HF 7

as introduced - 82nd Legislature (2001 - 2002) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act 
  1.2             relating to human services; providing rate adjustments 
  1.3             for nursing facilities, intermediate care facilities 
  1.4             for persons with mental retardation and related 
  1.5             conditions, and direct care providers; amending 
  1.6             Minnesota Statutes 2000, sections 256B.431, by adding 
  1.7             a subdivision; 256B.434, subdivision 4; and 256B.501, 
  1.8             by adding a subdivision. 
  1.9   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.10     Section 1.  Minnesota Statutes 2000, section 256B.431, is 
  1.11  amended by adding a subdivision to read: 
  1.12     Subd. 31.  [NURSING FACILITY RATE INCREASES BEGINNING JULY 
  1.13  1, 2001, AND JULY 1, 2002.] (a) For the rate years beginning 
  1.14  July 1, 2001, and July 1, 2002, the commissioner shall make 
  1.15  available to each nursing facility reimbursed under this section 
  1.16  or section 256B.434, an adjustment to the total operating 
  1.17  payment rate.  For nursing facilities reimbursed under this 
  1.18  section or section 256B.434, the payment rate increases provided 
  1.19  in this subdivision for each rate year shall be applied to each 
  1.20  facility's operating payment rate in effect on June 30 of the 
  1.21  prior rate year.  For each facility, total operating costs shall 
  1.22  be separated into costs that are compensation-related and all 
  1.23  other costs.  Compensation-related costs include salaries, 
  1.24  payroll taxes, and fringe benefits for all employees, except 
  1.25  management fees, the administrator, and central office staff. 
  1.26     (b) For the rate year beginning July 1, 2001, the 
  1.27  commissioner shall make available: 
  2.1      (1) a rate increase for each case mix payment rate which 
  2.2   must be used to increase the per-hour pay rate of all employees 
  2.3   except management fees, the administrator, and central office 
  2.4   staff by an equal dollar amount and to pay associated costs for 
  2.5   FICA, the Medicare tax, workers' compensation premiums, and 
  2.6   federal and state unemployment insurance, to be calculated 
  2.7   according to clauses (i) to (iii): 
  2.8      (i) the commissioner shall calculate the arithmetic mean of 
  2.9   the 11 June 30, 2001, operating rates for each facility; 
  2.10     (ii) the commissioner shall construct an array of nursing 
  2.11  facilities from highest to lowest, according to the arithmetic 
  2.12  mean calculated in clause (i).  A numerical rank shall be 
  2.13  assigned to each facility in the array.  The facility with the 
  2.14  highest mean shall be assigned a numerical rank of one.  The 
  2.15  facility with the lowest mean shall be assigned a numerical rank 
  2.16  equal to the total number of nursing facilities in the array.  
  2.17  All other facilities shall be assigned a numerical rank in 
  2.18  accordance with their position in the array; 
  2.19     (iii) the amount of the additional rate increase shall be 
  2.20  $1 plus an amount equal to $....... multiplied by the ratio of 
  2.21  the facility's numeric rank divided by the number of facilities 
  2.22  in the array; and 
  2.23     (2) a rate increase for all other operating costs of three 
  2.24  percent. 
  2.25     Money received by a facility as a result of the additional 
  2.26  rate increase provided under clause (1) shall be used only for 
  2.27  wage increases implemented on or after July 1, 2001, and shall 
  2.28  not be used for wage increases implemented prior to that date. 
  2.29     (c) For the rate year beginning July 1, 2002, the 
  2.30  commissioner shall make available: 
  2.31     (1) a rate increase for each case mix payment rate which 
  2.32  must be used to increase the per-hour pay rate of all employees 
  2.33  except management fees, the administrator, and central office 
  2.34  staff by an equal dollar amount and to pay associated costs for 
  2.35  FICA, the Medicare tax, workers' compensation premiums, and 
  2.36  federal and state unemployment insurance, to be calculated 
  3.1   according to clauses (i) to (iii): 
  3.2      (i) the commissioner shall calculate the arithmetic mean of 
  3.3   the 11 June 30, 2002, operating rates for each facility; 
  3.4      (ii) the commissioner shall construct an array of nursing 
  3.5   facilities from highest to lowest, according to the arithmetic 
  3.6   mean calculated in clause (i).  A numerical rank shall be 
  3.7   assigned to each facility in the array.  The facility with the 
  3.8   highest mean shall be assigned a numerical rank of one.  The 
  3.9   facility with the lowest mean shall be assigned a numerical rank 
  3.10  equal to the total number of nursing facilities in the array.  
