1.1                          A bill for an act
  1.2             relating to health; expanding the number of 
  1.3             living-at-home/block nurse programs; modifying 
  1.4             contract requirements for the living-at-home/block 
  1.5             nurse program; appropriating money; amending Minnesota 
  1.6             Statutes 1996, section 256B.0917, subdivisions 7 and 8.
  1.7   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.8      Section 1.  Minnesota Statutes 1996, section 256B.0917, 
  1.9   subdivision 7, is amended to read: 
  1.10     Subd. 7.  [CONTRACT.] The commissioner of human services 
  1.11  shall execute a contract with an organization experienced in 
  1.12  establishing and operating community-based programs that have 
  1.13  used the principles listed in subdivision 8, paragraph (b), in 
  1.14  order to meet the independent living and health needs of senior 
  1.15  citizens aged 65 and over and provide community-based long-term 
  1.16  care for senior citizens in their homes.  The organization shall:
  1.17     (1) assist the commissioner in developing criteria for and 
  1.18  in awarding grants to establish community-based organizations 
  1.19  that will implement living-at-home/block nurse programs 
  1.20  throughout the state; 
  1.21     (2) assist the commissioner in awarding grants to enable 
  1.22  current living-at-home/block nurse programs to implement the 
  1.23  combined living-at-home/block nurse program model; 
  1.24     (3) serve as a state technical assistance center to assist 
  1.25  and coordinate the living-at-home/block nurse programs 
  1.26  established; and 
  2.1      (4) develop the implementation plan required by subdivision 
  2.2   10; and 
  2.3      (5) manage the contracts between the commissioner and 
  2.4   individual living-at-home/block nurse programs. 
  2.5      Sec. 2.  Minnesota Statutes 1996, section 256B.0917, 
  2.6   subdivision 8, is amended to read: 
  2.7      Subd. 8.  [LIVING-AT-HOME/BLOCK NURSE PROGRAM GRANT.] (a) 
  2.8   The commissioner, in cooperation with the organization awarded 
  2.9   the contract under subdivision 7, shall develop and administer a 
  2.10  grant program to establish or expand up to 15 35 community-based 
  2.11  organizations that will implement living-at-home/block nurse 
  2.12  programs that are designed to enable senior citizens to live as 
  2.13  independently as possible in their homes and in their 
  2.14  communities.  At least seven of the programs must be in counties 
  2.15  outside the seven-county metropolitan area.  The 
  2.16  living-at-home/block nurse program funds shall be available to 
  2.17  the four to six SAIL projects established under this section. 
  2.18  Nonprofit organizations and units of local government are 
  2.19  eligible to apply for grants to establish the community 
  2.20  organizations that will implement living-at-home/block nurse 
  2.21  programs.  In awarding grants, the commissioner shall give 
  2.22  preference to nonprofit organizations and units of local 
  2.23  government from communities that: 
  2.24     (1) have high nursing home occupancy rates; 
  2.25     (2) have a shortage of health care professionals; and 
  2.26     (3) are located in counties adjacent to counties with 
  2.27  existing living-at-home/block nurse programs; and 
  2.28     (4) meet other criteria established by the commissioner, in 
  2.29  consultation with the organization under contract. 
  2.30     (b) Grant applicants must also meet the following criteria: 
  2.31     (1) the local community demonstrates a readiness to 
  2.32  establish a community model of care, including the formation of 
  2.33  a board of directors, advisory committee, or similar group, of 
  2.34  which at least two-thirds is comprised of community citizens 
  2.35  interested in community-based care for older persons; 
  2.36     (2) the program has sponsorship by a credible, 
  3.1   representative organization within the community; 
  3.2      (3) the program has defined specific geographic boundaries 
  3.3   and defined its organization, staffing and coordination/delivery 
  3.4   of services; 
  3.5      (4) the program demonstrates a team approach to 
  3.6   coordination and care, ensuring that the older adult 
  3.7   participants, their families, the formal and informal providers 
  3.8   are all part of the effort to plan and provide services; and 
  3.9      (5) the program provides assurances that all community 
  3.10  resources and funding will be coordinated and that other funding 
  3.11  sources will be maximized, including a person's own resources. 
