Minnesota Legislature
HF 2159
1st Engrossment - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am
Bill Text Versions
| Engrossments | ||
|---|---|---|
| Introduction | Posted on 03/15/2007 | |
| 1st Engrossment | Posted on 03/29/2007 |
Current Version - 1st Engrossment
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A bill for an act
relating to human services; requiring certain medical assistance enrollees who
are children with high-cost medical and mental health conditions to receive
integrated health care coordination and social support services through the U
special kids program; appropriating money; proposing coding for new law in
Minnesota Statutes, chapter 256B.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
new text begin
[256B.0751] CARE COORDINATION FOR CHILDREN WITH
HIGH-COST MEDICAL CONDITIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Care coordination required. new text end
new text begin
(a) The commissioner of human
services shall contract with the U special kids program to provide care coordination,
beginning October 1, 2007, for medical assistance enrollees who are children with
high-cost medical conditions, and to perform the other duties specified in this section.
new text end
new text begin
(b) For purposes of this section, "care coordination" means collaboration with
primary care physicians and specialists to manage care, development of medical
management plans for recurrent acute illnesses, oversight and coordination of all aspects
of care in partnership with families, organization of medical information into a summary
of critical information, coordination and appropriate sequencing of tests and multiple
appointments, information and assistance with accessing resources, and telephone triage
for acute illnesses or problems.
new text end
new text begin Subd. 2. new text end
new text begin Referrals. new text end
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The commissioner shall develop a mechanism to refer
children to the U special kids program for care coordination. Beginning October 1, 2007,
and subject to the limits on total program enrollment specified in subdivision 3, the
commissioner shall refer to the U special kids program children who:
new text end
new text begin
(1) incur medical expenses that exceed the qualifying level specified in subdivision 3;
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(2) have medical conditions that involve four or more major systems; require
multiple specialists; require use of technology such as G-tube, tracheotomy, central line,
or oxygen; and require multiple medications; and
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new text begin
(3) do not have a medical case manager for cancer, organ transplantation, epilepsy,
or bone marrow replacement.
new text end
new text begin Subd. 3. new text end
new text begin Qualifying level of medical expenses. new text end
new text begin
(a) For the period October 1, 2007,
through September 30, 2008, the commissioner shall refer children for care coordination
under this section if they incurred medical expenses of $500,000 or more during the
fiscal year ending June 30, 2007.
new text end
new text begin
(b) For the period October 1, 2008, through September 30, 2009, the commissioner
shall refer children for care coordination under this section if they incurred medical
expenses of $400,000 or more during the fiscal year ending June 30, 2008.
new text end
new text begin
(c) For the period October 1, 2009, through September 30, 2010, the commissioner
shall refer children for care coordination under this section if they incurred medical
expenses of $300,000 or more during the fiscal year ending June 30, 2009.
new text end
new text begin
(d) Beginning October 1, 2010, the commissioner shall refer children for care
coordination under this section if they incurred medical expenses of $250,000 or more
during the previous fiscal year.
new text end
new text begin
(e) The commissioner shall limit referrals to the extent necessary to ensure that
total enrollment in the U special kids program does not exceed 100 children for the
period October 1, 2007, through September 30, 2008, and does not exceed 150 children
beginning October 1, 2008.
new text end
new text begin Subd. 4. new text end
new text begin Case management. new text end
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Beginning October 1, 2007, the U special kids
program shall coordinate all nonmedical case management services provided to children
who are required to receive care coordination under this section. The program may
require all nonmedical case managers, including, but not limited to, county case managers
and case managers for children served under a home and community-based waiver,
to submit care plans for approval, and to document client compliance with the care
plans. The U special kids program, beginning October 1, 2008, may employ or contract
with nonmedical case managers to provide all nonmedical case management services to
children required to receive care coordination under this section. The commissioner shall
reimburse the U special kids program for case management services through the medical
assistance program.
new text end
new text begin Subd. 5. new text end
new text begin Statewide availability of care coordination. new text end
new text begin
The U special kids program
may contract with other entities to provide care coordination services as defined in
subdivision 1, in order to ensure the availability of these services in all regions of the state.
new text end
new text begin Subd. 6. new text end
new text begin Advance practice nurse telephone triage system. new text end
new text begin
The U special kids
program shall establish and operate an advance practice nurse telephone triage system that
is available statewide, 24 hours a day, seven days per week. The system must provide
advance practice nurses with access to a Web-based information system to appropriately
triage medical problems, manage care, and reduce unnecessary hospitalizations.
new text end
new text begin Subd. 7. new text end
new text begin Monitoring and evaluation. new text end
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The commissioner shall monitor program
outcomes and evaluate the extent to which referrals to the U special kids program have
improved the quality and coordination of care and provided financial savings to the
medical assistance program. The U special kids program shall submit to the commissioner,
in the form and manner specified by the commissioner, all data and information necessary
to monitor program outcomes and evaluate the program. The commissioner shall present a
preliminary evaluation to the legislature by January 15, 2008, and a final evaluation to the
legislature by January 15, 2010.
new text end
Sec. 2.
