HF 3866

as introduced - 91st Legislature (2019 - 2020) Posted on 02/26/2020 02:42pm

A bill for an act
relating to human services; restoring a requirement for notice to lead agencies
when MnCHOICES assessments are required for personal care assistance services;
amending Minnesota Statutes 2019 Supplement, section 256B.0911, subdivision
3a.

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

Section 1.

Minnesota Statutes 2019 Supplement, section 256B.0911, subdivision 3a, is
amended to read:

Subd. 3a.

Assessment and support planning.

(a) Persons requesting assessment, services
planning, or other assistance intended to support community-based living, including persons
who need assessment in order to determine waiver or alternative care program eligibility,
must be visited by a long-term care consultation team within 20 calendar days after the date
on which an assessment was requested or recommended. Upon statewide implementation
of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment of a person
requesting personal care assistance services. new text begin The commissioner shall provide at least a
90-day notice to lead agencies prior to the effective date of this requirement. new text end Face-to-face
assessments must be conducted according to paragraphs (b) to (i).

(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified
assessors to conduct the assessment. For a person with complex health care needs, a public
health or registered nurse from the team must be consulted.

(c) The MnCHOICES assessment provided by the commissioner to lead agencies must
be used to complete a comprehensive, conversation-based, person-centered assessment.
The assessment must include the health, psychological, functional, environmental, and
social needs of the individual necessary to develop a community support plan that meets
the individual's needs and preferences.

(d) The assessment must be conducted in a face-to-face conversational interview with
the person being assessed. The person's legal representative must provide input during the
assessment process and may do so remotely if requested. At the request of the person, other
individuals may participate in the assessment to provide information on the needs, strengths,
and preferences of the person necessary to develop a community support plan that ensures
the person's health and safety. Except for legal representatives or family members invited
by the person, persons participating in the assessment may not be a provider of service or
have any financial interest in the provision of services. For persons who are to be assessed
for elderly waiver customized living or adult day services under chapter 256S, with the
permission of the person being assessed or the person's designated or legal representative,
the client's current or proposed provider of services may submit a copy of the provider's
nursing assessment or written report outlining its recommendations regarding the client's
care needs. The person conducting the assessment must notify the provider of the date by
which this information is to be submitted. This information shall be provided to the person
conducting the assessment prior to the assessment. For a person who is to be assessed for
waiver services under section 256B.092 or 256B.49, with the permission of the person being
assessed or the person's designated legal representative, the person's current provider of
services may submit a written report outlining recommendations regarding the person's care
needs the person completed in consultation with someone who is known to the person and
has interaction with the person on a regular basis. The provider must submit the report at
least 60 days before the end of the person's current service agreement. The certified assessor
must consider the content of the submitted report prior to finalizing the person's assessment
or reassessment.

(e) The certified assessor and the individual responsible for developing the coordinated
service and support plan must complete the community support plan and the coordinated
service and support plan no more than 60 calendar days from the assessment visit. The
person or the person's legal representative must be provided with a written community
support plan within the timelines established by the commissioner, regardless of whether
the person is eligible for Minnesota health care programs.

(f) For a person being assessed for elderly waiver services under chapter 256S, a provider
who submitted information under paragraph (d) shall receive the final written community
support plan when available and the Residential Services Workbook.

(g) The written community support plan must include:

(1) a summary of assessed needs as defined in paragraphs (c) and (d);

(2) the individual's options and choices to meet identified needs, including all available
options for case management services and providers, including service provided in a
non-disability-specific setting;

(3) identification of health and safety risks and how those risks will be addressed,
including personal risk management strategies;

(4) referral information; and

(5) informal caregiver supports, if applicable.

For a person determined eligible for state plan home care under subdivision 1a, paragraph
(b), clause (1), the person or person's representative must also receive a copy of the home
care service plan developed by the certified assessor.

(h) A person may request assistance in identifying community supports without
participating in a complete assessment. Upon a request for assistance identifying community
support, the person must be transferred or referred to long-term care options counseling
services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for
telephone assistance and follow up.

(i) The person has the right to make the final decision between institutional placement
and community placement after the recommendations have been provided, except as provided
in section 256.975, subdivision 7a, paragraph (d).

(j) The lead agency must give the person receiving assessment or support planning, or
the person's legal representative, materials, and forms supplied by the commissioner
containing the following information:

(1) written recommendations for community-based services and consumer-directed
options;

(2) documentation that the most cost-effective alternatives available were offered to the
individual. For purposes of this clause, "cost-effective" means community services and
living arrangements that cost the same as or less than institutional care. For an individual
found to meet eligibility criteria for home and community-based service programs under
chapter 256S or section 256B.49, "cost-effectiveness" has the meaning found in the federally
approved waiver plan for each program;

(3) the need for and purpose of preadmission screening conducted by long-term care
options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects
nursing facility placement. If the individual selects nursing facility placement, the lead
agency shall forward information needed to complete the level of care determinations and
screening for developmental disability and mental illness collected during the assessment
to the long-term care options counselor using forms provided by the commissioner;

(4) the role of long-term care consultation assessment and support planning in eligibility
determination for waiver and alternative care programs, and state plan home care, case
management, and other services as defined in subdivision 1a, paragraphs (a), clause (6),
and (b);

(5) information about Minnesota health care programs;

(6) the person's freedom to accept or reject the recommendations of the team;

(7) the person's right to confidentiality under the Minnesota Government Data Practices
Act, chapter 13;

(8) the certified assessor's decision regarding the person's need for institutional level of
care as determined under criteria established in subdivision 4e and the certified assessor's
decision regarding eligibility for all services and programs as defined in subdivision 1a,
paragraphs (a), clause (6), and (b); and

(9) the person's right to appeal the certified assessor's decision regarding eligibility for
all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and
(8), and (b), and incorporating the decision regarding the need for institutional level of care
or the lead agency's final decisions regarding public programs eligibility according to section
256.045, subdivision 3. The certified assessor must verbally communicate this appeal right
to the person and must visually point out where in the document the right to appeal is stated.

(k) Face-to-face assessment completed as part of eligibility determination for the
alternative care, elderly waiver, developmental disabilities, community access for disability
inclusion, community alternative care, and brain injury waiver programs under chapter 256S
and sections 256B.0913, 256B.092, and 256B.49 is valid to establish service eligibility for
no more than 60 calendar days after the date of assessment.

(l) The effective eligibility start date for programs in paragraph (k) can never be prior
to the date of assessment. If an assessment was completed more than 60 days before the
effective waiver or alternative care program eligibility start date, assessment and support
plan information must be updated and documented in the department's Medicaid Management
Information System (MMIS). Notwithstanding retroactive medical assistance coverage of
state plan services, the effective date of eligibility for programs included in paragraph (k)
cannot be prior to the date the most recent updated assessment is completed.

(m) If an eligibility update is completed within 90 days of the previous face-to-face
assessment and documented in the department's Medicaid Management Information System
(MMIS), the effective date of eligibility for programs included in paragraph (k) is the date
of the previous face-to-face assessment when all other eligibility requirements are met.

(n) At the time of reassessment, the certified assessor shall assess each person receiving
waiver services currently residing in a community residential setting, or licensed adult foster
care home that is not the primary residence of the license holder, or in which the license
holder is not the primary caregiver, to determine if that person would prefer to be served in
a community-living setting as defined in section 256B.49, subdivision 23. The certified
assessor shall offer the person, through a person-centered planning process, the option to
receive alternative housing and service options.