HF 1110

1st Engrossment - 86th Legislature (2009 - 2010) Posted on 02/09/2010 01:44am

A bill for an act
relating to human services; modifying programs and licensure provisions for
services to persons with disabilities; allowing alternate overnight supervision
technology; making changes to home and community-based waivered services;
requiring reports; amending Minnesota Statutes 2008, sections 245A.10,
subdivisions 2, 3; 245A.11, by adding a subdivision; 245A.16, subdivisions 1,
3; 245C.04, subdivision 1; 245C.05, subdivision 4; 245C.08, subdivision 2;
245C.10, by adding a subdivision; 245C.17, by adding a subdivision; 245C.20;
245C.21, subdivision 1a; 245C.23, subdivision 2; 256B.5011, subdivision 2;
256B.5013, subdivision 1; 256D.44, subdivision 5; repealing Minnesota Statutes
2008, section 256B.5013, subdivision 5; Minnesota Rules, part 9555.6125,
subpart 4, item B.

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

Section 1.

Minnesota Statutes 2008, section 245A.10, subdivision 2, is amended to
read:

Subd. 2.

County fees for background studies and licensing inspections.

(a) For
purposes of family and group family child care licensing under this chapter, a county
agency may charge a fee to an applicant or license holder to recover the actual cost of
background studies, but in any case not to exceed $100 annually. A county agency may
also charge a license fee to an applicant or license holder not to exceed $50 for a one-year
license or $100 for a two-year license.

(b) A county agency may charge a fee to a legal nonlicensed child care provider or
applicant for authorization to recover the actual cost of background studies completed
under section 119B.125, but in any case not to exceed $100 annually.

(c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):

(1) in cases of financial hardship;

(2) if the county has a shortage of providers in the county's area;

(3) for new providers; or

(4) for providers who have attained at least 16 hours of training before seeking
initial licensure.

(d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on
an installment basis for up to one year. If the provider is receiving child care assistance
payments from the state, the provider may have the fees under paragraph (a) or (b)
deducted from the child care assistance payments for up to one year and the state shall
reimburse the county for the county fees collected in this manner.

(e) For purposes of adult foster care and child foster care licensing under this
chapter, a county agency may charge a fee to a corporate applicant or corporate license
holder to recover deleted text begin the actual cost of background studies. A county agency may also charge
a fee to a corporate applicant or corporate license holder to recover deleted text end the actual cost of
licensing inspections, not to exceed $500 annually.

(f) Counties may elect to reduce or waive the fees in paragraph (e) under the
following circumstances:

(1) in cases of financial hardship;

(2) if the county has a shortage of providers in the county's area; or

(3) for new providers.

Sec. 2.

Minnesota Statutes 2008, section 245A.10, subdivision 3, is amended to read:

Subd. 3.

Application fee for initial license or certification.

(a) For fees required
under subdivision 1, an applicant for an initial license or certification issued by the
commissioner shall submit a $500 application fee with each new application required
under this subdivision. The application fee shall not be prorated, is nonrefundable, and
is in lieu of the annual license or certification fee that expires on December 31. The
commissioner shall not process an application until the application fee is paid.

(b) Except as provided in clauses (1) to (3), an applicant shall apply for a license
to provide services at a specific location.

(1) For a license to provide waivered services to persons with developmental
disabilities or related conditions, an applicant shall submit an application for each county
in which the waivered services will be provided. new text begin Upon licensure, the license holder may
provide services to persons in that county plus no more than three persons at any one time
in each of up to ten additional counties. A license holder in one county may not provide
services under the home and community-based waiver for persons with developmental
disabilities to more than three people in a second county without holding a separate license
for that second county. Applicants or licensees providing services under this clause to
not more than three persons remain subject to the inspection fees established in section
245A.10, subdivision 2, for each location.
new text end

(2) For a license to provide semi-independent living services to persons with
developmental disabilities or related conditions, an applicant shall submit a single
application to provide services statewide.

(3) For a license to provide independent living assistance for youth under section
245A.22, an applicant shall submit a single application to provide services statewide.

