SF 1699

as introduced - 87th Legislature (2011 - 2012) Posted on 03/07/2012 03:17pm

A bill for an act
relating to human services; modifying group residential housing and Minnesota
supplemental aid shelter needy provisions; modifying adult foster care homes;
amending Minnesota Statutes 2010, sections 245A.11, subdivisions 2, 2a, 7,
7a, 8; 245B.07, subdivision 1; 245C.04, subdivision 6; 256B.092, subdivision
1b; 256D.44, subdivision 5; 256I.04, subdivision 2a; 326B.103, by adding a
subdivision; proposing coding for new law in Minnesota Statutes, chapters 245B;
256B; repealing Minnesota Rules, part 9555.5105, subpart 37, item B.

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

Section 1.

Minnesota Statutes 2010, section 245A.11, subdivision 2, is amended to read:

Subd. 2.

Permitted single-family residential use.

Residential programs with a
licensed capacity of six or fewer persons shall be considered a permitted single-family
residential use of property for the purposes of zoning and other land use regulations new text begin
and the State Building Code, sections 326B.101 to 326B.191 new text end , except that a residential
program whose primary purpose is to treat juveniles who have violated criminal statutes
relating to sex offenses or have been adjudicated delinquent on the basis of conduct in
violation of criminal statutes relating to sex offenses shall not be considered a permitted
use. This exception shall not apply to residential programs licensed before July 1, 1995.
Programs otherwise allowed under this subdivision shall not be prohibited by operation of
restrictive covenants or similar restrictions, regardless of when entered into, which cannot
be met because of the nature of the licensed program, including provisions which require
the home's occupants be related, and that the home must be occupied by the owner, or
similar provisions.

Sec. 2.

Minnesota Statutes 2010, section 245A.11, subdivision 2a, is amended to read:

Subd. 2a.

Adult foster care license capacity.

(a) The commissioner shall issue
adult foster care licenses with a maximum licensed capacity of four beds, including
nonstaff roomers and boarders, except that the commissioner may issue a license with a
capacity of five beds, including roomers and boarders, according to paragraphs (b) to (f).

(b) An adult foster care license holder may have a maximum license capacity of five
if all persons in care are age 55 or over and do not have a serious and persistent mental
illness or a developmental disability.

(c) The commissioner may grant variances to paragraph (b) to allow a foster care
provider with a licensed capacity of five persons to admit an individual under the age of 55
if the variance complies with section 245A.04, subdivision 9, and approval of the variance
is recommended by the county in which the licensed foster care provider is located.

(d) The commissioner may grant variances to paragraph (b) to allow the use of a
fifth bed for emergency crisis services for deleted text begin a person with serious and persistent mental
illness or a developmental disability deleted text end new text begin persons with disabilities, or for respite services as
defined in section 245A.02 new text end , regardless of age, if the variance complies with section
245A.04, subdivision 9, and approval of the variance is recommended by the county in
which the licensed foster care provider is located. new text begin Respite services may be provided
under the following conditions:
new text end

new text begin (1) staffing ratios cannot be reduced below the approved level for the individuals
being served;
new text end

new text begin (2) no more than two different individuals can be accepted for respite services in
any calendar month;
new text end

new text begin (3) the person receiving respite services must have a private bedroom, which could
be used for alternative purposes when not used as a respite bedroom, and cannot use the
room of another person who lives in the foster care home; and
new text end

new text begin (4) individuals living in the foster care home must be notified when the variance
is approved. The provider must give 60 days' notice in writing to the residents and their
legal representatives prior to accepting the first respite placement. Notice is not required
prior to each subsequent placement.
new text end

(e) deleted text begin If the 2009 legislature adopts a rate reduction that impacts providers of adult
foster care services, deleted text end The commissioner may issue an adult foster care license with a
capacity of five adults if the fifth bed does not increase the overall statewide capacity of
licensed adult foster care beds in homes that are not the primary residence of the license
holder, deleted text begin over the licensed capacity in such homes on July 1, 2009, deleted text end as identified in a plan
submitted to the commissioner by the county, when the capacity is recommended by
the county licensing agency of the county in which the facility is located and if the
recommendation verifies that:

(1) the facility meets the physical environment requirements in the adult foster
care licensing rule;

(2) the five-bed living arrangement is specified for each resident in the resident's:

(i) individualized plan of care;

(ii) individual service plan under section 256B.092, subdivision 1b, if required; or

(iii) individual resident placement agreement under Minnesota Rules, part
9555.5105, subpart 19, if required; new text begin and
new text end

