1.1                          A bill for an act 
  1.2             relating to human services; requiring the Department 
  1.3             of Human Services to increase nursing facility and 
  1.4             community services payment rates; appropriating money; 
  1.5             amending Minnesota Statutes 2002, section 256B.431, by 
  1.6             adding a subdivision; Minnesota Statutes 2003 
  1.7             Supplement, section 256B.431, subdivision 39. 
  1.8   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.9      Section 1.  Minnesota Statutes 2003 Supplement, section 
  1.10  256B.431, subdivision 39, is amended to read: 
  1.11     Subd. 39.  [NURSING FACILITY RATES BEGINNING ON OR AFTER 
  1.12  JULY 1, 2003.] For rate years beginning on or after July 1, 
  1.13  2003, nursing facilities reimbursed under this section shall 
  1.14  have their July 1 operating payment rate be equal to their 
  1.15  operating payment rate in effect on the prior June 30th 30. 
  1.16     Sec. 2.  Minnesota Statutes 2002, section 256B.431, is 
  1.17  amended by adding a subdivision to read: 
  1.18     Subd. 40.  [NURSING FACILITY RATE INCREASE BEGINNING JULY 
  1.19  1, 2004.] (a) For the rate year beginning July 1, 2004, the 
  1.20  commissioner shall provide to each nursing facility reimbursed 
  1.21  under this section or section 256B.434 an adjustment equal to 
  1.22  2.5 percent of the total operating payment rate.  
  1.23     (b) For the rate year beginning July 1, 2004, money 
  1.24  resulting from the rate adjustment under paragraph (a) must be 
  1.25  used to: 
  1.26     (1) increase wages and benefits and pay associated costs 
  2.1   for employees except management fees, the administrator, and 
  2.2   central office staff; or 
  2.3      (2) add staff, other than administrative personnel, above 
  2.4   the facility's average staff complement for the previous year. 
  2.5      (c) Money received by a facility as a result of the rate 
  2.6   adjustment provided in paragraph (a), which must be used as 
  2.7   provided in paragraph (b), must be used only for wage, benefit, 
  2.8   and staff increases implemented on or after July 1, 2004, and 
  2.9   must not be used for increases implemented prior to that date. 
  2.10     (d) Nursing facilities may apply for the portions of the 
  2.11  rate adjustment under paragraph (a), which must be used as 
  2.12  provided in paragraph (b).  The application must be made to the 
  2.13  commissioner and contain a plan by which the nursing facility 
  2.14  will distribute the funds according to paragraph (b).  For 
  2.15  nursing facilities in which the employees are represented by an 
  2.16  exclusive bargaining representative, an agreement negotiated and 
  2.17  agreed to by the employer and the exclusive bargaining 
  2.18  representative constitutes the plan.  A negotiated agreement may 
  2.19  constitute the plan only if the agreement is finalized after the 
  2.20  date of enactment of all increases for the rate year.  The 
  2.21  commissioner shall review the plan to ensure that the rate 
  2.22  adjustments are used as provided in paragraph (b).  To be 
  2.23  eligible, a facility must submit its distribution plan by 
  2.24  December 31, 2004.  If a facility's distribution plan is 
  2.25  effective after July 1, 2004, the portion of the rate 
  2.26  adjustments, which must be used as provided in paragraph (b), 
  2.27  are effective the same date as the facility's plan. 
  2.28     (e) A copy of the approved distribution plan must be made 
  2.29  available to all employees by giving each employee a copy or by 
  2.30  posting a copy in an area of the nursing facility to which all 
  2.31  employees have access.  If an employee does not receive the wage 
  2.32  and benefit adjustment described in the facility's approved plan 
  2.33  and is unable to resolve the problem with the facility's 
  2.34  management or through the employee's union representative, the 
  2.35  employee may contact the commissioner at an address or telephone 
  2.36  number provided by the commissioner and included in the approved 
  3.1   plan. 
  3.2      (f) Notwithstanding section 256B.48, subdivision 1, 
  3.3   paragraph (a), upon the request of a nursing facility, the 
  3.4   commissioner may authorize the facility to raise per diem rates 
  3.5   for private-pay residents on July 1 by the amount anticipated to 
  3.6   be required upon implementation of the rate adjustments 
  3.7   allowable under paragraph (a).  The commissioner shall require 
  3.8   any amounts collected under this paragraph, which must be used 
  3.9   as provided in paragraph (b), to be placed in an escrow account 
  3.10  established for this purpose with a financial institution that 
  3.11  provides deposit insurance until the medical assistance rate is 
  3.12  finalized.  The commissioner shall conduct audits as necessary 
  3.13  to ensure that: 
  3.14     (1) the amounts collected are retained in escrow until 
  3.15  medical assistance rates are increased to reflect the rate 
  3.16  adjustment; and 
  3.17     (2) any amounts collected from private-pay residents in 
  3.18  excess of the final medical assistance rate are repaid to the 
  3.19  private-pay residents with interest at the rate used by the 
  3.20  commissioner of revenue for the late payment of taxes and in 
  3.21  effect on the date the distribution plan is approved by the 
  3.22  commissioner of human services. 
