1999 Minnesota Statutes

     256B.5013 Payment rate adjustments. 

    Subdivision 1.    Variable rate adjustments.  When there 
 is a documented increase in the resource needs of a current 
 ICF/MR recipient or recipients, or a person is admitted to a 
 facility who requires additional resources, the county of 
 financial responsibility may approve an enhanced rate for one or 
 more persons in the facility.  Resource needs directly 
 attributable to an individual that may be considered under the 
 variable rate adjustment include increased direct staff hours 
 and other specialized services, equipment, and human resources.  
 The guidelines in paragraphs (a) to (d) apply for the payment 
 rate adjustments under this section. 

    (a) All persons must be screened according to section 
 256B.092, subdivisions 7 and 8, prior to implementation of the 
 new payment system and annually thereafter.  Screening data 
 shall be analyzed to develop broad profiles of the functional 
 characteristics of recipients.  Three components shall be used 
 to distinguish recipients based on the following broad profiles: 

    (1) functional ability to care for and maintain one's own 
 basic needs; 

    (2) the intensity of any aggressive or destructive 
 behavior; and 

    (3) any history of obstructive behavior in combination with 
 a diagnosis of psychosis or neurosis.  

    The profile groups shall be used to link resource needs to 
 funding.  The resource profile shall determine the level of 
 funding that may be authorized by the county.  The county of 
 financial responsibility may approve a rate adjustment for an 
 individual.  The commissioner shall recommend to the legislature 
 by January 15, 2000, a methodology using the profile groups to 
 determine variable rates.  The variable rate must be applied to 
 expenses related to increased direct staff hours and other 
 specialized services, equipment, and human resources.  This 
 variable rate component plus the facility's current operating 
 payment rate equals the individual's total operating payment 
 rate. 

    (b) A recipient must be screened by the county of financial 
 responsibility using the developmental disabilities screening 
 document completed immediately prior to approval of a variable 
 rate by the county.  A comparison of the updated screening and 
 the previous screening must demonstrate an increase in resource 
 needs. 

    (c) Rate adjustments projected to exceed the authorized 
 funding level associated with the person's profile must be 
 submitted to the commissioner. 

    (d) The new rate approved through this process shall not be 
 averaged across all persons living at a facility but shall be an 
 individual rate.  The county of financial responsibility must 
 indicate the projected length of time that the additional 
 funding may be needed by the individual.  The need to continue 
 an individual variable rate must be reviewed at the end of the 
 anticipated duration of need but at least annually through the 
 completion of the developmental disabilities screening document. 

    Subd. 2.    Other payment rate adjustments.  Facility 
 total payment rates may be adjusted by the host county, with 
 authorization from a statewide advisory committee, if, through 
 the local system needs planning process, it is determined that a 
 need exists to amend the package of purchased services with a 
 resulting increase or decrease in costs.  Except as provided in 
 section 252.292, subdivision 4, if a provider demonstrates that 
 the loss of revenues caused by the downsizing or closure of a 
 facility cannot be absorbed by the facility based on current 
 operations, the host county or the provider may submit a request 
 to the statewide advisory committee for a facility base rate 
 adjustment. 

    Subd. 3.    Relocation.  (a) Property rates for all 
 facilities relocated after December 31, 1997, and up to and 
 including October 1, 2000, shall have the full annual costs of 
 relocation included in their October 1, 2000, property rate.  
 The property rate for the relocated home is subject to the costs 
 that were allowable under Minnesota Rules, chapter 9553, and the 
 investment per bed limitation for newly constructed or newly 
 established class B facilities.  

    (b) In ensuing years, all relocated homes shall be subject 
 to the investment per bed limit for newly constructed or newly 
 established class B facilities under section 256B.501, 
 subdivision 11.  The limits shall be adjusted on January 1 of 
 each year by the percentage increase in the construction index 
 published by the Bureau of Economic Analysis of the United 
 States Department of Commerce in the Survey of Current Business 
 Statistics in October of the previous two years.  Facilities 
 that are relocated within the investment per bed limit may be 
 approved by the statewide advisory committee.  Costs for 
 relocation of a facility that exceed the investment per bed 
 limit must be absorbed by the facility. 

    (c) The payment rate shall take effect when the new 
 facility is licensed and certified by the commissioner of 
 health.  Rates for facilities that are relocated after December 
 31, 1997, through October 1, 2000, shall be adjusted to reflect 
 the full inclusion of the relocation costs, subject to the 
 investment per bed limit in paragraph (b).  The investment per 
 bed limit calculated rate for the year in which the facility was 
 relocated shall be the investment per bed limit used. 

    Subd. 4.    Temporary rate adjustments to address 
 occupancy and access.  If a facility is operating at less than 
 100 percent occupancy on September 30, 2000, or if a recipient 
 is discharged from a facility, the commissioner shall adjust the 
 total payment rate for up to 90 days for the remaining 
 recipients.  This mechanism shall not be used to pay for 
 hospital or therapeutic leave days beyond the maximums allowed.  
 Facility payment adjustments exceeding 90 days to address a 
 demonstrated need for access must be submitted to the statewide 
 advisory committee with a local system needs assessment, plan, 
 and budget for review and recommendation. 

    HIST: 1999 c 245 art 3 s 34