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Minnesota Legislature

Office of the Revisor of Statutes

Chapter 256I

Section 256I.05

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256I.05 MONTHLY RATES.
    Subdivision 1. Maximum rates. Monthly room and board rates negotiated by a county
agency for a recipient living in group residential housing must not exceed the MSA equivalent
rate specified under section 256I.03, subdivision 5.
    Subd. 1a. Supplementary service rates. (a) Subject to the provisions of section 256I.04,
subdivision 3
, the county agency may negotiate a payment not to exceed $426.37 for other
services necessary to provide room and board provided by the group residence if the residence
is licensed by or registered by the Department of Health, or licensed by the Department of
Human Services to provide services in addition to room and board, and if the provider of
services is not also concurrently receiving funding for services for a recipient under a home
and community-based waiver under title XIX of the Social Security Act; or funding from the
medical assistance program under section 256B.0655, subdivision 2, for personal care services for
residents in the setting; or residing in a setting which receives funding under Minnesota Rules,
parts 9535.2000 to 9535.3000. If funding is available for other necessary services through a home
and community-based waiver, or personal care services under section 256B.0655, subdivision 2,
then the GRH rate is limited to the rate set in subdivision 1. Unless otherwise provided in law,
in no case may the supplementary service rate exceed $426.37. The registration and licensure
requirement does not apply to establishments which are exempt from state licensure because
they are located on Indian reservations and for which the tribe has prescribed health and safety
requirements. Service payments under this section may be prohibited under rules to prevent the
supplanting of federal funds with state funds. The commissioner shall pursue the feasibility of
obtaining the approval of the Secretary of Health and Human Services to provide home and
community-based waiver services under title XIX of the Social Security Act for residents who
are not eligible for an existing home and community-based waiver due to a primary diagnosis
of mental illness or chemical dependency and shall apply for a waiver if it is determined to be
cost-effective.
(b) The commissioner is authorized to make cost-neutral transfers from the GRH fund
for beds under this section to other funding programs administered by the department after
consultation with the county or counties in which the affected beds are located. The commissioner
may also make cost-neutral transfers from the GRH fund to county human service agencies for
beds permanently removed from the GRH census under a plan submitted by the county agency
and approved by the commissioner. The commissioner shall report the amount of any transfers
under this provision annually to the legislature.
(c) The provisions of paragraph (b) do not apply to a facility that has its reimbursement rate
established under section 256B.431, subdivision 4, paragraph (c).
    Subd. 1b. Rates for uncertified boarding care homes. Effective July 1, 1992, the maximum
rate specified in subdivision 1 does not apply to a facility which was licensed by the Minnesota
Department of Health as a boarding care home before March 1, 1985, and which is not certified to
receive medical assistance.
    Subd. 1c. Rate increases. A county agency may not increase the rates negotiated for group
residential housing above those in effect on June 30, 1993, except as provided in paragraphs
(a) to (g).
(a) A county may increase the rates for group residential housing settings to the MSA
equivalent rate for those settings whose current rate is below the MSA equivalent rate.
(b) A county agency may increase the rates for residents in adult foster care whose difficulty
of care has increased. The total group residential housing rate for these residents must not exceed
the maximum rate specified in subdivisions 1 and 1a. County agencies must not include nor
increase group residential housing difficulty of care rates for adults in foster care whose difficulty
of care is eligible for funding by home and community-based waiver programs under title XIX
of the Social Security Act.
(c) The room and board rates will be increased each year when the MSA equivalent rate is
adjusted for SSI cost-of-living increases by the amount of the annual SSI increase, less the amount
of the increase in the medical assistance personal needs allowance under section 256B.35.
(d) When a group residential housing rate is used to pay for an individual's room and board,
or other costs necessary to provide room and board, the rate payable to the residence must
continue for up to 18 calendar days per incident that the person is temporarily absent from the
residence, not to exceed 60 days in a calendar year, if the absence or absences have received