Sec. 3.

Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision
to read:

new text begin Subd. 8. new text end

new text begin Alternate overnight supervision technology; adult foster care license.
new text end

new text begin (a) The commissioner may grant an applicant or license holder an adult foster care license
for a residence that does not have a caregiver in the residence during normal sleeping
hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, but uses
monitoring technology to alert the license holder when an incident occurs that may
jeopardize the health, safety, or rights of a foster care recipient. The applicant or license
holder must comply with all other requirements under Minnesota Rules, parts 9555.5105
to 9555.6265, and the requirements under this subdivision. The license printed by the
commissioner must state in bold and large font:
new text end

new text begin (1) that staff are not present on-site overnight; and
new text end

new text begin (2) the telephone number of the county's common entry point for making reports of
suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.
new text end

new text begin (b) Applications for a license under this section must be submitted directly to
the Department of Human Services licensing division. The licensing division must
immediately notify the host county and lead county contract agency and the host county
licensing agency. The licensing division must collaborate with the county licensing
agency in the review of the application and the licensing of the program.
new text end

new text begin (c) Before a license is issued by the commissioner, and for the duration of the license,
the applicant or license holder must establish, maintain, and document the implementation
of written policies and procedures addressing the requirements in paragraphs (c) to (f).
new text end

new text begin (d) The applicant or license holder must have policies and procedures that:
new text end

new text begin (1) establish characteristics of target populations that will be admitted into the home
and characteristics of populations that will not be accepted into the home;
new text end

new text begin (2) explain the discharge process when a foster care recipient requires overnight
supervision or other services that cannot be provided by the license holder due to the
limited hours that the license holder is on-site;
new text end

new text begin (3) describe the types of events to which the program will respond with a physical
presence when those events occur in the home during time when staff are not on-site, and
how the license holder's response plan meets the requirements in clause (1) or (2);
new text end

new text begin (4) establish a process for documenting a review of the implementation and
effectiveness of the response protocol for the response required under clause (1) or (2).
The documentation must include:
new text end

new text begin (i) a description of the triggering incident;
new text end

new text begin (ii) the date and time of the triggering incident;
new text end

new text begin (iii) the time of the response or responses under clause (1) or (2);
new text end

new text begin (iv) whether the response met the resident's needs;
new text end

new text begin (v) whether the existing policies and response protocols were followed; and
new text end

new text begin (vi) whether the existing policies and protocols are adequate or need modification.
new text end

new text begin When no physical presence response is completed for a three-month period, the
license holder's written policies and procedures must require a physical presence response
drill be to conducted for which the effectiveness of the response protocol under clause (1)
or (2), will be reviewed and documented as required under this clause; and
new text end

new text begin (5) establish that emergency and nonemergency phone numbers are posted in a
prominent location in a common area of the home where they can be easily observed by a
person responding to an incident who is not otherwise affiliated with the home.
new text end

new text begin (e) The license holder must document and include in the license application which
response alternative under clause (1) or (2) is in place for responding to situations that
present a serious risk to the health, safety, or rights of people receiving foster care services
in the home:
new text end

new text begin (1) response alternative (1) requires only the technology to provide an electronic
notification or alert to the license holder that an event is underway that requires a response.
Under this alternative, no more than ten minutes will pass before the license holder will be
physically present on-site to respond to the situation; or
new text end

new text begin (2) response alternative (2) requires the electronic notification and alert system
under alternative (1), but more than ten minutes may pass before the license holder is
present on-site to respond to the situation. Under alternative (2), all of the following
conditions are met:
new text end

new text begin (i) the license holder has a written description of the interactive technological
applications that will assist the licenser holder in communicating with and assessing the
needs related to care, health, and safety of the foster care recipients. This interactive
technology must permit the license holder to remotely assess the well being of the foster
care recipient without requiring the initiation or participation by the foster care recipient.
Requiring the foster care recipient to initiate a telephone call or answer a telephone call
does not meet this requirement;
new text end

new text begin (ii) the license holder documents how the remote license holder is qualified and
capable of meeting the needs of the foster care recipients and assessing foster care
recipients' needs during the absence of the license holder on-site;
new text end

