1.1.................... moves to amend H.F. No. 1233 as follows:
1.2Page 3, delete section 2 and insert:
1.3 "Sec. 2.
[256.0131] FEDERAL APPROVAL OF HEALTH CARE COVERAGE
1.4WAIVER.
1.5 Subdivision 1. Federal approval. (a) The commissioner of human services shall
1.6seek federal authority from the United States Department of Health and Human Services
1.7necessary to operate a health insurance program for Minnesotans with incomes up to
1.8275 percent of the federal poverty guidelines (FPG). The proposal shall seek to secure
1.9all funding available from at least the following services:
1.10(1) all premium tax credits and cost-sharing subsidies available under United States
1.11Code, title 26, section 36B, and United States Code, title 42, section 18071, for individuals
1.12with incomes above 133 percent and at or below 275 percent of FPG who would otherwise
1.13be enrolled in the Health Insurance Exchange;
1.14(2) Medicaid funding; and
1.15(3) other funding sources identified by the commissioner that support coverage or
1.16care redesign in Minnesota.
1.17(b) Funding received must be used to design and implement a health insurance
1.18program that creates a single streamlined program and meets the needs of Minnesotans
1.19with incomes up to 275 percent of FPG and shall incorporate:
1.20(1) payment reform characteristics included in the Health Care Delivery System and
1.21Accountable Care Organization payment models;
1.22(2) flexibility in benefit set design such that benefits can be targeted to meet enrollee
1.23needs in different income and health status situations and to create a more seamless
1.24transition from public to private health care coverage;
1.25(3) flexibility in co-payment or premium structures to incent patients to seek high
1.26quality, low-cost care settings; and
2.1(4) flexibility in premium structures to ease the transition from public to private
2.2health care coverage.
2.3(c) The commissioner shall develop and submit a proposal consistent with the above
2.4criteria and shall seek all federal authority necessary to implement the coverage program.
2.5In developing the request, the commissioner shall consult with appropriate stakeholder
2.6groups and consumers.
2.7(d) The commissioner is authorized to seek any available waivers or federal
2.8approvals to accomplish the goals under paragraph (b) prior to 2017.
2.9(e) The commissioner shall report to the chairs and ranking minority members
2.10of the legislative committees with jurisdiction over health and human services finance
2.11and policy by December 1, 2014.
2.12(f) The commissioner is authorized to accept and expend federal funds that support
2.13the purposes of this section."
2.14Page 12, line 34, delete "
(b)" and insert "
(c)"
2.15Page 21, after line 11 insert:
2.16 "Sec. 28. Minnesota Statutes 2012, section 256L.01, is amended by adding a
2.17subdivision to read:
2.18 Subd. 1b. Affordable Care Act. "Affordable Care Act" means Public Law 111-148,
2.19as amended by the federal Health Care and Education Reconciliation Act of 2010 (Public
2.20Law 111-152), and any amendments to, or regulations or guidance issued under, those acts.
2.21EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
2.22approval, whichever is later. The commissioner of human services shall notify the revisor
2.23of statutes when federal approval is obtained.
2.24 Sec. 29. Minnesota Statutes 2012, section 256L.01, subdivision 3a, is amended to read:
2.25 Subd. 3a.
Family with children. (a)
"Family with children" means:
2.26(1) parents and their children residing in the same household; or
2.27(2) grandparents, foster parents, relative caretakers as defined in the medical
2.28assistance program, or legal guardians; and their wards who are children residing in the
2.29same household. "Family" has the meaning given for family and family size as defined
2.30in Code of Federal Regulations, title 26, section 1.36B-1.
2.31(b) The term includes children who are temporarily absent from the household in
2.32settings such as schools, camps, or parenting time with noncustodial parents.
3.1EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
3.2approval, whichever is later. The commissioner of human services shall notify the revisor
3.3of statutes when federal approval is obtained.
3.4 Sec. 30. Minnesota Statutes 2012, section 256L.01, subdivision 5, is amended to read:
3.5 Subd. 5.
Income. (a) "Income" has the meaning given for
earned and unearned
3.6income for families and children in the medical assistance program, according to the
3.7state's aid to families with dependent children plan in effect as of July 16, 1996. The
3.8definition does not include medical assistance income methodologies and deeming
3.9requirements. The earned income of full-time and part-time students under age 19 is
3.10not counted as income. Public assistance payments and supplemental security income
3.11are not excluded income modified adjusted gross income, as defined in Code of Federal
3.12Regulations, title 26, section 1.36B-1.
3.13(b) For purposes of this subdivision, and unless otherwise specified in this section,
3.14the commissioner shall use reasonable methods to calculate gross earned and unearned
3.15income including, but not limited to, projecting income based on income received within
3.16the past 30 days, the last 90 days, or the last 12 months.
3.17EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
3.18approval, whichever is later. The commissioner of human services shall notify the revisor
3.19of statutes when federal approval is obtained.
3.20 Sec. 31. Minnesota Statutes 2012, section 256L.02, subdivision 2, is amended to read:
3.21 Subd. 2.
Commissioner's duties. The commissioner shall establish an office for
3.22the state administration of this plan. The plan shall be used to provide covered health
3.23services for eligible persons. Payment for these services shall be made to all eligible
3.24providers. The commissioner shall adopt rules to administer the MinnesotaCare program.
3.25The commissioner shall establish marketing efforts to encourage potentially eligible
3.26persons to receive information about the program and about other medical care programs
3.27administered or supervised by the Department of Human Services. A toll-free telephone
3.28number
and Web site must be used to provide information about medical programs and to
3.29promote access to the covered services.
3.30EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
3.31approval, whichever is later. The commissioner of human services shall notify the revisor
3.32of statutes when federal approval is obtained.
4.1 Sec. 32. Minnesota Statutes 2012, section 256L.03, subdivision 1, is amended to read:
4.2 Subdivision 1.
Covered health services. (a) "Covered health services" means the
4.3health services reimbursed under chapter 256B, with the exception of
inpatient hospital
4.4services, special education services, private duty nursing services, adult dental care
4.5services other than services covered under section
256B.0625, subdivision 9, orthodontic
4.6services, nonemergency medical transportation services, personal care assistance and case
4.7management services,
and nursing home or intermediate care facilities services
, inpatient
4.8mental health services, and chemical dependency services.
4.9 (b) No public funds shall be used for coverage of abortion under MinnesotaCare
4.10except where the life of the female would be endangered or substantial and irreversible
4.11impairment of a major bodily function would result if the fetus were carried to term; or
4.12where the pregnancy is the result of rape or incest.
4.13 (c) Covered health services shall be expanded as provided in this section.
4.14EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
4.15approval, whichever is later. The commissioner of human services shall notify the revisor
4.16of statutes when federal approval is obtained.
4.17 Sec. 33. Minnesota Statutes 2012, section 256L.03, subdivision 1a, is amended to read:
4.18 Subd. 1a.
Pregnant women and Children; MinnesotaCare health care reform
4.19waiver. Beginning January 1, 1999, Children
and pregnant women are eligible for coverage
4.20of all services that are eligible for reimbursement under the medical assistance program
4.21according to chapter 256B, except that abortion services under MinnesotaCare shall be
4.22limited as provided under subdivision 1.
Pregnant women and Children are exempt from
4.23the provisions of subdivision 5, regarding co-payments.
Pregnant women and Children
4.24who are lawfully residing in the United States but who are not "qualified noncitizens" under
4.25title IV of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996,
4.26Public Law 104-193, Statutes at Large, volume 110, page 2105, are eligible for coverage
4.27of all services provided under the medical assistance program according to chapter 256B.
4.28EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
4.29approval, whichever is later. The commissioner of human services shall notify the revisor
4.30of statutes when federal approval is obtained.
4.31 Sec. 34. Minnesota Statutes 2012, section 256L.03, subdivision 3, is amended to read:
4.32 Subd. 3.
Inpatient hospital services. (a) Covered health services shall include
4.33inpatient hospital services, including inpatient hospital mental health services and inpatient
5.1hospital and residential chemical dependency treatment, subject to those limitations
5.2necessary to coordinate the provision of these services with eligibility under the medical
5.3assistance spenddown.
The inpatient hospital benefit for adult enrollees who qualify under
5.4section
256L.04, subdivision 7, or who qualify under section
256L.04, subdivisions 1 and
5.52
, with family gross income that exceeds 200 percent of the federal poverty guidelines or
5.6215 percent of the federal poverty guidelines on or after July 1, 2009, and who are not
5.7pregnant, is subject to an annual limit of $10,000.
5.8 (b) Admissions for inpatient hospital services paid for under section
256L.11,
5.9subdivision 3
, must be certified as medically necessary in accordance with Minnesota
5.10Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2):
5.11 (1) all admissions must be certified, except those authorized under rules established
5.12under section
254A.03, subdivision 3, or approved under Medicare; and
5.13 (2) payment under section
256L.11, subdivision 3, shall be reduced by five percent
5.14for admissions for which certification is requested more than 30 days after the day of
5.15admission. The hospital may not seek payment from the enrollee for the amount of the
5.16payment reduction under this clause.
5.17EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
5.18approval, whichever is later. The commissioner of human services shall notify the revisor
5.19of statutes when federal approval is obtained.
5.20 Sec. 35. Minnesota Statutes 2012, section 256L.03, subdivision 5, is amended to read:
5.21 Subd. 5.
Cost-sharing. (a) Except as
otherwise provided in
paragraphs (b) and (c)
5.22 this subdivision, the MinnesotaCare benefit plan shall include the following cost-sharing
5.23requirements for all enrollees:
5.24 (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
5.25subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
5.26 (2) $3 per prescription for adult enrollees;
5.27 (3) $25 for eyeglasses for adult enrollees;
5.28 (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
5.29episode of service which is required because of a recipient's symptoms, diagnosis, or
5.30established illness, and which is delivered in an ambulatory setting by a physician or
5.31physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
5.32audiologist, optician, or optometrist;
5.33 (5) $6 for nonemergency visits to a hospital-based emergency room for services
5.34provided through December 31, 2010, and $3.50 effective January 1, 2011; and
6.1(6) a family deductible equal to the maximum amount allowed under Code of
6.2Federal Regulations, title 42, part 447.54.
6.3 (b) Paragraph (a), clause (1), does not apply to
parents and relative caretakers of
6.4 families with children under the age of 21.
6.5 (c) Paragraph (a) does not apply to
pregnant women and children under the age of 21.
6.6 (d) Paragraph (a), clause (4), does not apply to mental health services.
6.7 (e) Adult enrollees with family gross income that exceeds 200 percent of the federal
6.8poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009,
6.9and who are not pregnant shall be financially responsible for the coinsurance amount, if
6.10applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.
6.11 (f) (e) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
6.12or changes from one prepaid health plan to another during a calendar year,
any charges
6.13submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
6.14expenses incurred by the enrollee for inpatient services, that were submitted or incurred
6.15prior to enrollment, or prior to the change in health plans, shall be disregarded.
6.16(g) (f) MinnesotaCare reimbursements to fee-for-service providers and payments to
6.17managed care plans or county-based purchasing plans shall not be increased as a result of
6.18the reduction of the co-payments in paragraph (a), clause (5), effective January 1, 2011.
6.19(h) (g) The commissioner, through the contracting process under section
256L.12,
6.20may allow managed care plans and county-based purchasing plans to waive the family
6.21deductible under paragraph (a), clause (6). The value of the family deductible shall not be
6.22included in the capitation payment to managed care plans and county-based purchasing
6.23plans. Managed care plans and county-based purchasing plans shall certify annually to the
6.24commissioner the dollar value of the family deductible.
6.25EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
6.26approval, whichever is later. The commissioner of human services shall notify the revisor
6.27of statutes when federal approval is obtained.
6.28 Sec. 36. Minnesota Statutes 2012, section 256L.04, subdivision 1, is amended to read:
6.29 Subdivision 1.
Families with children. (a) Families with children with family
6.30income
above 133 percent of the federal poverty guidelines and equal to or less than
6.31275 200 percent of the federal poverty guidelines for the applicable family size shall be
6.32eligible for MinnesotaCare according to this section. All other provisions of sections
6.33256L.01
to
256L.18, including the insurance-related barriers to enrollment under section
6.34256L.07, shall apply unless otherwise specified.
