1.1                          A bill for an act 
  1.2             relating to human services; extending the expiration 
  1.3             date of the alternative quality assurance licensing 
  1.4             system project; modifying other requirements; 
  1.5             appropriating money; amending Minnesota Statutes 2000, 
  1.6             sections 256B.095; 256B.0951, subdivisions 1, 3, 4, 5, 
  1.7             7, and by adding subdivisions; and 256B.0952, 
  1.8             subdivisions 1 and 4; repealing Minnesota Statutes 
  1.9             2000, sections 256B.0951, subdivision 6. 
  1.10  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.11     Section 1.  Minnesota Statutes 2000, section 256B.095, is 
  1.12  amended to read: 
  1.13     256B.095 [THREE-YEAR QUALITY ASSURANCE PILOT PROJECT 
  1.14  ESTABLISHED.] 
  1.15     Effective July 1, 1998, an alternative quality assurance 
  1.16  licensing system pilot project for programs for persons with 
  1.17  developmental disabilities is established in Dodge, Fillmore, 
  1.18  Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, Steele, 
  1.19  Wabasha, and Winona counties for the purpose of improving the 
  1.20  quality of services provided to persons with developmental 
  1.21  disabilities.  A county, at its option, may choose to have all 
  1.22  programs for persons with developmental disabilities located 
  1.23  within the county licensed under chapter 245A using standards 
  1.24  determined under the alternative quality assurance licensing 
  1.25  system pilot project or may continue regulation of these 
  1.26  programs under the licensing system operated by the 
  1.27  commissioner.  The pilot project expires on June 30, 2001 2005. 
  2.1      Sec. 2.  Minnesota Statutes 2000, section 256B.0951, 
  2.2   subdivision 1, is amended to read: 
  2.3      Subdivision 1.  [MEMBERSHIP.] The region 10 quality 
  2.4   assurance commission is established.  The commission consists of 
  2.5   at least 14 but not more than 21 members as follows:  at least 
  2.6   three but not more than five members representing advocacy 
  2.7   organizations; at least three but not more than five members 
  2.8   representing consumers, families, and their legal 
  2.9   representatives; at least three but not more than five members 
  2.10  representing service providers; at least three but not more than 
  2.11  five members representing counties; and the commissioner of 
  2.12  human services or the commissioner's designee.  Initial 
  2.13  membership of the commission shall be recruited and approved by 
  2.14  the region 10 stakeholders group.  Prior to approving the 
  2.15  commission's membership, the stakeholders group shall provide to 
  2.16  the commissioner a list of the membership in the stakeholders 
  2.17  group, as of February 1, 1997, a brief summary of meetings held 
  2.18  by the group since July 1, 1996, and copies of any materials 
  2.19  prepared by the group for public distribution.  The first 
  2.20  commission shall establish membership guidelines for the 
  2.21  transition and recruitment of membership for the commission's 
  2.22  ongoing existence.  Members of the commission who do not receive 
  2.23  a salary or wages from an employer for time spent on commission 
  2.24  duties may receive a per diem payment when performing commission 
  2.25  duties and functions.  All members may be reimbursed for 
  2.26  expenses related to commission activities.  Notwithstanding the 
  2.27  provisions of section 15.059, subdivision 5, the commission 
  2.28  expires on June 30, 2001 2005. 
  2.29     Sec. 3.  Minnesota Statutes 2000, section 256B.0951, 
  2.30  subdivision 3, is amended to read: 
  2.31     Subd. 3.  [COMMISSION DUTIES.] (a) By October 1, 1997, the 
  2.32  commission, in cooperation with the commissioners of human 
  2.33  services and health, shall do the following:  (1) approve an 
  2.34  alternative quality assurance licensing system based on the 
  2.35  evaluation of outcomes; (2) approve measurable outcomes in the 
  2.36  areas of health and safety, consumer evaluation, education and 
  3.1   training, providers, and systems that shall be evaluated during 
  3.2   the alternative licensing process; and (3) establish variable 
  3.3   licensure periods not to exceed three years based on outcomes 
  3.4   achieved.  For purposes of this subdivision, "outcome" means the 
  3.5   behavior, action, or status of a person that can be observed or 
  3.6   measured and can be reliably and validly determined. 
  3.7      (b) By January 15, 1998, the commission shall approve, in 
  3.8   cooperation with the commissioner of human services, a training 
  3.9   program for members of the quality assurance teams established 
  3.10  under section 256B.0952, subdivision 4. 
  3.11     (c) The commission and the commissioner shall establish an 
  3.12  ongoing review process for the alternative quality assurance 
  3.13  licensing system.  The review shall take into account the 
  3.14  comprehensive nature of the alternative system, which is 
  3.15  designed to evaluate the broad spectrum of licensed and 
  3.16  unlicensed entities that provide services to clients, as 
  3.17  compared to the current licensing system.  