new text begin (iii) the license holder maintains written procedures to dispatch emergency response
personnel to the site in the event of an identified emergency; and
new text end

new text begin (iv) each foster care recipient's individualized plan of care, individual service plan
under section 256B.092, subdivision 1b, if required, or individual resident placement
agreement under Minnesota Rules, part 9555.5105, subpart 19, if required, identifies the
maximum response time, which may be greater than ten minutes, for the license holder
to be on-site for that foster care recipient.
new text end

new text begin (f) All placement agreements, individual service agreements, and plans applicable
to the foster care recipient must clearly state that the adult foster care license category is
a program without the presence of a caregiver in the residence during normal sleeping
hours; the protocols in place for responding to situations that present a serious risk
to health, safety, or rights of foster care recipients under paragraph (d), clause (1) or
(2); and a signed informed consent from each foster care recipient or the person's
legal representative documenting the person's or legal representative's agreement with
placement in the program. If electronic monitoring technology is used in the home, the
informed consent form must also explain the following:
new text end

new text begin (1) how any electronic monitoring is incorporated into the alternative supervision
system;
new text end

new text begin (2) the backup system for any electronic monitoring in times of electrical outages or
other equipment malfunctions;
new text end

new text begin (3) how the license holder is trained on the use of the technology;
new text end

new text begin (4) the event types and license holder response times established under paragraph (d);
new text end

new text begin (5) how the license holder protects the foster care recipient's privacy related to
electronic monitoring and related to any electronically recorded data generated by the
monitoring system. The consent form must explain where and how the electronically
recorded data is stored, with whom it will be shared, and how long it is retained; and
new text end

new text begin (6) the risks and benefits of the alternative overnight supervision system.
new text end

new text begin The written explanations under clauses (1) to (6) may be accomplished through
cross-references to other policies and procedures as long as they are explained to the
person giving consent, and the person giving consent is offered a copy.
new text end

new text begin (g) Nothing in this section requires the applicant or license holder to develop or
maintain separate or duplicative policies, procedures, documentation, consent forms, or
individual plans that may be required for other licensing standards, if the requirements of
this section are incorporated into those documents.
new text end

new text begin (h) The commissioner may grant variances to the requirements of this section
according to section 245A.04, subdivision 9.
new text end

new text begin (i) For the purposes of paragraphs (b) to (h), "license holder" has the meaning
under section 245A.02, subdivision 9, and additionally includes all staff, volunteers, and
contractors affiliated with the license holder.
new text end

Sec. 4.

Minnesota Statutes 2008, section 245A.16, subdivision 1, is amended to read:

Subdivision 1.

Delegation of authority to agencies.

(a) County agencies and
private agencies that have been designated or licensed by the commissioner to perform
licensing functions and activities under section 245A.04 new text begin and new text end background studies for
deleted text begin adult foster care, deleted text end family adult day services deleted text begin , deleted text end and family child care deleted text begin , deleted text end under chapter 245C; to
recommend denial of applicants under section 245A.05; to issue correction orders, to issue
variances, and recommend a conditional license under section 245A.06, or to recommend
suspending or revoking a license or issuing a fine under section 245A.07, shall comply
with rules and directives of the commissioner governing those functions and with this
section. The following variances are excluded from the delegation of variance authority
and may be issued only by the commissioner:

(1) dual licensure of family child care and child foster care, dual licensure of child
and adult foster care, and adult foster care and family child care;

(2) adult foster care maximum capacity;

(3) adult foster care minimum age requirement;

(4) child foster care maximum age requirement;

(5) variances regarding disqualified individuals except that county agencies may
issue variances under section 245C.30 regarding disqualified individuals when the county
is responsible for conducting a consolidated reconsideration according to sections 245C.25
and 245C.27, subdivision 2, clauses (a) and (b), of a county maltreatment determination
and a disqualification based on serious or recurring maltreatment; and

(6) the required presence of a caregiver in the adult foster care residence during
normal sleeping hours.

