1.1.................... moves to amend H.F. No. 1110 as follows:
1.2Delete everything after the enacting clause and insert:
1.3 "Section 1. Minnesota Statutes 2008, section 245A.10, subdivision 2, is amended to
1.4read:
1.5 Subd. 2.
County fees for background studies and licensing inspections. (a) For
1.6purposes of family and group family child care licensing under this chapter, a county
1.7agency may charge a fee to an applicant or license holder to recover the actual cost of
1.8background studies, but in any case not to exceed $100 annually. A county agency may
1.9also charge a license fee to an applicant or license holder not to exceed $50 for a one-year
1.10license or $100 for a two-year license.
1.11 (b) A county agency may charge a fee to a legal nonlicensed child care provider or
1.12applicant for authorization to recover the actual cost of background studies completed
1.13under section
119B.125, but in any case not to exceed $100 annually.
1.14 (c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):
1.15 (1) in cases of financial hardship;
1.16 (2) if the county has a shortage of providers in the county's area;
1.17 (3) for new providers; or
1.18 (4) for providers who have attained at least 16 hours of training before seeking
1.19initial licensure.
1.20 (d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on
1.21an installment basis for up to one year. If the provider is receiving child care assistance
1.22payments from the state, the provider may have the fees under paragraph (a) or (b)
1.23deducted from the child care assistance payments for up to one year and the state shall
1.24reimburse the county for the county fees collected in this manner.
1.25 (e) For purposes of adult foster care and child foster care licensing under this
1.26chapter, a county agency may charge a fee to a corporate applicant or corporate license
1.27holder to recover
the actual cost of background studies. A county agency may also charge
2.1a fee to a corporate applicant or corporate license holder to recover the actual cost of
2.2licensing inspections, not to exceed $500 annually.
2.3 (f) Counties may elect to reduce or waive the fees in paragraph (e) under the
2.4following circumstances:
2.5(1) in cases of financial hardship;
2.6(2) if the county has a shortage of providers in the county's area; or
2.7(3) for new providers.
2.8 Sec. 2. Minnesota Statutes 2008, section 245A.10, subdivision 3, is amended to read:
2.9 Subd. 3.
Application fee for initial license or certification. (a) For fees required
2.10under subdivision 1, an applicant for an initial license or certification issued by the
2.11commissioner shall submit a $500 application fee with each new application required
2.12under this subdivision. The application fee shall not be prorated, is nonrefundable, and
2.13is in lieu of the annual license or certification fee that expires on December 31. The
2.14commissioner shall not process an application until the application fee is paid.
2.15(b) Except as provided in clauses (1) to (3), an applicant shall apply for a license
2.16to provide services at a specific location.
2.17(1) For a license to provide waivered services to persons with developmental
2.18disabilities or related conditions, an applicant shall submit an application for each county
2.19in which the waivered services will be provided.
Upon licensure, the license holder may
2.20provide services to persons in that county plus no more than three persons at any one time
2.21in each of up to ten additional counties. A license holder in one county may not provide
2.22services under the home and community-based waiver for persons with developmental
2.23disabilities to more than three people in a second county without holding a separate license
2.24for that second county. Applicants or licensees providing services under this clause to
2.25not more than three persons, remain subject to the inspection fees established in section
2.26245A.10, subdivision 2, for each location.
2.27(2) For a license to provide semi-independent living services to persons with
2.28developmental disabilities or related conditions, an applicant shall submit a single
2.29application to provide services statewide.
2.30(3) For a license to provide independent living assistance for youth under section
2.31245A.22
, an applicant shall submit a single application to provide services statewide.
2.32 Sec. 3. Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision
2.33to read:
2.34 Subd. 7a. Alternate overnight supervision technology; adult foster care license.
2.35 (a) The commissioner may grant an applicant or license holder an adult foster care license
3.1for a residence that does not have a caregiver in the residence during normal sleeping
3.2hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, but uses
3.3monitoring technology to alert the license holder when an incident occurs that may
3.4jeopardize the health, safety, or rights of a foster care recipient. The applicant or license
3.5holder must comply with all other requirements under Minnesota Rules, parts 9555.5105
3.6to 9555.6265, and the requirements under this subdivision. The license printed by the
3.7commissioner must state in bold and large font:
3.8 (1) that staff are not present on-site overnight; and
3.9 (2) the telephone number of the county's common entry point for making reports of
3.10suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.
3.11(b) Applications for a license under this section must be submitted directly to
3.12the Department of Human Services licensing division. The licensing division must
3.13immediately notify the host county and lead county contract agency and the host county
3.14licensing agency. The licensing division must collaborate with the county licensing
3.15agency in the review of the application and the licensing of the program.