  3.23     Sec. 3.  [COMMUNITY SERVICES PROVIDER RATE INCREASES.] 
  3.24     (a) The commissioner of human services shall increase 
  3.25  reimbursement rates by 2.5 percent for the rate year beginning 
  3.26  July 1, 2004, effective for services rendered on or after that 
  3.27  date. 
  3.28     (b) The 2.5 percent rate increases described in this 
  3.29  section must be provided to: 
  3.30     (1) home and community-based waivered services for persons 
  3.31  with mental retardation or related conditions under Minnesota 
  3.32  Statutes, section 256B.501; 
  3.33     (2) home and community-based waivered services for the 
  3.34  elderly under Minnesota Statutes, section 256B.0915; 
  3.35     (3) waivered services under community alternatives for 
  3.36  disabled individuals under Minnesota Statutes, section 256B.49; 
  4.1      (4) community alternative care waivered services under 
  4.2   Minnesota Statutes, section 256B.49; 
  4.3      (5) traumatic brain injury waivered services under 
  4.4   Minnesota Statutes, section 256B.49; 
  4.5      (6) nursing services and home health services under 
  4.6   Minnesota Statutes, section 256B.0625, subdivision 6a; 
  4.7      (7) personal care services and nursing supervision of 
  4.8   personal care services under Minnesota Statutes, section 
  4.9   256B.0625, subdivision 19a; 
  4.10     (8) private duty nursing services under Minnesota Statutes, 
  4.11  section 256B.0625, subdivision 7; 
  4.12     (9) day training and habilitation services for adults with 
  4.13  mental retardation or related conditions under Minnesota 
  4.14  Statutes, sections 252.40 to 252.46; 
  4.15     (10) alternative care services under Minnesota Statutes, 
  4.16  section 256B.0913; 
  4.17     (11) adult residential program grants under Minnesota 
  4.18  Rules, parts 9535.2000 to 9535.3000; 
  4.19     (12) adult and family community support grants under 
  4.20  Minnesota Rules, parts 9535.1700 to 9535.1760; 
  4.21     (13) the group residential housing supplementary service 
  4.22  rate under Minnesota Statutes, section 256I.05, subdivision 1a; 
  4.23     (14) adult mental health integrated fund grants under 
  4.24  Minnesota Statutes, section 245.4661; 
  4.25     (15) semi-independent living services under Minnesota 
  4.26  Statutes, section 252.275, including SILS funding under county 
  4.27  social services grants formerly funded under Minnesota Statutes, 
  4.28  chapter 256I; 
  4.29     (16) community support services for deaf and 
  4.30  hard-of-hearing adults with mental illness who use or wish to 
  4.31  use sign language as their primary means of communication; and 
  4.32     (17) living skills training programs for persons with 
  4.33  intractable epilepsy who need assistance in the transition to 
  4.34  independent living. 
  4.35     (c) Providers that receive a rate increase under this 
  4.36  section shall use the additional revenue to: 
  5.1      (1) increase wages and benefits and pay associated costs 
  5.2   for employees except management fees, the administrator, and 
  5.3   central office staff; or 
  5.4      (2) add staff, other than administrative personnel, above 
  5.5   the provider's average staff complement for the previous year. 
  5.6      (d) For public employees, the portion of this increase 
  5.7   reserved to increase wages and benefits for certain staff is 
  5.8   available and pay rates shall be increased only to the extent 
  5.9   that they comply with laws governing public employees collective 
  5.10  bargaining.  Money received by a provider for pay increases 
  5.11  under this section may be used only for increases implemented on 
  5.12  or after the first day of the state fiscal year in which the 
  5.13  increase is available and must not be used for increases 
  5.14  implemented prior to that date. 
  5.15     (e) A copy of the provider's plan for complying with 
  5.16  paragraph (c) must be made available to all employees by giving 
  5.17  each employee a copy or by posting a copy in an area of the 
  5.18  provider's operation to which all employees have access.  If an 
  5.19  employee does not receive the adjustment described in the plan 
  5.20  and is unable to resolve the problem with the provider, the 
  5.21  employee may contact the employee's union representative.  If 
  5.22  the employee is not covered by a collective bargaining 
  5.23  agreement, the employee may contact the commissioner at a 
  5.24  telephone number provided by the commissioner and included in 
  5.25  the provider's plan. 
  5.26     Sec. 4.  [APPROPRIATIONS.] 
  5.27     $....... is appropriated in fiscal year 2005 from the 
  5.28  nursing home licensure surcharge in Minnesota Statutes, section 
  5.29  256.9657, subdivision 1, paragraph (d), to the commissioner of 
  5.30  human services for the purposes of sections 1 and 3.