Senate Counsel, Research
and Fiscal Analysis
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Tom Bottern
Director
   Senate   
State of Minnesota
 
 
 
 
 
H.F. No. 2294 - Health and Human Services Omnibus Bill Conference Committee Summary
 
Author: Senator David W. Hann
 
Prepared By: Katie Cavanor, Senate Counsel (651/296-3801)
Joan White, Senate Counsel (651/296-3814)
 
Date: April 23, 2012



 

Article 1

Health Care

Section 1 (62E.14, subdivision 4g) exempts individuals enrolled in the healthy MN contribution program from the MCHA six-month durational residency requirement.

Section 2 (72A.201, subdivision  8) eliminates a report required by health carriers on the number of chemical dependency evaluations done on behalf of the health carrier during the reporting period, the types performed, the results, number of appeals of denials based on the evaluations, results of the appeals, and number of complaints filed in court.

Section 3 (256B.0625, subdivision 18c) Paragraph (a) requires the Nonemergency Medical Transportation Advisory Committee to advise the commissioner on the administration of nonemergency medical transportation covered under MA.  Requires the committee to meet at least quarterly, and to annually elect a chair. Requires the commissioner, or the commissioner’s designee, to attend all advisory committee meetings.

Paragraph (b) requires the committee to advise and make recommendations to the commissioner on:

(1) the development of, and periodic updates to, a policy manual for nonemergency medical transportation services;

(2) policies and a funding source for reimbursing no-load miles;

(3) policies to prevent waste, fraud, and abuse and to improve efficiency;

(4) other issues identified in the 2011 Office of Legislative Auditor’s report on nonemergency medical transportation; and

(5) other aspects of nonemergency medical transportation, as requested by the commissioner.

Paragraph (c) requires the committee to coordinate its activities with the Minnesota Council on Transportation Access, and requires the committee chair or a designee to attend meetings of the council.

Paragraph (d) provides that the committee sunsets on December 1, 2014.

Section 4 (256B.0625, subdivision 18d) specifies membership of the nonemergency medical transportation advisory committee. Provides that members shall not be employed by DHS and receive no compensation.

Section 5 (256B.0625, subdivision 18e) Paragraph (a) requires the commissioner to implement a single administrative structure and delivery system for nonemergency medical transportation, beginning July 1, 2013.  Specifies criteria for the administrative structure and delivery system.

Paragraph (b) requires the commissioner to present to the legislature, by January 15, 2013, any draft legislation necessary to implement the administrative structure and delivery system.

Paragraph (c) requires the commissioner to consult with the Nonemergency Medical Transportation Advisory Committee in developing the administrative structure and delivery system and draft legislation.

Section 6 (256B.0625, subdivision  18f) requires the commissioner, in consultation with the Nonemergency Medical Transportation Advisory Committee, to develop and implement, by July 1, 2013, a comprehensive, statewide, standard assessment process for MA enrollees seeking nonemergency medical transportation services.  Specifies criteria for the assessment process.

Section 7 (256B.0625, subdivision 18g) requires the commissioner, in consultation with the Nonemergency Medical Transportation Advisory Committee, to establish performance measures to assess the cost-effectiveness and quality of nonemergency medical transportation.  Specifies criteria for the performance measures and also requires the commissioner to consider the measures identified in the 2012 DHS report to the legislature on nonemergency medical transportation.  Requires the commissioner to collect, audit, analyze, and report performance data beginning in CY 2013, and to periodically supplement this information with information from consumer surveys.

Section 8 (256B.0625, subdivision  28a) allows licensed physician assistants, supervised by a physician certified by the American Board of Psychiatry and Neurology or eligible for board certification in psychiatry, to bill for medication management and evaluation and management services provided to MA enrollees in inpatient hospital settings, consistent with their authorized scope of practice.  Billing by physician assistants is not allowed for psychotherapy, diagnostic assessments, and providing clinical supervision.

Section 9 (256B.0625, subdivision 38) sets MA payments for mental health services provided by physician assistants at 80.4 percent of the rate paid to psychiatrists.

Section 10 (256B.0631, subdivision 1) Paragraph (c) permits a prepaid health plan to waive the required family deductible in the Medical Assistance Program.

Paragraph (d) permits the family deductible to be waived for individuals and allows long-term care and waivered service providers to assume responsibility for the deductible.

Section 11 (256B.0751, subdivision  9) requires the commissioner to implement a pediatric care coordination service for children with high-cost medical or high-cost psychiatric conditions who are at risk of recurrent hospitalization or emergency room use for acute, chronic, or psychiatric illness, and who receive MA services.  Requires care coordination to be targeted to children not already receiving the service. Requires care coordination services to be provided by care coordinators who are directly linked to provider teams in the care delivery setting, but may be part of a community care team shared by providers or practices.  Requires the commissioner, to the extent possible, to use the existing health care home certification and payment structure.