3.16 (c) Before a license is issued by the commissioner, and for the duration of the
3.17license, the applicant or license holder must establish, maintain, and document the
3.18implementation of written policies and procedures addressing the requirements in
3.19paragraphs (c) through (f).
3.20 (d) The applicant or license holder must have policies and procedures that:
3.21 (1) establish characteristics of target populations that will be admitted into the home,
3.22and characteristics of populations that will not be accepted into the home;
3.23 (2) explain the discharge process when a foster care recipient requires overnight
3.24supervision or other services that cannot be provided by the license holder due to the
3.25limited hours that the license holder is on-site;
3.26 (3) describe the types of events to which the program will respond with a physical
3.27presence when those events occur in the home during time when staff are not on-site, and
3.28how the license holder's response plan meets the requirements in paragraph (d), clause
3.29(1) or (2);
3.30 (4) establish a process for documenting a review of the implementation and
3.31effectiveness of the response protocol for the response required under paragraph (d),
3.32clause (1) or (2). The documentation must include:
3.33 (i) a description of the triggering incident;
3.34 (ii) the date and time of the triggering incident;
3.35 (iii) the time of the response or responses under paragraph (d), clause (1) or (2);
3.36 (iv) whether the response met the resident's needs;
4.1 (v) whether the existing policies and response protocols were followed; and
4.2 (vi) whether the existing policies and protocols are adequate or need modification.
4.3 When no physical presence response is completed for a three-month period, the
4.4license holder's written policies and procedures must require a physical presence response
4.5drill be to conducted for which the effectiveness of the response protocol under paragraph
4.6(d), clause (1) or (2), will be reviewed and documented as required under this clause; and
4.7 (5) establish that emergency and nonemergency phone numbers are posted in a
4.8prominent location in a common area of the home where they can be easily observed by a
4.9person responding to an incident who is not otherwise affiliated with the home.
4.10 (e) The license holder must document and include in the license application which
4.11response alternative under clause (1) or (2) is in place for responding to situations that
4.12present a serious risk to the health, safety, or rights of people receiving foster care services
4.13in the home:
4.14 (1) response alternative (1) requires only the technology to provide an electronic
4.15notification or alert to the license holder that an event is underway that requires a response.
4.16Under this alternative, no more than ten minutes will pass before the license holder will be
4.17physically present on-site to respond to the situation; or
4.18 (2) response alternative (2) requires the electronic notification and alert system
4.19under alternative (1), but more than ten minutes may pass before the license holder is
4.20present on-site to respond to the situation. Under alternative (2), all of the following
4.21conditions are met:
4.22 (i) the license holder has a written description of the interactive technological
4.23applications that will assist the licenser holder in communicating with and assessing the
4.24needs related to care, health, and safety of the foster care recipients. This interactive
4.25technology must permit the license holder to remotely assess the well being of the foster
4.26care recipient without requiring the initiation or participation by the foster care recipient.
4.27Requiring the foster care recipient to initiate a telephone call or answer a telephone call
4.28does not meet this requirement;
4.29(ii) the license holder documents how the remote license holder is qualified and
4.30capable of meeting the needs of the foster care recipients and assessing foster care
4.31recipients' needs under item (ii) during the absence of the license holder on-site;
4.32(iii) the license holder maintains written procedures to dispatch emergency response
4.33personnel to the site in the event of an identified emergency; and
4.34 (iv) each foster care recipient's individualized plan of care, individual service plan
4.35under section 256B.092, subdivision 1b, if required, or individual resident placement
4.36agreement under Minnesota Rules, part 9555.5105, subpart 19, if required, identifies the
5.1maximum response time, which may be greater than ten minutes, for the license holder
5.2to be on-site for that foster care recipient.
5.3 (f) All placement agreements, individual service agreements, and plans applicable
5.4to the foster care recipient must clearly state that the adult foster care license category is
5.5a program without the presence of a caregiver in the residence during normal sleeping
5.6hours; the protocols in place for responding to situations that present a serious risk
5.7to health, safety, or rights of foster care recipients under paragraph (d), clause (1) or
5.8(2); and a signed informed consent from each foster care recipient or the person's
5.9legal representative documenting the person's or legal representative's agreement with
5.10placement in the program. If electronic monitoring technology is used in the home, the
5.11informed consent form must also explain the following:
5.12 (1) how any electronic monitoring is incorporated into the alternative supervision
5.13system;
5.14 (2) the backup system for any electronic monitoring in times of electrical outages or
5.15other equipment malfunctions;
5.16 (3) how the license holder is trained on the use of the technology;
5.17 (4) the event types and license holder response times established under paragraph (d);
5.18 (5) how the license holder protects the foster care recipient's privacy related to
5.19electronic monitoring and related to any electronically recorded data generated by the
5.20monitoring system. The consent form must explain where and how the electronically
5.21recorded data is stored, with whom it will be shared, and how long it is retained; and
5.22 (6) the risks and benefits of the alternative overnight supervision system.