(b) County agencies must report information about disqualification reconsiderations
under sections 245C.25 and 245C.27, subdivision 2, paragraphs (a) and (b), and variances
granted under paragraph (a), clause (5), to the commissioner at least monthly in a format
prescribed by the commissioner.

(c) For family day care programs, the commissioner may authorize licensing reviews
every two years after a licensee has had at least one annual review.

(d) For family adult day services programs, the commissioner may authorize
licensing reviews every two years after a licensee has had at least one annual review.

(e) A license issued under this section may be issued for up to two years.

Sec. 5.

Minnesota Statutes 2008, section 245A.16, subdivision 3, is amended to read:

Subd. 3.

Recommendations to commissioner.

The county or private agency
shall not make recommendations to the commissioner regarding licensure without first
conducting an inspection, and for deleted text begin adult foster care, deleted text end family adult day services deleted text begin , deleted text end and family
child care, a background study of the applicant under chapter 245C. The county or private
agency must forward its recommendation to the commissioner regarding the appropriate
licensing action within 20 working days of receipt of a completed application.

Sec. 6.

Minnesota Statutes 2008, section 245C.04, subdivision 1, is amended to read:

Subdivision 1.

Licensed programs.

(a) The commissioner shall conduct a
background study of an individual required to be studied under section 245C.03,
subdivision 1, at least upon application for initial license for all license types.

(b) The commissioner shall conduct a background study of an individual required to
be studied under section 245C.03, subdivision 1, at reapplication for a license for deleted text begin adult
foster care, deleted text end family adult day services deleted text begin , deleted text end and family child care.

(c) The commissioner is not required to conduct a study of an individual at the time
of reapplication for a license if the individual's background study was completed by the
commissioner of human services for an adult foster care license holder that is also:

(1) registered under chapter 144D; or

(2) licensed to provide home and community-based services to people with
disabilities at the foster care location and the license holder does not reside in the foster
care residence; and

(3) the following conditions are met:

(i) a study of the individual was conducted either at the time of initial licensure or
when the individual became affiliated with the license holder;

(ii) the individual has been continuously affiliated with the license holder since
the last study was conducted; and

(iii) the last study of the individual was conducted on or after October 1, 1995.

(d) From July 1, 2007, to June 30, 2009, the commissioner of human services shall
conduct a study of an individual required to be studied under section 245C.03, at the
time of reapplication for a child foster care license. The county or private agency shall
collect and forward to the commissioner the information required under section 245C.05,
subdivisions 1, paragraphs (a) and (b), and 5, paragraphs (a) and (b). The background
study conducted by the commissioner of human services under this paragraph must
include a review of the information required under section 245C.08, subdivisions 1,
paragraph (a), clauses (1) to (5), 3, and 4.

(e) The commissioner of human services shall conduct a background study of an
individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2)
to (6), who is newly affiliated with a child foster care license holder. The county or
private agency shall collect and forward to the commissioner the information required
under section 245C.05, subdivisions 1 and 5. The background study conducted by the
commissioner of human services under this paragraph must include a review of the
information required under section 245C.08, subdivisions 1, 3, and 4.

(f) new text begin From January 1, 2010, to December 31, 2012, unless otherwise specified in
paragraph (c), the commissioner shall conduct a study of an individual required to be
studied under section 245C.03 at the time of reapplication for an adult foster care license.
The county shall collect and forward to the commissioner the information required under
section 245C.05, subdivision 1, paragraphs (a) and (b), and subdivision 5, paragraphs (a)
and (b). The background study conducted by the commissioner under this paragraph
must include a review of the information required under section 245C.08, subdivision 1,
paragraph (a), clauses (1) to (5), and subdivisions 3 and 4.
new text end

new text begin (g) The commissioner shall conduct a background study of an individual specified
under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly
affiliated with an adult foster care license holder. The county shall collect and forward
to the commissioner the information required under section 245C.05, subdivision 1,
paragraphs (a) and (b), and subdivision 5, paragraphs (a) and (b). The background
study conducted by the commissioner under this paragraph must include a review of
the information required under section 245C.08, subdivision 1, paragraph (a), and
subdivisions 3 and 4.
new text end

new text begin (h) new text end Applicants for licensure, license holders, and other entities as provided in this
chapter must submit completed background study forms to the commissioner before
individuals specified in section 245C.03, subdivision 1, begin positions allowing direct
contact in any licensed program.

deleted text begin (g) deleted text end new text begin (i) new text end For purposes of this section, a physician licensed under chapter 147 is
considered to be continuously affiliated upon the license holder's receipt from the
commissioner of health or human services of the physician's background study results.

