HF 4106

as introduced - 93rd Legislature (2023 - 2024) Posted on 03/13/2024 12:46pm

A bill for an act
relating to human services; modifying timelines for medical assistance eligibility
determinations for certain hospital patients; providing supplemental payments for
certain disability waiver services; providing additional permissible circumstances
for the appointment of an emergency guardian; amending Minnesota Statutes 2022,
sections 256.01, subdivision 29; 256B.05, by adding a subdivision; 256B.0911,
by adding subdivisions; 256B.49, by adding a subdivision; 524.5-311.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2022, section 256.01, subdivision 29, is amended to read:

Subd. 29.

State medical review team.

(a) To ensure the timely processing of
determinations of disability by the commissioner's state medical review team under sections
256B.055, subdivisions 7, paragraph (b), and 12, and 256B.057, subdivision 9, the
commissioner shall review all medical evidence and seek information from providers,
applicants, and enrollees to support the determination of disability where necessary. Disability
shall be determined according to the rules of title XVI and title XIX of the Social Security
Act and pertinent rules and policies of the Social Security Administration.

(b) Prior to a denial or withdrawal of a requested determination of disability due to
insufficient evidence, the commissioner shall (1) ensure that the missing evidence is necessary
and appropriate to a determination of disability, and (2) assist applicants and enrollees to
obtain the evidence, including, but not limited to, medical examinations and electronic
medical records.

(c) Any appeal made under section 256.045, subdivision 3, of a disability determination
made by the state medical review team must be decided according to the timelines under
section 256.0451, subdivision 22, paragraph (a). If a written decision is not issued within
the timelines under section 256.0451, subdivision 22, paragraph (a), the appeal must be
immediately reviewed by the chief human services judge.

new text begin (d) The commissioner shall prioritize determinations of disability for patients who are
awaiting discharge from an acute care hospital at the time they are referred to the state
medical review team and who have requested an expedited MnCHOICES assessment visit
under section 256B.0911, subdivision 17a.
new text end

Sec. 2.

Minnesota Statutes 2022, section 256B.05, is amended by adding a subdivision to
read:

new text begin Subd. 6. new text end

new text begin Expedited medical assistance applications. new text end

new text begin (a) Notwithstanding subdivision
5 and Minnesota Rules, part 9505.0090, subparts 2 and 3, the local agency must act on an
application for medical assistance within five calendar days of receipt of a request for
medical assistance for a patient eligible for discharge, as determined by the hospital, but
who requires post-acute care covered by medical assistance to be safely discharged.
new text end

new text begin (b) If all information needed to act on the application is not obtained within the time
limit, the local agency must immediately inform the applicant about the deficiencies of the
application and the reason for the delay in determining the applicant's eligibility. If the
reason for the delay is the applicant's inability to obtain or provide the required information,
the local agency must assist the applicant in obtaining the required information within three
calendar days and act on the application immediately upon receipt of the required information.
new text end

new text begin (c) If the reason for the continued delay in determining the applicant's eligibility is that
the required information cannot be obtained even with the assistance of the local agency,
the local agency must immediately appeal the delay to the commissioner on the applicant's
behalf.
new text end

Sec. 3.

Minnesota Statutes 2022, section 256B.0911, is amended by adding a subdivision
to read:

new text begin Subd. 17a. new text end

new text begin Expedited MnCHOICES assessment visits. new text end

new text begin Notwithstanding subdivision
17, paragraph (a), a patient awaiting discharge from an acute care hospital requesting
long-term care consultation services must be visited by a long-term care consultation team
within three calendar days after the date on which an assessment was requested or
recommended.
new text end

Sec. 4.

Minnesota Statutes 2022, section 256B.0911, is amended by adding a subdivision
to read:

new text begin Subd. 29a. new text end

new text begin Expedited support planning. new text end

new text begin Notwithstanding subdivision 29, paragraph
(a), the certified assessor and the individual responsible for developing the support plan
must complete the assessment summary and the support plan no more than five calendar
days after an expedited assessment visit conducted according to subdivision 17a.
new text end

Sec. 5.

