1.1 .................... moves to amend the delete everything amendment (H3976DE2) to H.
1.2F. No. 3976, as follows:
1.3Page 41, after line 22, insert:
1.4 "Sec. 9. Minnesota Statutes 2006, section 256B.434, is amended by adding a
1.5subdivision to read:
1.6 Subd. 21. Nursing facility rate increases beginning October 1, 2009, and
1.7October 1, 2010. (a) For the rate year beginning October 1, 2009, the commissioner
1.8shall make available to each nursing facility reimbursed under this section operating
1.9payment rate adjustments equal to 5.0 percent of the operating payment rates in effect
1.10on September 30, 2009. For the rate year beginning October 1, 2010, the commissioner
1.11shall make available to each nursing facility reimbursed under this section, operating
1.12payment rate adjustments equal to 5.0 percent of the operating payment rates in effect
1.13on September 30, 2010.
1.14 (b) Seventy-five percent of the money resulting from the rate adjustment under
1.15paragraph (a) must be used for increases in compensation-related costs for employees
1.16directly employed by the nursing facility on or after the effective date of the rate
1.17adjustment, except:
1.18 (1) the administrator;
1.19 (2) persons employed in the central office of a corporation that has an ownership
1.20interest in the nursing facility or exercises control over the nursing facility; and
1.21 (3) persons paid by the nursing facility under a management contract.
1.22 (c) The commissioner shall allow as compensation-related costs all costs for:
1.23 (1) wages and salaries;
1.24 (2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers'
1.25compensation;
1.26 (3) the employer's share of health and dental insurance, life insurance, disability
1.27insurance, long-term care insurance, uniform allowance, and pensions; and
2.1 (4) other benefits provided, subject to the approval of the commissioner.
2.2 (d) The portion of the rate adjustment under paragraph (a) that is not subject to the
2.3requirements in paragraph (b) shall be provided to nursing facilities effective October 1,
2.42009, or October 1, 2010, as applicable.
2.5 (e) Nursing facilities may apply for the portion of the rate adjustment under paragraph
2.6(a) that is subject to the requirements in paragraph (b). The application must be submitted
2.7to the commissioner within six months of the effective date of the rate adjustment, and
2.8the nursing facility must provide additional information required by the commissioner
2.9within nine months of the effective date of the rate adjustment. The commissioner must
2.10respond to all applications within three weeks of receipt. The commissioner may waive
2.11the deadlines in this paragraph under extraordinary circumstances, to be determined at the
2.12sole discretion of the commissioner. The application must contain:
2.13 (1) an estimate of the amounts of money that must be used as specified in paragraph
2.14(b);
2.15 (2) a detailed distribution plan specifying the allowable compensation-related and
2.16wage increases the nursing facility will implement to use the funds available in clause (1);
2.17 (3) a description of how the nursing facility will notify eligible employees of
2.18the contents of the approved application, which must provide for giving each eligible
2.19employee a copy of the approved application, excluding the information required in clause
2.20(1), or posting a copy of the approved application, excluding the information required in
2.21clause (1), for a period of at least six weeks in an area of the nursing facility to which all
2.22eligible employees have access; and
2.23 (4) instructions for employees who believe they have not received the
2.24compensation-related or wage increases specified in clause (2), as approved by the
2.25commissioner, and which must include a mailing address, e-mail address, and the
2.26telephone number that may be used by the employee to contact the commissioner or the
2.27commissioner's representative.