7.1 (b) Parents who enroll in the MinnesotaCare program must also enroll their children,
7.2if the children are eligible. Children may be enrolled separately without enrollment by
7.3parents. However, if one parent in the household enrolls, both parents must enroll, unless
7.4other insurance is available. If one child from a family is enrolled, all children must
7.5be enrolled, unless other insurance is available. If one spouse in a household enrolls,
7.6the other spouse in the household must also enroll, unless other insurance is available.
7.7Families cannot choose to enroll only certain uninsured members.
7.8 (c) Beginning October 1, 2003, the dependent sibling definition no longer applies
7.9to the MinnesotaCare program. These persons are no longer counted in the parental
7.10household and may apply as a separate household.
7.11 (d) Parents are not eligible for MinnesotaCare if their gross income exceeds $57,500.
7.12(e) Children deemed eligible for MinnesotaCare under section
256L.07, subdivision
7.138
, are exempt from the eligibility requirements of this subdivision.
7.14EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
7.15approval, whichever is later. The commissioner of human services shall notify the revisor
7.16of statutes when federal approval is obtained.
7.17 Sec. 37. Minnesota Statutes 2012, section 256L.04, subdivision 7, is amended to read:
7.18 Subd. 7.
Single adults and households with no children. (a) The definition of
7.19eligible persons includes all individuals and
households families with no children who
7.20have
gross family incomes that are
above 133 percent and equal to or less than 200 percent
7.21of the federal poverty guidelines
for the applicable family size.
7.22 (b) Effective July 1, 2009, the definition of eligible persons includes all individuals
7.23and households with no children who have gross family incomes that are equal to or less
7.24than 250 percent of the federal poverty guidelines.
7.25EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
7.26approval, whichever is later. The commissioner of human services shall notify the revisor
7.27of statutes when federal approval is obtained.
7.28 Sec. 38. Minnesota Statutes 2012, section 256L.04, subdivision 8, is amended to read:
7.29 Subd. 8.
Applicants potentially eligible for medical assistance. (a) Individuals
7.30who receive supplemental security income or retirement, survivors, or disability benefits
7.31due to a disability, or other disability-based pension, who qualify under subdivision 7, but
7.32who are potentially eligible for medical assistance without a spenddown shall be allowed
7.33to enroll in MinnesotaCare for a period of 60 days, so long as the applicant meets all other
8.1conditions of eligibility. The commissioner shall identify and refer the applications of
8.2such individuals to their county social service agency. The county and the commissioner
8.3shall cooperate to ensure that the individuals obtain medical assistance coverage for any
8.4months for which they are eligible.
8.5(b) The enrollee must cooperate with the county social service agency in determining
8.6medical assistance eligibility within the 60-day enrollment period. Enrollees who do not
8.7cooperate with medical assistance within the 60-day enrollment period shall be disenrolled
8.8from the plan within one calendar month. Persons disenrolled for nonapplication for
8.9medical assistance may not reenroll until they have obtained a medical assistance
8.10eligibility determination. Persons disenrolled for noncooperation with medical assistance
8.11may not reenroll until they have cooperated with the county agency and have obtained a
8.12medical assistance eligibility determination.
8.13(c) Beginning January 1, 2000, counties that choose to become MinnesotaCare
8.14enrollment sites shall consider MinnesotaCare applications to also be applications for
8.15medical assistance.
Applicants who are potentially eligible for medical assistance, except
8.16for those described in paragraph (a), may choose to enroll in either MinnesotaCare or
8.17medical assistance.
8.18(d) The commissioner shall redetermine provider payments made under
8.19MinnesotaCare to the appropriate medical assistance payments for those enrollees who
8.20subsequently become eligible for medical assistance.
8.21EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
8.22approval, whichever is later. The commissioner of human services shall notify the revisor
8.23of statutes when federal approval is obtained.
8.24 Sec. 39. Minnesota Statutes 2012, section 256L.04, subdivision 10, is amended to read:
8.25 Subd. 10.
Citizenship requirements. (a) Eligibility for MinnesotaCare is limited to
8.26citizens or nationals of the United States
, qualified noncitizens, and other persons residing
8.27 and lawfully
in the United States present noncitizens as defined in Code of Federal
8.28Regulations, title 8, section 103.12. Undocumented noncitizens
and nonimmigrants
8.29 are ineligible for MinnesotaCare. For purposes of this subdivision,
a nonimmigrant
8.30is an individual in one or more of the classes listed in United States Code, title 8,
8.31section 1101(a)(15), and an undocumented noncitizen is an individual who resides in the
8.32United States without the approval or acquiescence of the United States Citizenship and
8.33Immigration Services. Families with children who are citizens or nationals of the United
8.34States must cooperate in obtaining satisfactory documentary evidence of citizenship or
9.1nationality according to the requirements of the federal Deficit Reduction Act of 2005,
9.2Public Law 109-171.
9.3(b) Eligible persons include individuals who are lawfully present and ineligible for
9.4medical assistance by reason of immigration status, who have family income equal to or
9.5less than 200 percent of the federal poverty guidelines for the applicable family size.
9.6EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
9.7approval, whichever is later. The commissioner of human services shall notify the revisor
9.8of statutes when federal approval is obtained.
9.9 Sec. 40. Minnesota Statutes 2012, section 256L.04, subdivision 12, is amended to read:
9.10 Subd. 12.
Persons in detention. Beginning January 1, 1999, an applicant
or enrollee
9.11 residing in a correctional or detention facility is not eligible for MinnesotaCare.
An
9.12enrollee residing in a correctional or detention facility is not eligible at renewal of eligibility
9.13under section
256L.05, subdivision 3a. Applicants or enrollees residing in a correctional
9.14or detention facility pending disposition of charges are eligible for MinnesotaCare.
9.15EFFECTIVE DATE.This section is effective January 1, 2014.
9.16 Sec. 41. Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision
9.17to read:
9.18 Subd. 14. Coordination with medical assistance. (a) Individuals eligible for
9.19medical assistance under chapter 256B are not eligible for MinnesotaCare under this
9.20section.
9.21(b) The commissioner shall coordinate eligibility and coverage such that individuals
9.22transitioning between medical assistance and MinnesotaCare have seamless eligibility
9.23and access to health care services.
9.24EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
9.25approval, whichever is later. The commissioner of human services shall notify the revisor
9.26of statutes when federal approval is obtained.
9.27 Sec. 42. Minnesota Statutes 2012, section 256L.05, subdivision 3, is amended to read:
9.28 Subd. 3.
Effective date of coverage. (a) The effective date of coverage is the
9.29first day of the month following the month in which eligibility is approved and the first
9.30premium payment has been received.
As provided in section
256B.057, coverage for
9.31newborns is automatic from the date of birth and must be coordinated with other health
9.32coverage. The effective date of coverage for eligible newly adoptive children added to a
10.1family receiving covered health services is the month of placement. The effective date
10.2of coverage for
other new members added to the family is the first day of the month
10.3following the month in which the change is reported. All eligibility criteria must be met
10.4by the family at the time the new family member is added. The income of the new family
10.5member is included with the family's
modified adjusted gross income and the adjusted
10.6premium begins in the month the new family member is added.
10.7(b) The initial premium must be received by the last working day of the month for
10.8coverage to begin the first day of the following month.
10.9(c) Benefits are not available until the day following discharge if an enrollee is
10.10hospitalized on the first day of coverage.
10.11(d) (c) Notwithstanding any other law to the contrary, benefits under sections
10.12256L.01
to
256L.18 are secondary to a plan of insurance or benefit program under which
10.13an eligible person may have coverage and the commissioner shall use cost avoidance
10.14techniques to ensure coordination of any other health coverage for eligible persons. The
10.15commissioner shall identify eligible persons who may have coverage or benefits under
10.16other plans of insurance or who become eligible for medical assistance.
10.17(e) (d) The effective date of coverage for individuals or families who are exempt
10.18from paying premiums under section
256L.15, subdivision 1, paragraph (d), is the first
10.19day of the month following the month in which verification of American Indian status
10.20is received or eligibility is approved, whichever is later.
10.21(f) (e) The effective date of coverage for children eligible under section
256L.07,
10.22subdivision 8, is the first day of the month following the date of termination from foster
10.23care or release from a juvenile residential correctional facility.
10.24EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
10.25approval, whichever is later. The commissioner of human services shall notify the revisor
10.26of statutes when federal approval is obtained.
10.27 Sec. 43. Minnesota Statutes 2012, section 256L.06, subdivision 3, is amended to read:
10.28 Subd. 3.
Commissioner's duties and payment. (a) Premiums are dedicated to the
10.29commissioner for MinnesotaCare.
10.30 (b) The commissioner shall develop and implement procedures to: (1) require
10.31enrollees to report changes in income; (2) adjust sliding scale premium payments, based
10.32upon both increases and decreases in enrollee income, at the time the change in income
10.33is reported; and (3) disenroll enrollees from MinnesotaCare for failure to pay required
10.34premiums. Failure to pay includes payment with a dishonored check, a returned automatic
10.35bank withdrawal, or a refused credit card or debit card payment. The commissioner may
11.1demand a guaranteed form of payment, including a cashier's check or a money order, as
11.2the only means to replace a dishonored, returned, or refused payment.
11.3 (c) Premiums are calculated on a calendar month basis and may be paid on a
11.4monthly, quarterly, or semiannual basis, with the first payment due upon notice from the
11.5commissioner of the premium amount required. The commissioner shall inform applicants
11.6and enrollees of these premium payment options. Premium payment is required before
11.7enrollment is complete and to maintain eligibility in MinnesotaCare. Premium payments
11.8received before noon are credited the same day. Premium payments received after noon
11.9are credited on the next working day.
11.10 (d) Nonpayment of the premium will result in disenrollment from the plan effective
11.11for the calendar month for which the premium was due.
Persons disenrolled for
11.12nonpayment or who voluntarily terminate coverage from the program may not reenroll
11.13until four calendar months have elapsed. Persons disenrolled for nonpayment who pay
11.14all past due premiums as well as current premiums due, including premiums due for the
11.15period of disenrollment, within 20 days of disenrollment, shall be reenrolled retroactively
11.16to the first day of disenrollment.
Persons disenrolled for nonpayment or who voluntarily
11.17terminate coverage from the program may not reenroll for four calendar months unless
11.18the person demonstrates good cause for nonpayment. Good cause does not exist if a
11.19person chooses to pay other family expenses instead of the premium. The commissioner
11.20shall define good cause in rule.
11.21EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
11.22approval, whichever is later. The commissioner of human services shall notify the revisor
11.23of statutes when federal approval is obtained.
11.24 Sec. 44. Minnesota Statutes 2012, section 256L.07, subdivision 1, is amended to read:
11.25 Subdivision 1.
General requirements. (a) Children enrolled in the original
11.26children's health plan as of September 30, 1992, children who enrolled in the
11.27MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549,
11.28article 4, section 17, and children who have family gross incomes that are equal to or
11.29less than 200 percent of the federal poverty guidelines are eligible without meeting the
11.30requirements of subdivision 2 and the four-month requirement in subdivision 3, as long as
11.31they maintain continuous coverage in the MinnesotaCare program or medical assistance.
11.32 Parents Individuals enrolled in MinnesotaCare under section
256L.04, subdivision 1,
11.33and individuals enrolled in MinnesotaCare under section 256L.04, subdivision 7, whose
11.34income increases above
275 200 percent of the federal poverty guidelines, are no longer
11.35eligible for the program and shall be disenrolled by the commissioner.
Beginning January
12.11, 2008, individuals enrolled in MinnesotaCare under section
256L.04, subdivision
12.27
, whose income increases above 200 percent of the federal poverty guidelines or 250
12.3percent of the federal poverty guidelines on or after July 1, 2009, are no longer eligible for
12.4the program and shall be disenrolled by the commissioner. For persons disenrolled under
12.5this subdivision, MinnesotaCare coverage terminates the last day of the calendar month
12.6following the month in which the commissioner determines that the income of a family or
12.7individual exceeds program income limits.
12.8 (b) Children may remain enrolled in MinnesotaCare if their gross family income as
12.9defined in section
256L.01, subdivision 4, is greater than 275 percent of federal poverty
12.10guidelines. The premium for children remaining eligible under this paragraph shall be the
12.11maximum premium determined under section
256L.15, subdivision 2, paragraph (b).
12.12 (c) Notwithstanding paragraph (a), parents are not eligible for MinnesotaCare if
12.13gross household income exceeds $57,500 for the 12-month period of eligibility.
