SF 3563

2nd Engrossment - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

A bill for an act
relating to human services; making changes to continuing care provisions;
clarifying licensing fines; clarifying senior nutrition appropriations; amending
local certification requirements; amending Minnesota Statutes 2007 Supplement,
sections 245A.07, subdivision 3; 256B.49, subdivision 16a; Laws 2007, chapter
147, article 19, section 3, subdivision 8.

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

Section 1.

Minnesota Statutes 2007 Supplement, section 245A.07, subdivision 3,
is amended to read:

Subd. 3.

License suspension, revocation, or fine.

(a) The commissioner may
suspend or revoke a license, or impose a fine if a license holder fails to comply fully with
applicable laws or rules, if a license holder, a controlling individual, or an individual
living in the household where the licensed services are provided or is otherwise subject
to a background study has a disqualification which has not been set aside under section
245C.22, or if a license holder knowingly withholds relevant information from or gives
false or misleading information to the commissioner in connection with an application
for a license, in connection with the background study status of an individual, during an
investigation, or regarding compliance with applicable laws or rules. A license holder
who has had a license suspended, revoked, or has been ordered to pay a fine must be
given notice of the action by certified mail or personal service. If mailed, the notice
must be mailed to the address shown on the application or the last known address of the
license holder. The notice must state the reasons the license was suspended, revoked, or
a fine was ordered.

(b) If the license was suspended or revoked, the notice must inform the license
holder of the right to a contested case hearing under chapter 14 and Minnesota Rules,
parts 1400.8505 to 1400.8612. The license holder may appeal an order suspending or
revoking a license. The appeal of an order suspending or revoking a license must be made
in writing by certified mail or personal service. If mailed, the appeal must be postmarked
and sent to the commissioner within ten calendar days after the license holder receives
notice that the license has been suspended or revoked. If a request is made by personal
service, it must be received by the commissioner within ten calendar days after the license
holder received the order. Except as provided in subdivision 2a, paragraph (c), a timely
appeal of an order suspending or revoking a license shall stay the suspension or revocation
until the commissioner issues a final order.

(c)(1) If the license holder was ordered to pay a fine, the notice must inform the
license holder of the responsibility for payment of fines and the right to a contested case
hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal
of an order to pay a fine must be made in writing by certified mail or personal service. If
mailed, the appeal must be postmarked and sent to the commissioner within ten calendar
days after the license holder receives notice that the fine has been ordered. If a request is
made by personal service, it must be received by the commissioner within ten calendar
days after the license holder received the order.

(2) The license holder shall pay the fines assessed on or before the payment date
specified. If the license holder fails to fully comply with the order, the commissioner
may issue a second fine or suspend the license until the license holder complies. If the
license holder receives state funds, the state, county, or municipal agencies or departments
responsible for administering the funds shall withhold payments and recover any payments
made while the license is suspended for failure to pay a fine. A timely appeal shall stay
payment of the fine until the commissioner issues a final order.

(3) A license holder shall promptly notify the commissioner of human services,
in writing, when a violation specified in the order to forfeit a fine is corrected. If upon
reinspection the commissioner determines that a violation has not been corrected as
indicated by the order to forfeit a fine, the commissioner may issue a second fine. The
commissioner shall notify the license holder by certified mail or personal service that a
second fine has been assessed. The license holder may appeal the second fine as provided
under this subdivision.

(4) Fines shall be assessed as follows: the license holder shall forfeit $1,000 for
each determination of maltreatment of a child under section 626.556 or the maltreatment
of a vulnerable adult under section 626.557 new text begin for which the license holder is determined
responsible for the maltreatment under section 626.556, subdivision 10e, paragraph (i),
or section 626.557, subdivision 9c, paragraph (c) new text end ; the license holder shall forfeit $200
for each occurrence of a violation of law or rule governing matters of health, safety, or
supervision, including but not limited to the provision of adequate staff-to-child or adult
ratios, and failure to submit a background study; and the license holder shall forfeit $100
for each occurrence of a violation of law or rule other than those subject to a $1,000
or $200 fine above. For purposes of this section, "occurrence" means each violation
identified in the commissioner's fine order. new text begin Fines assessed against a license holder that
holds a license to provide the residential-based habilitation services, as defined under
section 245B.02, subdivision 20, and a license to provide foster care, may be assessed
against both licenses for the same occurrence, but the combined amount of the fines shall
not exceed the amount specified in this clause for that occurrence.
new text end

(5) When a fine has been assessed, the license holder may not avoid payment by
closing, selling, or otherwise transferring the licensed program to a third party. In such an
event, the license holder will be personally liable for payment. In the case of a corporation,
each controlling individual is personally and jointly liable for payment.

