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SF 1286

as introduced - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - as introduced

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A bill for an act
relating to human services; allowing coverage of incidental nursing services
under the elderly waiver; providing rate exceptions; increasing elderly waiver
reimbursement rate limits; requiring a study and report; amending Minnesota
Statutes 2006, section 256B.0915, subdivision 3e, by adding a subdivision.

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

Section 1.

Minnesota Statutes 2006, section 256B.0915, subdivision 3e, is amended to
read:


Subd. 3e.

Assisted living service rate.

(a) Payment for assisted living service
shall be a monthly rate negotiated and authorized by the county agency based on an
individualized service plan for each resident and may not cover direct rent or food costs.

(b) The individualized monthly negotiated payment for assisted living services as
described in section 256B.0913, subdivisions 5d to 5f, and residential care services as
described in section 256B.0913, subdivision 5c, shall not exceed the nonfederal share, in
effect on July 1 of the state fiscal year for which the rate limit is being calculated, of the
greater of either the statewide or any of the geographic groups' weighted average monthly
nursing facility rate of the case mix resident class to which the elderly waiver eligible
client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, less the
maintenance needs allowance as described in subdivision 1d, paragraph (a), until the July
1 of the state fiscal year in which the resident assessment system as described in section
256B.437 for nursing home rate determination is implemented. Effective on July 1 of the
state fiscal year in which the resident assessment system as described in section 256B.437
for nursing home rate determination is implemented and July 1 of each subsequent state
fiscal year, the individualized monthly negotiated payment for the services described
in this clause shall not exceed the limit described in this clause which was in effect on
June 30 of the previous state fiscal year and which has been adjusted by the greater of
any legislatively adopted home and community-based services cost-of-living percentage
increase or any legislatively adopted statewide percent rate increase for nursing facilities.

(c) The individualized monthly negotiated payment for assisted living services
described in section 144A.4605 and delivered by a provider licensed by the Department
of Health as a class A home care provider or an assisted living home care provider and
provided in a building that is registered as a housing with services establishment under
chapter 144D and that provides 24-hour supervision in combination with the payment for
other elderly waiver services, including case management, must not exceed the limit
specified in subdivision 3a.

new text begin (d) Subject to the requirements of this section, customized living services and
24-hour customized living services include incidental nursing services that are provided
directly by a licensed nurse under a Class A or Class F home care license issued under
Minnesota Rules, chapter 4668, and that are not eligible to be covered by Medicare.
For purposes of this paragraph, "incidental nursing services" means medication set-ups,
injections, diabetic foot care, catheter insertion, monitoring of blood tests for therapeutic
treatments, nursing assessments, and any other service identified by the commissioner
of human services. If the commissioner determines that incidental nursing services, as
defined, are not permitted under the terms of the federally approved elderly home and
community-based services waiver, the commissioner shall apply to amend the waiver to
permit coverage of the services within customized living and 24-hour customized living.
new text end

Sec. 2.

Minnesota Statutes 2006, section 256B.0915, is amended by adding a
subdivision to read:


new text begin Subd. 3h. new text end

new text begin Individual rate exceptions authorized. new text end

new text begin Based on the determination of
the case manager, in consultation with the provider serving the elderly waiver client, if
the client needs additional services for 30 days or less in order to avoid a hospitalization
or nursing facility placement, the case manager may authorize additional elderly waiver
services that exceed the client's monthly cost limit. For these clients, the total cost of all
elderly waiver services may not exceed the monthly conversion limit for elderly waiver
applicants who reside in a nursing facility, as defined in subdivision 3b.
new text end

Sec. 3. new text beginELDERLY WAIVER PROVIDER RATE INCREASE.
new text end

new text begin The commissioner of human services shall increase reimbursement rate limits by
seven percent for the rate period beginning October 1, 2007, and by six percent for the rate
period beginning October 1, 2008, for home and community-based waivered services for
the elderly under Minnesota Statutes, section 256B.0915, effective for services provided
on or after those dates. The commissioner and each county agency shall take steps
necessary to implement the increases required by this section on the dates specified, and
the increases must be effective on the dates specified, regardless of the client's service
authorization date and notwithstanding the terms of any provider contract, service
agreement, or schedule that limits when a county may increase payment rates.
new text end

Sec. 4. new text beginSTUDY AND REPORT ON ELDERLY WAIVER.
new text end

new text begin The commissioner of human services, by January 15, 2008, shall present a report
to the legislature addressing the following aspects of the home and community-based
waivered services program for the elderly under Minnesota Statutes, section 256B.0915:
new text end

new text begin (1) the length of time it takes each county, or joint-county consultation team, as
applicable, to complete a long-term care consultation under Minnesota Statutes, section
256B.0911, for a person who is seeking to qualify for, or is a current recipient of, elderly
waiver services, including recommendations on how to improve the process, to the extent
counties or joint-county consultation teams are not achieving compliance with Minnesota
Statutes, section 256B.0911, subdivision 3a; and
new text end

new text begin (2) the methods and tools that county agencies use to establish the level of, and
payment rates for, customized living and 24-hour customized living services provided
under the elderly waiver program, including recommendations for how to achieve
consistency across these lead agencies in providing access to and funding for these
services.
new text end