SF 1250

as introduced - 91st Legislature (2019 - 2020) Posted on 02/14/2019 03:30pm

A bill for an act
relating to human services; modifying consumer-directed community supports;
establishing a onetime grant program to promote consumer-directed community
supports; appropriating money; amending Laws 2017, First Special Session chapter
6, article 1, section 45.

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

Section 1.

Laws 2017, First Special Session chapter 6, article 1, section 45, is amended
to read:

Sec. 45.

CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET
METHODOLOGY deleted text begin EXCEPTION FOR PERSONS LEAVING INSTITUTIONS AND
CRISIS RESIDENTIAL SETTINGS deleted text end .

new text begin Subdivision 1. new text end

new text begin Exception for persons leaving institutions and crisis residential
settings. new text end

(a) By September 30, 2017, the commissioner shall establish an institutional and
crisis bed consumer-directed community supports budget exception process in the home
and community-based services waivers under Minnesota Statutes, sections 256B.092 and
256B.49. This budget exception process shall be available for any individual who:

(1) is not offered available and appropriate services within 60 days since approval for
discharge from the individual's current institutional setting; and

(2) requires services that are more expensive than appropriate services provided in a
noninstitutional setting using the consumer-directed community supports option.

(b) Institutional settings for purposes of this exception include intermediate care facilities
for persons with developmental disabilities; nursing facilities; acute care hospitals; Anoka
Metro Regional Treatment Center; Minnesota Security Hospital; and crisis beds. The budget
exception shall be limited to no more than the amount of appropriate services provided in
a noninstitutional setting as determined by the lead agency managing the individual's home
and community-based services waiver. The lead agency shall notify the Department of
Human Services of the budget exception.

new text begin Subd. 2. new text end

new text begin Behavioral support services excluded. new text end

new text begin (a) Behavioral support services are
excluded from consumer-directed community supports budgets accessed from waiver funds
outside of the consumer-directed community supports budget.
new text end

new text begin (b) No later than September 30, 2019, the commissioner of human services shall submit
an amendment to the Centers for Medicare and Medicaid Services for the home and
community-based services waivers authorized under Minnesota Statutes, sections 256B.092
and 256B.49, to exclude behavioral support services from consumer-directed community
supports.
new text end

new text begin Subd. 3. new text end

new text begin Shared services. new text end

new text begin (a) Medical assistance payments for shared services under
consumer-directed community supports are limited to this subdivision.
new text end

new text begin (b) For purposes of this subdivision, "shared services" means services provided in the
same setting at the same time by the same worker for consumers who have entered into an
agreement to share consumer-directed community support services.
new text end

new text begin (c) The consumer-directed community supports shared services agreement must include:
new text end

new text begin (1) the names of the recipients, case manager, and financial management services
provider;
new text end

new text begin (2) the recipients' or recipients' representatives duties;
new text end

new text begin (3) the case manager's duties;
new text end

new text begin (4) the financial management services provider's duties;
new text end

new text begin (5) the schedule for shared services;
new text end

new text begin (6) the settings in which shared services are provided; and
new text end

new text begin (7) signatures of all parties involved in the shared services.
new text end

new text begin The recipient or recipient's representative may withdraw from participating in a shared
services agreement at any time.
new text end

new text begin (d) Covered shared services include:
new text end

new text begin (1) behavioral redirection;
new text end

new text begin (2) caregiver relief;
new text end

new text begin (3) community inclusion;
new text end

new text begin (4) night monitoring;
new text end

new text begin (5) skill building related to the disability;
new text end

new text begin (6) supervision; and
new text end

new text begin (7) vocational activities.
new text end

new text begin (e) Noncovered shared services include:
new text end

new text begin (1) services for more than three recipients provided by one worker at one time;
new text end

new text begin (2) caring for multiple recipients in more than one setting at the same time;
new text end

new text begin (3) additional services based on selection of the shared services option;
new text end

new text begin (4) use of more than one provider for the shared services;
new text end

new text begin (5) services requiring one-to-one assistance;
new text end

new text begin (6) services provided by a spouse or paid parent of a minor; and
new text end

new text begin (7) child care services.
new text end

new text begin (f) The recipient or recipient's representative must elect to use the option of shared
services with the assistance of the case manager. The case manager must determine the
shared services option to be appropriate based on the ages of the recipients, compatibility,
and coordination of their assessed care needs. The recipient or the recipient's representative,
in conjunction with the case manager, shall:
new text end

new text begin (1) arrange the setting and grouping of shared services based on the individual needs
and preferences of the recipients;
new text end

new text begin (2) provide training specific to each recipient served; and
new text end

new text begin (3) follow all required documentation for time and services provided.
new text end

new text begin (g) The financial management services provider shall:
new text end

new text begin (1) allow the recipient or recipient's representative to select the option of shared or
one-to-one services; and
new text end

new text begin (2) follow all required documentation for time and services provided.
new text end

new text begin (h) The case manager shall:
new text end

new text begin (1) evaluate the ability of the provider to provide services for all of the recipients in a
shared setting;
new text end

new text begin (2) visit the shared setting as services are being provided at least once every six months
or whenever needed for response to a recipient's request;
new text end

new text begin (3) provide quarterly monitoring and evaluation of the effectiveness and appropriateness
of the shared services;
new text end

new text begin (4) develop a contingency plan with each of the recipients that accounts for the absence
of the recipient in a shared services setting due to illness or other circumstances;
new text end

