SF 2799

as introduced - 88th Legislature (2013 - 2014) Posted on 03/20/2014 09:37am

A bill for an act
relating to human services; health; economic development; providing for
long-term care workforce needs; requiring studies; appropriating money;
amending Minnesota Statutes 2012, sections 144.1501, subdivision 3; 256B.431,
subdivision 36; 256B.441, by adding a subdivision; Minnesota Statutes 2013
Supplement, section 256B.441, subdivisions 13, 53.

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

Section 1.

Minnesota Statutes 2012, section 144.1501, subdivision 3, is amended to read:

Subd. 3.

Eligibility.

(a) To be eligible to participate in the loan forgiveness program,
an individual must:

(1) be a medical or dental resident, a licensed pharmacist or be enrolled in a dentist,
midlevel practitioner, registered nurse, or a licensed practical nurse training program; and

(2) submit an application to the commissioner of health. If fewer applications are
submitted by dental students or residents than there are dentist participant slots available,
the commissioner may consider applications submitted by dental program graduates who
are licensed dentists. new text begin The commissioner may consider applications submitted by nurse
program graduates who are registered nurses or licensed practical nurses.
new text end

(b) An applicant selected to participate must sign a contract to agree to serve a
minimum three-year full-time service obligation according to subdivision 2, which
shall begin no later than March 31 following completion of required training new text begin , with the
exception of a nurse, who must agree to serve a minimum two-year full-time service
obligation according to subdivision 2, which shall begin no later than March 31 following
completion of required training new text end .

Sec. 2.

Minnesota Statutes 2012, section 256B.431, subdivision 36, is amended to read:

Subd. 36.

Employee scholarship costs and training in English as a second
language.

(a) For the period between deleted text begin July 1, 2001, and June 30, 2003 deleted text end new text begin October 1,
2014, and September 30, 2016 new text end , the commissioner shall provide to each nursing facility
reimbursed under this section, section 256B.434, or any other section, a scholarship per
diem of 25 cents to the total operating payment rate to be used:

(1) for employee scholarships that satisfy the following requirements:

(i) scholarships are available to all employees who work an average of at least deleted text begin 20
deleted text end new text begin ten new text end hours per week at the facility except the administrator, deleted text begin department supervisors, and
registered nurses deleted text end new text begin and to reimburse student loan expenses for newly hired and recently
graduated registered nurses and licensed practical nurses new text end ; and

(ii) the course of study is expected to lead to career advancement with the facility or
in long-term care, including medical care interpreter services and social work; and

(2) to provide job-related training in English as a second language.

(b) A facility receiving a rate adjustment under this subdivision may submit to the
commissioner on a schedule determined by the commissioner and on a form supplied
by the commissioner a calculation of the scholarship per diem, including: the amount
received from this rate adjustment; the amount used for training in English as a second
language; the number of persons receiving the training; the name of the person or entity
providing the training; and for each scholarship recipient, the name of the recipient,
the amount awarded, the educational institution attended, the nature of the educational
program, the program completion date, and a determination of the per diem amount of
these costs based on actual resident days.

(c) On July 1, 2003, the commissioner shall remove the 25 cent scholarship per diem
from the total operating payment rate of each facility.

(d) For rate years beginning after June 30, 2003, the commissioner shall provide to
each facility the scholarship per diem determined in paragraph (b). In calculating the per
diem under paragraph (b), the commissioner shall allow only costs related to tuition and
direct educational expenses new text begin and may include child care costs and transportation expenses
related to direct educational expenses new text end .

new text begin (e) The $....... rate increase effective October 1, 2014, is an optional rate add-on
that the facility must request from the commissioner in a manner prescribed by the
commissioner. The rate increase must be used for scholarships as specified in this
subdivision.
new text end

new text begin (f) Nursing facilities that close beds during a rate year can request to have their
scholarship adjustment under paragraph (b) recalculated by the commissioner for the
remainder of the rate year to reflect the reduction in resident days compared to the cost
report year.
new text end

Sec. 3.

Minnesota Statutes 2013 Supplement, section 256B.441, subdivision 13,
is amended to read:

Subd. 13.

External fixed costs.

"External fixed costs" means costs related to the
nursing home surcharge under section 256.9657, subdivision 1; licensure fees under
section 144.122; until September 30, 2013, long-term care consultation fees under section
256B.0911, subdivision 6; family advisory council fee under section 144A.33; scholarships
under section 256B.431, subdivision 36; new text begin nursing assistant training under section 144A.611;
new text end planned closure rate adjustments under section 256B.437; or single bed room incentives
under section 256B.431, subdivision 42; property taxes and property insurance; and PERA.