Sec. 7.

Minnesota Statutes 2008, section 245C.05, subdivision 4, is amended to read:

Subd. 4.

Electronic transmission.

For background studies conducted by the
Department of Human Services, the commissioner shall implement a system for the
electronic transmission of:

(1) background study information to the commissioner;

(2) background study results to the license holder; deleted text begin and
deleted text end

(3) background study results to county and private agencies for background studies
conducted by the commissioner for child foster care new text begin ; and
new text end

new text begin (4) background study results to county agencies for background studies conducted
by the commissioner for adult foster care new text end .

Sec. 8.

Minnesota Statutes 2008, section 245C.08, subdivision 2, is amended to read:

Subd. 2.

Background studies conducted by a county agency.

(a) For a background
study conducted by a county agency for deleted text begin adult foster care, deleted text end family adult day services deleted text begin , deleted text end and
family child care services, the commissioner shall review:

(1) information from the county agency's record of substantiated maltreatment
of adults and the maltreatment of minors;

(2) information from juvenile courts as required in subdivision 4 for individuals
listed in section 245C.03, subdivision 1, clauses (2), (5), and (6); and

(3) information from the Bureau of Criminal Apprehension.

(b) If the individual has resided in the county for less than five years, the study shall
include the records specified under paragraph (a) for the previous county or counties of
residence for the past five years.

(c) Notwithstanding expungement by a court, the county agency may consider
information obtained under paragraph (a), clause (3), unless the commissioner received
notice of the petition for expungement and the court order for expungement is directed
specifically to the commissioner.

Sec. 9.

Minnesota Statutes 2008, section 245C.10, is amended by adding a subdivision
to read:

new text begin Subd. 5. new text end

new text begin Adult foster care services. new text end

new text begin The commissioner shall recover the cost
of background studies required under section 245C.03, subdivision 1, for the purposes
of adult foster care licensing, through a fee of no more than $20 per study charged to
the license holder. The fees collected under this subdivision are appropriated to the
commissioner for the purpose of conducting background studies.
new text end

Sec. 10.

Minnesota Statutes 2008, section 245C.17, is amended by adding a
subdivision to read:

new text begin Subd. 6. new text end

new text begin Notice to county agency. new text end

new text begin For studies on individuals related to a license to
provide adult foster care, the commissioner shall also provide a notice of the background
study results to the county agency that initiated the background study.
new text end

Sec. 11.

Minnesota Statutes 2008, section 245C.20, is amended to read:

245C.20 LICENSE HOLDER RECORD KEEPING.

A licensed program shall document the date the program initiates a background
study under this chapter in the program's personnel files. When a background study is
completed under this chapter, a licensed program shall maintain a notice that the study
was undertaken and completed in the program's personnel files. new text begin Except when background
studies are initiated through the commissioner's online system, new text end if a licensed program
has not received a response from the commissioner under section 245C.17 within 45
days of initiation of the background study request, the licensed program must contact the
deleted text begin commissioner deleted text end new text begin human services licensing division new text end to inquire about the status of the study. new text begin If
a license holder initiates a background study under the commissioner's online system, but
the background study subject's name does not appear in the list of active or recent studies
initiated by that license holder, the license holder must either contact the human services
licensing division or resubmit the background study information online for that individual.
new text end

Sec. 12.

Minnesota Statutes 2008, section 245C.21, subdivision 1a, is amended to read:

Subd. 1a.

Submission of reconsideration request deleted text begin to county or private agency deleted text end .

