1.1                          A bill for an act 
  1.2             relating to human services; expanding the alternative 
  1.3             quality assurance licensing system; eliminating a 
  1.4             sunset; appropriating money; amending Minnesota 
  1.5             Statutes 2002, sections 256B.095; 256B.0951, 
  1.6             subdivisions 1, 2, 3, 5, 7, 9; 256B.0952, subdivision 
  1.7             1; 256B.0953, subdivision 2; 256B.0955. 
  1.8   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.9      Section 1.  Minnesota Statutes 2002, section 256B.095, is 
  1.10  amended to read: 
  1.11     256B.095 [QUALITY ASSURANCE PROJECT SYSTEM ESTABLISHED.] 
  1.12     (a) Effective July 1, 1998, an alternative a quality 
  1.13  assurance licensing system project for persons with 
  1.14  developmental disabilities, which includes an alternative 
  1.15  quality assurance licensing system for programs for persons with 
  1.16  developmental disabilities, is established in Dodge, Fillmore, 
  1.17  Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, Steele, 
  1.18  Wabasha, and Winona counties for the purpose of improving the 
  1.19  quality of services provided to persons with developmental 
  1.20  disabilities.  A county, at its option, may choose to have all 
  1.21  programs for persons with developmental disabilities located 
  1.22  within the county licensed under chapter 245A using standards 
  1.23  determined under the alternative quality assurance licensing 
  1.24  system project or may continue regulation of these programs 
  1.25  under the licensing system operated by the commissioner.  The 
  1.26  project expires on June 30, 2005. 
  2.1      (b) Effective July 1, 2003, a county not listed in 
  2.2   paragraph (a) may apply to participate in the quality assurance 
  2.3   system established under paragraph (a).  The commission 
  2.4   established under section 256B.0951 may, at its option, allow 
  2.5   additional counties to participate in the system. 
  2.6      (c) Effective July 1, 2003, any county or group of counties 
  2.7   not listed in paragraph (a) may establish a quality assurance 
  2.8   system under this section.  A new system established under this 
  2.9   section shall have the same rights and duties as the system 
  2.10  established under paragraph (a).  A new system shall be governed 
  2.11  by a commission under section 256B.0951.  The commissioner shall 
  2.12  appoint the initial commission members based on recommendations 
  2.13  from advocates, families, service providers, and counties in the 
  2.14  geographic area included in the new system.  Counties that 
  2.15  choose to participate in a new system shall have the duties 
  2.16  assigned under section 256B.0952.  The new system shall 
  2.17  establish a quality assurance process under section 256B.0953.  
  2.18  The provisions of section 256B.0954 shall apply to a new system 
  2.19  established under this paragraph.  The commissioner shall 
  2.20  delegate authority to a new system established under this 
  2.21  paragraph according to section 256B.0955. 
  2.22     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
  2.23     Sec. 2.  Minnesota Statutes 2002, section 256B.0951, 
  2.24  subdivision 1, is amended to read: 
  2.25     Subdivision 1.  [MEMBERSHIP.] The region 10 quality 
  2.26  assurance commission is established.  The commission consists of 
  2.27  at least 14 but not more than 21 members as follows:  at least 
  2.28  three but not more than five members representing advocacy 
  2.29  organizations; at least three but not more than five members 
  2.30  representing consumers, families, and their legal 
  2.31  representatives; at least three but not more than five members 
  2.32  representing service providers; at least three but not more than 
  2.33  five members representing counties; and the commissioner of 
  2.34  human services or the commissioner's designee.  Initial 
  2.35  membership of the commission shall be recruited and approved by 
  2.36  the region 10 stakeholders group.  Prior to approving the 
  3.1   commission's membership, the stakeholders group shall provide to 
  3.2   the commissioner a list of the membership in the stakeholders 
  3.3   group, as of February 1, 1997, a brief summary of meetings held 
  3.4   by the group since July 1, 1996, and copies of any materials 
  3.5   prepared by the group for public distribution.  The first 
  3.6   commission shall establish membership guidelines for the 
  3.7   transition and recruitment of membership for the commission's 
  3.8   ongoing existence.  Members of the commission who do not receive 
  3.9   a salary or wages from an employer for time spent on commission 
  3.10  duties may receive a per diem payment when performing commission 
  3.11  duties and functions.  All members may be reimbursed for 
  3.12  expenses related to commission activities.  Notwithstanding the 
  3.13  provisions of section 15.059, subdivision 5, the commission 
  3.14  expires on June 30, 2005 shall not expire. 
