HF 2592

as introduced - 81st Legislature (1999 - 2000) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act 
  1.2             relating to human services; providing automatic annual 
  1.3             inflation adjustments for hospitals, nursing 
  1.4             facilities, and ICF/MRs; providing an additional rate 
  1.5             increase for nursing facilities, ICF/MRs, and home and 
  1.6             community-based providers; amending Minnesota Statutes 
  1.7             1998, sections 256B.431, subdivision 2l; and 256B.501, 
  1.8             subdivision 3c, by adding a subdivision; Minnesota 
  1.9             Statutes 1999 Supplement, sections 256.969, 
  1.10            subdivision 1; 256B.431, subdivisions 26 and 28; 
  1.11            256B.434, subdivision 4; 256B.435, subdivisions 1 and 
  1.12            3; Laws 1999, chapter 245, article 1, section 2, 
  1.13            subdivision 8. 
  1.14  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.15     Section 1.  Minnesota Statutes 1999 Supplement, section 
  1.16  256.969, subdivision 1, is amended to read: 
  1.17     Subdivision 1.  [HOSPITAL COST INDEX.] (a) The hospital 
  1.18  cost index shall be the change in the Consumer Price Index-All 
  1.19  Items (United States city average) (CPI-U) forecasted by Data 
  1.20  Resources, Inc. the commissioner of finance's national economic 
  1.21  consultant.  The commissioner shall use the indices as 
  1.22  forecasted in the third quarter of the calendar year prior to 
  1.23  the rate year.  The hospital cost index may be used to adjust 
  1.24  the base year operating payment rate through the rate year on an 
  1.25  annually compounded basis.  
  1.26     (b) For fiscal years beginning on or after July 1, 1993, 
  1.27  through June 30, 2001, the commissioner of human services shall 
  1.28  not provide automatic annual inflation adjustments for hospital 
  1.29  payment rates under medical assistance, nor under general 
  2.1   assistance medical care, except that the inflation adjustments 
  2.2   under paragraph (a) for medical assistance, excluding general 
  2.3   assistance medical care, shall apply through calendar year 
  2.4   2001.  The index for calendar year 2000 shall be reduced 2.5 
  2.5   percentage points to recover overprojections of the index from 
  2.6   1994 to 1996.  
  2.7      (c) For fiscal years beginning on or after July 1, 2001, 
  2.8   the commissioner of human services shall not provide automatic 
  2.9   annual inflation adjustments for hospital payment rates under 
  2.10  general assistance medical care.  The commissioner of finance 
  2.11  shall include as a budget change request in each biennial 
  2.12  detailed expenditure budget submitted to the legislature under 
  2.13  section 16A.11 annual adjustments in hospital payment rates 
  2.14  under medical assistance and general assistance medical care, 
  2.15  based upon the hospital cost index. 
  2.16     (d) For fiscal years beginning on or after July 1, 2001, 
  2.17  the commissioner of human services shall provide automatic 
  2.18  annual inflation adjustments for hospital payment rates under 
  2.19  medical assistance, using the hospital cost indexed established 
  2.20  in paragraph (a). 
  2.21     Sec. 2.  Minnesota Statutes 1998, section 256B.431, 
  2.22  subdivision 2l, is amended to read: 
  2.23     Subd. 2l.  [INFLATION ADJUSTMENTS AFTER JULY 1, 1990.] (a) 
  2.24  For rate years beginning on or after July 1, 1990, the 
  2.25  forecasted composite price index for a nursing facility's 
  2.26  allowable operating cost per diems shall be determined using 
  2.27  Data Resources, Inc., the commissioner of finance's national 
  2.28  economic consultant's forecast for change in the Nursing Home 
  2.29  Market Basket.  The commissioner of human services shall use the 
  2.30  indices as forecasted by Data Resources, Inc., the commissioner 
  2.31  of finance's national economic consultant in the fourth quarter 
  2.32  of the calendar year preceding the rate year. 
  2.33     (b) For rate years beginning on or after July 1, 1992, the 
  2.34  commissioner shall index the prior year's operating cost limits 
  2.35  by the percentage change in the Data Resources, Inc., 
  2.36  commissioner of finance's national economic consultant's Nursing 
  3.1   Home Market Basket between the midpoint of the current reporting 
  3.2   year and the midpoint of the previous reporting year.  The 
  3.3   commissioner shall use the indices as forecasted by Data 
  3.4   Resources, Inc., the commissioner of finance's national economic 
  3.5   consultant in the fourth quarter of the calendar year preceding 
  3.6   the rate year.  
  3.7      (c) For the rate years beginning on or after period July 1, 
  3.8   1993, through June 30, 2001, the commissioner shall not provide 
  3.9   automatic annual inflation adjustments for nursing facilities.  
  3.10  The commissioner of finance shall include annual adjustments in 
  3.11  operating costs for nursing facilities as a budget change 
  3.12  request in each biennial detailed expenditure budget submitted 
  3.13  to the legislature under section 16A.11.  
  3.14     (d) For rate years beginning on or after July 1, 2001, the 
  3.15  commissioner shall provide automatic annual inflation 
  3.16  adjustments for nursing facilities, using the methodology in 
  3.17  subdivision 26, paragraph (d). 
  3.18     Sec. 3.  Minnesota Statutes 1999 Supplement, section 
  3.19  256B.431, subdivision 26, is amended to read: 
  3.20     Subd. 26.  [CHANGES TO NURSING FACILITY REIMBURSEMENT 
  3.21  BEGINNING JULY 1, 1997.] The nursing facility reimbursement 
  3.22  changes in paragraphs (a) to (f) shall apply in the sequence 
  3.23  specified in Minnesota Rules, parts 9549.0010 to 9549.0080, and 
  3.24  this section, beginning July 1, 1997. 
  3.25     (a) For rate years beginning on or after July 1, 1997, the 
  3.26  commissioner shall limit a nursing facility's allowable 
  3.27  operating per diem for each case mix category for each rate year.
  3.28  The commissioner shall group nursing facilities into two groups, 
  3.29  freestanding and nonfreestanding, within each geographic group, 
  3.30  using their operating cost per diem for the case mix A 
  3.31  classification.  A nonfreestanding nursing facility is a nursing 
  3.32  facility whose other operating cost per diem is subject to the 
  3.33  hospital attached, short length of stay, or the rule 80 limits.  
  3.34  All other nursing facilities shall be considered freestanding 
  3.35  nursing facilities.  The commissioner shall then array all 
  3.36  nursing facilities in each grouping by their allowable case mix 
  4.1   A operating cost per diem.  In calculating a nursing facility's 
  4.2   operating cost per diem for this purpose, the commissioner shall 
  4.3   exclude the raw food cost per diem related to providing special 
  4.4   diets that are based on religious beliefs, as determined in 
  4.5   subdivision 2b, paragraph (h).  For those nursing facilities in 
  4.6   each grouping whose case mix A operating cost per diem: 
  4.7      (1) is at or below the median of the array, the 
  4.8   commissioner shall limit the nursing facility's allowable 
  4.9   operating cost per diem for each case mix category to the lesser 
  4.10  of the prior reporting year's allowable operating cost per diem 
  4.11  as specified in Laws 1996, chapter 451, article 3, section 11, 
  4.12  paragraph (h), plus the inflation factor as established in 
  4.13  paragraph (d), clause (2), increased by two percentage points, 
  4.14  or the current reporting year's corresponding allowable 
  4.15  operating cost per diem; or 
  4.16     (2) is above the median of the array, the commissioner 
  4.17  shall limit the nursing facility's allowable operating cost per 
  4.18  diem for each case mix category to the lesser of the prior 
  4.19  reporting year's allowable operating cost per diem as specified 
  4.20  in Laws 1996, chapter 451, article 3, section 11, paragraph (h), 
  4.21  plus the inflation factor as established in paragraph (d), 
  4.22  clause (2), increased by one percentage point, or the current 
  4.23  reporting year's corresponding allowable operating cost per diem.