Section 12 (256B.69, subdivision 5a) requires the clinical or utilization performance targets for managed care plans to consider evidence-based research and reasonable interventions when available or applicable to the population served.  This section also clarifies that the health plan's emergency room utilization rate reduction for purposes of the withhold is based on the utilization in 2009.  This section also requires the commissioner to consider when measuring performance the difference in health risk in a managed care or county-based purchasing plan's membership in the baseline year compared to the measurement year and work with the plan to account for differences that are significant.  This section also requires the commissioner to structure the withholds to return a portion of the withheld funds in amounts that commensurate with achieved reductions in utilization loss the targeted amount.

Section 13 (256B.69, subdivision  9) requires managed care and county-based purchasing plans to report to the commissioner on the extent to which providers employed or under contract use patient centered decision-making tools or procedures, and the steps taken by the plan to encourage their use.

Section 14 (256B.69, subdivision 9d) Paragraph (a) requires the Legislature Auditor to contract for a financial audit of the information required under section 256B.69, subdivision 9c, paragraph (b). Requires the audit to be conducted by an independent third-party firm in accordance with generally accepted government auditing standards. Requires the independent audit to include a determination of compliance with the federal Medicaid rate certification process. Requires the contract with the auditing firm to be designed and administered so that the independent audit will be eligible for a federal subsidy if available for that purpose.  Requires the audit to determine if administrative expenses and investment income reported by managed care plans and county-based purchasing plans are compliant with state and federal law.

Paragraph (b) defines “independent third party.”

Paragraph (c) states that the commissioner, as part of the request for bids and the resulting contracts with managed care plans and county-based purchasing plans, shall require the plans to submit to and fully cooperate with an annual independent third-party financial audit. States that contracts awarded under sections 256B.69 and 256B.692 must provide the commissioner and the audit firm with access to all data required to complete the audit. This paragraph also states that the auditing firm shall have the same investigative powers as the legislative auditor under section 3.978, subdivision 2.

Paragraph (d) requires the plans to provide encounter and claims data and participate in a quality assurance program that verifies the data provided.  Requires the commissioner to develop protocols for the program, to make the protocols public, and to contract with an independent third party auditor to evaluate the protocols.

Paragraph (e) requires the legislative auditor to provide copies of the audit report to the state auditor, the attorney general, and the legislature, and requires the commissioner to provide a copy of the protocol evaluation to the legislative auditor and the legislature.

Paragraph (f) requires any actuary providing actuarial services to the commissioner in connection with this subdivision to meet professional code requirements. States that the actuary or actuarial firm shall certify and attest to the rates paid to the managed care and county-based purchasing plans and that the certification and attestation must be auditable.

Paragraph (g) specifies that this section does not allow the release of information that is nonpublic data pursuant to section 13.02.

Section 15 (256B.69, subdivision  32) directs the commissioner to require managed care and county-based purchasing plans to implement strategies to reduce the incidence of low birth weight in geographic areas identified by the commissioner as having a higher than average incidence.  Requires the strategies to coordinate health care with social services and the local public health system.  Requires each plan to develop and report to the commissioner outcome measures, and requires the commissioner to consider these outcomes when considering plan participation in competitive bidding.

Section 16 (256B.69, subdivision  33) Paragraph (a) Allows the commissioner, for managed care contracts effective on or after January 1, 2014, to utilize a competitive price bidding program for nonelderly, nondisabled adults and children in MA and MinnesotaCare in the seven-county metropolitan area.  Requires the program to allow a minimum of two managed care plans to serve the area.

Paragraph (b) requires the commissioner to consider, and incorporate, where appropriate, procedures and criteria used in the current competitive bidding pilot project.  Exempts a Hennepin County pilot program from competitive bidding.

Paragraph (c) directs the commissioner to use past performance data as a factor in selecting vendors, and to consider this and other information, in determining whether to contract with a plan under the competitive bidding program.  Provides criteria for  collecting and evaluating data on past performance.  Requires the data submitted by plans    to include health outcome measures on reducing the incidence of low birth weight.

Section 17 (256B.76, subdivision 4) provides a critical access dental clinic with the critical access dental reimbursement rate for dental services provided off-site at a private dental office if the following requirements are met:

  1. the clinic is located in a health professional shortage are and outside the seven metropolitan counties;
  2. the clinic is not able to provide the service and refers the patient to the off-site dentist;
  3. the service would be reimbursed at the critical access reimbursement rate if the service was provided at the clinic;
  4. the dental professionals providing services off-site are licensed and in good standing;
  5. the dentist providing the services is enrolled as a Medical Assistance provider;
  6. the clinic submits the claim and receives the payment for the services provided off-site; and
  7. the clinic maintains dental records for each claim submitted.

Section 18 (256L.03, subdivision 5) permits a managed care or county-based purchasing plan to waive the required family deductible in the MinnesotaCare program.

Section 19 (256L.031, subdivision 2) increases from three to four months the period of time an enrollee has to select a health plan.  Allows the commissioner to determine criteria under which an enrollee would have more than four months to select a plan.  Also clarifies that the defined contribution can be used to pay premiums for coverage under MCHA and that this MCHA coverage must meet the requirements of the healthy MN contribution program.

