1.1                          A bill for an act 
  1.2             relating to human services; transferring certain 
  1.3             duties to the region 10 quality assurance commission 
  1.4             from the commissioner of human services; requiring a 
  1.5             waiver request to be submitted to the federal 
  1.6             government; appropriating money; amending Minnesota 
  1.7             Statutes 1998, sections 256B.0951, subdivisions 1 and 
  1.8             3; and 256B.0955. 
  1.9   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.10     Section 1.  Minnesota Statutes 1998, section 256B.0951, 
  1.11  subdivision 1, is amended to read: 
  1.12     Subdivision 1.  [MEMBERSHIP.] The region 10 quality 
  1.13  assurance commission is established.  The commission consists of 
  1.14  at least ~~13~~ 14 but not more than ~~20~~ 21 members as follows:  at 
  1.15  least three but not more than five members representing advocacy 
  1.16  organizations; at least three but not more than five members 
  1.17  representing consumers, families, and their legal 
  1.18  representatives; at least three but not more than five members 
  1.19  representing service providers; ~~and~~ at least three but not more 
  1.20  than five members representing counties; and the commissioner of 
  1.21  human services or the commissioner's designee.  Initial 
  1.22  membership of the commission shall be recruited and approved by 
  1.23  the region 10 stakeholders group.  Prior to approving the 
  1.24  commission's membership, the stakeholders group shall provide to 
  1.25  the commissioner a list of the membership in the stakeholders 
  1.26  group, as of February 1, 1997, a brief summary of meetings held 
  1.27  by the group since July 1, 1996, and copies of any materials 
  2.1   prepared by the group for public distribution.  The first 
  2.2   commission shall establish membership guidelines for the 
  2.3   transition and recruitment of membership for the commission's 
  2.4   ongoing existence.  Members of the commission who do not receive 
  2.5   a salary or wages from an employer for time spent on commission 
  2.6   duties may receive a per diem payment when performing commission 
  2.7   duties and functions.  All members may be reimbursed for 
  2.8   expenses related to commission activities.  Notwithstanding the 
  2.9   provisions of section 15.059, subdivision 5, the commission 
  2.10  expires on June 30, 2001. 
  2.11     Sec. 2.  Minnesota Statutes 1998, section 256B.0951, 
  2.12  subdivision 3, is amended to read: 
  2.13     Subd. 3.  [COMMISSION DUTIES.] (a) By October 1, 1997, the 
  2.14  commission, in cooperation with the commissioners of human 
  2.15  services and health, shall do the following:  (1) approve an 
  2.16  alternative quality assurance licensing system based on the 
  2.17  evaluation of outcomes; (2) approve measurable outcomes in the 
  2.18  areas of health and safety, consumer evaluation, education and 
  2.19  training, providers, and systems that shall be evaluated during 
  2.20  the alternative licensing process; and (3) establish variable 
  2.21  licensure periods not to exceed three years based on outcomes 
  2.22  achieved.  For purposes of this subdivision, "outcome" means the 
  2.23  behavior, action, or status of a person that can be observed or 
  2.24  measured and can be reliably and validly determined. 
  2.25     (b) By January 15, 1998, the commission shall approve, in 
  2.26  cooperation with the commissioner of human services, a training 
  2.27  program for members of the quality assurance teams established 
  2.28  under section 256B.0952, subdivision 4. 
  2.29     (c) The commission and the commissioner shall establish an 
  2.30  ongoing review process for the alternative quality assurance 
  2.31  licensing system.  The review shall take into account the 
  2.32  comprehensive nature of the alternative system, which is 
  2.33  designed to evaluate the broad spectrum of licensed and 
  2.34  unlicensed entities that provide services to clients, as 
  2.35  compared to the current licensing system.  
  2.36     (d) The commission shall contract with an independent 
  3.1   entity to conduct a financial review of the alternative quality 
  3.2   assurance pilot project.  The review shall take into account the 
  3.3   comprehensive nature of the alternative system, which is 
  3.4   designed to evaluate the broad spectrum of licensed and 
  3.5   unlicensed entities that provide services to clients, as 
  3.6   compared to the current licensing system.  The review shall 
  3.7   include an evaluation of possible budgetary savings within the 
  3.8   department of human services as a result of implementation of 
  3.9   the alternative quality assurance pilot project.  If a federal 
  3.10  waiver is approved under subdivision 7, the financial review 
  3.11  shall also evaluate possible savings within the department of 
  3.12  health.  This review must be completed by December 15, 2000. 
