subdivision 3) clarifies the timeline for required supervision of staff performing delegated tasks.

Section 27 (144A.4798) modifies, clarifies, and updates the requirements for home care providers’ infection control programs.

Sections 28 and 29 (144A.4799, subdivision 1; 144A.4799, subdivision 3) modify the membership and duties of the Home Care and Assisted Living Program Advisory Council.

Section 30 (144A.484, subdivision 1) deletes obsolete language.

Section 31 (Revisor’s Instruction) directs the Revisor of Statutes to modify terms in specified statutes.

Section 32 repeals obsolete provisions regarding tuberculosis prevention and control, and the transition to a new licensing structure for home care providers.

Article 3 – Community Supports and Continuing Care

Section 1 (245A.03, subdivision 7, paragraph (a), clause (7)) extends an existing foster care licensing moratorium from June 30, 2018, to June 30, 2019, for certain previously unlicensed setting to become licensed.

Clause (8) excludes from the foster care license moratorium a vacancy created in a foster care setting that has been granted a foster care licensing moratorium exception under clause (7).

Section 2 (245A.11, subdivision 2a, paragraph (g)) amends the Department of Human Services Licensing Act, specifically the provision determining capacity for adult foster care settings. This section modifies the requirements in paragraph (f) related to the commissioner’s authority to issue an adult foster care license with a capacity of five adults, by requiring that the facility be licensed before June 20, 2021, instead of March 11, 2011. Paragraph (g) provides that the commissioner shall not issue a new foster care license under paragraph (f) after June 30, 2021, instead of June 30, 2019. The commissioner is required to allow a facility with an adult foster care license before June 30, 2021, instead of June 30, 2019, to continue with a capacity of five adults provided the license holder complies with the requirements in paragraph

(f).

Section 3 (245D.03, subdivision 1) clarifies which services are governed by Minnesota

Statutes, chapter 245D, licensing standards by including the medical assistance waivers under which the services are provided, and changes the name of behavioral support services to positive support services.

Section 4 (245D.071, subdivision 5) amends the home and community-based services standards related to service planning for intensive support services.

Paragraph (a) is editorial.

Paragraph (b) requires a licensed provider of intensive home and community-based services, when conducting a service plan review, to include and document a discussion of how a person receiving intensive services might use technology to help the person meet the person’s goals. (In 2017, the legislature passed identical language for the purposes of initial service planning.)

Section 5 (245D.091, subdivision 2, clause (12), item (vi)) allows an individual with master’s degree or higher and a demonstrated expertise in positive supports to qualify as a positive supports professional.

Section 6 (245D.091, subdivision 3)

Paragraph (a), clause (3), permits a board-certified behavior analyst or assistant behavior analyst to qualify as a positive support analyst.

Paragraph (b), clause (1), modifies additional qualifications for a positive support analyst be requiring four years of supervised experience that includes specific tasks.

Paragraph (b), clause (2), allows a person who meets the other positive support analyst qualifications to qualify as a positive support analyst if the person receives the required training within 90 days following hire and adds additional training requirements.  Under current law, such a person does not qualify as a behavior analyst until after the training is completed.

Paragraph (c) allows a person who qualifies as a positive support professional to qualify as a positive support analyst without meeting the training requirements of paragraph (b).

Section 7 (245D.091, subdivision 4)

Paragraph (b) allows a person who meets the other positive support specialist qualifications to qualify as a behavior specialist if the person receives the required training within 90 days following hire.  Under current law, such a person does not qualify as a behavior specialist until after the training is completed.  The bill does change the existing training requirements.

Paragraph (c) allows a person who qualifies as a positive support professional to qualify.

Section 8 (256B.0659, subdivisions 3a) clarifies that lead agencies may continue to use legacy assessment tools for PCA assessments.

Section 9 (256B.0911, subdivision 1a, paragraph (b)) removes from the MnCHOICES assessment process service eligibility determinations for home care nursing and reassessments for people with developmental disabilities receiving only Rule 185 case management services, and also removes long-term care consultation services (otherwise known as a MnCHOICES assessment) as the required process for determining whether the family of a minor with a disability is eligible for a support grant.

Section 10 (256B.0911, subdivision 3a, paragraph (a)) makes conforming changes by striking from the MnCHOICES statute references to home care nursing.

Paragraph (c) requires the MnCHOICES assessment process to be conversational in nature.

Paragraph (d) removes a requirement that a legal representative of a person receiving a MnCHOICES assessment be physically present during an assessor’s face-to-face assessment of the person seeking long-term care, and permits the legal representative to participate in the assessment remotely instead.