12.14EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
12.15approval, whichever is later. The commissioner of human services shall notify the revisor
12.16of statutes when federal approval is obtained.
12.17 Sec. 45. Minnesota Statutes 2012, section 256L.07, subdivision 2, is amended to read:
12.18 Subd. 2.
Must not have access to employer-subsidized minimum essential
12.19 coverage. (a) To be eligible, a family or individual must not have access to subsidized
12.20health coverage
through an employer and must not have had access to employer-subsidized
12.21coverage through a current employer for 18 months prior to application or reapplication.
12.22A family or individual whose employer-subsidized coverage is lost due to an employer
12.23terminating health care coverage as an employee benefit during the previous 18 months is
12.24not eligible that is affordable and provides minimum value as defined in Code of Federal
12.25Regulations, title 26, section 1.36B-2.
12.26(b) This subdivision does not apply to a family or individual
who was enrolled
12.27in MinnesotaCare within six months or less of reapplication and who no longer has
12.28employer-subsidized coverage due to the employer terminating health care coverage as an
12.29employee benefit.
This subdivision does not apply to children with family gross incomes
12.30that are equal to or less than 200 percent of federal poverty guidelines.
12.31(c) For purposes of this requirement, subsidized health coverage means health
12.32coverage for which the employer pays at least 50 percent of the cost of coverage for
12.33the employee or dependent, or a higher percentage as specified by the commissioner.
12.34Children are eligible for employer-subsidized coverage through either parent, including
12.35the noncustodial parent. The commissioner must treat employer contributions to Internal
13.1Revenue Code Section 125 plans and any other employer benefits intended to pay
13.2health care costs as qualified employer subsidies toward the cost of health coverage for
13.3employees for purposes of this subdivision.
13.4EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
13.5approval, whichever is later. The commissioner of human services shall notify the revisor
13.6of statutes when federal approval is obtained.
13.7 Sec. 46. Minnesota Statutes 2012, section 256L.07, subdivision 3, is amended to read:
13.8 Subd. 3.
Other health coverage. (a)
Families and individuals enrolled in the
13.9MinnesotaCare program must have no To be eligible, a family or individual must not have
13.10minimum essential health coverage
while enrolled, as defined by section 5000A of the
13.11Internal Revenue Code.
Children with family gross incomes equal to or greater than 200
13.12percent of federal poverty guidelines, and adults, must have had no health coverage for
13.13at least four months prior to application and renewal. Children enrolled in the original
13.14children's health plan and children in families with income equal to or less than 200
13.15percent of the federal poverty guidelines, who have other health insurance, are eligible if
13.16the coverage:
13.17(1) lacks two or more of the following:
13.18(i) basic hospital insurance;
13.19(ii) medical-surgical insurance;
13.20(iii) prescription drug coverage;
13.21(iv) dental coverage; or
13.22(v) vision coverage;
13.23(2) requires a deductible of $100 or more per person per year; or
13.24(3) lacks coverage because the child has exceeded the maximum coverage for a
13.25particular diagnosis or the policy excludes a particular diagnosis.
13.26The commissioner may change this eligibility criterion for sliding scale premiums
13.27in order to remain within the limits of available appropriations. The requirement of no
13.28health coverage does not apply to newborns.
13.29(b) Coverage purchased as provided under section 256L.031, subdivision 2, medical
13.30assistance, and the Civilian Health and Medical Program of the Uniformed Service,
13.31CHAMPUS, or other coverage provided under United States Code, title 10, subtitle A,
13.32part II, chapter 55, are not considered insurance or health coverage for purposes of the
13.33four-month requirement described in this subdivision.
13.34(c) (b) For purposes of this subdivision, an applicant or enrollee who is entitled to
13.35Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social
14.1Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered
14.2to have
minimum essential health coverage. An applicant or enrollee who is entitled to
14.3premium-free Medicare Part A may not refuse to apply for or enroll in Medicare coverage
14.4to establish eligibility for MinnesotaCare.
14.5(d) Applicants who were recipients of medical assistance within one month of
14.6application must meet the provisions of this subdivision and subdivision 2.
14.7(e) Cost-effective health insurance that was paid for by medical assistance is not
14.8considered health coverage for purposes of the four-month requirement under this
14.9section, except if the insurance continued after medical assistance no longer considered it
14.10cost-effective or after medical assistance closed.
14.11EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
14.12approval, whichever is later. The commissioner of human services shall notify the revisor
14.13of statutes when federal approval is obtained.
14.14 Sec. 47. Minnesota Statutes 2012, section 256L.09, subdivision 2, is amended to read:
14.15 Subd. 2.
Residency requirement. To be eligible for health coverage under the
14.16MinnesotaCare program,
pregnant women, individuals, and families with children must
14.17meet the residency requirements as provided by Code of Federal Regulations, title 42,
14.18section 435.403, except that the provisions of section
256B.056, subdivision 1, shall apply
14.19upon receipt of federal approval.
14.20EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
14.21approval, whichever is later. The commissioner of human services shall notify the revisor
14.22of statutes when federal approval is obtained.
14.23 Sec. 48. Minnesota Statutes 2012, section 256L.11, subdivision 6, is amended to read:
14.24 Subd. 6.
Enrollees 18 or older Reimbursement of inpatient hospital services.
14.25Payment by the MinnesotaCare program for inpatient hospital services provided to
14.26MinnesotaCare enrollees eligible under section
256L.04, subdivision 7, or who qualify
14.27under section
256L.04,
subdivisions subdivision 1
and 2, with family gross income that
14.28exceeds 175 percent of the federal poverty guidelines and who are not pregnant, who
14.29are 18 years old or older on the date of admission to the inpatient hospital must be in
14.30accordance with paragraphs (a) and (b). Payment for adults who are not pregnant and are
14.31eligible under section
256L.04, subdivisions 1 and 2, and whose incomes are equal to or
14.32less than 175 percent of the federal poverty guidelines, shall be as provided for under
14.33paragraph (c)., shall be at the medical assistance rate minus any co-payment required
15.1under section 256L.03, subdivision 5. The hospital must not seek payment from the
15.2enrollee in addition to the co-payment. The MinnesotaCare payment plus the co-payment
15.3must be treated as payment in full.
15.4(a) If the medical assistance rate minus any co-payment required under section
15.5256L.03, subdivision 4, is less than or equal to the amount remaining in the enrollee's
15.6benefit limit under section
256L.03, subdivision 3, payment must be the medical
15.7assistance rate minus any co-payment required under section
256L.03, subdivision 4. The
15.8hospital must not seek payment from the enrollee in addition to the co-payment. The
15.9MinnesotaCare payment plus the co-payment must be treated as payment in full.
15.10(b) If the medical assistance rate minus any co-payment required under section
15.11256L.03, subdivision 4, is greater than the amount remaining in the enrollee's benefit limit
15.12under section
256L.03, subdivision 3, payment must be the lesser of:
15.13(1) the amount remaining in the enrollee's benefit limit; or
15.14(2) charges submitted for the inpatient hospital services less any co-payment
15.15established under section
256L.03, subdivision 4.
15.16The hospital may seek payment from the enrollee for the amount by which usual and
15.17customary charges exceed the payment under this paragraph. If payment is reduced under
15.18section
256L.03, subdivision 3, paragraph (b), the hospital may not seek payment from the
15.19enrollee for the amount of the reduction.
15.20(c) For admissions occurring on or after July 1, 2011, for single adults and
15.21households without children who are eligible under section
256L.04, subdivision 7, the
15.22commissioner shall pay hospitals directly, up to the medical assistance payment rate,
15.23for inpatient hospital benefits up to the $10,000 annual inpatient benefit limit, minus
15.24any co-payment required under section
256L.03, subdivision 5. Inpatient services paid
15.25directly by the commissioner under this paragraph do not include chemical dependency
15.26hospital-based and residential treatment.
15.27EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
15.28approval, whichever is later. The commissioner of human services shall notify the revisor
15.29of statutes when federal approval is obtained.
15.30 Sec. 49. Minnesota Statutes 2012, section 256L.15, subdivision 1, is amended to read:
15.31 Subdivision 1.
Premium determination. (a) Families with children and individuals
15.32shall pay a premium determined according to subdivision 2.
15.33 (b) Pregnant women and children under age two are exempt from the provisions
15.34of section
256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment
15.35for failure to pay premiums. For pregnant women, this exemption continues until the
16.1first day of the month following the 60th day postpartum. Women who remain enrolled
16.2during pregnancy or the postpartum period, despite nonpayment of premiums, shall be
16.3disenrolled on the first of the month following the 60th day postpartum for the penalty
16.4period that otherwise applies under section
256L.06, unless they begin paying premiums.
16.5 (c) Members of the military and their families who meet the eligibility criteria
16.6for MinnesotaCare upon eligibility approval made within 24 months following the end
16.7of the member's tour of active duty shall have their premiums paid by the commissioner.
16.8The effective date of coverage for an individual or family who meets the criteria of this
16.9paragraph shall be the first day of the month following the month in which eligibility is
16.10approved. This exemption applies for 12 months.
16.11(d) (b) Beginning July 1, 2009, American Indians enrolled in MinnesotaCare and
16.12their families shall have their premiums waived by the commissioner in accordance with
16.13section 5006 of the American Recovery and Reinvestment Act of 2009, Public Law 111-5.
16.14An individual must document status as an American Indian, as defined under Code of
16.15Federal Regulations, title 42, section
447.50, to qualify for the waiver of premiums.
16.16EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
16.17approval, whichever is later. The commissioner of human services shall notify the revisor
16.18of statutes when federal approval is obtained.
16.19 Sec. 50. Minnesota Statutes 2012, section 256L.15, subdivision 2, is amended to read:
16.20 Subd. 2.
Sliding fee scale; monthly gross individual or family income. (a) The
16.21commissioner shall establish a sliding fee scale to determine the percentage of monthly
16.22gross individual or family income that households at different income levels must pay to
16.23obtain coverage through the MinnesotaCare program. The sliding fee scale must be based
16.24on the enrollee's monthly
gross individual or family income. The sliding fee scale must
16.25contain separate tables based on enrollment of one, two, or three or more persons. Until
16.26June 30, 2009, the sliding fee scale begins with a premium of 1.5 percent of monthly gross
16.27individual or family income for individuals or families with incomes below the limits for
16.28the medical assistance program for families and children in effect on January 1, 1999, and
16.29proceeds through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and
16.308.8 percent. These percentages are matched to evenly spaced income steps ranging from
16.31the medical assistance income limit for families and children in effect on January 1, 1999,
16.32to 275 percent of the federal poverty guidelines for the applicable family size, up to a
16.33family size of five. The sliding fee scale for a family of five must be used for families of
16.34more than five. The sliding fee scale and percentages are not subject to the provisions of
17.1chapter 14. If a family or individual reports increased income after enrollment, premiums
17.2shall be adjusted at the time the change in income is reported.
17.3 (b) Children in families whose gross income is above 275 percent of the federal
17.4poverty guidelines shall pay the maximum premium. The maximum premium is defined
17.5as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare
17.6cases paid the maximum premium, the total revenue would equal the total cost of
17.7MinnesotaCare medical coverage and administration. In this calculation, administrative
17.8costs shall be assumed to equal ten percent of the total. The costs of medical coverage
17.9for pregnant women and children under age two and the enrollees in these groups shall
17.10be excluded from the total. The maximum premium for two enrollees shall be twice the
17.11maximum premium for one, and the maximum premium for three or more enrollees shall
17.12be three times the maximum premium for one.
17.13 (c) (b) Beginning July 1, 2009, MinnesotaCare enrollees shall pay premiums
17.14according to the premium scale specified in paragraph
(d) (c) with the exception that
17.15children in families with income at or below 200 percent of the federal poverty guidelines
17.16shall pay no premiums. For purposes of paragraph
(d) (c), "minimum" means a monthly
17.17premium of $4.
17.18 (d) (c) The following premium scale is established for individuals and families with
17.19gross family incomes of
275 200 percent of the federal poverty guidelines or less:
17.20
|
Federal Poverty Guideline Range
|
Percent of Average Gross Monthly Income
|
17.21
|
0-45%
|
minimum
|
17.22
17.23
|
46-54%
|
$4 or 1.1% of family income, whichever is
greater
|
17.24
|
55-81%
|
1.6%
|
17.25
|
82-109%
|
2.2%
|
17.26
|
110-136%
|
2.9%
|
17.27
|
137-164%
|
3.6%
|
17.28
17.29
|
165-191
165-200%
|
4.6%
|
17.30
|
192-219%
|
5.6%
|
17.31
|
220-248%
|
6.5%
|
17.32
|
249-275%
|
7.2%
|
17.33EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
17.34approval, whichever is later. The commissioner of human services shall notify the revisor
17.35of statutes when federal approval is obtained."
