HF 3955

1st Engrossment - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

A bill for an act
relating to human services; promoting community-based care for older adults
through the establishment of community consortiums; providing coverage for
costs associated with physical activities for home and community-based waiver
programs for persons with disabilities; amending Minnesota Statutes 2006,
sections 256B.092, by adding a subdivision; 256B.49, by adding a subdivision.

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

Section 1.

Minnesota Statutes 2006, section 256B.092, is amended by adding a
subdivision to read:

new text begin Subd. 4e. new text end

new text begin Costs associated with physical activities. new text end

new text begin Effective upon federal
approval, the costs associated with physical exercise or other physical activities to
maintain or improve a person's health and functioning included in a person's individual
service plan shall be an allowed expense for home and community-based waiver programs
for persons with disabilities to the extent that the costs will not increase the person's
authorized annual budget amount. By October 1, 2008, the commissioner of human
services shall submit an amendment to the Centers for Medicare and Medicaid Services
consistent with this subdivision.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 2.

Minnesota Statutes 2006, section 256B.49, is amended by adding a subdivision
to read:

new text begin Subd. 22. new text end

new text begin Costs associated with physical activities. new text end

new text begin Effective upon federal
approval, the costs associated with physical exercise or other physical activities to
maintain or improve a person's health and functioning included in a person's individual
service plan shall be an allowed expense for home and community-based waiver programs
for persons with disabilities to the extent that the costs will not increase the person's
authorized annual budget amount. By October 1, 2008, the commissioner of human
services shall submit an amendment to the Centers for Medicare and Medicaid Services
consistent with this subdivision.
new text end

Sec. 3. new text begin OLDER ADULT SERVICES COMMUNITY CONSORTIUMS.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin (a) The commissioner of human services, in
cooperation with the commissioners of health and housing finance, shall develop and
implement, beginning July 1, 2009, a three-year demonstration project for older adult
services community consortiums. An older adult services community consortium may
consist of health care and social service providers, county agencies, health plan companies,
and other community stakeholders within a demonstration site that have established a
process for joint decision making. Demonstration sites may include a portion of a county,
an entire county, or multiple counties.
new text end

new text begin (b) Each community consortium seeking to participate as a demonstration site
must submit an application to the commissioner of human services. The application
must include:
new text end

new text begin (1) a description of the entities participating in the consortium, the scope of
collaboration, and the process to be used for joint decision making;
new text end

new text begin (2) the methods by which the consortium plans to achieve the goals specified in
subdivision 2;
new text end

new text begin (3) a description of the proposed demonstration site; and
new text end

new text begin (4) other information the commissioner of human services determines to be
necessary to evaluate proposals.
new text end

new text begin (c) The commissioner of human services shall establish a process to review and
consider applicants. The commissioner of human services shall designate up to three
community consortiums as demonstration sites.
new text end

new text begin (d) Each community consortium selected to participate shall establish a local group
to assist in planning, designing, implementing, and evaluating the coordinated service
delivery system within the demonstration site. Planning for each consortium shall build
upon current planning processes developed by county gaps analyses and ElderCare
Development Partnerships under Minnesota Statutes, section 256B.0917.
new text end

new text begin Subd. 2. new text end

new text begin Goals. new text end

new text begin The community consortium demonstration project is intended to
accelerate the development of community-based services to fill in gaps identified within
communities, by using a pool of funds and providing flexibility in the use and distribution
of these funds within each demonstration site. These projects must be designed to:
new text end

new text begin (1) ensure consumer access to a continuum of older adult services;
new text end

new text begin (2) create an adequate supply of affordable home-based alternatives to care for
persons currently using nursing facilities, or likely to need nursing facility services
in the future;
new text end

new text begin (3) establish and achieve measurable performance targets for care delivered
throughout the continuum of care; and
new text end

new text begin (4) support the management of chronic and complex conditions through greater
coordination of all services needed by older adults.
new text end

new text begin Subd. 3. new text end

new text begin Priority for other grants. new text end

new text begin The commissioner of health shall give priority to
community consortiums selected as demonstration sites when awarding technology-related
grants, if the consortiums are using technology as a part of their proposal. To the extent
that the commissioner of the Housing Finance Agency funds projects to create or preserve
affordable housing options for older adults, the commissioner of housing finance shall
give priority to financially feasible projects proposed or supported by community
consortiums selected as demonstration sites. The commissioner of transportation shall
give priority to community consortiums selected as demonstration sites when distributing
transportation-related funds to create transportation options for older adults.
new text end