5.23 The written explanations under clauses (1) to (6) may be accomplished through
5.24cross-references to other policies and procedures as long as they are explained to the
5.25person giving consent, and the person giving consent is offered a copy.
5.26(g) Nothing in this section requires the applicant or license holder to develop or
5.27maintain separate or duplicative polices, procedures, documentation, consent forms, or
5.28individual plans that may be required for other licensing standards, if the requirements of
5.29this section are incorporated into those documents.
5.30(h) The commissioner may grant variances to the requirements of this section
5.31according to section 245A.04, subdivision 9.
5.32(i) For the purposes of paragraphs (b) through (h), license holder has the meaning
5.33under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and
5.34contractors affiliated with the license holder.
5.35 Sec. 4. Minnesota Statutes 2008, section 245A.16, subdivision 1, is amended to read:
6.1 Subdivision 1.
Delegation of authority to agencies. (a) County agencies and
6.2private agencies that have been designated or licensed by the commissioner to perform
6.3licensing functions and activities under section
245A.04 and background studies for
6.4adult foster care, family adult day services
, and family child care, under chapter 245C; to
6.5recommend denial of applicants under section
245A.05; to issue correction orders, to issue
6.6variances, and recommend a conditional license under section
245A.06, or to recommend
6.7suspending or revoking a license or issuing a fine under section
245A.07, shall comply
6.8with rules and directives of the commissioner governing those functions and with this
6.9section. The following variances are excluded from the delegation of variance authority
6.10and may be issued only by the commissioner:
6.11 (1) dual licensure of family child care and child foster care, dual licensure of child
6.12and adult foster care, and adult foster care and family child care;
6.13 (2) adult foster care maximum capacity;
6.14 (3) adult foster care minimum age requirement;
6.15 (4) child foster care maximum age requirement;
6.16 (5) variances regarding disqualified individuals except that county agencies may
6.17issue variances under section
245C.30 regarding disqualified individuals when the county
6.18is responsible for conducting a consolidated reconsideration according to sections
245C.25
6.19and
245C.27, subdivision 2, clauses (a) and (b), of a county maltreatment determination
6.20and a disqualification based on serious or recurring maltreatment; and
6.21 (6) the required presence of a caregiver in the adult foster care residence during
6.22normal sleeping hours.
6.23 (b) County agencies must report information about disqualification reconsiderations
6.24under sections
245C.25 and
245C.27, subdivision 2, paragraphs (a) and (b), and variances
6.25granted under paragraph (a), clause (5), to the commissioner at least monthly in a format
6.26prescribed by the commissioner.
6.27 (c) For family day care programs, the commissioner may authorize licensing reviews
6.28every two years after a licensee has had at least one annual review.
6.29 (d) For family adult day services programs, the commissioner may authorize
6.30licensing reviews every two years after a licensee has had at least one annual review.
6.31 (e) A license issued under this section may be issued for up to two years.
6.32 Sec. 5. Minnesota Statutes 2008, section 245A.16, subdivision 3, is amended to read:
6.33 Subd. 3.
Recommendations to commissioner. The county or private agency
6.34shall not make recommendations to the commissioner regarding licensure without first
6.35conducting an inspection, and for
adult foster care, family adult day services
, and family
7.1child care, a background study of the applicant under chapter 245C. The county or private
7.2agency must forward its recommendation to the commissioner regarding the appropriate
7.3licensing action within 20 working days of receipt of a completed application.
7.4 Sec. 6. Minnesota Statutes 2008, section 245C.04, subdivision 1, is amended to read:
7.5 Subdivision 1.
Licensed programs. (a) The commissioner shall conduct a
7.6background study of an individual required to be studied under section
245C.03,
7.7subdivision 1
, at least upon application for initial license for all license types.
7.8 (b) The commissioner shall conduct a background study of an individual required to
7.9be studied under section
245C.03, subdivision 1, at reapplication for a license for
adult
7.10foster care, family adult day services
, and family child care.