2.28 (f) The commissioner shall ensure that cost increases in distribution plans under
2.29paragraph (e), clause (2), that may be included in approved applications, comply with the
2.30following requirements:
2.31 (1) costs to be incurred during the applicable rate year resulting from wage and
2.32salary increases effective after October 1, 2008, and prior to the first day of the nursing
2.33facility's payroll period that includes October 1 of each year, shall be allowed if they
2.34were not used in the prior year's application;
2.35 (2) a portion of the costs resulting from tenure-related wage or salary increases
2.36may be considered to be allowable wage increases, according to formulas that the
3.1commissioner shall provide, where employee retention is above the average statewide
3.2rate of retention of direct care employees;
3.3 (3) the annualized amount of increases in costs for the employer's share of health
3.4and dental insurance, life insurance, disability insurance, and workers' compensation shall
3.5be allowable compensation-related increases if they are effective on or after April 1 of
3.6the year in which the rate adjustments are effective and prior to April 1 of the following
3.7year; and
3.8 (4) for nursing facilities in which employees are represented by an exclusive
3.9bargaining representative, the commissioner shall approve the application only upon
3.10receipt of a letter of acceptance of the distribution plan, in regard to members of the
3.11bargaining unit, signed by the exclusive bargaining agent and dated after May 25, 2009.
3.12Upon receipt of the letter of acceptance, the commissioner shall deem all requirements of
3.13this section as having been met in regard to the members of the bargaining unit.
3.14 (g) The commissioner shall review applications received under paragraph (e) and
3.15shall provide the portion of the rate adjustment under paragraph (b) if the requirements
3.16of this subdivision have been met. The rate adjustment shall be effective October 1.
3.17Notwithstanding paragraph (a), if the approved application distributes less money than is
3.18available, the amount of the rate adjustment shall be reduced so that the amount of money
3.19made available is equal to the amount to be distributed.
3.20 Sec. 10. Minnesota Statutes 2006, section 256B.5012, is amended by adding a
3.21subdivision to read:
3.22 Subd. 7. ICF/MR rate increases effective October 1, 2009, and October 1, 2010.
3.23 (a) For the rate year beginning October 1, 2009, the commissioner shall make available to
3.24each facility reimbursed under this section operating payment rate adjustments equal to 5.0
3.25percent of the operating payment rates in effect on September 30, 2009. For the rate year
3.26beginning July 1, 2010, the commissioner shall make available to each facility reimbursed
3.27under this section operating payment rate adjustments equal to 5.0 percent of the operating
3.28payment rates in effect on June 30, 2010. For each facility, the commissioner shall make
3.29available an adjustment, based on occupied beds, using the percentage specified in this
3.30paragraph multiplied by the total payment rate, including the variable rate but excluding
3.31the property-related payment rate, in effect on the preceding day. The total payment rate
3.32shall include the adjustment provided in section
256B.501, subdivision 12. A facility
3.33whose payment rates are governed by closure agreements, receivership agreements, or
3.34Minnesota Rules, part 9553.0075, is not eligible for an adjustment otherwise granted
3.35under this subdivision.
4.1 (b) Seventy-five percent of the money resulting from the rate adjustments under
4.2paragraph (a) must be used for increases in compensation-related costs for employees
4.3directly employed by the facility on or after the effective date of the rate adjustments,
4.4except:
4.5 (1) the administrator;
4.6 (2) persons employed in the central office of a corporation that has an ownership
4.7interest in the facility or exercises control over the facility; and
4.8 (3) persons paid by the facility under a management contract.
4.9 (c) The commissioner shall allow as compensation-related costs all costs for:
4.10 (1) wages and salaries;
4.11 (2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers'
4.12compensation;
4.13 (3) the employer's share of health and dental insurance, life insurance, disability
4.14insurance, long-term care insurance, uniform allowance, and pensions; and
4.15 (4) other benefits provided, subject to the approval of the commissioner.
4.16 (d) The portion of the rate adjustments under paragraph (a) that is not subject to the
4.17requirements in paragraph (b) shall be provided to facilities effective October 1 of each
4.18year.
