HF 2993

as introduced - 90th Legislature (2017 - 2018) Posted on 02/26/2018 04:00pm

A bill for an act
relating to human services; permitting the provision of limited personal care
assistance services to individuals receiving acute care in a hospital or outpatient
surgical center; amending Minnesota Statutes 2016, sections 256B.0625,
subdivision 19a; 256B.0651, subdivision 3; 256B.0659, subdivision 7, by adding
a subdivision.

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

Section 1.

Minnesota Statutes 2016, section 256B.0625, subdivision 19a, is amended to
read:

Subd. 19a.

Personal care assistance services.

Medical assistance covers personal care
assistance services in a recipient's home. Effective January 1, 2010, to qualify for personal
care assistance services, a recipient must require assistance and be determined dependent
in one activity of daily living as defined in section 256B.0659, subdivision 1, paragraph
(b), or in a Level I behavior as defined in section 256B.0659, subdivision 1, paragraph (c).
Recipients or responsible parties must be able to identify the recipient's needs, direct and
evaluate task accomplishment, and provide for health and safety. Approved hours may be
used outside the home when normal life activities take them outside the home. To use
personal care assistance services at school, the recipient or responsible party must provide
written authorization in the care plan identifying the chosen provider and the daily amount
of services to be used at school. Total hours for services, whether actually performed inside
or outside the recipient's home, cannot exceed that which is otherwise allowed for personal
care assistance services in an in-home setting according to sections 256B.0651 to 256B.0654.
Medical assistance does not cover personal care assistance services for residents of a hospital,
nursing facility, intermediate care facility, health care facility licensed by the commissioner
of health, new text begin except as authorized under section 256B.0659, subdivision 2a, new text end or unless a resident
who is otherwise eligible is on leave from the facility and the facility either pays for the
personal care assistance services or forgoes the facility per diem for the leave days that
personal care assistance services are used. All personal care assistance services must be
provided according to sections 256B.0651 to 256B.0654. Personal care assistance services
may not be reimbursed if the personal care assistant is the spouse or paid guardian of the
recipient or the parent of a recipient under age 18, or the responsible party or the family
foster care provider of a recipient who cannot direct the recipient's own care unless, in the
case of a foster care provider, a county or state case manager visits the recipient as needed,
but not less than every six months, to monitor the health and safety of the recipient and to
ensure the goals of the care plan are met. Notwithstanding the provisions of section
256B.0659, the unpaid guardian or conservator of an adult, who is not the responsible party
and not the personal care provider organization, may be reimbursed to provide personal
care assistance services to the recipient if the guardian or conservator meets all criteria for
a personal care assistant according to section 256B.0659, and shall not be considered to
have a service provider interest for purposes of participation on the screening team under
section 256B.092, subdivision 7.

Sec. 2.

Minnesota Statutes 2016, section 256B.0651, subdivision 3, is amended to read:

Subd. 3.

Noncovered home care services.

The following home care services are not
eligible for payment under medical assistance:

(1) services provided in a nursing facility, hospital, or intermediate care facility with
exceptions in deleted text begin section deleted text end new text begin sections new text end 256B.0653 new text begin and 256B.0659, subdivision 2a new text end ;

(2) services for the sole purpose of monitoring medication compliance with an established
medication program for a recipient;

(3) home care services for covered services under the Medicare program or any other
insurance held by the recipient;

(4) services to other members of the recipient's household;

(5) any home care service included in the daily rate of the community-based residential
facility where the recipient is residing;

(6) nursing and rehabilitation therapy services that are reasonably accessible to a recipient
outside the recipient's place of residence, excluding the assessment, counseling and education,
and personal assistance care; or

(7) Medicare evaluation or administrative nursing visits on dual-eligible recipients that
do not qualify for Medicare visit billing.

Sec. 3.

Minnesota Statutes 2016, section 256B.0659, is amended by adding a subdivision
to read:

new text begin Subd. 2a. new text end

new text begin Personal care assistance services; services covered in hospitals. new text end

new text begin (a)
Authorized personal care assistance hours may be used to provide the limited personal care
assistance services described in this subdivision to a person who is receiving acute care in
a hospital or outpatient surgical center and who qualified as having a need for assistance
due to behaviors under subdivision 4, paragraph (d). To use personal care assistance services
in a hospital or outpatient surgical center, the person's personal care assistance care plan
described under subdivision 7 must specify which permitted services the person shall receive
while receiving care in the hospital or outpatient surgical center. The total hours for personal
care assistance services provided, no matter where the services are provided, may not exceed
the number of hours that are otherwise allowed for personal care assistance services in an
in-home setting according to sections 256B.0651 to 256B.0654.
new text end

new text begin (b) Notwithstanding subdivision 2, a personal care assistant providing services to a
person receiving acute care in a hospital or outpatient surgical center may only assist in the
observation and redirection of behaviors and grooming. The personal care assistant may
offer nonbinding advice to the health care professionals in charge of the patient's care and
treatment on matters pertaining to the comfort and safety of the patient.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval. The commissioner
of human services shall inform the revisor of statutes when approval is granted or rejected.
new text end

Sec. 4.

Minnesota Statutes 2016, section 256B.0659, subdivision 7, is amended to read:

Subd. 7.

Personal care assistance care plan.

(a) Each recipient must have a current
personal care assistance care plan based on the service plan in subdivision 6 that is developed
by the qualified professional with the recipient and responsible party. A copy of the most
current personal care assistance care plan is required to be in the recipient's home and in
the recipient's file at the provider agency. new text begin The month-to-month plan for the use of personal
care assistance services is part of the personal care assistance care plan. The personal care
assistance care plan must be completed within the first week after the start of services with
a personal care provider agency and must be updated as needed when there is a change in
the need for personal care assistance services. A new personal care assistance care plan is
required annually at the time of the reassessment.
new text end

(b) The personal care assistance care plan must have the following components:

(1) start and end date of the care plan;

(2) recipient demographic information, including name and telephone number;

(3) emergency numbers, procedures, and a description of measures to address identified
safety and vulnerability issues, including a backup staffing plan;

(4) name of responsible party and instructions for contact;

(5) description of the recipient's individualized needs for assistance with activities of
daily living, instrumental activities of daily living, health-related tasks, and behaviors; deleted text begin and
deleted text end

(6) new text begin if the recipient qualifies under subdivision 2a for personal care assistance services
provided in a hospital or outpatient surgical center, a description of the recipient's
individualized needs for assistance in the event that the recipient is receiving acute care in
a hospital or outpatient surgical center; and
new text end

new text begin (7) new text end dated signatures of recipient or responsible party and qualified professional.

(c) The personal care assistance care plan must have instructions and comments about
the recipient's needs for assistance and any special instructions or procedures required,
including whether or not the recipient has requested a personal care assistant of the same
gender. deleted text begin The month-to-month plan for the use of personal care assistance services is part of
the personal care assistance care plan. The personal care assistance care plan must be
completed within the first week after start of services with a personal care provider agency
and must be updated as needed when there is a change in need for personal care assistance
services. A new personal care assistance care plan is required annually at the time of the
reassessment.
deleted text end