  4.24     For purposes of paragraph (a), if a nursing facility 
  4.25  reports on its cost report a reduction in cost due to a refund 
  4.26  or credit for a rate year beginning on or after July 1, 1998, 
  4.27  the commissioner shall increase that facility's spend-up limit 
  4.28  for the rate year following the current rate year by the amount 
  4.29  of the cost reduction divided by its resident days for the 
  4.30  reporting year preceding the rate year in which the adjustment 
  4.31  is to be made. 
  4.32     (b) For rate years beginning on or after July 1, 1997, the 
  4.33  commissioner shall limit the allowable operating cost per diem 
  4.34  for high cost nursing facilities.  After application of the 
  4.35  limits in paragraph (a) to each nursing facility's operating 
  4.36  cost per diem, the commissioner shall group nursing facilities 
  5.1   into two groups, freestanding or nonfreestanding, within each 
  5.2   geographic group.  A nonfreestanding nursing facility is a 
  5.3   nursing facility whose other operating cost per diem are subject 
  5.4   to hospital attached, short length of stay, or rule 80 limits.  
  5.5   All other nursing facilities shall be considered freestanding 
  5.6   nursing facilities.  The commissioner shall then array all 
  5.7   nursing facilities within each grouping by their allowable case 
  5.8   mix A operating cost per diem.  In calculating a nursing 
  5.9   facility's operating cost per diem for this purpose, the 
  5.10  commissioner shall exclude the raw food cost per diem related to 
  5.11  providing special diets that are based on religious beliefs, as 
  5.12  determined in subdivision 2b, paragraph (h).  For those nursing 
  5.13  facilities in each grouping whose case mix A operating cost per 
  5.14  diem exceeds 1.0 standard deviation above the median, the 
  5.15  commissioner shall reduce their allowable operating cost per 
  5.16  diem by three percent.  For those nursing facilities in each 
  5.17  grouping whose case mix A operating cost per diem exceeds 0.5 
  5.18  standard deviation above the median but is less than or equal to 
  5.19  1.0 standard deviation above the median, the commissioner shall 
  5.20  reduce their allowable operating cost per diem by two percent.  
  5.21  However, in no case shall a nursing facility's operating cost 
  5.22  per diem be reduced below its grouping's limit established at 
  5.23  0.5 standard deviations above the median. 
  5.24     (c) For rate years beginning on or after July 1, 1997, the 
  5.25  commissioner shall determine a nursing facility's efficiency 
  5.26  incentive by first computing the allowable difference, which is 
  5.27  the lesser of $4.50 or the amount by which the facility's other 
  5.28  operating cost limit exceeds its nonadjusted other operating 
  5.29  cost per diem for that rate year.  The commissioner shall 
  5.30  compute the efficiency incentive by: 
  5.31     (1) subtracting the allowable difference from $4.50 and 
  5.32  dividing the result by $4.50; 
  5.33     (2) multiplying 0.20 by the ratio resulting from clause 
  5.34  (1), and then; 
  5.35     (3) adding 0.50 to the result from clause (2); and 
  5.36     (4) multiplying the result from clause (3) times the 
  6.1   allowable difference. 
  6.2      The nursing facility's efficiency incentive payment shall 
  6.3   be the lesser of $2.25 or the product obtained in clause (4). 
  6.4      (d) For rate years beginning on or after July 1, 1997, the 
  6.5   forecasted price index for a nursing facility's allowable 
  6.6   operating cost per diem shall be determined under clauses (1) 
  6.7   and (2) using the change in the Consumer Price Index-All Items 
  6.8   (United States city average) (CPI-U) as forecasted by Data 
  6.9   Resources, Inc. the commissioner of finance's national economic 
  6.10  consultant.  The commissioner shall use the indices as 
  6.11  forecasted in the fourth quarter of the calendar year preceding 
  6.12  the rate year, subject to subdivision 2l, paragraph 
  6.13  paragraphs (c) and (d).  
  6.14     (1) The CPI-U forecasted index for allowable operating cost 
  6.15  per diem shall be based on the 21-month period from the midpoint 
  6.16  of the nursing facility's reporting year to the midpoint of the 
  6.17  rate year following the reporting year. 
  6.18     (2) For rate years beginning on or after July 1, 1997, the 
  6.19  forecasted index for operating cost limits referred to in 
  6.20  subdivision 21, paragraph (b), shall be based on the CPI-U for 
  6.21  the 12-month period between the midpoints of the two reporting 
  6.22  years preceding the rate year. 
  6.23     (e) After applying these provisions for the respective rate 
  6.24  years, the commissioner shall index these allowable operating 
  6.25  cost per diem by the inflation factor provided for in paragraph 
  6.26  (d), clause (1), and add the nursing facility's efficiency 
  6.27  incentive as computed in paragraph (c). 
  6.28     (f) For rate years beginning on or after July 1, 1997, the 
  6.29  total operating cost payment rates for a nursing facility shall 
  6.30  be the greater of the total operating cost payment rates 
  6.31  determined under this section or the total operating cost 
  6.32  payment rates in effect on June 30, 1997, subject to rate 
  6.33  adjustments due to field audit or rate appeal resolution.  This 
  6.34  provision shall not apply to subsequent field audit adjustments 
  6.35  of the nursing facility's operating cost rates for rate years 
  6.36  beginning on or after July 1, 1997. 
  7.1      (g) For the rate years beginning on July 1, 1997, July 1, 
  7.2   1998, and July 1, 1999, a nursing facility licensed for 40 beds 
  7.3   effective May 1, 1992, with a subsequent increase of 20 
  7.4   Medicare/Medicaid certified beds, effective January 26, 1993, in 
  7.5   accordance with an increase in licensure is exempt from 
  7.6   paragraphs (a) and (b). 
  7.7      (h) For a nursing facility whose construction project was 
  7.8   authorized according to section 144A.073, subdivision 5, 
  7.9   paragraph (g), the operating cost payment rates for the new 
  7.10  location shall be determined based on Minnesota Rules, part 
  7.11  9549.0057.  The relocation allowed under section 144A.073, 
  7.12  subdivision 5, paragraph (g), and the rate determination allowed 
  7.13  under this paragraph must meet the cost neutrality requirements 
  7.14  of section 144A.073, subdivision 3c.  Paragraphs (a) and (b) 
  7.15  shall not apply until the second rate year after the settle-up 
  7.16  cost report is filed.  Notwithstanding subdivision 2b, paragraph 
  7.17  (g), real estate taxes and special assessments payable by the 
  7.18  new location, a 501(c)(3) nonprofit corporation, shall be 
  7.19  included in the payment rates determined under this subdivision 
  7.20  for all subsequent rate years. 
