HF 345

as introduced - 81st Legislature (1999 - 2000) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act 
  1.2             relating to human services; requiring elimination of 
  1.3             the waiting list for home and community-based waivered 
  1.4             services for persons with mental retardation; 
  1.5             authorizing the reallocation of unspent resources; 
  1.6             requiring certain counties to form partnerships to 
  1.7             deliver waiver services; requiring a federal waiver 
  1.8             request to allow program flexibility; authorizing a 
  1.9             reserve account of one-half percent; appropriating 
  1.10            money; amending Minnesota Statutes 1998, section 
  1.11            256B.0916. 
  1.12  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.13     Section 1.  Minnesota Statutes 1998, section 256B.0916, is 
  1.14  amended to read: 
  1.15     256B.0916 [EXPANSION OF HOME AND COMMUNITY-BASED SERVICES; 
  1.16  MANAGEMENT AND ALLOCATION RESPONSIBILITIES.] 
  1.17     (a) The commissioner shall expand availability of home and 
  1.18  community-based services for persons with mental retardation and 
  1.19  related conditions to the extent allowed by federal law and 
  1.20  regulation and shall assist counties in transferring persons 
  1.21  from semi-independent living services to home and 
  1.22  community-based services.  The commissioner may transfer funds 
  1.23  from the state semi-independent living services account 
  1.24  available under section 252.275, subdivision 8, and state 
  1.25  community social services aids available under section 256E.15 
  1.26  to the medical assistance account to pay for the nonfederal 
  1.27  share of nonresidential and residential home and community-based 
  1.28  services authorized under section 256B.092 for persons 
  2.1   transferring from semi-independent living services. 
  2.2      (b) Upon federal approval, county boards are not 
  2.3   responsible for funding semi-independent living services as a 
  2.4   social service for those persons who have transferred to the 
  2.5   home and community-based waiver program as a result of the 
  2.6   expansion under this subdivision.  The county responsibility for 
  2.7   those persons transferred shall be assumed under section 
  2.8   256B.092.  Notwithstanding the provisions of section 252.275, 
  2.9   the commissioner shall continue to allocate funds under that 
  2.10  section for semi-independent living services and county boards 
  2.11  shall continue to fund services under sections 256E.06 and 
  2.12  256E.14 for those persons who cannot access home and 
  2.13  community-based services under section 256B.092. 
  2.14     (c) Eighty percent of the state funds made available to the 
  2.15  commissioner under section 252.275 as a result of persons 
  2.16  transferring from the semi-independent living services program 
  2.17  to the home and community-based services program shall be used 
  2.18  to fund additional persons in the semi-independent living 
  2.19  services program. 
  2.20     (d) Beginning August 1, 1998, the commissioner shall issue 
  2.21  an annual report on the home and community-based waiver for 
  2.22  persons with mental retardation or related conditions, that 
  2.23  includes a list of the counties in which less than 95 percent of 
  2.24  the allocation provided, excluding the county waivered services 
  2.25  reserve, has been committed for two or more quarters during the 
  2.26  previous state fiscal year.  For each listed county, the report 
  2.27  shall include the amount of funds allocated but not used, the 
  2.28  number and ages of individuals screened and waiting for 
  2.29  services, the services needed, a description of the technical 
  2.30  assistance provided by the commissioner to assist the counties 
  2.31  in jointly planning with other counties in order to serve more 
  2.32  persons, and additional actions which will be taken to serve 
  2.33  those screened and waiting for services. 
  2.34     (e) The commissioner shall make available to interested 
  2.35  parties, upon request, financial information by county including 
  2.36  the amount of resources allocated for the home and 
  3.1   community-based waiver for persons with mental retardation and 
  3.2   related conditions, the resources committed, the number of 
  3.3   persons screened and waiting for services, the type of services 
  3.4   requested by those waiting, and the amount of allocated 
  3.5   resources not committed. 
  3.6      (f) The legislature recognizes that as of January 1, 1999, 
  3.7   3,300 persons with mental retardation or related conditions have 
  3.8   been screened and determined eligible for the home and 
  3.9   community-based waivered services program for persons with 
  3.10  mental retardation or related conditions, and 900 families have 
  3.11  been screened and are eligible for the family support program.  
