1.1    .................... moves to amend H. F. No. 3955 as follows:
1.2Delete everything after the enacting clause and insert:

1.3    "Section 1. OLDER ADULT SERVICES COMMUNITY CONSORTIUMS.
1.4    Subdivision 1. Establishment. (a) The commissioner of human services, in
1.5cooperation with the commissioners of health and housing finance, shall develop and
1.6implement, beginning July 1, 2009, a three-year demonstration project for older adult
1.7services community consortiums. An older adult services community consortium may
1.8consist of health care and social service providers, county agencies, health plan companies,
1.9and other community stakeholders within a demonstration site that have established a
1.10process for joint decision-making. Demonstration sites may include a portion of a county,
1.11an entire county, or multiple counties.
1.12    (b) Each community consortium seeking to participate as a demonstration site must
1.13submit an application to the commissioner. The application must include:
1.14    (1) a description of the entities participating in the consortium, the scope of
1.15collaboration, and the process to be used for joint-decision making;
1.16    (2) the methods by which the consortium plans to achieve the goals specified in
1.17subdivision 2;
1.18    (3) a description of the proposed demonstration site; and
1.19    (4) other information the commissioner determines to be necessary to evaluate
1.20proposals.
1.21    (c) The commissioner of human services shall convene a review panel to select
1.22community consortiums to participate as demonstration sites. The review panel must
1.23include, at a minimum: representatives of the commissioners of human services,
1.24health, and housing finance; counties; and area agencies on aging. The commissioner,
1.25after considering the recommendations of the review panel, shall designate up to three
1.26community consortiums as demonstration sites.
2.1    (d) Each community consortium selected to participate shall establish a local group
2.2to assist in planning, designing, implementing, and evaluating the coordinated service
2.3delivery system within the demonstration site. Planning for each consortium shall build
2.4upon current planning processes developed by county gaps analyses and Elder Care
2.5Development Partnerships under Minnesota Statutes, section 256B.0917.
2.6    Subd. 2. Goals. The community consortium demonstration project is intended to
2.7accelerate the development of community based services to fill in gaps identified within
2.8communities, by using a pool of funds and providing flexibility in the use and distribution
2.9of these funds within each demonstration site. These projects must be designed to:
2.10    (1) ensure consumer access to a continuum of older adult services;
2.11    (2) create an adequate supply of affordable home-based alternatives to care for
2.12persons currently using nursing facilities, or likely to need nursing facility services
2.13in the future;
2.14    (3) establish and achieve measurable performance targets for care delivered
2.15throughout the continuum of care; and
2.16    (4) support the management of chronic and complex conditions through greater
2.17coordination of all services needed by older adults.
2.18    Subd. 3. Priority for other grants. The commissioner of health shall give
2.19priority to community consortiums selected as demonstration sites when awarding
2.20technology-related grants, if the consortiums are using technology as a part of their
2.21proposal. To the extent that the commissioner of the Housing Finance Agency funds
2.22projects to create or preserve affordable housing options for older adults, the commissioner
2.23shall give priority to financially feasible projects proposed or supported by community
2.24consortiums selected as demonstration sites. The commissioner of transportation shall
2.25give priority to community consortiums selected as demonstration sites when distributing
2.26transportation-related funds to create transportation options for older adults.
2.27    Subd. 4. Federal approval. The commissioner of human services shall request any
2.28federal approvals or waivers necessary to implement the community consortiums under
2.29the medical assistance program and include medical assistance funding as specified in
2.30subdivision 7 in the community consortium account.
2.31    Subd. 5. State waivers. The commissioner of health may waive applicable state
2.32laws and rules on a time-limited basis if the commissioner determines that a participating
2.33consortium requires a waiver in order to achieve demonstration project goals.
2.34    Subd. 6. Quality measures. (a) Community consortiums participating in the
2.35demonstration project shall report information to the commissioner of human services
3.1necessary to evaluate the demonstration project, in the form and manner specified by
3.2the commissioners. The information collected by the commissioner must include both
3.3process and outcome measures, including but not limited to measures related to enrollee
3.4satisfaction, service delivery, service coordination, service access, use of technology,
3.5individual outcomes, and costs.
3.6    (b) Participating consortiums shall identify state policies that limit the extent to
3.7which project goals can be achieved and recommend necessary changes to the appropriate
3.8state agencies.
3.9    Subd. 7. Community consortium account; financing. (a) The commissioner
3.10of finance shall establish a community consortium account as a special revenue
3.11account for the purpose of collecting funds for distribution to the selected community
3.12consortiums. Funds must be collected from the following existing grant programs within
3.13the Departments of Health and Human Services and must be transferred as follows to the
3.14community consortium account prior to awarding of the demonstration grants:
3.15    (1) ten percent of any funds appropriated for the biennium ending June 30, 2011,
3.16for the nursing home moratorium exceptions process under Minnesota Statutes, section
3.17144A.073;
3.18    (2) ten percent of the funds appropriated for the biennium ending June 30, 2011, for
3.19community service grants under Minnesota Statutes, section 256B.0917, subdivision 13
3.20and community services development grants under Minnesota Statutes, section 256.9754,
3.21subdivision 3; and
3.22    (3) ten percent of the funds appropriated for the biennium ending June 30, 2011,
3.23for nursing facility performance grants under Minnesota Statutes, section 256B.434,
3.24subdivision 4, paragraph (d).
3.25    (b) Money in the community consortium account may be used by the commissioner
3.26of human services to provide grants to participating community consortiums.
3.27    (c) Funds available from closure of nursing facility beds within a demonstration site
3.28may be used by the consortium to fund consortium-related activities if the closed beds
3.29have not been claimed as a planned closure rate adjustment under Minnesota Statutes,
3.30section 256B.437.
3.31    (d) The commissioner of human services, in consultation with the commissioner
3.32of health, may approve moratorium exception projects that are part of the applications
3.33submitted by the designated demonstration sites, using any funding made available under
3.34paragraph (a), clause (1), and subject to the limits of that funding. Nursing facilities
3.35receiving approval for moratorium exception projects under this paragraph shall receive
3.36a rate increase calculated in the same manner as facilities receiving exceptions under
4.1Minnesota Statutes, section 144A.073, and the rate increase shall continue to apply after
4.2the expiration of the demonstration project grant under this section. Once grants under this
4.3section are no longer made, any funds made available under paragraph (a), clause (1), that
4.4are not being used by demonstration projects, shall be transferred to the Department of
4.5Health to be used for moratorium exception projects approved under Minnesota Statutes,
4.6section 144A.073.
4.7    Subd. 8. Evaluation and report. The commissioner of human services, in
4.8cooperation with the commissioners of health and housing finance, shall evaluate the
4.9demonstration project, and report findings and recommendations to the legislature by
4.10November 15, 2011, on whether the demonstration project should be continued and
4.11whether the number of demonstration project sites increased. The evaluation and report
4.12must include:
4.13    (1) a comparison of the performance of demonstration sites relative to
4.14non-consortium communities on the quality measures specified in subdivision 6;
4.15    (2) an assessment of the extent to which the demonstration project can be
4.16successfully expanded to other parts of the state; and
4.17    (3) legislative changes necessary to improve the effectiveness of the demonstration
4.18project and to expand the projects to other parts of the state.
4.19    The commissioner of human services may use up to $50,000 of the funding provided
4.20to each participating community consortium under this section to fund the evaluation
4.21and report."