HF 3819

as introduced - 86th Legislature (2009 - 2010) Posted on 05/03/2010 11:04am

A bill for an act
relating to state government finance; appropriating money to the Department
of Human Services contingent upon federal enactment of an extension of the
enhanced federal medical assistance percentage; amending Minnesota Statutes
2008, sections 254B.03, by adding a subdivision; 256B.0625, subdivision 22;
256B.19, subdivision 1c; 256L.15, subdivision 1; Minnesota Statutes 2009
Supplement, sections 144.0724, subdivision 11; 256B.0911, subdivision 1a;
Laws 2005, First Special Session chapter 4, article 8, section 66, as amended;
Laws 2009, chapter 79, article 5, sections 17; 18; 22; Laws 2009, chapter 173,
article 1, section 17.

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

Section 1. new text begin SUMMARY OF HUMAN SERVICES APPROPRIATIONS. new text end

new text begin The amounts shown in this section summarize direct appropriations, by fund, made
in this bill.
new text end

		new text begin 2010 new text end		new text begin 2011 new text end		new text begin Total new text end
new text begin General new text end	new text begin $ new text end	new text begin -0- new text end	new text begin $ new text end	new text begin 13,383,000 new text end	new text begin $ new text end	new text begin 13,383,000 new text end
new text begin Health Care Access new text end		new text begin -0- new text end		new text begin 686,000 new text end		new text begin 686,000 new text end
new text begin Total new text end	new text begin $ new text end	new text begin -0- new text end	new text begin $ new text end	new text begin 14,069,000 new text end	new text begin $ new text end	new text begin 14,069,000 new text end

Sec. 2. new text begin HEALTH AND HUMAN SERVICES CONTINGENT APPROPRIATIONS. new text end

new text begin (a) The sums shown in the columns marked "Appropriations" are added to the
appropriations in Laws 2009, chapter 79, article 13, as amended by Laws 2009, chapter
173, article 2, to the agency and for the purposes specified in this bill. The appropriations
are from the general fund, or another named fund, and are available for the fiscal years
indicated for each purpose. The figures "2010" and "2011" used in this bill mean that the
addition to or subtraction from the appropriation listed under them is available for the
fiscal year ending June 30, 2010, or June 30, 2011, respectively.
new text end

new text begin (b) Upon enactment of the extension of the enhanced federal medical assistance
percentage (FMAP) under Public Law 111-5 to June 30, 2011, that is contained in the
president's budget for federal fiscal year 2011 or contained in House Resolution 2847,
the federal "Jobs for Main Street Act, 2010," or contained in House Resolution 4213,
"American Workers, State, and Business Relief Act of 2010," or subsequent federal
legislation, the appropriations identified in section 3 shall be made for fiscal year 2011.
new text end

			new text begin APPROPRIATIONS new text end
			new text begin Available for the Year new text end
			new text begin Ending June 30 new text end
				new text begin 2010 new text end		new text begin 2011 new text end

Sec. 3. new text begin COMMISSIONER OF HUMAN SERVICES new text end

new text begin Subdivision 1. new text end new text begin Total Appropriation new text end

new text begin $ new text end

new text begin -0- new text end

new text begin $ new text end

new text begin 14,069,000 new text end

new text begin Appropriations by Fund new text end
	new text begin 2010 new text end	new text begin 2011 new text end
new text begin General new text end	new text begin -0- new text end	new text begin 13,383,000 new text end
new text begin Health Care Access new text end	new text begin -0- new text end	new text begin 686,000 new text end

new text begin The appropriations for each purpose are
shown in the following subdivisions.
new text end

new text begin Subd. 2. new text end new text begin Basic Health Care Grants new text end

new text begin (a) MinnesotaCare Grants new text end

new text begin -0- new text end

new text begin 686,000 new text end

new text begin This appropriation is from the health care
access fund.
new text end

new text begin (b) Medical Assistance Basic Health Care Grants - Families and Children new text end

new text begin -0- new text end

new text begin 6,297,000 new text end

new text begin (c) Medical Assistance Basic Health Care Grants - Elderly and Disabled new text end

new text begin -0- new text end

new text begin 3,697,000 new text end

new text begin Subd. 3. new text end new text begin Continuing Care Grants new text end

new text begin (a) Medical Assistance - Long-Term Care Facilities Grants new text end

new text begin -0- new text end

new text begin 2,486,000 new text end

new text begin (b) Medical Assistance Grants - Long-Term Care Waivers and Home Care Grants new text end

new text begin -0- new text end

new text begin 547,000 new text end

new text begin (c) Chemical Dependency Entitlement Grants new text end

new text begin -0- new text end

new text begin 356,000 new text end

Sec. 4.

Minnesota Statutes 2009 Supplement, section 144.0724, subdivision 11,
is amended to read:

Subd. 11.

Nursing facility level of care.