  7.21     (i) For the rate year beginning July 1, 1997, the 
  7.22  commissioner shall compute the payment rate for a nursing 
  7.23  facility licensed for 94 beds on September 30, 1996, that 
  7.24  applied in October 1993 for approval of a total replacement 
  7.25  under the moratorium exception process in section 144A.073, and 
  7.26  completed the approved replacement in June 1995, with other 
  7.27  operating cost spend-up limit under paragraph (a), increased by 
  7.28  $3.98, and after computing the facility's payment rate according 
  7.29  to this section, the commissioner shall make a one-year positive 
  7.30  rate adjustment of $3.19 for operating costs related to the 
  7.31  newly constructed total replacement, without application of 
  7.32  paragraphs (a) and (b).  The facility's per diem, before the 
  7.33  $3.19 adjustment, shall be used as the prior reporting year's 
  7.34  allowable operating cost per diem for payment rate calculation 
  7.35  for the rate year beginning July 1, 1998.  A facility described 
  7.36  in this paragraph is exempt from paragraph (b) for the rate 
  8.1   years beginning July 1, 1997, and July 1, 1998. 
  8.2      (j) For the purpose of applying the limit stated in 
  8.3   paragraph (a), a nursing facility in Kandiyohi county licensed 
  8.4   for 86 beds that was granted hospital-attached status on 
  8.5   December 1, 1994, shall have the prior year's allowable 
  8.6   care-related per diem increased by $3.207 and the prior year's 
  8.7   other operating cost per diem increased by $4.777 before adding 
  8.8   the inflation in paragraph (d), clause (2), for the rate year 
  8.9   beginning on July 1, 1997. 
  8.10     (k) For the purpose of applying the limit stated in 
  8.11  paragraph (a), a 117 bed nursing facility located in Pine county 
  8.12  shall have the prior year's allowable other operating cost per 
  8.13  diem increased by $1.50 before adding the inflation in paragraph 
  8.14  (d), clause (2), for the rate year beginning on July 1, 1997. 
  8.15     (l) For the purpose of applying the limit under paragraph 
  8.16  (a), a nursing facility in Hibbing licensed for 192 beds shall 
  8.17  have the prior year's allowable other operating cost per diem 
  8.18  increased by $2.67 before adding the inflation in paragraph (d), 
  8.19  clause (2), for the rate year beginning July 1, 1997. 
  8.20     Sec. 4.  Minnesota Statutes 1999 Supplement, section 
  8.21  256B.431, subdivision 28, is amended to read: 
  8.22     Subd. 28.  [NURSING FACILITY RATE INCREASES BEGINNING JULY 
  8.23  1, 1999, AND JULY 1, 2000.] (a) For the rate years beginning 
  8.24  July 1, 1999, and July 1, 2000, the commissioner shall make 
  8.25  available to each nursing facility reimbursed under this section 
  8.26  or section 256B.434 an adjustment to the total operating payment 
  8.27  rate.  For each facility, total operating costs shall be 
  8.28  separated into costs that are compensation and salary related 
  8.29  and all other costs.  Compensation-related costs include 
  8.30  salaries, payroll taxes, and fringe benefits for all employees 
  8.31  except management fees, the administrator, and central office 
  8.32  staff.  Salary-related costs include salaries and payroll taxes 
  8.33  of all employees except management fees, the administrator, and 
  8.34  central office staff. 
  8.35     (b) For the rate year beginning July 1, 1999, the 
  8.36  commissioner shall make available a rate increase for 
  9.1   compensation-related costs of 4.843 percent and a rate increase 
  9.2   for all other operating costs of 3.446 percent. 
  9.3      (c) For the rate year beginning July 1, 2000, the 
  9.4   commissioner shall make available a rate increase for 
  9.5   compensation-related costs of 3.632 percent, a rate increase for 
  9.6   salary-related costs of five percent, and a rate increase for 
  9.7   all other operating costs of 2.585 percent. 
  9.8      (d) The payment rate adjustment for each nursing facility 
  9.9   must be determined under clause (1) or (2): 
  9.10     (1) for each nursing facility that reports salaries for 
  9.11  registered nurses, licensed practical nurses, aides, orderlies, 
  9.12  and attendants separately, the commissioner shall determine the 
  9.13  payment rate adjustment using the categories specified in 
  9.14  paragraph (a) multiplied by the rate increases specified in 
  9.15  paragraph (b) or (c), and then dividing the resulting amount by 
  9.16  the nursing facility's actual resident days.  In determining the 
  9.17  amount of a payment rate adjustment for a nursing facility 
  9.18  reimbursed under section 256B.434, the commissioner shall 
  9.19  determine the proportions of the facility's rates that are 
  9.20  compensation-related costs, salary-related costs, and all other 
  9.21  operating costs based on the facility's most recent cost report; 
  9.22  and 
  9.23     (2) for each nursing facility that does not report salaries 
  9.24  for registered nurses, licensed practical nurses, aides, 
  9.25  orderlies, and attendants separately, the payment rate 
  9.26  adjustment shall be computed using the facility's total 
  9.27  operating costs, separated into the categories specified in 
  9.28  paragraph (a) in proportion to the weighted average of all 
  9.29  facilities determined under clause (1), multiplied by the rate 
  9.30  increases specified in paragraph (b) or (c), and then dividing 
  9.31  the resulting amount by the nursing facility's actual resident 
  9.32  days. 
  9.33     (e) A nursing facility may apply for the 
  9.34  compensation-related compensation and salary-related payment 
  9.35  rate adjustment adjustments calculated under this subdivision.  
  9.36  The application must be made to the commissioner and contain a 
 10.1   plan by which the nursing facility will distribute the 
 10.2   compensation-related portion compensation and salary-related 
 10.3   portions of the payment rate adjustment to employees of the 
 10.4   nursing facility.  For nursing facilities in which the employees 
 10.5   are represented by an exclusive bargaining representative, an 
 10.6   agreement negotiated and agreed to by the employer and the 
 10.7   exclusive bargaining representative constitutes the plan.  The 
 10.8   commissioner shall review the plan to ensure that the payment 
 10.9   rate adjustment per diem is used as provided in paragraphs (a) 
 10.10  to (c).  To be eligible, a facility must submit its plan for the 
 10.11  compensation and salary distribution by December 31 each year.  
 10.12  A facility may amend its plan for the second rate year by 
 10.13  submitting a revised plan by December 31, 2000.  If a facility's 
 10.14  plan for compensation and salary distribution is effective for 
 10.15  its employees after July 1 of the year that the funds are 
 10.16  available, the payment rate adjustment per diem shall be 
 10.17  effective the same date as its plan. 
 10.18     (f) A copy of the approved distribution plan must be made 
 10.19  available to all employees.  This must be done by giving each 
 10.20  employee a copy or by posting it in an area of the nursing 
 10.21  facility to which all employees have access.  If an employee 
 10.22  does not receive the compensation adjustment and salary 
 10.23  adjustments described in their facility's approved plan and is 
 10.24  unable to resolve the problem with the facility's management or 
 10.25  through the employee's union representative, the employee may 
 10.26  contact the commissioner at an address or phone number provided 
 10.27  by the commissioner and included in the approved plan.  
 10.28     (g) If the reimbursement system under section 256B.435 is 
 10.29  not implemented until July 1, 2001, the salary adjustment per 
 10.30  diem authorized in subdivision 2i, paragraph (c), shall continue 
 10.31  until June 30, 2001.  
