HF 2178

1st Engrossment - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

A bill for an act
relating to human services; restoring funding for certain long-term care programs;
expanding home and community-based long-term care services for older adults
and family caregivers; establishing new grant programs; establishing a statewide
priority to enhance the mobility of older adults; establishing demonstration
projects; requiring a study of adult protection and ombudsman services; requiring
a study of access by older adults to services under the elderly waiver; requiring a
study of service adequacy across long-term care waivers; requiring a study of
access to hospice services; establishing a tax credit for family caregivers of
adults of all ages; appropriating money; amending Minnesota Statutes 2006,
sections 256.975, by adding subdivisions; 256B.0917, by adding a subdivision;
proposing coding for new law in Minnesota Statutes, chapters 256; 290.

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

Section 1.

Minnesota Statutes 2006, section 256.975, is amended by adding a
subdivision to read:

new text begin Subd. 10. new text end

new text begin Home modification. new text end

new text begin The Minnesota Board on Aging, in cooperation with
the area agencies on aging and local service providers, shall establish a home modification
program for low- to moderate-income adults age 60 and older who do not qualify for,
or whose needs cannot be met under, the alternative care program, elderly waiver, or
other publicly funded programs. The program shall provide for physical remodeling
and accessibility accommodations of existing single-family dwellings to enable frail
older persons to remain in their current homes. The program shall also pay for general
repairs when an accessibility modification triggers the need for such repair. The program
must deliver services at the local level, include outreach and education to the target
population, and allow reasonable expenditures for materials and labor. The maximum
amount of assistance provided to any one household shall not exceed $10,000. The board,
in consultation with area agencies on aging and local service providers, shall establish
cost-sharing arrangements for program participants based on a sliding scale.
new text end

Sec. 2.

Minnesota Statutes 2006, section 256.975, is amended by adding a subdivision
to read:

new text begin Subd. 12. new text end

new text begin Evidence-based caregiver support. new text end

new text begin The Minnesota Board on Aging, in
cooperation with the area agencies on aging and local service providers, shall establish a
caregiver support program for family caregivers of older adults, based on evidence-based
models that extend the family caregiver's ability to provide care, improve the quality of
family care, or reduce caregiver burden. Program services must be targeted to low- and
moderate-income caregivers of low- and moderate-income adults age 60 and older who
do not qualify for, or whose needs cannot be met under, other publicly funded programs.
The board, in consultation with area agencies on aging and local service providers, shall
establish cost-sharing arrangements for program participants based on a sliding scale.
new text end

Sec. 3.

new text begin [256.9755] BEST PRACTICES TO ENHANCE MOBILITY.
new text end

new text begin The commissioner of human services shall establish a statewide priority to enhance
the mobility of older adults. The commissioner of human services, in consultation with
the commissioner of transportation, shall gather and disseminate best practices in road
and sidewalk design, community development policy, innovative transportation services
and coordination models, and research to increase and extend the community mobility
of older adults.
new text end

Sec. 4.

Minnesota Statutes 2006, section 256B.0917, is amended by adding a
subdivision to read:

new text begin Subd. 6a. new text end

new text begin Duties with respect to caregiver credit; applications. new text end

new text begin (a) The
commissioner of human services shall develop by December 1, 2007, a caregiver burden
scale to score applicants for the caregiver credit made available under section 290.0678.
The score shall measure hours per week of care provided, the volume and type of
assistance provided, and other criteria determined by the commissioner to be pertinent.
new text end

new text begin (b) Each caregiver applying for the family care credit must apply to the
commissioner of human services. The commissioner shall approve or deny applications
based on an applicant's score on the caregiver burden scale and the certification and
related documentation submitted by assessors under section 290.0678, subdivision 6.
The commissioner shall limit approvals under this paragraph in order to keep the credit
payments under section 290.0678 within the limits of appropriations made specifically for
that purpose.
new text end

new text begin (c) In each calendar year, the commissioner shall accept until February 15
applications that are based on a caregiver burden scale score for the previous calendar
year. By March 15 of each calendar year, the commissioner shall issue approvals for
credits under section 290.0678, based on each applicant's score on the scale and the
appropriations available for credits, and shall provide a list of approved applicants to the
commissioner of revenue. The commissioner shall develop procedures to delegate to
appropriate organizations the responsibility to assign burden scale scores to applicants.
new text end

new text begin (d) The commissioner is exempt from chapter 14 for purposes of this subdivision.
new text end

Sec. 5.