7.11 (c) The commissioner is not required to conduct a study of an individual at the time
7.12of reapplication for a license if the individual's background study was completed by the
7.13commissioner of human services for an adult foster care license holder that is also:
7.14 (1) registered under chapter 144D; or
7.15 (2) licensed to provide home and community-based services to people with
7.16disabilities at the foster care location and the license holder does not reside in the foster
7.17care residence; and
7.18 (3) the following conditions are met:
7.19 (i) a study of the individual was conducted either at the time of initial licensure or
7.20when the individual became affiliated with the license holder;
7.21 (ii) the individual has been continuously affiliated with the license holder since
7.22the last study was conducted; and
7.23 (iii) the last study of the individual was conducted on or after October 1, 1995.
7.24 (d) From July 1, 2007, to June 30, 2009, the commissioner of human services shall
7.25conduct a study of an individual required to be studied under section
245C.03, at the
7.26time of reapplication for a child foster care license. The county or private agency shall
7.27collect and forward to the commissioner the information required under section
245C.05,
7.28subdivisions 1, paragraphs (a) and (b), and 5, paragraphs (a) and (b). The background
7.29study conducted by the commissioner of human services under this paragraph must
7.30include a review of the information required under section
245C.08, subdivisions 1,
7.31paragraph (a), clauses (1) to (5), 3, and 4.
7.32 (e) The commissioner of human services shall conduct a background study of an
7.33individual specified under section
245C.03, subdivision 1, paragraph (a), clauses (2)
7.34to (6), who is newly affiliated with a child foster care license holder. The county or
7.35private agency shall collect and forward to the commissioner the information required
8.1under section
245C.05, subdivisions 1 and 5. The background study conducted by the
8.2commissioner of human services under this paragraph must include a review of the
8.3information required under section
245C.08, subdivisions 1, 3, and 4.
8.4 (f)
From January 1, 2010, to December 31, 2012, unless otherwise specified in
8.5paragraph (c), the commissioner shall conduct a study of an individual required to be
8.6studied under section 245C.03, at the time of reapplication for an adult foster care license.
8.7The county shall collect and forward to the commissioner the information required under
8.8section 245C.05, subdivision 1, paragraphs (a) and (b), and subdivision 5, paragraphs (a)
8.9and (b). The background study conducted by the commissioner under this paragraph
8.10must include a review of the information required under section 245C.08, subdivision 1,
8.11paragraph (a), clauses (1) to (5), and subdivisions 3 and 4.
8.12(g) The commissioner shall conduct a background study of an individual specified
8.13under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly
8.14affiliated with an adult foster care license holder. The county shall collect and forward
8.15to the commissioner the information required under section 245C.05, subdivision 1,
8.16paragraphs (a) and (b), and subdivision 5, paragraphs (a) and (b). The background
8.17study conducted by the commissioner under this paragraph must include a review of
8.18the information required under section 245C.08, subdivision 1, paragraph (a), and
8.19subdivisions 3 and 4.
8.20 (h) Applicants for licensure, license holders, and other entities as provided in this
8.21chapter must submit completed background study forms to the commissioner before
8.22individuals specified in section
245C.03, subdivision 1, begin positions allowing direct
8.23contact in any licensed program.
8.24 (g) (i) For purposes of this section, a physician licensed under chapter 147 is
8.25considered to be continuously affiliated upon the license holder's receipt from the
8.26commissioner of health or human services of the physician's background study results.
8.27 Sec. 7. Minnesota Statutes 2008, section 245C.05, subdivision 4, is amended to read:
8.28 Subd. 4.
Electronic transmission. For background studies conducted by the
8.29Department of Human Services, the commissioner shall implement a system for the
8.30electronic transmission of:
8.31 (1) background study information to the commissioner;
8.32 (2) background study results to the license holder;
and
8.33 (3) background study results to county and private agencies for background studies
8.34conducted by the commissioner for child foster care
; and
9.1(4) background study results to county agencies for background studies conducted
9.2by the commissioner for adult foster care.
9.3 Sec. 8. Minnesota Statutes 2008, section 245C.08, subdivision 2, is amended to read:
9.4 Subd. 2.
Background studies conducted by a county agency. (a) For a background
9.5study conducted by a county agency for
adult foster care, family adult day services
, and
9.6family child care services, the commissioner shall review:
9.7 (1) information from the county agency's record of substantiated maltreatment
9.8of adults and the maltreatment of minors;
9.9 (2) information from juvenile courts as required in subdivision 4 for individuals
9.10listed in section
245C.03, subdivision 1, clauses (2), (5), and (6); and
9.11 (3) information from the Bureau of Criminal Apprehension.