 10.32     (h) For the rate year beginning July 1, 1999, the following 
 10.33  nursing facilities shall be allowed a rate increase equal to 67 
 10.34  percent of the rate increase that would be allowed if 
 10.35  subdivision 26, paragraph (a), was not applied: 
 10.36     (1) a nursing facility in Carver county licensed for 33 
 11.1   nursing home beds and four boarding care beds; 
 11.2      (2) a nursing facility in Faribault county licensed for 159 
 11.3   nursing home beds on September 30, 1998; and 
 11.4      (3) a nursing facility in Houston county licensed for 68 
 11.5   nursing home beds on September 30, 1998. 
 11.6      (i) For the rate year beginning July 1, 1999, the following 
 11.7   nursing facilities shall be allowed a rate increase equal to 67 
 11.8   percent of the rate increase that would be allowed if 
 11.9   subdivision 26, paragraphs (a) and (b), were not applied: 
 11.10     (1) a nursing facility in Chisago county licensed for 135 
 11.11  nursing home beds on September 30, 1998; and 
 11.12     (2) a nursing facility in Murray county licensed for 62 
 11.13  nursing home beds on September 30, 1998. 
 11.14     (j) For the rate year beginning July 1, 1999, a nursing 
 11.15  facility in Hennepin county licensed for 134 beds on September 
 11.16  30, 1998, shall: 
 11.17     (1) have the prior year's allowable care-related per diem 
 11.18  increased by $3.93 and the prior year's other operating cost per 
 11.19  diem increased by $1.69 before adding the inflation in 
 11.20  subdivision 26, paragraph (d), clause (2); and 
 11.21     (2) be allowed a rate increase equal to 67 percent of the 
 11.22  rate increase that would be allowed if subdivision 26, 
 11.23  paragraphs (a) and (b), were not applied. 
 11.24     Sec. 5.  Minnesota Statutes 1999 Supplement, section 
 11.25  256B.434, subdivision 4, is amended to read: 
 11.26     Subd. 4.  [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 
 11.27  nursing facilities which have their payment rates determined 
 11.28  under this section rather than section 256B.431, subdivision 25, 
 11.29  the commissioner shall establish a rate under this subdivision.  
 11.30  The nursing facility must enter into a written contract with the 
 11.31  commissioner. 
 11.32     (b) A nursing facility's case mix payment rate for the 
 11.33  first rate year of a facility's contract under this section is 
 11.34  the payment rate the facility would have received under section 
 11.35  256B.431, subdivision 25. 
 11.36     (c) A nursing facility's case mix payment rates for the 
 12.1   second and subsequent years of a facility's contract under this 
 12.2   section are the previous rate year's contract payment rates plus 
 12.3   an inflation adjustment.  The index for the inflation adjustment 
 12.4   must be based on the change in the Consumer Price Index-All 
 12.5   Items (United States City average) (CPI-U) forecasted by Data 
 12.6   Resources, Inc. the commissioner of finance's national economic 
 12.7   consultant, as forecasted in the fourth quarter of the calendar 
 12.8   year preceding the rate year.  The inflation adjustment must be 
 12.9   based on the 12-month period from the midpoint of the previous 
 12.10  rate year to the midpoint of the rate year for which the rate is 
 12.11  being determined.  For the rate years beginning on July 1, 1999, 
 12.12  and July 1, 2000, this paragraph shall apply only to the 
 12.13  property-related payment rate.  In determining the amount of the 
 12.14  property-related payment rate adjustment under this paragraph, 
 12.15  the commissioner shall determine the proportion of the 
 12.16  facility's rates that are property-related based on the 
 12.17  facility's most recent cost report. 
 12.18     (d) The commissioner shall develop additional 
 12.19  incentive-based payments of up to five percent above the 
 12.20  standard contract rate for achieving outcomes specified in each 
 12.21  contract.  The specified facility-specific outcomes must be 
 12.22  measurable and approved by the commissioner.  The commissioner 
 12.23  may establish, for each contract, various levels of achievement 
 12.24  within an outcome.  After the outcomes have been specified the 
 12.25  commissioner shall assign various levels of payment associated 
 12.26  with achieving the outcome.  Any incentive-based payment cancels 
 12.27  if there is a termination of the contract.  In establishing the 
 12.28  specified outcomes and related criteria the commissioner shall 
 12.29  consider the following state policy objectives: 
 12.30     (1) improved cost effectiveness and quality of life as 
 12.31  measured by improved clinical outcomes; 
 12.32     (2) successful diversion or discharge to community 
 12.33  alternatives; 
 12.34     (3) decreased acute care costs; 
 12.35     (4) improved consumer satisfaction; 
 12.36     (5) the achievement of quality; or 
 13.1      (6) any additional outcomes proposed by a nursing facility 
 13.2   that the commissioner finds desirable. 
 13.3      Sec. 6.  Minnesota Statutes 1999 Supplement, section 
 13.4   256B.435, subdivision 1, is amended to read: 
 13.5      Subdivision 1.  [IN GENERAL.] Effective July 1, 2001, the 
 13.6   commissioner shall implement a performance-based contracting 
 13.7   system to replace the current method of setting operating cost 
 13.8   payment rates under sections 256B.431 and 256B.434 and Minnesota 
 13.9   Rules, parts 9549.0010 to 9549.0080.  Operating cost payment 
 13.10  rates for newly established facilities under Minnesota Rules, 
 13.11  part 9549.0057, shall be established using section 256B.431 and 
 13.12  Minnesota Rules, parts 9549.0010 to 9549.0070.  A nursing 
 13.13  facility in operation on May 1, 1998, with payment rates not 
 13.14  established under section 256B.431 or 256B.434 on that date, is 
 13.15  ineligible for this performance-based contracting system.  In 
 13.16  determining prospective payment rates of nursing facility 
 13.17  services, the commissioner shall distinguish between operating 
 13.18  costs and property-related costs.  The commissioner of finance 
 13.19  shall include provide an annual inflationary adjustment in 
 13.20  operating costs for nursing facilities using the inflation 
 13.21  factor specified in subdivision 3 and.  The commissioner of 
 13.22  finance shall include funding for incentive-based payments as a 
 13.23  budget change request in each biennial detailed expenditure 
 13.24  budget submitted to the legislature under section 16A.11.  
 13.25  Property related payment rates, including real estate taxes and 
 13.26  special assessments, shall be determined under section 256B.431 
 13.27  or 256B.434 or under a new property-related reimbursement 
 13.28  system, if one is implemented by the commissioner under 
 13.29  subdivision 3.  The commissioner shall present additional 
 13.30  recommendations for performance-based contracting for nursing 
 13.31  facilities to the legislature by February 15, 2000, in the 
 13.32  following specific areas: 
 13.33     (1) development of an interim default payment mechanism for 
 13.34  nursing facilities that do not respond to the state's request 
 13.35  for proposal but wish to continue participation in the medical 
 13.36  assistance program, and nursing facilities the state does not 
 14.1   select in the request for proposal process, and nursing 
 14.2   facilities whose contract has been canceled; 
 14.3      (2) development of criteria for facilities to earn 
 14.4   performance-based incentive payments based on relevant outcomes 
 14.5   negotiated by nursing facilities and the commissioner and that 
 14.6   recognize both continuous quality efforts and quality 
 14.7   improvement; 
 14.8      (3) development of criteria and a process under which 
 14.9   nursing facilities can request rate adjustments for low base 
 14.10  rates, geographic disparities, or other reasons; 
 14.11     (4) development of a dispute resolution mechanism for 
 14.12  nursing facilities that are denied a contract, denied incentive 
 14.13  payments, or denied a rate adjustment; 
 14.14     (5) development of a property payment system to address the 
 14.15  capital needs of nursing facilities that will be funded with 
 14.16  additional appropriations; 
 14.17     (6) establishment of a transitional plan to move from dual 
 14.18  assessment instruments to the federally mandated resident 
 14.19  assessment system, whereby the financial impact for each 
 14.20  facility would be budget neutral; 
 14.21     (7) identification of net cost implications for facilities 
 14.22  and to the department of preparing for and implementing 
 14.23  performance-based contracting or any proposed alternative 
 14.24  system; 
 14.25     (8) identification of facility financial and statistical 
 14.26  reporting requirements; and 
 14.27     (9) identification of exemptions from current regulations 
 14.28  and statutes applicable under performance-based contracting.  
