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Key: (1) language to be deleted (2) new language

                             CHAPTER 156-H.F.No. 60 
                  An act relating to health; allowing reimbursement for 
                  supplemental private duty nursing services provided by 
                  spouses of recipients under the community alternative 
                  care home and community-based waivered services 
                  program; amending Minnesota Statutes 1998, section 
                  256B.49, by adding a subdivision. 
           Section 1.  Minnesota Statutes 1998, section 256B.49, is 
        amended by adding a subdivision to read: 
        SPOUSE.] The commissioner shall seek to amend the community 
        alternative care home and community-based waivered services 
        program to include payment for spouses providing private duty 
        nursing care to a recipient who can direct his or her own care.  
        For purposes of this subdivision, a recipient can direct his or 
        her own care if the recipient can communicate: 
           (1) orientation to person, place, and time; 
           (2) an understanding of the recipient's plan of care, 
        including medications and medication schedule; 
           (3) needs; and 
           (4) an understanding of safety issues, including how to 
        access emergency assistance. 
        Private duty nursing may be provided by a spouse who is a 
        licensed nurse employed by a Medicare certified home health 
        agency, in cases where there is a lack of a sufficient number of 
        qualified providers or private duty nurses and to prevent the 
        hospitalization of the recipient.  Private duty nursing services 
        provided by a spouse cannot be used in lieu of nursing services 
        covered and available under liable third-party payers including 
        Medicare and medical assistance not paid by the waiver.  The 
        private duty nursing provided by a spouse must be included in 
        the plan of care and must be scheduled by the home health 
        agency, and may be covered for up to 24 hours per week.  In no 
        case shall the authorization of these services provided by the 
        spouse exceed 50 percent of the total approved nursing hours or 
        eight hours per day, whichever is less.  Nothing in this 
        subdivision precludes the spouse's obligation of assuming the 
        nonreimbursed family responsibilities of emergency backup 
        caregiver and primary caregiver.  The waiver interdisciplinary 
        team shall recommend to the commissioner whether the provision 
        of private duty nursing care by a spouse is appropriate.  In no 
        case shall a spouse be paid to provide private duty nursing care 
        if the spouse fails to pass a criminal background check 
        according to section 245A.04, or if it has been determined by 
        the home health agency or the waiver case manager that the 
        private duty nursing care provided by the spouse is unsafe.  
        This subdivision is effective upon the date of federal approval. 
           Presented to the governor May 10, 1999 
           Signed by the governor May 13, 1999, 1:21 p.m.

Official Publication of the State of Minnesota
Revisor of Statutes