1.1                          A bill for an act 
  1.2             relating to human services; terminating a rate 
  1.3             reduction for certain providers; amending Laws 2003, 
  1.4             First Special Session chapter 14, article 13C, section 
  1.5             2, subdivision 9. 
  1.6   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.7      Section 1.  Laws 2003, First Special Session chapter 14, 
  1.8   article 13C, section 2, subdivision 9, is amended to read: 
  1.9   Subd. 9.  Continuing Care Grants 
  1.10                Summary by Fund
  1.11  General           1,504,933,000 1,490,958,000
  1.12  Lottery Prize Fund    1,408,000     1,408,000
  1.13  The amounts that may be spent from this 
  1.14  appropriation for each purpose are as 
  1.15  follows: 
  1.16  (a) Community Social Services
  1.17  General                 496,000       371,000
  1.18  (b) Aging and Adult Service Grant 
  1.19  General              12,998,000    13,951,000
  1.20  [LONG-TERM CARE PROGRAM REDUCTIONS.] 
  1.21  For the biennium ending June 30, 2005, 
  1.22  state funding for the following state 
  1.23  long-term care programs is reduced by 
  1.24  15 percent from the level of state 
  1.25  funding provided on June 30, 2003:  
  1.26  SAIL project grants under Minnesota 
  1.27  Statutes, section 256B.0917; senior 
  1.28  nutrition programs under Minnesota 
  1.29  Statutes, section 256.9752; foster 
  1.30  grandparents program under Minnesota 
  1.31  Statutes, section 256.976; retired 
  1.32  senior volunteer program under 
  1.33  Minnesota Statutes, section 256.9753; 
  2.1   and the senior companion program under 
  2.2   Minnesota Statutes, section 256.977. 
  2.3   (c) Deaf and Hard-of-hearing 
  2.4   Service Grants 
  2.5   General               1,719,000     1,490,000
  2.6   (d) Mental Health Grants 
  2.7   General              53,479,000    34,690,000
  2.8   Lottery Prize Fund    1,408,000     1,408,000
  2.9   [RESTRUCTURING OF ADULT MENTAL HEALTH 
  2.10  SERVICES.] The commissioner may make 
  2.11  transfers that do not increase the 
  2.12  state share of costs to effectively 
  2.13  implement the restructuring of adult 
  2.14  mental health services.  
  2.15  [COMPULSIVE GAMBLING.] Of the 
  2.16  appropriation from the lottery prize 
  2.17  fund, $250,000 each year is for the 
  2.18  following purposes: 
  2.19  (1) $100,000 each year is for a grant 
  2.20  to the Southeast Asian Problem Gambling 
  2.21  Consortium.  The consortium must 
  2.22  provide statewide compulsive gambling 
  2.23  prevention and treatment services for 
  2.24  Lao, Hmong, Vietnamese, and Cambodian 
  2.25  families, adults, and adolescents.  The 
  2.26  appropriation in this clause shall not 
  2.27  become part of base level funding for 
  2.28  the biennium beginning July 1, 2005.  
  2.29  Any unencumbered balance of the 
  2.30  appropriation in the first year does 
  2.31  not cancel but is available for the 
  2.32  second year; and 
  2.33  (2) $150,000 each year is for a grant 
  2.34  to a compulsive gambling council 
  2.35  located in St. Louis county.  The 
  2.36  gambling council must provide a 
  2.37  statewide compulsive gambling 
  2.38  prevention and education project for 
  2.39  adolescents.  Any unencumbered balance 
  2.40  of the appropriation in the first year 
  2.41  of the biennium does not cancel but is 
  2.42  available for the second year. 
  2.43  (e) Community Support Grants 
  2.44  General               12,523,000    9,093,000
  2.45  [CENTERS FOR INDEPENDENT LIVING STUDY.] 