17.36Page 21, delete subdivision 2 and insert:
17.37 "
Subd. 2. Repeal; certain MinnesotaCare provisions. Minnesota Statutes 2012,
17.38sections 256L.01, subdivision 4a; 256L.031; 256L.04, subdivisions 1b, 9, and 10a;
18.1256L.05, subdivision 3b; 256L.07, subdivisions 5, 8, and 9; 256L.11, subdivision 5; and
18.2256L.17 are repealed effective January 1, 2014."
18.3Page 23, line 14, delete "
and" and insert a comma and after "
disabilities" insert "
,
18.4and people with mental illnesses"
18.5Page 23, line 16, after the period, insert "
The report shall be submitted to the
18.6legislature no later than August 15, 2015."
18.7Page 32, line 25, delete "
who are"
18.8Page 32, line 26, delete "
admitted to a nursing facility from a hospital"
18.9Page 36, after line 22, insert
18.10"
EFFECTIVE DATE.This section is effective October 1, 2013."
18.11Page 37, after line 31, insert:
18.12"
EFFECTIVE DATE.This section is effective October 1, 2013."
18.13Page 38, after line 26, insert:
18.14"
EFFECTIVE DATE.This section is effective October 1, 2013."
18.15Page 39, after line 2, insert:
18.16"
EFFECTIVE DATE.This section is effective October 1, 2013."
18.17Page 45, line 32, after "a" insert "
Medicaid-certified"
18.18Page 45, line 33, strike "from a hospital"
18.19Page 47, after line 7, insert:
18.20"
EFFECTIVE DATE.This section is effective October 1, 2013."
18.21Page 53, line 27, after "
uniformity" insert "
for payment rates" and delete "
ICLS
18.22shall not be"
18.23Page 53, delete line 28 and insert "
Licensing standards for ICLS shall be reviewed
18.24jointly by the Departments of Health and Human Services to avoid conflict with provider
18.25regulatory standards pursuant to section 144A.43 and chapter 245D."
18.26Page 55, line 16, after "
program" insert "
governed by a board, the majority of whose
18.27members reside within the program's service area,"
18.28Page 63, line 29, delete "
acting as the employer of record" and insert "
by directly
18.29employing support workers"
18.30Page 64, line 14, delete "
including employing workers specifically selected by
18.31the participant"
18.32Page 65, line 4, delete "
regulatory requirements when acting as an employer of
18.33record for"
18.34Page 65, line 5, delete "
support workers or employer agent, that are" and insert
18.35"
employer-related requirements"
19.1Page 65, line 9, delete "
for the" and insert "
to facilitate participant"
19.2Page 67, line 3, after "
to" insert "
assistance regarding"
19.3Page 67, line 10, delete "
a regular or temporary employee of the agency-provider,"
19.4Page 67, line 11, delete "
the financial management services contractor, or the
19.5participant" and insert "
an employee of the agency provider or of the participant"
19.6Page 67, line 17, delete "
and"
19.7Page 67, line 18, after "
accounts" insert "
, or other forms of employee compensation
19.8and benefits"
19.9Page 67, line 19, before "
CFSS" insert "
(a)"
19.10Page 67, line 29, delete "
is determined eligible" and insert "
require assistance and be
19.11determined dependent in one activity of daily living or Level I behavior"
19.12Page 70, line 4, delete "
(a)"
19.13Page 70, line 14, delete "
and"
19.14Page 70, line 17, after the semicolon insert "
and"
19.15Page 70, before line 18, insert:
19.16"
(iii) fit within the annual limit of the participant's approved service allocation or
19.17budget;"
19.18Page 70, line 19, before the period, insert "
or intervention needed due to a
19.19participant's symptoms"
19.20Page 71, delete lines 9 and 10
19.21Page 71, line 26, delete "
CFSS" and insert "
PCA"
19.22Page 76, line 10, delete "
accept" and insert "
can exercise"
19.23Page 76, delete lines 12 and 13 and insert:
19.24"
(1) participants directly employ support workers;
19.25(2) participants may use a budget allocation to obtain supports and goods as defined
19.26in subdivision 7; and"
19.27Page 76, line 14, delete "
(2)" and insert "
(3)"
19.28Page 76, line 15, delete "
for" and insert "
services relating to"
19.29Page 76, line 17, after "
the" insert "
participant's"
19.30Page 76, line 18, delete the second "
and" and insert "
for"
19.31Page 76, line 30, delete "
employer and employer agent functions" and insert
19.32"
assisting participants in fulfilling employer-related requirements in accordance with"
19.33Page 77, line 6, delete the comma
19.34Page 77, line 7, delete everything before the semicolon and insert "
or service
19.35delivery models as authorized by the commissioner"
19.36Page 78, line 7, delete "
record for"
20.1Page 78, line 24, before "
FMS" insert "
assistance of the"
20.2Page 79, line 34, after "
practices," insert "
orientation to responding to a mental
20.3health crisis,"
20.4Page 85, line 10, delete "
triage system for investigations" and insert "
system for
20.5referring reports to the lead investigative agencies"
20.6Page 85, line 31, delete "
This"
20.7Page 85, delete line 32
20.8Page 85, line 33, delete everything before "
This"
20.9Page 86, delete section 48 and insert:
20.10 "Sec. 48.
REPEALER.
20.11(a) Minnesota Statutes 2012, sections 245A.655; and 256B.0917, subdivisions 1, 2,
20.123, 4, 5, 7, 8, 9, 10, 11, 12, and 14, are repealed.
20.13(b) Minnesota Statutes 2012, section 256B.0911, subdivisions 4a, 4b, and 4c, are
20.14repealed effective October 1, 2013."
20.15Page 87, line 25, delete "
$18,814,000" and insert "
$16,992,000"
20.16Page 115, line 31, before "
tribe" insert "
county or"
20.17Page 160, delete lines 23 to 30 and insert:
20.18"
(1) improving permanency for a child or children;
20.19(2) maintaining permanency for a child or children;
20.20(3) administrative simplification;
20.21(4) accessing additional federal funds;
20.22(5) converting pre-Northstar Care for Children relative custody assistance under
20.23section 257.85 to the guardianship assistance component of Northstar Care for Children;
20.24(6) complying with federal regulations; and
20.25(7) financial and budgetary constraints."
20.26Page 167, delete lines 30 and 31
20.27Page 167, line 32, delete "
(d)" and insert "
(c)"
20.28Page 168, line 1, delete "
(e)" and insert "
(d)"
20.29Page 168, after line 3, insert:
20.30 "Section 1. Minnesota Statutes 2012, section 245.4661, subdivision 5, is amended to
20.31read:
20.32 Subd. 5.
Planning for pilot projects. (a) Each local plan for a pilot project
, with
20.33the exception of the placement of a Minnesota specialty treatment facility as defined in
20.34paragraph (c), must be developed under the direction of the county board, or multiple
20.35county boards acting jointly, as the local mental health authority. The planning process
20.36for each pilot shall include, but not be limited to, mental health consumers, families,
21.1advocates, local mental health advisory councils, local and state providers, representatives
21.2of state and local public employee bargaining units, and the department of human services.
21.3As part of the planning process, the county board or boards shall designate a managing
21.4entity responsible for receipt of funds and management of the pilot project.
21.5(b) For Minnesota specialty treatment facilities, the commissioner shall issue a
21.6request for proposal for regions in which a need has been identified for services.
21.7(c) For purposes of this section, Minnesota specialty treatment facility is defined as
21.8an intensive rehabilitative mental health service under section 256B.0622, subdivision 2,
21.9paragraph (b).
21.10 Sec. 2. Minnesota Statutes 2012, section 245.4661, subdivision 6, is amended to read:
21.11 Subd. 6.
Duties of commissioner. (a) For purposes of the pilot projects, the
21.12commissioner shall facilitate integration of funds or other resources as needed and
21.13requested by each project. These resources may include:
21.14(1) residential services funds administered under Minnesota Rules, parts 9535.2000
21.15to 9535.3000, in an amount to be determined by mutual agreement between the project's
21.16managing entity and the commissioner of human services after an examination of the
21.17county's historical utilization of facilities located both within and outside of the county
21.18and licensed under Minnesota Rules, parts 9520.0500 to 9520.0690;
21.19(2) community support services funds administered under Minnesota Rules, parts
21.209535.1700 to 9535.1760;
21.21(3) other mental health special project funds;
21.22(4) medical assistance, general assistance medical care, MinnesotaCare and group
21.23residential housing if requested by the project's managing entity, and if the commissioner
21.24determines this would be consistent with the state's overall health care reform efforts;
and
21.25(5) regional treatment center resources consistent with section
246.0136, subdivision
21.261
.; and
21.27(6) funds transferred from section 246.18, subdivision 8, for grants to providers to
21.28participate in mental health specialty treatment services, awarded to providers through
21.29a request for proposal process.
21.30(b) The commissioner shall consider the following criteria in awarding start-up and
21.31implementation grants for the pilot projects:
21.32(1) the ability of the proposed projects to accomplish the objectives described in
21.33subdivision 2;
21.34(2) the size of the target population to be served; and
21.35(3) geographical distribution.
22.1(c) The commissioner shall review overall status of the projects initiatives at least
22.2every two years and recommend any legislative changes needed by January 15 of each
22.3odd-numbered year.
22.4(d) The commissioner may waive administrative rule requirements which are
22.5incompatible with the implementation of the pilot project.
22.6(e) The commissioner may exempt the participating counties from fiscal sanctions
22.7for noncompliance with requirements in laws and rules which are incompatible with the
22.8implementation of the pilot project.
22.9(f) The commissioner may award grants to an entity designated by a county board or
22.10group of county boards to pay for start-up and implementation costs of the pilot project."
22.11Page 169, line 17, delete "
and"
22.12Page 169, line 19, delete the period and insert "
; and"
22.13Page 169, after line 19, insert:
22.14"
(3) to fund the operation of the Intensive Residential Treatment Service program in
22.15Willmar."
22.16Page 170, after line 21, insert:
22.17 "Sec. 6. Minnesota Statutes 2012, section 256B.0946, is amended to read:
22.18256B.0946 INTENSIVE TREATMENT IN FOSTER CARE.
22.19 Subdivision 1.
Required covered service components. (a) Effective
July 1, 2006,
22.20 upon enactment and subject to federal approval, medical assistance covers medically
22.21necessary
intensive treatment services described under paragraph (b) that are provided
22.22by a provider entity eligible under subdivision 3 to a client eligible under subdivision 2
22.23who is placed in a
treatment foster home licensed under Minnesota Rules, parts 2960.3000
22.24to 2960.3340.
22.25(b)
Intensive treatment services to children with
severe emotional disturbance mental
22.26illness residing in
treatment foster
care family settings
must meet the relevant standards
22.27for mental health services under sections
245.487 to
245.4889. In addition, that comprise
22.28 specific
required service components
provided in clauses (1) to (5), are reimbursed by
22.29medical assistance
must when they meet the following standards:
22.30(1) case management service component must meet the standards in Minnesota
22.31Rules, parts 9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10;
22.32(1) psychotherapy provided by a mental health professional as defined in Minnesota
22.33Rules, part 9505.0371, subpart 5, item A, or a clinical trainee, as defined in Minnesota
22.34Rules, part 9505.0371, subpart 5, item C;
23.1(2)
psychotherapy, crisis assistance
, and skills training components must meet the
23.2 provided according to standards for children's therapeutic services and supports in section
23.3256B.0943
;
and
23.4(3)
individual family
, and group psychoeducation services
under supervision of,
23.5defined in subdivision 1a, paragraph (q), provided by a mental health professional
. or a
23.6clinical trainee;
23.7(4) clinical care consultation, as defined in subdivision 1a, and provided by a mental
23.8health professional or a clinical trainee; and
23.9(5) service delivery payment requirements as provided under subdivision 4.
23.10 Subd. 1a. Definitions. For the purposes of this section, the following terms have
23.11the meanings given them.