the prior approval of the county agency's social service staff. Prior approval is not required for
emergency absences due to crisis, illness, or injury.
(e) For facilities meeting substantial change criteria within the prior year. Substantial change
criteria exists if the group residential housing establishment experiences a 25 percent increase or
decrease in the total number of its beds, if the net cost of capital additions or improvements is in
excess of 15 percent of the current market value of the residence, or if the residence physically
moves, or changes its licensure, and incurs a resulting increase in operation and property costs.
(f) Until June 30, 1994, a county agency may increase by up to five percent the total rate
paid for recipients of assistance under sections 256D.01 to 256D.21 or 256D.33 to 256D.54 who
reside in residences that are licensed by the commissioner of health as a boarding care home, but
are not certified for the purposes of the medical assistance program. However, an increase under
this clause must not exceed an amount equivalent to 65 percent of the 1991 medical assistance
reimbursement rate for nursing home resident class A, in the geographic grouping in which the
facility is located, as established under Minnesota Rules, parts 9549.0050 to 9549.0058.
(g) For the rate year beginning July 1, 1996, a county agency may increase the total rate paid
for recipients of assistance under sections 256D.01 to 256D.21 or 256D.33 to 256D.54 who reside
in a residence that meets the following criteria:
(1) it is licensed by the commissioner of health as a boarding care home;
(2) it is not certified for the purposes of the medical assistance program;
(3) at least 50 percent of its residents have a primary diagnosis of mental illness;
(4) it has at least 17 beds; and
(5) it provides medication administration to residents.
The rate following an increase under this paragraph must not exceed an amount equivalent to
the average 1995 medical assistance payment for nursing home resident class A under the age of
65, in the geographic grouping in which the facility is located, as established under Minnesota
Rules, parts 9549.0010 to 9549.0080.
    Subd. 1d. Certain facilities for mental illness or chemical dependency; rates.
Notwithstanding the provisions of subdivisions 1a and 1c, a county agency may negotiate a
supplementary service rate in addition to the board and lodging rate for facilities licensed and
registered by the Minnesota Department of Health under section 157.17 prior to December 31,
1996, if the facility meets the following criteria:
(1) at least 75 percent of the residents have a primary diagnosis of mental illness, chemical
dependency, or both, and have related special needs;
(2) the facility provides 24-hour, on-site, year-round supportive services by qualified staff
capable of intervention in a crisis of persons with late-state inebriety or mental illness who are
vulnerable to abuse or neglect;
(3) the services at the facility include, but are not limited to:
(i) secure central storage of medication;
(ii) reminders and monitoring of medication for self-administration;
(iii) support for developing an individual medical and social service plan, updating the plan,
and monitoring compliance with the plan; and
(iv) assistance with setting up meetings, appointments, and transportation to access medical,
chemical health, and mental health service providers;
(4) each resident has a documented need for at least one of the services provided;
(5) each resident has been offered an opportunity to apply for admission to a licensed
residential treatment program for mental illness, chemical dependency, or both, have refused that
offer, and the offer and their refusal has been documented to writing; and
(6) the residents are not eligible for home and community-based services waivers because
of their unique need for community support.
Until June 30, 2002, the supplementary service rate of qualifying facilities under this
subdivision may be increased by up to 15 percent of the supplementary service rate in effect on
January 1, 2001, for the facility. Qualifying facilities with no supplementary service rate may
negotiate a supplementary service rate not to exceed $300 per month.
    Subd. 1e. Supplementary rate for certain facilities. Notwithstanding the provisions of
subdivisions 1a and 1c, beginning July 1, 2005, a county agency shall negotiate a supplementary
rate in addition to the rate specified in subdivision 1, not to exceed $700 per month, including any
legislatively authorized inflationary adjustments, for a group residential housing provider that:
(1) is located in Hennepin County and has had a group residential housing contract with
the county since June 1996;
(2) operates in three separate locations a 75-bed facility, a 50-bed facility, and a 26-bed
facility; and
(3) serves a chemically dependent clientele, providing 24 hours per day supervision and
limiting a resident's maximum length of stay to 13 months out of a consecutive 24-month period.