(3) the license holder deleted text begin obtains written and signed informed consent from deleted text end new text begin notifies new text end each
resident or resident's legal representative documenting the resident's informed choice to
living in the home and that the resident's refusal to consent would not have resulted in
service termination deleted text begin ; and deleted text end new text begin .
new text end

deleted text begin (4) the facility was licensed for adult foster care before March 1, 2009 deleted text end .

deleted text begin (f) The commissioner shall not issue a new adult foster care license under paragraph
(e) after June 30, 2011. The commissioner shall allow a facility with an adult foster care
license issued under paragraph (e) before June 30, 2011, to continue with a capacity of five
adults if the license holder continues to comply with the requirements in paragraph (e).
deleted text end

Sec. 3.

Minnesota Statutes 2010, section 245A.11, subdivision 7, is amended to read:

Subd. 7.

Adult foster care; variance for alternate overnight supervision.

(a) The
commissioner may grant a variance under section 245A.04, subdivision 9, to rule parts
requiring a caregiver to be present in an adult foster care home during normal sleeping
hours to allow for alternative methods of overnight supervision. The commissioner may
grant the variance if the local county licensing agency recommends the variance and the
county recommendation includes documentation verifying that:

(1) the county has approved the license holder's plan for alternative methods of
providing overnight supervision and determined the plan protects the residents' health,
safety, and rights;

(2) the license holder has obtained written and signed informed consent from
each resident or each resident's legal representative documenting the resident's or legal
representative's agreement with the alternative method of overnight supervision; and

(3) the alternative method of providing overnight supervision, which may include
the use of technology, is specified for each resident in the resident's: (i) individualized
plan of care; (ii) individual service plan under section 256B.092, subdivision 1b, if
required; or (iii) individual resident placement agreement under Minnesota Rules, part
9555.5105, subpart 19, if required.

(b) To be eligible for a variance under paragraph (a), the adult foster care license
holder must not have had a deleted text begin licensing action deleted text end new text begin conditional license issued new text end under section
245A.06 or 245A.07 during the prior deleted text begin 24 deleted text end new text begin 12 new text end months based on failure to deleted text begin provide adequate
supervision, health care services, or resident safety in the adult foster care home deleted text end new text begin perform
any of the functions directly related to overnight supervision new text end .

(c) A license holder requesting a variance under this subdivision to utilize
technology as a component of a plan for alternative overnight supervision may request
the commissioner's review in the absence of a county recommendation. Upon receipt of
such a request from a license holder, the commissioner shall review the variance request
with the county.

new text begin (d) For the purposes of this subdivision, "supervision" means oversight as specified
in the individual resident's place agreement and awareness of the resident's needs and
activities.
new text end

Sec. 4.

Minnesota Statutes 2010, section 245A.11, subdivision 7a, is amended to read:

Subd. 7a.

Alternate overnight supervision technology; adult foster care license.

(a) The commissioner may grant an applicant or license holder an adult foster care license
for a residence that does not have a caregiver in the residence during normal sleeping
hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, but uses
monitoring technology to alert the license holder when an incident occurs that may
jeopardize the health, safety, or rights of a foster care recipient. The applicant or license
holder must comply with all other requirements under Minnesota Rules, parts 9555.5105
to 9555.6265, and the requirements under this subdivision. The license printed by the
commissioner must state in bold and large font:

(1) that the facility is under electronic monitoring; and

(2) the telephone number of the county's common entry point for making reports of
suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.

(b) Applications for a license under this section must be submitted directly to
the Department of Human Services licensing division. The licensing division must
immediately notify the host county and lead county contract agency and the host county
licensing agency. The licensing division must collaborate with the county licensing
agency in the review of the application and the licensing of the program.

(c) Before a license is issued by the commissioner, and for the duration of the
license, the applicant or license holder must establish, maintain, and document the
implementation of written policies and procedures addressing the requirements in
paragraphs (d) through (f).

(d) The applicant or license holder must have policies and procedures that:

(1) establish characteristics of target populations that will be admitted into the home,
and characteristics of populations that will not be accepted into the home;

(2) explain the discharge process when a foster care recipient requires overnight
supervision or other services that cannot be provided by the license holder due to the
limited hours that the license holder is on site;

(3) describe the types of events to which the program will respond with a physical
presence when those events occur in the home during time when staff are not on site, and
how the license holder's response plan meets the requirements in paragraph (e), clause
(1) or (2);

(4) establish a process for documenting a review of the implementation and
effectiveness of the response protocol for the response required under paragraph (e),
clause (1) or (2). The documentation must include:

(i) a description of the triggering incident;

(ii) the date and time of the triggering incident;

(iii) the time of the response or responses under paragraph (e), clause (1) or (2);

(iv) whether the response met the resident's needs;

(v) whether the existing policies and response protocols were followed; and

(vi) whether the existing policies and protocols are adequate or need modification.