Sec. 2.

Minnesota Statutes 2007 Supplement, section 256B.49, subdivision 16a,
is amended to read:

Subd. 16a.

Medical assistance reimbursement.

(a) The commissioner shall
seek federal approval for medical assistance reimbursement of independent living skills
services, foster care waiver service, supported employment, prevocational service,
new text begin and new text end structured day service deleted text begin , and adult day care deleted text end under the home and community-based
waiver for persons with a traumatic brain injury, the community alternatives for disabled
individuals waivers, and the community alternative care waivers.

(b) Medical reimbursement shall be made only when the provider demonstrates
evidence of its capacity to meet basic health, safety, and protection standards through
new text begin the following methods:
new text end

new text begin (1) for independent living skills services, supported employment, prevocational
service, and structured day service through new text end one of the methods in paragraphs (c) deleted text begin to (e) deleted text end new text begin
and (d); and
new text end

new text begin (2) for foster care waiver services through the method in paragraph (e) new text end .

(c) The provider is licensed to provide services under chapter 245B and agrees to
apply these standards to services funded through the traumatic brain injury, community
alternatives for disabled, or community alternative care home and community-based
waivers.

(d) The deleted text begin local agency contracting for the services certifies on a form provided by the deleted text end
commissioner new text begin shall certify new text end that the provider has deleted text begin the capacity to meet the individual needs
as identified in each person's individual service plan. When certifying that the service
provider meets the necessary provider qualifications, the local agency shall verify that the
provider has deleted text end policies and procedures governing the following:

(1) protection of the consumer's rights and privacy;

(2) risk assessment and planning;

(3) record keeping and reporting of incidents and emergencies with documentation
of corrective action if needed;

(4) service outcomes, regular reviews of progress, and periodic reports;

(5) complaint and grievance procedures;

(6) service termination or suspension;

(7) necessary training and supervision of direct care staff that includes:

(i) documentation in personnel files of 20 hours of orientation training in providing
training related to service provision;

(ii) training in recognizing the symptoms and effects of certain disabilities, health
conditions, and positive behavioral supports and interventions;

(iii) a minimum of five hours of related training annually; and

(iv) when applicable:

(A) safe medication administration;

(B) proper handling of consumer funds; and

(C) compliance with prohibitions and standards developed by the commissioner to
satisfy federal requirements regarding the use of restraints and restrictive interventions.
The deleted text begin local agency deleted text end new text begin commissioner new text end shall review at least deleted text begin annually deleted text end new text begin biennially that new text end each service
provider's deleted text begin continued compliance with the standards deleted text end new text begin policies and procedures new text end governing
basic health, safety, and protection of rights new text begin continue to meet minimum standards new text end .

(e) The commissioner shall seek federal approval for Medicaid reimbursement
of foster care services under the home and community-based waiver for persons with
a traumatic brain injury, the community alternatives for disabled individuals waiver,
and community alternative care waiver when the provider demonstrates evidence of
its capacity to meet basic health, safety, and protection standards. The deleted text begin local agency deleted text end
new text begin commissioner new text end shall verify that the new text begin adult foster care new text end provider is licensed under Minnesota
Rules, parts 9555.5105 to 9555.6265, new text begin the child foster care provider is licensed as family
foster care or a foster care residence under Minnesota Rules, parts 2960.3000 to 2960.3340
new text end and certify that the provider has policies and procedures that govern:

(1) compliance with prohibitions and standards developed by the commissioner to
meet federal requirements regarding the use of restraints and restrictive interventions; deleted text begin and deleted text end

(2) documentation of service needs and outcomes, regular reviews of progress,
and periodic reports deleted text begin . deleted text end new text begin ; and
new text end

new text begin (3) safe medication management and administration.
new text end

The deleted text begin local agency deleted text end new text begin commissioner new text end shall review at least deleted text begin annually deleted text end new text begin biennially that new text end each service
provider's deleted text begin continued compliance with the standards deleted text end new text begin policies and procedures new text end governing
basic health, safety, and protection of rights standards new text begin continue to meet minimum
standards new text end .