Sec. 4.

Minnesota Statutes 2013 Supplement, section 256B.441, subdivision 53,
is amended to read:

Subd. 53.

Calculation of payment rate for external fixed costs.

The commissioner
shall calculate a payment rate for external fixed costs.

(a) For a facility licensed as a nursing home, the portion related to section 256.9657
shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care
home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the
result of its number of nursing home beds divided by its total number of licensed beds.

(b) The portion related to the licensure fee under section 144.122, paragraph (d),
shall be the amount of the fee divided by actual resident days.

(c) The portion related to scholarships shall be determined under section 256B.431,
subdivision 36.

(d) Until September 30, 2013, the portion related to long-term care consultation shall
be determined according to section 256B.0911, subdivision 6.

(e) The portion related to development and education of resident and family advisory
councils under section 144A.33 shall be $5 divided by 365.

(f) The portion related to planned closure rate adjustments shall be as determined
under section 256B.437, subdivision 6, and Minnesota Statutes 2010, section 256B.436.
Planned closure rate adjustments that take effect before October 1, 2014, shall no longer
be included in the payment rate for external fixed costs beginning October 1, 2016.
Planned closure rate adjustments that take effect on or after October 1, 2014, shall no
longer be included in the payment rate for external fixed costs beginning on October 1 of
the first year not less than two years after their effective date.

(g) The portions related to property insurance, real estate taxes, special assessments,
and payments made in lieu of real estate taxes directly identified or allocated to the nursing
facility shall be the actual amounts divided by actual resident days.

(h) The portion related to the Public Employees Retirement Association shall be
actual costs divided by resident days.

(i) The single bed room incentives shall be as determined under section 256B.431,
subdivision 42. Single bed room incentives that take effect before October 1, 2014, shall
no longer be included in the payment rate for external fixed costs beginning October 1,
2016. Single bed room incentives that take effect on or after October 1, 2014, shall no
longer be included in the payment rate for external fixed costs beginning on October 1 of
the first year not less than two years after their effective date.

(j) new text begin The portion related to the nursing assistant training costs under section 144A.611
shall be actual costs divided by resident days.
new text end

new text begin (k) new text end The payment rate for external fixed costs shall be the sum of the amounts in
paragraphs (a) to deleted text begin (i) deleted text end new text begin (j) new text end .

Sec. 5.

Minnesota Statutes 2012, section 256B.441, is amended by adding a
subdivision to read:

new text begin Subd. 64. new text end

new text begin Nursing facility apprenticeship rate incentive program. new text end

new text begin (a) The
commissioner of human services shall create a program providing an adjustment to nursing
facility payment rates to reflect increased wages for persons registered as apprentices in a
state or federal registered apprenticeship program that is approved by the commissioner of
labor and industry or a Minnesota postsecondary education institution.
new text end

new text begin (b) Beginning on or after October 1, 2014, within the limits of appropriations
specifically available for this purpose, the commissioner of human services shall make
funding available to nursing facility applicants to reimburse wage differentials for
employees participating in approved state or federal registered apprenticeship programs.
new text end

new text begin (c) Costs eligible for the rate increase under this subdivision shall be based on the
number of employees participating in the apprenticeship program and the wage differential
and associated benefit costs that are provided to them by the employer compared to similar
employees who are not in the apprenticeship program.
new text end

new text begin (d) The commissioner shall publish a request for proposals in the State Register by
August 1, 2014, specifying eligibility requirements, selection criteria, program specifics,
available funding, and methods of evaluation. The commissioner may publish additional
requests for proposals in subsequent years. Nursing facilities that are selected for the
incentive program under this subdivision shall receive a rate increase effective October
1, 2014.
new text end

new text begin (e) Within the limits of appropriations specifically available for this purpose,
effective October 1, 2014, the commissioner shall provide to each facility selected under
paragraph (d) an operating payment rate increase that is calculated as the costs identified
under paragraph (c) divided by resident days from the most recent cost report. Facilities
must repay any portion of funds awarded under this subdivision that are not used to fund
increased wages.
new text end

new text begin (f) Nursing facilities selected for this program shall report to the commissioner on a
schedule determined by the commissioner and on a form supplied by the commissioner.
The report shall include the amount spent during the reporting period on eligible wage
increases, and, for each recipient, the name of the recipient, the amount awarded, the
educational institution attended, the nature of the apprenticeship program, and the
expected or actual completion date. The commissioner shall require facilities to repay all
of the funds awarded under paragraph (e) if the report required in this paragraph is not
filed according to the schedule determined by the commissioner.
new text end

new text begin (g) The commissioner shall report to the legislature annually, beginning March
15, 2015, on the impact of this program, including the amount expended, number
of employees and facilities participating, and the impact of various measures on the
workforce, including recruitment and retention.
new text end

new text begin (h) For the rate year beginning October 1, 2014, the commissioner may approve
participants in the nursing facility apprenticeship rate incentive program under this
subdivision.
new text end