  2.46  The commissioner of human services, in 
  2.47  consultation with the commissioner of 
  2.48  economic security, the centers for 
  2.49  independent living, and consumer 
  2.50  representatives, shall study the 
  2.51  financing of the centers for 
  2.52  independent living authorized under 
  2.53  Minnesota Statutes, section 268A.11, 
  2.54  and make recommendations on options to 
  2.55  maximize federal financial 
  2.56  participation.  Study components shall 
  2.57  include: 
  2.58  (1) the demographics of individuals 
  3.1   served by the centers for independent 
  3.2   living; 
  3.3   (2) the range of services the centers 
  3.4   for independent living provide to these 
  3.5   individuals; 
  3.6   (3) other publicly funded services 
  3.7   received by individuals supported by 
  3.8   the centers; and 
  3.9   (4) strategies for maximizing federal 
  3.10  financial participation for eligible 
  3.11  activities carried out by centers for 
  3.12  independent living. 
  3.13  The commissioner shall report with 
  3.14  fiscal and programmatic recommendations 
  3.15  to the chairs of the appropriate house 
  3.16  of representatives and senate finance 
  3.17  and policy committees by January 15, 
  3.18  2004. 
  3.19  (f) Medical Assistance Long-Term 
  3.20  Care Waivers and Home Care Grants 
  3.21  General              659,211,000  718,665,000
  3.22  [RATE AND ALLOCATION DECREASES FOR 
  3.23  CONTINUING CARE PROGRAMS.] 
  3.24  Notwithstanding any law or rule to the 
  3.25  contrary, the commissioner of human 
  3.26  services shall decrease reimbursement 
  3.27  rates or reduce allocations to assure 
  3.28  the necessary reductions in state 
  3.29  spending for the providers or programs 
  3.30  listed in paragraphs (a) to (d).  The 
  3.31  decreases are effective for services 
  3.32  rendered on or after July 1, 2003, to 
  3.33  June 30, 2004.  Effective July 1, 2004, 
  3.34  the reimbursement rates and allocations 
  3.35  in effect prior to July 1, 2003, shall 
  3.36  be reinstated. 
  3.37  (a) Effective July 1, 2003, the 
  3.38  commissioner shall reduce payment rates 
  3.39  for services and individual or service 
  3.40  limits by one percent.  The rate 
  3.41  decreases described in this section 
  3.42  must be applied to: 
  3.43  (1) home and community-based waivered 
  3.44  services for the elderly under 
  3.45  Minnesota Statutes, section 256B.0915; 
  3.46  (2) day training and habilitation 
  3.47  services for adults with mental 
  3.48  retardation or related conditions under 
  3.49  Minnesota Statutes, sections 252.40 to 
  3.50  252.46; 
  3.51  (3) the group residential housing 
  3.52  supplementary service rate under 
  3.53  Minnesota Statutes, section 256I.05, 
  3.54  subdivision 1a; 
  3.55  (4) chemical dependency residential and 
  3.56  nonresidential service rates under 
  3.57  Minnesota Statutes, section 245B.03; 
  3.58  (5) consumer support grants under 
  4.1   Minnesota Statutes, section 256.476; 
  4.2   and 
  4.3   (6) home and community-based services 
  4.4   for alternative care services under 
  4.5   Minnesota Statutes, section 256B.0913. 
  4.6   (b) The commissioner shall reduce 
  4.7   allocations made available to county 
  4.8   agencies for home and community-based 
  4.9   waivered services to assure a 
  4.10  one-percent reduction in state spending 
  4.11  for services rendered on or after July 
  4.12  1, 2003.  The commissioner shall apply 
  4.13  the allocation decreases described in 
  4.14  this section to: 
  4.15  (1) persons with mental retardation or 
  4.16  related conditions under Minnesota 
  4.17  Statutes, section 256B.501; 
  4.18  (2) waivered services under community 
  4.19  alternatives for disabled individuals 
  4.20  under Minnesota Statutes, section 
  4.21  256B.49; 
  4.22  (3) community alternative care waivered 
  4.23  services under Minnesota Statutes, 
  4.24  section 256B.49; and 
  4.25  (4) traumatic brain injury waivered 
  4.26  services under Minnesota Statutes, 
  4.27  section 256B.49. 
  4.28  County agencies will be responsible for 
  4.29  100 percent of any spending in excess 
  4.30  of the allocation made by the 
  4.31  commissioner.  Nothing in this section 
  4.32  shall be construed as reducing the 
  4.33  county's responsibility to offer and 
  4.34  make available feasible home and 
  4.35  community-based options to eligible 
  4.36  waiver recipients within the resources 
  4.37  allocated to them for that purpose. 