  3.13     (e) The commission shall submit a report to the legislature 
  3.14  by January 15, 2001, on the results of the review process for 
  3.15  the alternative quality assurance pilot project, a summary of 
  3.16  the results of the independent financial review, and a 
  3.17  recommendation on whether the pilot project should be extended 
  3.18  beyond June 30, 2001. 
  3.19     Sec. 3.  Minnesota Statutes 1998, section 256B.0955, is 
  3.20  amended to read: 
  3.21     256B.0955 [DUTIES OF THE COMMISSIONER OF HUMAN SERVICES.] 
  3.22     (a) Effective July 1, 1998, the commissioner of human 
  3.23  services shall delegate authority to perform licensing functions 
  3.24  and activities, in accordance with section 245A.16, to counties 
  3.25  participating in the alternative licensing system.  The 
  3.26  commissioner shall not license or reimburse a facility, program, 
  3.27  or service for persons with developmental disabilities in a 
  3.28  county that participates in the alternative licensing system if 
  3.29  the commissioner has received from the appropriate county 
  3.30  notification that the facility, program, or service has been 
  3.31  reviewed by a quality assurance team and has failed to qualify 
  3.32  for licensure. 
  3.33     (b) The commissioner may conduct random licensing 
  3.34  inspections based on outcomes adopted under section 256B.0951 at 
  3.35  facilities, programs, and services governed by the alternative 
  3.36  licensing system.  The role of such random inspections shall be 
  4.1   to verify that the alternative licensing system protects the 
  4.2   safety and well-being of consumers and maintains the 
  4.3   availability of high-quality services for persons with 
  4.4   developmental disabilities.  
  4.5      (c) The commissioner shall provide technical assistance and 
  4.6   support or training to the alternative licensing system pilot 
  4.7   project. 
  4.8      ~~(d) The commissioner and the commission shall establish an~~ 
  4.9   ~~ongoing evaluation process for the alternative licensing system.~~ 
  4.10     ~~(e) The commissioner shall contract with an independent~~ 
  4.11  ~~entity to conduct a financial review of the alternative~~ 
  4.12  ~~licensing system, including an evaluation of possible budgetary~~ 
  4.13  ~~savings within the department of human services and the~~ 
  4.14  ~~department of health as a result of implementation of the~~ 
  4.15  ~~alternative quality assurance licensing system.  This review~~ 
  4.16  ~~must be completed by December 15, 2000.~~  
  4.17     ~~(f) The commissioner and the commission shall submit a~~ 
  4.18  ~~report to the legislature by January 15, 2001, on the results of~~ 
  4.19  ~~the evaluation process of the alternative licensing system, a~~ 
  4.20  ~~summary of the results of the independent financial review, and~~ 
  4.21  ~~a recommendation on whether the pilot project should be extended~~ 
  4.22  ~~beyond June 30, 2001.~~ 
  4.23     Sec. 4.  [REQUEST FOR WAIVER.] 
  4.24     By October 1, 1999, the commissioner of human services or 
  4.25  health shall request a waiver from the federal Department of 
  4.26  Health and Human Services to implement Minnesota Statutes, 
  4.27  256B.0951, subdivision 7. 
  4.28     Sec. 5.  [APPROPRIATION.] 
  4.29     (a) $280,000 is appropriated from the general fund to the 
  4.30  region 10 quality assurance commission established under 
  4.31  Minnesota Statutes, section 256B.0951, for each year of the 
  4.32  biennium beginning July 1, 1999, for the following purposes: 
  4.33     (1) $250,000 each year for the costs associated with the 
  4.34  operation of the quality assurance licensing system pilot 
  4.35  project and for the commission to provide grants to counties 
  4.36  participating in the alternative quality assurance licensing 
  5.1   system under Minnesota Statutes, section 256B.0953; 
  5.2      (2) $20,000 each year for the commission to contract with 
  5.3   an independent entity to conduct a financial review of the 
  5.4   alternative quality assurance licensing system, including an 
  5.5   evaluation of possible budgetary savings within the department 
  5.6   of human services and if applicable, the department of health as 
  5.7   a result of implementation of the alternative system; and 
  5.8      (3) $10,000 each year for the commission and the 
  5.9   commissioner of human services to establish an ongoing review 
  5.10  process for the alternative quality assurance licensing system.  
  5.11     (b) Any unspent portion of the appropriations in paragraph 
  5.12  (a) for fiscal year 2000 shall not cancel but shall be available 
  5.13  for the commission for fiscal year 2001.