23.12(a) "Clinical care consultation" means communication from a treating clinician to
23.13other providers working with the same client to inform, inquire, and instruct regarding
23.14the client's symptoms, strategies for effective engagement, care and intervention needs,
23.15and treatment expectations across service settings, including but not limited to the client's
23.16school, social services, day care, probation, home, primary care, medication prescribers,
23.17disabilities services, and other mental health providers and to direct and coordinate clinical
23.18service components provided to the client and family.
23.19(b) "Clinical supervision" means the documented time a clinical supervisor and
23.20supervisee spend together to discuss the supervisee's work, to review individual client
23.21cases, and for the supervisee's professional development. It includes the documented
23.22oversight and supervision responsibility for planning, implementation, and evaluation of
23.23services for a client's mental health treatment.
23.24(c) "Clinical supervisor" means the mental health professional who is responsible
23.25for clinical supervision.
23.26(d) "Clinical trainee" has the meaning given in Minnesota Rules, part 9505.0371,
23.27subpart 5, item C;
23.28(e) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a,
23.29including the development of a plan that addresses prevention and intervention strategies
23.30to be used in a potential crisis, but does not include actual crisis intervention.
23.31(f) "Culturally appropriate" means providing mental health services in a manner that
23.32incorporates the child's cultural influences, as defined in Minnesota Rules, part 9505.0370,
23.33subpart 9, into interventions as a way to maximize resiliency factors and utilize cultural
23.34strengths and resources to promote overall wellness.
24.1(g) "Culture" means the distinct ways of living and understanding the world that
24.2are used by a group of people and are transmitted from one generation to another or
24.3adopted by an individual.
24.4(h) "Diagnostic assessment" has the meaning given in Minnesota Rules, part
24.59505.0370, subpart 11.
24.6(i) "Family" means a person who is identified by the client or the client's parent or
24.7guardian as being important to the client's mental health treatment. Family may include,
24.8but is not limited to, parents, foster parents, children, spouse, committed partners, former
24.9spouses, persons related by blood or adoption, persons who are a part of the client's
24.10permanency plan, or persons who are presently residing together as a family unit.
24.11(j) "Foster care" has the meaning given in section 260C.007, subdivision 18.
24.12(k) "Foster family setting" means the foster home in which the license holder resides.
24.13(l) "Individual treatment plan" has the meaning given in Minnesota Rules, part
24.149505.0370, subpart 15.
24.15(m) "Mental health practitioner" has the meaning given in Minnesota Rules, part
24.169505.0370, subpart 17.
24.17(n) "Mental health professional" has the meaning given in Minnesota Rules, part
24.189505.0370, subpart 18.
24.19(o) "Mental illness" has the meaning given in Minnesota Rules, part 9505.0370,
24.20subpart 20.
24.21(p) "Parent" has the meaning given in section 260C.007, subdivision 25.
24.22(q) "Psychoeducation services" means information or demonstration provided to
24.23an individual, family, or group to explain, educate, and support the individual, family, or
24.24group in understanding a child's symptoms of mental illness, the impact on the child's
24.25development, and needed components of treatment and skill development so that the
24.26individual, family, or group can help the child to prevent relapse, prevent the acquisition
24.27of comorbid disorders, and to achieve optimal mental health and long-term resilience.
24.28(r) "Psychotherapy" has the meaning given in Minnesota Rules, part 9505.0370,
24.29subpart 27.
24.30(s) "Team consultation and treatment planning" means the coordination of treatment
24.31plans and consultation among providers in a group concerning the treatment needs of the
24.32child, including disseminating the child's treatment service schedule to all members of the
24.33service team. Team members must include all mental health professionals working with
24.34the child, a parent, the child unless the team lead or parent deem it clinically inappropriate,
24.35and at least two of the following: an individualized education program case manager;
24.36probation agent; children's mental health case manager; child welfare worker, including
25.1adoption or guardianship worker; primary care provider; foster parent; and any other
25.2member of the child's service team.
25.3 Subd. 2.
Determination of client eligibility. A client's eligibility to receive
25.4treatment foster care under this section shall be determined by An eligible recipient is an
25.5individual, from birth through age 20, who is currently placed in a foster home licensed
25.6under Minnesota Rules, parts 2960.3000 to 2960.3340, and has received a diagnostic
25.7assessment
, and an evaluation of level of care needed,
and development of an individual
25.8treatment plan, as defined in paragraphs (a)
to (c) and (b).
25.9(a) The diagnostic assessment must:
25.10(1)
meet criteria described in Minnesota Rules, part 9505.0372, subpart 1, and be
25.11conducted by a
psychiatrist, licensed psychologist, or licensed independent clinical social
25.12worker that is mental health professional or a clinical trainee;
25.13(2) determine whether or not a child meets the criteria for mental illness, as defined
25.14in Minnesota Rules, part 9505.0370, subpart 20;
25.15(3) document that intensive treatment services are medically necessary within a
25.16foster family setting to ameliorate identified symptoms and functional impairments;
25.17(4) be performed within 180 days
prior to before the start of service;
and
25.18(2) include current diagnoses on all five axes of the client's current mental health
25.19status;
25.20(3) determine whether or not a child meets the criteria for severe emotional
25.21disturbance in section
245.4871, subdivision 6, or for serious and persistent mental illness
25.22in section
245.462, subdivision 20; and
25.23(4) be completed annually until age 18. For individuals between age 18 and 21,
25.24unless a client's mental health condition has changed markedly since the client's most
25.25recent diagnostic assessment, annual updating is necessary. For the purpose of this section,
25.26"updating" means a written summary, including current diagnoses on all five axes, by a
25.27mental health professional of the client's current mental status and service needs.
25.28(5) be completed as either a standard or extended diagnostic assessment annually to
25.29determine continued eligibility for the service.
25.30(b) The evaluation of level of care must be conducted by the placing county
with
25.31an instrument, tribe, or case manager in conjunction with the diagnostic assessment as
25.32described by Minnesota Rules, part 9505.0372, subpart 1, item B, using a validated tool
25.33 approved by the commissioner of human services
and not subject to the rulemaking
25.34process, consistent with section 245.4885, subdivision 1, paragraph (d), the result of which
25.35evaluation demonstrates that the child requires intensive intervention without 24-hour
26.1medical monitoring. The commissioner shall update the list of approved level of care
26.2instruments tools annually
and publish on the department's Web site.
26.3(c) The individual treatment plan must be:
26.4(1) based on the information in the client's diagnostic assessment;
26.5(2) developed through a child-centered, family driven planning process that identifies
26.6service needs and individualized, planned, and culturally appropriate interventions that
26.7contain specific measurable treatment goals and objectives for the client and treatment
26.8strategies for the client's family and foster family;
26.9(3) reviewed at least once every 90 days and revised; and
26.10(4) signed by the client or, if appropriate, by the client's parent or other person
26.11authorized by statute to consent to mental health services for the client.
26.12 Subd. 3.
Eligible mental health services providers. (a) Eligible providers for
26.13intensive children's mental health services in a foster family setting must be certified
26.14by the state and have a service provision contract with a county board or a reservation
26.15tribal council and must be able to demonstrate the ability to provide all of the services
26.16required in this section.
26.17(b) For purposes of this section, a provider agency must
have an individual
26.18placement agreement for each recipient and must be a licensed child placing agency, under
26.19Minnesota Rules, parts 9543.0010 to 9543.0150, and either be:
26.20(1) a
county county-operated entity certified by the state;
26.21(2) an Indian Health Services facility operated by a tribe or tribal organization under
26.22funding authorized by United States Code, title 25, sections 450f to 450n, or title 3 of the
26.23Indian Self-Determination Act, Public Law 93-638, section 638 (facilities or providers); or
26.24(3) a noncounty entity
under contract with a county board.
26.25(c) Certified providers that do not meet the service delivery standards required in
26.26this section shall be subject to a decertification process.
26.27(d) For the purposes of this section, all services delivered to a client must be
26.28provided by a mental health professional or a clinical trainee.
26.29 Subd. 4.
Eligible provider responsibilities Service delivery payment
26.30requirements. (a) To be
an eligible
provider for payment under this section, a provider
26.31must develop
and practice written policies and procedures for
treatment foster care services
26.32 intensive treatment in foster care, consistent with subdivision 1, paragraph (b),
clauses (1),
26.33(2), and (3) and comply with the following requirements in paragraphs (b) to (n).
26.34(b) In delivering services under this section, a treatment foster care provider must
26.35ensure that staff caseload size reasonably enables the provider to play an active role in
26.36service planning, monitoring, delivering, and reviewing for discharge planning to meet
27.1the needs of the client, the client's foster family, and the birth family, as specified in each
27.2client's individual treatment plan.
27.3(b) A qualified clinical supervisor, as defined in and performing in compliance with
27.4Minnesota Rules, part 9505.0371, subpart 5, item D, must supervise the treatment and
27.5provision of services described in this section.
27.6(c) Each client receiving treatment services must receive an extended diagnostic
27.7assessment, as described in Minnesota Rules, part 9505.0372, subpart 1, item C, within
27.830 days of enrollment in this service unless the client has a previous extended diagnostic
27.9assessment that the client, parent, and mental health professional agree still accurately
27.10describes the client's current mental health functioning.
27.11(d) Each previous and current mental health, school, and physical health treatment
27.12provider must be contacted to request documentation of treatment and assessments that the
27.13eligible client has received and this information must be reviewed and incorporated into
27.14the diagnostic assessment and team consultation and treatment planning review process.
27.15(e) Each client receiving treatment must be assessed for a trauma history and
27.16the client's treatment plan must document how the results of the assessment will be
27.17incorporated into treatment.
27.18(f) Each client receiving treatment services must have an individual treatment plan
27.19that is reviewed, evaluated, and signed every 90 days using the team consultation and
27.20treatment planning process, as defined in subdivision 1a, paragraph (s).
27.21(g) Care consultation, as defined in subdivision 1a, paragraph (a), must be provided
27.22in accordance with the client's individual treatment plan.
27.23(h) Each client must have a crisis assistance plan within ten days of initiating
27.24services and must have access to clinical phone support 24 hours per day, seven days per
27.25week, during the course of treatment, and the crisis plan must demonstrate coordination
27.26with the local or regional mobile crisis intervention team.
27.27(i) Services must be delivered and documented at least three days per week, equaling
27.28at least six hours of treatment per week, unless reduced units of service are specified on
27.29the treatment plan as part of transition or on a discharge plan to another service or level of
27.30care. Documentation must comply with Minnesota Rules, parts 9505.2175 and 9505.2197.
27.31(j) Location of service delivery must be in the client's home, day care setting,
27.32school, or other community-based setting that is specified on the client's individualized
27.33treatment plan.
27.34(k) Treatment must be developmentally and culturally appropriate for the client.
27.35(l) Services must be delivered in continual collaboration and consultation with the
27.36client's medical providers and, in particular, with prescribers of psychotropic medications,
28.1including those prescribed on an off-label basis, and members of the service team must be
28.2aware of the medication regimen and potential side effects.
28.3(m) Parents, siblings, foster parents, and members of the child's permanency plan
28.4must be involved in treatment and service delivery unless otherwise noted in the treatment
28.5plan.
28.6(n) Transition planning for the child must be conducted starting with the first
28.7treatment plan and must be addressed throughout treatment to support the child's
28.8permanency plan and postdischarge mental health service needs.
28.9 Subd. 5.
Service authorization. The commissioner will administer authorizations
28.10for services under this section in compliance with section
256B.0625, subdivision 25.
28.11 Subd. 6.
Excluded services. (a) Services in clauses (1) to
(4) (7) are not
covered
28.12under this section and are not eligible
for medical assistance payment as components of
28.13intensive treatment
in foster care services
, but may be billed separately:
28.14(1) treatment foster care services provided in violation of medical assistance policy
28.15in Minnesota Rules, part 9505.0220;
28.16(2) service components of children's therapeutic services and supports
28.17simultaneously provided by more than one treatment foster care provider;
28.18(3) home and community-based waiver services; and
28.19(4) treatment foster care services provided to a child without a level of care
28.20determination according to section
245.4885, subdivision 1.
28.21(1) inpatient psychiatric hospital treatment;
28.22(2) mental health targeted case management;
28.23(3) partial hospitalization;
28.24(4) medication management;
28.25(5) children's mental health day treatment services;
28.26(6) crisis response services under section 256B.0944; and
28.27(7) transportation.
