Minnesota Legislature
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2nd Engrossment - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am
Current Version - 2nd Engrossment
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A bill for an act
relating to human services; establishing a self-directed personal supports option;
modifying the Minnesota supplemental aid standard; directing the commissioner
to license programs for youth with disabilities; requiring reports; appropriating
money; amending Minnesota Statutes 2006, sections 256B.0625, by adding
a subdivision; 256D.44, subdivisions 2, 5; proposing coding for new law in
Minnesota Statutes, chapter 256B.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2006, section 256B.0625, is amended by adding a
subdivision to read:
new text begin Subd. 49. new text end
new text begin Self-directed supports option. new text end
new text begin
Upon federal approval, medical
assistance covers the self-directed supports option as defined under section 256B.0657 and
section 6087 of the Federal Deficit Reduction Act of 2005, Public Law 109-171.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective upon federal approval of the state
Medicaid plan amendment. The commissioner of human services shall inform the Office
of the Revisor of Statutes when approval is obtained.
new text end
Sec. 2.
new text begin
[256B.0657] SELF-DIRECTED SUPPORTS OPTION.
new text end
new text begin Subdivision 1. new text end
new text begin Definition. new text end
new text begin
"Self-directed supports option" means personal
assistance, supports, items, and related services purchased under an approved budget plan
and budget by a participant who is otherwise eligible for personal care assistance under
section 256B.0655 and lives in the participant's own apartment or home which is not
owned, operated, or controlled by a provider of services not related by blood or marriage.
new text end
new text begin Subd. 2. new text end
new text begin Assessment and plan requirements. new text end
new text begin
The self-directed supports option
assessment and plan must meet the following requirements:
new text end
new text begin
(a) The assessment and plan must be completed using a person-centered process that:
new text end
new text begin
(1) builds upon the participant's capacity to engage in activities that promote
community life;
new text end
new text begin
(2) respects the participant's preferences, choices, and abilities; and
new text end
new text begin
(3) involves families, friends, and professionals in the planning or delivery of
services or supports as desired or required by the participant.
new text end
new text begin
(b) The person-centered assessment and annual reassessments shall be completed
with the assistance of a county public health nurse considering the participant's needs,
strengths, and preferences using the process for a medical assistance home care assessment
under section 256B.0658, subdivision 3.
new text end
new text begin
(c) The plan for the self-directed supports option for the participant shall be
developed annually by the participant, guardian or parent of a minor child, and, if the
participant chooses, with the assistance of an enrolled medical assistance provider
who meets the requirements established for using a person-centered planning process.
The commissioner shall establish the format and criteria for the plan as well as the
requirements for providers who assist with plan development.
new text end
new text begin Subd. 3. new text end
new text begin Self-directed budget requirements. new text end
new text begin
The budget for the provision of the
self-directed supports option must meet the following requirements:
new text end
new text begin
(a) The budget available is equal to either (1) the annual amount of personal care
assistant services under section 256B.0655, which the participant has used in the most
recent 12-month period, or (2) the amount determined using the consumer support grant
methodology under section 256.476, subdivision 11, except that the budget amount shall
include the federal share of the average service costs as well as the nonfederal share,
whichever is greater. The budget amount may be used for:
new text end
new text begin
(1) personal care assistant services under section 256B.0655; and
new text end
new text begin
(2) items, related services, and supports, including assistive technology, that increase
independence or substitute for human assistance to the extent expenditures would
otherwise be used for human assistance.
new text end
new text begin
Items, supports, and related services purchased under this option are not considered
home care services for purposes of section 144A.43.
new text end
new text begin
(b) The participant has the responsibility and authority to hire, fire, supervise,
establish staff compensation, and manage the individuals providing services, and to choose
and obtain items, related services, and supports as described in the participant's plan.
new text end
new text begin
(c) The budget may not restrict access to other medically necessary care and services
furnished under the plan and approved by the state but not included in the budget, except
that persons receiving home and community-based waiver services are not eligible for
funding under the self-directed supports option.
new text end
new text begin
(d) The plan for self-directed supports must include the total budget amount
available divided in monthly amounts, which cover the number of months of personal care
assistant service authorization included in the budget. The amount used each month may
vary; however, additional funds will not be provided beyond the annual personal care
assistant services authorized amount unless a change in condition is documented.
