SF 967

as introduced - 91st Legislature (2019 - 2020) Posted on 02/07/2019 02:57pm

A bill for an act
relating to human services; establishing an integrated health care, services, and
supports partnership demonstration project; establishing a long-term care access
fund; proposing coding for new law in Minnesota Statutes, chapters 16A; 256B.

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

Section 1.

new text begin [16A.7241] LONG-TERM CARE ACCESS FUND.
new text end

new text begin A long-term care access fund is created in the state treasury. The fund is a
direct-appropriated special revenue fund. The commissioner shall deposit to the credit of
the fund money made available to the fund. Notwithstanding section 11A.20, all investment
income and all investment losses attributable to the investment of the long-term care access
fund not currently needed shall be credited to the long-term care access fund.
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. 2.

new text begin [256B.0759] INTEGRATED HEALTH CARE, SERVICES, AND SUPPORTS
PARTNERSHIP DEMONSTRATION PROJECT.
new text end

new text begin Subdivision 1. new text end

new text begin Implementation. new text end

new text begin (a) The commissioner shall create an integrated health
care, services, and supports partnership demonstration project to test alternative and
innovative delivery systems that integrate the delivery of health care services and long-term
services and supports to individuals enrolled in both the special needs basic care program
and one of the home and community-based waivers under section 256B.092 or 256B.49. A
partnership must:
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new text begin (1) provide health care services to the specified population for an agreed-upon total cost
of care, risk-sharing and gain-sharing payment model, or other value-based payment model;
and
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new text begin (2) provide fee-for-service home and community-based waiver services according to a
savings-sharing or other value-based payment model.
new text end

new text begin (b) The commissioner shall develop a request for proposals for participation in the
demonstration project in consultation with providers of community-based waiver services
under sections 256B.092 and 256B.49, accountable care organizations, integrated health
partnerships, mental health providers, pharmacies, home health care providers, primary care
providers, and other key stakeholders.
new text end

new text begin (c) In developing the request for proposals, the commissioner shall:
new text end

new text begin (1) establish uniform statewide methods of forecasting utilization and cost of health care
and of long-term services and supports for individuals in the community-based waivers
under sections 256B.092 and 256B.49 to be used by the commissioner for the integrated
health care, services, and supports partnership projects;
new text end

new text begin (2) identify key indicators of quality, access, patient satisfaction, and other performance
indicators that will be measured, in addition to indicators for measuring cost savings;
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new text begin (3) allow maximum flexibility to encourage innovation and variation to allow a variety
of provider collaborations to become integrated health care, services, and supports
partnerships;
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new text begin (4) encourage different levels and types of financial risk;
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new text begin (5) encourage projects representing a wide variety of geographic locations, patient
populations, provider relationships, and care coordination models;
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new text begin (6) encourage projects involving home and community-based waiver service providers
in rural communities;
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new text begin (7) identify the health care services and home and community-based waiver services to
be considered under each value-based payment model option;
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new text begin (8) establish a mechanism to monitor enrollment; and
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new text begin (9) establish quality standards for the integrated health care, services, and supports
partnerships that are appropriate for the particular population to be served.
new text end

new text begin (d) To be eligible to participate in the demonstration project, an integrated health care,
services, and supports partnership must:
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new text begin (1) provide required covered services and care coordination to individuals enrolled in
the integrated health care, services, and supports partnership;
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new text begin (2) establish a process to monitor enrollment and ensure the quality of health care and
long-term services and supports provided;
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new text begin (3) in cooperation with counties and community social service agencies, coordinate the
delivery of health care services and home and community-based waiver services with existing
social services programs;
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new text begin (4) provide a system for advocacy and consumer protection; and
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new text begin (5) adopt innovative and cost-effective methods for the delivery and coordination of
health care services and home and community-based waiver services.
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new text begin (e) An integrated health care, services, and supports partnership may be formed between
an integrated health partnership and providers of home and community-based waiver services
if they have established a mechanism for shared governance.
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new text begin (f) A managed care plan or county-based purchasing plan must not participate in this
demonstration project unless the plan is a member of an integrated health partnership prior
to the integrated health partnership's participation in the demonstration project.
new text end