 14.29     Sec. 7.  Minnesota Statutes 1999 Supplement, section 
 14.30  256B.435, subdivision 3, is amended to read: 
 14.31     Subd. 3.  [PAYMENT RATE PROVISIONS.] (a) For rate years 
 14.32  beginning on or after July 1, 2001, within the limits of 
 14.33  appropriations specifically for this purpose, the commissioner 
 14.34  shall determine operating cost payment rates for each licensed 
 14.35  and certified nursing facility by indexing its operating cost 
 14.36  payment rates in effect on June 30, 2001, for inflation.  For 
 15.1   rate years beginning on or after July 1, 2001, the inflation 
 15.2   factor must be based on the change in the Employment Cost Index 
 15.3   for Private Industry Workers - Total Compensation as forecasted 
 15.4   by the commissioner of finance's national economic consultant, 
 15.5   in the fourth quarter preceding the rate year.  The forecasted 
 15.6   index for operating cost payment rates shall be based on the 
 15.7   12-month period from the midpoint of the nursing facility's 
 15.8   prior rate year to the midpoint of the rate year for which the 
 15.9   operating payment rate is being determined.  The operating cost 
 15.10  payment rate to be inflated shall be the total payment rate in 
 15.11  effect on June 30, 2001, minus the portion determined to be the 
 15.12  property-related payment rate, minus the per diem amount of the 
 15.13  preadmission screening cost included in the nursing facility's 
 15.14  last payment rate established under section 256B.431. 
 15.15     (b) A per diem amount for preadmission screening will be 
 15.16  added onto the contract payment rates according to the method of 
 15.17  distribution of county allocation described in section 
 15.18  256B.0911, subdivision 6, paragraph (a). 
 15.19     (c) For rate years beginning on or after July 1, 2001, the 
 15.20  commissioner may implement a new method of payment for 
 15.21  property-related costs that addresses the capital needs of 
 15.22  facilities.  The new property payment system or systems, if 
 15.23  implemented, shall replace the current methods of setting 
 15.24  property payment rates under sections 256B.431 and 256B.434. 
 15.25     Sec. 8.  Minnesota Statutes 1998, section 256B.501, 
 15.26  subdivision 3c, is amended to read: 
 15.27     Subd. 3c.  [FORECASTED INDEX.] For rate years beginning on 
 15.28  or after October 1, 1990 2001, the commissioner shall index a 
 15.29  facility's allowable operating costs in the program, 
 15.30  maintenance, and administrative operating cost categories by 
 15.31  using Data Resources, Inc., the commissioner of finance's 
 15.32  national economic consultant's forecast for change in the 
 15.33  Consumer Price Index-All Items (U.S. city average) (CPI-U).  The 
 15.34  commissioner shall use the indices as forecasted by Data 
 15.35  Resources, Inc., the commissioner of finance's national economic 
 15.36  consultant in the first quarter of the calendar year in which 
 16.1   the rate year begins.  For fiscal years beginning after June 30, 
 16.2   1993 the period July 1, 1993, through September 30, 2001, the 
 16.3   commissioner shall not provide automatic inflation adjustments 
 16.4   for intermediate care facilities for persons with mental 
 16.5   retardation.  The commissioner of finance shall include annual 
 16.6   inflation adjustments in operating costs for intermediate care 
 16.7   facilities for persons with mental retardation and related 
 16.8   conditions as a budget change request in each biennial detailed 
 16.9   expenditure budget submitted to the legislature under section 
 16.10  16A.11.  The commissioner shall use the Consumer Price Index-All 
 16.11  Items (United States city average) (CPI-U) as forecasted by Data 
 16.12  Resources, Inc. the commissioner of finance's national economic 
 16.13  consultant, to take into account economic trends and conditions 
 16.14  for changes in facility allowable historical general operating 
 16.15  costs and limits.  The forecasted index shall be established for 
 16.16  allowable historical general operating costs as follows: 
 16.17     (1) the CPI-U forecasted index for allowable historical 
 16.18  general operating costs shall be determined in the first quarter 
 16.19  of the calendar year in which the rate year begins and shall be 
 16.20  based on the 21-month period from the midpoint of the facility's 
 16.21  reporting year to the midpoint of the rate year following the 
 16.22  reporting year; and 
 16.23     (2) for rate years beginning on or after October 1, 1995, 
 16.24  the CPI-U forecasted index for the overall operating cost limits 
 16.25  and for the individual compensation limit shall be determined in 
 16.26  the first quarter of the calendar year in which the rate year 
 16.27  begins and shall be based on the 12-month period between the 
 16.28  midpoints of the two reporting years preceding the rate year. 
 16.29     Sec. 9.  Minnesota Statutes 1998, section 256B.501, is 
 16.30  amended by adding a subdivision to read: 
 16.31     Subd. 13.  [ICF/MR RATE INCREASES BEGINNING OCTOBER 1, 
 16.32  1999, AND OCTOBER 1, 2000.] (a) For the rate years beginning 
 16.33  October 1, 1999, and October 1, 2000, the commissioner shall 
 16.34  make available to each facility reimbursed under this section, 
 16.35  section 256B.5011, and Laws 1993, First Special Session chapter 
 16.36  1, article 4, section 11, an adjustment to the total operating 
 17.1   payment rate.  For each facility, total operating costs shall be 
 17.2   separated into costs that are compensation and salary related, 
 17.3   and all other costs.  "Compensation-related costs" means the 
 17.4   facility's allowable program operating cost category employee 
 17.5   training expenses, and the facility's allowable salaries, 
 17.6   payroll taxes, and fringe benefits.  "Salary-related costs" 
 17.7   means the facility's allowable salaries and payroll taxes.  The 
 17.8   terms do not include the same compensation and salary-related 
 17.9   costs for both administrative or central office employees. 
 17.10     For the purpose of determining the adjustment to be granted 
 17.11  under this subdivision, the commissioner must use the most 
 17.12  recent cost report that has been subject to desk audit. 
 17.13     (b) For the rate year beginning October 1, 1999, the 
 17.14  commissioner shall make available a rate increase for 
 17.15  compensation-related costs of 4.6 percent and a rate increase 
 17.16  for all other operating costs of 3.2 percent. 
 17.17     (c) For the rate year beginning October 1, 2000, the 
 17.18  commissioner shall make available a rate increase for 
 17.19  compensation-related costs of 3.6 percent, a rate increase for 
 17.20  salary-related costs of five percent, and a rate increase for 
 17.21  all other operating costs of two percent. 
 17.22     (d) For each facility, the commissioner shall determine the 
 17.23  payment rate adjustment using the categories specified in 
 17.24  paragraph (a) multiplied by the rate increases specified in 
 17.25  paragraph (b) or (c), and then dividing the resulting amount by 
 17.26  the nursing facility's actual resident days. 