  3.11  All other facilities shall be assigned a numerical rank in 
  3.12  accordance with their position in the array; 
  3.13     (iii) the amount of the additional rate increase shall be 
  3.14  $1 plus an amount equal to $....... multiplied by the ratio of 
  3.15  the facility's numeric rank divided by the number of facilities 
  3.16  in the array; and 
  3.17     (2) a rate increase for all other operating costs of three 
  3.18  percent. 
  3.19     Money received by a facility as a result of the additional 
  3.20  rate increase provided under clause (1) shall be used only for 
  3.21  wage increases implemented on or after July 1, 2002, and shall 
  3.22  not be used for wage increases implemented prior to that date. 
  3.23     (d) The payment rate adjustment for each nursing facility 
  3.24  must be determined under clause (1) or (2): 
  3.25     (1) for each nursing facility that reports salaries for 
  3.26  registered nurses, licensed practical nurses, aides, orderlies, 
  3.27  and attendants separately, the commissioner shall determine the 
  3.28  payment rate adjustment using the categories specified in 
  3.29  paragraph (a) multiplied by the rate increases specified in 
  3.30  paragraph (b) or (c), and then dividing the resulting amount by 
  3.31  the nursing facility's actual resident days.  In determining the 
  3.32  amount of a payment rate adjustment for a nursing facility 
  3.33  reimbursed under section 256B.434, the commissioner shall 
  3.34  determine the proportions of the facility's rates that are 
  3.35  compensation-related costs and all other operating costs based 
  3.36  on the facility's most recent cost report; and 
  4.1      (2) for each nursing facility that does not report salaries 
  4.2   for registered nurses, licensed practical nurses, aides, 
  4.3   orderlies, and attendants separately, the payment rate 
  4.4   adjustment shall be computed using the facility's total 
  4.5   operating costs, separated into the categories specified in 
  4.6   paragraph (a) in proportion to the weighted average of all 
  4.7   facilities determined under clause (1), multiplied by the rate 
  4.8   increases specified in paragraph (b) or (c), and then dividing 
  4.9   the resulting amount by the nursing facility's actual resident 
  4.10  days. 
  4.11     (e) A nursing facility may apply for the 
  4.12  compensation-related payment rate adjustment calculated under 
  4.13  this subdivision.  The application must be made to the 
  4.14  commissioner and contain a plan by which the nursing facility 
  4.15  will distribute the compensation-related portion of the payment 
  4.16  rate adjustment to employees of the nursing facility.  For 
  4.17  nursing facilities in which the employees are represented by an 
  4.18  exclusive bargaining representative, an agreement negotiated and 
  4.19  agreed to by the employer and the exclusive bargaining 
  4.20  representative constitutes the plan.  For the second rate year, 
  4.21  a negotiated agreement constitutes the plan only if the 
  4.22  agreement is finalized after the date of enactment of all rate 
  4.23  increases for the second rate year.  The commissioner shall 
  4.24  review the plan to ensure that the payment rate adjustment per 
  4.25  diem is used as provided in paragraphs (b) and (c).  To be 
  4.26  eligible, a facility must submit its plan for the compensation 
  4.27  distribution by December 31 each year.  If a facility's plan for 
  4.28  compensation distribution is effective for its employees after 
  4.29  July 1 of the year that the funds are available, the payment 
  4.30  rate adjustment per diem shall be effective the same date as its 
  4.31  plan. 
  4.32     (f) A copy of the approved distribution plan must be made 
  4.33  available to all employees.  This must be done by giving each 
  4.34  employee a copy or by posting it in an area of the nursing 
  4.35  facility to which all employees have access.  If an employee 
  4.36  does not receive the compensation adjustment described in their 
  5.1   facility's approved plan and is unable to resolve the problem 
  5.2   with the facility's management or through the employee's union 
  5.3   representative, the employee may contact the commissioner at an 
  5.4   address or phone number provided by the commissioner and 
  5.5   included in the approved plan. 
  5.6      Sec. 2.  Minnesota Statutes 2000, section 256B.434, 
  5.7   subdivision 4, is amended to read: 
  5.8      Subd. 4.  [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 
  5.9   nursing facilities which have their payment rates determined 
  5.10  under this section rather than section 256B.431, the 
  5.11  commissioner shall establish a rate under this subdivision.  The 
  5.12  nursing facility must enter into a written contract with the 
  5.13  commissioner. 
  5.14     (b) A nursing facility's case mix payment rate for the 
  5.15  first rate year of a facility's contract under this section is 
  5.16  the payment rate the facility would have received under section 
  5.17  256B.431. 