When no physical presence response is completed for a three-month period, the
license holder's written policies and procedures must require a physical presence response
drill to be conducted for which the effectiveness of the response protocol under paragraph
(e), clause (1) or (2), will be reviewed and documented as required under this clause; and

(5) establish that emergency and nonemergency phone numbers are posted in a
prominent location in a common area of the home where they can be easily observed by a
person responding to an incident who is not otherwise affiliated with the home.

(e) The license holder must document and include in the license application which
response alternative under clause (1) or (2) is in place for responding to situations that
present a serious risk to the health, safety, or rights of people receiving foster care services
in the home:

(1) response alternative (1) requires only the technology to provide an electronic
notification or alert to the license holder that an event is underway that requires a response.
Under this alternative, no more than ten minutes will pass before the license holder will be
physically present on site to respond to the situation; or

(2) response alternative (2) requires the electronic notification and alert system
under alternative (1), but more than ten minutes may pass before the license holder is
present on site to respond to the situation. Under alternative (2), all of the following
conditions are met:

(i) the license holder has a written description of the interactive technological
applications that will assist the license holder in communicating with and assessing the
needs related to the care, health, and safety of the foster care recipients. This interactive
technology must permit the license holder to remotely assess the well being of the foster
care recipient without requiring the initiation of the foster care recipient. Requiring the
foster care recipient to initiate a telephone call does not meet this requirement;

(ii) the license holder documents how the remote license holder is qualified and
capable of meeting the needs of the foster care recipients and assessing foster care
recipients' needs under item (i) during the absence of the license holder on site;

(iii) the license holder maintains written procedures to dispatch emergency response
personnel to the site in the event of an identified emergency; and

(iv) each foster care recipient's individualized plan of care, individual service plan
under section 256B.092, subdivision 1b, if required, or individual resident placement
agreement under Minnesota Rules, part 9555.5105, subpart 19, if required, identifies the
maximum response time, which may be greater than ten minutes, for the license holder
to be on site for that foster care recipient.

(f) All placement agreements, individual service agreements, and plans applicable
to the foster care recipient must clearly state that the adult foster care license category is
a program without the presence of a caregiver in the residence during normal sleeping
hours; the protocols in place for responding to situations that present a serious risk to
the health, safety, or rights of foster care recipients under paragraph (e), clause (1)
or (2); and a signed informed consent from each foster care recipient or the person's
legal representative documenting the person's or legal representative's agreement with
placement in the program. If electronic monitoring technology is used in the home, the
informed consent form must also explain the following:

(1) how any electronic monitoring is incorporated into the alternative supervision
system;

(2) the backup system for any electronic monitoring in times of electrical outages or
other equipment malfunctions;

(3) how the license holder is trained on the use of the technology;

(4) the event types and license holder response times established under paragraph (e);

(5) how the license holder protects the foster care recipient's privacy related to
electronic monitoring and related to any electronically recorded data generated by the
monitoring system. A foster care recipient may not be removed from a program under
this subdivision for failure to consent to electronic monitoring. The consent form must
explain where and how the electronically recorded data is stored, with whom it will be
shared, and how long it is retained; and

(6) the risks and benefits of the alternative overnight supervision system.

The written explanations under clauses (1) to (6) may be accomplished through
cross-references to other policies and procedures as long as they are explained to the
person giving consent, and the person giving consent is offered a copy.

(g) Nothing in this section requires the applicant or license holder to develop or
maintain separate or duplicative policies, procedures, documentation, consent forms, or
individual plans that may be required for other licensing standards, if the requirements of
this section are incorporated into those documents.

(h) The commissioner may grant variances to the requirements of this section
according to section 245A.04, subdivision 9.

(i) For the purposes of paragraphs (d) through (h), "license holder" has the meaning
under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and
contractors affiliated with the license holder.