 17.27     (e) Any facility whose payment rates are governed by 
 17.28  closure agreements, receivership agreements, or Minnesota Rules, 
 17.29  part 9553.0075, are not eligible for an adjustment otherwise 
 17.30  granted under this subdivision. 
 17.31     (f) A facility may apply for the compensation-related and 
 17.32  salary-related payment rate adjustments calculated under this 
 17.33  subdivision.  The application must be made to the commissioner 
 17.34  and contain a plan by which the facility will distribute the 
 17.35  compensation-related and salary-related portions of the payment 
 17.36  rate adjustment to employees of the facility.  For facilities in 
 18.1   which the employees are represented by an exclusive bargaining 
 18.2   representative, an agreement negotiated and agreed to by the 
 18.3   employer and the exclusive bargaining representative constitutes 
 18.4   the plan.  The commissioner shall review the plan to ensure that 
 18.5   the payment rate adjustment per diem is used as provided in this 
 18.6   subdivision.  To be eligible, a facility must submit its plan 
 18.7   for the compensation distribution by December 31 each year.  A 
 18.8   facility may amend its plan for the second rate year by 
 18.9   submitting a revised plan by December 31, 2000.  If a facility's 
 18.10  plan for compensation and salary distribution is effective for 
 18.11  its employees after October 1 of the year the funds are 
 18.12  available, the payment rate adjustment per diem shall be 
 18.13  effective the same date as its plan. 
 18.14     (g) A copy of the approved distribution plan must be made 
 18.15  available to all employees.  This must be done by giving each 
 18.16  employee a copy or by posting it in an area of the nursing 
 18.17  facility to which all employees have access.  If an employee 
 18.18  does not receive the compensation and salary adjustments 
 18.19  described in their facility's approved plan and is unable to 
 18.20  resolve the problem with the facility's management or through 
 18.21  the employee's union representative, the employee may contact 
 18.22  the commissioner at an address or telephone number provided by 
 18.23  the commissioner and included in the approved plan. 
 18.24     Sec. 10.  Laws 1999, chapter 245, article 1, section 2, 
 18.25  subdivision 8, is amended to read: 
 18.26  Subd. 8.  Continuing Care and 
 18.27  Community Support Grants
 18.28  General           1,174,195,000 1,259,767,000
 18.29  Lottery Prize         1,158,000     1,158,000
 18.30  The amounts that may be spent from this 
 18.31  appropriation for each purpose are as 
 18.32  follows: 
 18.33  (a) Community Social Services
 18.34  Block Grants
 18.35      42,597,000     43,498,000 
 18.36  [CSSA TRADITIONAL APPROPRIATION.] 
 18.37  Notwithstanding Minnesota Statutes, 
 18.38  section 256E.06, subdivisions 1 and 2, 
 18.39  the appropriations available under that 
 18.40  section in fiscal years 2000 and 2001 
 19.1   must be distributed to each county 
 19.2   proportionately to the aid received by 
 19.3   the county in calendar year 1998.  The 
 19.4   commissioner, in consultation with 
 19.5   counties, shall study the formula 
 19.6   limitations in subdivision 2 of that 
 19.7   section, and report findings and any 
 19.8   recommendations for revision of the 
 19.9   CSSA formula and its formula limitation 
 19.10  provisions to the legislature by 
 19.11  January 15, 2000. 
 19.12  (b) Consumer Support Grants
 19.13       1,123,000      1,123,000 
 19.14  (c) Aging Adult Service Grants
 19.15       7,965,000      7,765,000 
 19.16  [LIVING-AT-HOME/BLOCK NURSE PROGRAM.] 
 19.17  Of the general fund appropriation, 
 19.18  $120,000 in fiscal year 2000 and 
 19.19  $120,000 in fiscal year 2001 is for the 
 19.20  commissioner to provide funding to six 
 19.21  additional living-at-home/block nurse 
 19.22  programs.  This appropriation shall 
 19.23  become part of the base for the 
 19.24  2002-2003 biennium. 
 19.25  [MINNESOTA SENIOR SERVICE CORPS.] Of 
 19.26  this appropriation, $160,000 for the 
 19.27  biennium is from the general fund to 
 19.28  the commissioner for the following 
 19.29  purposes: 
 19.30  (a) $40,000 in fiscal year 2000 and 
 19.31  $40,000 in fiscal year 2001 is to 
 19.32  increase the hourly stipend by ten 
 19.33  cents per hour in the foster 
 19.34  grandparent program, the retired and 
 19.35  senior volunteer program, and the 
 19.36  senior companion program. 
 19.37  (b) $40,000 in fiscal year 2000 and 
 19.38  $40,000 in fiscal year 2001 is for a 
 19.39  grant to the tri-valley opportunity 
 19.40  council in Crookston to expand services 
 19.41  in the ten-county area of northwestern 
 19.42  Minnesota. 
 19.43  (c) This appropriation shall become 
 19.44  part of the base for the 2002-2003 
 19.45  biennium.
 19.46  [HEALTH INSURANCE COUNSELING.] Of this 
 19.47  appropriation, $100,000 in fiscal year 
 19.48  2000 and $100,000 in fiscal year 2001 
 19.49  is from the general fund to the 
 19.50  commissioner to transfer to the board 
 19.51  on aging for the purpose of awarding 
 19.52  health insurance counseling and 
 19.53  assistance grants to the area agencies 
 19.54  on aging providing state-funded health 
 19.55  insurance counseling services.  Access 
 19.56  to health insurance counseling programs 
 19.57  shall be provided by the senior linkage 
 19.58  line service of the board on aging and 
 19.59  the area agencies on aging. The board 
 19.60  on aging shall explore opportunities 
 19.61  for obtaining alternative funding from 
 20.1   nonstate sources, including 
 20.2   contributions from individuals seeking 
 20.3   health insurance counseling services.  
 20.4   This is a one-time appropriation and 
 20.5   shall not become part of base level 
 20.6   funding for this activity for the 
 20.7   2002-2003 biennium. 
 20.8   (d) Deaf and Hard-of-Hearing 
 20.9   Services Grants
 20.10       1,859,000      1,760,000 
 20.11  [SERVICES TO DEAF PERSONS WITH MENTAL 
 20.12  ILLNESS.] Of this appropriation, 
 20.13  $100,000 each year is to the 
 20.14  commissioner for a grant to a nonprofit 
 20.15  agency that currently serves deaf and 
 20.16  hard-of-hearing adults with mental 
 20.17  illness through residential programs 
 20.18  and supported housing outreach.  The 
 20.19  grant must be used to operate a 
 20.20  community support program for persons 
 20.21  with mental illness that is 
 20.22  communicatively accessible for persons 
 20.23  who are deaf or hard-of-hearing.  This 
 20.24  is a one-time appropriation and shall 
 20.25  not become part of base level funding 
 20.26  for this activity for the 2002-2003 
 20.27  biennium. 
 20.28  [DEAF-BLIND ORIENTATION AND MOBILITY 
 20.29  SERVICES.] Of this appropriation, 
 20.30  $120,000 for the biennium is to the 
 20.31  commissioner for a grant to DeafBlind 
 20.32  Services Minnesota to hire an 
 20.33  orientation and mobility specialist to 
 20.34  work with deaf-blind people.  The 
 20.35  specialist will provide services to 
 20.36  deaf-blind Minnesotans, and training to 
 20.37  teachers and rehabilitation counselors, 
 20.38  on a statewide basis.  This is a 
 20.39  one-time appropriation and shall not 
 20.40  become part of base level funding for 
 20.41  this activity for the 2002-2003 
 20.42  biennium. 
