Section 1 (144.0724, subdivision 4) allows assessments for determining nursing facility level of care to include: the nursing facility preadmission screening process created in Section 7; preadmission screenings completed by the Senior LinkAge Line, Disability Linkage Line or other organization under contract with the Minnesota Board on Aging; and the level of care determination process created under Section 21.

Section 2 (144.351) requires the Department of Human Services (DHS) to conduct a one-time critical access study on the local capacity and availability of home and community-based services (HCBS) for older adults and people with disabilities.

Section 3 (148E.065, subdivision 4a) specifies that cities, counties and state agencies are not required to have licensed social workers assisting older adults and people with disabilities with long-term care counseling.

Section 4 (256.01, subdivision 2) adds to the list of the specific powers of the commissioner of human services  the designation of the Senior LinkAge Line and Disability Linkage Line as the state’s Aging and Disability Resource Centers under federal law.

Section 5 (256.01, subdivision 24) designates the Disability Linkage Line as a state Aging and Disability Resource Center under federal law, requires that it be available during business hours through a toll-free number and the Internet, and adds nursing facility preadmission screening to its list of duties.

Section 6 (256.975, subdivision 7) designates the Senior LinkAge Line as a state Aging and Disability Resource Center under federal law; requires the Senior LinkAge Line to receive referrals from nursing facility staff and residents, and to identify and contact residents deemed appropriate for discharge after developing criteria in consultation with DHS.

Section 7 (256.975, subdivision 7a) adds a subdivision to conform Medicaid certified nursing facility preadmission screening activities to federal law by requiring everyone seeking admission to be screened regardless of income, assets or funding sources with certain exceptions; establishes the criteria and process for preadmission screening; states that the purpose of the screening is to determine if the potential resident meets the nursing facility level of care criteria.

Section 8 (256.975, subdivision 7b) adds a new subdivision listing exemptions to the federal screening requirements in Section 7, and allowing emergency nursing facility admission without screening under conditions listed in the subdivision; requires nursing facilities to provide all admitted people written information on their right to request and receive long-term care consultation services.

Section 9 (256.975, subdivision 7c) adds a new subdivision allowing nursing facility admission screening to be conducted by telephone or face-to-face interviews and requires the Senior LinkAge Line to identify each individual’s need for a telephone or face-to-face interview.

Section 10 (256.975, subdivision 7d) adds a new subdivision requiring DHS to provide preadmission screening funding to the Minnesota Board on Aging.

Section 11 (256.9754, subdivision 3a) adds a new subdivision requiring the Minnesota Department of Health (MDH) to give priority to grantees of community services development grants for older adults if technology is used as part of a proposal; the Department of Transportation must also give priority to community services development grantees when distributing transportation-related funds to create options for older adults.

Section 12 (256.9754, subdivision 3b) adds a new subdivision allowing MDH to waive state laws and rules on a time-limited basis if it is determined that community services development grantees require a waiver in order to achieve the demonstration project goals.

Section 13 (256.9754, subdivision 5) requires DHS to give preference when awarding community services development grants to areas identified with service needs in the Balancing Long-Term Care Services and Supports report due to the Legislature by August 15, 2013.

Section 14 (256B.021, subdivision 4a) adds a subdivision requiring DHS to evaluate projects intended to: offer more flexible and updated community support services; improve information and assistance to inform long-term care decisions; and implement nursing facility level of care criteria.

Section 15 (256B.021, subdivision 6) adds a subdivision creating a demonstration project, upon federal approval, to provide navigation, employment supports and benefits planning services to a targeted group of Medical Assistance (MA) recipients beginning July 1, 2014.

Section 16 (256B.021, subdivision 7) adds a subdivision creating a demonstration project, upon federal approval, to provide service coordination, outreach, in-state, tenancy support and community living assistance to a targeted group of MA recipients beginning July 1, 2014.

Section 17 (256B.0911, subdivision 1) updates cross-references to incorporate changes made in Sections 6, 7, 8, 9 and 20.

Section 18 (256B.0911, subdivision 1a) removes a reference to federally mandated preadmission screening activities, as the subdivisions cited are repealed in Section 48 (and replaced in Sections 7 and 8); updates a cross-reference.