4.19 (f) Facilities may apply for the portion of the rate adjustments under paragraph (a)
4.20that is subject to the requirements in paragraph (b). The application must be submitted to
4.21the commissioner within six months of the effective date of the rate adjustments, and the
4.22facility must provide additional information required by the commissioner within nine
4.23months of the effective date of the rate adjustments. The commissioner must respond to all
4.24applications within three weeks of receipt. The commissioner may waive the deadlines in
4.25this paragraph under extraordinary circumstances, to be determined at the sole discretion
4.26of the commissioner. The application must contain:
4.27 (1) an estimate of the amounts of money that must be used as specified in paragraph
4.28(b);
4.29 (2) a detailed distribution plan specifying the allowable compensation-related and
4.30wage increases the facility will implement to use the funds available in clause (1);
4.31 (3) a description of how the facility will notify eligible employees of the contents of
4.32the approved application, which must provide for giving each eligible employee a copy of
4.33the approved application, excluding the information required in clause (1), or posting a
4.34copy of the approved application, excluding the information required in clause (1), for
4.35a period of at least six weeks in an area of the facility to which all eligible employees
4.36have access; and
5.1 (4) instructions for employees who believe they have not received the
5.2compensation-related or wage increases specified in clause (2), as approved by the
5.3commissioner, and which must include a mailing address, e-mail address, and the
5.4telephone number that may be used by the employee to contact the commissioner or the
5.5commissioner's representative.
5.6 (f) The commissioner shall ensure that cost increases in distribution plans under
5.7paragraph (e), clause (2), that may be included in approved applications, comply with
5.8requirements in clauses (1) to (4):
5.9 (1) costs to be incurred during the applicable rate year resulting from wage and
5.10salary increases effective after October 1, 2008, and prior to the first day of the facility's
5.11payroll period that includes October 1 of each year shall be allowed if they were not used
5.12in the prior year's application and they meet the requirements of paragraph (b);
5.13 (2) a portion of the costs resulting from tenure-related wage or salary increases
5.14may be considered to be allowable wage increases, according to formulas that the
5.15commissioner shall provide, where employee retention is above the average statewide
5.16rate of retention of direct care employees;
5.17 (3) the annualized amount of increases in costs for the employer's share of health
5.18and dental insurance, life insurance, disability insurance, and workers' compensation shall
5.19be allowable compensation-related increases if they are effective on or after April 1 of
5.20the year in which the rate adjustments are effective and prior to April 1 of the following
5.21year; and
5.22 (4) for facilities in which employees are represented by an exclusive bargaining
5.23representative, the commissioner shall approve the application only upon receipt of a letter
5.24of acceptance of the distribution plan, as regards members of the bargaining unit, signed
5.25by the exclusive bargaining agent and dated after May 25, 2009. Upon receipt of the letter
5.26of acceptance, the commissioner shall deem all requirements of this section as having
5.27been met in regard to the members of the bargaining unit.
5.28 (g) The commissioner shall review applications received under paragraph (e) and
5.29shall provide the portion of the rate adjustments under paragraph (b) if the requirements of
5.30this subdivision have been met. The rate adjustments shall be effective October 1 of each
5.31year. Notwithstanding paragraph (a), if the approved application distributes less money
5.32than is available, the amount of the rate adjustment shall be reduced so that the amount of
5.33money made available is equal to the amount to be distributed."
5.34Page 43, after line 15, insert:
5.35 "Sec. 13.
PROVIDER RATE INCREASES.
6.1 (a) The commissioner of human services shall increase allocations, reimbursement
6.2rates, or rate limits, as applicable, by 5.0 percent beginning October 1, 2009, and by 5.0
6.3percent beginning July 1, 2010, effective for services rendered on or after those dates.
6.4County contracts for services specified in this section must be amended to pass through
6.5these rate adjustments within 60 days of the effective date of the increase and must be
6.6retroactive from the effective date of the rate adjustment.