  4.38  (c) The commissioner shall reduce deaf 
  4.39  and hard-of-hearing grants by one 
  4.40  percent on July 1, 2003. 
  4.41  (d) Effective July 1, 2003, the 
  4.42  commissioner shall reduce payment rates 
  4.43  for each facility reimbursed under 
  4.44  Minnesota Statutes, section 256B.5012, 
  4.45  by decreasing the total operating 
  4.46  payment rate for intermediate care 
  4.47  facilities for the mentally retarded by 
  4.48  one percent.  For each facility, the 
  4.49  commissioner shall multiply the 
  4.50  adjustment by the total payment rate, 
  4.51  excluding the property-related payment 
  4.52  rate, in effect on June 30, 2003.  A 
  4.53  facility whose payment rates are 
  4.54  governed by closure agreements, 
  4.55  receivership agreements, or Minnesota 
  4.56  Rules, part 9553.0075, is not subject 
  4.57  to an adjustment otherwise taken under 
  4.58  this subdivision. 
  4.59  Notwithstanding section 14, these 
  4.60  adjustments the reimbursement rates and 
  4.61  allocations effective July 1, 2004, 
  5.1   shall not expire. 
  5.2   [REDUCE GROWTH IN MR/RC WAIVER.] The 
  5.3   commissioner shall reduce the growth in 
  5.4   the MR/RC waiver by not allocating the 
  5.5   300 additional diversion allocations 
  5.6   that are included in the February 2003 
  5.7   forecast for the fiscal years that 
  5.8   begin on July 1, 2003, and July 1, 2004.
  5.9   [MANAGE THE GROWTH IN THE TBI WAIVER.] 
  5.10  During the fiscal years beginning on 
  5.11  July 1, 2003, and July 1, 2004, the 
  5.12  commissioner shall allocate money for 
  5.13  home and community-based programs 
  5.14  covered under Minnesota Statutes, 
  5.15  section 256B.49, to assure a reduction 
  5.16  in state spending that is equivalent to 
  5.17  limiting the caseload growth of the TBI 
  5.18  waiver to 150 in each year of the 
  5.19  biennium.  Priorities for the 
  5.20  allocation of funds shall be for 
  5.21  individuals anticipated to be 
  5.22  discharged from institutional settings 
  5.23  or who are at imminent risk of a 
  5.24  placement in an institutional setting. 
  5.25  [TARGETED CASE MANAGEMENT FOR HOME CARE 
  5.26  RECIPIENTS.] Implementation of the 
  5.27  targeted case management benefit for 
  5.28  home care recipients, according to 
  5.29  Minnesota Statutes, section 256B.0621, 
  5.30  subdivisions 2, 3, 5, 6, 7, 9, and 10, 
  5.31  will be delayed until July 1, 2005. 
  5.32  [COMMON SERVICE MENU.] Implementation 
  5.33  of the common service menu option 
  5.34  within the home and community-based 
  5.35  waivers, according to Minnesota 
  5.36  Statutes, section 256B.49, subdivision 
  5.37  16, will be delayed until July 1, 2005. 
  5.38  [LIMITATION ON COMMUNITY ALTERNATIVES 
  5.39  FOR DISABLED INDIVIDUALS CASELOAD 
  5.40  GROWTH.] For the biennium ending June 
  5.41  30, 2005, the commissioner shall limit 
  5.42  the allocations made available in the 
  5.43  community alternatives for disabled 
  5.44  individuals waiver program in order not 
  5.45  to exceed average caseload growth of 95 
  5.46  per month from June 2003 program 
  5.47  levels, plus any additional 
  5.48  legislatively authorized program 
  5.49  growth.  The commissioner shall 
  5.50  allocate available resources to achieve 
  5.51  the following outcomes: 
  5.52  (1) the establishment of feasible and 
  5.53  viable alternatives for persons in 
  5.54  institutional or hospital settings to 
  5.55  relocate to home and community-based 
  5.56  settings; 
  5.57  (2) the availability of timely 
  5.58  assistance to persons at imminent risk 
  5.59  of institutional or hospital placement 
  5.60  or whose health and safety is at 
  5.61  immediate risk; and 
  5.62  (3) the maximum provision of essential 
  5.63  community supports to eligible persons 
  6.1   in need of and waiting for home and 
  6.2   community-based service alternatives.  
