2001 Minnesota Statutes

     256B.0916 Expansion of home and community-based 
  services; management and allocation responsibilities. 

    Subdivision 1.    Reduction of waiting list.  (a) The 
 legislature recognizes that as of January 1, 1999, 3,300 persons 
 with mental retardation or related conditions have been screened 
 and determined eligible for the home and community-based waiver 
 services program for persons with mental retardation or related 
 conditions.  Many wait for several years before receiving 
 service. 

    (b) The waiting list for this program shall be reduced or 
 eliminated by June 30, 2003.  In order to reduce the number of 
 eligible persons waiting for identified services provided 
 through the home and community-based waiver for persons with 
 mental retardation or related conditions, during the period from 
 July 1, 1999, to June 30, 2003, funding shall be increased to 
 add 100 additional eligible persons each year beyond the 
 February 1999 medical assistance forecast. 

    (c) The commissioner shall allocate resources in such a 
 manner as to use all resources budgeted for the home and 
 community-based waiver for persons with mental retardation or 
 related conditions according to the priorities listed in 
 subdivision 2, paragraph (b), and then to serve other persons on 
 the waiting list.  Resources allocated for a fiscal year to 
 serve persons affected by public and private sector ICF/MR 
 closures, but not expected to be expended for that purpose, must 
 be reallocated within that fiscal year to serve other persons on 
 the waiting list, and the number of waiver diversion slots shall 
 be adjusted accordingly. 

    (d) For fiscal year 2001, at least one-half of the increase 
 in funding over the previous year provided in the February 1999 
 medical assistance forecast for the home and community-based 
 waiver for persons with mental retardation and related 
 conditions, including changes made by the 1999 legislature, must 
 be used to serve persons who are not affected by public and 
 private sector ICF/MR closures. 

    Subd. 2.    Distribution of funds; partnerships.  (a) 
 Beginning with fiscal year 2000, the commissioner shall 
 distribute all funding available for home and community-based 
 waiver services for persons with mental retardation or related 
 conditions to individual counties or to groups of counties that 
 form partnerships to jointly plan, administer, and authorize 
 funding for eligible individuals.  The commissioner shall 
 encourage counties to form partnerships that have a sufficient 
 number of recipients and funding to adequately manage the risk 
 and maximize use of available resources.  

    (b) Counties must submit a request for funds and a plan for 
 administering the program as required by the commissioner.  The 
 plan must identify the number of clients to be served, their 
 ages, and their priority listing based on: 

    (1) requirements in Minnesota Rules, part 9525.1880; 

    (2) unstable living situations due to the age or incapacity 
 of the primary caregiver; 

    (3) the need for services to avoid out-of-home placement of 
 children; and 

    (4) the need to serve persons affected by private sector 
 ICF/MR closures. 

 The plan must also identify changes made to improve services to 
 eligible persons and to improve program management. 

    (c) In allocating resources to counties, priority must be 
 given to groups of counties that form partnerships to jointly 
 plan, administer, and authorize funding for eligible individuals 
 and to counties determined by the commissioner to have 
 sufficient waiver capacity to maximize resource use. 

    (d) Within 30 days after receiving the county request for 
 funds and plans, the commissioner shall provide a written 
 response to the plan that includes the level of resources 
 available to serve additional persons. 

    (e) Counties are eligible to receive medical assistance 
 administrative reimbursement for administrative costs under 
 criteria established by the commissioner.  

    Subd. 3.    Failure to develop partnerships or submit a 
 plan.  (a) By October 1 of each year the commissioner shall 
 notify the county board if any county determined by the 
 commissioner to have insufficient capacity to maximize use of 
 available resources fails to develop a partnership with other 
 counties or fails to submit a plan as required in subdivision 
 2.  The commissioner shall provide needed technical assistance 
 to a county or group of counties that fails to form a 
 partnership or submit a plan.  If a county has not joined a 
 county partnership or submitted a plan within 30 days following 
 the notice by the commissioner of its failure, the commissioner 
 shall require and assist that county to develop a plan or 
 contract with another county or group of counties to plan and 
 administer the waiver services program in that county. 

    (b) Counties may request technical assistance, management 
 information, and administrative support from the commissioner at 
 any time.  The commissioner shall respond to county requests 
 within 30 days.  Priority shall be given to activities that 
 support the administrative needs of newly formed county 
 partnerships. 

    Subd. 4.    Allowed reserve.  Counties or groups of 
 counties participating in partnerships that have submitted a 
 plan under this section may develop an allowed reserve amount to 
 meet crises and other unmet needs of current home and 
 community-based waiver recipients.  The amount of the allowed 
 reserve shall be a county specific amount based upon documented 
 past experience and projected need for the coming year described 
 in an allowed reserve plan submitted for approval to the 
 commissioner with the allocation request for the fiscal year. 

    Subd. 5.    Priorities for reassignment of resources and 
 approval of increased capacity.  In order to maximize the 
 number of persons served with waiver funds, the commissioner 
 shall monitor county utilization of allocated resources and, as 
 appropriate, reassign resources not utilized and approve 
 increased capacity within available county allocations.  
 Priority consideration for reassignment of resources and 
 approval of increased capacity shall be given to counties with 
 sufficient capacity and counties that form partnerships.  In 
 addition to the priorities listed in Minnesota Rules, part 
 9525.1880, the commissioner shall also give priority 
 consideration to persons whose living situations are unstable 
 due to the age or incapacity of the primary caregiver and to 
 children to avoid out-of-home placement. 

