SF 345

as introduced - 80th Legislature (1997 - 1998) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act 
  1.2             relating to medical assistance; establishing 
  1.3             performance-based contracting demonstration projects 
  1.4             for recipients of services from intermediate care 
  1.5             facilities for persons with mental retardation or 
  1.6             related conditions; amending Laws 1993, First Special 
  1.7             Session chapter 1, article 4, section 11. 
  1.8   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.9      Section 1.  Laws 1993, First Special Session chapter 1, 
  1.10  article 4, section 11, is amended to read: 
  1.11     Sec. 11.  [DEMONSTRATION PROJECT PROJECTS.] 
  1.12     (a) The commissioner may shall establish a up to 40 
  1.13  demonstration project projects to improve the efficiency and 
  1.14  effectiveness of service provision for recipients of services 
  1.15  from intermediate care facilities for persons with mental 
  1.16  retardation or related conditions. 
  1.17     The commissioner shall establish procedures to implement 
  1.18  the project projects.  The demonstration project projects may be 
  1.19  coordinated with other projects authorized in other areas.  
  1.20  Participation by providers in the demonstration project projects 
  1.21  is voluntary.  The commissioner shall seek any necessary federal 
  1.22  waivers to implement the pilot project projects. 
  1.23     (b) The commissioner may waive rules relating to the 
  1.24  provision of residential services for persons with mental 
  1.25  retardation or related conditions to the extent necessary to 
  1.26  implement the demonstration project projects.  In waiving rules, 
  2.1   the commissioner shall consider the recommendations of persons 
  2.2   who are and who represent consumers and providers of service and 
  2.3   of representatives of state and local agencies administering 
  2.4   services.  Individuals receiving services under the 
  2.5   demonstration project projects may not be denied rights or 
  2.6   procedural protections under Minnesota Statutes, sections 
  2.7   245.825; 245.91 to 245.97; 252.41, subdivision 9; 256.045; 
  2.8   256B.092; 626.556; and 626.557, including the county agency's 
  2.9   responsibility to arrange for appropriate services and 
  2.10  procedures for the monitoring of psychotropic medications. 
  2.11     (c) The project projects must meet the following 
  2.12  requirements: 
  2.13     (1) persons and their legal representatives, if any, must 
  2.14  be provided with information about the project; 
  2.15     (2) the project projects must comply with applicable 
  2.16  federal requirements; 
  2.17     (3) the project proposal proposals must include specific 
  2.18  measures to be taken to ensure the health, safety, and 
  2.19  protection of the persons participating; and 
  2.20     (4) persons participating in the project projects must be 
  2.21  informed when any part of Minnesota Rules is waived. 
  2.22     (d) The commissioner shall request and evaluate proposals 
  2.23  from county agencies and provider organizations to 
  2.24  participate in the projects.  Upon federal approval, the 
  2.25  commissioner shall enter into a performance-based contract with 
  2.26  counties and existing licensed ICF/MR providers that specifies 
  2.27  the amount and conditions of reimbursement, requirements for 
  2.28  monitoring and evaluation, and expected client-based outcomes.  
  2.29  Counties and providers shall present potential outcome 
  2.30  indicators for consideration in the following areas: 
  2.31     (1) personal health, safety, and comfort; 
  2.32     (2) personal growth, independence, and productivity; 
  2.33     (3) client choice and control over daily life decisions; 
  2.34     (4) consumer, family, and the case manager's satisfaction 
  2.35  with services; and 
  2.36     (5) community inclusion, including social relationships and 
  3.1   participation in valued community roles. 
  3.2      Outcome indicators must be determined by the person and the 
  3.3   legal representative, if any, with assistance from the county 
  3.4   case manager and provider. 
  3.5      (e) The cost of services for intermediate care facilities 
  3.6   for persons with mental retardation paid for under the contract 
  3.7   must not exceed 95 percent of the cost of the services that 
  3.8   would otherwise have been paid to the intermediate care facility 
  3.9   or group of intermediate care facilities during a biennium, 
  3.10  including applicable special needs rates and rate adjustments, 
  3.11  under the reimbursement system in effect at the time the 
  3.12  contracted rate is effective.  An intermediate care facility 
  3.13  participating in the a demonstration project must continue to be 
  3.14  licensed.  After participation in the a project, the facility 
  3.15  may be recertified as an intermediate care facility for persons 
  3.16  with mental retardation, notwithstanding the provisions of 
  3.17  Minnesota Statutes, section 252.291, or the services provided 
  3.18  under the a demonstration project may be converted to home- and 
  3.19  community-based services authorized under Minnesota Statutes, 
  3.20  section 256B.092, if the applicable standards are met.  The rate 
  3.21  paid to a recertified facility must not be greater than the rate 
  3.22  paid to the facility before participation in the a project.  The 
  3.23  commissioner may establish emergency rate setting procedures to 
  3.24  allow for the transition back to intermediate care services for 
  3.25  persons with mental retardation or related conditions.