  3.12     (c) Grant applicants must provide a minimum of five percent 
  3.13  of total estimated development costs from local community 
  3.14  funding.  Grants shall be awarded for two-year periods, and the 
  3.15  base amount shall not exceed $40,000 per applicant for the grant 
  3.16  period.  The commissioner, in consultation with the organization 
  3.17  under contract, may increase the grant amount for applicants 
  3.18  from communities that have socioeconomic characteristics that 
  3.19  indicate a higher level of need for development 
  3.20  assistance.  Subject to the availability of funding, grants and 
  3.21  grant renewals awarded or entered into on or after July 1, 1997, 
  3.22  shall be renewed by the commissioner every two years, unless the 
  3.23  commissioner, in consultation with the organization awarded the 
  3.24  contract under subdivision 7, determines that the grant 
  3.25  recipient has not satisfactorily operated the 
  3.26  living-at-home/block nurse program in compliance with the 
  3.27  requirements of paragraph (d).  Grants provided to 
  3.28  living-at-home/block nurse programs under this paragraph may be 
  3.29  used for both program development and the delivery of services. 
  3.30     (d) Each living-at-home/block nurse program shall be 
  3.31  designed by representatives of the communities being served to 
  3.32  ensure that the program addresses the specific needs of the 
  3.33  community residents.  The programs must be designed to: 
  3.34     (1) incorporate the basic community, organizational, and 
  3.35  service delivery principles of the living-at-home/block nurse 
  3.36  program model; 
  4.1      (2) provide senior citizens with registered nurse directed 
  4.2   assessment, provision and coordination of health and personal 
  4.3   care services on a sliding fee basis as an alternative to 
  4.4   expensive nursing home care; 
  4.5      (3) provide information, support services, homemaking 
  4.6   services, counseling, and training for the client and family 
  4.7   caregivers; 
  4.8      (4) encourage the development and use of respite care, 
  4.9   caregiver support, and in-home support programs, such as adult 
  4.10  foster care and in-home adult day care; 
  4.11     (5) encourage neighborhood residents and local 
  4.12  organizations to collaborate in meeting the needs of senior 
  4.13  citizens in their communities; 
  4.14     (6) recruit, train, and direct the use of volunteers to 
  4.15  provide informal services and other appropriate support to 
  4.16  senior citizens and their caregivers; and 
  4.17     (7) provide coordination and management of formal and 
  4.18  informal services to senior citizens and their families using 
  4.19  less expensive alternatives. 
  4.20     Sec. 3.  [LIVING-AT-HOME/BLOCK NURSE CONTRACT.] 
  4.21     The commissioner shall contract with the organization 
  4.22  awarded the initial contract under section 256B.0917, 
  4.23  subdivision 7, to carry out the duties assigned in that 
  4.24  subdivision.  The contract shall be effective July 1, 1997, and 
  4.25  section 16B.17 shall not apply.  Subject to the availability of 
  4.26  funding, the contract does not expire, except that the contract 
  4.27  must provide that the commissioner may unilaterally terminate 
  4.28  the contract, if the commissioner determines that the 
  4.29  organization awarded the contract has not effectively carried 
  4.30  out the duties assigned in section 256B.0917, subdivision 7. 
  4.31     Sec. 4.  [APPROPRIATIONS.] 
  4.32     Subdivision 1.  [EXPANSION OF PROGRAMS.] $....... is 
  4.33  appropriated from the general fund to the commissioner of human 
  4.34  services for the biennium ending June 30, 1999, to provide 
  4.35  funding to an additional 20 living-at-home/block nurse programs. 
  4.36     Subd. 2.  [EQUALIZING FUNDING BETWEEN PROGRAMS.] $....... 
  5.1   is appropriated from the general fund to the commissioner of 
  5.2   human services for the biennium ending June 30, 1999, to 
  5.3   increase funding for certain living-at-home/block nurse programs 
  5.4   so that funding for all programs is at the same level for each 
  5.5   fiscal year. 
  5.6      Subd. 3.  [TECHNICAL RESOURCE CENTER.] An additional 
  5.7   $....... per fiscal year is appropriated from the general fund 
  5.8   to the commissioner of human services for the biennium ending 
  5.9   June 30, 1999, to be used as additional contract funding for the 
  5.10  organization awarded the contract under section 3.