(a) For disqualifications related to studies conducted by county agencies new text begin for family child
care and family adult day services new text end , and for disqualifications related to studies conducted
by the commissioner for child foster care new text begin and adult foster care new text end , the individual shall
submit the request for reconsideration to the county deleted text begin or private deleted text end agency that initiated the
background study.

(b) new text begin For disqualifications related to studies conducted by the commissioner for child
foster care, the individual shall submit the request for reconsideration to the private agency
that initiated the background study.
new text end

new text begin (c) new text end A reconsideration request shall be submitted within 30 days of the individual's
receipt of the disqualification notice or the time frames specified in subdivision 2,
whichever time frame is shorter.

deleted text begin (c) deleted text end new text begin (d) new text end The county or private agency shall forward the individual's request for
reconsideration and provide the commissioner with a recommendation whether to set aside
the individual's disqualification.

Sec. 13.

Minnesota Statutes 2008, section 245C.23, subdivision 2, is amended to read:

Subd. 2.

Commissioner's notice of disqualification that is not set aside.

(a) The
commissioner shall notify the license holder of the disqualification and order the license
holder to immediately remove the individual from any position allowing direct contact
with persons receiving services from the license holder if:

(1) the individual studied does not submit a timely request for reconsideration
under section 245C.21;

(2) the individual submits a timely request for reconsideration, but the commissioner
does not set aside the disqualification for that license holder under section 245C.22;

(3) an individual who has a right to request a hearing under sections 245C.27 and
256.045, or 245C.28 and chapter 14 for a disqualification that has not been set aside, does
not request a hearing within the specified time; or

(4) an individual submitted a timely request for a hearing under sections 245C.27
and 256.045, or 245C.28 and chapter 14, but the commissioner does not set aside the
disqualification under section 245A.08, subdivision 5, or 256.045.

(b) If the commissioner does not set aside the disqualification under section 245C.22,
and the license holder was previously ordered under section 245C.17 to immediately
remove the disqualified individual from direct contact with persons receiving services or
to ensure that the individual is under continuous, direct supervision when providing direct
contact services, the order remains in effect pending the outcome of a hearing under
sections 245C.27 and 256.045, or 245C.28 and chapter 14.

(c) For background studies related to child foster care, the commissioner shall
also notify the county or private agency that initiated the study of the results of the
reconsideration.

new text begin (d) For background studies related to adult foster care, the commissioner shall also
notify the county that initiated the study of the results of the reconsideration.
new text end

Sec. 14.

Minnesota Statutes 2008, section 256B.5011, subdivision 2, is amended to
read:

Subd. 2.

Contract provisions.

(a) The service contract with each intermediate
care facility must include provisions for:

(1) modifying payments when significant changes occur in the needs of the
consumers;

(2) deleted text begin the establishment and use of a quality improvement plan. Using criteria and
options for performance measures developed by the commissioner, each intermediate care
facility must identify a minimum of one performance measure on which to focus its efforts
for quality improvement during the contract period;
deleted text end

deleted text begin (3) deleted text end appropriate and necessary statistical information required by the commissioner;

deleted text begin (4) deleted text end new text begin (3) new text end annual aggregate facility financial information; and

deleted text begin (5) deleted text end new text begin (4) new text end additional requirements for intermediate care facilities not meeting the
standards set forth in the service contract.

(b) The commissioner of human services and the commissioner of health, in
consultation with representatives from counties, advocacy organizations, and the provider
community, shall review the consolidated standards under chapter 245B and the supervised
living facility rule under Minnesota Rules, chapter 4665, to determine what provisions
in Minnesota Rules, chapter 4665, may be waived by the commissioner of health for
intermediate care facilities in order to enable facilities to implement the performance
measures in their contract and provide quality services to residents without a duplication
of or increase in regulatory requirements.

Sec. 15.

Minnesota Statutes 2008, section 256B.5013, subdivision 1, is amended to
read:

Subdivision 1.

Variable rate adjustments.

