1.1                          A bill for an act 
  1.2             relating to human services; modifying the division of 
  1.3             costs for ICFs/MR; requiring an ICF/MR plan; amending 
  1.4             Minnesota Statutes 2003 Supplement, section 256B.19, 
  1.5             subdivision 1. 
  1.6   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.7      Section 1.  Minnesota Statutes 2003 Supplement, section 
  1.8   256B.19, subdivision 1, is amended to read: 
  1.9      Subdivision 1.  [DIVISION OF COST.] The state and county 
  1.10  share of medical assistance costs not paid by federal funds 
  1.11  shall be as follows:  
  1.12     (1) beginning January 1, 1992, 50 percent state funds and 
  1.13  50 percent county funds for the cost of placement of severely 
  1.14  emotionally disturbed children in regional treatment centers; 
  1.15     (2) beginning January 1, 2003, 80 percent state funds and 
  1.16  20 percent county funds for the costs of nursing facility 
  1.17  placements of persons with disabilities under the age of 65 that 
  1.18  have exceeded 90 days.  This clause shall be subject to chapter 
  1.19  256G and shall not apply to placements in facilities not 
  1.20  certified to participate in medical assistance; and 
  1.21     (3) beginning July 1, 2004, 80 percent state funds and 20 
  1.22  percent county funds for the costs of placements that have 
  1.23  exceeded 90 days in intermediate care facilities for persons 
  1.24  with mental retardation or a related condition that have seven 
  1.25  or more beds.  This provision includes pass-through payments 
  2.1   made under section 256B.5015; and 
  2.2      (4) beginning July 1, 2004, when state funds are used to 
  2.3   pay for a nursing facility placement due to the facility's 
  2.4   status as an institution for mental diseases (IMD), the county 
  2.5   shall pay 20 percent of the nonfederal share of costs that have 
  2.6   exceeded 90 days.  This clause is subject to chapter 256G. 
  2.7      For counties that participate in a Medicaid demonstration 
  2.8   project under sections 256B.69 and 256B.71, the division of the 
  2.9   nonfederal share of medical assistance expenses for payments 
  2.10  made to prepaid health plans or for payments made to health 
  2.11  maintenance organizations in the form of prepaid capitation 
  2.12  payments, this division of medical assistance expenses shall be 
  2.13  95 percent by the state and five percent by the county of 
  2.14  financial responsibility.  
  2.15     In counties where prepaid health plans are under contract 
  2.16  to the commissioner to provide services to medical assistance 
  2.17  recipients, the cost of court ordered treatment ordered without 
  2.18  consulting the prepaid health plan that does not include 
  2.19  diagnostic evaluation, recommendation, and referral for 
  2.20  treatment by the prepaid health plan is the responsibility of 
  2.21  the county of financial responsibility. 
  2.22     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
  2.23  following final enactment.  
  2.24     Sec. 2.  [ICF/MR PLAN.] 
  2.25     The commissioner of human services shall consult with 
  2.26  ICF/MR providers, advocates, counties, and consumer families to 
  2.27  develop recommendations and legislation concerning the future 
  2.28  services provided to people now served in ICFs/MR.  The 
  2.29  recommendations shall be reported to the house and senate 
  2.30  committees with jurisdiction over health and human services 
  2.31  policy and finance issues by January 15, 2005.  In preparing the 
  2.32  recommendations, the commissioner shall consider: 
  2.33     (1) consumer choice of services; 
  2.34     (2) consumers' service needs, including, but not limited 
  2.35  to, active treatment; 
  2.36     (3) the total cost of providing services in ICFs/MR and 
  3.1   alternative delivery systems; 
  3.2      (4) whether it is the policy of the state to maintain an 
  3.3   ICF/MR system and, if so, the recommendations shall define the 
  3.4   ICF/MR payment system to ensure adequate resources to meet 
  3.5   changing consumer needs, provide crisis and respite services, 
  3.6   and ensure stability when occupancy changes; and 
  3.7      (5) if alternative services are recommended to support 
  3.8   people now receiving services in an ICF/MR, the recommendations 
  3.9   shall ensure adequate financial resources are available to meet 
  3.10  the needs of ICF/MR recipients. 
  3.11     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
  3.12  following final enactment.