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H.F. No. 1406 - Continuing Care Provisions (Second Engrossment)
 
Author: Senator Sean R. Nienow
 
Prepared By:
 
Date: May 19, 2011



 
Article 1 – Telephone Equipment Program
Section 1 (237.50) updates definitions within the Telephone Equipment Distribution (TED) program.
Section 2 (237.51) updates terminology within the Telecommunications Access Minnesota program, provides devices based on assessed need, and requires any advisory board to have at least one member who has a physical disability making access to telecommunication services difficult.
Section 3 (237.52) updates terminology within the Telecommunications Access Minnesota fund and clarifies a reference to the Public Utilities Commission (PUC).
Section 4 (237.53) updates terminology regarding telecommunication devices, removes requirement for telephone companies to install outside wiring to certain households, and requires the establishment of policies and procedures for the return of equipment once recipients are ineligible for the program.
Section 5 (237.54) updates terminology regarding telecommunications relay services (TRS) and requires TRS providers to comply with FCC regulations and inform persons with communication disabilities and the public on the availability and use of TRS.
Section 6 (237.55) updates terminology and clarifies a reference to the PUC.
Section 7 (237.56) updates terminology and clarifies who may participate in the consumer protection process.
 
 
 
Article 2 – Disability Services
Section 1 (245A.03, subdivision 7) provides for an exception to the child care licensing moratorium due to nursing facility, intermediate care facility for the mentally retarded, or regional treatment center downsizing. This section requires child care license applicants (or those reapplying for licensure) to specify whether the physical location is or will be the primary residence of the license holder. This section also specifies requirements of license holders who also provide services in the foster care home that are covered by a federally approved home and community-based waiver (HCBW).
Section 2 (245A.11 subdivision 8) postpones for one year proposed statutory language changes and an implementation plan for licensing requirements for residential support services.
Section 3 (252.32, subdivision 1a) makes families receiving services under the HCBW for persons with disabilities, personal care assistance (PCA) services, or a consumer support grant ineligible to receive a family support grant.
Section 4 (252.34) requires the Commissioner of Human Services to submit one biennial report to the Legislature that contains the overarching goals and priorities for individuals with disabilities.
Section 5 (252A.21, subdivision 2) removes a requirement that the guardianship rule address quarterly reports for public wards.
Section 6 (256.476, subdivision 11) modifies the methodology used to calculate the maximum allowable monthly consumer support grant.
Section 7 (256B.0625, subdivision 19c) clarifies references.
Section 8 (256B.0659, subdivision 1) modifies the extended PCA service definition.
Section 9 (256B.0659, subdivision 3) clarifies language and removes an obsolete date.
Section 10 (256B.0659, subdivision 9) modifies the list of persons prohibited from being the “responsible party.”
Section 11 (256B.0659, subdivision 11) removes obsolete language and makes technical changes.
Section 12 (256B.0659, subdivision 13) postpones the effective date, by one year, of certain training requirements for qualified professionals. Makes technical and clarifying changes regarding the requirements of the training. Requires qualified professionals working for a Medicare-certified home health agency to successfully complete the competency test.
Section 13 (256B.0659, subdivision 14) makes technical changes, modifies the list of activities that are not eligible for medical assistance (MA) payment as qualified professional services, and allows the professional to conduct additional training and evaluation visits.
Sections 14 (256B.0659, subdivision 19) modifies the list of PCA choice provider agency requirements.
Section 15 (256B.0659, subdivision 21) modifies requirements related to employee training. Requires Medicare-certified home health agency owners, supervisors, and managers to successfully complete the competency test.
Section 16 (256B.0659, subdivision 30) places a sunset date of January 1, 2012, on a requirement to provide notice of changes in MA PCA services to each affected recipient at least 30 days before the effective date of the change.
Section 17 (256B.0916, subdivision 7) sunsets an annual reporting requirement related to the developmental disability (DD) waiver on January 1, 2012. This reporting requirement is replaced by the new report created under section 4.
Section 18 (256B.092, subdivision 11) makes providers licensed to provide child foster care or adult foster care registered under this section.
Section 19 (256B.096, subdivision 5) sunsets a biennial reporting requirement related to the quality management, assurance, and improvement system on January 1, 2012. This reporting requirement is replaced by the new report created under section 4.
Section 20 (256B.49, subdivision 21) sunsets an annual reporting requirement related to home and community-based waivers on January 1, 2012. This reporting requirement is replaced by the new report created under section 4.
Section 21 (256B.4912, subdivisions 1 through 7):
  • modifies provider qualifications for the home and community-based waivers;
  • defines "home and community-based service providers" and "home and community-based service administrators;”
  • establishes payment rate criteria;
  •  requires an exception process for certain persons with special needs in the payment structures and methodologies;
  • allows the commissioner to limit the number of people who share waiver and day services, and requires the payment structures and methodologies to reflect the option to share services within the limits established by the commissioner;
  • requires the commissioner to define roles and responsibilities of home and community-based service administrators; and
  • requires the commissioner to consult with existing advisory groups to develop and test processes, roles, and rate-setting methodologies, and to report to the Legislature by January 15, 2012, with recommendations for statutory changes for full implementation by January 1, 2013.
Section 22 requires the Commissioner of Human Services to prepare and provide recommendations for streamlining administrative oversight, financial management, and payment protocols for various consumer-directed services administered through the commissioner. Requires the commissioner to report to the Legislature by January 15, 2012, with the recommendations prepared under this section.
Article 3 – Comprehensive Assessment and Case Management Reform
Section 1 (256B.0659, subdivision 1) modifies the definitions of "Level I behavior."