(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to
remotely determine what action the license holder needs to take to protect the well-being
of the foster care recipient.

new text begin (k) The commissioner shall evaluate license applications using the requirements in
paragraphs (d) to (f). The commissioner shall publicly post guidance or criteria used in
evaluating applications.
new text end

new text begin (l) To be eligible for a variance under paragraph (a), the adult foster care license
holder must not have had a conditional license issued under section 245A.06 during
the prior 12 months.
new text end

new text begin (m) The commissioner shall approve or deny an application for an alternative
overnight supervision license within 60 days of receipt of the application. If no notification
is issued, the application shall be considered approved until written notification to the
applicant is issued by the commissioner. If the application is denied, the commissioner
shall provide a written explanation to the applicant listing the criteria that were not
satisfied and describe how the applicant may meet the criteria in order to be issued a
license. The commissioner shall allow the applicant to modify and update the application
to correct deficiencies. The commissioner shall respond to the updated application within
14 days of receipt of the updated application.
new text end

new text begin (n) For the purposes of this subdivision, "supervision" means oversight as specified
in the individual resident's place agreement and awareness of the resident's needs and
activities.
new text end

Sec. 5.

Minnesota Statutes 2010, section 245A.11, subdivision 8, is amended to read:

Subd. 8.

Community residential setting license.

(a) The commissioner shall
establish provider standards for residential support services that integrate service standards
and the residential setting under one license. The commissioner shall propose statutory
language and an implementation plan for licensing requirements for residential support
services to the legislature by January 15, 2011.

(b) Providers licensed under chapter 245B, and providing, contracting, or arranging
for services in settings licensed as adult foster care under Minnesota Rules, parts
9555.5105 to 9555.6265, or child foster care under Minnesota Rules, parts 2960.3000 to
2960.3340; and meeting the provisions of section 256B.092, subdivision 11, paragraph
(b), must be required to obtain a community residential setting license.

new text begin (c) Providers of adult foster care licensed under this chapter and governed by the
standards in chapter 245B are exempt from Minnesota Rules, chapter 4665.
new text end

Sec. 6.

new text begin [245B.065] COMMUNITY RESIDENTIAL SETTINGS.
new text end

new text begin (a) Individuals who are receiving services under the community residential setting
license issued pursuant to section 245A.11, subdivision 8, shall have a support team to
help them make decisions regarding services. The team shall be composed of:
new text end

new text begin (1) the individual receiving services;
new text end

new text begin (2) the case manager or services coordinator;
new text end

new text begin (3) the individual's legal representative;
new text end

new text begin (4) the person's advocate, if any;
new text end

new text begin (5) other individuals chosen by the individual receiving services; and
new text end

new text begin (6) representatives of the providers of service, described in the individual service
plan, relevant to the needs of the individual.
new text end

new text begin (b) Support teams shall have the final decision regarding plans to mitigate the
individual's identified vulnerabilities. Based on an assessment by the support team, the
team may choose not to create a plan for identified vulnerabilities if the vulnerabilities do
not rise to the level of self-neglect, maltreatment, or violations of the law. If the support
team chooses not to create a plan, the team must provide written documentation, signed by
all members of the team, supporting its decision. Licensors or other regulators shall not
have the authority to challenge the decision of the team.
new text end

new text begin (c) Support teams shall be included in any formal or informal evaluation of the
quality of services provided to an individual.
new text end

new text begin (d) Region 10 staff shall be consulted regarding establishment of a system to
evaluate the quality of services provided under the community residential setting license.
new text end

Sec. 7.

Minnesota Statutes 2010, section 245B.07, subdivision 1, is amended to read:

Subdivision 1.

Consumer data file.

The license holder must maintain the following
information for each consumer:

(1) identifying information that includes date of birth, medications, legal
representative, history, medical, and other individual-specific information, and names and
telephone numbers of contacts;

(2) consumer health information, including individual medication administration
and monitoring information;

(3) the consumer's individual service plan.

new text begin (i) new text end When a consumer's case manager does not provide a current individual service
plan, the license holder shall make a written request to the case manager to provide a
copy of the individual service plan and inform the consumer or the consumer's legal
representative of the right to an individual service plan and the right to appeal under
section 256.045 deleted text begin ; deleted text end new text begin .
new text end

new text begin (ii) In the event the case manager fails to provide an individual service plan after
a written request from the license holder, the license holder shall not be sanctioned or
penalized financially for not having a current individual service plan in the consumer's
data file;
new text end

(4) copies of assessments, analyses, summaries, and recommendations;

(5) progress review reports;

(6) incidents involving the consumer;

(7) reports required under section 245B.05, subdivision 7;

(8) discharge summary, when applicable;

(9) record of other license holders serving the consumer that includes a contact
person and telephone numbers, services being provided, services that require coordination
between two license holders, and name of staff responsible for coordination;

(10) information about verbal aggression directed at the consumer by another
consumer; and

(11) information about self-abuse.

Sec. 8.

Minnesota Statutes 2010, section 245C.04, subdivision 6, is amended to read:

Subd. 6.