new text begin [290.0678] FAMILY CARE CREDIT.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin The terms used in this section have the following
meanings unless otherwise provided for by text.
new text end

new text begin (a) "Caregiver" means an individual who provides unpaid assistance on a daily basis
equivalent to personal care assistant services under section 256B.0655, subdivision 2, to
a service recipient in either the caregiver's home or the service recipient's home located
in the state of Minnesota.
new text end

new text begin (b) "Service recipient" means an individual who:
new text end

new text begin (1) requires assistance with three or more activities of daily living;
new text end

new text begin (2) does not reside in a nursing facility; and
new text end

new text begin (3) meets one of the following criteria:
new text end

new text begin (i) is age 60 or older;
new text end

new text begin (ii) is at least age 19 but under age 60; or
new text end

new text begin (iii) is of any age and diagnosed with Alzheimer's disease or other dementia.
new text end

new text begin Subd. 2. new text end

new text begin Credit allowed. new text end

new text begin (a) An individual is allowed a credit against the tax
imposed by this chapter equal to $200 for each month during the tax year that the individual
is a caregiver for a service recipient. The maximum credit in a tax year shall be $2,400.
new text end

new text begin (b) The commissioner shall require individuals claiming the credit to certify that the
individual and the service recipient satisfy all the requirements of this section.
new text end

new text begin (c) An individual may claim only one credit in any tax year. Only one credit may be
claimed for each service recipient in any tax year.
new text end

new text begin (d) For a nonresident or part-year resident, the credit must be allocated based on the
percentage calculated under section 290.06, subdivision 2c, paragraph (e).
new text end

new text begin Subd. 3. new text end

new text begin Credit limitations. new text end

new text begin (a) Eligibility for the credit in subdivision 2 is limited
to persons with total household income, as defined in section 290A.03, subdivision 5,
that does not exceed the maximum household income level eligible for a refund under
section 290A.04, subdivision 2.
new text end

new text begin (b) Eligibility for the credit in subdivision 2 is limited to persons who have been
assessed as provided by subdivisions 5 and 6, and who apply to and are approved by the
commissioner of human services under section 256B.0917, subdivision 6a.
new text end

new text begin Subd. 4. new text end

new text begin Credit refundable. new text end

new text begin If the amount of the credit under this section exceeds
the individual's tax liability under this chapter, the commissioner shall refund the excess
amount to the claimant.
new text end

new text begin Subd. 5. new text end

new text begin Assessment. new text end

new text begin (a) Local agencies that provide caregiver coaching and
counseling services under the Minnesota Board on Aging's national family caregiver
support program shall assess adult family caregivers of service recipients age 60 and older
and adult family caregivers caring for a service recipient of any age with Alzheimer's
disease or other dementias applying for a tax credit. A request for assessment shall be
made through the statewide Senior LinkAge line via the existing toll-free phone number.
If a caregiver coach/counselor who is a licensed social worker or registered nurse is not
available to perform the assessment, a licensed social worker, licensed practical nurse, or
registered nurse of the local area agency on aging's Senior LinkAge line shall perform
the assessment.
new text end

new text begin (b) Local agencies and providers that receive funding under the community
alternative care, community alternative for disabled individuals, traumatic brain injury,
or MR/RC home and community-based waivers to provide services to persons with
developmental, physical, and other disabilities shall assess family caregivers of persons
at least age 19 but under age 60. A request for assessment shall be made through the
statewide disability linkage line via the existing toll-free number. The assessment shall be
performed by a licensed social worker, licensed practical nurse, or registered nurse.
new text end

new text begin Subd. 6. new text end

new text begin Assessment criteria. new text end

new text begin (a) Individuals conducting assessments under
subdivision 5 must certify according to procedures established by the commissioner of
human services that the care provided by the caregiver:
new text end

new text begin (1) qualifies as personal care assistant services under section 256B.0655, subdivision
2;
new text end

new text begin (2) is needed and provided in-person on a daily basis;
new text end

new text begin (3) is appropriate based on the care recipient's needs and is likely to delay or avoid
transferring the person to a nursing facility; and
new text end

new text begin (4) has been given a score using a caregiver burden scale developed by the
commissioner of human services.
new text end

new text begin (b) Individuals conducting assessments must provide the certification and related
documentation to the commissioner of human services, in the form and manner specified
by that commissioner.
new text end

new text begin Subd. 7. new text end

new text begin Caregiver training. new text end

new text begin For each year in which a credit is claimed under this
section, the caregiver must attend at least eight hours of training, education, or counseling
focused on improving the quality of caregiving or preventing caregiver injury or illness, or
otherwise designed to help sustain caregiving.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for taxable years beginning after
December 31, 2007.
new text end