9.12 (b) If the individual has resided in the county for less than five years, the study shall
9.13include the records specified under paragraph (a) for the previous county or counties of
9.14residence for the past five years.
9.15 (c) Notwithstanding expungement by a court, the county agency may consider
9.16information obtained under paragraph (a), clause (3), unless the commissioner received
9.17notice of the petition for expungement and the court order for expungement is directed
9.18specifically to the commissioner.
9.19 Sec. 9. Minnesota Statutes 2008, section 245C.10, is amended by adding a subdivision
9.20to read:
9.21 Subd. 5. Adult foster care services. The commissioner shall recover the cost
9.22of background studies required under section 245C.03, subdivision 1, for the purposes
9.23of adult foster care licensing, through a fee of no more than $20 per study charged to
9.24the license holder. The fees collected under this subdivision are appropriated to the
9.25commissioner for the purpose of conducting background studies.
9.26 Sec. 10. Minnesota Statutes 2008, section 245C.17, is amended by adding a
9.27subdivision to read:
9.28 Subd. 6. Notice to county agency. For studies on individuals related to a license to
9.29provide adult foster care, the commissioner shall also provide a notice of the background
9.30study results to the county agency that initiated the background study.
9.31 Sec. 11. Minnesota Statutes 2008, section 245C.20, is amended to read:
9.32245C.20 LICENSE HOLDER RECORD KEEPING.
10.1A licensed program shall document the date the program initiates a background
10.2study under this chapter in the program's personnel files. When a background study is
10.3completed under this chapter, a licensed program shall maintain a notice that the study
10.4was undertaken and completed in the program's personnel files.
Except when background
10.5studies are initiated through the commissioner's online system, if a licensed program
10.6has not received a response from the commissioner under section
245C.17 within 45
10.7days of initiation of the background study request, the licensed program must contact the
10.8commissioner human services licensing division to inquire about the status of the study.
If
10.9a license holder initiates a background study under the commissioner's online system, but
10.10the background study subject's name does not appear in the list of active or recent studies
10.11initiated by that license holder, the license holder must either contact the human services
10.12licensing division or resubmit the background study information online for that individual.
10.13 Sec. 12. Minnesota Statutes 2008, section 245C.21, subdivision 1a, is amended to read:
10.14 Subd. 1a.
Submission of reconsideration request to county or private agency.
10.15 (a) For disqualifications related to studies conducted by county agencies
for family child
10.16care and family adult day services, and for disqualifications related to studies conducted
10.17by the commissioner for child foster care
and adult foster care, the individual shall
10.18submit the request for reconsideration to the county
or private agency that initiated the
10.19background study.
10.20 (b)
For disqualifications related to studies conducted by the commissioner for child
10.21foster care, the individual shall submit the request for reconsideration to the private agency
10.22that initiated the background study.
10.23(c) A reconsideration request shall be submitted within 30 days of the individual's
10.24receipt of the disqualification notice or the time frames specified in subdivision 2,
10.25whichever time frame is shorter.
10.26 (c) (d) The county or private agency shall forward the individual's request for
10.27reconsideration and provide the commissioner with a recommendation whether to set aside
10.28the individual's disqualification.
10.29 Sec. 13. Minnesota Statutes 2008, section 245C.23, subdivision 2, is amended to read:
10.30 Subd. 2.
Commissioner's notice of disqualification that is not set aside. (a) The
10.31commissioner shall notify the license holder of the disqualification and order the license
10.32holder to immediately remove the individual from any position allowing direct contact
10.33with persons receiving services from the license holder if:
10.34 (1) the individual studied does not submit a timely request for reconsideration
10.35under section
245C.21;
11.1 (2) the individual submits a timely request for reconsideration, but the commissioner
11.2does not set aside the disqualification for that license holder under section
245C.22;
11.3 (3) an individual who has a right to request a hearing under sections
245C.27 and
11.4256.045
, or
245C.28 and chapter 14 for a disqualification that has not been set aside, does
11.5not request a hearing within the specified time; or
11.6 (4) an individual submitted a timely request for a hearing under sections
245C.27
11.7and
256.045, or
245C.28 and chapter 14, but the commissioner does not set aside the
11.8disqualification under section
245A.08, subdivision 5, or
256.045.
11.9 (b) If the commissioner does not set aside the disqualification under section
245C.22,
11.10and the license holder was previously ordered under section
245C.17 to immediately
11.11remove the disqualified individual from direct contact with persons receiving services or
11.12to ensure that the individual is under continuous, direct supervision when providing direct
11.13contact services, the order remains in effect pending the outcome of a hearing under
11.14sections
245C.27 and
256.045, or
245C.28 and chapter 14.