Paragraph (e) removes the existing requirement that a MnCHOICES assessor complete a community support plan within 40 calendar days of the assessment. DHS will determine a new deadline for completing the community support plan, but the total time for the assessor to complete the community support plan and the case manager to complete the coordinated service and support plan must not exceed 56 days.

Paragraph (j), clause (9), requires a certified assessor to point out in the assessment documents the location of the statement concerning the person’s right to appeal the results of an assessment.

Paragraph (k) allows the results of a MnCHOICES assessment to establish service eligibility for developmental disability waiver services for up to 60 days from the time of the assessment.

Paragraph (k) interacts with existing paragraph (m) to permit a service eligibility update for developmental disability waiver services to extend the validity of a MnCHOICES assessment for an additional 30 days. These changes align the service eligibility timelines for developmental disability waiver services with the timelines for the other home and community-based waiver and alternative care services.

Section 11 (256B.0911, subdivision 3f, paragraph (a)) requires a certified assessor to review a person’s most recent assessment prior to a reassessment, and requires DHS to establish timelines for a MnCHOICES assessor, following an annual MnCHOICES reassessment, to complete an updated coordinated support plan and a case manager to complete an updated coordinated service and support plan.

Section 12 (256B.0911, subdivision 5, paragraph (c)) requires the Commissioner of Human Services, in cooperation with lead agencies, to develop and collect data on a set of measures of increasing efficiency in the MnCHOICES assessment process, and to report an analysis of that data to lead agencies and to the Legislature.  Paragraphs (a) and (b) contain existing requirements that the commissioner make the assessment process more efficient.  This paragraph requires the commissioner to demonstrate that the process is becoming more efficient.

Section 13 (256B.0915, subdivision 6, paragraph (a), clause (1)) removes the current ten-day deadline for case managers to complete coordinated service and support plans for people receiving any home and community-based waiver services or alternative care.  DHS will determine a new deadline for completing coordinated service and support plans, but the total time for a MnCHOICES assessor to complete the community support plan and the case manager to complete the coordinated service and support plan must not exceed 56 days.

Section 14 (256B.092, subdivision 1b, paragraph (a), clause (1)) removes the current ten-day deadline for case managers to complete coordinated service and support plans for people receiving any home and community-based waiver services or alternative care.  DHS will determine a new deadline for completing coordinated service and support plans, but the total time for a MnCHOICES assessor to complete the community support plan and the case manager to complete the coordinated service and support plan must not exceed 56 days.

Section 15 (256B.092, subdivision 1g) amends the developmental disability waiver statute to permit individuals who are currently receiving only Rule 185 case management services to make an informed choice to decline a MnCHOICES reassessment.

Section 16 (256B.0921) modifies the name of the grant program.

Section 17 (256B.49, subdivision 13, paragraph (a), clause (1)) removes the current ten-day deadline for case managers to complete coordinated service and support plans for people receiving any home and community-based waiver services or alternative care.  DHS will determine a new deadline for completing coordinated service and support plans, but the total time for a MnCHOICES assessor to complete the community support plan and the case manager to complete the coordinated service and support plan must not exceed 56 days.

Section 18 (256B.4914, subdivision 3) makes conforming and editorial changes.

Section 19 (256I.03, subdivision 8) amends the definition of “supplementary services” by adding a cross-reference to the requirements under Minnesota Statutes, section 256I.04, subdivision 2h.

Section 20 (256I.04, subdivision 2b) requires that providers of housing supports confirm in their housing support agreement that the provider will not limit or restrict the number of hours an applicant or recipient chooses to be employed, as specified in subdivision 5.

Section 21 (256I.04, subdivision 2h) is a new subdivision that requires providers of supplementary services to ensure that recipients have, at a minimum, assistance with services identified in the individual’s professional statement of need.  This section also requires all providers to maintain case notes with the date and description of services provided to individual recipients.

Section 22 (256I.04, subdivision 5) is a new subdivision that prohibits a provider from limiting or restricting the number of hours an applicant or recipient is employed.

Section 23 (256I.05, subdivision 3) modifies the housing support chapter of law, specifically the limits on rates.  The modification in this section maintains rates for clients who meet the same eligibility criteria, but allow the provider to charge a lower rate for individuals who do not qualify for housing support.

Section 24 (Direction to the Commissioner) permits an existing housing with services establishment providing customized living services under the BI and CADI waivers to redistribute its service capacity to other establishments.

Section 25 (Direction to the Commissioner) requires the Commissioner of Human Services to ensure that the updates to the MnCHOICES assessment tool incorporates a qualitative approach to interviewing.

Section 26 (Revisor’s instruction) instructs the revisor of statutes to correct inconsistent terminology related to the DD waiver.

