1.1                          A bill for an act 
  1.2             relating to human services; expanding eligibility for 
  1.3             the consumer support program; amending Minnesota 
  1.4             Statutes 1998, section 256.476, subdivisions 1 and 5; 
  1.5             Minnesota Statutes 1999 Supplement, section 256.476, 
  1.6             subdivision 3. 
  1.7   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.8      Section 1.  Minnesota Statutes 1998, section 256.476, 
  1.9   subdivision 1, is amended to read: 
  1.10     Subdivision 1.  [PURPOSE AND GOALS.] The commissioner of 
  1.11  human services shall establish a consumer support grant program 
  1.12  to assist individuals with functional limitations and their 
  1.13  families in purchasing and securing supports which the 
  1.14  individuals need to live as independently and productively in 
  1.15  the community as possible.  The commissioner and local agencies 
  1.16  shall jointly develop an implementation plan which must include 
  1.17  a way to resolve the issues related to county liability.  The 
  1.18  program shall: 
  1.19     (1) make support grants available to individuals or 
  1.20  families as an effective alternative to existing programs and 
  1.21  services, such as the developmental disability family support 
  1.22  program~~,~~; the alternative care program~~,~~; services under the 
  1.23  community alternatives for disabled individuals waiver, the 
  1.24  community alternative care waiver, the traumatic brain injury 
  1.25  waiver, or the elderly waiver; personal care attendant 
  1.26  services~~,~~; home health aide services~~,~~; and nursing facility 
  2.1   services; 
  2.2      (2) provide consumers more control, flexibility, and 
  2.3   responsibility over the needed supports; 
  2.4      (3) promote local program management and decision making; 
  2.5   and 
  2.6      (4) encourage the use of informal and typical community 
  2.7   supports. 
  2.8      Sec. 2.  Minnesota Statutes 1999 Supplement, section 
  2.9   256.476, subdivision 3, is amended to read: 
  2.10     Subd. 3.  [ELIGIBILITY TO APPLY FOR GRANTS.] (a) A person 
  2.11  is eligible to apply for a consumer support grant if the person 
  2.12  meets all of the following criteria: 
  2.13     (1) the person is eligible for and has been approved to 
  2.14  receive services under medical assistance as determined under 
  2.15  sections 256B.055 and 256B.056 ~~or the person is eligible for and~~ 
  2.16  ~~has been approved to receive services under~~, alternative care 
  2.17  services as determined under section 256B.0913, traumatic brain 
  2.18  injury waiver services under section 256B.093, community 
  2.19  alternatives for disabled individuals waiver services under 
  2.20  section 256B.49, community alternative care waiver services 
  2.21  under section 256B.49, or elderly waiver services under section 
  2.22  256B.0915, or the person has been approved to receive a grant 
  2.23  under the developmental disability family support program under 
  2.24  section 252.32; 
  2.25     (2) the person is able to direct and purchase the person's 
  2.26  own care and supports, or the person has a family member, legal 
  2.27  representative, or other authorized representative who can 
  2.28  purchase and arrange supports on the person's behalf; 
  2.29     (3) the person has functional limitations, requires ongoing 
  2.30  supports to live in the community, and is at risk of or would 
  2.31  continue institutionalization without such supports; and 
  2.32     (4) the person will live in a home.  For the purpose of 
  2.33  this section, "home" means the person's own home or home of a 
  2.34  person's family member.  These homes are natural home settings 
  2.35  and are not licensed by the department of health or human 
  2.36  services. 
  3.1      (b) Persons may not concurrently receive a consumer support 
  3.2   grant if they are: 
  3.3      (1) receiving home and community-based services under 
  3.4   United States Code, title 42, section ~~1396h(c)~~ 1396n(c); 
  3.5   personal care attendant and home health aide services under 
  3.6   section 256B.0625; a developmental disability family support 
  3.7   grant; or alternative care services under section 256B.0913; or 
  3.8      (2) residing in an institutional or congregate care setting.
  3.9      (c) A person or person's family receiving a consumer 
  3.10  support grant shall not be charged a fee or premium by a local 
  3.11  agency for participating in the program.  
  3.12     (d) The commissioner may limit the participation of nursing 
  3.13  facility residents, residents of intermediate care facilities 
  3.14  for persons with mental retardation, and the recipients of 
  3.15  services from federal waiver programs in the consumer support 
  3.16  grant program if the participation of these individuals will 
  3.17  result in an increase in the cost to the state. 