11.15 (c) For background studies related to child foster care, the commissioner shall
11.16also notify the county or private agency that initiated the study of the results of the
11.17reconsideration.
11.18(d) For background studies related to adult foster care, the commissioner shall also
11.19notify the county that initiated the study of the results of the reconsideration.
11.20 Sec. 14. Minnesota Statutes 2008, section 256B.5011, subdivision 2, is amended to
11.21read:
11.22 Subd. 2.
Contract provisions. (a) The service contract with each intermediate
11.23care facility must include provisions for:
11.24(1) modifying payments when significant changes occur in the needs of the
11.25consumers;
11.26(2)
the establishment and use of a quality improvement plan. Using criteria and
11.27options for performance measures developed by the commissioner, each intermediate care
11.28facility must identify a minimum of one performance measure on which to focus its efforts
11.29for quality improvement during the contract period;
11.30(3) appropriate and necessary statistical information required by the commissioner;
11.31(4) (3) annual aggregate facility financial information; and
11.32(5) (4) additional requirements for intermediate care facilities not meeting the
11.33standards set forth in the service contract.
11.34(b) The commissioner of human services and the commissioner of health, in
11.35consultation with representatives from counties, advocacy organizations, and the provider
12.1community, shall review the consolidated standards under chapter 245B and the supervised
12.2living facility rule under Minnesota Rules, chapter 4665, to determine what provisions
12.3in Minnesota Rules, chapter 4665, may be waived by the commissioner of health for
12.4intermediate care facilities in order to enable facilities to implement the performance
12.5measures in their contract and provide quality services to residents without a duplication
12.6of or increase in regulatory requirements.
12.7 Sec. 15. Minnesota Statutes 2008, section 256B.5013, subdivision 1, is amended to
12.8read:
12.9 Subdivision 1.
Variable rate adjustments. (a) For rate years beginning on or after
12.10October 1, 2000, when there is a documented increase in the needs of a current ICF/MR
12.11recipient, the county of financial responsibility may recommend a variable rate to enable
12.12the facility to meet the individual's increased needs. Variable rate adjustments made under
12.13this subdivision replace payments for persons with special needs under section
256B.501,
12.14subdivision 8
, and payments for persons with special needs for crisis intervention services
12.15under section
256B.501, subdivision 8a. Effective July 1, 2003, facilities with a base rate
12.16above the 50th percentile of the statewide average reimbursement rate for a Class A
12.17facility or Class B facility, whichever matches the facility licensure, are not eligible for a
12.18variable rate adjustment. Variable rate adjustments may not exceed a 12-month period,
12.19except when approved for purposes established in paragraph (b), clause (1). Variable rate
12.20adjustments approved solely on the basis of changes on a developmental disabilities
12.21screening document will end June 30, 2002.
12.22(b) A variable rate may be recommended by the county of financial responsibility
12.23for increased needs in the following situations:
12.24(1) a need for resources due to an individual's full or partial retirement from
12.25participation in a day training and habilitation service when the individual: (i) has reached
12.26the age of 65 or has a change in health condition that makes it difficult for the person
12.27to participate in day training and habilitation services over an extended period of time
12.28because it is medically contraindicated; and (ii) has expressed a desire for change through
12.29the developmental disability screening process under section
256B.092;
12.30(2) a need for additional resources for intensive short-term programming which is
12.31necessary prior to an individual's discharge to a less restrictive, more integrated setting;
12.32(3) a demonstrated medical need that significantly impacts the type or amount of
12.33services needed by the individual; or
12.34(4) a demonstrated behavioral need that significantly impacts the type or amount of
12.35services needed by the individual.
13.1(c) The county of financial responsibility must justify the purpose, the projected
13.2length of time, and the additional funding needed for the facility to meet the needs of
13.3the individual.
13.4(d)
The facility shall provide a quarterly report to the county case manager on
13.5the use of the variable rate funds and the status of the individual on whose behalf the
13.6funds were approved. The county case manager will forward the facility's report with a
13.7recommendation to the commissioner to approve or disapprove a continuation of the
13.8variable rate.
13.9(e) Funds made available through the variable rate process that are not used by
13.10the facility to meet the needs of the individual for whom they were approved shall be
13.11returned to the state.
13.12 Sec. 16. Minnesota Statutes 2008, section 256D.44, subdivision 5, is amended to read:
13.13 Subd. 5.
Special needs. In addition to the state standards of assistance established in
13.14subdivisions 1 to 4, payments are allowed for the following special needs of recipients of
13.15Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
13.16center, or a group residential housing facility.