Minnesota Statutes 2022, section 256B.49, is amended by adding a subdivision to
read:

new text begin Subd. 30. new text end

new text begin Residential support services supplemental payments. new text end

new text begin (a) For the purposes
of this subdivision, "residential support services" means the following residential support
services reimbursed under section 256B.4914: (1) 24-hour customized living services; (2)
community residential services; (3) customized living services; (4) family residential services;
and (5) integrated community supports.
new text end

new text begin (b) The commissioner shall make emergency supplemental payments to providers who
provide residential support services to a person who is discharged from an acute care hospital
and immediately enrolls in a home and community-based waiver for persons with disabilities
following an expedited assessment visit and expedited support planning conducted under
section 256B.0911. The amount of the supplemental payments must be equal to the amount
required to increase the total payments for the first 30 days of residential support services
to the 99th percentile of nonrate exception daily rates for individuals on the same waiver.
new text end

new text begin (c) The commissioner shall seek federal financial participation in emergency supplemental
payments under this subdivision. If federal financial participation is denied, the commissioner
must make emergency supplemental payments under this subdivision from state-only money.
new text end

Sec. 6.

Minnesota Statutes 2022, section 524.5-311, is amended to read:

524.5-311 EMERGENCY GUARDIAN.

(a) If the court finds that compliance with the procedures of this article will likely result
in substantial harm to the respondent's health, safety, or welfare, and that no other person
appears to have authority and willingness to act in the circumstances, the court, on petition
by a person interested in the respondent's welfare, may appoint an emergency guardian
whose authority may not exceed 60 days and who may exercise only the powers specified
in the order. A county that is acting under section 626.557, subdivision 10, by petitioning
for appointment of an emergency guardian on behalf of a vulnerable adult may be granted
authority to act for a period not to exceed 90 days. An emergency guardian's appointment
under this section may only be extended once for a period not to exceed 60 days if the court
finds good cause for the continuation of the guardianship. Immediately upon receipt of the
petition for an emergency guardianship, the court shall appoint a lawyer to represent the
respondent in the proceeding. Except as otherwise provided in paragraph (b), reasonable
notice of the time and place of a hearing on the petition must be given to the respondent
and any other persons as the court directs.

(b) An emergency guardian may be appointed without notice to the respondent and the
respondent's lawyer only if the court finds from affidavit or other sworn testimony that the
respondent will be substantially harmed before a hearing on the appointment can be held.
If the court appoints an emergency guardian without notice to the respondent, the respondent
must be given notice of the appointment within 48 hours after the appointment. The court
shall hold a hearing on the appropriateness of the appointment within five days after the
appointment.

(c) Appointment of an emergency guardian, with or without notice, is not a determination
of the respondent's incapacity.

(d) The court may remove an emergency guardian at any time. An emergency guardian
shall make any report the court requires. In other respects, the provisions of this article
concerning guardians apply to an emergency guardian.

(e) Any documents or information disclosing or pertaining to health or financial
information shall be filed as confidential documents, consistent with the bill of particulars
under section 524.5-121.

new text begin (f) Upon petition by a person interested in the respondent's welfare, the court shall appoint
an emergency guardian within five days of receipt of the petition if the court finds that at
the time of the petition the respondent is awaiting release from a hospital emergency
department or discharge from an acute care hospital because the hospital cannot identify a
safe location to release or discharge the respondent without the respondent having coverage
under medical assistance. The authority of an emergency guardian appointed pursuant to
this paragraph must not exceed 60 days and may be extended for an additional period not
to exceed 60 days. The court shall appoint a lawyer to represent the respondent in proceedings
brought under this paragraph. Notice must be provided consistent with this section.
Paragraphs (b) to (e) apply to petitions filed pursuant to this paragraph.
new text end