HF 2556

1st Engrossment - 88th Legislature (2013 - 2014) Posted on 04/10/2014 06:08pm

A bill for an act
relating to veterans; veterans housing and long-term care; providing exemptions
for certain moratoriums on new residential facilities; providing grants for
housing needs assessments for veterans; appropriating money; amending
Minnesota Statutes 2012, section 256I.04, subdivision 3; Minnesota Statutes
2013 Supplement, section 245A.03, subdivision 7.

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

Section 1.

Minnesota Statutes 2013 Supplement, section 245A.03, subdivision 7,
is amended to read:

Subd. 7.

Licensing moratorium.

(a) The commissioner shall not issue an initial
license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340,
or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under
this chapter for a physical location that will not be the primary residence of the license
holder for the entire period of licensure. If a license is issued during this moratorium, and
the license holder changes the license holder's primary residence away from the physical
location of the foster care license, the commissioner shall revoke the license according
to section 245A.07. The commissioner shall not issue an initial license for a community
residential setting licensed under chapter 245D. Exceptions to the moratorium include:

(1) foster care settings that are required to be registered under chapter 144D;

(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
community residential setting licenses replacing adult foster care licenses in existence on
December 31, 2013, and determined to be needed by the commissioner under paragraph (b);

(3) new foster care licenses or community residential setting licenses determined to
be needed by the commissioner under paragraph (b) for the closure of a nursing facility,
ICF/DD, or regional treatment center; restructuring of state-operated services that limits
the capacity of state-operated facilities; or allowing movement to the community for
people who no longer require the level of care provided in state-operated facilities as
provided under section 256B.092, subdivision 13, or 256B.49, subdivision 24;

(4) new foster care licenses or community residential setting licenses determined
to be needed by the commissioner under paragraph (b) for persons requiring hospital
level care; deleted text begin or
deleted text end

(5) new foster care licenses or community residential setting licenses determined to
be needed by the commissioner for the transition of people from personal care assistance
to the home and community-based services deleted text begin . deleted text end new text begin ; or
new text end

new text begin (6) new foster care licenses or community residential setting licenses determined
to be needed by the commissioner for the care of disabled veterans or veterans requiring
nursing home level care in veteran exclusive homes.
new text end

(b) The commissioner shall determine the need for newly licensed foster care
homes or community residential settings as defined under this subdivision. As part of the
determination, the commissioner shall consider the availability of foster care capacity in
the area in which the licensee seeks to operate, and the recommendation of the local
county board. The determination by the commissioner must be final. A determination of
need is not required for a change in ownership at the same address.

(c) When an adult resident served by the program moves out of a foster home
that is not the primary residence of the license holder according to section 256B.49,
subdivision 15, paragraph (f), or the adult community residential setting, the county
shall immediately inform the Department of Human Services Licensing Division. The
department shall decrease the statewide licensed capacity for adult foster care settings
where the physical location is not the primary residence of the license holder, or for adult
community residential settings, if the voluntary changes described in paragraph (e) are
not sufficient to meet the savings required by reductions in licensed bed capacity under
Laws 2011, First Special Session chapter 9, article 7, sections 1 and 40, paragraph (f),
and maintain statewide long-term care residential services capacity within budgetary
limits. Implementation of the statewide licensed capacity reduction shall begin on July
1, 2013. The commissioner shall delicense up to 128 beds by June 30, 2014, using the
needs determination process. Under this paragraph, the commissioner has the authority
to reduce unused licensed capacity of a current foster care program, or the community
residential settings, to accomplish the consolidation or closure of settings. Under this
paragraph, the commissioner has the authority to manage statewide capacity, including
adjusting the capacity available to each county and adjusting statewide available capacity,
to meet the statewide needs identified through the process in paragraph (e). A decreased
licensed capacity according to this paragraph is not subject to appeal under this chapter.

