HF 2203

as introduced - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am

A bill for an act
relating to human services; implementing the
recommendations of the tripartisan Long-Term Care Task
Force; reducing excess capacity of nursing facility
beds; allocating resultant savings to home and
community-based services for elderly persons and
family caregivers; expanding home and community-based
services for elderly persons and family caregivers;
establishing a demonstration project.

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

Section 1. new text begin PURPOSE.
new text end

new text begin Minnesota's long-term care system serving older Minnesotans
supports self-determination, provides services that meet
consumers' needs and preferences, provides high quality care,
and ensures efficiency and affordability.
new text end

Sec. 2. new text begin LONG-TERM CARE SERVICE OPTIONS.
new text end

new text begin To ensure the availability of long-term care service
options for older persons, the commissioner shall develop
service options that meet the following objectives:
new text end

new text begin (1) choice to ensure a range of options including nursing
facilities, housing with services establishments, and home and
community-based services and support that include, but are not
limited to, home health care, living at home block nurse
programs, home-delivered meals, congregate dining, chore
assistance, transportation, homemaker assistance, assisted
living programs, senior companionship, respite and other
caregiver support services, adult day health services,
technology, and care coordination;
new text end

new text begin (2) cost-effectiveness methodologies that ensure incentives
for lower cost quality options, fair compensation for services
delivered, appropriate use of trained community volunteers, and
flexible funding streams such as the alternative care, elderly
waiver, and aging grants programs;
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new text begin (3) high quality and good outcomes with assurances that
services are provided by sufficient, trained, and competent
staff that meet industry standards;
new text end

new text begin (4) least restrictive alternatives to minimize disruption
to an older person's life while still meeting the person's
assistance needs;
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new text begin (5) avoidance of premature use of nursing facilities and
diversion from nursing facilities to community supports when
feasible;
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new text begin (6) elder-friendly communities with family, government,
faith communities, businesses, and other sectors working
together to support vital aging and long-term care at home; and
new text end

new text begin (7) strengthening informal care systems that include
family, friends, volunteers, and existing community resources.
new text end

Sec. 3. new text begin ALLOCATION OF STATE AND FEDERAL FUNDS.
new text end

new text begin By 2010, at least 60 percent of state and federal funds for
long-term care for elderly persons shall be allocated to home
and community-based services developed according to section 2,
through the alternative care, elderly waiver, medical assistance
home care, and aging grants programs, and other relevant
programs and demonstration projects. The commissioner of human
services shall establish a baseline for fiscal year 2005 and
shall measure progress each fiscal year thereafter and report on
the status of achieving the allocation of funds under this
section to the legislature by January 31 of each year.
new text end

Sec. 4. new text begin BED CLOSURES AND REALLOCATION OF FUNDS.
new text end

new text begin The commissioner of human services, in consultation with
nursing facilities, shall establish and implement a program by
December 31, 2005, to close at least 3,000 nursing facility beds
in fiscal years 2006 and 2007 and at least 3,000 additional beds
in fiscal years 2008 and 2009 through incentives or other
measures determined by the commissioner. All of the cost
savings shall be tracked by the commissioner and used to fund
home and community-based services in section 2, the
demonstration project in section 6, and the regional planning
process in section 5, subdivision 2.
new text end

Sec. 5. new text begin EXPANSION OF HOME AND COMMUNITY-BASED SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Expansion of services. new text end

new text begin The commissioner
shall expand services to elderly persons and caregivers and
provide ongoing funding for home and community-based services in
section 2 through the alternative care, elderly waiver, medical
assistance home care, and aging grant programs. Additional
categories of services, such as transportation, may be developed
and funded under the aging grant programs if determined
necessary through the regional planning process under section 5,
subdivision 2, and with the agreement of the commissioner.
new text end

new text begin Subd. 2. new text end

new text begin Expansion priorities. new text end

new text begin Service expansion
priorities shall be determined by December 31, 2005, through a
coordinated regional planning process conducted jointly by area
agencies on aging, counties, health plans that hold contracts as
MSHO or elderly waiver administrators, and nursing facilities.
new text end

new text begin Subd. 3. new text end

new text begin Caregiver support. new text end

new text begin The commissioner, in
partnership with the Minnesota Board on Aging, shall develop and
implement access to caregiver support using the Internet to
provide family caregivers information and tools to support the
caregiver's ability to provide care longer and to identify and
engage service providers such as respite workers, caregiver
consultants, and adult day health services. Respite, caregiver
consultation, adult day health, and other services shall be
expanded in underserved areas according to subdivisions 1 and 2.
new text end