28.28(b) Children receiving
intensive treatment
in foster care services are not eligible for
28.29medical assistance reimbursement for the following services while receiving
intensive
28.30treatment
in foster care:
28.31(1) mental health case management services under section
256B.0625, subdivision
28.3220
; and
28.33(2) (1) psychotherapy and
skill skills training components of children's therapeutic
28.34services and supports under section
256B.0625, subdivision 35b.;
28.35(2) mental health behavioral aide services as defined in section 256B.0943,
28.36subdivision 1, paragraph (m);
29.1(3) home and community-based waiver services;
29.2(4) mental health residential treatment; and
29.3(5) room and board costs as defined in section 256I.03, subdivision 6.
29.4 Subd. 7. Medical assistance payment and rate setting. The commissioner shall
29.5establish a single daily per-client encounter rate for intensive treatment in foster care
29.6services. The rate must be constructed to cover only eligible services delivered to an
29.7eligible recipient by an eligible provider, as prescribed in subdivision 1, paragraph (b)."
29.8Page 174, line 24, before "
financial" insert "
the provider's"
29.9Page 176, line 12, after "
provider" insert "
, license holder, controlling individual,"
29.10Page 176, line 18, after "
provider" insert "
, license holder, or controlling individual"
29.11Page 176, line 19, after the comma, insert "
license holder, or controlling individual"
29.12Page 178, line 33, before "
appealed" insert "
timely"
29.13Page 178, lines 35 and 36, delete "
an" and insert "
a timely"
29.14Page 179, line 24, before "
action" and insert "
the"
29.15Page 179, line 25, delete "
and" and insert "
or" and before "
program" insert "
child
29.16care assistance"
29.17Page 179, line 26, delete "
an overpayment" and insert "
a financial misconduct
29.18sanction"
29.19Page 179, line 27, delete "
recovery action"
29.20Page 184, delete section 7 and insert:
29.21 "Sec. 7. Minnesota Statutes 2012, section 256B.064, subdivision 1a, is amended to read:
29.22 Subd. 1a.
Grounds for sanctions against vendors. The commissioner may
29.23impose sanctions against a vendor of medical care for any of the following: (1) fraud,
29.24theft, or abuse in connection with the provision of medical care to recipients of public
29.25assistance; (2) a pattern of presentment of false or duplicate claims or claims for services
29.26not medically necessary; (3) a pattern of making false statements of material facts for
29.27the purpose of obtaining greater compensation than that to which the vendor is legally
29.28entitled; (4) suspension or termination as a Medicare vendor; (5) refusal to grant the state
29.29agency access during regular business hours to examine all records necessary to disclose
29.30the extent of services provided to program recipients and appropriateness of claims for
29.31payment; (6) failure to repay an overpayment
or a fine finally established under this
29.32section;
and (7)
failure to correct errors in the maintenance of health service or financial
29.33records for which a fine was imposed or after issuance of a warning by the commissioner;
29.34and (8) any reason for which a vendor could be excluded from participation in the
29.35Medicare program under section 1128, 1128A, or 1866(b)(2) of the Social Security Act.
29.36The determination of services not medically necessary may be made by the commissioner
30.1in consultation with a peer advisory task force appointed by the commissioner on the
30.2recommendation of appropriate professional organizations. The task force expires as
30.3provided in section
15.059, subdivision 5.
30.4 Sec. 8. Minnesota Statutes 2012, section 256B.064, subdivision 1b, is amended to read:
30.5 Subd. 1b.
Sanctions available. The commissioner may impose the following
30.6sanctions for the conduct described in subdivision 1a: suspension or withholding of
30.7payments to a vendor and suspending or terminating participation in the program
, or
30.8imposition of a fine under subdivision 2, paragraph (f). When imposing sanctions under
30.9this section, the commissioner shall consider the nature, chronicity, or severity of the
30.10conduct and the effect of the conduct on the health and safety of persons served by the
30.11vendor. Regardless of imposition of sanctions, the commissioner may make a referral
30.12to the appropriate state licensing board.
30.13 Sec. 9. Minnesota Statutes 2012, section 256B.064, subdivision 2, is amended to read:
30.14 Subd. 2.
Imposition of monetary recovery and sanctions. (a) The commissioner
30.15shall determine any monetary amounts to be recovered and sanctions to be imposed upon
30.16a vendor of medical care under this section. Except as provided in paragraphs (b) and
30.17(d), neither a monetary recovery nor a sanction will be imposed by the commissioner
30.18without prior notice and an opportunity for a hearing, according to chapter 14, on the
30.19commissioner's proposed action, provided that the commissioner may suspend or reduce
30.20payment to a vendor of medical care, except a nursing home or convalescent care facility,
30.21after notice and prior to the hearing if in the commissioner's opinion that action is
30.22necessary to protect the public welfare and the interests of the program.
30.23(b) Except when the commissioner finds good cause not to suspend payments under
30.24Code of Federal Regulations, title 42, section
455.23 (e) or (f), the commissioner shall
30.25withhold or reduce payments to a vendor of medical care without providing advance
30.26notice of such withholding or reduction if either of the following occurs:
30.27(1) the vendor is convicted of a crime involving the conduct described in subdivision
30.281a; or
30.29(2) the commissioner determines there is a credible allegation of fraud for which an
30.30investigation is pending under the program. A credible allegation of fraud is an allegation
30.31which has been verified by the state, from any source, including but not limited to:
30.32(i) fraud hotline complaints;
30.33(ii) claims data mining; and
31.1(iii) patterns identified through provider audits, civil false claims cases, and law
31.2enforcement investigations.
31.3Allegations are considered to be credible when they have an indicia of reliability
31.4and the state agency has reviewed all allegations, facts, and evidence carefully and acts
31.5judiciously on a case-by-case basis.
31.6(c) The commissioner must send notice of the withholding or reduction of payments
31.7under paragraph (b) within five days of taking such action unless requested in writing by a
31.8law enforcement agency to temporarily withhold the notice. The notice must:
31.9(1) state that payments are being withheld according to paragraph (b);
31.10(2) set forth the general allegations as to the nature of the withholding action, but
31.11need not disclose any specific information concerning an ongoing investigation;
31.12(3) except in the case of a conviction for conduct described in subdivision 1a, state
31.13that the withholding is for a temporary period and cite the circumstances under which
31.14withholding will be terminated;
31.15(4) identify the types of claims to which the withholding applies; and
31.16(5) inform the vendor of the right to submit written evidence for consideration by
31.17the commissioner.
31.18The withholding or reduction of payments will not continue after the commissioner
31.19determines there is insufficient evidence of fraud by the vendor, or after legal proceedings
31.20relating to the alleged fraud are completed, unless the commissioner has sent notice of
31.21intention to impose monetary recovery or sanctions under paragraph (a).
31.22(d) The commissioner shall suspend or terminate a vendor's participation in the
31.23program without providing advance notice and an opportunity for a hearing when the
31.24suspension or termination is required because of the vendor's exclusion from participation
31.25in Medicare. Within five days of taking such action, the commissioner must send notice of
31.26the suspension or termination. The notice must:
31.27(1) state that suspension or termination is the result of the vendor's exclusion from
31.28Medicare;
31.29(2) identify the effective date of the suspension or termination; and
31.30(3) inform the vendor of the need to be reinstated to Medicare before reapplying
31.31for participation in the program.
31.32(e) Upon receipt of a notice under paragraph (a) that a monetary recovery or
31.33sanction is to be imposed, a vendor may request a contested case, as defined in section
31.3414.02, subdivision 3
, by filing with the commissioner a written request of appeal. The
31.35appeal request must be received by the commissioner no later than 30 days after the date
32.1the notification of monetary recovery or sanction was mailed to the vendor. The appeal
32.2request must specify:
32.3(1) each disputed item, the reason for the dispute, and an estimate of the dollar
32.4amount involved for each disputed item;
32.5(2) the computation that the vendor believes is correct;
32.6(3) the authority in statute or rule upon which the vendor relies for each disputed item;
32.7(4) the name and address of the person or entity with whom contacts may be made
32.8regarding the appeal; and
32.9(5) other information required by the commissioner.
32.10(f) The commissioner may order a vendor to forfeit a fine for failure to fully
32.11document services according to standards in this chapter and Minnesota Rules, chapter
32.129505. Fines may be assessed when the commissioner has no evidence that services were
32.13not provided and services are partially documented in the health service or financial
32.14record, but specific required components of documentation are missing. The fine for
32.15incomplete documentation shall equal 20 percent of the amount paid on the claims for
32.16reimbursement submitted by the vendor, or up to $5,000, whichever is less.
32.17(g) The vendor shall pay the fine assessed on or before the payment date specified. If
32.18the vendor fails to pay the fine, the commissioner may withhold or reduce payments and
32.19recover the amount of the fine. A timely appeal shall stay payment of the fine until the
32.20commissioner issues a final order.
32.21 Sec. 10. Minnesota Statutes 2012, section 256B.0659, subdivision 21, is amended to
32.22read:
32.23 Subd. 21.
Requirements for initial enrollment of personal care assistance
32.24provider agencies. (a) All personal care assistance provider agencies must provide, at the
32.25time of enrollment as a personal care assistance provider agency in a format determined
32.26by the commissioner, information and documentation that includes, but is not limited to,
32.27the following:
32.28 (1) the personal care assistance provider agency's current contact information
32.29including address, telephone number, and e-mail address;
32.30 (2) proof of surety bond coverage in the amount of
$50,000 $100,000 or ten percent
32.31of the provider's payments from Medicaid in the previous year, whichever is
less more.
32.32The performance bond must be in a form approved by the commissioner, must be renewed
32.33annually, and must allow for recovery of costs and fees in pursuing a claim on the bond;
32.34 (3) proof of fidelity bond coverage in the amount of $20,000;
32.35 (4) proof of workers' compensation insurance coverage;
33.1 (5) proof of liability insurance;
33.2 (6) a description of the personal care assistance provider agency's organization
33.3identifying the names of all owners, managing employees, staff, board of directors, and
33.4the affiliations of the directors, owners, or staff to other service providers;
33.5 (7) a copy of the personal care assistance provider agency's written policies and
33.6procedures including: hiring of employees; training requirements; service delivery;
33.7and employee and consumer safety including process for notification and resolution
33.8of consumer grievances, identification and prevention of communicable diseases, and
33.9employee misconduct;
33.10 (8) copies of all other forms the personal care assistance provider agency uses in
33.11the course of daily business including, but not limited to:
33.12 (i) a copy of the personal care assistance provider agency's time sheet if the time
33.13sheet varies from the standard time sheet for personal care assistance services approved
33.14by the commissioner, and a letter requesting approval of the personal care assistance
33.15provider agency's nonstandard time sheet;
33.16 (ii) the personal care assistance provider agency's template for the personal care
33.17assistance care plan; and
33.18 (iii) the personal care assistance provider agency's template for the written
33.19agreement in subdivision 20 for recipients using the personal care assistance choice
33.20option, if applicable;
33.21 (9) a list of all training and classes that the personal care assistance provider agency
33.22requires of its staff providing personal care assistance services;
33.23 (10) documentation that the personal care assistance provider agency and staff have
33.24successfully completed all the training required by this section;
33.25 (11) documentation of the agency's marketing practices;
33.26 (12) disclosure of ownership, leasing, or management of all residential properties
33.27that is used or could be used for providing home care services;
33.28 (13) documentation that the agency will use the following percentages of revenue
33.29generated from the medical assistance rate paid for personal care assistance services
33.30for employee personal care assistant wages and benefits: 72.5 percent of revenue in the
33.31personal care assistance choice option and 72.5 percent of revenue from other personal
33.32care assistance providers. The revenue generated by the qualified professional and the
33.33reasonable costs associated with the qualified professional shall not be used in making
33.34this calculation; and
33.35 (14) effective May 15, 2010, documentation that the agency does not burden
33.36recipients' free exercise of their right to choose service providers by requiring personal
34.1care assistants to sign an agreement not to work with any particular personal care
34.2assistance recipient or for another personal care assistance provider agency after leaving
34.3the agency and that the agency is not taking action on any such agreements or requirements
34.4regardless of the date signed.
34.5 (b) Personal care assistance provider agencies shall provide the information specified
34.6in paragraph (a) to the commissioner at the time the personal care assistance provider
34.7agency enrolls as a vendor or upon request from the commissioner. The commissioner
34.8shall collect the information specified in paragraph (a) from all personal care assistance
34.9providers beginning July 1, 2009.