Sec. 6. new text begin STUDY AND RECOMMENDATIONS ON HOME AND
COMMUNITY-BASED SCHOLARSHIP PROGRAM.
new text end

new text begin (a) By January 15, 2015, the commissioner of employment and economic
development, in consultation with stakeholders, shall report to the legislative committees
with jurisdiction over employment and economic development, health, and human
services policy and finance recommendations on the creation of a scholarship program
for the state's workforce serving an aging population, including service providers funded
through the following programs:
new text end

new text begin (1) home and community-based waivered services for the elderly under Minnesota
Statutes, section 256B.0915;
new text end

new text begin (2) nursing services and home health services under Minnesota Statutes, section
256B.0625, subdivision 6a; and
new text end

new text begin (3) private duty nursing services under Minnesota Statutes, section 256B.0625,
subdivision 7.
new text end

new text begin (b) The report shall include, but not be limited to:
new text end

new text begin (1) demographic demand and anticipated job growth in home and community-based
services;
new text end

new text begin (2) staffing challenges currently faced by providers serving older adults;
new text end

new text begin (3) program goals;
new text end

new text begin (4) participating providers and selection criteria;
new text end

new text begin (5) funding requirements;
new text end

new text begin (6) reporting requirements; and
new text end

new text begin (7) evaluation options.
new text end

Sec. 7. new text begin APPROPRIATION; LONG-TERM CARE GRANT PROGRAM.
new text end

new text begin (a) $....... in fiscal year 2015 is appropriated from the general fund to the
commissioner of employment and economic development for a grant program to further
the advancement of long-term care careers. Long-term care employers, Minnesota
postsecondary education institutions, and adult training programs may apply to receive
grants for the following purposes:
new text end

new text begin (1) to provide funding for employees to further education opportunities;
new text end

new text begin (2) conferences;
new text end

new text begin (3) to highlight long-term care week;
new text end

new text begin (4) to provide hiring incentives to attract employees to the long-term care field;
new text end

new text begin (5) to provide leadership training for staff;
new text end

new text begin (6) to fund innovative adult training programs that train low-income and
underemployed individuals;
new text end

new text begin (7) to provide mentorship models;
new text end

new text begin (8) to fund simulation centers at local community colleges to train employees for
long-term care careers;
new text end

new text begin (9) to support health care education programming; and
new text end

new text begin (10) to provide innovative models for employers to implement policies and programs
to attract and retain employees in the long-term care field.
new text end

new text begin (b) Eligible organizations must apply to the commissioner of employment and
economic development for a grant on the forms and according to the timelines established
by the commissioner. The commissioner shall give preference to long-term care providers
including nursing facilities, home care agencies licensed under Minnesota Statutes,
chapter 144A, and providers registered as housing with services establishments under
Minnesota Statutes, chapter 144D.
new text end

new text begin (c) The commissioner shall publish the grant notice twice per year and make grants
on October 1 and March 1 of each year the long-term care grant program is funded.
new text end

Sec. 8. new text begin APPROPRIATION; LONG-TERM CARE STUDY.
new text end

new text begin $....... in fiscal year 2015 is appropriated from the general fund to the commissioner
of employment and economic development to study ways in which tax credits or
hiring incentives can benefit long-term care employers to recruit, retain, and provide
career ladders to employees in the long-term care field. The commissioner must
report recommendations to the chairs and ranking minority members of the legislative
committees with jurisdiction over employment and economic development, health, and
human services policy and finance by February 1, 2015.
new text end

Sec. 9. new text begin APPROPRIATION; NURSE LOAN FORGIVENESS PROGRAM.
new text end

new text begin $260,000 in fiscal year 2015 is appropriated from the general fund to the
commissioner of health for the nurse loan forgiveness program under Minnesota Statutes,
section 144.1501. This appropriation is in addition to any previous appropriation for this
purpose and is added to the program's base.
new text end

Sec. 10. new text begin APPROPRIATION; NURSING FACILITY APPRENTICESHIP RATE
INCENTIVE PROGRAM.
new text end

new text begin $....... in fiscal year 2015 is appropriated from the general fund to the commissioner
of human services for the nursing facility apprenticeship rate incentive program under
Minnesota Statutes, section 256B.441, subdivision 64. This appropriation shall be
increased by ten percent in each subsequent rate year to allow for ongoing growth in
program participation.
new text end