 20.43  (e) Mental Health Grants
 20.44  General          45,169,000     46,528,000 
 20.45  Lottery Prize     1,158,000      1,158,000 
 20.46  [CRISIS HOUSING.] Of the general fund 
 20.47  appropriation, $126,000 in fiscal year 
 20.48  2000 and $150,000 in fiscal year 2001 
 20.49  is to the commissioner for the adult 
 20.50  mental illness crisis housing 
 20.51  assistance program under Minnesota 
 20.52  Statutes, section 245.99.  This 
 20.53  appropriation shall become part of the 
 20.54  base for the 2002-2003 biennium. 
 20.55  [ADOLESCENT COMPULSIVE GAMBLING GRANT.] 
 20.56  $150,000 in fiscal year 2000 and 
 20.57  $150,000 in fiscal year 2001 is 
 20.58  appropriated from the lottery prize 
 20.59  fund created under Minnesota Statutes, 
 20.60  section 349A.10, subdivision 2, to the 
 20.61  commissioner for the purposes of a 
 20.62  grant to a compulsive gambling council 
 21.1   located in St. Louis county for a 
 21.2   statewide compulsive gambling 
 21.3   prevention and education project for 
 21.4   adolescents. 
 21.5   (f) Developmental Disabilities
 21.6   Community Support Grants
 21.7      9,323,000     10,958,000 
 21.8   [CRISIS INTERVENTION PROJECT.] Of this 
 21.9   appropriation, $40,000 in fiscal year 
 21.10  2000 is to the commissioner for the 
 21.11  action, support, and prevention project 
 21.12  of southeastern Minnesota. 
 21.13  [SILS FUNDING.] Of this appropriation, 
 21.14  $1,000,000 each year is for 
 21.15  semi-independent living services under 
 21.16  Minnesota Statutes, section 252.275. 
 21.17  This appropriation must be added to the 
 21.18  base level funding for this activity 
 21.19  for the 2002-2003 biennium.  Unexpended 
 21.20  funds for fiscal year 2000 do not 
 21.21  cancel but are available to the 
 21.22  commissioner for this purpose in fiscal 
 21.23  year 2001. 
 21.24  [FAMILY SUPPORT GRANTS.] Of this 
 21.25  appropriation, $1,000,000 in fiscal 
 21.26  year 2000 and $2,500,000 in fiscal year 
 21.27  2001 is to increase the availability of 
 21.28  family support grants under Minnesota 
 21.29  Statutes, section 252.32.  This 
 21.30  appropriation must be added to the base 
 21.31  level funding for this activity for the 
 21.32  2002-2003 biennium.  Unexpended funds 
 21.33  for fiscal year 2000 do not cancel but 
 21.34  are available to the commissioner for 
 21.35  this purpose in fiscal year 2001. 
 21.36  (g) Medical Assistance Long-Term 
 21.37  Care Waivers and Home Care
 21.38     349,052,000    414,240,000 
 21.39  [PROVIDER RATE INCREASES.] (a) The 
 21.40  commissioner shall increase 
 21.41  reimbursement rates by four percent the 
 21.42  first year of the biennium and by three 
 21.43  percent the second year for the 
 21.44  providers listed in paragraph (b).  The 
 21.45  increases shall be effective for 
 21.46  services rendered on or after July 1 of 
 21.47  each year. 
 21.48  (b) The rate increases described in 
 21.49  this section shall be provided to home 
 21.50  and community-based waivered services 
 21.51  for persons with mental retardation or 
 21.52  related conditions under Minnesota 
 21.53  Statutes, section 256B.501; home and 
 21.54  community-based waivered services for 
 21.55  the elderly under Minnesota Statutes, 
 21.56  section 256B.0915; waivered services 
 21.57  under community alternatives for 
 21.58  disabled individuals under Minnesota 
 21.59  Statutes, section 256B.49; community 
 21.60  alternative care waivered services 
 21.61  under Minnesota Statutes, section 
 21.62  256B.49; traumatic brain injury 
 22.1   waivered services under Minnesota 
 22.2   Statutes, section 256B.49; nursing 
 22.3   services and home health services under 
 22.4   Minnesota Statutes, section 256B.0625, 
 22.5   subdivision 6a; personal care services 
 22.6   and nursing supervision of personal 
 22.7   care services under Minnesota Statutes, 
 22.8   section 256B.0625, subdivision 19a; 
 22.9   private-duty nursing services under 
 22.10  Minnesota Statutes, section 256B.0625, 
 22.11  subdivision 7; day training and 
 22.12  habilitation services for adults with 
 22.13  mental retardation or related 
 22.14  conditions under Minnesota Statutes, 
 22.15  sections 252.40 to 252.46; alternative 
 22.16  care services under Minnesota Statutes, 
 22.17  section 256B.0913; adult residential 
 22.18  program grants under Minnesota Rules, 
 22.19  parts 9535.2000 to 9535.3000; adult and 
 22.20  family community support grants under 
 22.21  Minnesota Rules, parts 9535.1700 to 
 22.22  9535.1760; semi-independent living 
 22.23  services under Minnesota Statutes, 
 22.24  section 252.275, including SILS funding 
 22.25  under county social services grants 
 22.26  formerly funded under Minnesota 
 22.27  Statutes, chapter 256I; and community 
 22.28  support services for deaf and 
 22.29  hard-of-hearing adults with mental 
 22.30  illness who use or wish to use sign 
 22.31  language as their primary means of 
 22.32  communication. 
 22.33  (c) The commissioner shall increase 
 22.34  reimbursement rates by two percent for 
 22.35  the group residential housing 
 22.36  supplementary service rate under 
 22.37  Minnesota Statutes, section 256I.05, 
 22.38  subdivision 1a, for services rendered 
 22.39  on or after January 1, 2000. 
 22.40  (d) The commissioner shall increase 
 22.41  reimbursement rates in effect on June 
 22.42  30, 2000, by an additional five percent 
 22.43  the second year for providers listed in 
 22.44  paragraph (b).  This increase is in 
 22.45  addition to the increase provided in 
 22.46  paragraph (a) and shall be effective 
 22.47  for services rendered on or after July 
 22.48  1, 2000.  Providers that receive a rate 
 22.49  increase under this paragraph shall use 
 22.50  all of the additional revenue resulting 
 22.51  from the increase under this paragraph 
 22.52  to increase the wages paid to employees 
 22.53  other than the administrator and 
 22.54  central office staff, and to pay for 
 22.55  related payroll taxes. 
 22.56  (e) Providers that receive a rate 
 22.57  increase under this section paragraph 
 22.58  (a) or (c) shall use at least 80 
 22.59  percent of the additional revenue to 
 22.60  increase the compensation paid to 
 22.61  employees other than the administrator 
 22.62  and central office staff. 
 22.63  (e) (f) A copy of the provider's plan 
 22.64  for complying with paragraph 
 22.65  paragraphs (d) and (e) must be made 
 22.66  available to all employees.  This must 
 22.67  be done by giving each employee a copy 
 23.1   or by posting it in an area of the 
 23.2   provider's operation to which all 
 23.3   employees have access.  If an employee 
 23.4   does not receive the salary adjustment 
 23.5   described in the plan and is unable to 
 23.6   resolve the problem with the provider, 
 23.7   the employee may contact the employee's 
 23.8   union representative.  If the employee 
 23.9   is not covered by a collective 
 23.10  bargaining agreement, the employee may 
 23.11  contact the commissioner at a phone 
 23.12  number provided by the commissioner and 
 23.13  included in the provider's plan. 