34.10 (c) All personal care assistance provider agencies shall require all employees in
34.11management and supervisory positions and owners of the agency who are active in the
34.12day-to-day management and operations of the agency to complete mandatory training
34.13as determined by the commissioner before enrollment of the agency as a provider.
34.14Employees in management and supervisory positions and owners who are active in
34.15the day-to-day operations of an agency who have completed the required training as
34.16an employee with a personal care assistance provider agency do not need to repeat
34.17the required training if they are hired by another agency, if they have completed the
34.18training within the past three years. By September 1, 2010, the required training must
34.19be available with meaningful access according to title VI of the Civil Rights Act and
34.20federal regulations adopted under that law or any guidance from the United States Health
34.21and Human Services Department. The required training must be available online or by
34.22electronic remote connection. The required training must provide for competency testing.
34.23Personal care assistance provider agency billing staff shall complete training about
34.24personal care assistance program financial management. This training is effective July 1,
34.252009. Any personal care assistance provider agency enrolled before that date shall, if it
34.26has not already, complete the provider training within 18 months of July 1, 2009. Any new
34.27owners or employees in management and supervisory positions involved in the day-to-day
34.28operations are required to complete mandatory training as a requisite of working for the
34.29agency. Personal care assistance provider agencies certified for participation in Medicare
34.30as home health agencies are exempt from the training required in this subdivision. When
34.31available, Medicare-certified home health agency owners, supervisors, or managers must
34.32successfully complete the competency test.
34.33EFFECTIVE DATE.This section is effective the day following final enactment."
34.34Page 201, line 33, delete everything after the period and insert "
The commissioner
34.35shall discount the payment rate for drugs obtained through the federal 340B Drug Discount
34.36Program by 33 percent."
35.1Page 201, delete lines 34 and 35
35.2Page 201, line 36, delete "
commissioner."
35.3Page 202, after line 22, insert:
35.4 "Sec. 3. Minnesota Statutes 2012, section 256B.0625, subdivision 31, is amended to
35.5read:
35.6 Subd. 31.
Medical supplies and equipment. (a) Medical assistance covers medical
35.7supplies and equipment. Separate payment outside of the facility's payment rate shall
35.8be made for wheelchairs and wheelchair accessories for recipients who are residents
35.9of intermediate care facilities for the developmentally disabled. Reimbursement for
35.10wheelchairs and wheelchair accessories for ICF/MR recipients shall be subject to the same
35.11conditions and limitations as coverage for recipients who do not reside in institutions. A
35.12wheelchair purchased outside of the facility's payment rate is the property of the recipient.
35.13The commissioner may set reimbursement rates for specified categories of medical
35.14supplies at levels below the Medicare payment rate.
35.15(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies
35.16must enroll as a Medicare provider.
35.17(c) When necessary to ensure access to durable medical equipment, prosthetics,
35.18orthotics, or medical supplies, the commissioner may exempt a vendor from the Medicare
35.19enrollment requirement if:
35.20(1) the vendor supplies only one type of durable medical equipment, prosthetic,
35.21orthotic, or medical supply;
35.22(2) the vendor serves ten or fewer medical assistance recipients per year;
35.23(3) the commissioner finds that other vendors are not available to provide same or
35.24similar durable medical equipment, prosthetics, orthotics, or medical supplies; and
35.25(4) the vendor complies with all screening requirements in this chapter and Code of
35.26Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from
35.27the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare
35.28and Medicaid Services approved national accreditation organization as complying with
35.29the Medicare program's supplier and quality standards and the vendor serves primarily
35.30pediatric patients.
35.31(d) Durable medical equipment means a device or equipment that:
35.32(1) can withstand repeated use;
35.33(2) is generally not useful in the absence of an illness, injury, or disability; and
35.34(3) is provided to correct or accommodate a physiological disorder or physical
35.35condition or is generally used primarily for a medical purpose.
36.1(e) Electronic tablets may be considered durable medical equipment if the electronic
36.2tablet will be used as an augmentative and alternative communication system as defined
36.3under subdivision 31a, paragraph (a). To be covered by medical assistance, the device
36.4must be locked in order to prevent use not related to communication."
36.5Page 203, after line 14, insert:
36.6 "Sec. 5. Minnesota Statutes 2012, section 256B.0625, subdivision 39, is amended to
36.7read:
36.8 Subd. 39.
Childhood immunizations. Providers who administer pediatric vaccines
36.9within the scope of their licensure, and who are enrolled as a medical assistance provider,
36.10must enroll in the pediatric vaccine administration program established by section 13631
36.11of the Omnibus Budget Reconciliation Act of 1993. Medical assistance shall pay
an
36.12$8.50 fee per dose for administration of the vaccine to children eligible for medical
36.13assistance. Medical assistance does not pay for vaccines that are available at no cost from
36.14the pediatric vaccine administration program."
36.15Page 203, after line 20, insert:
36.16 "Sec. 7. Minnesota Statutes 2012, section 256B.76, is amended by adding a subdivision
36.17to read:
36.18 Subd. 7. Payment for certain primary care services and immunization
36.19administration. Payment for certain primary care services and immunization
36.20administration services rendered on or after January 1, 2013, through December 31, 2014,
36.21shall be made in accordance with section 1902(a)(13) of the Social Security Act.
36.22 Sec. 8. Minnesota Statutes 2012, section 256B.764, is amended to read:
36.23256B.764 REIMBURSEMENT FOR FAMILY PLANNING SERVICES.
36.24 (a) Effective for services rendered on or after July 1, 2007, payment rates for family
36.25planning services shall be increased by 25 percent over the rates in effect June 30, 2007,
36.26when these services are provided by a community clinic as defined in section
145.9268,
36.27subdivision 1.
36.28 (b) Effective for services rendered on or after July 1, 2013, payment rates for
36.29family planning services shall be increased by 20 percent over the rates in effect June
36.3030, 2013, when these services are provided by a community clinic as defined in section
36.31145.9268, subdivision 1. The commissioner shall adjust capitation rates to managed care
36.32and county-based purchasing plans to reflect this increase, and shall require plans to pass
36.33on the full amount of the rate increase to eligible community clinics, in the form of higher
36.34payment rates for family planning services.
37.1EFFECTIVE DATE.This section is effective July 1, 2013."
37.2Page 205, line 22, after "(2)" insert "
the license holder's beds occupied by residents
37.3whose primary diagnosis is mental illness and"
37.4Page 206, line 19, before "
The" insert "
(a)"
37.5Page 206, after line 22, insert:
37.6"
(b) For the purposes of this section, the commissioner has the authority to transfer
37.7funds between the medical assistance account and the home and community-based
37.8services transitions grants account."
37.9Page 207, lines 29 and 33, delete "
June" and insert "
September"
37.10Page 208, line 36, delete "
July" and insert "
October"
37.11Page 219, line 34, delete "
June" and insert "
September"
37.12Page 220, delete sections 14 and 15 and insert:
37.13 "Sec. 14. Minnesota Statutes 2012, section 256B.441, is amended by adding a
37.14subdivision to read:
37.15 Subd. 46b. Calculation of operating rate increase and quality add-on for the
37.16October 1, 2013, rate year. (a) Effective October 1, 2013, the commissioner shall
37.17implement operating payment rate increases for each facility. The increase shall be equal
37.18to 1.09 percent multiplied by the difference between the operating rates in effect on
37.19September 30, 2013, less any amount received under section 256B.434, subdivision 4.
37.20(b) The commissioner shall determine quality add-ons to the operating payment rates
37.21for each facility. The quality add-on amounts shall be based on rates in effect on September
37.2230, 2013, less any amount received under section 256B.434, subdivision 4. For each
37.23facility, the commissioner shall compute a quality factor by subtracting 40 from the most
37.24recent quality score computed under subdivision 44, and then dividing by 60. If the quality
37.25factor is less than zero, the commissioner shall use the value zero. The quality add-ons
37.26shall be the operating payment rates multiplied by the quality factor multiplied by 2.60
37.27percent. The commissioner shall implement the quality add-ons effective October 1, 2013.
37.28(c) Facilities receiving rate adjustments under subdivision 55a must have rate
37.29increases under paragraphs (a) and (b) computed based on their rates in effect before the
37.30increases given under subdivision 55a became effective. The amount of rate increases
37.31computed under this subdivision shall be added to the rates that the nursing facility would
37.32otherwise be paid without application of subdivision 55a.
37.33 Sec. 15. Minnesota Statutes 2012, section 256B.441, is amended by adding a
37.34subdivision to read:
38.1 Subd. 46c. Calculation of operating rate increase and quality add-on for the
38.2October 1, 2014, rate year. (a) Effective October 1, 2014, the commissioner shall
38.3implement operating payment rate increases for each facility. The increase shall be equal
38.4to 1.09 percent multiplied by the difference between the operating rates in effect on
38.5September 30, 2014, less any amount received under section 256B.434, subdivision 4.
38.6(b) The commissioner shall determine quality add-ons to the operating payment rates
38.7for each facility. The quality add-on amounts shall be based on rates in effect on September
38.830, 2014, less any amount received under section 256B.434, subdivision 4. For each
38.9facility, the commissioner shall compute a quality factor by subtracting 40 from the most
38.10recent quality score computed under subdivision 44, and then dividing by 60. If the quality
38.11factor is less than zero, the commissioner shall use the value zero. The quality add-ons
38.12shall be the operating payment rates multiplied by the quality factor multiplied by 2.60
38.13percent. The commissioner shall implement the quality add-ons effective October 1, 2014.
38.14(c) Facilities receiving rate adjustments under subdivision 55a must have rate
38.15increases under paragraphs (a) and (b) computed based on their rates before subdivision
38.1655a became effective. The amount of rate increases computed under this subdivision shall
38.17be added to the rates that the nursing facility would otherwise be paid without application
38.18of subdivision 55a, but after the increases computed in subdivision 46b."
38.19Page 221, delete sections 16 and 17 and insert:
38.20 "Sec. 16. Minnesota Statutes 2012, section 256B.441, is amended by adding a
38.21subdivision to read:
38.22 Subd. 46d. Calculation of quality add-on for the October 1, 2015, rate year. (a)
38.23The commissioner shall determine quality add-ons to the operating payment rates for each
38.24facility. The quality add-on amounts shall be based on rates in effect on September 30,
38.252015, less any amount received under section 256B.434, subdivision 4. For each facility,
38.26the commissioner shall compute a quality factor by subtracting 40 from the most recent
38.27quality score computed under subdivision 44, and then dividing by 60. If the quality factor
38.28is less than zero, the commissioner shall use the value zero. The quality add-ons shall be
38.29the operating payment rates multiplied by the quality factor multiplied by 5.40 percent.
38.30The commissioner shall implement the quality add-ons effective October 1, 2015.
38.31(b) Facilities receiving rate adjustments under subdivision 55a must have rate
38.32increases under paragraph (a) computed based on their rates before subdivision 55a
38.33became effective. The amount of rate increases computed under this subdivision shall be
38.34added to the rates that the nursing facility would otherwise be paid without application of
38.35subdivision 55a, but after the sum of the increases computed in subdivisions 46b and 46c.
39.1 Sec. 17. Minnesota Statutes 2012, section 256B.441, is amended by adding a
39.2subdivision to read:
39.3 Subd. 46e. Calculation of quality add-on for the October 1, 2016, rate year. (a)
39.4The commissioner shall determine quality add-ons to the operating payment rates for each
39.5facility. The quality add-on amounts shall be based on rates in effect on September 30,
39.62016, less any amount received under section 256B.434, subdivision 4. For each facility,
39.7the commissioner shall compute a quality factor by subtracting 40 from the most recent
39.8quality score computed under subdivision 44, and then dividing by 60. If the quality factor
39.9is less than zero, the commissioner shall use the value zero. The quality add-ons shall be
39.10the operating payment rates multiplied by the quality factor multiplied by 5.40 percent.
39.11The commissioner shall implement the quality add-ons effective October 1, 2016.
39.12(b) Facilities receiving rate adjustments under subdivision 55a must have rate
39.13increases under paragraph (a) computed based on their rates before subdivision 55a
39.14became effective. The amount of rate increases computed under this subdivision shall be
39.15added to the rates that the nursing facility would otherwise be paid without application of
39.16subdivision 55a, but after the sum of the increases computed in subdivisions 46b to 46d."
39.17Page 222, line 12, delete "
June" and insert "
September"
39.18Page 226, line 5, delete "
developmental disabilities waiver" and insert "
brain injury,
39.19community alternatives for disabled individuals, or community alternative care waivers"
39.20Page 227, after line 23, insert:
39.21 "Sec. 27.
