HF 3955

2nd Engrossment - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

A bill for an act
relating to human services; modifying regulations of certain home care service
providers; promoting community-based care for older adults through the
establishment of community consortiums; requiring reports; amending Minnesota
Statutes 2006, section 144A.45, subdivision 1, by adding a subdivision.

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

Section 1.

Minnesota Statutes 2006, section 144A.45, subdivision 1, is amended to
read:

Subdivision 1.

Rules.

The commissioner shall adopt rules for the regulation of
home care providers pursuant to sections 144A.43 to 144A.47. The rules shall include
the following:

deleted text begin (a) deleted text end new text begin (1) new text end provisions to assure, to the extent possible, the health, safety and well-being,
and appropriate treatment of persons who receive home care services;

deleted text begin (b) deleted text end new text begin (2) new text end requirements that home care providers furnish the commissioner with
specified information necessary to implement sections 144A.43 to 144A.47;

deleted text begin (c) deleted text end new text begin (3) new text end standards of training of home care provider personnel, which may vary
according to the nature of the services provided or the health status of the consumer;

deleted text begin (d) deleted text end new text begin (4) new text end standards for medication management which may vary according to the
nature of the services provided, the setting in which the services are provided, or the
status of the consumer. Medication management includes the central storage, handling,
distribution, and administration of medications;

deleted text begin (e) deleted text end new text begin (5) new text end standards for supervision of home care services requiring supervision by a
registered nurse or other appropriate health care professional which must occur on site
at least every 62 days, or more frequently if indicated by a clinical assessment, and in
accordance with sections 148.171 to 148.285 and rules adopted thereunder new text begin , except that,
notwithstanding the provisions of Minnesota Rules, part 4668.0110, subpart 5, item B,
supervision of a person performing home care aide tasks for a class B licensee providing
paraprofessional services must occur only every 180 days, or more frequently if indicated
by a clinical assessment new text end ;

deleted text begin (f) deleted text end new text begin (6) new text end standards for client evaluation or assessment which may vary according to the
nature of the services provided or the status of the consumer;

deleted text begin (g) deleted text end new text begin (7) new text end requirements for the involvement of a consumer's physician, the
documentation of physicians' orders, if required, and the consumer's treatment plan, and
the maintenance of accurate, current clinical records;

deleted text begin (h) deleted text end new text begin (8) new text end the establishment of different classes of licenses for different types of
providers and different standards and requirements for different kinds of home care
services; and

deleted text begin (i) deleted text end new text begin (9) new text end operating procedures required to implement the home care bill of rights.

Sec. 2.

Minnesota Statutes 2006, section 144A.45, is amended by adding a subdivision
to read:

new text begin Subd. 1a. new text end

new text begin Home care aide tasks. new text end

new text begin Notwithstanding the provisions of Minnesota
Rules, part 4668.0110, subpart 1, item E, home care aide tasks also include assisting
toileting, transfers, and ambulation if the client is ambulatory and if the client has no
serious acute illness or infectious disease.
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 may 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 commissioner. 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 financing. new text end

new text begin (a) The commissioner of health shall
reserve ten percent of any funds appropriated for the biennium ending June 30, 2011,
for the nursing home moratorium exception process under Minnesota Statutes, section
144A.073, for distribution to qualifying projects that are part of a community consortium.
new text end

new text begin (b) Notwithstanding Minnesota Statutes, section 256B.434, subdivision 4, paragraph
(d), the nursing facility performance incentive payments shall be reduced by ten percent
for the biennium ending June 30, 2011. This shall be a onetime reduction.
new text end

new text begin (c) Base level funding for community service grants under Minnesota Statutes,
section 256B.0917, subdivision 13, and community services development grants under
Minnesota Statutes, section 256.9754, shall be reduced by ten percent for the biennium
ending June 30, 2011. These shall be onetime reductions.
new text end

new text begin (d) The commissioner of finance shall establish a community consortium account
as a special revenue account. Funding is appropriated from the general fund to the
commissioner of human services in an amount equal to the state share of the reductions
in paragraphs (b) and (c), for deposit in the special revenue account to fund community
consortiums. Community consortium funds shall carry forward until expended.
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 preliminary 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 final
report of findings and recommendations shall be delivered to the legislature by January
15, 2013. The preliminary and final 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 preliminary
and final evaluation and report.
new text end