new text begin (g) An integrated health care, services, and supports partnership may contract with a
managed care plan or a county-based purchasing plan to provide administrative services,
including the administration of a payment system using the payment methods established
by the commissioner for integrated health care, services, and supports partnerships.
new text end

new text begin (h) The commissioner may require an integrated health care, services, and supports
partnership to enter into additional third-party contractual relationships for the assessment
of risk and purchase of stop-loss insurance or another form of insurance risk management
related to the delivery of health care, services, and supports described in paragraph (d).
new text end

new text begin Subd. 2. new text end

new text begin Enrollment. new text end

new text begin (a) Individuals eligible for medical assistance under section
256B.055, subdivision 7, 7a, or 12; 256B.092; or 256B.49, are eligible for enrollment in an
integrated health care, services, and supports partnership.
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new text begin (b) Eligible applicants and recipients may enroll in an integrated health care, services,
and supports partnership if the integrated health care, services, and supports partnership
serves the county in which the applicant or recipient resides. If more than one integrated
health care, services, and supports partnership serves a county, the applicant or recipient
must be allowed to choose among the integrated health care, services, and supports
partnerships.
new text end

new text begin Subd. 3. new text end

new text begin Accountability. new text end

new text begin (a) Integrated health care, services, and supports partnerships
must accept responsibility for the quality of health care, services, and supports based on
standards established under subdivision 1, paragraph (c), clause (9), and the cost of or
utilization of health care, services, and supports provided to its enrollees under subdivision
1, paragraph (c), clause (1). Accountability standards must be appropriate to the particular
population served.
new text end

new text begin (b) An integrated health care, services, and supports partnership may contract and
coordinate with providers and clinics for the delivery of health care services and shall
contract with community health clinics, federally qualified health centers, community mental
health centers or programs, county agencies, and rural clinics to the extent practicable.
new text end

new text begin (c) An integrated health care, services, and supports partnership must indicate how it
will coordinate with other services affecting patients' health, quality of care, and community
integration. The integrated health care, services, and supports partnership must describe
how local providers, counties, organizations, and other relevant purchasers were consulted
in developing the application to participate in the demonstration project.
new text end

new text begin Subd. 4. new text end

new text begin Payment system. new text end

new text begin (a) In developing a payment system for integrated health
care, services, and supports partnerships, the commissioner shall establish a total cost of
care benchmark, a risk-sharing and gain-sharing payment model or other value-based
payment model to be paid for health care services, and a shared-savings or outcome-based
payment model for home and community-based waiver services provided to the individuals
enrolled in an integrated health care, services, and supports partnership.
new text end

new text begin (b) The payment system may include incentive payments to integrated health care,
services, and supports partnerships that meet or exceed annual quality and performance
targets realized through the coordination of health care and long-term services and supports.
new text end

new text begin (c) An amount equal to the savings realized to the general fund as a result of the
demonstration project must be transferred each fiscal year to the long-term care access fund
established under section 16A.7241.
new text end

new text begin Subd. 5. new text end

new text begin Outpatient prescription drug coverage. new text end

new text begin Outpatient prescription drug coverage
may be provided through accountable care organizations only if the delivery method qualifies
for federal prescription drug rebates.
new text end

new text begin Subd. 6. new text end

new text begin Federal approval. new text end

new text begin The commissioner shall apply for any federal waivers or
other federal approval required to implement this section.
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new text begin EFFECTIVE DATE. new text end

new text begin Subdivisions 1 to 5 are effective July 1, 2019, or upon federal
approval, whichever is later. The commissioner of human services shall inform the revisor
of statutes when federal approval is obtained. Subdivision 6 is effective the day following
final enactment.
new text end