(a) For purposes of medical assistance
payment of long-term care services, a recipient must be determined, using assessments
defined in subdivision 4, to meet one of the following nursing facility level of care criteria:

(1) the person needs the assistance of another person or constant supervision to begin
and complete at least four of the following activities of living: bathing, bed mobility,
dressing, eating, grooming, toileting, transferring, and walking;

(2) the person needs the assistance of another person or constant supervision to begin
and complete toileting, transferring, or positioning and the assistance cannot be scheduled;

(3) the person has significant difficulty with memory, using information, daily
decision making, or behavioral needs that require intervention;

(4) the person has had a qualifying nursing facility stay of at least 90 days; or

(5) the person is determined to be at risk for nursing facility admission or
readmission through a face-to-face long-term care consultation assessment as specified
in section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care
organization under contract with the Department of Human Services. The person is
considered at risk under this clause if the person currently lives alone or will live alone
upon discharge and also meets one of the following criteria:

(i) the person has experienced a fall resulting in a fracture;

(ii) the person has been determined to be at risk of maltreatment or neglect,
including self-neglect; or

(iii) the person has a sensory impairment that substantially impacts functional ability
and maintenance of a community residence.

(b) The assessment used to establish medical assistance payment for nursing facility
services must be the most recent assessment performed under subdivision 4, paragraph
(b), that occurred no more than 90 calendar days before the effective date of medical
assistance eligibility for payment of long-term care services. In no case shall medical
assistance payment for long-term care services occur prior to the date of the determination
of nursing facility level of care.

(c) The assessment used to establish medical assistance payment for long-term care
services provided under sections 256B.0915 and 256B.49 and alternative care payment
for services provided under section 256B.0913 must be the most recent face-to-face
assessment performed under section 256B.0911, subdivision 3a, 3b, or 4d, that occurred
no more than 60 calendar days before the effective date of medical assistance eligibility
for payment of long-term care services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2011.
new text end

Sec. 5.

Minnesota Statutes 2008, section 254B.03, is amended by adding a subdivision
to read:

new text begin Subd. 4a. new text end

new text begin Division of costs for medical assistance services. new text end

new text begin Notwithstanding
subdivision 4, for chemical dependency services provided on or after October 1, 2008, and
reimbursed by medical assistance, the county share is 30 percent of the nonfederal share.
new text end

Sec. 6.

Minnesota Statutes 2008, section 256B.0625, subdivision 22, is amended to
read:

Subd. 22.

Hospice care.

Medical assistance covers hospice care services under
Public Law 99-272, section 9505, to the extent authorized by rule new text begin , except that a recipient
age 21 or under who elects to receive hospice services does not waive coverage for
services that are related to the treatment of the condition for which a diagnosis of terminal
illness has been made new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactive from March 23, 2010.
new text end

Sec. 7.

Minnesota Statutes 2009 Supplement, section 256B.0911, subdivision 1a,
is amended to read:

Subd. 1a.

Definitions.

For purposes of this section, the following definitions apply:

(a) "Long-term care consultation services" means:

(1) assistance in identifying services needed to maintain an individual in the most
inclusive environment;

(2) providing recommendations on cost-effective community services that are
available to the individual;

(3) development of an individual's person-centered community support plan;

(4) providing information regarding eligibility for Minnesota health care programs;

(5) face-to-face long-term care consultation assessments, which may be completed
in a hospital, nursing facility, intermediate care facility for persons with developmental
disabilities (ICF/DDs), regional treatment centers, or the person's current or planned
residence;

(6) federally mandated screening to determine the need for a institutional level of
care under section 256B.0911, deleted text begin subdivision 4 deleted text end deleted text begin , paragraph (a) deleted text end new text begin subdivision 4a new text end ;

(7) determination of home and community-based waiver service eligibility including
level of care determination for individuals who need an institutional level of care as
defined under section 144.0724, subdivision 11, or 256B.092, service eligibility including
state plan home care services identified in section 256B.0625, subdivisions 6, 7, and
19, paragraphs (a) and (c), based on assessment and support plan development with
appropriate referrals;

(8) providing recommendations for nursing facility placement when there are no
cost-effective community services available; and

(9) assistance to transition people back to community settings after facility
admission.

(b) "Long-term care options counseling" means the services provided by the linkage
lines as mandated by sections 256.01 and 256.975, subdivision 7, and also includes
telephone assistance and follow up once a long-term care consultation assessment has
been completed.

(c) "Minnesota health care programs" means the medical assistance program under
chapter 256B and the alternative care program under section 256B.0913.

(d) "Lead agencies" means counties or a collaboration of counties, tribes, and health
plans administering long-term care consultation assessment and support planning services.

Sec. 8.

Minnesota Statutes 2008, section 256B.19, subdivision 1c, is amended to read:

Subd. 1c.

Additional portion of nonfederal share.

(a) Hennepin County shall
be responsible for a monthly transfer payment of $1,500,000, due before noon on the
15th of each month and the University of Minnesota shall be responsible for a monthly
transfer payment of $500,000 due before noon on the 15th of each month, beginning July
15, 1995. These sums shall be part of the designated governmental unit's portion of the
nonfederal share of medical assistance costs.