  3.15     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
  3.16     Sec. 3.  Minnesota Statutes 2002, section 256B.0951, 
  3.17  subdivision 2, is amended to read: 
  3.18     Subd. 2.  [AUTHORITY TO HIRE STAFF; CHARGE FEES; AND 
  3.19  PROVIDE TECHNICAL ASSISTANCE.] (a) The commission may hire staff 
  3.20  to perform the duties assigned in this section.  
  3.21     (b) The commission may charge fees for its services. 
  3.22     (c) The commission may provide technical assistance to 
  3.23  other counties, families, providers, and advocates interested in 
  3.24  participating in a quality assurance system under section 
  3.25  256B.095, paragraph (b) or (c). 
  3.26     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
  3.27     Sec. 4.  Minnesota Statutes 2002, section 256B.0951, 
  3.28  subdivision 3, is amended to read: 
  3.29     Subd. 3.  [COMMISSION DUTIES.] (a) By October 1, 1997, the 
  3.30  commission, in cooperation with the commissioners of human 
  3.31  services and health, shall do the following:  (1) approve an 
  3.32  alternative quality assurance licensing system based on the 
  3.33  evaluation of outcomes; (2) approve measurable outcomes in the 
  3.34  areas of health and safety, consumer evaluation, education and 
  3.35  training, providers, and systems that shall be evaluated during 
  3.36  the alternative licensing process; and (3) establish variable 
  4.1   licensure periods not to exceed three years based on outcomes 
  4.2   achieved.  For purposes of this subdivision, "outcome" means the 
  4.3   behavior, action, or status of a person that can be observed or 
  4.4   measured and can be reliably and validly determined. 
  4.5      (b) By January 15, 1998, the commission shall approve, in 
  4.6   cooperation with the commissioner of human services, a training 
  4.7   program for members of the quality assurance teams established 
  4.8   under section 256B.0952, subdivision 4. 
  4.9      (c) The commission and the commissioner shall establish an 
  4.10  ongoing review process for the alternative quality assurance 
  4.11  licensing system.  The review shall take into account the 
  4.12  comprehensive nature of the alternative system, which is 
  4.13  designed to evaluate the broad spectrum of licensed and 
  4.14  unlicensed entities that provide services to clients, as 
  4.15  compared to the current licensing system.  
  4.16     (d) The commission shall contract with an independent 
  4.17  entity to conduct a financial review of the alternative quality 
  4.18  assurance project.  The review shall take into account the 
  4.19  comprehensive nature of the alternative system, which is 
  4.20  designed to evaluate the broad spectrum of licensed and 
  4.21  unlicensed entities that provide services to clients, as 
  4.22  compared to the current licensing system.  The review shall 
  4.23  include an evaluation of possible budgetary savings within the 
  4.24  department of human services as a result of implementation of 
  4.25  the alternative quality assurance project.  If a federal waiver 
  4.26  is approved under subdivision 7, the financial review shall also 
  4.27  evaluate possible savings within the department of health.  This 
  4.28  review must be completed by December 15, 2000. 
  4.29     (e) The commission shall submit a report to the legislature 
  4.30  by January 15, 2001, on the results of the review process for 
  4.31  the alternative quality assurance project, a summary of the 
  4.32  results of the independent financial review, and a 
  4.33  recommendation on whether the project should be extended beyond 
  4.34  June 30, 2001. 
  4.35     (f) The commissioner commission, in consultation with 
  4.36  the commission commissioner, shall examine the feasibility of 
  5.1   expanding work cooperatively with other populations to expand 
  5.2   the project system to other those populations or geographic 
  5.3   areas and identify barriers to expansion.  The commissioner 
  5.4   shall report findings and recommendations to the legislature by 
  5.5   December 15, 2004. 
  5.6      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
  5.7      Sec. 5.  Minnesota Statutes 2002, section 256B.0951, 
  5.8   subdivision 5, is amended to read: 
  5.9      Subd. 5.  [VARIANCE OF CERTAIN STANDARDS PROHIBITED.] The 
  5.10  safety standards, rights, or procedural protections under 
  5.11  sections 245.825; 245.91 to 245.97; 245A.04, subdivisions 3, 3a, 
  5.12  3b, and 3c; 245A.09, subdivision 2, paragraph (c), clauses (2) 
  5.13  and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, 
  5.14  subdivisions 1b, clause (7), and 10; 626.556; 626.557, and 
  5.15  procedures for the monitoring of psychotropic medications shall 
  5.16  not be varied under the alternative licensing quality assurance 
  5.17  licensing system project.  The commission may make 
  5.18  recommendations to the commissioners of human services and 
  5.19  health or to the legislature regarding alternatives to or 
  5.20  modifications of the rules and procedures referenced in this 
  5.21  subdivision. 