new text end
new text begin Subd. 4. new text end
new text begin Quality assurance and risk management. new text end
new text begin
The commissioner is required
to establish quality assurance and risk management techniques for use in developing and
implementing self-directed plans and budgets that recognize the roles and responsibilities
involved in obtaining services in a self-directed manner and that assure the appropriateness
of such plans and budgets based upon a participant's resources and capabilities.
new text end
new text begin Subd. 5. new text end
new text begin Financial management services. new text end
new text begin
Each participant shall choose a financial
management services provider certified by the commissioner to make payments for
services, items, supports, and costs related to managing a self-directed service plan
authorized for payment in the approved plan and budget. The commissioner shall certify
both fiscal support entities and agencies with choice models of financial management
services and assure that both are available to participants throughout the state.
new text end
new text begin Subd. 6. new text end
new text begin Advisory task force. new text end
new text begin
The commissioner shall establish a statewide
consumer-directed services advisory task force, including representatives of all types of
consumer-directed service users, advocacy organizations, county, and consumer-directed
service providers. The advisory task force shall meet at least three times per year and
provide advice on policy, implementation, and other aspects of consumer and self-directed
services. The commissioner shall seek recommendations from this advisory task
force in developing the self-directed plan format; requirements and guidelines for the
person-centered plan assessment and planning process; and implementation of the option,
the quality assurance and risk management techniques, standards, and requirements,
including rates, for the personal support plan development provider and the fiscal support
entity, and other self-directed supports option policies, training, and implementation issues.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
Subdivisions 1 to 5 are effective upon federal approval of
the state Medicaid plan amendment. The commissioner of human services shall inform
the Office of the Revisor of Statutes when federal approval is obtained. Subdivision 6
is effective July 1, 2007.
new text end
Sec. 3.
Minnesota Statutes 2006, section 256D.44, subdivision 2, is amended to read:
Subd. 2.
Standard of assistance for persons eligible for medical assistance
waivers or at risk of placement in a group residential housing facility.
The state
standard of assistance for a person new text begin (1) new text end who is eligible for a medical assistance home
and community-based services waiver deleted text begin or a persondeleted text end new text begin , (2)new text end who has been determined by the
local agency to meet the plan requirements for placement in a group residential housing
facility under section 256I.04, subdivision 1a, new text begin or (3) who is eligible for a shelter needy
payment under subdivision 5, paragraph (f), new text end is the standard established in subdivision 3,
paragraph (a) or (b).
Sec. 4.
Minnesota Statutes 2006, section 256D.44, subdivision 5, is amended to read:
Subd. 5.
Special needs.
In addition to the state standards of assistance established in
subdivisions 1 to 4, payments are allowed for the following special needs of recipients of
Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
center, or a group residential housing facility.
(a) The county agency shall pay a monthly allowance for medically prescribed
diets if the cost of those additional dietary needs cannot be met through some other
maintenance benefit. The need for special diets or dietary items must be prescribed by
a licensed physician. Costs for special diets shall be determined as percentages of the
allotment for a one-person household under the thrifty food plan as defined by the United
States Department of Agriculture. The types of diets and the percentages of the thrifty
food plan that are covered are as follows:
(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent
of thrifty food plan;
(3) controlled protein diet, less than 40 grams and requires special products, 125
percent of thrifty food plan;
(4) low cholesterol diet, 25 percent of thrifty food plan;
(5) high residue diet, 20 percent of thrifty food plan;
(6) pregnancy and lactation diet, 35 percent of thrifty food plan;
(7) gluten-free diet, 25 percent of thrifty food plan;
(8) lactose-free diet, 25 percent of thrifty food plan;
(9) antidumping diet, 15 percent of thrifty food plan;
(10) hypoglycemic diet, 15 percent of thrifty food plan; or
(11) ketogenic diet, 25 percent of thrifty food plan.
(b) Payment for nonrecurring special needs must be allowed for necessary home
repairs or necessary repairs or replacement of household furniture and appliances using
the payment standard of the AFDC program in effect on July 16, 1996, for these expenses,
as long as other funding sources are not available.
(c) A fee for guardian or conservator service is allowed at a reasonable rate
negotiated by the county or approved by the court. This rate shall not exceed five percent
of the assistance unit's gross monthly income up to a maximum of $100 per month. If the
guardian or conservator is a member of the county agency staff, no fee is allowed.
(d) The county agency shall continue to pay a monthly allowance of $68 for
restaurant meals for a person who was receiving a restaurant meal allowance on June 1,
1990, and who eats two or more meals in a restaurant daily. The allowance must continue
until the person has not received Minnesota supplemental aid for one full calendar month
or until the person's living arrangement changes and the person no longer meets the criteria
for the restaurant meal allowance, whichever occurs first.