Section 20 (256L.031, subdivision 3) makes a conforming change related to enrollee eligibility for MCHA.

Section 21 (256L.031, subdivision 6) allows MinnesotaCare enrollees who are eligible for MCHA coverage for any reason (not just because they have been denied coverage in the individual market) to receive MCHA coverage under the healthy MN defined contribution program.

Section 22 (256L.07, subdivision  3) exempts coverage purchased under the healthy MN contribution program from being considered health coverage for purposes of the MinnesotaCare four-month uninsured requirement.  Also removes obsolete references to the General Assistance Medical Care program.

Section 23 (256L.12, subdivision 9) requires the clinical or utilization performance targets for managed care plans to consider evidence-based research and reasonable interventions when available or applicable to the population served.  This section also clarifies that the health plan's emergency room utilization rate reduction for purposes of the withhold is based on the utilization in 2009.  This section also requires the commissioner to consider when measuring performance the difference in health risk in a managed care or county-based purchasing plan's membership in the baseline year compared to the measurement year and work with the plan to account for differences that are significant.  This section also requires the commissioner to structure the withholds to return a portion of the withheld funds in amounts that commensurate with achieved reductions in utilization loss the targeted amount.

Section 24 requires the Commissioner of Human Services to issue a request for information from vendors about potential solutions for the management of nonemergency medical transportation services.  Specifies criteria for the RFI.  Requires the commissioner to provide information obtained from the RFI to the chairs and ranking members of legislative committees with jurisdiction over health and human services policy and financing, by November 15, 2012.

Section 25  requires the Commissioner of Human Services to convene a group of stakeholders to assist the commissioner in developing recommendations to improve access to, and the quality of, outpatient mental health services for MA enrollees through the use of physician assistants.  Requires the commissioner to report recommendations to specified legislative chairs and ranking minority members, by January 15, 2013.

Section 26 directs the Health Services Advisory Council to review literature on the efficacy of various treatments of autism spectrum disorder, and recommend to the Commissioner of Human Services authorization criteria for services based on existing evidence, by December 31, 2012.  Allows the council to recommend coverage with ongoing collection of outcomes evidence, in circumstances where evidence is currently unavailable or the strength of evidence is low.

Section 27 eliminates certain reporting requirements related to the evidence-based childbirth program and provider networks adequacy.

Section 28 requires the Commissioner of Human Services to develop a plan to provide coordinated and cost-effective health care and coverage for individuals who are eligible for Emergency Medical Assistance, and to submit the plan to the legislature by January 15, 2013.

Section 29 provides coverage for dialysis services and chemotherapy and related services under Emergency Medical Assistance from May 1, 2012, until June 30, 2013.

Section 30 requires the Commissioner of Human Services to develop recommendations to implement a revised cost-sharing structure for state public health care programs and report back to the legislature by January 15, 2013.

Section 31 requires the Commissioner of Human Services to contract with an independent vendor to evaluate the value of managed care for state public health care programs.  Part of the evaluation must consider the need to continue the requirement for HMOs to participate in the Medical Assistance and MinnesotaCare programs as a condition of licensure.  The evaluation must be reported to the legislature by January 15, 2013.

Section 32 repeals:  Minnesota Statutes, sections 62M.09, subdivision 9 (medical necessity denials and appeals report); and 62Q.64 (salary reports; and a rule requiring a summary of complaints and grievances).

Article 2

Department of Health

Section 1 (62Q.80) makes changes to the community-based health care coverage program by removing references to the program by removing references to the program being a demonstration project, removing references to demonstration project grants, removing the sunset date, and removing oversight by the Commissioner of Human Services.

Section 2 (144.1222, subdivision 5) creates an exception from the swimming pool regulations for a naturally treated swimming pool located in the city of Minneapolis.  The pool would still have to meet drain cover and inspection requirements.

Section 3 (144.1225, subdivision 1) defines advanced diagnostic imaging services.  The definition does not include computed tomography, x-ray, ultrasound, or fluoroscopy.

Subdivision  2, paragraph (a), states that in order to be eligible for reimbursement from any source, including health insurance, worker compensation insurance, automobile insurance, the state employee group insurance program, and other state health care programs, advanced diagnostic imaging services must be conducted and processed in a facility that is accredited by one of the specified entities.  The accreditation standards recognized under this section must include:  (1) provisions establishing qualifications of the physician; (2) standards for quality control and routine monitoring by a medical physicist; (3) qualifications of the technologist; (4) guidelines for personnel and patient safety; and (5) standards for initial and ongoing quality control using clinical image review and quantitative testing.

Paragraph (b) requires any facility currently performing advanced diagnostic imaging services to obtain accreditation by August 1, 2013, if they want reimbursement by the programs listed in paragraph (a).  After this date, all facilities that provide these services must obtain accreditation before commencing operations and must maintain accreditation with an accrediting organization.