  5.22     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
  5.23     Sec. 6.  Minnesota Statutes 2002, section 256B.0951, 
  5.24  subdivision 7, is amended to read: 
  5.25     Subd. 7.  [WAIVER OF RULES.] If a federal waiver is 
  5.26  approved under subdivision 8, the commissioner of health may 
  5.27  exempt residents of intermediate care facilities for persons 
  5.28  with mental retardation (ICFs/MR) who participate in the 
  5.29  alternative quality assurance project system established in 
  5.30  section 256B.095 from the requirements of Minnesota Rules, 
  5.31  chapter 4665. 
  5.32     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
  5.33     Sec. 7.  Minnesota Statutes 2002, section 256B.0951, 
  5.34  subdivision 9, is amended to read: 
  5.35     Subd. 9.  [EVALUATION.] The commission, in consultation 
  5.36  with the commissioner of human services, shall conduct an 
  6.1   evaluation of the alternative quality assurance system, and 
  6.2   present a report to the commissioner by June 30, 2004. 
  6.3      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
  6.4      Sec. 8.  Minnesota Statutes 2002, section 256B.0952, 
  6.5   subdivision 1, is amended to read: 
  6.6      Subdivision 1.  [NOTIFICATION.] For each year of the 
  6.7   project, region 10 Counties shall give notice to the commission 
  6.8   and commissioners of human services and health by March 15 of 
  6.9   intent to join the quality assurance alternative quality 
  6.10  assurance licensing system, effective July 1 of that year.  A 
  6.11  county choosing to participate in the alternative quality 
  6.12  assurance licensing system commits to participate until June 30, 
  6.13  2005.  Counties participating in the quality assurance 
  6.14  alternative licensing system as of January 1, 2001, shall notify 
  6.15  the commission and the commissioners of human services and 
  6.16  health by March 15, 2001, of intent to continue participation.  
  6.17  Counties that elect to continue participation must participate 
  6.18  in the alternative licensing system until June 30, 2005 for 
  6.19  three years. 
  6.20     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
  6.21     Sec. 9.  Minnesota Statutes 2002, section 256B.0953, 
  6.22  subdivision 2, is amended to read: 
  6.23     Subd. 2.  [LICENSURE PERIODS.] (a) In order to be licensed 
  6.24  under the alternative quality assurance process licensing 
  6.25  system, a facility, program, or service must satisfy the health 
  6.26  and safety outcomes approved for the pilot project alternative 
  6.27  quality assurance licensing system. 
  6.28     (b) Licensure shall be approved for periods of one to three 
  6.29  years for a facility, program, or service that satisfies the 
  6.30  requirements of paragraph (a) and achieves the outcome 
  6.31  measurements in the categories of consumer evaluation, education 
  6.32  and training, providers, and systems. 
  6.33     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
  6.34     Sec. 10.  Minnesota Statutes 2002, section 256B.0955, is 
  6.35  amended to read: 
  6.36     256B.0955 [DUTIES OF THE COMMISSIONER OF HUMAN SERVICES.] 
  7.1      (a) Effective July 1, 1998, the commissioner of human 
  7.2   services shall delegate authority to perform licensing functions 
  7.3   and activities, in accordance with section 245A.16, to counties 
  7.4   participating in the alternative quality assurance licensing 
  7.5   system.  The commissioner shall not license or reimburse a 
  7.6   facility, program, or service for persons with developmental 
  7.7   disabilities in a county that participates in the 
  7.8   alternative quality assurance licensing system if the 
  7.9   commissioner has received from the appropriate county 
  7.10  notification that the facility, program, or service has been 
  7.11  reviewed by a quality assurance team and has failed to qualify 
  7.12  for licensure. 
  7.13     (b) The commissioner may conduct random licensing 
  7.14  inspections based on outcomes adopted under section 256B.0951 at 
  7.15  facilities, programs, and services governed by the alternative 
  7.16  quality assurance licensing system.  The role of such random 
  7.17  inspections shall be to verify that the alternative quality 
  7.18  assurance licensing system protects the safety and well-being of 
  7.19  consumers and maintains the availability of high-quality 
  7.20  services for persons with developmental disabilities.  
  7.21     (c) The commissioner shall provide technical assistance and 
  7.22  support or training to the alternative licensing system pilot 
  7.23  project. 
  7.24     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2003. 
  7.25     Sec. 11.  [APPROPRIATION.] 
  7.26     $....... is appropriated from the general fund to the 
  7.27  commissioner of human services for the biennium ending June 30, 
  7.28  2005, to be allocated to the quality assurance commission for 
  7.29  the operating costs of the quality assurance system.