  3.18     (d) The commission shall contract with an independent 
  3.19  entity to conduct a financial review of the alternative quality 
  3.20  assurance pilot project.  The review shall take into account the 
  3.21  comprehensive nature of the alternative system, which is 
  3.22  designed to evaluate the broad spectrum of licensed and 
  3.23  unlicensed entities that provide services to clients, as 
  3.24  compared to the current licensing system.  The review shall 
  3.25  include an evaluation of possible budgetary savings within the 
  3.26  department of human services as a result of implementation of 
  3.27  the alternative quality assurance pilot project.  If a federal 
  3.28  waiver is approved under subdivision 7, the financial review 
  3.29  shall also evaluate possible savings within the department of 
  3.30  health.  This review must be completed by December 15, 2000. 
  3.31     (e) The commission shall submit a report to the legislature 
  3.32  by January 15, 2001, on the results of the review process for 
  3.33  the alternative quality assurance pilot project, a summary of 
  3.34  the results of the independent financial review, and a 
  3.35  recommendation on whether the pilot project should be extended 
  3.36  beyond June 30, 2001. 
  4.1      (f) The commissioner, in consultation with the commission, 
  4.2   shall examine the feasibility of expanding the project to other 
  4.3   populations or geographic areas and identify barriers to 
  4.4   expansion.  The commissioner shall report findings and 
  4.5   recommendations to the legislature by December 15, 2004. 
  4.6      Sec. 4.  Minnesota Statutes 2000, section 256B.0951, 
  4.7   subdivision 4, is amended to read: 
  4.8      Subd. 4.  [COMMISSION'S AUTHORITY TO RECOMMEND VARIANCES OF 
  4.9   LICENSING STANDARDS.] The commission may recommend to the 
  4.10  commissioners of human services and health variances from the 
  4.11  standards governing licensure of programs for persons with 
  4.12  developmental disabilities in order to improve the quality of 
  4.13  services by implementing an alternative developmental 
  4.14  disabilities licensing system if the commission determines that 
  4.15  the alternative licensing system does not adversely affect the 
  4.16  health or safety of persons being served by the licensed program 
  4.17  nor compromise the qualifications of staff to provide services. 
  4.18     Sec. 5.  Minnesota Statutes 2000, section 256B.0951, 
  4.19  subdivision 5, is amended to read: 
  4.20     Subd. 5.  [VARIANCE OF CERTAIN STANDARDS PROHIBITED.] The 
  4.21  safety standards, rights, or procedural protections under 
  4.22  sections 245.825; 245.91 to 245.97; 245A.04, subdivisions 3, 3a, 
  4.23  3b, and 3c; 245A.09, subdivision 2, paragraph (c), clauses (2) 
  4.24  and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, 
  4.25  subdivisions 1b, clause (7), and 10; 626.556; 626.557, and 
  4.26  procedures for the monitoring of psychotropic medications shall 
  4.27  not be varied under the alternative licensing system pilot 
  4.28  project.  The commission may make recommendations to the 
  4.29  commissioners of human services and health or to the legislature 
  4.30  regarding alternatives to or modifications of the rules and 
  4.31  procedures referenced in this subdivision. 
  4.32     Sec. 6.  Minnesota Statutes 2000, section 256B.0951, 
  4.33  subdivision 7, is amended to read: 
  4.34     Subd. 7.  [WAIVER OF RULES.] The commissioner of health may 
  4.35  exempt residents of intermediate care facilities for persons 
  4.36  with mental retardation (ICFs/MR) who participate in the 
  5.1   three-year quality assurance pilot project established in 
  5.2   section 256B.095 from the requirements of Minnesota Rules, 
  5.3   chapter 4665, upon approval by the federal government of a 
  5.4   waiver of federal certification requirements for ICFs/MR.  The 
  5.5   commissioners of health and human services shall apply for any 
  5.6   necessary waivers as soon as practicable and shall submit the 
  5.7   concept paper to the federal government by June 1, 1998.  
  5.8      Sec. 7.  Minnesota Statutes 2000, section 256B.0951, is 
  5.9   amended by adding a subdivision to read: 
  5.10     Subd. 8.  [FEDERAL WAIVER.] The commissioner of human 
  5.11  services shall seek federal authority to waive provisions of 
  5.12  intermediate care facilities for persons with mental retardation 
  5.13  (ICFs/MR) regulations to enable the demonstration and evaluation 
  5.14  of the alternative quality assurance system for ICFs/MR under 
  5.15  the project.  The commissioner of human services shall apply for 
  5.16  any necessary waivers as soon as practicable. 