Unlicensed home and community-based waiver providers of service to
seniors and individuals with disabilities.

(a) Providers required to initiate background
studies under section 256B.4912 must initiate a study before the individual begins in a
position allowing direct contact with persons served by the provider.

(b) deleted text begin The commissioner shall conduct deleted text end new text begin Except as provided in paragraph (c), the
providers must initiate new text end a background study annually of an individual required to be studied
under section 245C.03, subdivision 6.

new text begin (c) After an initial background study under this subdivision is initiated on an
individual by a provider of both services licensed by the commissioner and the unlicensed
services under this subdivision, a repeat annual background study is not required if:
new text end

new text begin (1) the provider maintains compliance with the requirements of section 245C.07,
paragraph (a), regarding one individual with one address and telephone number as the
person to receive sensitive background study information for the multiple programs that
depend on the same background study, and that the individual who is designated to receive
the sensitive background information is capable of determining, upon the request of the
commissioner, whether a background study subject is providing direct contact services
in one or more of the provider's programs or services and, if so, at which location or
locations; and
new text end

new text begin (2) the individual who is the subject of the background study provides direct
contact services under the provider's licensed program for at least 40 hours per year so
the individual will be recognized by a probation officer or corrections agent to prompt
a report to the commissioner regarding criminal convictions as required under section
245C.05, subdivision 7.
new text end

Sec. 9.

Minnesota Statutes 2010, section 256B.092, subdivision 1b, is amended to read:

Subd. 1b.

Individual service plan.

new text begin (a) new text end The individual service plan must:

(1) include the results of the assessment information on the person's need for service,
including identification of service needs that will be or that are met by the person's
relatives, friends, and others, as well as community services used by the general public;

(2) identify the person's preferences for services as stated by the person, the person's
legal guardian or conservator, or the parent if the person is a minor;

(3) identify long- and short-range goals for the person;

(4) identify specific services and the amount and frequency of the services to be
provided to the person based on assessed needs, preferences, and available resources.
The individual service plan shall also specify other services the person needs that are
not available;

(5) identify the need for an individual program plan to be developed by the provider
according to the respective state and federal licensing and certification standards, and
additional assessments to be completed or arranged by the provider after service initiation;

(6) identify provider responsibilities to implement and make recommendations for
modification to the individual service plan;

(7) include notice of the right to request a conciliation conference or a hearing
under section 256.045;

(8) be agreed upon and signed by the person, the person's legal guardian
or conservator, or the parent if the person is a minor, and the authorized county
representative; and

(9) be reviewed by a health professional if the person has overriding medical needs
that impact the delivery of services.

new text begin (b) new text end Service planning formats developed for interagency planning such as transition,
vocational, and individual family service plans may be substituted for service planning
formats developed by county agencies.

new text begin (c) Approved, written, and signed changes to a consumer's services shall be an
addendum to that consumer's individual service plan.
new text end

Sec. 10.

new text begin [256B.492] ADULT FOSTER CARE VOLUNTARY CLOSURE;
ALTERNATIVES.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) The following definitions apply for the purposes
of this section.
new text end

new text begin (b) "Closure" means the cessation of operations of an adult foster care home,
licensed under Minnesota Rules, parts 9555.5105 to 9555.6265.
new text end

new text begin (c) "Closure plan" means a plan to close a foster care home.
new text end

new text begin (d) "Commencement of closure" means the date on which residents and designated
representatives are notified of a planned closure as part of an approved closure plan.
new text end

new text begin (e) "Completion of closure" means the date on which the final resident of the adult
foster care home designated for closure in an approved closure plan is discharged from
the adult foster care home.
new text end

new text begin (f) "Partial closure" means the licensed capacity of the adult foster care home has
been decreased by the department.
new text end

new text begin (g) "Planned closure rate adjustment" means an increase in the operating rate of an
adult foster care home resulting from a planned closure or planned partial closure of
another adult foster care home.
new text end

new text begin Subd. 2. new text end

new text begin Applications for planned closure of adult foster care homes. new text end

new text begin (a) By
August 15, 2012, the commissioner shall implement and announce a program for closure
or partial closure of adult foster care homes. Names and identifying information provided
in response to the announcement shall remain private unless approved according to the
timelines established in the plan. The announcement must specify:
new text end

new text begin (1) the criteria in subdivision 3 that will be used by the commissioner to approve or
reject applications; and
new text end

new text begin (2) the information that must accompany the application.
new text end

new text begin (b) To be considered for approval, an application must include:
new text end

new text begin (1) a description of the proposed closure plan, which must include identification of
the home or homes to receive a planned closure rate adjustment;
new text end

