2002 Minnesota Statutes

     256B.5013 Payment rate adjustments. 

    Subdivision 1.    Variable rate adjustments.  (a) For 
 rate years beginning on or after October 1, 2000, when there is 
 a documented increase in the needs of a current ICF/MR 
 recipient, the county of financial responsibility may recommend 
 a variable rate to enable the facility to meet the individual's 
 increased needs.  Variable rate adjustments made under this 
 subdivision replace payments for persons with special needs 
 under section 256B.501, subdivision 8, and payments for persons 
 with special needs for crisis intervention services under 
 section 256B.501, subdivision 8a.  Effective July 1, 2003, 
 facilities with a base rate above the 50th percentile of the 
 statewide average reimbursement rate for a Class A facility or 
 Class B facility, whichever matches the facility licensure, are 
 not eligible for a variable rate adjustment.  Variable rate 
 adjustments may not exceed a 12-month period, except when 
 approved for purposes established in paragraph (b), clause (1).  
 Variable rate adjustments approved solely on the basis of 
 changes on a developmental disabilities screening document will 
 end June 30, 2002. 

    (b) A variable rate may be recommended by the county of 
 financial responsibility for increased needs in the following 
 situations: 

    (1) a need for resources due to an individual's full or 
 partial retirement from participation in a day training and 
 habilitation service when the individual:  (i) has reached the 
 age of 65 or has a change in health condition that makes it 
 difficult for the person to participate in day training and 
 habilitation services over an extended period of time because it 
 is medically contraindicated; and (ii) has expressed a desire 
 for change through the mental retardation and related conditions 
 screening process under section 256B.092; 

    (2) a need for additional resources for intensive 
 short-term programming which is necessary prior to an 
 individual's discharge to a less restrictive, more integrated 
 setting; 

    (3) a demonstrated medical need that significantly impacts 
 the type or amount of services needed by the individual; or 

    (4) a demonstrated behavioral need that significantly 
 impacts the type or amount of services needed by the individual. 

    (c) The county of financial responsibility must justify the 
 purpose, the projected length of time, and the additional 
 funding needed for the facility to meet the needs of the 
 individual.  

    (d) The facility shall provide a quarterly report to the 
 county case manager on the use of the variable rate funds and 
 the status of the individual on whose behalf the funds were 
 approved.  The county case manager will forward the facility's 
 report with a recommendation to the commissioner to approve or 
 disapprove a continuation of the variable rate. 

    (e) Funds made available through the variable rate process 
 that are not used by the facility to meet the needs of the 
 individual for whom they were approved shall be returned to the 
 state. 

    Subd. 2.    Other payment rate adjustments.  Facility 
 total payment rates may be adjusted by the commissioner 
 following the recommendation of both the host county and the 
 statewide advisory committee if, through the local system needs 
 planning process, it is determined that a need exists to amend 
 the package of purchased services with a resulting increase or 
 decrease in costs.  Except as provided in section 252.292, 
 subdivision 4, if a provider demonstrates that the loss of 
 revenues caused by the downsizing or closure of a facility 
 cannot be absorbed by the facility based on current operations, 
 the host county or the provider may submit a request to the 
 statewide advisory committee for a facility base rate 
 adjustment.  Funds for this purpose are limited to those made 
 available through a legislative appropriation and published in 
 the State Register notice required by section 252.282, 
 subdivision 5. 

    Subd. 3.    Relocation.  (a) Property rates for all 
 facilities relocated after December 31, 1997, and up to and 
 including October 1, 2000, shall have the full annual costs of 
 relocation included in their October 1, 2000, property rate.  
 The property rate for the relocated home is subject to the costs 
 that were allowable under Minnesota Rules, chapter 9553, and the 
 investment per bed limitation for newly constructed or newly 
 established class B facilities.  

    (b) In ensuing years, all relocated homes shall be subject 
 to the investment per bed limit for newly constructed or newly 
 established class B facilities under section 256B.501, 
 subdivision 11.  The limits shall be adjusted on January 1 of 
 each year by the percentage increase in the construction index 
 published by the Bureau of Economic Analysis of the United 
 States Department of Commerce in the Survey of Current Business 
 Statistics in October of the previous two years.  Facilities 
 that are relocated within the investment per bed limit may be 
 approved by the statewide advisory committee.  Costs for 
 relocation of a facility that exceed the investment per bed 
 limit must be absorbed by the facility. 

    (c) The payment rate shall take effect when the new 
 facility is licensed and certified by the commissioner of 
 health.  Rates for facilities that are relocated after December 
 31, 1997, through October 1, 2000, shall be adjusted to reflect 
 the full inclusion of the relocation costs, subject to the 
 investment per bed limit in paragraph (b).  The investment per 
 bed limit calculated rate for the year in which the facility was 
 relocated shall be the investment per bed limit used. 

    Subd. 4.    Temporary rate adjustments to address 
 occupancy and access.  Beginning July 1, 2002, the 
 commissioner shall adjust the total payment rate for up to 75 
 days for the remaining recipients for facilities in which the 
 monthly occupancy rate of licensed beds is 75 percent or 
 greater.  This mechanism shall not be used to pay for hospital 
 or therapeutic leave days beyond the maximums allowed.  

    Subd. 5.    Required occupancy data.  Facilities shall 
 maintain monthly occupancy bed use data by client and report 
 this data monthly in a format determined by the commissioner. 

    Subd. 6.    Commissioner's responsibilities.  The 
 commissioner shall: 

    (1) make a determination to approve, deny, or modify a 
 request for a variable rate adjustment within 30 days of the 
 receipt of the completed application; 

    (2) notify the ICF/MR facility and county case manager of 
 the duration and conditions of variable rate adjustment 
 approvals; 

    (3) modify MMIS II service agreements to reimburse ICF/MR 
 facilities for approved variable rates; 

    (4) provide notification of legislatively appropriated 
 funding for facility closures, downsizings, and relocations; 

    (5) assess the fiscal impacts of the proposals for 
 closures, downsizings, and relocations forwarded for 
 consideration through the state advisory committee; and 

    (6) review the payment rate process on a biannual basis and 
 make recommendations to the legislature for necessary 
 adjustments to the review and approval process.  

    HIST: 1999 c 245 art 3 s 34; 2000 c 474 s 14-16; 2001 c 203 s 
 13; 2002 c 220 art 14 s 14-18; 2002 c 374 art 10 s 7