13.17 (a) The county agency shall pay a monthly allowance for medically prescribed
13.18diets if the cost of those additional dietary needs cannot be met through some other
13.19maintenance benefit. The need for special diets or dietary items must be prescribed by
13.20a licensed physician. Costs for special diets shall be determined as percentages of the
13.21allotment for a one-person household under the thrifty food plan as defined by the United
13.22States Department of Agriculture. The types of diets and the percentages of the thrifty
13.23food plan that are covered are as follows:
13.24 (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
13.25 (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent
13.26of thrifty food plan;
13.27 (3) controlled protein diet, less than 40 grams and requires special products, 125
13.28percent of thrifty food plan;
13.29 (4) low cholesterol diet, 25 percent of thrifty food plan;
13.30 (5) high residue diet, 20 percent of thrifty food plan;
13.31 (6) pregnancy and lactation diet, 35 percent of thrifty food plan;
13.32 (7) gluten-free diet, 25 percent of thrifty food plan;
13.33 (8) lactose-free diet, 25 percent of thrifty food plan;
13.34 (9) antidumping diet, 15 percent of thrifty food plan;
13.35 (10) hypoglycemic diet, 15 percent of thrifty food plan; or
14.1 (11) ketogenic diet, 25 percent of thrifty food plan.
14.2 (b) Payment for nonrecurring special needs must be allowed for necessary home
14.3repairs or necessary repairs or replacement of household furniture and appliances using
14.4the payment standard of the AFDC program in effect on July 16, 1996, for these expenses,
14.5as long as other funding sources are not available.
14.6 (c) A fee for guardian or conservator service is allowed at a reasonable rate
14.7negotiated by the county or approved by the court. This rate shall not exceed five percent
14.8of the assistance unit's gross monthly income up to a maximum of $100 per month. If the
14.9guardian or conservator is a member of the county agency staff, no fee is allowed.
14.10 (d) The county agency shall continue to pay a monthly allowance of $68 for
14.11restaurant meals for a person who was receiving a restaurant meal allowance on June 1,
14.121990, and who eats two or more meals in a restaurant daily. The allowance must continue
14.13until the person has not received Minnesota supplemental aid for one full calendar month
14.14or until the person's living arrangement changes and the person no longer meets the criteria
14.15for the restaurant meal allowance, whichever occurs first.
14.16 (e) A fee of ten percent of the recipient's gross income or $25, whichever is less,
14.17is allowed for representative payee services provided by an agency that meets the
14.18requirements under SSI regulations to charge a fee for representative payee services. This
14.19special need is available to all recipients of Minnesota supplemental aid regardless of
14.20their living arrangement.
14.21 (f)(1) Notwithstanding the language in this subdivision, an amount equal to the
14.22maximum allotment authorized by the federal Food Stamp Program for a single individual
14.23which is in effect on the first day of July of each year will be added to the standards of
14.24assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify
14.25as shelter needy and are: (i) relocating from an institution, or an adult mental health
14.26residential treatment program under section
256B.0622; (ii) eligible for the self-directed
14.27supports option as defined under section
256B.0657, subdivision 2; or (iii) home and
14.28community-based waiver recipients living in their own home or rented or leased apartment
14.29which is not owned, operated, or controlled by a provider of service not related by blood
14.30or marriage.
14.31 (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the
14.32shelter needy benefit under this paragraph is considered a household of one. An eligible
14.33individual who receives this benefit prior to age 65 may continue to receive the benefit
14.34after the age of 65.
14.35 (3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that
14.36exceed 40 percent of the assistance unit's gross income before the application of this
15.1special needs standard. "Gross income" for the purposes of this section is the applicant's or
15.2recipient's income as defined in section
256D.35, subdivision 10, or the standard specified
15.3in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or
15.4state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be
15.5considered shelter needy for purposes of this paragraph.
15.6(g) Notwithstanding this subdivision, recipients of home and community-based
15.7services may relocate to services without 24-hour supervision and receive the equivalent
15.8of the recipient's group residential housing allocation in Minnesota supplemental
15.9assistance shelter needy funding if the cost of the services and housing is equal to or less
15.10than provided to the recipient in home and community-based services and the relocation is
15.11the recipient's choice and is approved by the recipient or guardian.
15.12(h) To access housing and services as provided in paragraph (g), the recipient may
15.13choose housing that may or may not be owned, operated, or controlled by the recipient's
15.14service provider.