Section 19 (256B.0911, subdivision 3a) updates a cross-reference; requires lead agencies to provide DHS-provided materials to individuals receiving assessment or support planning on the need and purpose of preadmission screening; requires lead agencies to forward to the long-term care options counselor information to complete the level of care determinations if the individual selects nursing facility placement.

Section 20 (256B.0911, subdivision 4d) modifies the preadmission screening requirement for nursing facility admission directly from a hospital for individuals 65 years of age down to 60.

Section 21 (256B.0911, subdivision 4e) adds a subdivision requiring level of care determinations for nursing facilities, hospitals and intermediate care facilities in accordance with criteria developed by DHS until the level of care changes made in 2008 are implemented in 2014 for individuals 21 years of age and older, and in 2019 for individuals under 21.

Section 22 (256B.0911, subdivision 7) updates cross-references to incorporate changes made in Sections 7, 8, 9 and 20.

Section 23 (256B.0913, subdivision 4) updates a cross-reference to incorporate the new subdivision created in Section 21.

Section 24 (256B.0913, subdivision 17) adds a new subdivision establishing Essential Community Supports Grants for individuals 65 years of age or older who do not meet the nursing facility level of care criteria but would otherwise qualify for the Alternative Care program.

Section 25 (256B.0915, subdivision 3a) calculates a new monthly cost limit for elderly waiver (EW) services for ventilator-dependent individuals by averaging 1) the monthly MA amount for ventilator-dependent home care services and 2) the average contracted amount for nursing facility services for ventilator-dependent  individuals. The monthly limit is adjusted annually and effective July 1, 2013.

Section 26 (256B.0915, subdivision 3j) adds a subdivision creating Individual Community Living Support (ICLS) services for EW recipients.

Section 27 (256B.0915, subdivision 5) updates a cross-reference to incorporate the new subdivision created in Section 21.

Sections 28 through 33 replace repealed Senior’s Agenda for Independent Living (SAIL) Projects language.

Section 28 (256B.0917, subdivision 1a) adds a new subdivision stating the purpose of SAIL projects is to make strategic changes in the long-term services and supports for older adults and lists the goals of these projects.

Section 29 (256B.0917, subdivision 1b) adds a new subdivision listing definitions applicable to 256B.0917.

Section 30 (256B.0917, subdivision 1c) adds a new subdivision directing DHS to contract, through a request for proposal (RFP) process, with eldercare development partnerships capable of providing statewide service development and assistance.

Section 31 (256B.0917, subdivision 6) requires DHS to create projects to increase caregiver support and respite care services administered by nonprofit agencies and chosen through an RFP process.

Section 32 (256B.0917, 7a) adds a new subdivision requiring DHS to create projects to provide services and supports to older adults and their informal caregivers, administered by HCBS providers and chosen through an RFP process.

Section 33 (256B.0917, subdivision 13) modifies the preference for awarding community service grants to not only areas where nursing facilities have closed but to areas identified in the Balancing Long-Term Care Services and Supports report.

Section 34 (256B.092, subdivision 14) adds a new subdivision requiring developmental disability (DD) waiver recipients admitted to an emergency room, psychiatric unit or other type of institution at least twice in a calendar year to receive a behavioral or mental health professional consultation.

Section 35 (256B.439, subdivision 1) requires DHS and MDH to develop and implement long-term care quality profiles for all nursing facilities no later than July 1, 2014.

Section 36 (256B.439, subdivision 2) makes a technical change.

Section 37 (256B.439, subdivision 3) specifies that consumer surveys of long-term care services are for nursing facility services.

Section 38 (256B.439, subdivision 3a) adds a subdivision requiring DHS and MDH to incorporate long-term care quality profiles into a report card maintained by the Minnesota Board on Aging.

Section 39 (256B.439, subdivision 4) requires DHS and MDH to publically disseminate the long-term care quality profiles through the Senior LinkAge Line and Disability Linkage Line.

Section 40 (256B.49, subdivision 12) updates a cross-reference to incorporate the new subdivision created in Section 21.

Section 41 (256B.49, subdivision 14) updates a cross-reference to incorporate the new subdivision created in Section 21.

