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SF 3117

1st Engrossment - 91st Legislature (2019 - 2020) Posted on 02/25/2020 09:00am

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - 1st Engrossment

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A bill for an act
relating to human services; extending the corporate adult foster care moratorium
exception for a fifth bed until 2024; modifying timelines for intensive support
service planning; permitting delegation of competency evaluations of direct support
staff; amending Minnesota Statutes 2018, sections 245A.11, subdivision 2a;
245D.071, subdivision 3; 245D.081, subdivision 2.

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

Section 1.

Minnesota Statutes 2018, section 245A.11, subdivision 2a, is amended to read:


Subd. 2a.

Adult foster care and community residential setting license capacity.

(a)
The commissioner shall issue adult foster care and community residential setting licenses
with a maximum licensed capacity of four beds, including nonstaff roomers and boarders,
except that the commissioner may issue a license with a capacity of five beds, including
roomers and boarders, according to paragraphs (b) to (g).

(b) The license holder may have a maximum license capacity of five if all persons in
care are age 55 or over and do not have a serious and persistent mental illness or a
developmental disability.

(c) The commissioner may grant variances to paragraph (b) to allow a facility with a
licensed capacity of up to five persons to admit an individual under the age of 55 if the
variance complies with section 245A.04, subdivision 9, and approval of the variance is
recommended by the county in which the licensed facility is located.

(d) The commissioner may grant variances to paragraph (a) to allow the use of an
additional bed, up to five, for emergency crisis services for a person with serious and
persistent mental illness or a developmental disability, regardless of age, if the variance
complies with section 245A.04, subdivision 9, and approval of the variance is recommended
by the county in which the licensed facility is located.

(e) The commissioner may grant a variance to paragraph (b) to allow for the use of an
additional bed, up to five, for respite services, as defined in section 245A.02, for persons
with disabilities, regardless of age, if the variance complies with sections 245A.03,
subdivision 7
, and 245A.04, subdivision 9, and approval of the variance is recommended
by the county in which the licensed facility is located. Respite care may be provided under
the following conditions:

(1) staffing ratios cannot be reduced below the approved level for the individuals being
served in the home on a permanent basis;

(2) no more than two different individuals can be accepted for respite services in any
calendar month and the total respite days may not exceed 120 days per program in any
calendar year;

(3) the person receiving respite services must have his or her own bedroom, which could
be used for alternative purposes when not used as a respite bedroom, and cannot be the
room of another person who lives in the facility; and

(4) individuals living in the facility must be notified when the variance is approved. The
provider must give 60 days' notice in writing to the residents and their legal representatives
prior to accepting the first respite placement. Notice must be given to residents at least two
days prior to service initiation, or as soon as the license holder is able if they receive notice
of the need for respite less than two days prior to initiation, each time a respite client will
be served, unless the requirement for this notice is waived by the resident or legal guardian.

(f) The commissioner may issue an adult foster care or community residential setting
license with a capacity of five adults if the fifth bed does not increase the overall statewide
capacity of licensed adult foster care or community residential setting beds in homes that
are not the primary residence of the license holder, as identified in a plan submitted to the
commissioner by the county, when the capacity is recommended by the county licensing
agency of the county in which the facility is located and if the recommendation verifies
that:

(1) the facility meets the physical environment requirements in the adult foster care
licensing rule;

(2) the five-bed living arrangement is specified for each resident in the resident's:

(i) individualized plan of care;

(ii) individual service plan under section 256B.092, subdivision 1b, if required; or

(iii) individual resident placement agreement under Minnesota Rules, part 9555.5105,
subpart 19, if required;

(3) the license holder obtains written and signed informed consent from each resident
or resident's legal representative documenting the resident's informed choice to remain
living in the home and that the resident's refusal to consent would not have resulted in
service termination; and

(4) the facility was licensed for adult foster care before March 1, deleted text begin2011deleted text endnew text begin 2016new text end.

(g) The commissioner shall not issue a new adult foster care license under paragraph (f)
after June 30, deleted text begin2019deleted text endnew text begin 2024new text end. The commissioner shall allow a facility with an adult foster care
license issued under paragraph (f) before June 30, deleted text begin2019deleted text endnew text begin 2024new text end, to continue with a capacity
of five adults if the license holder continues to comply with the requirements in paragraph
(f).

Sec. 2.

Minnesota Statutes 2018, section 245D.071, subdivision 3, is amended to read:


Subd. 3.

Assessment and initial service planning.

(a) Within 15 days of service initiation
the license holder must complete a preliminary coordinated service and support plan
addendum based on the coordinated service and support plan.