  5.18     (c) A nursing facility's case mix payment rates for the 
  5.19  second and subsequent years of a facility's contract under this 
  5.20  section are the previous rate year's contract payment rates plus 
  5.21  an inflation adjustment.  The index for the inflation adjustment 
  5.22  must be based on the change in the Consumer Price Index-All 
  5.23  Items (United States City average) (CPI-U) forecasted by Data 
  5.24  Resources, Inc., as forecasted in the fourth quarter of the 
  5.25  calendar year preceding the rate year.  The inflation adjustment 
  5.26  must be based on the 12-month period from the midpoint of the 
  5.27  previous rate year to the midpoint of the rate year for which 
  5.28  the rate is being determined.  For the rate years beginning on 
  5.29  July 1, 1999, and July 1, 2000, July 1, 2001, and July 1, 2002, 
  5.30  this paragraph shall apply only to the property-related payment 
  5.31  rate.  In determining the amount of the property-related payment 
  5.32  rate adjustment under this paragraph, the commissioner shall 
  5.33  determine the proportion of the facility's rates that are 
  5.34  property-related based on the facility's most recent cost report.
  5.35     (d) The commissioner shall develop additional 
  5.36  incentive-based payments of up to five percent above the 
  6.1   standard contract rate for achieving outcomes specified in each 
  6.2   contract.  The specified facility-specific outcomes must be 
  6.3   measurable and approved by the commissioner.  The commissioner 
  6.4   may establish, for each contract, various levels of achievement 
  6.5   within an outcome.  After the outcomes have been specified the 
  6.6   commissioner shall assign various levels of payment associated 
  6.7   with achieving the outcome.  Any incentive-based payment cancels 
  6.8   if there is a termination of the contract.  In establishing the 
  6.9   specified outcomes and related criteria the commissioner shall 
  6.10  consider the following state policy objectives: 
  6.11     (1) improved cost effectiveness and quality of life as 
  6.12  measured by improved clinical outcomes; 
  6.13     (2) successful diversion or discharge to community 
  6.14  alternatives; 
  6.15     (3) decreased acute care costs; 
  6.16     (4) improved consumer satisfaction; 
  6.17     (5) the achievement of quality; or 
  6.18     (6) any additional outcomes proposed by a nursing facility 
  6.19  that the commissioner finds desirable. 
  6.20     Sec. 3.  Minnesota Statutes 2000, section 256B.501, is 
  6.21  amended by adding a subdivision to read: 
  6.22     Subd. 14.  [ICF/MR RATE INCREASES BEGINNING OCTOBER 1, 
  6.23  2001, AND OCTOBER 1, 2002.] (a) For the rate years beginning 
  6.24  October 1, 2001, and October 1, 2002, the commissioner shall 
  6.25  make available to each facility reimbursed under this section, 
  6.26  section 256B.5011, and Laws 1993, First Special Session chapter 
  6.27  1, article 4, section 11, an adjustment to the total operating 
  6.28  payment rate.  For each facility, total operating costs shall be 
  6.29  separated into costs that are compensation related and all other 
  6.30  costs.  "Compensation-related costs" means the facility's 
  6.31  allowable program operating cost category employee training 
  6.32  expenses and the facility's allowable salaries, payroll taxes, 
  6.33  and fringe benefits.  The term does not include these same 
  6.34  salary-related costs for both administrative or central office 
  6.35  employees. 
  6.36     For the purpose of determining the adjustment to be granted 
  7.1   under this subdivision, the commissioner must use the most 
  7.2   recent cost report that has been subject to desk audit. 
  7.3      (b) For the rate year beginning October 1, 2001, the 
  7.4   commissioner shall make available a rate increase for 
  7.5   compensation-related costs of ... percent and a rate increase 
  7.6   for all other operating costs of ... percent. 
  7.7      (c) For the rate year beginning October 1, 2002, the 
  7.8   commissioner shall make available a rate increase for 
  7.9   compensation related costs of ... percent, and a rate increase 
  7.10  for all other operating costs of ... percent. 
  7.11     (d) For each facility, the commissioner shall determine the 
  7.12  payment rate adjustment using the categories specified in 
  7.13  paragraph (a) multiplied by the rate increases specified in 
  7.14  paragraph (b) or (c), and then dividing the resulting amount by 
  7.15  the facility's actual resident days.  
  7.16     (e) Any facility whose payment rates are governed by 
  7.17  closure agreements, receivership agreements, or Minnesota Rules, 
  7.18  part 9553.0075, are not eligible for an adjustment otherwise 
  7.19  granted under this subdivision.  
  7.20     (f) A facility may apply for the compensation-related 
  7.21  payment rate adjustment calculated under this subdivision.  The 
  7.22  application must be made to the commissioner and contain a plan 
  7.23  by which the facility will distribute the compensation-related 
  7.24  portion of the payment rate adjustment to employees of the 
  7.25  facility.  For facilities in which the employees are represented 
  7.26  by an exclusive bargaining representative, an agreement 
  7.27  negotiated and agreed to by the employer and the exclusive 
  7.28  bargaining representative constitutes the plan.  The 
  7.29  commissioner shall review the plan to ensure that the payment 
  7.30  rate adjustment per diem is used as provided in this 
  7.31  subdivision.  To be eligible, a facility must submit its plan 
  7.32  for the compensation distribution by December 31 each year.  If 
  7.33  a facility's plan for compensation distribution is effective for 
  7.34  its employees after October 1 of the year that the funds are 
  7.35  available, the payment rate adjustment per diem shall be 
  7.36  effective the same date as its plan. 