  3.18     (e) The commissioner shall establish a budgeted 
  3.19  appropriation each fiscal year for the consumer support grant 
  3.20  program.  The number of individuals participating in the program 
  3.21  will be adjusted so the total amount allocated to counties does 
  3.22  not exceed the amount of the budgeted appropriation.  The 
  3.23  budgeted appropriation will be adjusted annually to accommodate 
  3.24  changes in demand for the consumer support grants. 
  3.25     Sec. 3.  Minnesota Statutes 1998, section 256.476, 
  3.26  subdivision 5, is amended to read: 
  3.27     Subd. 5.  [REIMBURSEMENT, ALLOCATIONS, AND REPORTING.] (a) 
  3.28  For the purpose of transferring persons to the consumer support 
  3.29  grant program from specific programs or services, such as the 
  3.30  developmental disability family support program and alternative 
  3.31  care program, home and community-based waiver services, personal 
  3.32  care attendant, home health aide, or nursing facility services, 
  3.33  the amount of funds transferred by the commissioner between the 
  3.34  developmental disability family support program account, the 
  3.35  alternative care account, the medical assistance account, or the 
  3.36  consumer support grant account shall be based on each county's 
  4.1   participation in transferring persons to the consumer support 
  4.2   grant program from those programs and services. 
  4.3      (b) At the beginning of each fiscal year, county 
  4.4   allocations for consumer support grants shall be based on: 
  4.5      (1) the number of persons to whom the county board expects 
  4.6   to provide consumer supports grants; 
  4.7      (2) their eligibility for current program and services; 
  4.8      (3) the amount of nonfederal dollars expended on those 
  4.9   individuals for those programs and services or, in situations 
  4.10  where an individual is unable to obtain the support needed from 
  4.11  the program of origination due to the unavailability of service 
  4.12  providers at the time or the location where the supports are 
  4.13  needed, the allocation will be based on the county's best 
  4.14  estimate of the nonfederal dollars that would have been expended 
  4.15  if the services had been available; and 
  4.16     (4) projected dates when persons will start receiving 
  4.17  grants.  County allocations shall be adjusted periodically by 
  4.18  the commissioner based on the actual transfer of persons or 
  4.19  service openings, and the nonfederal dollars associated with 
  4.20  those persons or service openings, to the consumer support grant 
  4.21  program. 
  4.22     (c) The amount of funds transferred by the commissioner 
  4.23  from the alternative care account and the medical assistance 
  4.24  account for an individual may be changed if it is determined by 
  4.25  the county or its agent that the individual's need for support 
  4.26  has changed. 
  4.27     (d) The authority to utilize funds transferred to the 
  4.28  consumer support grant account for the purposes of implementing 
  4.29  and administering the consumer support grant program will not be 
  4.30  limited or constrained by the spending authority provided to the 
  4.31  program of origination. 
  4.32     (e) The commissioner shall use up to five percent of each 
  4.33  county's allocation, as adjusted, for payments to that county 
  4.34  for administrative expenses, to be paid as a proportionate 
  4.35  addition to reported direct service expenditures. 
  4.36     (f) Except as provided in this paragraph, the county 
  5.1   allocation for each individual or individual's family cannot 
  5.2   exceed 80 percent of the total nonfederal dollars expended on 
  5.3   the individual by the program of origination except for the 
  5.4   developmental disabilities family support grant program which 
  5.5   can be approved up to 100 percent of the nonfederal dollars and 
  5.6   in situations as described in paragraph (b), clause (3).  In 
  5.7   situations where exceptional need exists or the individual's 
  5.8   need for support increases, up to 100 percent of the nonfederal 
  5.9   dollars expended may be allocated to the county.  Allocations 
  5.10  that exceed 80 percent of the nonfederal dollars expended on the 
  5.11  individual by the program of origination must be approved by the 
  5.12  commissioner.  The remainder of the amount expended on the 
  5.13  individual by the program of origination will be used in the 
  5.14  following proportions:  half will be made available to the 
  5.15  consumer support grant program and participating counties for 
  5.16  consumer training, resource development, and other costs, and 
  5.17  half will be returned to the state general fund. 
  5.18     (g) The commissioner may recover, suspend, or withhold 
  5.19  payments if the county board, local agency, or grantee does not 
  5.20  comply with the requirements of this section.