Subdivision 3 requires advanced diagnostic imaging facilities and providers of advanced diagnostic imaging services to annually provide the commissioner with evidence of accreditation.  Authorizes the commissioner to promulgate rules to administer the required reporting.

Section 4 (144.292, subdivision 6) modifies a provision related to the cost of providing a patient with copies of a health record. Permits providers to charge a $10 retrieval fee, but not the per page copying fee for copies if requested by a patient for purposes of appealing a denial of certain Social Security benefits. Provides that no fee can be charged to persons who are on public assistance, or are represented by legal services or a volunteer attorney.

Section 5 (144.298, subdivision 2) establishes liability for an intentional, unauthorized access of patient health records, or intentionally accessing a record locator service without authorization.

Section 6 (144.5509) Paragraph (b) creates an exception to the current moratorium to allow the relocation of a radiation therapy machine from a hospital in Maplewood to a hospital in Woodbury.

Paragraph (c) creates a modification to the radiation therapy facility construction moratorium beginning August 1, 2014.  After this date, a facility located in the specified 14 counties may only be constructed if the entity constructing the radiation therapy   facility is controlled by or under common control with a licensed hospital and the new facility is located at least seven miles from an existing radiation therapy facility.

Paragraph (d) requires any referring physician to provide each patient with a list of all radiation therapy facilities located within a 14-county area, and requires physicians with a financial interest in a radiation therapy facility to disclose to the patient the interest.

Paragraph (e) defines "controlled by" or "under common control with."

Paragraph (f) defined "financial interest in any radiation therapy facility."

Paragraph (g) creates an exception for the relocation or reconstruction of an existing facility.

Section 7 (145.881) requires the commisisoner to reestablish the maternal and child health advisory task force.

Section 8 (145.906) requires the commissioner to work with the WIC program to make information about postpartum depression available at WIC sites.

Section 9 requires the Commissioners of Health and Human Services to update information on websites related to certain licensed facilities and services to provide consistent clear information to providers. Requires the commissioner of management and budget to evaluate and make recommendations as to whether to reorganize certain regulatory functions within the Departments of Health and Human Services.

Section 10 requires the Commissioner of Health in consultation with the e-Health Advisory Committee, to study the unauthorized access to patient’s health records and report to the legislature with recommendations by February 15, 2013.

Section 11 requires the Commissioner of Health to publicly report data on the prevalence and incidence of sexual violence in Minnesota using data provided by Centers for Disease Control and Prevention, to the extent federal funding is available for this purpose.

Section 12 requires the Commissioner of Health to make recommendations to the legislature by February 1, 2013, as to development of a plan for regulation of licensed home care providers.

Section 13 requires the Commissioners of Health and Commerce to make recommendations on maximizing administrative efficiency in regulation of health maintenance organizations, county-based purchasers, health carriers, and related entities while maintaining quality health outcomes, regulatory stability, and price stability, and report to the legislature by February 15, 2013.

Section 14 requires the Commissioner of Health to study the current treatment capacity of existing radiation facilities; the present need for these services; and the projected need in the next ten years.  Permits the commissioner to contract with a qualified entity to conduct the study.

Section 15 requires the Commissioner of Health to distribute $300,000 to Gillette Children’s Specialty Healthcare before making the required medical education fund distribution for the fiscal year 2013 distribution.  This is effective upon federal approval.

Article 3

Children and Family Services

Section 1 (119B.13, subdivision 7) modifies the child care assistance ten absent day policy for reimbursement to allow more absent days for children in families where at least one parent is (1) under the age of 21; (2) does not have a high school diploma or GED; and (3) is a student in a school district or similar program that provides or arranges child care, and other supportive services.

Section 2 (256.01, subdivision 18c) requires the State Court Administrator to provide to the Commissioner of Human Services a report every six months of each individual convicted of a felony under chapter 152 (controlled substances).  Requires the commissioner to determine whether any of the individuals are receiving public assistance under chapter 256D or 256J, and for those individuals instruct the counties to proceed under section 256D.024 or 256J.26, whichever is applicable.  Also requires the State Court Administrator to provide a onetime report for individuals with a felony drug conviction dated from July 1, 1997, until the date of transfer. Provides a July 1, 2013, effective date.

Section 3 (256.01, subdivision 18d) requires the Commissioner of Public Safety to, on a monthly basis,  provide the Commissioner of Human Services with information of all applicants and holders whose drivers’ licenses and state identification cards have been canceled by the Commissioner of Public Safety.  Requires the Commissioner of Human Services to compare this information with the data on recipients of all public assistance programs to determine whether any person has illegally or improperly enrolled in any public assistance programs.  Requires the commissioner to provide all due process protections to the person before terminating the person from the applicable program and notifying the County Attorney.  Provides a July 1, 2013 effective date.

Section 4 (256.01, subdivision 18e) requires the Commissioner of Public Safety on a monthly basis to provide the Commissioner of Human Services with information on all applicants and holders of drivers’ licenses and state identification cards whose temporary legal presence status has expired and whose license or identification card has been canceled by the Commissioner of Public Safety.  Requires the commissioner to use this information to determine whether the eligibility of any recipient of public assistance programs has changed due to status change in this data.  Requires the commissioner to provide all due process protections to the individual before terminating the individual from the program and notifying the County Attorney.  Provides a July 1, 2013 effective date.

