1.1                          A bill for an act 
  1.2             relating to medical assistance; establishing projects 
  1.3             for recipients of services from intermediate care 
  1.4             facilities for persons with mental retardation or 
  1.5             related conditions. 
  1.6   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.7      Section 1.  [PROJECTS FOR ICF/MR CONVERSION TO WAIVERED 
  1.8   SERVICES.] 
  1.9      (a) The commissioner shall establish projects to improve 
  1.10  the efficiency and effectiveness of service provisions for 
  1.11  recipients of services from intermediate care facilities for 
  1.12  persons with mental retardation or related conditions. 
  1.13     The commissioner shall establish procedures to implement 
  1.14  the project.  The projects may be coordinated with other 
  1.15  projects authorized in other areas.  Participation by providers 
  1.16  in the projects is voluntary.  The commissioner shall seek any 
  1.17  necessary federal waivers to implement the projects. 
  1.18     (b) The commissioner may waive rules relating to the 
  1.19  provision of residential services for persons with mental 
  1.20  retardation or related conditions to the extent necessary to 
  1.21  implement the projects.  In waiving rules, the commissioner 
  1.22  shall consider the recommendations of persons who are consumers 
  1.23  and providers of service or represent those persons and of 
  1.24  representatives of state and local agencies administering 
  1.25  services.  Individuals receiving services under the projects may 
  2.1   not be denied rights or procedural protections under Minnesota 
  2.2   Statutes, sections 245.825; 245.91 to 245.97; 252.41, 
  2.3   subdivision 9; 256.045; 256B.092; 626.556; and 626.557, 
  2.4   including the county agency's responsibility to arrange for 
  2.5   appropriate services and procedures for the monitoring of 
  2.6   psychotropic medications. 
  2.7      (c) The projects must meet the following requirements: 
  2.8      (1) persons and their legal representatives, if any, must 
  2.9   be provided with information about the project; 
  2.10     (2) the project must comply with applicable federal 
  2.11  requirements; 
  2.12     (3) the project proposals must include specific measures to 
  2.13  be taken to ensure the health, safety, and protection of the 
  2.14  persons participating; and 
  2.15     (4) persons participating in the project must be informed 
  2.16  when any part of Minnesota Rules is waived. 
  2.17     (d) The commissioner shall request and evaluate proposals 
  2.18  from county agencies and provider organizations to participate 
  2.19  in the projects.  Upon federal approval, the commissioner shall 
  2.20  enter into a performance-based contract with counties and 
  2.21  existing licensed ICF/MR providers that specifies the amount and 
  2.22  conditions of reimbursement, requirements for monitoring and 
  2.23  evaluation, and expected client-based outcomes.  Counties and 
  2.24  providers shall present potential outcome indicators for 
  2.25  consideration in the following areas: 
  2.26     (1) personal health, safety, and comfort; 
  2.27     (2) personal growth, independence, and productivity; 
  2.28     (3) client choice and control over daily life decisions; 
  2.29     (4) consumer, family, and the case manager's satisfaction 
  2.30  with services; 
  2.31     (5) community inclusion, including social relationships and 
  2.32  participation in valued community roles; and 
  2.33     (6) waivered services projects must have a capacity of 16 
  2.34  beds or less. 
  2.35     Outcome indicators must be determined by the person and the 
  2.36  person's legal representative, if any, with assistance from the 
  3.1   county case manager and provider. 
  3.2      (e) The cost of services for intermediate care facilities 
  3.3   for persons with mental retardation paid for under the contract 
  3.4   must not exceed 95 percent of the cost of the services that 
  3.5   would otherwise have been paid to the intermediate care facility 
  3.6   or group of intermediate care facilities during a biennium, 
  3.7   including applicable special needs rates and rate adjustments, 
  3.8   under the reimbursement system in effect at the time the 
  3.9   contracted rate is effective.  An intermediate care facility 
  3.10  participating in the demonstration project must continue to be 
  3.11  licensed, but must be decertified and converted to home- and 
  3.12  community-based services authorized under Minnesota Statutes, 
  3.13  section 256B.092.  After participation in the project, the 
  3.14  facility may be recertified as an intermediate care facility for 
  3.15  persons with mental retardation, notwithstanding the provisions 
  3.16  of Minnesota Statutes, section 252.291, or the services provided 
  3.17  under the project may continue as home- and community-based 
  3.18  services if the applicable standards are met.  The rate paid to 
  3.19  a recertified facility must not be greater than the rate paid to 
  3.20  the facility before participation in the project.  The 
  3.21  commissioner may establish emergency rate setting procedures to 
  3.22  allow for the transition back to intermediate care services for 
  3.23  persons with mental retardation or related conditions.