Section 2 (256B.0659, subdivision 2) clarifies coverage of PCA services to align with current policy and the comprehensive assessment.
Section 3 (256B.0659, subdivision 3a) clarifies who can do PCA assessments and adds a sunset date to the subdivision. Makes timelines for completing assessments consistent with all assessments identified in the long-term care statute.
Section 4 (256B.0659, subdivision 4) modifies the list of limitations that apply to PCA assessments.
Section 5 (256B.0911, subdivision 1) makes technical and clarifying changes to the purpose and goal of long-term care consultation services.
Section 6 (256B.0911, subdivision 1a) modifies the definition of "long-term care consultation services."
Section 7 (256B.0911, subdivision 2b) makes this section effective upon completion of training and certification requirements for certified assessors. Removes language requiring assessors to be part of a multidisciplinary team and removes requirements related to assessments for persons with complex health care needs.
Section 8 (256B.0911, subdivision 2c) sets the timeline for required training and certification for certified assessors.
Section 9 (256B.0911, subdivision 3) continues the requirement that counties must have long-term care consultation teams, and specifies that certified assessors must be part of a multidisciplinary team and specifies the other professionals that must be part of the team. Adds a reference to tribes.
Section 10 (256B.0911, subdivision 3a) specifies who must be consulted for persons with complex health care needs. Adds language specifying the information that must be included in the written community support plan. Modifies the list of information that must be provided to the person receiving the assessment. Makes technical changes.
Section 11 (256B.0911, subdivision 3b) makes technical and conforming changes and modifies lead agency duties related to transition assistance.
Section 12 (256B.0911, subdivision 3c) makes technical and conforming changes.
Section 13 (256B.0911, subdivision 4a) makes technical and conforming changes.
Section 14 (256B.0911, subdivision 4c) makes technical and conforming changes.
Section 15 (256B.0911, subdivision 6) adds a cross-reference. Removes a cross-reference. Clarifies that until a new payment methodology is implemented, payment for assessments will continue to be billed as it is currently.
Section 16 (256B.0913, subdivision 7) makes technical and conforming changes and specifies case manager responsibilities.
Section 17 (256B.0913, subdivision 8) makes technical and conforming changes. Specifies the requirements the coordinated services and support plan must meet.
Section 18 (256B.0915, subdivision 1a) modifies the activities included in case management services. Requires case managers to collaborate with specified persons in the development and review of the coordinated services and support plan. Requires case management services to be provided by either a public or private agency. Defines "private agency." Lists the activities included under case management services. Requires the health plan to provide or arrange to provide  EW case management services for certain enrollees of prepaid MA programs.
Section 19 (256B.0915, subdivision 1b) makes a conforming change.
Section 20 (256B.0915, subdivision 3c) makes a conforming change.
Section 21 (256B.0915, subdivision 6) lists the requirements related to coordinated services and support plan.
Section 22 (256B.0915, subdivision 10) makes technical and conforming changes.
Section 23 (256B.092, subdivision 1) requires a certified assessor to conduct needs assessments for people diagnosed as having a developmental disability.
Section 24 (256B.092, subdivision 1a) removes language related to the administrative functions of case management. Requires home and community-based waiver recipients to be provided case management services by qualified vendors as described in the federally approved waiver application. Modifies the list of case management service activities. Requires case management services to be provided by either a public or private agency. Defines "private agency." Makes technical and conforming changes.
Section 25 (256B.092, subdivision 1b) requires each recipient of case management services and any legal representative to be provided a written copy of the coordinated service and support plan and specifies requirements of the plans.
Section 26 (256B.092, subdivision 1e) makes technical and conforming changes.
Section 27 (256B.092, subdivision 1g) makes technical and conforming changes.
Section 28 (256B.092, subdivision 2) makes a conforming language change.
Section 29 (256B.092, subdivision 3) makes technical and conforming changes and adds a cross-reference to long-term care consultations.
Section 30 (256B.092, subdivision 5) makes conforming changes to terminology.
Section 31 (256B.092, subdivision 7) requires assessments and reassessments to be conducted by certified assessors according to the long-term care consultation statute, and requires assessments and reassessments to incorporate appropriate referrals to determine eligibility for case management. Makes technical and conforming changes. Removes language related to screening teams and case manager responsibilities.
Section 32 (256B.092, subdivision 8) modifies the certified assessor's duties for persons with developmental disabilities.
Section 33 (256B.092, subdivision 8a) modifies the procedure by which a county of financial responsibility places a person in another county for services. Specifies that this section also applies to the  community alternative care (CAC), community alternatives for disabled individuals (CADI), and traumatic brain injury (TBI) waivers.
Section 34 (256B.092, subdivision 9) makes technical and conforming changes related to changes in terminology.
Section 35 (256B.092, subdivision 11) makes technical and conforming changes related to changes in terminology.
Section 36 (256B.49, subdivision 13) modifies the list of case management service activities for the CAC, CADI, and TBI waivers. Prohibits the case manager from delegating certain duties. Requires case management services to be provided by either a public or private agency. Defines "private agency."
Section 37 (256B.49, subdivision 14) requires assessments and reassessments for CAC, CADI, and TBI services to be conducted by certified assessors according to the long-term care consultation statute.
Section 38 (256B.49, subdivision 15) aligns the coordinated service and support plan requirements for recipients of waivers under this section with the requirements for recipients of the DD waiver.
Section 39 (256G.02, subdivision 6) removes a reference to the PCA program from the definition of "excluded time" under the unitary residence and financial responsibility chapter.
Section 40 requires the commissioner to develop a legislative report with specific recommendations and language for proposed legislation to be effective July 1, 2012, for further case management redesign. Specifies what must be included in the recommendations and proposed legislation.
 