Section 5 (256.9831, subdivision 2) adds liquor stores, tobacco stores, and tattoo parlors to the list of locations at which no person may obtain cash benefits through the use of an EBT card.

Section 6 (256.987, subdivision 1) modifies EBT legislation passed last session, which required a separate EBT card for cash benefits.  This section allows cash benefits and food assistance to be issued on the same EBT card.

Section 7 (256.987, subdivision 2) modifies the prohibition on using the EBT card to purchase tobacco products and alcoholic beverages and imposes penalties under Section 9.

Section 8 (256.987,  subdivision 3) limits use of the cash portion of EBT cards to Minnesota and surrounding states. This section is effective March 1, 2013.

Section 9 (256.987, subdivision 4) disqualifies anyone found to be guilty of using an EBT card to purchase prohibited items for one year for the first offense, two years for the second offense, and permanently for the third offense.  Specifies the needs of the disqualified individual shall not be taken into consideration in determining the grant fund level for that assistance unit.  This section is effective June 1, 2012.

Section 10 (256D.06, subdivision 1b) increases the general assistance earned income savings disregard from $150 to $500 per month for certain specified persons, and increases the maximum amount in the savings account that must be disregarded from asset limits from $1,000 to $2,000. This section is effective October 1, 2012.

Sections 11 and 12 (256E.35, subdivisions 5 and 6) modify the family assets for independence program, by reinstating language that was stricken last session regarding state and federal TANF matching funds.

Section 13 (256E.37, subdivision  1) directs 80 percent of grant funds to construct or rehabilitate facilities for early childhood programs, crisis nurseries, or parenting time centers to facilities located in counties outside of the seven-county metro area.

Section 14 (256I.05, subdivision  1a)  prohibits counties from negotiating supplementary service rates with GRH providers that do not make referrals to available community services for volunteer and employment opportunities for residents.

Section 15 (256I.05, subdivision  1e) requires a county agency to negotiate a supplementary rate, not to exceed $700 per month, including any legislatively authorized inflationary adjustments, for a certain GRH provider, not to exceed an additional 115 beds.

Section 16 (256J.26, subdivision 1) modifies the MFIP eligibility criteria for individuals convicted of a drug offense. Requires individuals who have been convicted of a felony drug offense within the past ten years to have benefits vendor paid and to submit to random drug testing. Currently, individuals who have had a drug conviction anytime since July 1, 1997, must have benefits vendor paid and submit to random drug testing.  Modifies the definition of “drug offense” to include the felony offense for manufacturing or attempting to manufacture methamphetamine in the presence of a child or vulnerable adult.  Makes this section effective October 1, 2012, for all new MFIP applicants who apply on or after that date and for all recertifications occurring on or after that date.

Section 17 (256J.26, by adding subdivision 5) requires counties to cease MFIP vendor payments for rent to a landlord when a MFIP assistance unit’s housing unit has been deemed uninhabitable. Prohibits a landlord who is required to return vendor paid rent or who is prohibited from receiving future rent under this subdivision from taking an eviction action against anyone in the MFIP assistance unit.

Sections 18 to 22 modify the Minnesota Family Investment Program, specifically the family stabilization services.

Section 18 (256J.575, subdivision 1) strikes the paragraph that specifies the goal of family stabilization services.

Section 19 (256J.575, subdivision 2) deletes the definition of “case manager” and “case management,” and modifies the definition of the term “family stabilization services.”

Section 20 (256J.575, subdivision 5) strikes references to the case management model, and strikes language specifying what the family stabilization plan must include. New language requires the county agency to meet with the participant within 30 days to develop a plan, and requires that the participants have access to employment and training services.

Section 21 (256J.575, subdivision 6) strikes references to case management, and requires the county agency to review the participant’s progress toward the participant’s goals every six months. 

Section 22 (256J.575, subdivision 8) strikes language specifying that persons who are working for a certain number of hours per month are no longer part of family stabilization services.

Section 23 (626.5533) requires a peace officer to report to the head of the officer’s department every arrest where a person possesses multiple electronic benefit transfer (EBT) cards.  The report must include: the offender’s name, license or ID number, and home address; name and number on each EBT card; date and location of offense; crime committed; and any other information deemed necessary.  The law enforcement agency must forward the report to the Commissioner of Human Services within 30 days to be used by the commissioner in assessing the person’s continued eligibility for benefits.  Finally, it directs the Commissioner of Human Services, in consultation with the Bureau of Criminal Apprehension, to adopt reporting forms.

Section 24 (626.556, subdivision 10n) modifies the Maltreatment of Minors Act, requiring that a child under age three who is involved in a substantiated case of maltreatment be referred for screening under the Individuals with Disabilities Act, Part C.  Parents must be informed that the evaluation and acceptance of services are voluntary.  Within available appropriations, the commissioner must monitor referral rates by the county and annually report to the Legislature, beginning March 15, 2014.

