HF 1285

1st Engrossment - 91st Legislature (2019 - 2020) Posted on 03/25/2019 03:46pm

A bill for an act
relating to human services; modifying consumer-directed community supports;
establishing a onetime grant program to promote consumer-directed community
supports; appropriating money; amending Laws 2017, First Special Session chapter
6, article 1, section 45.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Laws 2017, First Special Session chapter 6, article 1, section 45, is amended
to read:

Sec. 45.

CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET
METHODOLOGY deleted text begin EXCEPTION FOR PERSONS LEAVING INSTITUTIONS AND
CRISIS RESIDENTIAL SETTINGS deleted text end .

new text begin Subdivision 1. new text end

new text begin Exception for persons leaving institutions and crisis residential
settings. new text end

(a) By September 30, 2017, the commissioner shall establish an institutional and
crisis bed consumer-directed community supports budget exception process in the home
and community-based services waivers under Minnesota Statutes, sections 256B.092 and
256B.49. This budget exception process shall be available for any individual who:

(1) is not offered available and appropriate services within 60 days since approval for
discharge from the individual's current institutional setting; and

(2) requires services that are more expensive than appropriate services provided in a
noninstitutional setting using the consumer-directed community supports option.

(b) Institutional settings for purposes of this exception include intermediate care facilities
for persons with developmental disabilities; nursing facilities; acute care hospitals; Anoka
Metro Regional Treatment Center; Minnesota Security Hospital; and crisis beds. The budget
exception shall be limited to no more than the amount of appropriate services provided in
a noninstitutional setting as determined by the lead agency managing the individual's home
and community-based services waiver. The lead agency shall notify the Department of
Human Services of the budget exception.

new text begin Subd. 2. new text end

new text begin Behavioral interventions. new text end

new text begin (a) Behavioral interventions may include any services
not identified in the community support plan but are needed to prevent imminent crisis
placement or institutionalization, or to intervene in a crisis.
new text end

new text begin (b) Behavioral interventions must be calculated outside of the individual's
consumer-directed community supports budget and paid for using aggregate waiver funds
from the county of financial responsibility.
new text end

new text begin (c) No later than September 30, 2019, the commissioner of human services shall submit
an amendment to the federal Centers for Medicare and Medicaid Services for the home and
community-based services waivers authorized under Minnesota Statutes, sections 256B.092
and 256B.49, to exclude the cost of behavioral interventions as described in paragraph (a)
from an individual's consumer-directed community supports budget.
new text end

new text begin Subd. 3. new text end

new text begin Shared services. new text end

new text begin (a) Medical assistance payments for shared services under
consumer-directed community supports are limited to this subdivision.
new text end

new text begin (b) For purposes of this subdivision, "shared services" means services provided at the
same time by the same direct care staff for individuals who have entered into an agreement
to share consumer-directed community supports services.
new text end

new text begin (c) Shared services may include but are not limited to any services in the categories of
personal supports or treatment and training as outlined in the consumer-directed community
supports plan and shared services agreement, except for the following:
new text end

new text begin (1) services for more than three individuals provided by one direct support staff at one
time;
new text end

new text begin (2) use of more than one provider for the shared services; and
new text end

new text begin (3) a child care program licensed under Minnesota Statutes, chapter 245A, or operated
by a local school district or private school.
new text end

new text begin (d) Individuals sharing services must use the same financial management services
provider.
new text end

new text begin (e) The individuals or, as needed, their representatives shall develop the plan for shared
services when developing or amending the consumer-directed community supports plan
and must follow the consumer-directed community supports process for approval of the
plan by the lead agency. The plan for shared services in an individual's consumer-directed
community supports plan shall include:
new text end

new text begin (1) the grouping of shared services based on individuals' needs and preferences;
new text end

new text begin (2) training specific to each individual served; and
new text end

new text begin (3) instructions to follow all required documentation for time and services provided.
new text end

new text begin (f) Individuals whose consumer-directed community supports plans include shared
services must also jointly develop, with the support of their representatives as needed, a
consumer-directed community supports shared services agreement. The agreement must
include:
new text end

new text begin (1) the names of the individuals receiving shared services;
new text end

new text begin (2) the individuals' representatives, if identified in their consumer-directed community
supports plans, and their duties;
new text end

new text begin (3) the case managers;
new text end

new text begin (4) the financial management services provider;
new text end

new text begin (5) the shared services that must be provided;
new text end

new text begin (6) the schedule for shared services;
new text end

new text begin (7) where shared services must be provided;
new text end

new text begin (8) a contingency plan for each of the recipients that accounts for service provision and
billing in the absence of one of the recipients in a shared services setting due to illness or
other circumstances;
new text end

new text begin (9) signatures of all parties involved in the shared services; and
new text end

new text begin (10) agreement by each of the recipients who are sharing services on the number of
shared hours for services provided.
new text end

new text begin (g) Any recipient or any recipient's representative may withdraw from participating in
a shared services agreement at any time.
new text end

new text begin (h) The financial management services provider shall follow all required documentation
for time and services provided.
new text end

new text begin (i) The case manager for each recipient shall:
new text end

new text begin (1) authorize the use of the shared services option based on the criteria that the shared
service is appropriate to meet the needs, health, and safety of each individual for whom
case management services are provided;
new text end

new text begin (2) visit the shared setting as services are being provided at least once every six months
or whenever needed for response to a recipient's request;
new text end