Sec. 3.

Laws 2007, chapter 147, article 19, section 3, subdivision 8, is amended to read:

Subd. 8. Continuing Care Grants

The amounts that may be spent from the
appropriation for each purpose are as follows:

(a) Aging and Adult Services Grants

General

14,357,000

14,727,000

Information and Assistance
Reimbursement. Federal administrative
reimbursement obtained from information
and assistance services provided by the
Senior LinkAge Line to people who are
identified as eligible for medical assistance
is appropriated to the commissioner for this
activity.

Senior Companion Program. Of this
appropriation, $42,000 each year is for the
senior companion program under Minnesota
Statutes, section 256.977.

Volunteer Senior Citizens. Of this
appropriation, $42,000 each year is for the
volunteer programs for retired senior citizens
under Minnesota Statutes, section 256.9753.

Foster Grandparent Program. Of this
appropriation, $41,000 each year is for the
foster grandparent program in Minnesota
Statutes, section 256.976.

Senior Nutrition. Of this appropriation,
$125,000 each year is for the senior nutrition
programs under Minnesota Statutes, section
256.9752. The commissioner shall give
priority to deleted text begin increase services to: (1) persons
facing language or cultural barriers, (2)
persons with special diets, (3) persons
living in isolated rural areas, and (4) other
hard-to-serve populations deleted text end new text begin maintaining home
delivery and congregate dining services
existing on July 1, 2007 new text end .

Base Adjustment. The general fund base
is $14,774,000 in fiscal year 2010 and
$14,899,000 in fiscal year 2011.

(b) Alternative Care Grants

General

49,858,000

51,758,000

Alternative Care Transfer. Any money
allocated to the alternative care program that
is not spent for the purposes indicated does
not cancel but is transferred to the medical
assistance account.

Base Adjustment. The general fund
base is $52,120,000 in fiscal year 2010
and $52,277,000 in fiscal year 2011 for
alternative care grants.

(c) Medical Assistance Grants - Long-Term Care Facilities

General

496,920,000

499,556,000

Long-Term Care Consultation Funding
Increase. For the rate year beginning
October 1, 2008, the county long-term
care consultation allocations in Minnesota
Statutes, section 256B.0911, subdivision
6, must be increased based on the number
of transitional long-term care consultation
visits projected by the commissioner in
each county. For the rate year beginning
October 1, 2009, final allocations must be
determined based on the average between
the actual number of transitional long-term
care visits that were conducted in the prior
12-month period and the projected number
of consultations that will be provided in
the rate year beginning October 1, 2009.
Notwithstanding any contrary provision in
this article, this paragraph expires June 30,
2010.

Nursing Facility Sprinkler Systems. Of
the general fund appropriation, $2,500,000
the first year is to reimburse the costs of
nursing facility sprinkler systems under
Minnesota Statutes, section 256B.434,
subdivision 4, paragraph (e). Any portion of
this appropriation not spent in the first year
shall not cancel but shall be available for the
second year.

Nursing Home Moratorium Exceptions.
During fiscal year 2008, the commissioner of
health may approve moratorium exception
projects under Minnesota Statutes, section
144A.073, for which the full annualized
state share of medical assistance costs does
not exceed $3,000,000. During fiscal year
2009, the commissioner of health may
approve moratorium exception projects
under Minnesota Statutes, section 144A.073,
for which the full annualized state share of
medical assistance costs does not exceed
$3,000,000 less the amount approved during
the first year. Priority shall be given to
proposals that entail:

(1) complete building replacement in
conjunction with reductions in the number of
beds in a county, with greater weight given
to projects in counties with a greater than
average number of beds per 1,000 elderly;

(2) technology improvements;

(3) improvements in life safety;

(4) construction of nursing facilities that are
part of senior services campuses; and

(5) improvements in the work environment.

(d) Medical Assistance Grants - Long-Term Care Waivers and Home Care Grants

General

957,020,000

1,075,074,000

County CADI allocation adjustment.
(1) The commissioner shall adjust 2007
home and community-based allocations
under Minnesota Statutes, section 256B.49,
to qualifying counties that transferred
persons to the community alternatives for
disabled individuals (CADI) waiver program
under Laws 2006, chapter 282, article 20,
section 35. The adjustment shall reflect
the amount that county-authorized funding
for CADI waiver services exceeded the
allowable amount as shown in the Medicaid
Management Information System (MMIS)
on March 1, 2007.