Section 25 (Laws 2010, chapter 374, section  1) modifies the membership of the task force, modifies the duties of the task force, extends the expiration date of the task force to June 1, 2014, and makes this section effective the day following final enactment.

Section 26 modifies TANF maintenance of effort amounts and federal child care development funds appropriations.

Section 27 Minnesota Visible Child Work Group.

Subdivision 1. Purpose.  Establishes the Minnesota visible child work group to identify and recommend issues that should be addressed in a statewide, comprehensive plan to improve the well-being of children who are homeless or have experienced homelessness.

Subdivision 2. Membership.  Lists the members of the work group.

Subdivision 3. Duties.  Lists the duties of the work group.

Subdivision 4. Work group convening and facilitation. Specifies the organizations that will staff the work group.

Subdivision 5. Report.  Requires the work group to make recommendations related to the duties under subdivision 3 to the legislative committees with jurisdiction over education, housing, health, and human services policy and finance by December 15, 2012.  Requires the recommendations to also be submitted to the Children’s Cabinet to provide the foundation for a statewide visible child plan.

Subdivision 6.  Expiration.  Specifies the work group expires on June 30, 2013.

Section 28 (Uniform Asset Limit Requirements) requires the Commissioner of Human Services, in consultation with others, to analyze the various asset limits within programs administered by the commissioner and to establish a consistent asset limit across human services programs to minimize the administrative burdens on counties in implementing asset tests. Requires the commissioner to report the findings and conclusions to the legislature by January 15, 2013, and include draft legislation establishing a uniform asset limit for human services assistance programs.

Section 29 (Direction to the Commissioner) instructs the Commissioner of Human Services, in consultation with the commissioner of public safety, to issue a report to the legislature regarding implementation of section 256.01, subdivisions 18c, 18d, and 18e. Requires the report to be submitted no later than December 1, 2013.

Section 30 (Revisor’s Instruction) instructs the Revisor to change certain specified terms in statute. Allows the Revisor to make changes necessary to correct the punctuation, grammar, or structure of the remaining text and preserve its meaning.

Article 4

Continuing Care

Section 1 (62J.496, subdivision  2)  adds nursing facilities certified to participate in the MA program and certain elderly waiver providers to the list of providers receiving priority for the electronic health record system revolving loan program.

Section 2 (144A.073) adds a new subdivision that allows the MDH to approve an exception to the nursing facility moratorium if the full annualized share of Medical Assistance costs does not exceed $1 million.

Section 3 (144A.351) modifies an annual report on long-term care services to include consultation with stakeholders and information on the status of long-term care supports for persons with disabilities and mental illnesses.

Section 4 (144D.04, subdivision 2) modifies what must be included in a housing with services contract.

Section 5 (245A.03, subdivision 6a) adds a new subdivision instructing DHS to develop an optional certification process for adult foster care homes that serve people with mental illness. The proposed certification is for licensed adult foster care homes where the license holder does not primarily reside at the licensed home. 

All staff are required to meet certain training requirements, and must receive seven hours of training each year. The following are required for certification: the availability of mental health professionals and practitioners for consultation; a plan and protocol in place to address a mental health crisis; and an individual crisis prevention and management plan in each person’s Individual Placement Agreement.  The new subdivision creates the certification request process and an ongoing compliance review by the county licensing agency.  Certification denials are not subject to appeal, but applicants may reapply once all requirements are met.

Section 6 (245A.03, subdivision 7) allows DHS to de-license up to 128 adult foster care beds by June 30, 2014, under certain circumstances using a needs determination process.  Requires DHS to work with stakeholders in collecting data on long-term care services and supports capacity, and provide information by February 1 of each year.  Exempts adult foster care homes certified for people with mental illness, along with other residential settings, from bed closure requirements.

Section 7 (245A.11, subdivision 2a) exempts adult foster care homes from the four-bed license maximum, allowing a fifth bed for respite services, with certain staffing, time-restriction, and notification requirements.

Section 8 (245A.11, subdivision 7) clarifies that to receive a variance for alternate oversight supervision, the adult foster care license holder must not have had a conditional license issued or other licensing sanctions.

Section 9 (245A.11, subdivision 7a) clarifies certain requirements in order to receive an adult foster care home license where a caregiver is not present during normal sleeping hours.  It outlines license application review timelines and processes, and approval or denial timelines and processes.

Section 10 (245B.07, subdivision  1) prohibits license holders from being sanctioned or penalized financially for not having a current individual service plan in the consumer's data file if the case manager fails to provide the plan after receiving a written request from the license holder.

Section 11 (245C.04, subdivision 6) exempts providers of both licensed and unlicensed home and community-based waiver services from repeating annual background studies under certain conditions.

Section 12 (245C.05, subdivision 7) specifies that a probation officer or corrections agent must notify DHS of an individual’s conviction if the individual has been affiliated in the preceding year with: a program or facility regulated by DHS or MDH; a youth facility licensed by the Department of Corrections; or any type of home care agency or personal care assistance provider.

