SF 3703

as introduced - 91st Legislature (2019 - 2020) Posted on 02/27/2020 03:40pm

A bill for an act
relating to human services; requiring child care assistance program providers to
provide proof of surety bond coverage; authorizing reallocation of unspent human
services grant funding by counties and tribes; requiring enrollment of qualified
professionals supervising personal care assistants; requiring report on impact of
nonemergency medical transportation driver enrollment; requiring legislative
proposal to reform payment system for nursing services and home health services;
amending Minnesota Statutes 2018, sections 119B.125, by adding a subdivision;
256B.0659, subdivision 14; proposing coding for new law in Minnesota Statutes,
chapter 256.

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

Section 1.

Minnesota Statutes 2018, section 119B.125, is amended by adding a subdivision
to read:

new text begin Subd. 10. new text end

new text begin Proof of surety bond coverage. new text end

new text begin All licensed child care centers authorized
for reimbursement under this chapter that received child care assistance program revenue
equal to or greater than $250,000 in the previous calendar year must provide to the
commissioner proof of surety bond coverage. The surety bond must provide coverage of
$100,000, be in a form approved by the commissioner, be renewed at least annually, and
allow for recovery of costs and fees in pursuing a claim on the bond.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2021.
new text end

Sec. 2.

new text begin [256.0113] COUNTY HUMAN SERVICES STATE FUNDING
REALLOCATION.
new text end

new text begin (a) Beginning October 1, 2020, counties and tribes or tribal agencies receiving human
services grants funded exclusively with state general fund dollars may allocate unexpended
grant amounts to county or tribal human services activity for the fourth quarter of the county
or tribe's fiscal year.
new text end

new text begin (b) Any proposed reallocation of unspent funds must be approved by a majority vote of
the county board or the tribe or tribal agency's governing body.
new text end

new text begin (c) Each county, tribe, or tribal agency must report any approved reallocation of unspent
grant funds to the commissioner of human services by March 31 of each year following a
reallocation under this section. The report must describe the use of the reallocated human
services grant funds, compare how the funds were allocated prior to the reallocation, and
explain the advantages or disadvantages of the reallocation.
new text end

Sec. 3.

Minnesota Statutes 2018, section 256B.0659, subdivision 14, is amended to read:

Subd. 14.

Qualified professional; duties.

(a) Effective January 1, 2010, all personal
care assistants must be supervised by a qualified professional.

(b) Through direct training, observation, return demonstrations, and consultation with
the staff and the recipient, the qualified professional must ensure and document that the
personal care assistant is:

(1) capable of providing the required personal care assistance services;

(2) knowledgeable about the plan of personal care assistance services before services
are performed; and

(3) able to identify conditions that should be immediately brought to the attention of the
qualified professional.

(c) The qualified professional shall evaluate the personal care assistant within the first
14 days of starting to provide regularly scheduled services for a recipient, or sooner as
determined by the qualified professional, except for the personal care assistance choice
option under subdivision 19, paragraph (a), clause (4). For the initial evaluation, the qualified
professional shall evaluate the personal care assistance services for a recipient through direct
observation of a personal care assistant's work. The qualified professional may conduct
additional training and evaluation visits, based upon the needs of the recipient and the
personal care assistant's ability to meet those needs. Subsequent visits to evaluate the personal
care assistance services provided to a recipient do not require direct observation of each
personal care assistant's work and shall occur:

(1) at least every 90 days thereafter for the first year of a recipient's services;

(2) every 120 days after the first year of a recipient's service or whenever needed for
response to a recipient's request for increased supervision of the personal care assistance
staff; and

(3) after the first 180 days of a recipient's service, supervisory visits may alternate
between unscheduled phone or Internet technology and in-person visits, unless the in-person
visits are needed according to the care plan.

(d) Communication with the recipient is a part of the evaluation process of the personal
care assistance staff.

(e) At each supervisory visit, the qualified professional shall evaluate personal care
assistance services including the following information:

(1) satisfaction level of the recipient with personal care assistance services;

(2) review of the month-to-month plan for use of personal care assistance services;

(3) review of documentation of personal care assistance services provided;

(4) whether the personal care assistance services are meeting the goals of the service as
stated in the personal care assistance care plan and service plan;

(5) a written record of the results of the evaluation and actions taken to correct any
deficiencies in the work of a personal care assistant; and

(6) revision of the personal care assistance care plan as necessary in consultation with
the recipient or responsible party, to meet the needs of the recipient.

(f) The qualified professional shall complete the required documentation in the agency
recipient and employee files and the recipient's home, including the following documentation:

(1) the personal care assistance care plan based on the service plan and individualized
needs of the recipient;

(2) a month-to-month plan for use of personal care assistance services;

(3) changes in need of the recipient requiring a change to the level of service and the
personal care assistance care plan;

(4) evaluation results of supervision visits and identified issues with personal care
assistance staff with actions taken;

(5) all communication with the recipient and personal care assistance staff; and

(6) hands-on training or individualized training for the care of the recipient.

(g) The documentation in paragraph (f) must be done on agency templates.

(h) The services that are not eligible for payment as qualified professional services
include:

(1) direct professional nursing tasks that could be assessed and authorized as skilled
nursing tasks;

(2) agency administrative activities;

(3) training other than the individualized training required to provide care for a recipient;
and

(4) any other activity that is not described in this section.

new text begin (i) The qualified professional must notify the commissioner on a form prescribed by the
commissioner within 30 days of when a qualified professional is no longer employed by or
otherwise affiliated with the personal care assistance agency for whom the qualified
professional previously provided qualified professional services.
new text end

Sec. 4. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
NONEMERGENCY MEDICAL TRANSPORTATION REPORTING.
new text end

new text begin By August 1, 2022, the commissioner of human services must report to the chairs and
ranking minority members of the legislative committees with jurisdiction over health and
human services. The report must include the commissioner's findings regarding the impact
of individual driver enrollment under Minnesota Statutes, section 256B.0625, subdivision
17, paragraph (c), on the program integrity of the provision of nonemergency medical
transportation services and the availability of drivers.
new text end

Sec. 5. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; HOME
CARE SERVICES PAYMENT REFORM PROPOSAL.
new text end

new text begin By August 1, 2022, the commissioner of human services must submit to the chairs and
ranking minority members of the legislative committees with jurisdiction over human
services finance and policy a proposal to adopt a budget-neutral prospective payment system
for nursing services and home health services under Minnesota Statutes, sections 256B.0625,
subdivision 6a, and 256B.0653, and home care nursing services under Minnesota Statutes,
sections 256B.0625, subdivision 7, and 256B.0624, modeled on the Medicare fee-for-service
home health prospective payment system. The commissioner must include in the proposal
a case mix adjusted episodic rate, including services, therapies and supplies, minimum visits
required for an episodic rate, consolidated billing requirements, outlier payments,
low-utilization payments, and other criteria at the commissioner's discretion. In addition to
the budget-neutral payment reform proposal, the commissioner must submit a proposed
mechanism for updating the payment rates to reflect inflation in health care costs.
new text end