 23.14  (f) (g) Section 13, sunset of 
 23.15  uncodified language, does not apply to 
 23.16  this provision. 
 23.17  [DEVELOPMENTAL DISABILITIES WAIVER 
 23.18  SLOTS.] Of this appropriation, 
 23.19  $1,746,000 in fiscal year 2000 and 
 23.20  $4,683,000 in fiscal year 2001 is to 
 23.21  increase the availability of home and 
 23.22  community-based waiver services for 
 23.23  persons with mental retardation or 
 23.24  related conditions.  
 23.25  (h) Medical Assistance Long-Term
 23.26  Care Facilities
 23.27     546,228,000    558,349,000 
 23.28  [MORATORIUM EXCEPTIONS.] Of this 
 23.29  appropriation, $250,000 in fiscal year 
 23.30  2000 and $250,000 in fiscal year 2001 
 23.31  is from the general fund to the 
 23.32  commissioner for the medical assistance 
 23.33  costs of moratorium exceptions approved 
 23.34  by the commissioner of health under 
 23.35  Minnesota Statutes, section 144A.073.  
 23.36  Unexpended money appropriated for 
 23.37  fiscal year 2000 shall not cancel but 
 23.38  shall be available for fiscal year 2001.
 23.39  [NURSING FACILITY OPERATED BY THE RED 
 23.40  LAKE BAND OF CHIPPEWA INDIANS.] (1) The 
 23.41  medical assistance payment rates for 
 23.42  the 47-bed nursing facility operated by 
 23.43  the Red Lake Band of Chippewa Indians 
 23.44  must be calculated according to 
 23.45  allowable reimbursement costs under the 
 23.46  medical assistance program, as 
 23.47  specified in Minnesota Statutes, 
 23.48  section 246.50, and are subject to the 
 23.49  facility-specific Medicare upper limits.
 23.50  (2) In addition, the commissioner shall 
 23.51  make available an operating payment 
 23.52  rate adjustment effective July 1, 1999, 
 23.53  and July 1, 2000, that is equal to the 
 23.54  adjustment provided under Minnesota 
 23.55  Statutes, section 256B.431, subdivision 
 23.56  28.  The commissioner must use the 
 23.57  facility's final 1998 and 1999 Medicare 
 23.58  cost reports, respectively, to 
 23.59  calculate the adjustment.  The 
 23.60  adjustment shall be available based on 
 23.61  a plan submitted and approved according 
 23.62  to Minnesota Statutes, section 
 23.63  256B.431, subdivision 28.  Section 13, 
 23.64  sunset of uncodified language, does not 
 24.1   apply to this paragraph. 
 24.2   [ICF/MR DISALLOWANCES.] Of this 
 24.3   appropriation, $65,000 in fiscal 2000 
 24.4   is to reimburse a four-bed ICF/MR in 
 24.5   Ramsey county for disallowances 
 24.6   resulting from field audit findings.  
 24.7   This is a one-time appropriation and 
 24.8   shall not become part of base level 
 24.9   funding for this activity for the 
 24.10  2002-2003 biennium.* (The preceding 
 24.11  text beginning "ICF/MR DISALLOWANCES." 
 24.12  was vetoed by the governor.) 
 24.13  [COSTS RELATED TO FACILITY 
 24.14  CERTIFICATION.] Of this appropriation, 
 24.15  $168,000 is for the costs of providing 
 24.16  one-half the state share of medical 
 24.17  assistance reimbursement for 
 24.18  residential and day habilitation 
 24.19  services under article 3, section 39.  
 24.20  This amount is available the day 
 24.21  following final enactment. 
 24.22  (i) Alternative Care Grants  
 24.23  General              60,873,000    59,981,000
 24.24  [ALTERNATIVE CARE TRANSFER.] Any money 
 24.25  allocated to the alternative care 
 24.26  program that is not spent for the 
 24.27  purposes indicated does not cancel but 
 24.28  shall be transferred to the medical 
 24.29  assistance account. 
 24.30  [PREADMISSION SCREENING AMOUNT.] The 
 24.31  preadmission screening payment to all 
 24.32  counties shall continue at the payment 
 24.33  amount in effect for fiscal year 1999. 
 24.34  [ALTERNATIVE CARE APPROPRIATION.] The 
 24.35  commissioner may expend the money 
 24.36  appropriated for the alternative care 
 24.37  program for that purpose in either year 
 24.38  of the biennium. 
 24.39  (j) Group Residential Housing
 24.40  General              66,477,000    70,390,000
 24.41  [GROUP RESIDENTIAL FACILITY FOR WOMEN 
 24.42  IN RAMSEY COUNTY.] (a) Notwithstanding 
 24.43  Minnesota Statutes 1998, section 
 24.44  256I.05, subdivision 1d, the new 23-bed 
 24.45  group residential facility for women in 
 24.46  Ramsey county, with approval by the 
 24.47  county agency, may negotiate a 
 24.48  supplementary service rate in addition 
 24.49  to the board and lodging rate for 
 24.50  facilities licensed and registered by 
 24.51  the Minnesota department of health 
 24.52  under Minnesota Statutes, section 
 24.53  15.17.  The supplementary service rate 
 24.54  shall not exceed $564 per person per 
 24.55  month and the total rate may not exceed 
 24.56  $1,177 per person per month. 
 24.57  (b) Of the general fund appropriation, 
 24.58  $19,000 in fiscal year 2000 and $38,000 
 24.59  in fiscal year 2001 is to the 
 24.60  commissioner for the costs associated 
 25.1   with paragraph (a).  This appropriation 
 25.2   shall become part of the base for the 
 25.3   2002-2003 biennium. 
 25.4   (k) Chemical Dependency
 25.5   Entitlement Grants
 25.6   General              36,751,000    38,847,000
 25.7   (l) Chemical Dependency 
 25.8   Nonentitlement Grants
 25.9   General               6,778,000     6,328,000
 25.10  [CHEMICAL DEPENDENCY SERVICES.] Of this 
 25.11  appropriation, $450,000 in fiscal year 
 25.12  2000 is to the commissioner for 
 25.13  chemical dependency services to persons 
 25.14  who qualify under Minnesota Statutes, 
 25.15  section 254B.04, subdivision 1, 
 25.16  paragraph (b). 
 25.17  [REPEAT DWI OFFENDER PROGRAM.] Of this 
 25.18  appropriation, $100,000 in fiscal year 
 25.19  2000 and $100,000 in fiscal year 2001 
 25.20  is for the commissioner to pay for 
 25.21  chemical dependency treatment for 
 25.22  repeat DWI offenders at Brainerd 
 25.23  regional human services center.  
 25.24  Payment to the Brainerd regional human 
 25.25  services center may only be authorized 
 25.26  from this appropriation after all 
 25.27  potential public and private 
 25.28  third-party payers have been billed and 
 25.29  a determination made that the offender 
 25.30  is not eligible for reimbursement of 
 25.31  the treatment costs.  This 
 25.32  appropriation shall not become part of 
 25.33  the base for the 2002-2003 biennium.* 
 25.34  (The preceding text beginning "REPEAT 
 25.35  DWI OFFENDER PROGRAM." was vetoed by 
 25.36  the governor.)