S.F. 2934 modifies the personal care assistance program changes adopted in 2009.

Section 1 (256B.0625, subdivision 6a) states that Medical Assistance (MA) home health services covers services for a recipient who lives at home rather than covering services only at the recipient's home.

Section 2 (256B.0653, subdivision 3) states that MA home health aide visits are provided for a recipient who lives at home rather than only at the recipient's home.

Section 3 (256B.0659, subdivision 1) amends the definitions section of the personal care assistance (PCA) law by adding definitions of "extended personal care assistance service," "personal care support service," and "wages and benefits."

Section 4 (256B.0659, subdivision 3) modifies the prohibition on payment for PCA services for instrumental activities of daily living for children under the age of 18 by permitting payment for these activities if they are listed in the service plan by the assessor.

Section 5 (256B.0659, subdivision 4) modifies the needs a person must exhibit in order to be assessed in need of PCA services. It requires the assessment to be based on the person's ongoing need, rather than daily need, for assistance in activities of daily living. It defines a person as dependent in an activity if the person needs prompting and cueing to ensure accomplishment of a task.

Section 6 (256B.0659, subdivision 11) requires DHS to issue a unique medical provider identification number to a qualified PCA within five days of a PCA agency's request. After five days, the PCA may begin providing services. If DHS has not issued the ID number, the agency may bill using the agency's ID number. Claims submitted under that number for more than 24 hours of services per day may not be rejected if more than one PCA is billing using the agency ID number. This section also allows the number of hours worked per day by a PCA to be set by the agency and not disallowed by DHS unless in violation of law.

Section 7 (256B.0659, subdivision 13) delays by six months, until July 1, 2010, the requirement that qualified professionals must complete the required training program within six months of hire. The training must be available online or by electronic remote connection and provide for testing without attending in-person training. The training requirement does not apply until this provision is satisfied. In addition, a qualified professional employed by a PCA provider agency that is also a Medicare-certified home health agency is exempt from the training requirement.

Section 8 (256B.0659, subdivision 14) modifies the requirements for PCA supervision by a qualified professional. After an initial evaluation of the PCA, subsequent visits to the recipient do not require direct observation of each PCA's work. After the first 180 days of service, supervisory visits may alternate between unscheduled phone or Internet technology and in-person visits, unless in-person visits are required by the care plan.

Section 9 (256B.0659, subdivision 18) states that the recipient's responsibility under the PCA choice option to hire, train, schedule, and fire PCAs is governed by the written agreement with the PCA choice agency required under a later section of this bill.

Section 10 (256B.0659, subdivision 19) restates that the recipient's responsibility under the PCA choice option to hire, train, schedule, and fire PCAs is governed by the written agreement with the PCA choice agency.

Section 11 (256B.0659, subdivision 20) states that the required written agreement under the PCA choice option is between the PCA choice agency and the recipient. PCAs and the qualified professional are removed as parties to the agreement but must be given a copy of it.

Section 12 (256B.0659, subdivision 21) requires PCA agencies to document to DHS that they do not require PCAs to sign an employment contract agreeing not to work for another agency in the future when no longer employed with the first agency. This section also provides that the PCA agency personnel subject to mandatory training are management and supervisory personnel and owners who are active in day-to-day management and operations. By September 1, 2010, the training must be available online or by electronic remote connection. Medicare-certified home health agencies are exempt from this training requirement.

Section 13 (256B.0659, subdivision 27) exempts Medicare-certified home health agencies from providing ventilator training to PCAs who work with ventilator-dependent recipients.

Section 14 (256B.0659, subdivision 29) expands transitional assistance to recipients and families affected by the 2009 PCA amendments to include continued PCA services at the previously assessed level under certain conditions.

Section 15 (256B.0659, subdivision 30) expands the list of items DHS must provide to recipients likely to be affected by the 2009 changes in the PCA program. A requirement is added to provide a service agreement authorizing PCA hours of service at the previous level when requested by a recipient while an appeal is pending.

Section 16 requires DHS to add personal care support to each home and community-based waiver for persons who meet listed criteria.

DG/rdr

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