HF 841

1st Engrossment - 88th Legislature (2013 - 2014) Posted on 04/25/2013 02:21pm

A bill for an act
relating to human services; modifying requirements for assessments; amending
Minnesota Statutes 2012, section 256B.0911, subdivision 3a.

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

Section 1.

Minnesota Statutes 2012, section 256B.0911, subdivision 3a, is amended to
read:

Subd. 3a.

Assessment and support planning.

(a) Persons requesting assessment,
services planning, or other assistance intended to support community-based living,
including persons who need assessment in order to determine waiver or alternative care
program eligibility, must be visited by a long-term care consultation team within 20
calendar days after the date on which an assessment was requested or recommended.
Upon statewide implementation of subdivisions 2b, 2c, and 5, this requirement also
applies to an assessment of a person requesting personal care assistance services and
private duty nursing. The commissioner shall provide at least a 90-day notice to lead
agencies prior to the effective date of this requirement. Face-to-face assessments must be
conducted according to paragraphs (b) to (i).

(b) The lead agency may utilize a team of either the social worker or public health
nurse, or both. Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall
use certified assessors to conduct the assessment. The consultation team members must
confer regarding the most appropriate care for each individual screened or assessed. For
a person with complex health care needs, a public health or registered nurse from the
team must be consulted.

(c) The assessment must be comprehensive and include a person-centered assessment
of the health, psychological, functional, environmental, and social needs of referred
individuals and provide information necessary to develop a community support plan that
meets the consumers needs, using an assessment form provided by the commissioner.

(d) The assessment must be conducted in a face-to-face interview with the person
being assessed and the person's legal representative, and other individuals as requested by
the person, who can provide information on the needs, strengths, and preferences of the
person necessary to develop a community support plan that ensures the person's health and
safety, but who is not a provider of service or has any financial interest in the provision
of services. For persons who are to be assessed for elderly waiver customized living
services under section 256B.0915, with the permission of the person being assessed or
the person's designated or legal representative, the client's current or proposed provider
of services may submit a copy of the provider's nursing assessment or written report
outlining its recommendations regarding the client's care needs. The person conducting
the assessment will notify the provider of the date by which this information is to be
submitted. This information shall be provided to the person conducting the assessment
prior to the assessment.

(e) If the person chooses to use community-based services, the person or the person's
legal representative must be provided with a written community support plan within 40
calendar days of the assessment visit, regardless of whether the individual is eligible for
Minnesota health care programs. The written community support plan must include:

(1) a summary of assessed needs as defined in paragraphs (c) and (d);

(2) the individual's options and choices to meet identified needs, including all
available options for case management services and providers;

(3) identification of health and safety risks and how those risks will be addressed,
including personal risk management strategies;

(4) referral information; and

(5) informal caregiver supports, if applicable.

For a person determined eligible for state plan home care under subdivision 1a,
paragraph (b), clause (1), the person or person's representative must also receive a copy of
the home care service plan developed by the certified assessor.

(f) A person may request assistance in identifying community supports without
participating in a complete assessment. Upon a request for assistance identifying
community support, the person must be transferred or referred to long-term care options
counseling services available under sections 256.975, subdivision 7, and 256.01,
subdivision 24, for telephone assistance and follow up.

(g) The person has the right to make the final decision between institutional
placement and community placement after the recommendations have been provided,
except as provided in subdivision 4a, paragraph (c).

(h) The lead agency must give the person receiving assessment or support planning,
or the person's legal representative, materials, and forms supplied by the commissioner
containing the following information:

(1) written recommendations for community-based services and consumer-directed
options;

(2) documentation that the most cost-effective alternatives available were offered to
the individual. For purposes of this clause, "cost-effective" means community services and
living arrangements that cost the same as or less than institutional care. For an individual
found to meet eligibility criteria for home and community-based service programs under
section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the federally
approved waiver plan for each program;

(3) the need for and purpose of preadmission screening if the person selects nursing
facility placement;

(4) the role of long-term care consultation assessment and support planning in
eligibility determination for waiver and alternative care programs, and state plan home
care, case management, and other services as defined in subdivision 1a, paragraphs (a),
clause (7), and (b);

(5) information about Minnesota health care programs;

(6) the person's freedom to accept or reject the recommendations of the team;

(7) the person's right to confidentiality under the Minnesota Government Data
Practices Act, chapter 13;

(8) the certified assessor's decision regarding the person's need for institutional level
of care as determined under criteria established in section 256B.0911, subdivision 4a,
paragraph (d), and the certified assessor's decision regarding eligibility for all services and
programs as defined in subdivision 1a, paragraphs (a), clause (7), and (b); and

(9) the person's right to appeal the certified assessor's decision regarding eligibility
for all services and programs as defined in subdivision 1a, paragraphs (a), clause (7), and
(b), and incorporating the decision regarding the need for institutional level of care or the
lead agency's final decisions regarding public programs eligibility according to section
256.045, subdivision 3.

(i) Face-to-face assessment completed as part of eligibility determination for
the alternative care, elderly waiver, community alternatives for disabled individuals,
community alternative care, and brain injury waiver programs under sections 256B.0913,
256B.0915, and 256B.49 is valid to establish service eligibility for no more than 60
calendar days after the date of assessment.

(j) The effective eligibility start date for programs in paragraph (i) can never be
prior to the date of assessment. If an assessment was completed more than 60 days
before the effective waiver or alternative care program eligibility start date, assessment
and support plan information must be updated deleted text begin in a face-to-face visit deleted text end and documented in
the department's Medicaid Management Information System (MMIS). Notwithstanding
retroactive medical assistance coverage of state plan services, the effective date of
eligibility for programs included in paragraph (i) cannot be prior to the date the most
recent updated assessment is completed.