new text begin (2) the proposed timetable for a proposed closure, including the proposed dates for
announcement to residents or designated representatives, commencement of closure,
and completion of closure;
new text end

new text begin (3) if available, the proposed relocation plan for current residents of the adult foster
care home designated for closure. If a relocation plan is not available, the application must
include a statement agreeing to develop a relocation plan; and
new text end

new text begin (4) documentation, in a format approved by the commissioner, that all adult foster
care homes receiving a planned closure rate adjustment under the plan have accepted joint
and several liability for recovery of overpayments under section 256B.0641, subdivision
2, for the adult foster care home designated for closure under the plan.
new text end

new text begin (c) The application must address the criteria in subdivision 3.
new text end

new text begin Subd. 3. new text end

new text begin Criteria for review of application. new text end

new text begin In reviewing and approving closure
proposals, the commissioner shall consider, but not be limited to, the following criteria:
new text end

new text begin (1) improved quality of care and quality of life for consumers;
new text end

new text begin (2) development of alternative services that reduce the cost of care to the Medicaid
program;
new text end

new text begin (3) low occupancy rates. In analyzing occupancy rates, the commissioner shall
examine waiting lists in the applicant facility and at facilities in the surrounding area;
new text end

new text begin (4) proposed usage of funds available from a planned closure rate adjustment for
care-related purposes;
new text end

new text begin (5) evidence that the proposal serves the interests of the state; and
new text end

new text begin (6) evidence of other factors that affect the viability of the facility.
new text end

new text begin Subd. 4. new text end

new text begin Review and approval of applications. new text end

new text begin (a) The commissioner of human
services shall approve or disapprove an application on a regularly scheduled basis.
new text end

new text begin (b) Approval of a planned closure expires 18 months after approval by the
commissioner, unless the commencement of closure has begun.
new text end

new text begin Subd. 5. new text end

new text begin Planned closure rate adjustment. new text end

new text begin Within the limits of money specifically
appropriated to the medical assistance program for this purpose, the commissioner may
approve increases to rates for planned closure rate adjustments. The commissioner shall
negotiate the adjustment to rates directly with the applicant. The commissioner shall
approve or disapprove a project. The commissioner shall base approvals or disapprovals
on a comparison and ranking of proposals using only the criteria in subdivision 3, and
any rules adopted by the commissioner. The cost to the medical assistance program of
approved proposals must be within the limits of the appropriation specifically made for
this purpose.
new text end

Sec. 11.

Minnesota Statutes 2010, section 256D.44, subdivision 5, is amended to read:

Subd. 5.

Special needs.

In addition to the state standards of assistance established in
subdivisions 1 to 4, payments are allowed for the following special needs of recipients of
Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
center, or a group residential housing facility.

(a) The county agency shall pay a monthly allowance for medically prescribed
diets if the cost of those additional dietary needs cannot be met through some other
maintenance benefit. The need for special diets or dietary items must be prescribed by
a licensed physician. Costs for special diets shall be determined as percentages of the
allotment for a one-person household under the thrifty food plan as defined by the United
States Department of Agriculture. The types of diets and the percentages of the thrifty
food plan that are covered are as follows:

(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;

(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent
of thrifty food plan;

(3) controlled protein diet, less than 40 grams and requires special products, 125
percent of thrifty food plan;

(4) low cholesterol diet, 25 percent of thrifty food plan;

(5) high residue diet, 20 percent of thrifty food plan;

(6) pregnancy and lactation diet, 35 percent of thrifty food plan;

(7) gluten-free diet, 25 percent of thrifty food plan;

(8) lactose-free diet, 25 percent of thrifty food plan;

(9) antidumping diet, 15 percent of thrifty food plan;

(10) hypoglycemic diet, 15 percent of thrifty food plan; or

(11) ketogenic diet, 25 percent of thrifty food plan.

(b) Payment for nonrecurring special needs must be allowed for necessary home
repairs or necessary repairs or replacement of household furniture and appliances using
the payment standard of the AFDC program in effect on July 16, 1996, for these expenses,
as long as other funding sources are not available.

(c) A fee for guardian or conservator service is allowed at a reasonable rate
negotiated by the county or approved by the court. This rate shall not exceed five percent
of the assistance unit's gross monthly income up to a maximum of $100 per month. If the
guardian or conservator is a member of the county agency staff, no fee is allowed.