(2) A county that may qualify under
paragraph (1) shall apply to the commissioner
by June 10, 2007. Following a review of the
county request and the MMIS documentation,
the commissioner shall adjust the county
allocation, as appropriate, by June 25, 2007.

(3) The amounts provided to a county under
this section shall become part of the county's
base level state allocation for the CADI
waiver for the biennium beginning July 1,
2007.

(4) This rider is effective the day following
final enactment.

(e) Mental Health Grants

Appropriations by Fund
General	59,632,000	62,217,000
Health Care Access	750,000	750,000
Lottery Prize	1,933,000	1,633,000

Mental Health Crisis Services. Of the
general fund appropriation, $2,528,000 in
fiscal year 2008 and $3,278,000 in fiscal
year 2009 are for statewide funding of adult
mental health crisis services. Providers must
utilize all available funding streams.

Adult Mental Health Evidence-Based
and Best Practices. Of the general fund
appropriation, $375,000 in fiscal year 2008
and $750,000 in fiscal year 2009 are for
adult mental health evidence-based and
best practices including, but not limited
to, Assertive Community Treatment and
Integrated Dual Diagnosis Treatment
services. The commissioner shall require
grantees to utilize all available third-party
reimbursement sources as a condition of
using state grant funds.

Culturally Specific Mental Health
Treatment Grants. Of the general fund
appropriation, $75,000 in fiscal year 2008
and $300,000 in fiscal year 2009 are for adult
mental health grants to support increased
availability of mental health services for
persons from cultural and ethnic minorities
within the state. The commissioner shall use
at least 20 percent of these funds to help
members of cultural and ethnic minority
communities to become qualified mental
health professionals and practitioners. The
commissioner shall assist grantees to meet
third-party credentialing requirements
and require them to utilize all available
third-party reimbursement sources as a
condition of using state grant funds.

Mental Health Services for Adults with
Special Treatment Needs. Of the general
fund appropriation, $50,000 in fiscal year
2008 and $200,000 in fiscal year 2009 are
for adult mental health grants to support
increased availability of mental health
services for adults with special treatment
needs. These adults shall include, but not
be limited to: victims of trauma, including
persons subjected to abuse or neglect,
veterans and their families, and refugee
populations; person's with complex treatment
needs, such as eating disorders; and those
with low incidence disorders.

Supportive Housing Services for Adults
with Mental Illness. Of the general fund
appropriation, $1,750,000 in fiscal year
2008 and $1,500,000 in fiscal year 2009 are
for adult mental health grants to support
increased availability of a range of housing
options with supports for persons with
serious mental illness.

National Council on Problem Gambling.
(1) Of the appropriation from the lottery prize
fund, $225,000 each year is for a grant to
the state affiliate recognized by the National
Council on Problem Gambling. The affiliate
must provide services to increase public
awareness of problem gambling, education,
and training for individuals and organizations
providing effective treatment services to
problem gamblers and their families, and
research relating to problem gambling. These
services must be complementary to and not
duplicative of the services provided through
the problem gambling program administered
by the commissioner of human services. This
grant does not prevent the commissioner
from regular monitoring and oversight of the
grant or the ability to reallocate the funds to
other services within the problem gambling
program for nonperformance of duties by
the grantee.

(2) Of this appropriation, $100,000 in
fiscal year 2008 and $100,000 in fiscal year
2009 are contingent on the contribution
of nonstate matching funds. Matching
funds may be either cash or qualifying
in-kind contributions. The commissioner of
finance may disburse the state portion of the
matching funds in increments of $25,000
upon receipt of a commitment for an equal
amount of matching nonstate funds. The
general fund base shall be $100,000 in fiscal
year 2010 and $100,000 in fiscal year 2011.

(3) Of the lottery prize fund appropriation,
$100,000 in fiscal year 2008 is for a grant
or grants to be awarded competitively
to develop programs and services for
problem gambling treatment, prevention,
and education in immigrant communities.
This appropriation is available until June
30, 2009, at which time the project must
be completed and final products delivered,
unless an earlier completion date is specified
in the work program.

Compulsive Gambling. Of the lottery prize
fund appropriation, $300,000 in fiscal year
2008 and $100,000 in fiscal year 2009 are for
purposes of compulsive gambling education,
assessment, and treatment under Minnesota
Statutes, section 245.98.