new text begin Subd. 4. new text end

new text begin Federal approval. new text end

new text begin The commissioner of human services shall request any
federal approvals or waivers necessary to implement the community consortiums under
the medical assistance program and include medical assistance funding as specified in
subdivision 7 in the community consortium account.
new text end

new text begin Subd. 5. new text end

new text begin State waivers. new text end

new text begin The commissioner of health may waive applicable state
laws and rules on a time-limited basis if the commissioner of health determines that a
participating consortium requires a waiver in order to achieve demonstration project goals.
new text end

new text begin Subd. 6. new text end

new text begin Quality measures. new text end

new text begin (a) Community consortiums participating in the
demonstration project shall report information to the commissioner of human services
necessary to evaluate the demonstration project, in the form and manner specified by
the commissioners. The information collected by the commissioner of human services
must include both process and outcome measures, including but not limited to measures
related to enrollee satisfaction, service delivery, service coordination, service access, use
of technology, individual outcomes, and costs.
new text end

new text begin (b) Participating consortiums shall identify state policies that limit the extent to
which project goals can be achieved and recommend necessary changes to the appropriate
state agencies.
new text end

new text begin Subd. 7. new text end

new text begin Community consortium account; financing. new text end

new text begin (a) The commissioner
of finance shall establish a community consortium account as a special revenue
account for the purpose of collecting funds for distribution to the selected community
consortiums. Funds must be collected from the following existing grant programs within
the Departments of Health and Human Services and must be transferred as follows to the
community consortium account prior to awarding of the demonstration grants:
new text end

new text begin (1) ten percent of any funds appropriated for the biennium ending June 30, 2011,
for the nursing home moratorium exceptions process under Minnesota Statutes, section
144A.073;
new text end

new text begin (2) ten percent of the funds appropriated for the biennium ending June 30, 2011, for
community service grants under Minnesota Statutes, section 256B.0917, subdivision 13,
and community services development grants under Minnesota Statutes, section 256.9754,
subdivision 3; and
new text end

new text begin (3) ten percent of the funds appropriated for the biennium ending June 30, 2011,
for nursing facility performance grants under Minnesota Statutes, section 256B.434,
subdivision 4, paragraph (d).
new text end

new text begin (b) Money in the community consortium account may be used by the commissioner
of human services to provide grants to participating community consortiums.
new text end

new text begin (c) Funds available from closure of nursing facility beds within a demonstration site
may be used by the consortium to fund consortium-related activities if the closed beds
have not been claimed as a planned closure rate adjustment under Minnesota Statutes,
section 256B.437.
new text end

new text begin (d) The commissioner of human services, in consultation with the commissioner
of health, may approve moratorium exception projects that are part of the applications
submitted by the designated demonstration sites, using any funding made available under
paragraph (a), clause (1), and subject to the limits of that funding. Nursing facilities
receiving approval for moratorium exception projects under this paragraph shall receive
a rate increase calculated in the same manner as facilities receiving exceptions under
Minnesota Statutes, section 144A.073, and the rate increase shall continue to apply after
the expiration of the demonstration project grant under this section. Once grants under this
section are no longer made, any funds made available under paragraph (a), clause (1), that
are not being used by demonstration projects, shall be transferred to the Department of
Health to be used for moratorium exception projects approved under Minnesota Statutes,
section 144A.073.
new text end

new text begin Subd. 8. new text end

new text begin Evaluation and report. new text end

new text begin The commissioner of human services, in
cooperation with the commissioners of health and housing finance, shall evaluate the
demonstration project, and report findings and recommendations to the legislature by
November 15, 2011, on whether the demonstration project should be continued and
whether the number of demonstration project sites increased. The evaluation and report
must include:
new text end

new text begin (1) a comparison of the performance of demonstration sites relative to nonconsortium
communities on the quality measures specified in subdivision 6;
new text end

new text begin (2) an assessment of the extent to which the demonstration project can be
successfully expanded to other parts of the state; and
new text end

new text begin (3) legislative changes necessary to improve the effectiveness of the demonstration
project and to expand the projects to other parts of the state.
new text end

new text begin The commissioner of human services may use up to $50,000 of the funding provided
to each participating community consortium under this section to fund the evaluation
and report.
new text end