Section 13 (252.27, subdivision 2a) modifies the TEFRA family contribution statute by extending from 2013 to 2015 the current parental fee schedule.

Section 14 (256.975, subdivision 7) requires the Senior LinkAge Line to develop processes to assist health care homes and hospitals to identify at-risk older adults, and determine when long-term care counseling is appropriate.

Section 15 (256B.056, subdivision 1a) adds a cross-reference for language related to changes made to the Medical Assistance for Employed People with Disabilities (MA-EPD), effective April 1, 2012.

Section 16 (256B.056, subdivision 3) disregards, for Medical Assistance (MA) eligibility purposes, the assets and spousal income, up to certain limits, of MA-EPD participants who turn 65 years of age and have been enrolled in MA-EPD for at least 24 consecutive months, effective April 1, 2012.

Section 17 (256B.057, subdivision 9) removes age limits for the MA-EPD program, effective April 1, 2012.

Section 18 (256B.0659, subdivision 11) delays the 20 percent relative PCA rate reduction until July 1, 2013.

Section 19 (256B.0659) adds a subdivision requiring PCA agencies to allow DHS access to records when investigating Medicaid overpayment.

Section 20 (256B.0911, subdivision 3a) allows providers of elderly waiver and customized living services to provide input during assessments and reassessments.

Section 21 (256B.0911, subdivision 3c) requires housing with services establishments to inform a prospective resident or their legal representative of the long-term care options counseling requirement and the opportunity to decline the counseling. Changes to the list of circumstances when consultation services are required within five working days are also made. 

Section 22 (256.0911, subdivision 3d) adds a new subdivision exempting long-term care consultation requirements under certain circumstances.

Section 23 (256B.0911, subdivision 3e) adds a new subdivision requiring a long-term care consultation at the time of hospital discharge, effective October 1, 2012.

Section 24 (256B.0915, subdivision 3e) allows customized living providers to have input during the documented needs process.

Section 25 (256B.0915, subdivision 3h) allows 24-hour customized living providers to have input during the documented needs process.

Section 26 (256B.092, subdivision 1b) states that changes to a consumer’s services should serve as an addendum to the consumer’s individual service plan.

Section 27 ( 256B.092, subdivision  7) allows a person’s current provider of services to submit a written report outlining recommendations for the person’s care needs.  Requires the screening team to notify the provider of the date by which the information must be submitted.  Requires the information to be submitted to the screening team and the person or person’s legal representative and to be considered prior to the finalization of the screening.

Section 28 (256B.097, subdivision 3) requires the State Quality Council to identify financial and personal risk issues that prevent people with disabilities from optimizing community-based services and recommend statutory and rule changes to the Legislature by January 15, 2013.

Section 29 (256B.431, subdivision 17e) allows the replacement-costs-new per bed amount to increase under the nursing facility moratorium exception in section 3, beginning October 1, 2012.

Section 30 (256B.431, subdivision 45) adds a new subdivision allowing a rate adjustment for certain nursing facilities under the moratorium exception, effective upon federal approval.

Section 31 (256B.434, subdivision 10) removes a reference to a subdivision being repealed from the list of exemptions for nursing facilities participating in the Alternative Payment Demonstration Project.

Section 32 (256B.441, subdivision 63) adds a new subdivision creating a critical access designation for nursing facilities. DHS will work with the MDH and stakeholders in establishing the designation proposal process, and grant the designation on a competitive basis.

DHS will request designation proposals every two years. Facilities currently designated may apply for continued designation; if the continued designation is not granted, the benefits listed below will no longer apply.

Section 33 (256B.48, subdivision 6a) adds a new subdivision requiring nonMedicare participating nursing facilities to refer dual-eligible (Medicare and Medicaid) recipients qualifying for Medicare-covered stay to Medicare providers.

Section 34 (256B.49, subdivision 14) allows a recipient’s current provider of services to submit a written report outlining recommendations for the person’s care needs.  Requires the person conducting the assessment or reassessment to notify the provider of the date by which the information must be submitted.  Requires the information to be submitted to the person conducting the assessment and the person or the person’s legal representative and to be considered prior to the finalization of the assessment or reassessment.

Section 35 (256B.49, subdivision 15) allows licensed adult foster care capacity to not be reduced if savings realized through the licensed bed closure reductions for foster care settings are met.

Section 36 (256B.49, subdivision 23) specifies that the definition of “community-living settings” includes the existence of a lease agreement between the service recipient and the landlord; requires the service provider to transfer the lease to the service recipient, and allows an exemption to this requirement if the landlord is not willing to transfer the lease.

Section 37 (256B.492) describes, for people receiving home and community-based waiver services, the types and characteristics of living settings both allowed and not allowed in order to receive services.  People receiving home and community-based waiver services whose living settings are not allowed under the new criteria are grandfathered in.