(b) Beginning July 1, 2001, Hennepin County's payment under paragraph (a) shall
be $2,066,000 each month.

(c) Beginning July 1, 2001, the commissioner shall increase annual capitation
payments to the metropolitan health plan under section 256B.69 for the prepaid medical
assistance program by approximately deleted text begin $3,400,000, plus any available federal matching
funds, deleted text end new text begin $6,800,000 new text end to recognize higher than average medical education costs.

(d) Effective August 1, 2005, Hennepin County's payment under paragraphs (a)
and (b) shall be reduced to $566,000, and the University of Minnesota's payment under
paragraph (a) shall be reduced to zero. new text begin Effective October 1, 2008, to December 31, 2010,
Hennepin County's payment under paragraphs (a) and (b) shall be $434,688. Effective
January 1, 2011, Hennepin County's payment under paragraphs (a) and (b) shall be
$566,000.
new text end

new text begin (e) Notwithstanding paragraph (d), upon federal enactment of an extension to June
30, 2011, of the enhanced federal medical assistance percentage (FMAP) originally
provided under Public Law 111-5, for the six-month period from January 1, 2011, to June
30, 2011, Hennepin County's payment under paragraphs (a) and (b) shall be $434,688.
new text end

Sec. 9.

Minnesota Statutes 2008, section 256L.15, subdivision 1, is amended to read:

Subdivision 1.

Premium determination.

(a) Families with children and individuals
shall pay a premium determined according to subdivision 2.

(b) Pregnant women and children under age two are exempt from the provisions
of section 256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment
for failure to pay premiums. For pregnant women, this exemption continues until the
first day of the month following the 60th day postpartum. Women who remain enrolled
during pregnancy or the postpartum period, despite nonpayment of premiums, shall be
disenrolled on the first of the month following the 60th day postpartum for the penalty
period that otherwise applies under section 256L.06, unless they begin paying premiums.

(c) Members of the military and their families who meet the eligibility criteria
for MinnesotaCare upon eligibility approval made within 24 months following the end
of the member's tour of active duty shall have their premiums paid by the commissioner.
The effective date of coverage for an individual or family who meets the criteria of this
paragraph shall be the first day of the month following the month in which eligibility is
approved. This exemption applies for 12 months. This paragraph expires June 30, 2010.
new text begin If the expiration of this provision is in violation of section 5001 of Public Law 111-5, this
provision will expire on the date when it is no longer subject to section 5001 of Public Law
111-5. The commissioner of human services shall notify the revisor of statutes of that date.
new text end

Sec. 10.

Laws 2005, First Special Session chapter 4, article 8, section 66, as amended
by Laws 2009, chapter 173, article 3, section 24, the effective date, is amended to read:

EFFECTIVE DATE.

Paragraph (a) is effective August 1, 2009, deleted text begin and deleted text end new text begin upon federal
approval and on the date when it is no longer subject to the maintenance of effort
requirements of section 5001 of Public Law 111-5. The commissioner of human services
shall notify the revisor of statutes of that date. new text end Paragraph (e) is effective September 1,
2006.

Sec. 11.

Laws 2009, chapter 79, article 5, section 17, the effective date, is amended to
read:

EFFECTIVE DATE.

This section is effective January 1, 2011, or upon federal
approval deleted text begin , whichever is later deleted text end new text begin and on the date when it is no longer subject to the maintenance
of effort requirements of section 5001 of Public Law 111-5. The commissioner of human
services shall notify the revisor of statutes of that date new text end .

Sec. 12.

Laws 2009, chapter 79, article 5, section 18, the effective date, is amended to
read:

EFFECTIVE DATE.

This section is effective deleted text begin January 1, 2011 deleted text end new text begin upon federal
approval and on the date when it is no longer subject to the maintenance of effort
requirements of section 5001 of Public Law 111-5. The commissioner of human services
shall notify the revisor of statutes when federal approval is obtained new text end .

Sec. 13.

Laws 2009, chapter 79, article 5, section 22, the effective date, is amended to
read:

EFFECTIVE DATE.

This section is effective for periods of ineligibility established
on or after January 1, 2011 new text begin , unless it is in violation of section 5001 of Public Law 111-5.
If it is in violation of that section, then it shall be effective on the date when it is no longer
subject to maintenance of effort requirements of section 5001 of Public Law 111-5. The
commissioner of human services shall notify the revisor of statutes of that date new text end .

Sec. 14.

Laws 2009, chapter 173, article 1, section 17, the effective date, is amended to
read:

EFFECTIVE DATE.

This section is effective for pooled trust accounts established
on or after January 1, 2011 new text begin , unless it is in violation of section 5001 of Public Law 111-5.
If it is in violation of that section, then it shall be effective on the date when it is no longer
subject to maintenance of effort requirements of section 5001 of Public Law 111-5. The
commissioner of human services shall notify the revisor of statutes of that date new text end .