  6.3   The commissioner may reallocate 
  6.4   resources from one county or region to 
  6.5   another if available funding in that 
  6.6   county or region is not likely to be 
  6.7   spent and the reallocation is necessary 
  6.8   to achieve the outcomes specified in 
  6.9   this paragraph. 
  6.10  (g) Medical Assistance Long-term 
  6.11  Care Facilities Grants 
  6.12  General             543,999,000   514,483,000
  6.13  (h) Alternative Care Grants 
  6.14  General              75,206,000    66,351,000
  6.15  [ALTERNATIVE CARE TRANSFER.] Any money 
  6.16  allocated to the alternative care 
  6.17  program that is not spent for the 
  6.18  purposes indicated does not cancel but 
  6.19  shall be transferred to the medical 
  6.20  assistance account. 
  6.21  [ALTERNATIVE CARE APPROPRIATION.] The 
  6.22  commissioner may expend the money 
  6.23  appropriated for the alternative care 
  6.24  program for that purpose in either year 
  6.25  of the biennium. 
  6.26  [ALTERNATIVE CARE IMPLEMENTATION OF 
  6.27  CHANGES TO FEES AND ELIGIBILITY.] 
  6.28  Changes to Minnesota Statutes, section 
  6.29  256B.0913, subdivision 4, paragraph 
  6.30  (d), and subdivision 12, are effective 
  6.31  July 1, 2003, for all persons found 
  6.32  eligible for the alternative care 
  6.33  program on or after July 1, 2003.  All 
  6.34  recipients of alternative care funding 
  6.35  as of June 30, 2003, shall be subject 
  6.36  to Minnesota Statutes, section 
  6.37  256B.0913, subdivision 4, paragraph 
  6.38  (d), and subdivision 12, on the annual 
  6.39  reassessment and review of their 
  6.40  eligibility after July 1, 2003, but no 
  6.41  later than January 1, 2004. 
  6.42  (i) Group Residential Housing Grants 
  6.43  General              94,996,000    80,472,000
  6.44  [GROUP RESIDENTIAL HOUSING COSTS 
  6.45  REFINANCED.] (1) Effective July 1, 
  6.46  2004, the commissioner shall increase 
  6.47  the home and community-based service 
  6.48  rates and county allocations provided 
  6.49  to programs for persons with 
  6.50  disabilities established under section 
  6.51  1915(c) of the Social Security Act to 
  6.52  the extent that these programs will be 
  6.53  paying for the costs above the rate 
  6.54  established in Minnesota Statutes, 
  6.55  section 256I.05, subdivision 1. 
  6.56  (2) For persons in receipt of services 
  6.57  under Minnesota Statutes, section 
  6.58  256B.0915, who reside in licensed adult 
  6.59  foster care beds for which a 
  6.60  supplemental room and board payment was 
  7.1   being made under Minnesota Statutes, 
  7.2   section 256I.05, subdivision 1, 
  7.3   counties may request an exception to 
  7.4   the individual caps specified in 
  7.5   Minnesota Statutes, section 256B.0915, 
  7.6   subdivision 3, paragraph (b), not to 
  7.7   exceed the difference between the 
  7.8   individual cap and the client's monthly 
  7.9   service expenditures plus the amount of 
  7.10  the supplemental room and board rate.  
  7.11  The county must submit a request to 
  7.12  exceed the individual cap to the 
  7.13  commissioner for approval. 
  7.14  (j) Chemical Dependency
  7.15  Entitlement Grants 
  7.16  General              49,251,000    50,337,000
  7.17  (k) Chemical Dependency Nonentitlement 
  7.18  Grants 
  7.19  General               1,055,000     1,055,000
  7.20     Sec. 2.  [APPROPRIATION.] 
  7.21     $....... is appropriated from the general fund to the 
  7.22  commissioner of human services for the fiscal year beginning 
  7.23  July 1, 2004, for the purposes of section 1.