Section 38 (256B.493) adds a new section establishing an adult foster care closure program, requiring DHS to seek proposals for the conversion of services for persons with developmental disabilities to other community settings and submit a report to the Legislature by February 15, 2013 on the inventory of assessed needs and total license capacity.  The section outlines the process for voluntary closure of adult foster care homes if the total licensed capacity is deemed in excess of the assessed need.

Section 39 (256B.5012, subdivision 13) delays the ICF/DD contingent rate reduction by one year.

Section 40 (256D.44, subdivision 5) requires service providers for those deemed shelter needy and who meet certain requirements to transfer the lease to the service recipient within two years, and allows an exemption to this requirement if the landlord is not willing to transfer the lease.  Also sets the maximum number of units in a building utilized by general assistance recipients to be four units, or 25 percent, whichever is greater.

Section 41 (Laws 2011, First Special Session chapter 9, article 7, section 52) provides for federal approval of the nursing facility level of care after July 1, 2012.

Section 42 (Laws 2011, First Special Session chapter 9, article 7, section 54) delays continuing care provider contingent rate reductions by one year.

Section 43 (Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision 3)  requires lead agencies to consult with providers to identify changes to reduce services while still maintaining health and safety of individuals; and allows a reduced congregate living rate reduction if a federal waiver is granted.

Section 44 (Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision 4) designates $100,000 for administrative services and $400,000 for data collection and analysis related congregate living grants.

Section 45 requires DHS to allow 15-minute and daily rate billing for independent living services under the Brain Injury (BI) and Community Alternatives for Disabled Individuals (CADI) waivers, and instructs DHS to submit a waiver amendment to the state plan to the federal government, if required.

Section 46 requires the Commissioner of Human Services by September 1, 2012, to submit amendments to the home and community-based waiver plans consistent with the definition of home and community-based settings, including a request to allow certain exceptions. 

Section 47 requires the Commissioner of Human Services by July 1, 2012, to request an amendment to the home and community-based services waiver for persons with disabilities to establish an exception to the consumer-directed community supports budget methodology to provide up to 20 percent more funds for certain participants.  Makes the exception process effective upon federal approval for persons eligible during 2013 and 2014. Makes this section effective the day following final enactment.

Section 48 directs the ombudsman for long-term care to (1) research the existence of differential treatment based on source of payment in assisted living settings, (2) convene stakeholders to provide technical assistance and expertise in studying and addressing these issues, and (3) submit a report of findings to the legislature by January 31, 2013, with recommendations for the development of policies and procedures to prevent and remedy instances of discrimination based on participation in or potential eligibility for MA.

Section 49 directs the Commissioner of Human Services to study the feasibility of licensing PCA services and issue a report to the legislature by January 15, 2013.

Section 50 directs DHS to study models of housing with supports for children with autism, with a report due to the legislature by January 15, 2013.

Section 51 repeals sections related to the nursing home moratorium exception and non-Medicare certified nursing home provisions, and an administrative rule to conform to federal regulations.

Article 5

Miscellaneous

Section 1 (62A.047) clarifies that a health carrier may use a network of providers and impose cost-sharing requirements for out-of-network providers and use reasonable medical management techniques to determine frequency, method, treatment or setting for child health supervision services and prenatal care services.  This section is effective for policies issued or renewed on or after August 1, 2012, and expires June 30, 2013.

Section 2 (245.697, subdivision 1) strikes the specific member number on the council and adds marriage and family therapy and professional clinical counseling  to the list of core mental health professionals on the State Advisory Council on Mental Health. 

Section 3 (254A.19, adding subdivision  4) relieves the county of requirement to perform a Rule 25 chemical dependency assessment when an individual is being civilly committed as a chemically dependent person, in order to be eligible for consolidated chemical dependency treatment funds (CCDTF).  The county must determine if the individual meets the financial eligibility requirements for CCDTF. 

Section 4 (256B.0943, subdivision 9) eliminates the requirement that day treatment programs for children have a county contract and deletes an obsolete reference to the Adult Mental Health Act.

Section 5 (518A.40, subdivision  4) modifies the child support chapter of law by allowing the public authority to stop collecting child care support if either party informs the public authority no child care costs are being incurred and the obligee verifies the information, or the obligee fails to respond to a written request for information about child care costs.

Section 6 corrects a subtracting error from last session to the base adjustment for the administrative services unit.

Section 7 (Foster Care Licensing Moratorium Exception for Autism Authorization)  requires the Commissioner of Human Services to identify and coordinate with one or more counties that agree to issue a license for foster care for certain individuals with autism.  The commissioner shall coordinate with interested counties and issue a request for information to identify providers who have training and skills to meet the needs of individuals identified in this section.

Section 8 (Chemical Health Integrated Model of Care Development) instructs the commissioner to work with stakeholders and counties to develop a plan to more efficiently and effectively provide chemical dependency services.  Requires a report to the legislature no later than March 15, 2013.

Section 9 encourages the Board of Regents of the University of Minnesota to include a request for funding as part of the biennial budget request to the Department of Management and Budget for rural primary care training delivered by family practice residence programs.

 

 

 
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