    Subd. 1f. Supplementary service rate increases on or after July 1, 2001. Until June 30,
2002, the supplementary service rate for recipients of assistance under section 256I.04 who reside
in a residence that is licensed by the commissioner of health as a boarding care home but is not
certified for purposes of the medical assistance program may be increased by up to 32 percent of
the supplementary service rate in effect for that facility on January 1, 2001. The new rate shall
not exceed the nonfederal share of the statewide weighted average monthly medical assistance
nursing facility payment rate for case mix A in effect on January 1, 2001.
    Subd. 1g. Supplementary service rate for certain facilities. On or after July 1, 2005, a
county agency may negotiate a supplementary service rate for recipients of assistance under
section 256I.04, subdivision 1, paragraph (b), who relocate from a homeless shelter licensed and
registered prior to December 31, 1996, by the Minnesota Department of Health under section
157.17, to a supportive housing establishment developed and funded in whole or in part with
funds provided specifically as part of the plan to end long-term homelessness required under Laws
2003, chapter 128, article 15, section 9, not to exceed $456.75.
    Subd. 2. Monthly rates; exemptions. The maximum group residential housing rate does
not apply to a residence that on August 1, 1984, was licensed by the commissioner of health
only as a boarding care home, certified by the commissioner of health as an intermediate care
facility, and licensed by the commissioner of human services under Minnesota Rules, parts
9520.0500 to 9520.0690. Notwithstanding the provisions of subdivision 1c, the rate paid to
a facility reimbursed under this subdivision shall be determined under section 256B.431, or
under section 256B.434 if the facility is accepted by the commissioner for participation in the
alternative payment demonstration project.
    Subd. 3. Limits on rates. When a group residential housing rate is used to pay for an
individual's room and board, the rate payable to the residence must not exceed the rate paid by an
individual not receiving a group residential housing rate under this chapter.
    Subd. 4.[Repealed, 1Sp1993 c 1 art 8 s 29]
    Subd. 5. Adult foster care rates. The commissioner shall annually establish statewide
maintenance and difficulty of care limits for adults in foster care.
    Subd. 6. Statewide rate setting system. The commissioner shall establish a comprehensive
statewide system of rates and payments for recipients who reside in group residential housing
to be effective as soon as possible. The commissioner may adopt rules to establish this rate
setting system.
    Subd. 7.[Repealed, 1992 c 513 art 8 s 59]
    Subd. 7a.[Repealed, 1992 c 513 art 8 s 59]
    Subd. 7b. Commissioner's duties. The commissioner shall not provide automatic annual
inflation adjustments for group residential housing rates for the fiscal year beginning on July 1,
1993, and for subsequent fiscal years. The commissioner of finance shall include as a budget
change request annual adjustments in reimbursement rates for group residential housing in each
biennial detailed expenditure budget submitted to the legislature under section 16A.11.
    Subd. 7c. Demonstration project. The commissioner is authorized to pursue a demonstration
project under federal food stamp regulation for the purpose of gaining federal reimbursement
of food and nutritional costs currently paid by the state group residential housing program. The
commissioner shall seek approval no later than January 1, 2004. Any reimbursement received
is nondedicated revenue to the general fund.
    Subd. 8. State participation. For a resident of a group residence who is eligible under
section 256I.04, subdivision 1, paragraph (b), state participation in the group residential housing
payment is determined according to section 256D.03, subdivision 2. For a resident of a group
residence who is eligible under section 256I.04, subdivision 1, paragraph (a), state participation in
the group residential housing rate is determined according to section 256D.36.
    Subd. 9.[Repealed, 1Sp 1993 c 1 art 8 s 29]
    Subd. 10.[Repealed, 1Sp1993 c 1 art 8 s 29]
History: 1989 c 282 art 5 s 119; 1990 c 568 art 4 s 59,60; 1991 c 292 art 4 s 71-74; art 6 s
51; 1992 c 363 art 1 s 10; 1992 c 513 art 8 s 38-47; 1Sp1993 c 1 art 8 s 22-26; 1995 c 207 art 5 s
32-34; 1996 c 312 s 1; 1996 c 451 art 2 s 52; art 3 s 8; 1997 c 203 art 3 s 13; art 4 s 60; 3Sp1997 c
3 s 20; 1998 c 407 art 3 s 21; 1999 c 245 art 3 s 40-42; 1Sp2001 c 9 art 13 s 14-16; 2002 c 379 art
1 s 113; 1Sp2002 c 1 s 13; 1Sp2003 c 14 art 2 s 44-46; 2005 c 159 art 5 s 6; 1Sp2005 c 4 art 3 s 13

NOTE: The amendment to subdivision 1 by Laws 2003, First Special Session chapter 14,
article 2, section 44, is effective July 1, 2004, or upon receipt of federal approval of waiver
amendment, whichever is later. Laws 2003, First Special Session chapter 14, article 2, section
44, the effective date.