(a) For rate years beginning on or after
October 1, 2000, when there is a documented increase in the needs of a current ICF/MR
recipient, the county of financial responsibility may recommend a variable rate to enable
the facility to meet the individual's increased needs. Variable rate adjustments made under
this subdivision replace payments for persons with special needs under section 256B.501,
subdivision 8, and payments for persons with special needs for crisis intervention services
under section 256B.501, subdivision 8a. Effective July 1, 2003, facilities with a base rate
above the 50th percentile of the statewide average reimbursement rate for a Class A
facility or Class B facility, whichever matches the facility licensure, are not eligible for a
variable rate adjustment. Variable rate adjustments may not exceed a 12-month period,
except when approved for purposes established in paragraph (b), clause (1). Variable rate
adjustments approved solely on the basis of changes on a developmental disabilities
screening document will end June 30, 2002.

(b) A variable rate may be recommended by the county of financial responsibility
for increased needs in the following situations:

(1) a need for resources due to an individual's full or partial retirement from
participation in a day training and habilitation service when the individual: (i) has reached
the age of 65 or has a change in health condition that makes it difficult for the person
to participate in day training and habilitation services over an extended period of time
because it is medically contraindicated; and (ii) has expressed a desire for change through
the developmental disability screening process under section 256B.092;

(2) a need for additional resources for intensive short-term programming which is
necessary prior to an individual's discharge to a less restrictive, more integrated setting;

(3) a demonstrated medical need that significantly impacts the type or amount of
services needed by the individual; or

(4) a demonstrated behavioral need that significantly impacts the type or amount of
services needed by the individual.

(c) The county of financial responsibility must justify the purpose, the projected
length of time, and the additional funding needed for the facility to meet the needs of
the individual.

(d) deleted text begin The facility shall provide a quarterly report to the county case manager on
the use of the variable rate funds and the status of the individual on whose behalf the
funds were approved. The county case manager will forward the facility's report with a
recommendation to the commissioner to approve or disapprove a continuation of the
variable rate.
deleted text end

deleted text begin (e) deleted text end Funds made available through the variable rate process that are not used by
the facility to meet the needs of the individual for whom they were approved shall be
returned to the state.

Sec. 16.

Minnesota Statutes 2008, 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)(1) 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 July of each year will be added to the standards of
assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify
as shelter needy and are: (i) relocating from an institution, or an adult mental health
residential treatment program under section 256B.0622; (ii) eligible for the self-directed
supports option as defined under section 256B.0657, subdivision 2; or (iii) home and
community-based waiver recipients living in their own home or rented or leased apartment
which is not owned, operated, or controlled by a provider of service not related by blood
or marriage.

(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the
shelter needy benefit under this paragraph is considered a household of one. An eligible
individual who receives this benefit prior to age 65 may continue to receive the benefit
after the age of 65.

(3) "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, paragraph (a) or (b), 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.

new text begin (g) Notwithstanding this subdivision, recipients of home and community-based
services may relocate to services without 24-hour supervision and receive the equivalent
of the recipient's group residential housing allocation in Minnesota supplemental
assistance shelter needy funding if the cost of the services and housing is equal to or less
than provided to the recipient in home and community-based services and the relocation is
the recipient's choice and is approved by the recipient or guardian.
new text end

new text begin (h) To access housing and services as provided in paragraph (g), the recipient may
choose housing that may or may not be owned, operated, or controlled by the recipient's
service provider.
new text end

new text begin (i) The provisions in paragraphs (g) and (h) are effective to June 30, 2011. The
commissioner shall assess the development of publicly owned housing, other housing
alternatives, and whether a public equity housing fund may be established that would
maintain the state's interest, to the extent paid from group residential housing and
Minnesota supplemental aid shelter needy funds in provider-owned housing so that when
sold, the state would recover its share for a public equity fund to be used for future public
needs under this chapter. The commissioner shall report findings and recommendations to
the legislative committees and budget divisions with jurisdiction over health and human
services policy and financing by January 15, 2012.
new text end

new text begin (j) In selecting prospective services needed by recipients for whom home and
community-based services have been authorized, the recipient and the recipient's guardian
shall first consider alternatives to home and community-based services. Minnesota
supplemental aid shelter needy funding for recipients who utilize Minnesota supplemental
aid shelter needy funding as provided in this section shall remain permanent unless the
recipient with the recipient's guardian later chooses to access home and community-based
services.
new text end