15.15(i) The provisions in paragraphs (g) and (h) are effective to June 30, 2011. The
15.16commissioner shall assess the development of publicly owned housing, other housing
15.17alternatives, and whether a public equity housing fund may be established that would
15.18maintain the state's interest, to the extent paid from group residential housing and
15.19Minnesota supplemental aid shelter needy funds in provider-owned housing so that when
15.20sold, the state would recover its share for a public equity fund to be used for future public
15.21needs under this chapter. The commissioner shall report findings and recommendations to
15.22the legislative committees and budget divisions with jurisdiction over health and human
15.23services policy and financing by January 15, 2012.
15.24(j) In selecting prospective services needed by recipients for whom home and
15.25community-based services have been authorized, the recipient and the recipient's guardian
15.26shall first consider alternatives to home and community-based services. Minnesota
15.27supplemental aid shelter needy funding for recipients who utilize Minnesota supplemental
15.28aid shelter needy funding as provided in this section shall remain permanent unless the
15.29recipient with the recipient's guardian later chooses to access home and community-based
15.30services.
15.31 Sec. 17.
ESTABLISHING A SINGLE SET OF STANDARDS.
15.32(a) The commissioner of human services shall consult with disability service
15.33providers, advocates, counties, and consumer families to develop a single set of standards
15.34governing services for people with disabilities receiving services under the home and
15.35community-based waiver services program to replace all or portions of existing laws and
15.36rules including, but not limited to, data practices, licensure of facilities and providers,
16.1background studies, reporting of maltreatment of minors, reporting of maltreatment of
16.2vulnerable adults, and the psychotropic medication checklist. The standards must:
16.3(1) enable optimum consumer choice;
16.4(2) be consumer driven;
16.5(3) link services to individual needs and life goals;
16.6(4) be based on quality assurance and individual outcomes;
16.7(5) utilize the people closest to the recipient, who may include family, friends, and
16.8health and service providers, in conjunction with the recipient's risk management plan to
16.9assist the recipient or the recipient's guardian in making decisions that meet the recipient's
16.10needs in a cost-effective manner and assure the recipient's health and safety;
16.11(6) utilize person-centered planning; and
16.12(7) maximize federal financial participation.
16.13(b) The commissioner may consult with existing stakeholder groups convened under
16.14the commissioner's authority, including the home and community-based expert services
16.15panel established by the commissioner in 2008, to meet the requirements of this section.
16.16(c) The commissioner shall provide the reports and plans required by this section to
16.17the legislative committees and budget divisions with jurisdiction over health and human
16.18services policy and finance by January 15, 2012.
16.19 Sec. 18.
COMMON SERVICE MENU FOR HOME AND COMMUNITY-BASED
16.20WAIVER PROGRAMS.
16.21The commissioner of human services shall confer with representatives of recipients,
16.22advocacy groups, counties, providers, and health plans to develop and update a common
16.23service menu for home and community-based waiver programs. The commissioner may
16.24consult with existing stakeholder groups convened under the commissioner's authority
16.25to meet the requirements of this section.
16.26 Sec. 19.
INTERMEDIATE CARE FACILITIES FOR PERSONS WITH
16.27DEVELOPMENTAL DISABILITIES REPORT.
16.28The commissioner of human services shall also consult with intermediate care
16.29facilities for persons with developmental disabilities providers and advocates to
16.30monitor progress made in response to the commissioner's December 15, 2008, report
16.31to the legislature regarding intermediate care facilities for persons with developmental
16.32disabilities.
16.33 Sec. 20.
REPEALER.
17.1Minnesota Statutes 2008, section 256B.5013, subdivision 5, and Minnesota Rules,
17.2part 9555.6125, subpart 4, item B, are repealed."
17.3Delete the title and insert:
17.5relating to human services; modifying programs and licensure provisions for
17.6services to persons with disabilities; requiring a report; amending Minnesota
17.7Statutes 2008, sections 245A.10, subdivisions 2, 3; 245A.11, by adding a
17.8subdivision; 245A.16, subdivisions 1, 3; 245C.04, subdivision 1; 245C.05,
17.9subdivision 4; 245C.08, subdivision 2; 245C.10, by adding a subdivision;
17.10245C.17, by adding a subdivision; 245C.20; 245C.21, subdivision 1a;
17.11245C.23, subdivision 2; 256B.5011, subdivision 2; 256B.5013, subdivision 1;
17.12256D.44, subdivision 5; repealing Minnesota Statutes 2008, section 256B.5013,
17.13subdivision 5; Minnesota Rules, part 9555.6125, subpart 4, item B."