(d) The county agency shall continue to pay a monthly allowance of $68 for
restaurant meals for a person who was receiving a restaurant meal allowance on June 1,
1990, and who eats two or more meals in a restaurant daily. The allowance must continue
until the person has not received Minnesota supplemental aid for one full calendar month
or until the person's living arrangement changes and the person no longer meets the criteria
for the restaurant meal allowance, whichever occurs first.

(e) A fee of ten percent of the recipient's gross income or $25, whichever is less,
is allowed for representative payee services provided by an agency that meets the
requirements under SSI regulations to charge a fee for representative payee services. This
special need is available to all recipients of Minnesota supplemental aid regardless of
their living arrangement.

(f)(1) Notwithstanding the language in this subdivision, an amount equal to the
maximum allotment authorized by the federal Food Stamp Program for a single individual
which is in effect on the first day of July of each year will be added to the standards of
assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify
as shelter needy and are: (i) relocating from an institution, or an adult mental health
residential treatment program under section 256B.0622; (ii) eligible for the self-directed
supports option as defined under section 256B.0657, subdivision 2; or (iii) home and
community-based waiver recipients living in their own home or rented or leased apartment
which is not owned, operated, or controlled by a provider of service not related by blood
or marriage, unless allowed under paragraph (g).

(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the
shelter needy benefit under this paragraph is considered a household of one. An eligible
individual who receives this benefit prior to age 65 may continue to receive the benefit
after the age of 65.

(3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that
exceed 40 percent of the assistance unit's gross income before the application of this
special needs standard. "Gross income" for the purposes of this section is the applicant's or
recipient's income as defined in section 256D.35, subdivision 10, or the standard specified
in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or
state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be
considered shelter needy for purposes of this paragraph.

(g) Notwithstanding this subdivision, to access housing and services as provided
in paragraph (f), the recipient may choose housing that may be owned, operated, or
controlled by the recipient's service provider. In a multifamily building deleted text begin of four or more
units, the maximum number of apartments that may be used by recipients of this program
shall be 50 percent of the units in a building. This paragraph expires on June 30, 2012. deleted text end new text begin the
service provider shall implement a plan with the recipient to transition the lease to the
recipient's name. Within two years of the initial lease, the service provider shall transfer
the lease entered into under this subdivision to the recipient. In the event the landlord
denies this transfer, the commissioner shall approve an exception within sufficient time to
ensure the continued occupancy by the recipient.
new text end

Sec. 12.

Minnesota Statutes 2010, section 256I.04, subdivision 2a, is amended to read:

Subd. 2a.

License required.

A county agency may not enter into an agreement with
an establishment to provide group residential housing unless:

(1) the establishment is licensed by the Department of Health as a hotel and
restaurant; a board and lodging establishment; a residential care home; a boarding care
home before March 1, 1985; or a supervised living facility, and the service provider
for residents of the facility is licensed under chapter 245A. However, an establishment
licensed by the Department of Health to provide lodging need not also be licensed to
provide board if meals are being supplied to residents under a contract with a food vendor
who is licensed by the Department of Health;

(2) the residence is: (i) licensed by the commissioner of human services under
Minnesota Rules, parts 9555.5050 to 9555.6265; (ii) certified by a county human services
agency prior to July 1, 1992, using the standards under Minnesota Rules, parts 9555.5050
to 9555.6265; or (iii) a residence licensed by the commissioner under Minnesota Rules,
parts 2960.0010 to 2960.0120, with a variance under section 245A.04, subdivision 9;

(3) the establishment is registered under chapter 144D and provides three meals a
day, or is an establishment voluntarily registered under section 144D.025 as a supportive
housing establishment; or

(4) an establishment voluntarily registered under section 144D.025, other than
a supportive housing establishment under clause (3), is not eligible to provide group
residential housing.

The requirements under clauses (1) to (4) do not apply to establishments exempt
from state licensure because they are located on Indian reservations and subject to tribal
health and safety requirements.

new text begin Notwithstanding clause (2), if a recipient receiving group residential housing
payments chooses services not licensed under Minnesota Rules, parts 9555.5050 to
9555.6265, the recipient may continue receiving group residential housing payments if the
recipient remains at the same address and if access to shelter needy funding under section
256D.44, subdivision 5, is unavailable. If the housing provider and service provider is the
same entity, the provider shall enter into a lease agreement with the recipient receiving
group residential housing payments within one year after the facility is no longer licensed
as an adult foster care facility.
new text end

Sec. 13.