  3.12  Many wait for several years before receiving services.  The 
  3.13  waiting list for these programs shall be eliminated by June 30, 
  3.14  2003.  In order to reduce the number of eligible persons waiting 
  3.15  for identified services provided through the home and 
  3.16  community-based waivered services for persons with mental 
  3.17  retardation or related conditions, funding shall be increased to 
  3.18  add 500 additional eligible persons each year beyond the 
  3.19  November 1998 medical assistance forecast for the period July 1, 
  3.20  1999, to June 30, 2003. 
  3.21     (g) In order to maximize the number of persons served with 
  3.22  waivered funds, the commissioner shall monitor county 
  3.23  utilization of allocated resources and, as appropriate, reassign 
  3.24  resources not utilized.  Priority consideration for the 
  3.25  reassignment of resources shall be given to counties that enter 
  3.26  into written agreements with other counties to jointly plan, 
  3.27  request resources, and develop services for persons with mental 
  3.28  retardation or related conditions who are eligible and are 
  3.29  waiting for waivered services.  In addition to the priorities 
  3.30  listed in Minnesota Rules, part 9525.1880, the commissioner 
  3.31  shall also give priority consideration to persons whose living 
  3.32  situations are unstable due to the age or incapacity of the 
  3.33  primary caregiver.  The commissioner shall report to the chairs 
  3.34  of the senate health and family security budget division and the 
  3.35  house health and human services finance division by March 1 of 
  3.36  each year on the authorization and utilization of waivered 
  4.1   services for persons with mental retardation or related 
  4.2   conditions, including crisis respite services; the number of 
  4.3   counties managing waivered funds in joint partnerships; 
  4.4   additional persons served by the reassignment of resources; and 
  4.5   options that would decrease the number of eligible persons 
  4.6   waiting for services. 
  4.7      (h) Beginning on July 1, 1999, the commissioner shall 
  4.8   distribute all new funding available for the home and 
  4.9   community-based waivered services for persons with mental 
  4.10  retardation or related conditions to individual counties or 
  4.11  groups of counties that form partnerships to jointly plan, 
  4.12  administer, and authorize funding for eligible individuals.  In 
  4.13  order to receive funding, a county or group of counties must 
  4.14  have provided home and community-based waivered services for 
  4.15  persons with mental retardation or related conditions to at 
  4.16  least 100 eligible clients as of January 1, 1999.  For counties 
  4.17  that had less than 100 home and community-based waivered 
  4.18  services recipients as of that date and do not join a 
  4.19  partnership with other counties by August 1, 1999, the 
  4.20  commissioner shall assign planning and management 
  4.21  responsibilities for waivered service funds to a qualified 
  4.22  nonprofit entity.  The entity must serve a minimum of 100 home 
  4.23  and community-based waivered services recipients and must comply 
  4.24  with all requirements applicable to counties in managing the 
  4.25  program.  In order to obtain funds under this provision, 
  4.26  counties and nonprofit entities selected by the commissioner 
  4.27  must submit a request for funds and a plan for administering the 
  4.28  program to the commissioner by September 1, 1999.  The plan must 
  4.29  identify the number of clients to be served, their ages, and 
  4.30  their priority listing based on:  (1) requirements in Minnesota 
  4.31  Rules, part 9525.1880; and (2) whether living situations are 
  4.32  unstable due to the age or incapacity of the primary caregiver.  
  4.33  The commissioner shall select one or more qualified nonprofit 
  4.34  entities to plan and manage the waivered services program for 
  4.35  eligible recipients in counties that served over 100 clients on 
  4.36  January 1, 1999, but fail to submit a plan by September 1, 
  5.1   1999.  Counties and nonprofit entities managing waivered service 
  5.2   funds are eligible to receive reimbursement for administrative 
  5.3   costs under criteria established by the commissioner. 
