HF 1897

as introduced - 88th Legislature (2013 - 2014) Posted on 02/25/2014 01:37pm

A bill for an act
relating to human services; modifying requirements for the State Quality Council
and regional quality councils; appropriating money; amending Minnesota
Statutes 2012, section 256B.097, subdivision 4; Minnesota Statutes 2013
Supplement, section 256B.097, subdivision 3.

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

Section 1.

Minnesota Statutes 2013 Supplement, section 256B.097, subdivision 3,
is amended to read:

Subd. 3.

State Quality Council.

(a) There is hereby created a State Quality
Council which must define regional quality councils, and carry out a community-based,
person-directed quality review component, and a comprehensive system for effective
incident reporting, investigation, analysis, and follow-up.

(b) By August 1, 2011, the commissioner of human services shall appoint the
members of the initial State Quality Council. Members shall include representatives
from the following groups:

(1) disability service recipients and their family members;

(2) during the first four years of the State Quality Council, there must be at least
three members from the Region 10 stakeholders. As regional quality councils are formed
under subdivision 4, each regional quality council shall appoint one member;

(3) disability service providers;

(4) disability advocacy groups; and

(5) county human services agencies and staff from the Department of Human
Services and Ombudsman for Mental Health and Developmental Disabilities.

(c) Members of the council who do not receive a salary or wages from an employer
for time spent on council duties may receive a per diem payment when performing council
duties and functions.

(d) The State Quality Council shall:

(1) assist the Department of Human Services in fulfilling federally mandated
obligations by monitoring disability service quality and quality assurance and
improvement practices in Minnesota;

(2) establish state quality improvement priorities with methods for achieving results
and provide an annual report to the legislative committees with jurisdiction over policy
and funding of disability services on the outcomes, improvement priorities, and activities
undertaken by the commission during the previous state fiscal year;

(3) identify issues pertaining to financial and personal risk that impede Minnesotans
with disabilities from optimizing choice of community-based services; and

(4) recommend to the chairs and ranking minority members of the legislative
committees with jurisdiction over human services and civil law by January 15, 2014,
statutory and rule changes related to the findings under clause (3) that promote
individualized service and housing choices balanced with appropriate individualized
protection.

(e) The State Quality Council, in partnership with the commissioner, shall:

(1) approve and direct implementation of the community-based, person-directed
system established in this section;

(2) recommend an appropriate method of funding this system, and determine the
feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;

(3) approve measurable outcomes in the areas of health and safety, consumer
evaluation, education and training, providers, and systems;

(4) establish variable licensure periods not to exceed three years based on outcomes
achieved; and

(5) in cooperation with the Quality Assurance Commission, design a transition plan
for licensed providers from Region 10 into the alternative licensing system new text begin by July 1, 2014 new text end .

(f) The State Quality Council shall notify the commissioner of human services that a
facility, program, or service has been reviewed by quality assurance team members under
subdivision 4, paragraph (b), clause (13), and qualifies for a license.

(g) The State Quality Council, in partnership with the commissioner, shall establish
an ongoing review process for the system. The review shall take into account the
comprehensive nature of the system which is designed to evaluate the broad spectrum of
licensed and unlicensed entities that provide services to persons with disabilities. The
review shall address efficiencies and effectiveness of the system.

(h) The State Quality Council may recommend to the commissioner certain
variances from the standards governing licensure of programs for persons with disabilities
in order to improve the quality of services so long as the recommended variances do
not adversely affect the health or safety of persons being served or compromise the
qualifications of staff to provide services.

(i) The safety standards, rights, or procedural protections referenced under
subdivision deleted text begin 2 deleted text end new text begin 4 new text end , paragraph (c), shall not be varied. The State Quality Council may make
recommendations to the commissioner or to the legislature in the report required under
paragraph deleted text begin (c) deleted text end new text begin (d) new text end regarding alternatives or modifications to the safety standards, rights, or
procedural protections referenced under subdivision deleted text begin 2 deleted text end new text begin 4 new text end , paragraph (c).

(j) The State Quality Council may hire staff to perform the duties assigned in this
subdivision.

Sec. 2.

Minnesota Statutes 2012, section 256B.097, subdivision 4, is amended to read:

Subd. 4.

Regional quality councils.