6.7 (b) The annual rate increases described in this section must be provided to:
6.8 (1) home and community-based waivered services for persons with developmental
6.9disabilities or related conditions, including consumer-directed community supports, under
6.10Minnesota Statutes, section
256B.501;
6.11 (2) home and community-based waivered services for the elderly, including
6.12consumer-directed community supports, under Minnesota Statutes, section
256B.0915;
6.13 (3) waivered services under community alternatives for disabled individuals,
6.14including consumer-directed community supports, under Minnesota Statutes, section
6.15256B.49;
6.16 (4) community alternative care waivered services, including consumer-directed
6.17community supports, under Minnesota Statutes, section
256B.49;
6.18 (5) traumatic brain injury waivered services, including consumer-directed
6.19community supports, under Minnesota Statutes, section
256B.49;
6.20 (6) nursing services and home health services under Minnesota Statutes, section
6.21256B.0625, subdivision 6a;
6.22 (7) personal care services and qualified professional supervision of personal care
6.23services under Minnesota Statutes, section
256B.0625, subdivision 19a;
6.24 (8) private duty nursing services under Minnesota Statutes, section
256B.0625,
6.25subdivision 7
;
6.26 (9) day training and habilitation services for adults with developmental disabilities
6.27or related conditions under Minnesota Statutes, sections
252.40 to
252.46, including the
6.28additional cost of rate adjustments on day training and habilitation services, provided as a
6.29social service under Minnesota Statutes, section 256M.60
;
6.30 (10) alternative care services under Minnesota Statutes, section
256B.0913;
6.31 (11) adult residential program grants under Minnesota Statutes, section
245.73;
6.32 (12) children's community-based mental health services grants and adult community
6.33support and case management services grants under Minnesota Rules, parts 9535.1700
6.34to 9535.1760;
6.35 (13) the group residential housing supplementary service rate under Minnesota
6.36Statutes, section
256I.05, subdivision 1a;
7.1 (14) adult mental health integrated fund grants under Minnesota Statutes, section
7.2245.4661;
7.3 (15) semi-independent living services (SILS) under Minnesota Statutes, section
7.4252.275, including SILS funding under county social services grants formerly funded
7.5under Minnesota Statutes, chapter 256I;
7.6 (16) community support services for deaf and hard-of-hearing adults with mental
7.7illness who use or wish to use sign language as their primary means of communication
7.8under Minnesota Statutes, section
256.01, subdivision 2; and deaf and hard-of-hearing
7.9grants under Minnesota Statutes, sections
256C.233 and
256C.25; Laws 1985, chapter 9,
7.10article 1; and Laws 1997, First Special Session chapter 5, section 20;
7.11 (17) living skills training programs for persons with intractable epilepsy who need
7.12assistance in the transition to independent living under Laws 1988, chapter 689;
7.13 (18) physical therapy services under sections
256B.0625, subdivision 8, and
7.14256D.03, subdivision 4;
7.15 (19) occupational therapy services under sections
256B.0625, subdivision 8a, and
7.16256D.03, subdivision 4;
7.17 (20) speech-language therapy services under section
256D.03, subdivision 4, and
7.18Minnesota Rules, part 9505.0390;
7.19 (21) respiratory therapy services under section
256D.03, subdivision 4, and
7.20Minnesota Rules, part 9505.0295;
7.21 (22) adult rehabilitative mental health services under section
256B.0623;
7.22 (23) children's therapeutic services and support services under section
256B.0943;
7.23 (24) tier I chemical health services under Minnesota Statutes, chapter 254B;
7.24 (25) consumer support grants under Minnesota Statutes, section
256.476;
7.25 (26) family support grants under Minnesota Statutes, section
252.32;
7.26 (27) grants for case management services to persons with HIV or AIDS under
7.27Minnesota Statutes, section
256.01, subdivision 19; and
7.28 (28) aging grants under Minnesota Statutes, sections
256.975 to
256.977,
256B.0917,
7.29and
256B.0928.
7.30 (c) For services funded through Minnesota disability health options, the rate
7.31increases under this section apply to all medical assistance payments, including former
7.32group residential housing supplementary rates under Minnesota Statutes, chapter 256I.
7.33 (d) The commissioner may recoup payments made under this section from a provider
7.34that does not comply with paragraph (f).
8.1 (e) A managed care plan receiving state payments for the services in this section
8.2must include these increases in their payments to providers on a prospective basis,
8.3effective on January 1 following the effective date of the rate increase.