Section 42 (256B.49, subdivision 25) adds a new subdivision requiring HCBS waiver recipients (excluding DD, see Section 34) admitted to an emergency room, psychiatric unit or other type of institution at least twice in a calendar year to receive a behavioral or mental health professional consultation.

Section 43 (256B.85) creates a new section, COMMUNITY FIRST SERVICES AND SUPPORTS. The entire section is effective upon receiving federal approval.

Subdivision 1 establishes the Community First Services and Supports (CFSS) program’s basis and scope, and replaces the personal care assistance (PCA) program, contingent upon federal approval.

Subdivision 2 lists the definitions applicable to the CFSS section.

Subdivision 3 provides who is eligible (and not eligible) for CFSS, including people receiving certain MA services, Alternative Care recipients, certain HCBS waiver recipients, among others.

Subdivision 4 states that CFSS participation does not restrict access to other services provided under the state plan MA benefit or other services the Alternative Care program.

Subdivision 5 establishes the  CFSS assessment process.

Subdivision 6 outlines the CFSS delivery plan requirements, including: that it be a “person-centered planning process” as defined in subdivision 2, and outlined in paragraph (c); and that DHS establishes the format and criteria.

Subdivision 7 lists the services covered under CFSS, including:

• assistance with activities of daily living (ADL), instrumental activities of daily (IADL), and health-related procedures and tasks as defined in subdivision 2
• assistance in allowing participants to complete ADLs, IADLs and health-related procedures and tasks on their own
• expenditures on services, supports, environmental modifications and goods—including assistive technology—to allow participants greater independence
• behavioral observations, redirections and assessments
• technological devices such as pagers or other electronic devices to ensure service and support continuity
• costs of transitioning to less-restrictive living settings
• support specialist services, as defined in subdivision 2

Subdivision 8 requires DHS to create a home care rating methodology for determining the amount of CFSS for each participant.

Subdivision 9 lists services not covered under CFSS, including:

• those not authorized by a certified assessor or included in the CFSS service delivery plan
• those provided prior to authorization or approval of the CFSS service delivery plan
• those that duplicate those of other paid services in the CFSS service delivery plan
• those that supplant unpaid supports on a voluntary basis, chosen by the participant
• those that do not meet the participant’s needs
• those available through other funding streams
• those not directly benefitting the participant
• fees incurred by the participant, such as co-pays and legal fees
• insurance, except for those related to employee coverage
• room and board costs, not including transition costs in subdivision 7
• any good, service or support not related to an assessed need
• special education and related services under certain federal laws
• technological devices, not including those listed  in subdivision 7
• medical supplies and equipment
• environmental modifications, not including those listed in subdivision 7
• expenses related to training the participant or others exceeding $500 a year
• experimental treatments
• goods and services covered by MA state plan services, including medications, premiums and co-pays, among others
• membership dues, unless necessary and appropriate to treat, improve or maintain the participant’s physical condition
• vacation expenses
• vehicle maintenance or enhancement not related to the disability, health condition or need
• recreational event-related costs

Subdivision 10 requires DHS to develop policies and procedures to ensure provider integrity and financial accountability, and establishes provider qualifications and requirements, including:

• enrolling as an MA health care programs provider
• complying with MA enrollment requirements
• demonstrating compliance with CFSS policies
• complying with background study requirements
• verifying  and maintaining participants’ service and expense records
• refraining from agency-initiated contact or marketing activity to potential participants, guardians, family members or participants’ representatives
• paying support workers and specialists based on actual service hours provided
• complying with all federal and state payroll tax laws
• paying unemployment and liability insurance, taxes, and worker’s compensation
• entering into written agreements with participants and their representatives assigning roles and responsibilities before goods, services and supports are provided
• reporting suspected neglect and abuse appropriately
• providing participants with a copy of their service-related rights

Subdivision 11 specifies the agency-provider model (defined in subdivision 2) characteristics, including allowing participants a role in selecting and dismissing support workers, and sharing CFSS services; and requiring agency-providers to use 72.5 percent of MA-generated revenue go towards support worker wages and benefits.