  8.1      (g) A copy of the approved distribution plan must be made 
  8.2   available to all employees.  This must be done by giving each 
  8.3   employee a copy or by posting it in an area of the facility to 
  8.4   which all employees have access.  If an employee does not 
  8.5   receive the compensation adjustment described in their 
  8.6   facility's approved plan and is unable to resolve the problem 
  8.7   with the facility's management or through the employee's union 
  8.8   representative, the employee may contact the commissioner at an 
  8.9   address or telephone number provided by the commissioner and 
  8.10  included in the approved plan. 
  8.11     (h) Money received by a facility as a result of the 
  8.12  additional rate increases provided under this subdivision shall 
  8.13  be used only for compensation increases implemented on or after 
  8.14  the first day of the state fiscal year in which the increase is 
  8.15  available, and must not be used for compensation increases 
  8.16  implemented before those dates. 
  8.17     Sec. 4.  [PROVIDER RATE INCREASES.] 
  8.18     (a) The commissioner of human services shall increase 
  8.19  reimbursement rates by ... percent each year of the biennium 
  8.20  ending June 30, 2003, for the providers listed in paragraph 
  8.21  (b).  The increases shall be effective for services rendered on 
  8.22  or after July 1 of each year. 
  8.23     (b) The rate increases described in this section shall be 
  8.24  provided to home and community-based waivered services for 
  8.25  persons with mental retardation or related conditions under 
  8.26  Minnesota Statutes, section 256B.501; home and community-based 
  8.27  waivered services for the elderly under Minnesota Statutes, 
  8.28  section 256B.0915; waivered services under community 
  8.29  alternatives for disabled individuals under Minnesota Statutes, 
  8.30  section 256B.49; community alternative care waivered services 
  8.31  under Minnesota Statutes, section 256B.49; traumatic brain 
  8.32  injury waivered services under Minnesota Statutes, section 
  8.33  256B.49; nursing services and home health services under 
  8.34  Minnesota Statutes, section 256B.0625, subdivision 6a; personal 
  8.35  care services and nursing supervision of personal care services 
  8.36  under Minnesota Statutes, section 256B.0625, subdivision 19a; 
  9.1   private-duty nursing services under Minnesota Statutes, section 
  9.2   256B.0625, subdivision 7; day training and habilitation services 
  9.3   for adults with mental retardation or related conditions under 
  9.4   Minnesota Statutes, sections 252.40 to 252.46; alternative care 
  9.5   services under Minnesota Statutes, section 256B.0913; adult 
  9.6   residential program grants under Minnesota Rules, parts 
  9.7   9535.2000 to 9535.3000; adult and family community support 
  9.8   grants under Minnesota Rules, parts 9535.1700 to 9535.1760; 
  9.9   semi-independent living services under Minnesota Statutes, 
  9.10  section 252.275, including SILS funding under county social 
  9.11  services grants formerly funded under Minnesota Statutes, 
  9.12  chapter 256I; community support services for deaf and 
  9.13  hard-of-hearing adults with mental illness who use or wish to 
  9.14  use sign language as their primary means of communication; and 
  9.15  living skills training programs for persons with intractable 
  9.16  epilepsy who need assistance in the transition to independent 
  9.17  living. 
  9.18     (c) Providers that receive a rate increase under this 
  9.19  section shall use at least 80 percent of the additional revenue 
  9.20  to increase the compensation paid to employees other than the 
  9.21  administrator and central office staff.  Money received by a 
  9.22  provider as a result of the additional rate increases in this 
  9.23  section shall be used only for compensation increases 
  9.24  implemented on or after the first day of the state fiscal year 
  9.25  in which the increase is available, and must not be used for 
  9.26  compensation increases implemented before that date. 
  9.27     (d) A copy of the provider's plan for complying with 
  9.28  paragraph (c) must be made available to all employees.  This 
  9.29  must be done by giving each employee a copy or by posting it in 
  9.30  an area of the provider's operation to which all employees have 
  9.31  access.  If an employee does not receive the salary adjustment 
  9.32  described in the plan and is unable to resolve the problem with 
  9.33  the provider, the employee may contact the employee's union 
  9.34  representative.  If the employee is not covered by a collective 
  9.35  bargaining agreement, the employee may contact the commissioner 
  9.36  at a phone number provided by the commissioner and included in 
 10.1   the provider's plan.