Minnesota Statutes 2010, section 326B.103, is amended by adding a
subdivision to read:

new text begin Subd. 12a. new text end

new text begin Residential programs; permitted single-family residential use.
new text end

new text begin Residential programs under section 245A.11, subdivision 2, are considered single-family
residences for the purposes of the State Building Code.
new text end

Sec. 14. new text begin CONSUMER CHOICE TASK FORCE.
new text end

new text begin (a) The commissioner of human services shall convene a consumer choice task force
comprised of the following representatives: two representatives from the Department of
Human Services, one from the disability services division and one from the licensing
division; one representative from the Department of Health; one representative from
the attorney general's office; three representatives, including one recipient of disability
services, appointed by the Minnesota Consortium for Citizens with Disabilities; one
representative from the Disability Law Center; and three service providers.
new text end

new text begin (b) The task force shall:
new text end

new text begin (1) identify issues pertaining to financial and personal risk that impede Minnesotans
with disabilities from optimizing their choice of community-based services; and
new text end

new text begin (2) recommend to the chairs of the legislative committees with jurisdiction over
human services and civil law, by January 15, 2013, statutory and rule changes related to
the findings under clause (1) that promote individualized service and housing choices
balanced with appropriate individualized protection.
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. 15. new text begin INNOVATION COMMISSION.
new text end

new text begin (a) The commissioner of human services shall appoint members to the Innovation
Commission to review and make recommendations on provider or lead agency initiated
pilot projects in home and community-based services for people with disabilities that
otherwise would be limited by state-imposed regulatory or funding restrictions.
new text end

new text begin (b) The commission membership shall include: two providers of disability services;
one person receiving disability services or a family member; one advocate for people with
disabilities; one representative from the Disability Law Center; one county representative;
and two representatives from the Department of Human Services, one from the disability
services division and one from the licensing division. Members of the commission shall
serve three-year terms and shall not be reimbursed for commission work or meetings.
new text end

new text begin (c) On January 1 and July 1 of each year, the commissioner shall issue a request for
proposals in the State Register for service providers or lead agencies to develop and
implement new models for residential services that support people with disabilities. The
commission shall review and recommend to the commissioner projects for implementation
twice per year.
new text end

new text begin (d) Each proposed pilot project must:
new text end

new text begin (1) spend no more in state and federal funding than is spent in total funding for the
affected service recipients;
new text end

new text begin (2) be two years in duration;
new text end

new text begin (3) have the informed consent of all affected recipients or their guardians;
new text end

new text begin (4) be based on recipients' individual needs and designed for specific quality
outcomes; and
new text end

new text begin (5) be evaluated by the commission after two years with recommendations to the
commissioner to either discontinue the pilot project or continue the pilot project with
no time limitation.
new text end

new text begin (e) The commissioner shall review the commission's recommendations for start-up
or continuation of pilot projects and may approve new and continued pilot projects twice
per year.
new text end

new text begin (f) If a pilot project is discontinued, the affected recipients may return to services
provided prior to the pilot project and shall have funding for services restored to prepilot
project levels.
new text end

new text begin (g) Providers or lead agencies whose pilot projects are not continued shall not be
penalized due to a pilot project's performance but remain accountable to state and federal
Medicaid, vulnerable adult, and maltreatment of minors laws.
new text end

Sec. 16. new text begin DIRECTION TO THE COMMISSIONER; DUPLICATIVE
STANDARDS.
new text end

new text begin The commissioner of human services shall consult with the commissioner of health
and stakeholders, including service providers, advocates, and counties to consolidate the
ICF/DD standards in Minnesota Statutes, chapter 245B, and the standards in Minnesota
Rules to eliminate duplicative and outdated standards and report their recommendations to
the chairs of the legislative committees with jurisdiction over health and human services
policy by January 15, 2013.
new text end

Sec. 17. new text begin RESIDENTIAL SERVICES FOR THE DISABLED.
new text end

new text begin The commissioner shall not impose any limitations on the authorization for services
or resident capacity in living settings more restrictive than those prescribed under federal
regulations for recipients of CADI, BI, or DD waivered services. If necessary to comply
with this requirement, the commissioner shall submit a waiver amendment to the state
plan no later than December 31, 2012.
new text end

Sec. 18. new text begin INDEPENDENT LIVING SERVICES BILLING.
new text end

new text begin The commissioner shall allow for day rate and 15 minute increment billing for
independent living services under the BI and CADI waivers. If necessary to comply with
this requirement, the commissioner shall submit a waiver amendment to the state plan
no later than December 31, 2012.
new text end

Sec. 19. new text begin REPEALER.
new text end

new text begin Minnesota Rules, part 9555.5105, subpart 37, item B, new text end new text begin is repealed. If necessary to
comply with this repeal, the commissioner shall submit a waiver amendment to the state
plan no later than December 31, 2012.
new text end