new text begin (5) obtain permission from each of the recipients who are sharing services for the number
of shared hours for services provided inside and outside the home residence; and
new text end

new text begin (6) document the training completed by the financial management services provider
specific to the shared setting and recipients sharing services.
new text end

new text begin (i) The commissioner shall: (1) authorize the use of the shared services option based on
the criteria that: (i) the shared service is appropriate to meet all of the recipients' needs; and
(ii) the health and safety of the recipients will be maintained; and (2) provide a rate system
for shared services under the consumer-directed community supports option. For two persons
sharing services, the rate paid to a provider must not exceed one and one-half times the rate
paid for serving one person. For three persons sharing services, the rate paid to a provider
must not exceed twice the rate paid for serving one person. These rates apply only when all
of the criteria for the shared services under consumer-directed community supports have
been met.
new text end

new text begin (j) Recipients sharing services must use the same financial management services provider.
new text end

new text begin (k) Nothing in this subdivision must be construed to reduce the total number of hours
of service authorized for an individual recipient.
new text end

new text begin (l) No later than September 30, 2019, the commissioner of human services shall submit
an amendment to the Centers for Medicare and Medicaid Services for the home and
community-based services waivers authorized under Minnesota Statutes, sections 256B.092
and 256B.49, to allow for a shared services option under consumer-directed community
supports.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2019, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 2. new text begin REGIONAL AND LOCAL CONSUMER-DIRECTED COMMUNITY
SUPPORTS EDUCATION AND MARKETING GRANTS.
new text end

new text begin (a) The commissioner of human services shall award onetime, competitive grants to
eligible applicants for regional and local projects targeted to a designated community of the
applicant's choosing, which may consist of a specific geographic area or population, to:
increase awareness of consumer-directed community supports; increase the rate of utilization
of consumer-directed community supports, specifically in counties with low enrollment in
the program; promote the benefits of support planning services; or connect eligible persons
with disabilities, their parents and family members, and lead agency staff to education and
resources related to consumer-directed community supports.
new text end

new text begin (b) The project areas for the grant include local or community-based initiatives to: (1)
promote the benefits of consumer-directed community supports; and (2) provide informational
materials and other resources to persons with disabilities eligible for consumer-directed
community supports, their parents and family members, and lead agency staff.
new text end

new text begin (c) Eligible applicants may include but are not limited to statewide nonprofit organizations
with regional and local presence that provide advocacy services and supports for persons
with disabilities and their parents and family members.
new text end

new text begin (d) Applicants must: (1) describe the proposed project, including the targeted community
and how the project meets the requirements of this section; and (2) identify the proposed
outcomes of the project and the evaluation process to measure these outcomes.
new text end

new text begin (e) In awarding the regional and local consumer-directed community supports education
and marketing grants, the commissioner of human services must give priority to applicants
who demonstrate that the proposed project:
new text end

new text begin (1) is supported by and appropriately targeted to the community the applicant serves;
new text end

new text begin (2) is designed to coordinate with other community activities related to initiatives aimed
at promoting independence, inclusion, and self-direction in the lives of persons with
disabilities;
new text end

new text begin (3) is conducted by an applicant able to demonstrate expertise in the project areas;
new text end

new text begin (4) utilizes and enhances existing activities and resources or involves innovative
approaches to achieve success in the project areas; and
new text end

new text begin (5) strengthens community relationships and partnerships in order to achieve the project
areas.
new text end

new text begin (f) The commissioner shall divide the state into specific geographic regions and allocate
a percentage of the money available for the regional and local consumer-directed community
supports education and marketing grants to projects aimed at each geographic region with
an emphasis on counties with low rates of utilization of consumer-directed community
supports.
new text end

new text begin (g) The commissioner shall award the grants by January 31, 2020.
new text end

new text begin (h) A grantee shall report to the commissioner of human services on the progress of the
project at least once during the grant period and, within two months of the end of the grant
period, shall submit a final report to the commissioner that includes the measurable outcomes.
new text end

new text begin (i) The commissioner of human services shall:
new text end

new text begin (1) develop the criteria and procedures to allocate the grants under this section, evaluate
all applicants on a competitive basis, award the grants, and select qualified providers to
offer technical assistance to grant applicants and grantees. The selected providers shall assist
applicants and grantees with project design, evaluation methods, materials, and training;
and
new text end

new text begin (2) submit by January 15, 2021, a progress report on the consumer-directed community
supports education and marketing grants under this section to the chairs and ranking minority
members of the legislative committees with jurisdiction over health finance and policy. The
report shall include:
new text end

new text begin (i) information on the grantees;
new text end

new text begin (ii) a summary of all projects undertaken with the grants;
new text end

new text begin (iii) the measurable outcomes established by the grantees, an explanation of the evaluation
process used to determine whether the outcomes were met, and the results of the evaluation;
and
new text end

new text begin (iv) an accounting of how the grant funds were spent.
new text end

Sec. 3. new text begin APPROPRIATION.
new text end

new text begin $....... in fiscal year 2020 is appropriated from the general fund to the commissioner of
human services for the regional and local consumer-directed community supports education
and marketing grants described in this act. This is a onetime appropriation.
new text end

Sec. 4. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes, in consultation with the House Research Department, Office of
Senate Counsel, Research and Fiscal Analysis, and Department of Human Services, shall
prepare legislation for the 2020 legislative session to codify laws governing
consumer-directed community supports in Minnesota Statutes, chapter 256B.
new text end