Article 4 – Nursing Facilities
Section 1 (144A.071, subdivision 3) creates a process, and lists the criteria, under which the Commissioner of Health, in coordination with the Commissioner of Human Services, may approve the addition of new licensed and certified nursing home beds. Specifies the criteria to be used to determine that an area of the state is a hardship area with regard to access to nursing facility services. Specifies the process to be used in designated hardship areas to add beds.
Section 2 (144A.073, subdivision 3c) requires the Commissioner of Human Services to determine the allowable payment rates of the facility receiving beds in relocation projects. Removes language exempting proposals approved under this subdivision from the six-mile limit.
Section 3 (144A.073, subdivision 4a) sets the criteria for review under the nursing facility moratorium process.
Section 4 (144D.08) makes this section not applicable to certain establishments serving the homeless.
Section 5 (256B.19, subdivision 1e) clarifies the start date of the intergovernmental transfer program, provides for the continuation of the program when the phase-in of rebasing is complete and specifies a replacement limit to go into effect at that time, and allows the commissioner to revoke participation rather than withhold funds in the event that an owner fails to make a timely payment of the nonfederal share.
Section 6 (256B.431, subdivision 2t) updates resident reimbursement classifications from resource utilization group (RUG) RUG-III to RUG-IV case-mix effective January 1, 2012.
Section 7 (256B.438, subdivision 1) updates cross-references and updates resident reimbursement classifications from RUG-III to RUG-IV effective January 1, 2012.
Section 8 (256B.438, subdivision 3) requires the commissioner to assign a case-mix index to each resident class based on the Centers for Medicare and Medicaid Services staff time measurement study upon implementation of the 48-group RUG-IV resident classification system. Requires the case-mix indices assigned to each resident class to be published in the State Register at least 120 days prior to the implementation of the RUG-IV resident classification system.
Section 9 (256B.438, subdivision 4) requires the commissioner to determine payment rates to account for the transition to RUG-IV, in a facility-specific, revenue-neutral manner effective January 1, 2012.
Section 10 (256B.438, adding subdivision 8) requires the commissioner to determine payment rates at the time of transition to the RUG-IV-based payment model. Requires nursing facilities to report certain information related to MA resident days to the commissioner for the six-month reporting period ending June 30, 2011. Specifies how the commissioner shall determine the case-mix adjusted component for the January 1, 2012, rate. Specifies that noncase-mix components will be allocated to each RUG group as a constant amount to determine the operating payment rate.
Section 11 (256B.441, subdivision 55a) clarifies the start date of the intergovernmental transfer program for nursing facilities, provides for the continuation of the program when the phase-in of rebasing is complete and specifies a replacement limit to go into effect at that time, allows annual application to participate, and permits the owner to revoke an application.
Section 12 (256B.441, adding subdivision 60):
  • specifies how nursing facility rates for bed relocations must be calculated. Specifies that nursing facility beds on layaway status that are being moved must be included in the calculation for both the originating and receiving facility and treated as though they were in active status with the occupancy characteristics of the active beds of the originating facility;
  • specifies how MA costs of the beds in the originating nursing facilities must be calculated;
  • specifies how MA costs in the receiving facility, prior to the bed relocation, must be calculated;
  • requires the commissioner to determine the MA costs prior to the bed relocation;
  • specifies how the commissioner must estimate the MA costs after the bed relocation;
  • specifies how the commissioner shall determine total payment rates;
  • specifies the process the commissioner must use to determine total payment rates if the commissioner relies on certain provider estimates; and
  • requires rates to be adjusted by any adjustment amounts that were implemented after the date of the letter of approval when beds approved for relocation are put into active service at the destination facility.
Article 5 – Technical
Section 1 (144A.071, subdivision 4a) removes a cross-reference that is repealed in article 4.
Section 2 (144.071, subdivision 5a) corrects a cross-reference.
Section 3 (256B.431, subdivision 26) removes language related to a cross-reference that is repealed in article 4.

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