Sec. 6. new text begin TARGETED CASE MANAGEMENT RELOCATION DEMONSTRATION
PROJECT.
new text end

new text begin Subdivision 1. new text end

new text begin Case management. new text end

new text begin The commissioner shall
develop and implement, through a request for proposal process, a
relocation demonstration project by July 1, 2006, of case
management targeted at elderly persons currently residing in
nursing facilities with care needs that could be met in the
community. The priority focus shall be on elderly persons
during their first 60 days of residence in a nursing facility.
new text end

new text begin Subd. 2. new text end

new text begin Persons served. new text end

new text begin The demonstration project shall
serve 500 persons by June 30, 2007, and shall be implemented in
at least one urban market area and one rural market area.
Elderly persons are eligible for targeted relocation if enrolled
in medical assistance or will spend down to medical assistance
eligibility within 180 days.
new text end

new text begin Subd. 3. new text end

new text begin Providers. new text end

new text begin Providers eligible for the targeted
case management demonstration project are county health and
human service agencies, area agencies on aging, or other
nonprofit or for profit entities that do not have a conflict of
interest and meet medical assistance or other federal and state
requirements. Counties in the demonstration area have the first
right of refusal. Targeted case management providers must have:
new text end

new text begin (1) the legal authority to provide case management
services;
new text end

new text begin (2) the demonstrated capacity and experience to provide the
components of case management to coordinate and link community
resources needed by elderly persons;
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new text begin (3) a financial management system that provides accurate
documentation of and billing for services and costs; and
new text end

new text begin (4) the capacity to document and maintain individual case
records.
new text end

new text begin Subd. 4. new text end

new text begin Covered services and activities. new text end

new text begin Targeted case
management services eligible for reimbursement of state funds
and federal funds under the demonstration for a nine-month
period are:
new text end

new text begin (1) in-person assessments;
new text end

new text begin (2) written individual service plan development,
completion, and regular review that is based on the older
person's needs and preferences, and which ensures access to
community-based long-term care services, medical care, and other
related services and supports;
new text end

new text begin (3) routine contact and support for the elderly person, the
person's family, and any primary caregiver, and routine
communication with service providers or other persons necessary
to develop and implement the goals of the individual service
plan;
new text end

new text begin (4) coordination and monitoring of overall service delivery
to ensure quality of services, appropriateness, and continued
need;
new text end

new text begin (5) maintenance of records and documentation that supports
and verifies the activities in this subdivision;
new text end

new text begin (6) travel necessary to conduct one or more visits with the
elderly person to develop or implement the goals of the
individual service plan;
new text end

new text begin (7) coordination with the nursing facility discharge
planner; and
new text end

new text begin (8) performance of the administrative activities of the
demonstration project.
new text end

Sec. 7. new text begin TRANSITIONAL SUPPORT GRANT.
new text end

new text begin A cash grant of up to $3,000 shall be available to elderly
persons participating in the demonstration project who are
moving from a nursing facility to a community setting with a
onetime payment to cover the costs, not covered by other
sources, associated with moving into a community setting.
Covered costs include, but are not limited to:
new text end

new text begin (1) lease or rent deposits;
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new text begin (2) security deposits;
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new text begin (3) utility setup costs, including telephone;
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new text begin (4) essential furnishings and supplies; and
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new text begin (5) personal supports and transports needed to locate and
transition to community settings.
new text end

Sec. 8. new text begin APPROPRIATIONS.
new text end

new text begin Subdivision 1. $....... is appropriated for the biennium
ending June 30, 2007, from the general fund to the commissioner
of human services to fund the expansion of home and
community-based services under section 5.
new text end

new text begin Subd. 2. $....... is appropriated for the biennium ending
June 30, 2007, from the general fund to the commissioner of
human services to fund the targeted case management relocation
demonstration project under section 6.
new text end

new text begin Subd. 3. $....... is appropriated for the biennium ending
June 30, 2007, from the general fund to the commissioner of
human services to fund comparable cost-of-living increases for
state-funded home and community-based service providers not
covered under the cost-of-living provisions granted to nursing
facility providers.
new text end