1.1                          A bill for an act 
  1.2             relating to health; allowing reimbursement for 
  1.3             supplemental private duty nursing services provided by 
  1.4             spouses of recipients and other individuals who meet 
  1.5             criteria related to financial hardship; amending 
  1.6             Minnesota Statutes 1998, section 256B.0625, 
  1.7             subdivision 7. 
  1.8   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.9      Section 1.  Minnesota Statutes 1998, section 256B.0625, 
  1.10  subdivision 7, is amended to read: 
  1.11     Subd. 7.  [PRIVATE DUTY NURSING.] (a) Medical assistance 
  1.12  covers private duty nursing services in a recipient's home.  
  1.13  Recipients who are authorized to receive private duty nursing 
  1.14  services in their home may use approved hours outside of the 
  1.15  home during hours when normal life activities take them outside 
  1.16  of their home and when, without the provision of private duty 
  1.17  nursing, their health and safety would be jeopardized.  To use 
  1.18  private duty nursing services at school, the recipient or 
  1.19  responsible party must provide written authorization in the care 
  1.20  plan identifying the chosen provider and the daily amount of 
  1.21  services to be used at school.  Medical assistance does not 
  1.22  cover private duty nursing services for residents of a hospital, 
  1.23  nursing facility, intermediate care facility, or a health care 
  1.24  facility licensed by the commissioner of health, except as 
  1.25  authorized in section 256B.64 for ventilator-dependent 
  1.26  recipients in hospitals or unless a resident who is otherwise 
  2.1   eligible is on leave from the facility and the facility either 
  2.2   pays for the private duty nursing services or forgoes the 
  2.3   facility per diem for the leave days that private duty nursing 
  2.4   services are used.  Total hours of service and payment allowed 
  2.5   for services outside the home cannot exceed that which is 
  2.6   otherwise allowed in an in-home setting according to section 
  2.7   256B.0627.  All private duty nursing services must be provided 
  2.8   according to the limits established under section 256B.0627.  
  2.9   Private duty nursing services may not be reimbursed if the nurse 
  2.10  is the spouse of the recipient or the parent or foster care 
  2.11  provider of a recipient who is under age 18, or the recipient's 
  2.12  legal guardian, except as provided in paragraph (b). 
  2.13     (b) Private duty nursing services provided by a nurse who 
  2.14  is the recipient's spouse or the parent or foster care provider 
  2.15  of a recipient who is under age 18, or the recipient's legal 
  2.16  guardian, may be reimbursed only if: 
  2.17     (1) the services of the individual are needed, due to labor 
  2.18  conditions or intermittent hours of care, to supplement the 
  2.19  services of regular private duty nursing staff of a home health 
  2.20  agency, in order to provide an adequate number of private duty 
  2.21  nurses to meet the medical needs of the recipient; 
  2.22     (2) the individual must reduce hours worked and income 
  2.23  received at other employment in order to provide supplemental 
  2.24  private duty nursing services to the recipient; 
  2.25     (3) the individual provides supplemental private duty 
  2.26  nursing services through a home health agency, and the home 
  2.27  health agency closely monitors the care provided by that 
  2.28  individual; and 
  2.29     (4) the commissioner, after consultation with the 
  2.30  recipient's case manager and the home health agency that will be 
  2.31  employing the individual, approves reimbursement for the 
  2.32  services.