1.1 	A bill for an act
1.2 	relating to human services; changing long-term care
1.3 	provisions; amending Minnesota Statutes 2004, sections
1.4 	144A.071, subdivision 1a; 256B.0913, subdivision 8;
1.5 	256B.0915, subdivisions 1a, 6, 9.
1.6 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.7 	ARTICLE 1
1.8 	LONG-TERM CARE FACILITIES

1.9 	Section 1. Minnesota Statutes 2004, section 144A.071,
1.10 	subdivision 1a, is amended to read:
1.11 		Subd. 1a.Definitions.  For purposes of sections 144A.071
1.12 	to 144A.073, the following terms have the meanings given them:
1.13 	(a) "Attached fixtures" has the meaning given in Minnesota
1.14 	Rules, part 9549.0020, subpart 6.
1.15 	(b) "Buildings" has the meaning given in Minnesota Rules,
1.16 	part 9549.0020, subpart 7.
1.17 	(c) "Capital assets" has the meaning given in section
1.18 	256B.421, subdivision 16.
1.19 	(d) "Commenced construction" means that all of the
1.20 	following conditions were met:  the final working drawings and
1.21 	specifications were approved by the commissioner of health; the
1.22 	construction contracts were let; a timely construction schedule
1.23 	was developed, stipulating dates for beginning, achieving
1.24 	various stages, and completing construction; and all zoning and
1.25 	building permits were applied for.
2.1 	(e) "Completion date" means the date on which a certificate
2.2 	of occupancy is issued for a construction project, or if a
2.3 	certificate of occupancy is not required, the date on which the
2.4 	construction project is available for facility use.
2.5 	(f) "Construction" means any erection, building,
2.6 	alteration, reconstruction, modernization, or improvement
2.7 	necessary to comply with the nursing home licensure rules.
2.8 	(g) "Construction project" means:
2.9 	(1) a capital asset addition to, or replacement of a
2.10 	nursing home or certified boarding care home that results in new
2.11 	space or the remodeling of or renovations to existing facility
2.12 	space; and 
2.13 	(2) the remodeling or renovation of existing facility space
2.14 	the use of which is modified as a result of the project
2.15 	described in clause (1).  This existing space and the project
2.16 	described in clause (1) must be used for the functions as
2.17 	designated on the construction plans on completion of the
2.18 	project described in clause (1) for a period of not less than 24
2.19 	months~~; or~~ 
2.20 	~~(3) capital asset additions or replacements that are~~
2.21 	~~completed within 12 months before or after the completion date~~
2.22 	~~of the project described in clause (1)~~.
2.23 	(h) "Depreciation guidelines" means the most recent
2.24 	publication of "The Estimated Useful Lives of Depreciable
2.25 	Hospital Assets," issued by the American Hospital Association,
2.26 	840 North Lake Shore Drive, Chicago, Illinois, 60611.
2.27 	(i) "New licensed" or "new certified beds" means:
2.28 	(1) newly constructed beds in a facility or the
2.29 	construction of a new facility that would increase the total
2.30 	number of licensed nursing home beds or certified boarding care
2.31 	or nursing home beds in the state; or
2.32 	(2) newly licensed nursing home beds or newly certified
2.33 	boarding care or nursing home beds that result from remodeling
2.34 	of the facility that involves relocation of beds but does not
2.35 	result in an increase in the total number of beds, except when
2.36 	the project involves the upgrade of boarding care beds to
3.1 	nursing home beds, as defined in section 144A.073, subdivision
3.2 	1.  "Remodeling" includes any of the type of conversion,
3.3 	renovation, replacement, or upgrading projects as defined in
3.4 	section 144A.073, subdivision 1.
3.5 	~~(i)~~ (j) "Project construction costs" means the cost of the
3.6 	following items that have a completion date within 12 months
3.7 	before or after the completion date of the project described in
3.8 	item (g), clause (1):
3.9 	(1) facility capital asset additions~~,~~;
3.10 	(2) replacements~~,~~;
3.11 	(3) renovations~~, or~~ ;
3.12 	(4) remodeling projects~~,~~;
3.13 	(5) construction site preparation costs~~, and~~ ;
3.14 	(6) related soft costs~~.  Project construction costs include~~
3.15 	~~the cost of any remodeling or renovation of existing facility~~
3.16 	~~space which is modified as a result of the construction~~
3.17 	~~project.  Project construction costs also includes the cost of~~
3.18 	~~new technology implemented as part of the construction project.~~
3.19 	~~Project construction costs also include~~ ; and 
3.20 	(7) the cost of new technology implemented as part of the
3.21 	construction project and depreciable equipment directly
3.22 	identified to the project, if the construction costs for clauses
3.23 	(1) to (6) exceed the threshold for additions and replacements
3.24 	stated in section 256B.431, subdivision 16. ~~Any new~~ Technology
3.25 	and depreciable equipment shall be included in the project
3.26 	construction costs ~~shall, at the~~ unless a written election ~~of~~ is
3.27 	made by the facility, ~~be included~~ to not include it in the
3.28 	facility's appraised value for purposes of Minnesota Rules, part
3.29 	9549.0020, subpart 5~~, and~~ .Debt incurred for ~~its~~ purchase of
3.30 	technology and depreciable equipment shall be included as
3.31 	allowable debt for purposes of Minnesota Rules, part 9549.0060,
3.32 	subpart 5, items A and C, unless the written election is to not
3.33 	include it.  Any new technology and depreciable equipment
3.34 	included in the project construction costs that the facility
3.35 	elects not to include in its appraised value and allowable debt
3.36 	shall be treated as provided in section 256B.431, subdivision
4.1 	17, paragraph (b).  Written election under this paragraph must
4.2 	be included in the facility's request for the rate change
4.3 	related to the project, and this election may not be changed.
4.4 	~~(j)~~ (k) "Technology" means information systems or devices
4.5 	that make documentation, charting, and staff time more efficient
4.6 	or encourage and allow for care through alternative settings
4.7 	including, but not limited to, touch screens, monitors,
4.8 	hand-helds, swipe cards, motion detectors, pagers, telemedicine,
4.9 	medication dispensers, and equipment to monitor vital signs and
4.10 	self-injections, and to observe skin and other conditions.

