1.1                          A bill for an act 
  1.2             relating to human services; directing the Minnesota 
  1.3             home care association to study reimbursing home care 
  1.4             and personal care providers for transportation 
  1.5             expenses; modifying enrollment in the senior health 
  1.6             options project; authorizing demonstration projects 
  1.7             for persons with disabilities; amending Minnesota 
  1.8             Statutes 1998, section 256B.69, subdivision 23; 
  1.9             Minnesota Statutes 1999 Supplement, section 256B.69, 
  1.10            subdivision 6b. 
  1.11  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.12     Section 1.  Minnesota Statutes 1999 Supplement, section 
  1.13  256B.69, subdivision 6b, is amended to read: 
  1.14     Subd. 6b.  [HOME AND COMMUNITY-BASED WAIVER SERVICES.] (a) 
  1.15  For individuals enrolled in the Minnesota senior health options 
  1.16  project authorized under subdivision 23, elderly waiver services 
  1.17  shall be covered according to the terms and conditions of the 
  1.18  federal agreement governing that demonstration project. 
  1.19     (b) For individuals under age 65 with physical disabilities 
  1.20  but without a primary diagnosis of mental illness or 
  1.21  developmental disabilities, except for related conditions, 
  1.22  enrolled in the Minnesota senior health options project 
  1.23  demonstrations authorized under subdivision 23, home and 
  1.24  community-based waiver services shall be covered according to 
  1.25  the terms and conditions of the federal agreement governing that 
  1.26  demonstration project. 
  1.27     Sec. 2.  Minnesota Statutes 1998, section 256B.69, 
  1.28  subdivision 23, is amended to read: 
  2.1      Subd. 23.  [ALTERNATIVE INTEGRATED LONG-TERM CARE SERVICES; 
  2.2   ELDERLY AND DISABLED PERSONS.] (a) The commissioner may 
  2.3   implement demonstration projects to create alternative 
  2.4   integrated delivery systems for acute and long-term care 
  2.5   services to elderly persons and disabled persons with 
  2.6   disabilities as defined in section 256B.77, subdivision 7a, that 
  2.7   provide increased coordination, improve access to quality 
  2.8   services, and mitigate future cost increases.  The commissioner 
  2.9   may seek federal authority to combine Medicare and Medicaid 
  2.10  capitation payments for the purpose of such demonstrations.  
  2.11  Medicare funds and services shall be administered according to 
  2.12  the terms and conditions of the federal waiver and demonstration 
  2.13  provisions.  For the purpose of administering medical assistance 
  2.14  funds, demonstrations under this subdivision are subject to 
  2.15  subdivisions 1 to 17 22.  The provisions of Minnesota Rules, 
  2.16  parts 9500.1450 to 9500.1464, apply to these demonstrations, 
  2.17  with the exceptions of parts 9500.1452, subpart 2, item B; and 
  2.18  9500.1457, subpart 1, items B and C, which do not apply 
  2.19  to elderly persons enrolling in demonstrations under this 
  2.20  section.  An initial open enrollment period may be provided.  
  2.21  Persons who disenroll from demonstrations under this subdivision 
  2.22  remain subject to Minnesota Rules, parts 9500.1450 to 
  2.23  9500.1464.  When a person is enrolled in a health plan under 
  2.24  these demonstrations and the health plan's participation is 
  2.25  subsequently terminated for any reason, the person shall be 
  2.26  provided an opportunity to select a new health plan and shall 
  2.27  have the right to change health plans within the first 60 days 
  2.28  of enrollment in the second health plan.  Persons required to 
  2.29  participate in health plans under this section who fail to make 
  2.30  a choice of health plan shall not be randomly assigned to health 
  2.31  plans under these demonstrations. Notwithstanding section 
  2.32  256L.12, subdivision 5, and Minnesota Rules, part 9505.5220, 
  2.33  subpart 1, item A, if adopted, for the purpose of demonstrations 
  2.34  under this subdivision, the commissioner may contract with 
  2.35  managed care organizations, including counties, to serve only 
  2.36  elderly persons eligible for medical assistance, elderly and 
  3.1   disabled persons, or disabled persons only.  For persons with 
  3.2   primary diagnoses of mental retardation or a related condition, 
  3.3   serious and persistent mental illness, or serious emotional 
  3.4   disturbance, the commissioner must ensure that the county 
  3.5   authority has approved the demonstration and contracting 
  3.6   design.  Enrollment in these projects shall be voluntary until 
  3.7   July 1, 2001.  The commissioner shall not implement any 
  3.8   demonstration project under this subdivision for persons with 
  3.9   primary diagnoses of mental retardation or a related condition, 
  3.10  serious and persistent mental illness, or serious emotional 
  3.11  disturbance, without approval of the county board of the county 
  3.12  in which the demonstration is being implemented. 
  3.13     Before implementation of a demonstration project for 
  3.14  disabled persons, the commissioner must provide information to 
  3.15  appropriate committees of the house of representatives and 
  3.16  senate and must involve representatives of affected disability 
  3.17  groups in the design of the demonstration projects. 
  3.18     (b) A nursing facility reimbursed under the alternative 
  3.19  reimbursement methodology in section 256B.434 may, in 
  3.20  collaboration with a hospital, clinic, or other health care 
  3.21  entity provide services under paragraph (a).  The commissioner 
  3.22  shall amend the state plan and seek any federal waivers 
  3.23  necessary to implement this paragraph. 
  3.24     Sec. 3.  [HOME CARE TRANSPORTATION.] 
  3.25     By December 15, 2000, the Minnesota home care association, 
  3.26  in collaboration with the commissioner of human services, shall 
  3.27  prepare a study and report to the legislature on reimbursing 
  3.28  home care and personal care service providers receiving 
  3.29  reimbursement under medical assistance, general assistance 
  3.30  medical care, or home and community-based waiver services under 
  3.31  Minnesota Statutes, chapter 256B, for worker transportation 
  3.32  costs.  The commissioner shall provide technical assistance to 
  3.33  the home care association in conducting the study.  The study 
  3.34  shall include, but not be limited to: 
  3.35     (1) an analysis of the characteristics of home care 
  3.36  provider worker transportation costs and needs; 
  4.1      (2) proposed methods of reimbursement, including, but not 
  4.2   limited to: 
  4.3      (i) per mile reimbursement; 
  4.4      (ii) per visit reimbursement; 
  4.5      (iii) countywide average per visit reimbursement; 
  4.6      (iv) per visit reimbursement based on distance to the home 
  4.7   care provider office; and 
  4.8      (v) incorporating a transportation reimbursement amount 
  4.9   into statewide home care services reimbursement rates; 
  4.10     (3) options for funding transportation reimbursement; 
  4.11     (4) options for obtaining federal matching funds for 
  4.12  transportation reimbursement; and 
  4.13     (5) methods for home care providers to compensate their 
  4.14  workers for transportation expenses using the additional revenue.