  5.17     Sec. 8.  Minnesota Statutes 2000, section 256B.0951, is 
  5.18  amended by adding a subdivision to read: 
  5.19     Subd. 9.  [EVALUATION.] The commission, in consultation 
  5.20  with the commissioner of human services, shall conduct an 
  5.21  evaluation of the alternative quality assurance system, and 
  5.22  present a report to the commissioner by June 30, 2004. 
  5.23     Sec. 9.  Minnesota Statutes 2000, section 256B.0952, 
  5.24  subdivision 1, is amended to read: 
  5.25     Subdivision 1.  [NOTIFICATION.] By January 15, 1998, each 
  5.26  affected county shall notify the commission and the 
  5.27  commissioners of human services and health as to whether it 
  5.28  chooses to implement on July 1, 1998, the alternative licensing 
  5.29  system for the pilot project.  A county that does not implement 
  5.30  the alternative licensing system on July 1, 1998, may give 
  5.31  notice to the commission and the commissioners by January 15, 
  5.32  1999, or January 15, 2000, that it will implement the 
  5.33  alternative licensing system on the following July 1.  A county 
  5.34  that implements the alternative licensing system commits to 
  5.35  participate until June 30, 2001.  For each year of the project, 
  5.36  region 10 counties shall give notice to the commission and 
  6.1   commissioners of human services and health by March 15 of intent 
  6.2   to join the quality assurance alternative licensing system, 
  6.3   effective July 1 of that year.  A county choosing to participate 
  6.4   in the alternative licensing system commits to participate until 
  6.5   June 30, 2005.  Counties participating in the quality assurance 
  6.6   alternative licensing system as of January 1, 2001, shall notify 
  6.7   the commission and the commissioners of human services and 
  6.8   health by March 15, 2001, of intent to continue participation.  
  6.9   Counties that elect to continue participation must participate 
  6.10  in the alternative licensing system until June 30, 2005. 
  6.11     Sec. 10.  Minnesota Statutes 2000, section 256B.0952, 
  6.12  subdivision 4, is amended to read: 
  6.13     Subd. 4.  [APPOINTMENT OF QUALITY ASSURANCE MANAGER.] (a) A 
  6.14  county or group of counties that chooses to participate in the 
  6.15  alternative licensing system shall designate a quality assurance 
  6.16  manager and shall establish quality assurance teams in 
  6.17  accordance with subdivision 5.  The manager shall recruit, 
  6.18  train, and assign duties to the quality assurance team members.  
  6.19  In assigning team members to conduct the quality assurance 
  6.20  process at a facility, program, or service, the manager shall 
  6.21  take into account the size of the service provider, the number 
  6.22  of services to be reviewed, the skills necessary for team 
  6.23  members to complete the process, and other relevant factors.  
  6.24  The manager shall ensure that no team member has a financial, 
  6.25  personal, or family relationship with the facility, program, or 
  6.26  service being reviewed or with any clients of the facility, 
  6.27  program, or service. 
  6.28     (b) Quality assurance teams shall report the findings of 
  6.29  their quality assurance reviews to the quality assurance manager.
  6.30  The quality assurance manager shall provide the report from the 
  6.31  quality assurance team to the county and, upon request, to the 
  6.32  commissioners of human services and health, and shall provide a 
  6.33  summary of the report to the quality assurance review council.  
  6.34     Sec. 11.  [APPROPRIATION; REGION 10 QUALITY ASSURANCE 
  6.35  COMMISSION.] 
  6.36     Subdivision 1.  [OPERATING COSTS; COUNTY GRANTS.] $496,900 
  7.1   is appropriated from the general fund to the commissioner of 
  7.2   human services for the biennium ending June 30, 2003, to be 
  7.3   allocated to the region 10 quality assurance commission for 
  7.4   operating costs of the alternative quality assurance licensing 
  7.5   project and for grants to counties participating in that project.
  7.6      Subd. 2.  [EVALUATION.] $50,000 is appropriated from the 
  7.7   general fund to the commissioner of human services for the 
  7.8   biennium ending June 30, 2003, for the region 10 quality 
  7.9   assurance commission to conduct the evaluation required under 
  7.10  Minnesota Statutes, section 256B.0951, subdivision 9. 
  7.11     Subd. 3.  [FEDERALLY REQUIRED EVALUATION.] $150,000 is 
  7.12  appropriated from the general fund to the commissioner of human 
  7.13  services for the biennium ending June 30, 2003, for the 
  7.14  commissioner to conduct the project evaluation required for the 
  7.15  federal 1115 waiver of ICF/MR regulations. 
  7.16     Sec. 12.  [REPEALER.] 
  7.17     Minnesota Statutes 2000, section 256B.0951, subdivision 6, 
  7.18  is repealed.