  5.4      (i) The commissioner shall submit to the federal Health 
  5.5   Care Financing Administration by July 1, 1999, a request to 
  5.6   amend the home and community-based waiver for persons with 
  5.7   mental retardation or related conditions to allow more 
  5.8   flexibility to meet the needs of eligible persons under that 
  5.9   program.  The waiver request must include an option that would 
  5.10  allow waivered service recipients to:  (1) directly receive 95 
  5.11  percent of the funds that would be allocated to individuals 
  5.12  based on the profile amount assigned by the commissioner for 
  5.13  this waiver; and (2) use these funds to purchase services to 
  5.14  meet their long-term needs.  The waiver request must include a 
  5.15  provision requiring recipients who receive funds directly to 
  5.16  provide to the commissioner annually a description of the type 
  5.17  of services used, the period of time each service was provided, 
  5.18  the amount paid for the services purchased, and the amount of 
  5.19  unspent funds.  If this waiver is approved and implemented, any 
  5.20  unspent money from the waivered services allocation, including 
  5.21  the five percent not directly allocated to recipients and any 
  5.22  unspent portion of the money that is directly allocated, shall 
  5.23  be used to meet the needs of other eligible persons waiting for 
  5.24  services funded through the waiver.  Any portion of the 
  5.25  allocation remaining unspent at the end of a fiscal year shall 
  5.26  not cancel but shall be carried forward to the next fiscal year 
  5.27  for this purpose.  The commissioner, in consultation with county 
  5.28  social service agencies, waivered service providers, recipients, 
  5.29  and recipients' families and legal guardians, shall evaluate the 
  5.30  effectiveness of this option within two years of its 
  5.31  implementation. 
  5.32     (j) Counties with more than 100 waivered service recipients 
  5.33  and counties participating in partnerships may develop a reserve 
  5.34  account to meet crises and other unmet needs of current home and 
  5.35  community-based waivered recipients.  The amount of the allowed 
  5.36  reserve account shall be the lesser of:  (1) an amount 
  6.1   specifically based upon the documented past experience of the 
  6.2   counties, described in a reserve account plan submitted for 
  6.3   approval to the commissioner with the allocation request; or (2) 
  6.4   one-half percent of the waiver funding allocation for the fiscal 
  6.5   year.  Any funds remaining in a reserve account at the end of 
  6.6   the fiscal year do not cancel, but shall carry forward and be 
  6.7   used by counties or regional partnerships for home and 
  6.8   community-based services for the next fiscal year, unless 
  6.9   reallocated to other counties. 
  6.10     Sec. 2.  [APPROPRIATION.] 
  6.11     (a) $....... is appropriated from the general fund to the 
  6.12  commissioner of human services for the biennium beginning July 
  6.13  1, 1999, for increased home and community-based waivered 
  6.14  services for persons with mental retardation or a related 
  6.15  condition.  
  6.16     (b) $2,000,000 is appropriated from the general fund to the 
  6.17  commissioner of human services for each year of the biennium 
  6.18  beginning July 1, 1999, for semi-independent living services 
  6.19  under Minnesota Statutes, section 252.275. 
  6.20     (c) $3,000,000 is appropriated from the general fund to the 
  6.21  commissioner of human services for each year of the biennium 
  6.22  beginning July 1, 1999, for family support grants under 
  6.23  Minnesota Statutes, section 252.32. 
  6.24     (d) $....... is appropriated from the general fund to the 
  6.25  commissioner of human services for the biennium beginning July 
  6.26  1, 1999, to reimburse county and nonprofit entity administrative 
  6.27  costs. 
  6.28     (e) $250,000 is appropriated from the general fund to the 
  6.29  commissioner of human services for the biennium beginning July 
  6.30  1, 1999, for technical assistance to counties to improve county 
  6.31  management of the waivered services program and to assist 
  6.32  counties in forming joint partnerships. 
  6.33     (f) Any unspent portion of the appropriations in this 
  6.34  section for fiscal year 2000 does not cancel but shall be 
  6.35  available for the same purpose for fiscal year 2001. 
  6.36     (g) The appropriations in this section shall become part of 
  7.1   the base-level funding for the commissioner of human services.