4.11 	ARTICLE 2
4.12 	CONTINUING CARE FOR THE ELDERLY

4.13 	Section 1. Minnesota Statutes 2004, section 256B.0913,
4.14 	subdivision 8, is amended to read:
4.15 		Subd. 8.Requirements for individual care plan.  (a) The
4.16 	case manager shall implement the plan of care for each
4.17 	alternative care client and ensure that a client's service needs
4.18 	and eligibility are reassessed at least every 12 months.  The
4.19 	plan shall include any services prescribed by the individual's
4.20 	attending physician as necessary to allow the individual to
4.21 	remain in a community setting.  In developing the individual's
4.22 	care plan, the case manager should include the use of volunteers
4.23 	from families and neighbors, religious organizations, social
4.24 	clubs, and civic and service organizations to support the formal
4.25 	home care services.  The county shall be held harmless for
4.26 	damages or injuries sustained through the use of volunteers
4.27 	under this subdivision including workers' compensation
4.28 	liability.  The ~~lead agency~~ county of service shall provide
4.29 	documentation in each individual's plan of care and, if
4.30 	requested, to the commissioner that the most cost-effective
4.31 	alternatives available have been offered to the individual and
4.32 	that the individual was free to choose among available qualified
4.33 	providers, both public and private, including qualified case
4.34 	management or service coordination providers other than those
4.35 	employed by ~~the lead agency when the lead agency~~ any county;
4.36 	however, the county or tribe maintains responsibility for prior
5.1 	authorizing services in accordance with statutory and
5.2 	administrative requirements.  The case manager must give the
5.3 	individual a ten-day written notice of any denial, termination,
5.4 	or reduction of alternative care services.
5.5 	(b) ~~If~~ The county ~~administering alternative care services~~
5.6 	~~is different than the county of financial responsibility, the~~
5.7 	~~care plan may be implemented without the approval~~ of service
5.8 	must provide access to and arrange for case management services,
5.9 	including assuring implementation of the plan.  The county of
5.10 	service must notify the county of financial responsibility of
5.11 	the approved care plan and the amount of encumbered funds.

5.12 	Sec. 2. Minnesota Statutes 2004, section 256B.0915,
5.13 	subdivision 1a, is amended to read:
5.14 		Subd. 1a.Elderly waiver case management services. (a) 
5.15 	Elderly case management services under the home and
5.16 	community-based services waiver for elderly individuals are
5.17 	available from providers meeting qualification requirements and
5.18 	the standards specified in subdivision 1b.  Eligible recipients
5.19 	may choose any qualified provider of elderly case management
5.20 	services.
5.21 	(b) The county of service or tribe must provide access to
5.22 	or arrange for case management services.

5.23 	Sec. 3. Minnesota Statutes 2004, section 256B.0915,
5.24 	subdivision 6, is amended to read:
5.25 		Subd. 6.Implementation of care plan.  Each elderly
5.26 	waiver client shall be provided a copy of a written care plan
5.27 	that meets the requirements outlined in section 256B.0913,
5.28 	subdivision 8. ~~If~~ The care plan must be implemented by the 
5.29 	county administering waivered services when it is different than
5.30 	the county of financial responsibility~~, the care plan may be~~
5.31 	~~implemented without the approval of~~ .  The county administering
5.32 	waivered services must notify the county of financial
5.33 	responsibility of the approved care plan.

5.34 	Sec. 4. Minnesota Statutes 2004, section 256B.0915,
5.35 	subdivision 9, is amended to read:
5.36 		Subd. 9.Tribal management of elderly waiver.
 6.1 	Notwithstanding contrary provisions of this section, or those in
6.2 	other state laws or rules, the commissioner ~~and White Earth~~
6.3 	~~reservation~~ may develop a model for tribal management of the
6.4 	elderly waiver program and implement this model through a
6.5 	contract between the state and ~~White Earth Reservation~~ any of
6.6 	the state's federally recognized tribal governments.  The model
6.7 	shall include the provision of tribal waiver case management,
6.8 	assessment for personal care assistance, and administrative
6.9 	requirements otherwise carried out by counties but shall not
6.10 	include tribal financial eligibility determination for medical
6.11 	assistance.