new text begin
[256B.0752] CARE COORDINATION FOR CHILDREN WITH
HIGH-COST MENTAL HEALTH CONDITIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Care coordination required. new text end
new text begin
(a) The commissioner of human
services shall contract with the U special kids program to provide care coordination,
beginning October 1, 2007, for medical assistance enrollees who are children with
high-cost mental health conditions and behavioral problems, and to perform the other
duties specified in this section.
new text end
new text begin
(b) For purposes of this section, "care coordination" means collaboration with
primary care physicians and specialists to manage care, development of mental health
management plans for recurrent mental health issues, oversight and coordination of all
aspects of care in partnership with families, organization of medical, treatment, and
therapy information into a summary of critical information, coordination and appropriate
sequencing of evaluations and multiple appointments, information and assistance with
accessing resources, and telephone triage for behavior or other problems.
new text end
new text begin Subd. 2. new text end
new text begin Referrals. new text end
new text begin
The commissioner shall develop a mechanism to refer children
to the program for care coordination. Beginning October 1, 2007, and subject to the limits
on total program enrollment specified in subdivision 3, the commissioner shall refer to
the U special kids program children who:
new text end
new text begin
(1) incur mental health expenses that exceed the qualifying level specified in
subdivision 3; and
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(2) are currently receiving or at risk of needing inpatient mental health treatment,
foster home care, or both.
new text end
new text begin Subd. 3. new text end
new text begin Qualifying level of medical expenses. new text end
new text begin
(a) Beginning October 1, 2007, the
commissioner shall refer children for care coordination under this section if they incurred
medical and mental health expenses of $250,000 or more in the previous fiscal year.
new text end
new text begin
(b) The commissioner shall limit referrals to the extent necessary to ensure that total
enrollment in the U special kids program does not exceed 25 children for the period
October 1, 2007, through September 30, 2008; does not exceed 75 children for the
period October 1, 2008, through September 30, 2009; and does not exceed 125 children
beginning October 1, 2009.
new text end
new text begin Subd. 4. new text end
new text begin Case management. new text end
new text begin
The U special kids program, beginning October 1,
2007, shall coordinate all nonmedical case management services provided to children who
are required to receive care coordination under this section. The program may require all
nonmedical case managers, including but not limited to county case managers and case
managers for children served under a home and community-based waiver, to submit care
plans for approval, and to document client compliance with the care plans. The U special
kids program, beginning October 1, 2008, may employ or contract with nonmedical case
managers to provide all nonmedical case management services to children required to
receive care coordination under this section. The commissioner shall reimburse the
U special kids program for case management services through the medical assistance
program.
new text end
new text begin Subd. 5. new text end
new text begin Statewide availability of care coordination. new text end
new text begin
The program may contract
with other entities to provide care coordination services as defined in subdivision 1, in
order to ensure the availability of these services in all regions of the state.
new text end
new text begin Subd. 6. new text end
new text begin Monitoring and evaluation. new text end
new text begin
The commissioner shall monitor program
outcomes and shall evaluate the extent to which referrals to the U special kids program
have improved the quality and coordination of care and provided financial savings to the
medical assistance program. The U special kids program shall submit to the commissioner,
in the form and manner specified by the commissioner, all data and information necessary
to monitor program outcomes and evaluate the program. The commissioner shall present a
preliminary evaluation to the legislature by January 15, 2008, and a final evaluation to the
legislature by January 15, 2010.
new text end
Sec. 3. new text begin APPROPRIATION.
new text end
new text begin Subdivision 1. new text end
new text begin Care coordination for medical conditions. new text end
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(a) $1,500,000 in fiscal
year 2008 and $1,500,000 in fiscal year 2009 are appropriated from the general fund to the
commissioner of human services for contracting for care coordination with the U special
kids program under Minnesota Statutes, section 256B.0751.
new text end
new text begin
(b) $500,000 in fiscal year 2008 and $500,000 in fiscal year 2009 are appropriated
from the general fund to the commissioner of human services for the U special kids
program to establish and administer an advance practice nurse telephone triage system
under Minnesota Statutes, section 256B.0751, subdivision 6.
new text end
new text begin
(c) $500,000 in fiscal year 2008 and $750,000 in fiscal year 2009 are appropriated
from the general fund to the commissioner of human services to reimburse the U special
kids program for complementary alternative medicine treatment not covered under
medical assistance.
new text end
new text begin Subd. 2. new text end
new text begin Care coordination for mental health conditions. new text end
new text begin
(a) $500,000 in fiscal
year 2008 and $1,000,000 in fiscal year 2009 are appropriated from the general fund to the
commissioner of human services for contracting for care coordination with the U special
kids program under section 1. The base funding for this activity shall be $1,500,000
for fiscal years 2010 and beyond.
new text end
new text begin
(b) $125,000 in fiscal year 2008 and $375,000 in fiscal year 2009 are appropriated
from the general fund to the commissioner of human services for the U special kids
program to cover complementary alternative medicine services and over-the-counter
nutritional supplements not covered under medical assistance, subject to an annual limit of
$5,000 per patient. The base funding for this activity shall be $625,000 for fiscal years
2010 and beyond.
new text end