Subdivision 12 specifies initial enrollment requirements for CFSS provider agencies, including providing:

• current contact information
• proof of surety bond coverage
• proof of fidelity bond coverage
• proof of workers’ compensation insurance coverage
• proof of liability insurance coverage
• a description of the agency’s organizational structure, including the names of owners, managing employees, staff, board of  directors and their affiliations to other service providers
• copies of the agency’s written policies and procedures
• copies of forms used by the agency in the daily course of business
• training requirements of the agency’s staff
• documentation of training completed by staff
• documentation of the agency’s marketing practices
• disclosure of ownership, leasing or management of all residential properties currently or potentially used for home care services
• documentation of adherence to the MA-generated revenue requirement in subdivision 11
• documentation that demonstrates the agency does not prevent former employees from working for a CFSS participant , via a signed agreement, in order to allow CFSS participants the right to choose their service provider

Subdivision 13 specifies the flexible spending model (defined in subdivision 2) characteristics, including:

• allowing CFSS participants to directly employ and pay support workers and purchase other goods and services
• describing the role of the financial management services (FMS) contractor is assisting participants in managing their budgets and payment responsibilities
• allowing participants’ representatives the authority to manage the participants budget, if agreed to by the participant
• preventing FMS contractors from providing CFSS services
• outlining FMS contractor duties and responsibilities
• outlining DHS’s duties and responsibilities

Subdivision 14 lists the participants’ responsibilities under the flexible spending model.

Subdivision 15 establishes documentation requirements for all support services provided to CFSS participants in both agency-provider and flexible spending models.

Subdivision 16 lists support worker requirements, including background studies, training, and ability to provide the services  and supports according to the CFSS participants’ service delivery plan, among others;  and lists circumstances where DHS may deny or terminate support worker employment with the provider agency or CFSS participant.

Subdivision 17 requires DHS to develop qualificaitons, requirements and payment rates for  support specialists.

Subdivision 18 establishes budget allocation parameters for both the agency-provider and flexible spending models.

Subdivision 19 requires DHS to provide the support necessary to ensure CFSS participants are able to manage their care and budgets, if applicable.

Subdivision 20 requires that CFSS participants must be provided the support and information necessary to choose and manage their services.

Subdivision 21 requires DHS create a Development and Implementation Council, with a majority of members being individuals with disabilities, elderly individuals and their representatives, to assist in the development and implementation of CFSS.

Subdivision 22 requires DHS to establish quality assurance and risk management measures for use in developing and implementing CFSS.

Subdivision 23 allows DHS immediate access to the agency provider or FMS contractor’s documents and office space (during regular business hours) without prior notice when investigating possible MA overpayment.

Subdivision 24 requires CFSS agency-providers to initiate background studies on its owners, managing employees, support specialists and support workers, and bars agency-providers from CFSS enrollment if certain conditions related to the background studies are not met.

Section 44 (256I.05, subdivision 1o) modifies the group residential housing statute, by prohibiting a county from negotiating a supplementary rate for an individual who is eligible for the federal Housing Stability Services and who resides in a certain setting.

Sections 45 to 47 modify the vulnerable adult act.

Section 45 (626.557, subdivision 4) allows the common entry point (CEP) to accept electronic reports of abuse, neglect, or exploitation submitted through a web-based reporting system, established by the commissioner.

Section 46 (626.557, subdivision 9) requires the commissioner to establish a CEP effective July 1, 2014.  Current law allows each county to designate a common entry point.  New language in paragraph (g) requires that the CEP have access to the centralized database to immediately identify prior reports. New paragraph (h) requires CEP staff to refer calls that do not allege abuse or neglect to other organizations, in an effort to resolve the reporter’s concerns. New paragraph (i) provides that the CEP must be operated so the commissioner can perform the duties under this section. New paragraph (j) requires the commissioner of Health and Human Services to collaborate on the creation of a triage system for investigations.

Section 47 (626.557, subdivision 9e) requires the commissioner to conduct an outreach campaign to promote the CEP for

Section 48 repeals a provision related to federal grants to establish a common entry point (section 245A.655), repeals several subdivisions relating to long term care consultation (section256B.0911, subd 4a, 4b, 4c) and repeals several subdivisions related to the Seniors’ Agenda for Independent Living (SAIL).