(a) new text begin By July 1, 2014, new text end the commissioner shall
establish deleted text begin , as selected by the State Quality Council, deleted text end new text begin or continue the operation of new text end new text begin three
new text end regional quality councils of key stakeholders, deleted text begin including deleted text end new text begin as selected by the State Quality
Council new text end new text begin . One regional quality council shall be established in the Twin Cities metropolitan
area, one shall be established in greater Minnesota, and one shall be the Quality Assurance
Commission established under section 256B.0951. By July 1, 2016, the commissioner
shall establish three additional regional quality councils, as selected by the State Quality
Council. The regional quality councils established under this paragraph shall include
new text end regional representatives of:

(1) disability service recipients and their family members;

(2) disability service providers;

(3) disability advocacy groups; and

(4) county human services agencies and staff from the Department of Human
Services and Ombudsman for Mental Health and Developmental Disabilities.

(b) Each regional quality council shall:

(1) direct and monitor the community-based, person-directed quality assurance
system in this section;

(2) approve a training program for quality assurance team members under clause (13);

(3) review summary reports from quality assurance team reviews and make
recommendations to the State Quality Council regarding program licensure;

(4) make recommendations to the State Quality Council regarding the system;

(5) resolve complaints between the quality assurance teams, counties, providers,
persons receiving services, their families, and legal representatives;

(6) analyze and review quality outcomes and critical incident data reporting
incidents of life safety concerns immediately to the Department of Human Services
licensing division;

(7) provide information and training programs for persons with disabilities and their
families and legal representatives on service options and quality expectations;

(8) disseminate information and resources developed to other regional quality
councils;

(9) respond to state-level priorities;

(10) establish regional priorities for quality improvement;

(11) submit an annual report to the State Quality Council on the status, outcomes,
improvement priorities, and activities in the region;

(12) choose a representative to participate on the State Quality Council and assume
other responsibilities consistent with the priorities of the State Quality Council; and

(13) recruit, train, and assign duties to members of quality assurance teams, taking
into account the size of the service provider, the number of services to be reviewed,
the skills necessary for the team members to complete the process, and ensure that no
team member has a financial, personal, or family relationship with the facility, program,
or service being reviewed or with anyone served at the facility, program, or service.
Quality assurance teams must be comprised of county staff, persons receiving services
or the person's families, legal representatives, members of advocacy organizations,
providers, and other involved community members. Team members must complete
the training program approved by the regional quality council and must demonstrate
performance-based competency. Team members may be paid a per diem and reimbursed
for expenses related to their participation in the quality assurance process.

(c) The commissioner shall monitor the safety standards, rights, and procedural
protections for the monitoring of psychotropic medications and those identified under
sections 245.825; 245.91 to 245.97; 245A.09, subdivision 2, paragraph (c), clauses (2)
and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, subdivision 1b, clause
(7); 626.556; and 626.557.

(d) The regional quality councils may hire staff to perform the duties assigned in
this subdivision.

(e) The regional quality councils may charge fees for their services.

(f) The quality assurance process undertaken by a regional quality council consists of
an evaluation by a quality assurance team of the facility, program, or service. The process
must include an evaluation of a random sample of persons served. The sample must be
representative of each service provided. The sample size must be at least five percent but
not less than two persons served. All persons must be given the opportunity to be included
in the quality assurance process in addition to those chosen for the random sample.

(g) A facility, program, or service may contest a licensing decision of the regional
quality council as permitted under chapter 245A.

Sec. 3. new text begin APPROPRIATION; QUALITY ASSURANCE FOR SERVICES FOR
PEOPLE WITH DISABILITIES.
new text end

new text begin $2,021,000 is appropriated from the general fund for fiscal year 2015 to the
commissioner of human services for quality assurance initiatives for services provided to
people with disabilities. Of this amount:
new text end

new text begin (1) $381,000 shall be distributed to the State Quality Council, of which $281,000
shall be used for council operations, $50,000 shall be used to determine measurable
outcomes, and $50,000 shall be used for quality improvement priority setting;
new text end

new text begin (2) $1,290,000 shall be used to fund three regional quality councils established or
continued under Minnesota Statutes, section 256B.097, subdivision 4, paragraph (a); and
new text end

new text begin (3) $350,000 shall be used to fund an annual survey of disability service recipients
under Minnesota Statutes, section 256B.097, subdivision 5.
new text end