    Subd. 6.    Waiver request.  (a) The commissioner shall 
 submit to the federal Health Care Financing Administration by 
 September 1, 1999, a request for a waiver to include an option 
 that would allow waiver service recipients to directly receive 
 95 percent of the funds that would be allocated to individuals 
 based on written county criteria and procedures approved by the 
 commissioner for the purchase of services to meet their 
 long-term care needs.  The waiver request must include a 
 provision requiring recipients who receive funds directly to 
 provide to the commissioner annually, a description of the type 
 of services used, the amount paid for the services purchased, 
 and the amount of unspent funds. 

    (b) The commissioner, in cooperation with county 
 representatives, waiver service providers, recipients, 
 recipients' families, legal guardians, and advocacy groups, 
 shall develop criteria for: 

    (1) eligibility to receive funding directly; 

    (2) determination of the amount of funds made available to 
 each eligible person based on need; and 

    (3) the accountability required of persons directly 
 receiving funds. 

    (c) If this waiver is approved and implemented, any unspent 
 money from the waiver services allocation, including the five 
 percent not directly allocated to recipients and any unspent 
 portion of the money that is directly allocated, shall be used 
 to meet the needs of other eligible persons waiting for services 
 funded through the waiver. 

    (d) The commissioner, in consultation with county social 
 services agencies, waiver services providers, recipients, 
 recipients' families, legal guardians, and advocacy groups shall 
 evaluate the effectiveness of this option within two years of 
 its implementation. 

    Subd. 6a.    Statewide availability of consumer-directed 
 community support services.  (a) The commissioner shall submit 
 to the federal Health Care Financing Administration by August 1, 
 2001, an amendment to the home and community-based waiver for 
 persons with mental retardation or related conditions to make 
 consumer-directed community support services available in every 
 county of the state by January 1, 2002. 

    (b) If a county declines to meet the requirements for 
 provision of consumer-directed community supports, the 
 commissioner shall contract with another county, a group of 
 counties, or a private agency to plan for and administer 
 consumer-directed community supports in that county. 

    (c) The state of Minnesota, county agencies, tribal 
 governments, or administrative entities under contract to 
 participate in the implementation and administration of the home 
 and community-based waiver for persons with mental retardation 
 or a related condition, shall not be liable for damages, 
 injuries, or liabilities sustained through the purchase of 
 support by the individual, the individual's family, legal 
 representative, or the authorized representative with funds 
 received through the consumer-directed community support service 
 under this section.  Liabilities include but are not limited 
 to:  workers' compensation liability, the Federal Insurance 
 Contributions Act (FICA), or the Federal Unemployment Tax Act 
 (FUTA). 

    Subd. 7.    Annual report by commissioner.  Beginning 
 November 1, 2001, and each November 1 thereafter, the 
 commissioner shall issue an annual report on county and state 
 use of available resources for the home and community-based 
 waiver for persons with mental retardation or related 
 conditions.  For each county or county partnership, the report 
 shall include: 

    (1) the amount of funds allocated but not used; 

    (2) the county specific allowed reserve amount approved and 
 used; 

    (3) the number, ages, and living situations of individuals 
 screened and waiting for services; 

    (4) the urgency of need for services to begin within one, 
 two, or more than two years for each individual; 

    (5) the services needed; 

    (6) the number of additional persons served by approval of 
 increased capacity within existing allocations; 

    (7) results of action by the commissioner to streamline 
 administrative requirements and improve county resource 
 management; and 

    (8) additional action that would decrease the number of 
 those eligible and waiting for waivered services. 

 The commissioner shall specify intended outcomes for the program 
 and the degree to which these specified outcomes are attained. 

    Subd. 8.    Financial information by county.  The 
 commissioner shall make available to interested parties, upon 
 request, financial information by county including the amount of 
 resources allocated for the home and community-based waiver for 
 persons with mental retardation and related conditions, the 
 resources committed, the number of persons screened and waiting 
 for services, the type of services requested by those waiting, 
 and the amount of allocated resources not committed. 

    Subd. 9.    Legal representative participation exception. 
  The commissioner, in cooperation with representatives of 
 counties, service providers, service recipients, family members, 
 legal representatives and advocates, shall develop criteria to 
 allow legal representatives to be reimbursed for providing 
 specific support services to meet the person's needs when a plan 
 which assures health and safety has been agreed upon and carried 
 out by the legal representative, the person, and the county.  
 Legal representatives providing support under the home and 
 community-based waiver for persons with mental retardation or 
 related conditions or the consumer support grant program 
 pursuant to section 256.476, shall not be considered to have a 
 direct or indirect service provider interest under section 
 256B.092, subdivision 7, if a health and safety plan which meets 
 the criteria established has been agreed upon and implemented.  
 By August 1, 2001, the commissioner shall submit, for federal 
 approval, amendments to allow legal representatives to provide 
 support and receive reimbursement under the home and 
 community-based waiver plan. 

    HIST: 1Sp1993 c 1 art 4 s 8; 1998 c 407 art 4 s 39; 1999 c 245 
 art 4 s 61; 2000 c 488 art 11 s 7; 1Sp2001 c 9 art 3 s 43-45