Minnesota Legislature
SF 2410
as introduced - 91st Legislature (2019 - 2020) Posted on 03/21/2019 03:31pm
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A bill for an act
relating to human services; requiring housing with services establishments to set
aside capacity for elderly waiver participants; establishing a rate adjustment for
housing with service establishments serving a large portion of elderly waiver
participants; amending Minnesota Statutes 2018, section 256B.0915, subdivision
10, by adding a subdivision; proposing coding for new law in Minnesota Statutes,
chapter 144D.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
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[144D.12] REQUIRED ELDERLY WAIVER CAPACITY.
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new text begin Subdivision 1. new text end
new text begin Elderly waiver services required. new text end
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Each housing with services
establishment that offers or provides assisted living under chapter 144G, except those
registered under section 144D.025, must, as a condition of maintaining its registration,
demonstrate that at least ten percent of its residents are elderly waiver participants. Newly
registered housing with services establishments must comply with this section by the date
of the establishment's second annual registration. If the commissioner determines that an
establishment is out of compliance with this section, the commissioner shall notify the
establishment that the establishment is out of compliance and allow the establishment 180
calendar days to come into compliance with this section. If after 180 days the commissioner
determines that the establishment remains out of compliance, the commissioner shall suspend
the establishment's registration until the establishment demonstrates compliance.
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new text begin Subd. 2. new text end
new text begin Demonstrating proportion of elderly waiver participants. new text end
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Each housing
with services establishment required under subdivision 1 to demonstrate that at least ten
percent of its residents are elderly waiver participants must document in a manner determined
by the commissioner the average daily census of elderly waiver participants living in the
establishment during the 12-month period prior to the date of the establishment's annual
registration.
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Sec. 2.
Minnesota Statutes 2018, section 256B.0915, subdivision 10, is amended to read:
Subd. 10.
Waiver payment rates; managed care organizations.
The commissioner
shall adjust the elderly waiver capitation payment rates for managed care organizations paid
under section 256B.69, subdivisions 6b and 23, to reflect the maximum service rate limits
for customized living services and 24-hour customized living services under subdivisions
3e deleted text begin anddeleted text end new text begin ,new text end 3hnew text begin , and 18new text end . Medical assistance rates paid to customized living providers by managed
care organizations under this section shall not exceed the maximum service rate limits and
component rates as determined by the commissioner under subdivisions 3e deleted text begin anddeleted text end new text begin ,new text end 3hnew text begin , and 18new text end .
Sec. 3.
Minnesota Statutes 2018, section 256B.0915, is amended by adding a subdivision
to read:
new text begin Subd. 18. new text end
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Disproportionate share establishment customized living rate
adjustment.
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(a) For purposes of this section, "designated disproportionate share
establishment" means a housing with services establishment registered under chapter 144D
that meets the requirements of paragraph (d).
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(b) A housing with services establishment registered under chapter 144D may apply
annually between June 1 and June 15 to the lead agency to be designated as a disproportionate
share establishment. The applying housing with services establishment must apply to the
lead agency in the manner determined by the commissioner. The applying housing with
services establishment must document as a percentage the average daily census of elderly
waiver participants residing in the establishment over the 12 months prior to submitting its
annual application.
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(c) Only a housing with services establishment registered under chapter 144D with an
average daily census of at least 50 percent elderly waiver participants during the 12 months
prior to submitting its annual application is eligible under this section for designation as a
disproportionate share establishment. An applying housing with services establishment must
agree in writing to monitor each month its 12-month average daily census of elderly waiver
participants and, if in any month the 12-month average daily census decreases by more than
ten percentage points, notify the lead agency of the establishment's current 12-month average.
If an establishment's 12-month average falls below 40 percent, the establishment is no longer
eligible for designation as a disproportionate share establishment, and the lead agency shall
immediately revoke the designation and cease to apply the establishment's rate adjustment.
A revocation of a designation does not prohibit an establishment from applying for
designation in the future. If an establishment's 12-month average daily census of elderly
waiver participants decreases more than ten percentage points, but not below 40 percent,
the lead agency shall immediately recalculate the establishment's rate adjustment under
paragraph (f) using the establishment's current 12-month average.
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(d) By June 30, the lead agency shall designate as a disproportionate share establishment
any housing with services establishment that complies with the requirements of paragraph
(b) and meets the eligibility criteria described in paragraph (c).
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(e) When authorizing rates for customized living services and 24-hour customized living
services for elderly waiver participants who are residents of designated disproportionate
share establishments, the lead agency shall utilize the component values established by the
commissioner under subdivision 3e, and the component values established under subdivision
16, and shall multiply the component values by the establishment's customized living rate
adjustment as determined under paragraph (f).
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(f) A designated disproportionate share establishment's customized living rate adjustment
is the sum of 0.89 plus the product of 0.29 multiplied by the 12-month average daily census
of elderly waiver participants as a percentage of the residents of the establishment as reported
on the establishment's most recent application for designation as a disproportionate share
establishment or as reported to the lead agency under paragraph (c). No establishment may
receive a customized living rate adjustment greater than 1.10.
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(g) The customized living monthly service rate limit for housing with services
establishments designated as disproportionate share establishments under paragraph (d)
shall not exceed the product of half the monthly case mix budget determined under
subdivision 3e multiplied by the designated disproportionate share establishment's customized
living rate adjustment determined under paragraph (f).
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(h) The 24-hour customized living monthly service limit for housing with services
establishments designated as disproportionate share establishments under paragraph (d) is
the limit determined under subdivision 3h multiplied by the designated disproportionate
share establishment's customized living rate adjustment determined under paragraph (f).
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(i) When requesting or renewing an eligibility determination for elderly waiver services,
a participant who is a resident or a potential resident of a disproportionate share establishment
may request a disproportionate share monthly case mix budget cap for the cost of elderly
waiver services.
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(j) Only a resident of a designated disproportionate share establishment is eligible under
this section for a disproportionate share monthly case mix budget cap.
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(k) Effective each July, the disproportionate share monthly case mix budget cap for all
case mix classifications shall be the sum of half the monthly case mix budget cap determined
under subdivision 3a plus the product of half the monthly case mix budget cap multiplied
by the designated disproportionate share establishment's customized living rate adjustment
determined under paragraph (f).
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