8.4 (f) Providers that receive a rate increase under paragraph (a) shall use 75 percent
8.5of the additional revenue to increase compensation-related costs for employees directly
8.6employed by the program on or after the effective date of the rate adjustments, except:
8.7 (1) the administrator;
8.8 (2) persons employed in the central office of a corporation or entity that has an
8.9ownership interest in the provider or exercises control over the provider; and
8.10 (3) persons paid by the provider under a management contract.
8.11Compensation-related costs include: wages and salaries; FICA taxes, Medicare taxes,
8.12state and federal unemployment taxes, and workers' compensation; and the employer's
8.13share of health and dental insurance, life insurance, disability insurance, long-term care
8.14insurance, uniform allowance, and pensions.
8.15 (g) For public employees, the increase for wages and benefits for certain staff is
8.16available and pay rates must be increased only to the extent that they comply with laws
8.17governing public employees collective bargaining. Money received by a provider for pay
8.18increases under this section may be used only for increases implemented on or after the
8.19first day of the rate period in which the increase is available and must not be used for
8.20increases implemented prior to that date.
8.21 (h) The commissioner shall amend state grant contracts that include direct
8.22personnel-related grant expenditures to include the allocation for the portion of the contract
8.23that is employee compensation related. Grant contracts for compensation-related services
8.24must be amended to pass through these adjustments within 60 days of the effective date of
8.25the increase and must be retroactive to the effective date of the rate adjustment.
8.26 (i) The Board on Aging and its Area Agencies on Aging shall amend their
8.27grants that include direct personnel-related grant expenditures to include the rate
8.28adjustment for the portion of the grant that is employee compensation related. Grants
8.29for compensation-related services must be amended to pass through these adjustments
8.30within 60 days of the effective date of the increase and must be retroactive to the effective
8.31date of the rate adjustment.
8.32 (j) The calendar year 2010 rate for vendors reimbursed under Minnesota Statutes,
8.33chapter 254B, shall be at least 5.0 percent above the rate in effect on January 1, 2009. The
8.34calendar year 2011 rate shall be at least 5.0 percent above the rate in effect on January
8.351, 2010.
9.1 (k) Providers that receive a rate adjustment under paragraph (a) that is subject to
9.2paragraph (f) shall provide to the commissioner, and those counties with whom they have
9.3a contract, within six months after the effective date of each rate adjustment, a letter, in
9.4a format specified by the commissioner, that provides assurances that the provider has
9.5developed and implemented a compensation plan and complied with paragraph (f). The
9.6provider shall keep on file, and produce for the commissioner or county upon request, its
9.7plan, which must specify:
9.8 (1) an estimate of the amounts of money that must be used as specified in paragraph
9.9(f); and
9.10 (2) a detailed distribution plan specifying the allowable compensation-related and
9.11wage increases the provider will implement to use the funds available in clause (1).
9.12 (l) Within six months after the effective date of each rate adjustment, the provider
9.13shall post this plan, excluding the information required in paragraph (k), clause (1), for
9.14a period of at least six weeks in an area of the provider's operation to which all eligible
9.15employees have access and provide instructions for employees who believe they have
9.16not received the wage and other compensation-related increases specified in paragraph
9.17(k), clause (2). Instructions must include a mailing address, e-mail address, and the
9.18telephone number that may be used by the employee to contact the commissioner or the
9.19commissioner's representative. Providers shall also make assurances to the commissioner
9.20and counties with whom they have a contract that they have complied with the requirement
9.21in this paragraph."
9.22Page 48, after line 20, insert:
9.23"
Long-term care rate adjustments.
9.24$273,500,000 from the health care access
9.25fund is transferred to the general fund for
9.26long-term care provider rate adjustments for
9.27the 2010-1011 biennium."
9.28Renumber the sections in sequence and correct the internal references
9.29Amend the title accordingly
9.30Amend the totals and summaries by fund accordingly