Sec. 17. new text begin ESTABLISHING A SINGLE SET OF STANDARDS.
new text end

new text begin (a) The commissioner of human services shall consult with disability service
providers, advocates, counties, and consumer families to develop a single set of standards
governing services for people with disabilities receiving services under the home and
community-based waiver services program to replace all or portions of existing laws and
rules including, but not limited to, data practices, licensure of facilities and providers,
background studies, reporting of maltreatment of minors, reporting of maltreatment of
vulnerable adults, and the psychotropic medication checklist. The standards must:
new text end

new text begin (1) enable optimum consumer choice;
new text end

new text begin (2) be consumer-driven;
new text end

new text begin (3) link services to individual needs and life goals;
new text end

new text begin (4) be based on quality assurance and individual outcomes;
new text end

new text begin (5) utilize the people closest to the recipient, who may include family, friends, and
health and service providers, in conjunction with the recipient's risk management plan to
assist the recipient or the recipient's guardian in making decisions that meet the recipient's
needs in a cost-effective manner and assure the recipient's health and safety;
new text end

new text begin (6) utilize person-centered planning; and
new text end

new text begin (7) maximize federal financial participation.
new text end

new text begin (b) The commissioner may consult with existing stakeholder groups convened under
the commissioner's authority, including the home and community-based expert services
panel established by the commissioner in 2008, to meet all or some of the requirements
of this section.
new text end

new text begin (c) The commissioner shall provide the reports and plans required by this section to
the legislative committees and budget divisions with jurisdiction over health and human
services policy and finance by January 15, 2012.
new text end

Sec. 18. new text begin COMMON SERVICE MENU FOR HOME AND COMMUNITY-BASED
WAIVER PROGRAMS.
new text end

new text begin The commissioner of human services shall confer with representatives of recipients,
advocacy groups, counties, providers, and health plans to develop and update a common
service menu for home and community-based waiver programs. The commissioner may
consult with existing stakeholder groups convened under the commissioner's authority to
meet all or some of the requirements of this section.
new text end

Sec. 19. new text begin INTERMEDIATE CARE FACILITIES FOR PERSONS WITH
DEVELOPMENTAL DISABILITIES REPORT.
new text end

new text begin The commissioner of human services shall consult with providers and advocates of
intermediate care facilities for persons with developmental disabilities to monitor progress
made in response to the commissioner's December 15, 2008, report to the legislature
regarding intermediate care facilities for persons with developmental disabilities.
new text end

Sec. 20. new text begin HOUSING OPTIONS.
new text end

new text begin The commissioner of human services, in consultation with the commissioner of
administration and the Minnesota Housing Finance Agency, and representatives of
counties, residents' advocacy groups, consumers of housing services, and provider
agencies shall explore ways to maximize the availability and affordability of housing
choices available to persons with disabilities or who need care assistance due to other
health challenges. A goal shall also be to minimize state physical plant costs in order to
serve more persons with appropriate program and care support. Consideration shall be
given to:
new text end

new text begin (1) improved access to rent subsidies;
new text end

new text begin (2) use of cooperatives, land trusts, and other limited equity ownership models;
new text end

new text begin (3) the desirability of the state acquiring an ownership interest or promoting the
use of publicly owned housing;
new text end

new text begin (4) promoting more choices in the market for accessible housing that meets the
needs of persons with physical challenges; and
new text end

new text begin (5) what consumer ownership models, if any, are appropriate.
new text end

new text begin The commissioner shall provide a written report on the findings of the evaluation of
housing options to the chairs and ranking minority members of the house of representatives
and senate standing committees with jurisdiction over health and human services policy
and funding by December 15, 2010.
new text end

Sec. 21. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2008, section 256B.5013, subdivision 5, new text end new text begin and new text end new text begin Minnesota Rules,
part 9555.6125, subpart 4, item B, new text end new text begin are repealed.
new text end