(b) Within the scope of services, the license holder must, at a minimum, complete
assessments in the following areas before the 45-day planning meeting:

(1) the person's ability to self-manage health and medical needs to maintain or improve
physical, mental, and emotional well-being, including, when applicable, allergies, seizures,
choking, special dietary needs, chronic medical conditions, self-administration of medication
or treatment orders, preventative screening, and medical and dental appointments;

(2) the person's ability to self-manage personal safety to avoid injury or accident in the
service setting, including, when applicable, risk of falling, mobility, regulating water
temperature, community survival skills, water safety skills, and sensory disabilities; and

(3) the person's ability to self-manage symptoms or behavior that may otherwise result
in an incident as defined in section 245D.02, subdivision 11, clauses (4) to (7), suspension
or termination of services by the license holder, or other symptoms or behaviors that may
jeopardize the health and welfare of the person or others.

Assessments must produce information about the person that describes the person's overall
strengths, functional skills and abilities, and behaviors or symptoms. Assessments must be
based on the person's status within the last 12 months at the time of service initiation.
Assessments based on older information must be documented and justified. Assessments
must be conducted annually at a minimum or within 30 days of a written request from the
person or the person's legal representative or case manager. The results must be reviewed
by the support team or expanded support team as part of a service plan review.

(c) deleted text beginWithindeleted text endnew text begin Before providingnew text end 45 days of service deleted text begininitiationdeleted text endnew text begin or within 60 calendar days of
the first day of service, whichever is shorter
new text end, the license holder must meet with the person,
the person's legal representative, the case manager, deleted text beginanddeleted text end other members of the support team
or expanded support teamnew text begin, and other people as identified by the person or the person's legal
representative
new text end to determine the following based on information obtained from the assessments
identified in paragraph (b), the person's identified needs in the coordinated service and
support plan, and the requirements in subdivision 4 and section 245D.07, subdivision 1a:

(1) the scope of the services to be provided to support the person's daily needs and
activities;

(2) the person's desired outcomes and the supports necessary to accomplish the person's
desired outcomes;

(3) the person's preferences for how services and supports are provided, including how
the provider will support the person to have control of the person's schedule;

(4) whether the current service setting is the most integrated setting available and
appropriate for the person; and

(5) how services must be coordinated across other providers licensed under this chapter
serving the person and members of the support team or expanded support team to ensure
continuity of care and coordination of services for the person.

(d) A discussion of how technology might be used to meet the person's desired outcomes
must be included in the 45-day planning meeting. The coordinated service and support plan
or support plan addendum must include a summary of this discussion. The summary must
include a statement regarding any decision that is made regarding the use of technology
and a description of any further research that needs to be completed before a decision
regarding the use of technology can be made. Nothing in this paragraph requires that the
coordinated service and support plan include the use of technology for the provision of
services.

Sec. 3.

Minnesota Statutes 2018, section 245D.081, subdivision 2, is amended to read:


Subd. 2.

Coordination and evaluation of individual service delivery.

(a) Delivery
and evaluation of services provided by the license holder must be coordinated by a designated
staff person. new text beginExcept as provided in clause (3), new text endthe designated coordinator must provide
supervision, support, and evaluation of activities that include:

(1) oversight of the license holder's responsibilities assigned in the person's coordinated
service and support plan and the coordinated service and support plan addendum;

(2) taking the action necessary to facilitate the accomplishment of the outcomes according
to the requirements in section 245D.07;

(3) instruction and assistance to direct support staff implementing the coordinated service
and support plan and the service outcomes, including direct observation of service delivery
sufficient to assess staff competencynew text begin. The designated coordinator may delegate the direct
observation and competency assessment of the service delivery activities of direct support
staff to an individual whom the designated coordinator has previously deemed competent
in those activities
new text end; and

(4) evaluation of the effectiveness of service delivery, methodologies, and progress on
the person's outcomes based on the measurable and observable criteria for identifying when
the desired outcome has been achieved according to the requirements in section 245D.07.

(b) The license holder must ensure that the designated coordinator is competent to
perform the required duties identified in paragraph (a) through education, training, and work
experience relevant to the primary disability of persons served by the license holder and
the individual persons for whom the designated coordinator is responsible. The designated
coordinator must have the skills and ability necessary to develop effective plans and to
design and use data systems to measure effectiveness of services and supports. The license
holder must verify and document competence according to the requirements in section
245D.09, subdivision 3. The designated coordinator must minimally have:

(1) a baccalaureate degree in a field related to human services, and one year of full-time
work experience providing direct care services to persons with disabilities or persons age
65 and older;

(2) an associate degree in a field related to human services, and two years of full-time
work experience providing direct care services to persons with disabilities or persons age
65 and older;

(3) a diploma in a field related to human services from an accredited postsecondary
institution and three years of full-time work experience providing direct care services to
persons with disabilities or persons age 65 and older; or

(4) a minimum of 50 hours of education and training related to human services and
disabilities; and

(5) four years of full-time work experience providing direct care services to persons
with disabilities or persons age 65 and older under the supervision of a staff person who
meets the qualifications identified in clauses (1) to (3).