1.1 	A bill for an act
1.2 	relating to human services; implementing long-term care service options; 
1.3 	requiring an investment study and report on core county long-term care 
1.4 	functions; appropriating money; proposing coding for new law in Minnesota 
1.5 	Statutes, chapter 256B.
1.6 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.7 	Section 1. [256B.096] LONG-TERM CARE SERVICE OPTIONS.
1.8 	(a) To guarantee a high-quality long-term care system, the commissioner shall ensure 
1.9 	that the system meets the following objectives:  the system must be sustainable and support 
1.10 	self-determination; it must provide services that meet consumers' needs and preferences; 
1.11 	it must provide high-quality care; and it must ensure efficiency and affordability. 
1.12 	(b) The system must ensure a range of options, including nursing facilities, housing 
1.13 	with services, and home and community-based services and support that include, but 
1.14 	are not limited to, the following:
1.15 	(1) home health care services;
1.16 	(2) living at home/block nurse programs;
1.17 	(3) meals and nutrition services;
1.18 	(4) chore, homemaker, transportation, assisted living programs, senior 
1.19 	companionship, respite, and other caregiver support services;
1.20 	(5) adult day services;
1.21 	(6) technology facilitated care; 
1.22 	(7) end-of-life care; and
1.23 	(8) care coordination.
1.24 	(c) The system must be cost-effective and provide incentives for lower-cost quality 
1.25 	options, fair compensation for services delivered, appropriate use of trained community 
2.1 	volunteers, and flexible funding streams, such as the alternative care, elderly waiver, 
2.2 	Medicaid, and aging grants programs.
2.3 	(d) The system must support high-quality services that meet contemporary standards, 
2.4 	achieve positive outcomes, and are provided by a sufficient number of trained, competent 
2.5 	staff.
2.6 	(e) The system must incorporate policies, including incentives, to ensure the least 
2.7 	restrictive alternative for each service recipient in order to minimize disruption to an older 
2.8 	person's life while meeting the person's care needs.
2.9 	(f) The system must minimize premature use of nursing facilities and support 
2.10 	diversions from nursing facilities to the community when feasible.
2.11 	(g) The system must support elder-friendly communities with family, government, 
2.12 	faith communities, businesses, and other sectors working together to support vital aging 
2.13 	and long-term care at home.
2.14 	(h) The system must strengthen informal care networks that include family, friends, 
2.15 	volunteers, and other community resources.

2.16 	Sec. 2. LONG-TERM CARE INVESTMENT STUDY AND REBALANCING 
2.17 	GOALS DEVELOPMENT.
 2.18 	(a) By February 15, 2007, the commissioner of human services, in consultation with 
2.19 	the commissioner of health, shall report to the legislature:
2.20 	(1) the results of the investment study conducted under paragraphs (b) to (f); and
2.21 	(2) the balancing goals developed under paragraphs (g) and (h).
2.22 	(b) The investment study shall include recommendations for a rebalanced allocation 
2.23 	of public funding between nursing facility services and home and community-based 
2.24 	services. The recommendations may include variations based on population density or 
2.25 	other factors. The study shall also recommend a standard set of core services, utilizing 
2.26 	culturally appropriate social models in an elder-friendly environment, to be reasonably 
2.27 	accessible to older persons and family caregivers, irrespective of their community of 
2.28 	residence.
2.29 	(c) The investment study must:
2.30 	(1) include proposals to implement the recommendations related to age-friendly 
2.31 	communities and family caregiving in the 2005 report on financing long-term care for 
2.32 	Minnesota baby boomers;
2.33 	(2) gather and report community level and other data about the specific needs of 
2.34 	older persons and of family caregivers of frail older persons within the existing long-term 
2.35 	care system; 
3.1 	(3) determine the efficacy and efficiency of existing services and service models 
3.2 	within varying economic, demographic, and social groups at the community level; and 
3.3 	(4) quantify the costs and benefits of existing services and service models, 
3.4 	specifically including home and community-based services for older persons, their family 
3.5 	caregivers, communities, and the state.
3.6 	(d) The study shall be conducted in five Minnesota communities, including three in 
3.7 	greater Minnesota, one of which must be conducted in a city of the first or second class, and 
3.8 	two in the seven-county metropolitan area. The study must include one greater Minnesota 
3.9 	community and one metropolitan community with a significant minority population.
3.10 	(e) The study shall be conducted utilizing a community engagement process and a 
3.11 	community planning advisory group in each community. A majority of the group members 
3.12 	in each community must be community leaders age 65 and older, family caregivers of 
3.13 	persons age 65 and older, and caregivers of persons age 85 and older. Each advisory group 
3.14 	must also include representatives of counties; cities; health plans; nonprofit and for-profit 
3.15 	health and social services providers; area agencies on aging; minority organizations; 
3.16 	housing, transportation, community development, and economic development agencies; 
3.17 	and the local business community.
3.18 	(f) The study process shall include interviews, focus groups, opinion surveys, and 
3.19 	other methods to obtain direct input from community members. The study shall also 
3.20 	incorporate:
3.21 	(1) existing, relevant local community and state agency data;
3.22 	(2) other relevant data used in population models; and
3.23 	(3) individual case studies, including those of family caregivers of frail older persons.
3.24 	(g) The goals development report shall include recommended allocation goals for 
3.25 	long-term care spending that reflect an increasing reliance on home and community-based 
3.26 	services. The allocation goals shall:
3.27 	(1) incorporate the findings and recommendations of the investment study described 
3.28 	in paragraphs (b) to (f); and 
3.29 	(2) include a plan and timeline to achieve rebalancing goals by state fiscal year 2011, 
3.30 	with progress measures, including specific allocations percentages, specified for each 
3.31 	fiscal year beginning in fiscal year 2008. 
3.32 	(h) The 2007 report shall include data for fiscal year 2006 on state spending for 
3.33 	nursing facility care and home and community-based services, including numbers of 
3.34 	recipients, through medical assistance, the Older Americans Act, the elderly waiver, the 
3.35 	alternative care program, state aging grants, and other funds administered by the state that 
3.36 	pay for long-term care services for older Minnesotans.
4.1 	(i) The commissioner shall select a contractor by August 15, 2006, to conduct the 
4.2 	study.

4.3 	Sec. 3. LIST OF COUNTY LONG-TERM CARE FUNCTIONS.
 4.4 	The commissioner of human services, in consultation with county organizations, 
4.5 	shall develop and report to the legislature by February 15, 2007, a list of core county 
4.6 	long-term care functions, the estimated future costs to counties to perform these functions, 
4.7 	and an analysis of possible funding sources for these costs.

4.8 	Sec. 4. APPROPRIATION.
 4.9 	$250,000 is appropriated from the general fund for the fiscal year ending June 30, 
4.10 	2007, to the commissioner of human services to hire a contractor to conduct the long-term 
4.11 	care investment study under section 2.