(d) Residential settings that would otherwise be subject to the decreased license
capacity established in paragraph (c) shall be exempt under the following circumstances:

(1) until August 1, 2013, the license holder's beds occupied by residents whose
primary diagnosis is mental illness and the license holder is:

(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental
health services (ARMHS) as defined in section 256B.0623;

(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to
9520.0870;

(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to
9520.0870; or

(iv) a provider of intensive residential treatment services (IRTS) licensed under
Minnesota Rules, parts 9520.0500 to 9520.0670; or

(2) the license holder's beds occupied by residents whose primary diagnosis is
mental illness and the license holder is certified under the requirements in subdivision 6a
or section 245D.33.

(e) A resource need determination process, managed at the state level, using the
available reports required by section 144A.351, and other data and information shall
be used to determine where the reduced capacity required under paragraph (c) will be
implemented. The commissioner shall consult with the stakeholders described in section
144A.351, and employ a variety of methods to improve the state's capacity to meet
long-term care service needs within budgetary limits, including seeking proposals from
service providers or lead agencies to change service type, capacity, or location to improve
services, increase the independence of residents, and better meet needs identified by the
long-term care services reports and statewide data and information. By February 1, 2013,
and August 1, 2014, and each following year, the commissioner shall provide information
and data on the overall capacity of licensed long-term care services, actions taken under
this subdivision to manage statewide long-term care services and supports resources, and
any recommendations for change to the legislative committees with jurisdiction over
health and human services budget.

(f) At the time of application and reapplication for licensure, the applicant and the
license holder that are subject to the moratorium or an exclusion established in paragraph
(a) are required to inform the commissioner whether the physical location where the foster
care will be provided is or will be the primary residence of the license holder for the entire
period of licensure. If the primary residence of the applicant or license holder changes, the
applicant or license holder must notify the commissioner immediately. The commissioner
shall print on the foster care license certificate whether or not the physical location is the
primary residence of the license holder.

(g) License holders of foster care homes identified under paragraph (f) that are not
the primary residence of the license holder and that also provide services in the foster care
home that are covered by a federally approved home and community-based services
waiver, as authorized under section 256B.0915, 256B.092, or 256B.49, must inform the
human services licensing division that the license holder provides or intends to provide
these waiver-funded services.

Sec. 2.

Minnesota Statutes 2012, section 256I.04, subdivision 3, is amended to read:

Subd. 3.

Moratorium on development of group residential housing beds.

(a)
County agencies shall not enter into agreements for new group residential housing beds
with total rates in excess of the MSA equivalent rate except:

(1) for group residential housing establishments licensed under Minnesota Rules,
parts 9525.0215 to 9525.0355, provided the facility is needed to meet the census reduction
targets for persons with developmental disabilities at regional treatment centers;

(2) to ensure compliance with the federal Omnibus Budget Reconciliation Act
alternative disposition plan requirements for inappropriately placed persons with
developmental disabilities or mental illness;

(3) up to 80 beds in a single, specialized facility located in Hennepin County that will
provide housing for chronic inebriates who are repetitive users of detoxification centers
and are refused placement in emergency shelters because of their state of intoxication,
and planning for the specialized facility must have been initiated before July 1, 1991,
in anticipation of receiving a grant from the Housing Finance Agency under section
462A.05, subdivision 20a, paragraph (b);

(4) notwithstanding the provisions of subdivision 2a, for up to 190 supportive
housing units in Anoka, Dakota, Hennepin, or Ramsey County for homeless adults with a
mental illness, a history of substance abuse, or human immunodeficiency virus or acquired
immunodeficiency syndrome. For purposes of this section, "homeless adult" means a
person who is living on the street or in a shelter or discharged from a regional treatment
center, community hospital, or residential treatment program and has no appropriate
housing available and lacks the resources and support necessary to access appropriate
housing. At least 70 percent of the supportive housing units must serve homeless adults
with mental illness, substance abuse problems, or human immunodeficiency virus or
acquired immunodeficiency syndrome who are about to be or, within the previous six
months, has been discharged from a regional treatment center, or a state-contracted
psychiatric bed in a community hospital, or a residential mental health or chemical
dependency treatment program. If a person meets the requirements of subdivision 1,
paragraph (a), and receives a federal or state housing subsidy, the group residential housing
rate for that person is limited to the supplementary rate under section 256I.05, subdivision
1a, and is determined by subtracting the amount of the person's countable income that
exceeds the MSA equivalent rate from the group residential housing supplementary rate.
A resident in a demonstration project site who no longer participates in the demonstration
program shall retain eligibility for a group residential housing payment in an amount
determined under section 256I.06, subdivision 8, using the MSA equivalent rate. Service
funding under section 256I.05, subdivision 1a, will end June 30, 1997, if federal matching
funds are available and the services can be provided through a managed care entity. If
federal matching funds are not available, then service funding will continue under section
256I.05, subdivision 1a;

