SF 1891

as introduced - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

A bill for an act
relating to human services; establishing community initiatives to cover the
uninsured and underinsured; appropriating money.

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

Section 1. new text begin LEGISLATIVE INTENT.
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new text begin The legislature finds that there is a compelling state interest in providing enhanced
and affordable health care services to uninsured and underinsured persons with specific
health problems or conditions which, if left untreated, may deteriorate until the person
is unemployable or may lead to impairment in function or development and require
extensive and costly treatment. To meet this need, the legislature hereby establishes
community initiatives to test the impact of providing enhanced health care to the uninsured
and underinsured including, but not limited to, measuring change in health, functioning,
employability and work performance by providing enhanced health care, examining the
costs to hospitals and clinics for uncompensated care, and examining costs to government
entities.
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Sec. 2. new text begin COMMUNITY INITIATIVES TO COVER THE UNINSURED AND
UNDERINSURED.
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new text begin Subdivision 1. new text end

new text begin Community partnerships. new text end

new text begin The commissioner of human services
shall provide grants to and authorization for up to three community partnerships that
satisfy the requirements in this section. A community partnership is eligible for a grant
and authorization if the community partnership includes:
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new text begin (1) at least one county;
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new text begin (2) at least one local hospital;
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new text begin (3) at least one local employer who collectively provides at least 300 jobs in the
community;
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new text begin (4) at least one school system;
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new text begin (5) at least one of the following:
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new text begin (i) one or more integrated health care clinics or physician groups. For purposes of
this section, "integrated health care" means integrated mental health and primary care; or
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new text begin (ii) one or more health care clinics or physician groups and one or more mental
health clinics; and
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new text begin (6) a third-party payer, which may include a county-based purchasing plan, a
self-insured employer, a licensed health plan company, or a community integrated service
network.
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new text begin Subd. 2 new text end

new text begin Proposal requirements. new text end

new text begin The community partnerships shall submit
initiative proposals which must:
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new text begin (1) include a method of ensuring that each uninsured and underinsured person
enrolled in the program will have an "enhanced health care home," defined as a health
clinic responsible for providing, arranging for, and coordinating enhanced health care
services and helping manage the person's health condition effectively. For purposes of this
section, "enhanced health care services" means evidence-based integrated mental health
and primary and specialty medical care and disease management;
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new text begin (2) include a method of coordinating services between all providers and agencies
providing services to an enrolled individual;
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new text begin (3) include a method of helping uninsured or underinsured persons retain
employment or become employable if currently unemployed;
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new text begin (4) coordinate with the state's quality care and rewarding excellence (QCare)
initiative, Executive Order 06-10; and
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new text begin (5) include a method for comparing actual costs for serving the identified uninsured
or underinsured person to the predicted costs that would have been incurred in the absence
of early intervention and consistent treatment to manage the chronic condition, including
the costs to medical assistance, MinnesotaCare, and general assistance medical care.
new text end

new text begin Subd. 3. new text end

new text begin Proposal evaluation criteria. new text end

new text begin Proposals shall be evaluated by actuarial,
financial, and clinical experts based on the likelihood that the initiative would produce a
positive return on investment for the community. Preference shall be given to proposals
that:
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new text begin (1) have broad community support from local business, provider counties, and other
public and private organizations;
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new text begin (2) would provide services to uninsured or underinsured persons of every age who
have or are at risk of developing multiple, co-occuring chronic conditions;
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new text begin (3) integrate or coordinate resources from multiple sources such as employer
contributions, county funds, social service programs, provider financial or in-kind support,
or other sources;
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new text begin (4) provide continuity of treatment and services when uninsured or underinsured
individuals in the program become eligible for public or private health insurance or when
insured individuals lose their coverage;
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new text begin (5) demonstrate how administrative costs for health coverage plans and providers can
be reduced through greater simplification, coordination, consolidation, standardization,
reducing billing errors, or other methods; and
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new text begin (6) involve local contributions to the cost of the initiative.
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new text begin Subd. 4. new text end

new text begin Initiative requirements. new text end

new text begin The initiative must:
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new text begin (1) provide affordable health care services to uninsured and underinsured persons
with the following conditions:
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new text begin (i) mental illness;
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new text begin (ii) diabetes;
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new text begin (iii) asthma;
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new text begin (iv) hypertension or heart disease; and
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new text begin (v) any other chronic illness as determined by the community partnership;
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new text begin (2) identify and contact persons in their community who are uninsured or
underinsured and who have or are at risk of developing one of the conditions in clause
(1); and
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new text begin (3) develop a method to help uninsured or underinsured persons obtain health
insurance coverage if possible or enroll in any public health care programs for which
they are eligible.
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new text begin Subd. 5. new text end

new text begin Grants. new text end

new text begin (a) The commissioner of human services shall provide grants to
community partnerships as follows:
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new text begin (1) up to 50 percent of the community partnership's costs for planning,
administration, and evaluation; and
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new text begin (2) up to 50 percent of the community partnership's costs for services provided to
uninsured or underinsured persons.
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new text begin (b) Any remaining costs incurred are the responsibility of the community
partnership, but may be paid by another source or by agreement of a health care provider
to contribute the cost as charity care.
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new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007
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Sec. 3. new text begin APPROPRIATION.
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new text begin $....... is appropriated for the biennium beginning July 1, 2007, from the general
fund to the commissioner of human services for the purposes of funding the community
initiatives to cover the uninsured and underinsured in section 2.
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