Compulsive Gambling Study. Of the lottery
prize fund appropriation, $100,000 in fiscal
year 2008 is to continue the study currently
being done on compulsive gambling
treatment effectiveness and long-term effects
of gambling.

Base Adjustment. The general fund base
is $59,460,000 in each of fiscal years 2010
and 2011.

Base Adjustment. The lottery prize fund
base is $1,508,000 in each of fiscal years
2010 and 2011.

(f) Deaf and Hard-of-Hearing Grants

General

1,730,000

1,964,000

Hearing Loss Mentors. Of the general
fund appropriation, $40,000 each year is to
provide mentors who have a hearing loss
to parents of newly identified infants and
children with hearing loss.

Base Adjustment. The general fund base is
$1,968,000 in each of fiscal years 2010 and
2011.

(g) Chemical Dependency Entitlement Grants

General

78,225,000

88,138,000

(h) Chemical Dependency Nonentitlement Grants

General	1,655,000	1,805,000
TANF	150,000	150,000

Methamphetamine Abuse Grants. Of the
general fund appropriation, $175,000 in the
first year and $375,000 in the second year
are for grants to existing programs that treat
methamphetamine abuse, and the abuse
of other substances in Carlton, Faribault,
Martin, Olmsted, and Anoka Counties, that
received grant funds under Laws 2005,
chapter 136, article 1, section 9, subdivision
6. The commissioner shall administer the
grants to programs that the commissioner
deems successful, and may discontinue
grants to programs after an evaluation of
the program and a determination by the
commissioner that the program should no
longer receive funds. This appropriation
shall not become part of base level funding.

Native American Juvenile Treatment
Center. Of the general fund appropriation,
$50,000 is to conduct a feasibility study
of and to predesign a Native American
juvenile treatment center on or near the
White Earth Reservation. The facility must
house and treat Native American juveniles
and provide culturally specific programming
to juveniles placed in the treatment center.
The commissioner of human services may
contract with parties who have experience
in the design and construction of juvenile
treatment centers to assist in the feasibility
study and predesign. On or before January
15, 2008, the commissioner shall present
the results of the feasibility study and the
predesign of the facility to the chairs of house
of representatives and senate committees
having jurisdiction over human services
finance, public safety finance, and capital
investment.

Leech Lake Youth Treatment Center. Of
the general fund appropriation, $75,000 each
year are for a grant to the Leech Lake Youth
Treatment Center project partners, in order
to pay the salaries and other directly related
costs associated with the development of this
project. This is a onetime appropriation.

Base Adjustment. The general fund base is
$1,055,000 in each of fiscal years 2010 and
2011.

(i) Other Continuing Care Grants

General

21,409,000

16,983,000

Repayment. Of the general fund
appropriation, $4,302,000 the first year
is to repay the amount of overspending
in the waiver program for persons with
developmental disabilities incurred by
Fillmore, Steele, and St. Louis Counties
in calendar years 2004 and 2005. * (The
preceding text beginning "Repayment. Of
the general fund" was indicated as vetoed by
the governor.)

Department of Employment and Economic
Development Transfer. For fiscal year 2008,
the commissioner of finance shall transfer
$200,000 from the methamphetamine
abatement loan fund to the commissioner
of human services for methamphetamine
treatment programs.

Disability Linkage Line. Of the general
fund appropriation, $469,000 in fiscal year
2008 and $626,000 in fiscal year 2009 are to
establish and maintain the disability linkage
line.

Base Adjustment. The general fund base
is $17,103,000 in fiscal year 2010 and
$17,141,000 in fiscal year 2011 for other
continuing care grants.

Sec. 4. new text begin REPORT ON STAFFING CRITERIA.
new text end

new text begin The commissioner of human services in consultation with the commissioner of
health, as well as consumers, nursing facility providers, and nursing facility employees,
shall: (1) review the definitions of nursing facility direct care staff in Minnesota Statutes,
Minnesota Rules, and agency bulletins; (2) determine how to standardize definitions to
allow the public to compare direct care staffing across facilities; and (3) examine how new
and emerging staff positions and titles, including but not limited to "resident assistant,"
should be incorporated over time into direct care staffing. The commissioner shall
report recommendations to the chairs and ranking minority members of the legislative
committees and divisions with jurisdiction over health and human services by January
15, 2009.
new text end