Article 4 –Miscellaneous

Section 1 (243.166, subdivision 4b) amends the predatory offender registration statute, to require that the predatory offender notice of status required in this subdivision be provided to licensed home care providers in the same manner that health care facilities receive notice. Article 5 – Children and Families; Licensing

Section 1 (256K.45, subdivision 2) provides that the commissioner is exempt from preparing the required report under this section of law, and instead update the 2007 report on homeless youth under section 2.

Section 2 requires the Commissioner of Human Services to update the information in the 2007 Legislative Report on homeless youth in lieu of the biennial homeless youth report under chapter 256K.  In developing the updated report, the commissioner may use existing data, studies, and analysis provided by the state, county, and other entities, including the different sources listed in the bill. The report may include three key elements, which are listed in subdivision 2. The report is due February 15, 2020.

Section 3 instructs the Revisor of Statutes, in consultation with the Department of Human Services, House Research Department, and Senate Counsel, Research and Fiscal Analysis to change the terms “food support” and “food stamps” to “Supplemental Nutrition Assistance Program” or “SNAP” in Minnesota Statutes and Rules when appropriate. Allows the revisor to make technical and other necessary changes to sentence structure to preserve the meaning of the text.

Article 6 – State-Operated Services; Chemical and Mental Health

Section 1 (245A.04, subdivision 7) allows the commissioner of human services to issue a temporary change of ownership license or provisional license. Prohibits commissioner from issuing or reissuing a license if the applicant had been denied a license, including a license following expiration of a provisional license, within the past two years.

Section 2 (245A.04, subdivision 7a) paragraph (a) requires a license holder to notify the commissioner and obtain approval before making any changes that would alter the license information.

Paragraph (b) requires a license holder to notify the commissioner at least 30 days before the change is effective, in writing, of certain listed changes.

Paragraph (c) requires a license holder to provide amended articles of incorporation or other documents reflecting a change to business structure or services.

Makes this section effective August 1, 2019.

Section 3 (245A.043) is a new section of law establishing procedures for a license application after a change of ownership.

Subdivision 1 specifies that a license is not transferable or assignable.

Subdivision 2 requires submission of a new license application when the commissioner determines that a change in ownership will occur. Specifies what constitutes a change in ownership.

Subdivision 3, paragraph (a) requires written notice to the commissioner of any proposed sale or change of ownership at least 60 days prior to the anticipated change, when the new owner intends to assume operation without interruption.

Paragraph (b) requires a prospective new owner or operator to submit a license application at least 30 days prior to the change, and comply with all statutory requirements.

Paragraph (c) allows the commissioner to develop application procedures for when the applicant is a current license holder, and the program is currently licensed by DHS and in substantial compliance.

Paragraph (d) specifies that the existing license holder is responsible for operating the program until a license is issued to the new owner or operator.

Paragraph (e) allows the commissioner to waive a new owner or operator’s licensing inspection, under certain circumstances.

Paragraph (f) requires a new owner or operator to submit a letter identifying how and when they will resolve any outstanding correction orders, if applicable.

Paragraph (g) specifies that any licensing actions taken against the existing license holder when the new owner or operator is applying for a license will remain in effect until the grounds for the action are corrected or no longer exist.

Paragraph (h) requires the commissioner to evaluate a license application according to statute.

Paragraph (i) allows the commissioner to deny an application according to statute, and allows for appeals.

Paragraph (j) specifies that this subdivision does not apply to a home-based program or service.

Subdivision 4 establishes a temporary change of ownership license for a new owner or operator while the commissioner evaluates the new owner or operator’s license application.  Allows commissioner to establish criteria for issuing such licenses.

Makes this section effective August 1, 2019.

Section 4 (245C.22, subdivision 4) requires the commissioner to set aside a disqualification for an individual in the chemical dependency field if:

  1. the individual is a nonviolent controlled substance offender;
  2. the individual is disqualified for one or more listed controlled substance offenses;
  3. the individual provides documentation of successful completion of treatment at least one year prior;
  4. the individual provides documentation of abstinence from controlled substances for at least one year prior; and
  5. the individual is seeking employment in the chemical dependency field.

Section 5 (245C.22, subdivision 5) provides an exception for a set-aside for a person in the chemical dependency field, under subdivision 4.

Section 6 (254B.03, subdivision 2) removes provision requiring prior approval from the commissioner for chemical dependency services. Allows the commissioner to deny a license if the services in the local area are sufficient to meet local need, and the addition of new services would be detrimental.

Section 7 (256.045, subdivision 3) permits a state agency hearing for a county that disputes the cost of care for a client in a state-operated facility, when discharge is delayed and the county has developed a viable discharge plan.

Section 8 (Repealer) repeals rules related to the assessment of need for treatment programs and county board responsibility to review program needs.

 
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