SF 909

as introduced - 91st Legislature (2019 - 2020) Posted on 02/07/2019 02:19pm

A bill for an act
relating to human services; modifying intermediate care facility for persons with
developmental disabilities payment rates; amending Minnesota Statutes 2018,
sections 256B.5013, subdivisions 1, 6; 256B.5015, subdivision 2.

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

Section 1.

Minnesota Statutes 2018, section 256B.5013, subdivision 1, is amended to read:

Subdivision 1.

Variable rate adjustments.

(a) deleted text begin For rate years beginning on or after
October 1, 2000, deleted text end When there is a documented increase in the needs of a current ICF/DD
recipient, the county of financial responsibility may recommend a variable rate to enable
the facility to meet the individual's increased needs. Variable rate adjustments made under
this subdivision replace payments for persons with special needs for crisis intervention
services under section 256B.501, subdivision 8a. deleted text begin Effective July 1, 2003, facilities with a
base rate above the 50th percentile of the statewide average reimbursement rate for a Class
A facility or Class B facility, whichever matches the facility licensure, are not eligible for
a variable rate adjustment. Variable rate adjustments may not exceed a 12-month period,
except when approved for purposes established in paragraph (b), clause (1). deleted text end new text begin Once approved,
variable rate adjustments must continue to remain in place unless there is an identified
change in need. A review of needed resources must be done at the time of the individual's
annual support plan meeting. A request to adjust the resources of the individual must be
submitted if any change in need is identified. new text end Variable rate adjustments approved solely on
the basis of changes on a developmental disabilities screening document will end June 30,
2002.

new text begin (b) The county of financial responsibility must act on a variable rate request within 30
days and notify the initiator of the request of the county's recommendation in writing.
new text end

deleted text begin (b) deleted text end new text begin (c) new text end A variable rate may be recommended by the county of financial responsibility
for increased needs in the following situations:

(1) a need for resources due to an individual's full or partial retirement from participation
in a day training and habilitation service when the individual: (i) has reached the age of 65
or has a change in health condition that makes it difficult for the person to participate in
day training and habilitation services over an extended period of time because it is medically
contraindicated; and (ii) has expressed a desire for change through the developmental
disability screening process under section 256B.092;

(2) a need for additional resources for intensive short-term programming which is
necessary prior to an individual's discharge to a less restrictive, more integrated setting;

(3) a demonstrated medical need that significantly impacts the type or amount of services
needed by the individual; deleted text begin or
deleted text end

(4) a demonstrated behavioral new text begin or cognitive new text end need that significantly impacts the type or
amount of services needed by the individual deleted text begin . deleted text end new text begin ; or
new text end

deleted text begin (c) The county of financial responsibility must justify the purpose, the projected length
of time, and the additional funding needed for the facility to meet the needs of the individual.
deleted text end

deleted text begin (d) The facility shall provide an annual report to the county case manager on the use of
the variable rate funds and the status of the individual on whose behalf the funds were
approved. The county case manager will forward the facility's report with a recommendation
to the commissioner to approve or disapprove a continuation of the variable rate.
deleted text end

deleted text begin (e) Funds made available through the variable rate process that are not used by the facility
to meet the needs of the individual for whom they were approved shall be returned to the
state.
deleted text end

new text begin (5) a demonstrated increased need for staff assistance, changes in the type of staff
credentials needed, or a need for expert consultation based on assessments conducted prior
to the annual support plan meeting.
new text end

new text begin (d) Variable rate requests must include the following information:
new text end

new text begin (1) the service needs change;
new text end

new text begin (2) the variable rate requested and the difference from the current rate;
new text end

new text begin (3) a basis for the underlying costs used for the variable rate and any accompanying
documentation; and
new text end

new text begin (4) documentation of the expected outcomes to be achieved and the frequency of progress
monitoring associated with the rate increase.
new text end

Sec. 2.

Minnesota Statutes 2018, section 256B.5013, subdivision 6, is amended to read:

Subd. 6.

Commissioner's responsibilities.

The commissioner shall:

(1) make a determination to approve, deny, or modify a request for a variable rate
adjustment within 30 days of the receipt of the completed application;

(2) notify the ICF/DD facility and county case manager of the deleted text begin duration and conditions
of variable rate adjustment approvals deleted text end new text begin determination new text end ; and

(3) modify MMIS II service agreements to reimburse ICF/DD facilities for approved
variable rates.

Sec. 3.

Minnesota Statutes 2018, section 256B.5015, subdivision 2, is amended to read:

Subd. 2.

Services during the day.

new text begin (a) new text end Services during the day, as defined in section
256B.501, but excluding day training and habilitation services, shall be paid as a pass-through
payment deleted text begin no later than January 1, 2004 deleted text end . The commissioner shall establish rates for these
services, other than day training and habilitation services, at levels deleted text begin that do not exceed 75 deleted text end new text begin
no less than 100 new text end percent of a recipient's day training and habilitation service costs prior to
the service change.

new text begin (b) An individual qualifies for no less than 100 percent of the rate paid to day training
and habilitation services if:
new text end

new text begin (1) through consultation with the individual and their support team or interdisciplinary
team, it has been determined that the individual's needs can best be met through partial or
full retirement from:
new text end

new text begin (i) participation in a day training and habilitation service; or
new text end

new text begin (ii) the use of services during the day in the individual's home environment; and
new text end

new text begin (2) in consultation with the individual and their support team or interdisciplinary team,
an individualized plan has been developed with designated outcomes that:
new text end

new text begin (i) addresses the support needs and desires contained in the person-centered plan or
individual support plan; and
new text end

new text begin (ii) includes goals that focus on community integration as appropriate for the individual.
new text end

new text begin (c) new text end When establishing a rate for these services, the commissioner shall also consider an
individual recipient's needs as identified in the deleted text begin individualized service deleted text end new text begin individual support new text end
plan and the person's need for active treatment as defined under federal regulations. The
pass-through payments for services during the day shall be paid separately by the
commissioner and shall not be included in the computation of the ICF/DD facility total
payment rate.