(e) A fee of ten percent of the recipient's gross income or $25, whichever is less,
is allowed for representative payee services provided by an agency that meets the
requirements under SSI regulations to charge a fee for representative payee services. This
special need is available to all recipients of Minnesota supplemental aid regardless of
their living arrangement.
(f) Notwithstanding the language in this subdivision, an amount equal to the
maximum allotment authorized by the federal Food Stamp Program for a single individual
which is in effect on the first day of deleted text begin Januarydeleted text end new text begin Julynew text end of deleted text begin the previousdeleted text end new text begin eachnew text end year will be added to
the standards of assistance established in subdivisions 1 to 4 for deleted text begin individualsdeleted text end new text begin adultsnew text end under
the age of 65 who new text begin qualify as shelter needy and new text end arenew text begin : (1)new text end relocating from an institution, or
an adult mental health residential treatment program under section 256B.0622deleted text begin , and who
are shelter needydeleted text end new text begin ; (2) self-directed supports option participants defined under section
256B.0657 if enacted in the 2007 legislative session; or (3) home and community-based
waiver recipients living in their own rented, leased, or owned apartment or home not
owned, operated, or controlled by a provider of service not related by blood or marriagenew text end .
new text begin Notwithstanding subdivision 3, paragraph (c), an individual eligible for the shelter needy
benefit under subdivision 5, paragraph (f), is considered a household of one.new text end An eligible
individual who receives this benefit prior to age 65 may continue to receive the benefit
after the age of 65.
new text begin
(g)(1) Persons eligible for shelter needy funding under paragraph (f), who are not
receiving medial assistance home and community-based waiver services, are eligible for
a state-funded transitional supports allowance under section 256B.49, subdivision 16,
paragraph (e), to establish their own residence not owned, operated, or controlled by a
provider of service not related by blood or marriage.
new text end
new text begin (2) new text end "Shelter needy" means that the assistance unit incurs monthly shelter costs that
exceed 40 percent of the assistance unit's gross income before the application of this
special needs standard. "Gross income" for the purposes of this section is the applicant's or
recipient's income as defined in section 256D.35, subdivision 10, or the standard specified
in subdivision 3, new text begin paragraph (a) or (b),new text end whichever is greater. A recipient of a federal or
state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be
considered shelter needy for purposes of this paragraph.
Sec. 5. new text begin LICENSURE; SERVICES FOR YOUTH WITH DISABILITIES.
new text end
new text begin
(a) Notwithstanding the requirements of Minnesota Statutes, chapter 245A, upon the
recommendation of a county agency, the commissioner of human services shall grant a
license with any necessary variances to a nonresidential program for youth which provides
services to youth with disabilities under age 21 during nonschool hours established
to ensure health and safety, prevent out-of-home placement, and increase community
inclusion of youth with disabilities. The nonresidential youth program is subject to the
conditions of any variances granted and with consumer rights under Minnesota Statutes,
section 245B.04, consumer protection standards under Minnesota Statutes, section
245B.05, service standards under Minnesota Statutes, section 245B.06, management
standards under Minnesota Statutes, section 245B.07, and fire marshal inspections under
Minnesota Statutes, section 245A.151, until the commissioner develops other licensure
requirements for this type of program.
new text end
new text begin
(b) By February 1, 2008, the commissioner shall recommend amendments to
licensure requirements in Minnesota Statutes, chapter 245A, to allow licensure of
appropriate services for school-age youth with disabilities under age 21 who need
supervision and services to develop skills necessary to maintain personal safety and
increase their independence, productivity, and participation in their communities during
nonschool hours. As part of developing the recommendations, the commissioner shall
survey county agencies to determine how the needs of youth with disabilities under age 21
who require supervision and support services are being met and the funding sources used.
The recommendations must be provided to the house and senate chairs of the committees
with jurisdiction over licensing of programs for youth with disabilities.
new text end
Sec. 6. new text begin APPROPRIATIONS.
new text end
new text begin
$....... is appropriated from the general fund to the commissioner of human services
to provide the nonfederal Medicaid match for the assessment, self-directed supports option
plan development, and other administrative costs related to implementing and managing
the self-directed supports option, including quality assurance measures. Federal Medicaid
match obtained for administrative activities for this option must be dedicated to the
commissioner for this purpose.
new text end