Sec. 6. new text begin ELDER ABUSE AND NEGLECT STUDY.
new text end

new text begin The commissioner of human services shall evaluate the adequacy of adult protective
services for adults age 65 and older provided by counties and for adults age 60 and
older provided by the Office of Ombudsman for Older Minnesotans. In conducting the
study, the commissioner shall convene and consult with a stakeholder group. By May
15, 2008, the commissioner shall report to the legislature the results of the evaluation
and recommendations to meet the needs of the growing population of frail, older adults
residing in the community, in assisted living settings, and in nursing homes. The study
shall include, but is not limited to, program standards, structure, staffing, funding, and rural
and urban issues. The study must also include an evaluation of, and any recommendations
for change in, the Vulnerable Adult Act under Minnesota Statutes, sections 626.557 to
626.5572.
new text end

Sec. 7. new text begin ACCESS STUDIES.
new text end

new text begin Subdivision 1. new text end

new text begin Elderly waiver services. new text end

new text begin The commissioner of human services,
through a competitive selection process, shall procure an independent evaluation to
identify and evaluate access barriers and quality of care issues under the elderly waiver
as administered by managed care organizations. The evaluation must include, but is
not limited to:
new text end

new text begin (1) issues of cultural appropriateness and cultural competency;
new text end

new text begin (2) quality of care planning and service coordination including knowledge of home
and community-based services and of consumer directed care options;
new text end

new text begin (3) recognition of needs of family caregivers and related service planning;
new text end

new text begin (4) utilization of Customized Living and Customized Living Plus services;
new text end

new text begin (5) transition of persons from the long-term care waiver programs for persons with
disabilities to the elderly waiver program; and
new text end

new text begin (6) accuracy and efficiency in paying service providers.
new text end

new text begin The commissioner shall establish an advisory group consisting of: consumers,
representatives of managed care organizations, county agencies, area agencies on aging,
service providers, and other stakeholders, to advise the independent evaluator. The
commissioner shall submit the evaluation report, with the commissioner's comments and
recommendations, to the chairs of house and senate committees having jurisdiction over
human services by September 15, 2008.
new text end

new text begin Subd. 2. new text end

new text begin Service adequacy across long-term care waivers. new text end

new text begin (a) The commissioner
of human services, through a competitive selection process, shall procure an independent
evaluation to identify and evaluate issues of service development, including:
new text end

new text begin (1) technical assistance for contract development, business planning, and licensing
requirements;
new text end

new text begin (2) network maintenance such as training, problem resolution, and coordination; and
new text end

new text begin (3) quality assurance under the alternative care program and the elderly, community
alternatives for disabled individuals, community alternative care, traumatic brain injury,
and MR/RC home and community-based waiver programs.
new text end

new text begin (b) Evaluation elements must include, but are not limited to:
new text end

new text begin (1) current status of, and future responsibility for, development of additional home
and community-based services to meet the needs of waiver enrollees;
new text end

new text begin (2) current status of, and future responsibility for, maintenance of the home and
community-based service provider network;
new text end

new text begin (3) current status of, and future responsibility for, strategies to ensure quality of care
provided by home and community-based service providers; and
new text end

new text begin (4) sources and adequacy of funding for the services and providers referred to in
clauses (1) to (3).
new text end

new text begin (c) The commissioner shall establish an advisory group consisting of: consumers;
representatives of managed care organizations, county agencies, centers for independent
living, area agencies on aging, and service providers; and other stakeholders, to advise
the independent evaluator. The commissioner shall submit the evaluation report, with
the commissioner's comments and recommendations, to the chairs of house and senate
committees having jurisdiction over human services by September 15, 2008.
new text end

new text begin Subd. 3. new text end

new text begin Hospice services. new text end

new text begin The commissioner of health, in consultation with the
commissioner of human services, shall procure an independent evaluation through a
competitive process to identify and evaluate the barriers that limit access by persons of
all ages to Medicare-certified hospice services. The evaluation shall include, but is not
limited to:
new text end

new text begin (1) coverage of services by private and publicly funded health plan companies;
new text end

new text begin (2) urban/rural factors; and
new text end

new text begin (3) issues of cultural appropriateness and cultural competency.
new text end

new text begin The commissioner shall submit the evaluation report to the chairs of house and
senate committees having jurisdiction over human services by September 15, 2008,
with the commissioner's comments and recommendations, including but not limited to
recommendations on funding issues related to training and development costs to serve
unserved or underserved populations, inclusion of hospice services in the benefit sets of
privately and publicly funded health plan companies, and coverage of hospice services for
persons who are uninsured. The commissioner shall establish a diverse stakeholder group
to advise the evaluator.
new text end