new text begin (3) provide quarterly monitoring and evaluation of the effectiveness and appropriateness
of the shared services plan;
new text end

new text begin (4) develop a contingency plan with each of the recipients that accounts for the absence
of one of the recipients in a shared services setting due to illness or other circumstances;
and
new text end

new text begin (5) document the training completed by the provider specific to the shared services
setting and individuals sharing services.
new text end

new text begin (j) Nothing in this subdivision must be construed to reduce the total authorized
consumer-directed community supports budget for an individual recipient.
new text end

new text begin (k) No later than September 30, 2019, the commissioner of human services shall:
new text end

new text begin (1) submit an amendment to the federal Centers for Medicare and Medicaid Services
for the home and community-based services waivers authorized under Minnesota Statutes,
sections 256B.092 and 256B.49, to allow for a shared services option under
consumer-directed community supports; and
new text end

new text begin (2) with stakeholder input, develop guidance for shared services in consumer-directed
community supports within the Community Based Services Manual. The guidance must
include:
new text end

new text begin (i) recommendations for negotiating payment for one-to-two and one-to-three services;
and
new text end

new text begin (ii) a template of the shared services agreement.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2019, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 2. new text begin REGIONAL AND LOCAL CONSUMER-DIRECTED COMMUNITY
SUPPORTS EDUCATION AND MARKETING GRANTS.
new text end

new text begin (a) The commissioner of human services shall award onetime, competitive grants to
eligible applicants for regional and local projects targeted to a designated community of the
applicant's choosing, which may consist of a specific geographic area or population, to:
increase awareness of consumer-directed community supports; increase the rate of utilization
of consumer-directed community supports, specifically in counties with low enrollment in
the program; promote the benefits of support planning services; or connect eligible persons
with disabilities, their parents and family members, and lead agency staff to education and
resources related to consumer-directed community supports.
new text end

new text begin (b) The project areas for the grant include local or community-based initiatives to: (1)
promote the benefits of consumer-directed community supports; and (2) provide informational
materials and other resources to persons with disabilities eligible for consumer-directed
community supports, their parents and family members, and lead agency staff.
new text end

new text begin (c) Eligible applicants may include but are not limited to statewide nonprofit organizations
with regional and local presence that provide advocacy services and supports for persons
with disabilities and their parents and family members.
new text end

new text begin (d) Applicants must: (1) describe the proposed project, including the targeted community
and how the project meets the requirements of this section; and (2) identify the proposed
outcomes of the project and the evaluation process to measure these outcomes.
new text end

new text begin (e) In awarding the regional and local consumer-directed community supports education
and marketing grants, the commissioner of human services must give priority to applicants
who demonstrate that the proposed project:
new text end

new text begin (1) is supported by and appropriately targeted to the community the applicant serves;
new text end

new text begin (2) is designed to coordinate with other community activities related to initiatives aimed
at promoting independence, inclusion, and self-direction in the lives of persons with
disabilities;
new text end

new text begin (3) is conducted by an applicant able to demonstrate expertise in the project areas;
new text end

new text begin (4) utilizes and enhances existing activities and resources or involves innovative
approaches to achieve success in the project areas; and
new text end

new text begin (5) strengthens community relationships and partnerships in order to achieve the project
areas.
new text end

new text begin (f) The commissioner shall divide the state into specific geographic regions and allocate
a percentage of the money available for the regional and local consumer-directed community
supports education and marketing grants to projects aimed at each geographic region with
an emphasis on counties with low rates of utilization of consumer-directed community
supports.
new text end

new text begin (g) The commissioner shall award the grants by January 31, 2020.
new text end

new text begin (h) A grantee shall report to the commissioner of human services on the progress of the
project at least once during the grant period and, within two months of the end of the grant
period, shall submit a final report to the commissioner that includes the measurable outcomes.
new text end

new text begin (i) The commissioner of human services shall:
new text end

new text begin (1) develop the criteria and procedures to allocate the grants under this section, evaluate
all applicants on a competitive basis, award the grants, and select qualified providers to
offer technical assistance to grant applicants and grantees. The selected providers shall assist
applicants and grantees with project design, evaluation methods, materials, and training;
and
new text end

new text begin (2) submit by January 15, 2021, a progress report on the consumer-directed community
supports education and marketing grants under this section to the chairs and ranking minority
members of the legislative committees with jurisdiction over health finance and policy. The
report shall include:
new text end

new text begin (i) information on the grantees;
new text end

new text begin (ii) a summary of all projects undertaken with the grants;
new text end

new text begin (iii) the measurable outcomes established by the grantees, an explanation of the evaluation
process used to determine whether the outcomes were met, and the results of the evaluation;
and
new text end

new text begin (iv) an accounting of how the grant funds were spent.
new text end

Sec. 3. new text begin APPROPRIATION.
new text end

new text begin $....... in fiscal year 2020 is appropriated from the general fund to the commissioner of
human services for the regional and local consumer-directed community supports education
and marketing grants described in this act. This is a onetime appropriation.
new text end

Sec. 4. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes, in consultation with the House Research Department, Office of
Senate Counsel, Research and Fiscal Analysis, and Department of Human Services, shall
prepare legislation for the 2020 legislative session to codify laws governing
consumer-directed community supports in Minnesota Statutes, chapter 256B.
new text end