(5) for group residential housing beds in settings meeting the requirements of
subdivision 2a, clauses (1) and (3), which are used exclusively for recipients receiving
home and community-based waiver services under sections 256B.0915, 256B.092,
subdivision 5, 256B.093, and 256B.49, and who resided in a nursing facility for the six
months immediately prior to the month of entry into the group residential housing setting.
The group residential housing rate for these beds must be set so that the monthly group
residential housing payment for an individual occupying the bed when combined with the
nonfederal share of services delivered under the waiver for that person does not exceed the
nonfederal share of the monthly medical assistance payment made for the person to the
nursing facility in which the person resided prior to entry into the group residential housing
establishment. The rate may not exceed the MSA equivalent rate plus $426.37 for any case;

(6) for an additional two beds, resulting in a total of 32 beds, for a facility located in
Hennepin County providing services for recovering and chemically dependent men that
has had a group residential housing contract with the county and has been licensed as a
board and lodge facility with special services since 1980;

(7) for a group residential housing provider located in the city of St. Cloud, or a county
contiguous to the city of St. Cloud, that operates a 40-bed facility, that received financing
through the Minnesota Housing Finance Agency Ending Long-Term Homelessness
Initiative and serves chemically dependent clientele, providing 24-hour-a-day supervision;

(8) for a new 65-bed facility in Crow Wing County that will serve chemically
dependent persons, operated by a group residential housing provider that currently
operates a 304-bed facility in Minneapolis, and a 44-bed facility in Duluth;

(9) for a group residential housing provider that operates two ten-bed facilities, one
located in Hennepin County and one located in Ramsey County, that provide community
support and 24-hour-a-day supervision to serve the mental health needs of individuals
who have chronically lived unsheltered; deleted text begin and
deleted text end

(10) for a group residential facility in Hennepin County with a capacity of up to 48
beds that has been licensed since 1978 as a board and lodging facility and that until August
1, 2007, operated as a licensed chemical dependency treatment program deleted text begin . deleted text end new text begin ; and
new text end

new text begin (11) for a group residential housing provider operating a facility of up to 45 beds,
providing services to veterans as a board and lodging facility with supportive services or
licensed chemical dependency treatment program.
new text end

(b) A county agency may enter into a group residential housing agreement for beds
with rates in excess of the MSA equivalent rate in addition to those currently covered
under a group residential housing agreement if the additional beds are only a replacement
of beds with rates in excess of the MSA equivalent rate which have been made available
due to closure of a setting, a change of licensure or certification which removes the beds
from group residential housing payment, or as a result of the downsizing of a group
residential housing setting. The transfer of available beds from one county to another can
only occur by the agreement of both counties.

Sec. 3. new text begin VETERANS HOUSING SURVEY GRANTS.
new text end

new text begin $250,000 in fiscal year 2015 is appropriated from the general fund to the
commissioner of administration for up to five grants to conduct a housing needs
assessment for veterans in a community. The grants may be awarded to any government
or nongovernmental organization. The assessment, which may be a study or a survey,
may examine the need for scattered site housing for veterans and their families who are
homeless or in danger of homelessness or for housing that addresses the health care needs
of disabled or aging veterans. The assessment must be started no later than July 30, 2015,
and completed no later than July 30, 2016. The commissioner of administration must
provide copies of any completed assessment to the legislative committees with jurisdiction
over housing and veterans affairs no later than January 1, 2017.
new text end

Sec. 4. new text begin APPROPRIATION; HUMAN SERVICES.
new text end

new text begin $340,000 in fiscal year 2015 is appropriated from the general fund to the
commissioner of human services for sections 1 and 2. Of this amount, $74,000 is for
medical assistance, long-term waivers and home care and $266,000 is for group residential
housing grants.
new text end