Sec. 8. new text begin PILOT MOBILITY CENTER.
new text end

new text begin The commissioner of human services shall conduct a competitive selection process
to establish a pilot mobility center in a region or community to support older drivers and
assist with transition to nonauto travel, and offer education, assessment, driver retraining,
and transit travel training.
new text end

Sec. 9. new text begin COORDINATION OF INTAKE, ASSESSMENT, AND CARE
PLANNING.
new text end

new text begin The commissioner of human services shall conduct a competitive selection process
to establish demonstration projects at the local level for providers of volunteer-based
informal and formal services, to streamline intake and assessment processes for adults age
60 and over who are seeking or receiving services but are not eligible for, or choose not
to enroll in, the alternative care and elderly waiver programs. Providers selected to take
part in the demonstration shall:
new text end

new text begin (1) develop replicable models to streamline intake and assessment;
new text end

new text begin (2) coordinate tools and models, as feasible, with the universal assessment under
development by the commissioner of human services;
new text end

new text begin (3) establish referral protocols and coordinated care management models among
local agencies to include data sharing arrangements where permitted by law; and
new text end

new text begin (4) utilize technology to the extent possible.
new text end

Sec. 10. new text begin BUDGET REQUEST; AGING AND ADULT SERVICES GRANTS.
new text end

new text begin The commissioner of human services shall include in each biennial budget,
beginning with the budget for the biennium beginning July 1, 2009, a methodology and an
estimate of the cost of providing the funding increases for aging and adult services grants
that are necessary to meet the service needs of older adults and family caregivers.
new text end

Sec. 11. new text begin RESTORATION OF FUNDING FOR LONG-TERM CARE
PROGRAMS.
new text end

new text begin The following amounts are appropriated from the general fund to the commissioner
of human services for the biennium beginning July 1, 2007, to restore funding for the
following programs:
new text end

new text begin (1) $260,000 for seniors' agenda for independent living (SAIL) project grants under
Minnesota Statutes, section 256B.0917;
new text end

new text begin (2) $120,000 for technical assistance to local living-at-home/block nurse programs
under Minnesota Statutes, section 256B.0917, subdivision 7;
new text end

new text begin (3) $822,000 for senior nutrition programs under Minnesota Statutes, section
256.9752;
new text end

new text begin (4) $278,000 for the foster grandparents program under Minnesota Statutes, section
256.976;
new text end

new text begin (5) $172,000 for the retired senior volunteer program under Minnesota Statutes,
section 256.9753; and
new text end

new text begin (6) $178,000 for the senior companion program under Minnesota Statutes, section
256.977.
new text end

new text begin The amount appropriated for each program shall become part of the base funding
for that program for the biennium beginning July 1, 2009.
new text end

Sec. 12. new text begin APPROPRIATION; AGING AND ADULT SERVICES GRANTS.
new text end

new text begin $....... is appropriated from the general fund to the commissioner of human services
for the biennium beginning July 1, 2007, to increase grants funded through the aging and
adult services grants budget activity by three percent each year of the biennium. These
increases shall become part of the base funding for each grant for the biennium beginning
July 1, 2009.
new text end

Sec. 13. new text begin ADDITIONAL APPROPRIATIONS.
new text end

new text begin (a) $8,200,000 is appropriated from the general fund to the commissioner of human
services for the biennium beginning July 1, 2007, for the following purposes:
new text end

new text begin (1) $3,200,000 is for the home modification program under Minnesota Statutes,
section 256.975, subdivision 10;
new text end

new text begin (2) $1,600,000 is for the caregiver support program under Minnesota Statutes,
section 256.975, subdivision 12;
new text end

new text begin (3) $175,000 is for an innovation specialist responsible for seeking and disseminating
best practice and innovative models related to the new services and programs authorized
by this act;
new text end

new text begin (4) $150,000 is for the elder abuse and neglect study under section 6;
new text end

new text begin (5) $100,000 is for the evaluation of elderly waiver services under section 7,
subdivision 1;
new text end

new text begin (6) $100,000 is for the evaluation of service development of long-term care waiver
services under section 7, subdivision 2;
new text end

new text begin (7) $100,000 is for the evaluation of hospice services under section 7, subdivision 3;
new text end

new text begin (8) $575,000 is for the pilot mobility center under section 8 and the enhancement of
best practices to enhance mobility under Minnesota Statutes, section 256.9755; and
new text end

new text begin (9) $600,000 is for the demonstration project to streamline intake and assessment
processes under section 9.
new text end

new text begin (b) $....... is appropriated from the general fund to the commissioner of revenue for
the biennium beginning July 1, 2007, to provide tax credits under Minnesota Statutes,
section 290.0678.
new text end