REPEALER.
39.22 Minnesota Statutes 2012, section 256B.5012, subdivision 13, and Laws 2011, First
39.23Special Session chapter 9, article 7, section 54, as amended by Laws 2012, chapter 247,
39.24article 4, section 42, and Laws 2012, chapter 298, section 3, are repealed."
39.25Page 229, line 4, delete everything after the period
39.26Page 229, delete line 5
39.27Page 229, line 7, delete "
aversive and"
39.28Page 229, line 8, delete "
for" and insert "
with persons receiving services from
39.29providers regulated under Minnesota Rules, parts 9525.2700 to 9525.2810, and incidents
39.30involving persons receiving services from"
39.31Page 229, line 9, delete everything after the period and insert "
Providers shall report
39.32the data in a format and at a frequency provided by the commissioner of human services."
39.33Page 229, delete lines 10 to 13 and insert:
39.34"
(b) Beginning July 1, 2013, providers regulated under Minnesota Rules, parts
39.359525.2700 to 9525.2810, shall submit data regarding the use of all controlled procedures
39.36in a format and at a frequency provided by the commissioner."
40.1Page 232, after line 29, insert:
40.2 "Sec. 7. Minnesota Statutes 2012, section 245A.03, subdivision 8, is amended to read:
40.3 Subd. 8.
Excluded providers seeking licensure. Nothing in this section shall
40.4prohibit a program that is excluded from licensure under subdivision 2, paragraph
40.5(a), clause
(28) (26), from seeking licensure. The commissioner shall ensure that any
40.6application received from such an excluded provider is processed in the same manner as
40.7all other applications for child care center licensure."
40.8Page 251, after line 26, insert:
40.9 "
Subd. 2a. Authorized representative. "Authorized representative" means a parent,
40.10family member, advocate, or other adult authorized by the person or the person's legal
40.11representative, to serve as a representative in connection with the provision of services
40.12licensed under this chapter. This authorization must be in writing or by another method
40.13that clearly indicates the person's free choice. The authorized representative must have no
40.14financial interest in the provision of any services included in the person's service delivery
40.15plan and must be capable of providing the support necessary to assist the person in the use
40.16of home and community-based services licensed under this chapter."
40.17Page 253, line 8, delete "
person's conduct" and insert "
person"
40.18Page 253, line 9, delete everything after "
and" and insert "
is the least restrictive
40.19intervention that would achieve safety."
40.20Page 253, line 13, after "
health" insert "
or mental health"
40.21Page 255, line 8, delete everything after the period and insert "
Other representatives
40.22with legal authority to make decisions include but are not limited to a health care agent or
40.23an attorney-in-fact authorized through a health care directive or power of attorney"
40.24Page 255, delete lines 9 to 11
40.25Page 258, lines 22 and 27, after "
plan" insert "
or coordinated service and support
40.26plan addendum"
40.27Page 259, line 2, after the period, insert "
For the purpose of chapter 245D, "time out"
40.28does not mean voluntary removal or self-removal for the purpose of calming, prevention
40.29of escalation, or de-escalation of behavior for a period of up to 15 minutes. "Time out"
40.30does not include a person voluntarily moving from an ongoing activity to an unlocked
40.31room or otherwise separating from a situation or social contact with others if the person
40.32chooses. For the purposes of this definition, "voluntarily" means without being forced,
40.33compelled, or coerced."
40.34Page 259, line 7, after "
health" insert "
or mental health"
40.35Page 260, line 16, after "
training" insert "
treatment,"
40.36Page 263, after line 20, insert:
41.1 "
Subd. 4. Program certification. An applicant or a license holder may apply for
41.2program certification as identified in section 245D.33."
41.3Page 263, delete section 18
41.4Page 271, line 13, delete "
community" and insert "
coordinated"
41.5Page 272, delete lines 27 to 30 and insert:
41.6"
(d) If a person is prescribed a psychotropic medication, monitoring the use of the
41.7psychotropic medication must be assigned to the license holder in the coordinated service
41.8and support plan or the coordinated service and support plan addendum. The assigned
41.9license holder must monitor the psychotropic medication as required by this section."
41.10Page 273, delete lines 10 and 11
41.11Page 273, after line 34, insert:
41.12"
(f) When a death or serious injury occurs in a facility certified as an intermediate
41.13care facility for persons with developmental disabilities, the death or serious injury must
41.14be reported to the Department of Health, Office of Health Facility Complaints, and the
41.15Office of Ombudsman for Mental Health and Developmental Disabilities, as required
41.16under sections 245.91 and 245.94, subdivision 2a, unless the license holder has reason to
41.17know that the death has already been reported."
41.18Page 274, line 1, strike "(f)" and insert "
(g)"
41.19Page 274, line 13, delete "
(g)" and insert "
(h)" and after "
must" insert "
verbally"
41.20Page 274, line 14, delete "
and to the Department of Human Services Licensing"
41.21Page 274, line 15, delete "
Division" and delete "
conduct an" and insert "
ensure the
41.22written report and"
41.23Page 274, line 16, after "
restraints" insert "
are completed"
41.24Page 275, line 6, after "
plan" insert "
or coordinated service and support plan
41.25addendum"
41.26Page 275, strike line 19
41.27Page 275, line 20, delete the new language and strike the old language
41.28Page 275, strike lines 21 to 23
41.29Page 278, line 3, after "
(2)" insert "
the type of" and after "
restraint" insert "
used"
41.30and delete "
possible"
41.31Page 278, line 4, delete everything after "
safety" and insert "
. The manual restraint
41.32must end when the threat of harm ends."
41.33Page 278, delete line 5
41.34Page 278, line 19, after "
plan" insert "
addendum"
41.35Page 279, line 27, delete "
The license" and insert "
Within three calendar days after
41.36an emergency use of a manual restraint, the staff person who implemented the emergency
42.1use must report in writing to the designated coordinator the following information about
42.2the emergency use:"
42.3Page 279, delete lines 28 to 30
42.4Page 282, line 11, delete "
and"
42.5Page 282, after line 13, insert:
42.6"
(vii) the communicative intent of behaviors; and
42.7(viii) relationship building;"
42.8Page 283, line 28, after "planning" insert "
requirements for basic support services"
42.9Page 283, line 31, delete "
service plan" and insert "
coordinated service and support
42.10plan addendum"
42.11Page 283, line 32, delete "
develop and"
42.12Page 283, delete line 33 and insert "
review and revise as needed the preliminary
42.13coordinated service and support plan addendum to document the services that"
42.14Page 284, line 13, after "
245D.07" insert "
, subdivisions 1 and 3,"
42.15Page 284, line 18, delete "
service plan" and insert "
coordinated service and support
42.16plan addendum"
42.17Page 285, line 20, delete "
developed under" and insert "
to be implemented to support
42.18the accomplishment of outcomes related to acquiring, retaining, or improving skills"
42.19Page 285, line 21, delete "
paragraph (a)"
42.20Page 286, line 11, after "
plan" insert "
or coordinated service and support plan
42.21addendum"
42.22Page 287, delete lines 35 and 36 and insert:
42.23"
(4) a minimum of 50 hours of education and training related to human services
42.24and disabilities, and"
42.25Page 288, line 2, after "
older" insert "
under the supervision of a staff person who
42.26meets the qualifications identified in clauses (1) to (3)"
42.27Page 289, lines 13 and 25, after "
plan" insert "
or coordinated service and support
42.28plan addendum"
42.29Page 289, line 18, after "plan" insert "
or coordinated service and support plan
42.30addendum"
42.31Page 291, line 5, after "plan" insert "
or coordinated service and support plan
42.32addendum"
42.33Page 296, line 29, after "
plan" insert "
or coordinated service and support plan
42.34addendum"
42.35Page 297, line 18, after "
plan" insert "
or coordinated service and support plan
42.36addendum"
43.1Page 298, line 8, after "
plan" insert "
or coordinated service and support plan
43.2addendum"
43.3Page 301, line 6, strike "revised policies and procedures" and insert "
procedural
43.4revisions to policies" and after "person's" insert "
service-related or protection-related"
43.5Page 301, line 7, after "254D.04" insert "
and maltreatment reporting policies and
43.6procedures"
43.7Page 301, line 8, strike "reason" and insert "
reasonable cause"
43.8Page 301, after line 12, insert:
43.9"
(e) The license holder must annually notify all persons, or their legal representatives,
43.10and case managers of any procedural revisions to policies required under this chapter,
43.11other than those in paragraph (c). Upon request, the license holder must provide the
43.12person, or the person's legal representative, and case manager with copies of the revised
43.13policies and procedures."
43.14Page 303, line 2, delete everything before the comma and insert "
coordinated service
43.15and support plan addendum"
43.16Page 304, line 2, after the semicolon, insert "
and"
43.17Page 304, delete lines 3 to 7
43.18Page 304, line 11, after the period, insert "
The license holder must not refuse to
43.19admit a person based solely on the type of residential services the person is receiving, or
43.20solely on the person's severity of disability, orthopedic or neurological handicaps, sight
43.21or hearing impairments, lack of communication skills, physical disabilities, toilet habits,
43.22behavioral disorders, or past failure to make progress."
43.23Page 306, line 10, delete "
must be" and after "
aid" insert "
must be available on site"
43.24Page 306, line 11, after "
plan" insert "
or coordinated service and support plan
43.25addendum" and delete everything after "
resuscitation," and insert "
whenever persons are
43.26present and staff are required to be at the site to provide direct service. The training must
43.27include in-person instruction, hands-on practice, and an observed skills assessment under
43.28the direct supervision of a first aid instructor."
43.29Page 306, delete line 12
43.30Page 309, line 15, after the period, insert "
A person may choose to use a mattress
43.31other than an innerspring mattress and may choose to not have the mattress on a mattress
43.32frame or support."
43.33Page 309, line 17, after the period, insert "
If a person chooses to use a mattress other
43.34than an innerspring mattress or chooses to not have a mattress frame or support, the license
43.35holder must document this choice and allow the alternative desired by the person."
43.36Page 311, line 28, delete "
and each staff person or employee"
44.1Page 318, after line 17, insert:
44.2 "Sec. 45. Minnesota Statutes 2012, section 256B.092, subdivision 11, is amended to
44.3read:
44.4 Subd. 11.
Residential support services. (a) Upon federal approval, there is
44.5established a new service called residential support that is available on the community
44.6alternative care, community alternatives for disabled individuals, developmental
44.7disabilities, and brain injury waivers. Existing waiver service descriptions must be
44.8modified to the extent necessary to ensure there is no duplication between other services.
44.9Residential support services must be provided by vendors licensed as a community
44.10residential setting as defined in section
245A.11, subdivision 8, a foster care setting
44.11licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or an adult foster care
44.12setting licensed under Minnesota Rules, parts 9555.5105 to 9555.6265.
44.13 (b) Residential support services must meet the following criteria:
44.14 (1) providers of residential support services must own or control the residential site;
44.15 (2) the residential site must not be the primary residence of the license holder;
44.16 (3) (1) the residential site must have a designated
program supervisor person
44.17 responsible for program
management, oversight, development, and implementation of
44.18policies and procedures;
44.19 (4) (2) the provider of residential support services must provide supervision, training,
44.20and assistance as described in the person's coordinated service and support plan; and
44.21 (5) (3) the provider of residential support services must meet the requirements of
44.22licensure and additional requirements of the person's coordinated service and support plan.
44.23 (c) Providers of residential support services that meet the definition in paragraph (a)
44.24must be registered using a process determined by the commissioner beginning July 1, 2009
44.25 must be licensed according to chapter 245D. Providers licensed to provide child foster care
44.26under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult foster care licensed under
44.27Minnesota Rules, parts 9555.5105 to 9555.6265, and that meet the requirements in section
44.28245A.03, subdivision 7
, paragraph (g), are considered registered under this section."
44.29Page 319, after line 13, insert:
44.30 "Sec. 48. Minnesota Statutes 2012, section 256B.4912, is amended by adding a
44.31subdivision to read:
44.32 Subd. 8. Data on use of emergency use of manual restraint. Beginning July 1,
44.332013, facilities and services to be licensed under chapter 245D shall submit data regarding
44.34the use of emergency use of manual restraint as identified in section 245D.061 in a format
44.35and at a frequency identified by the commissioner."
44.36Page 319, line 16, delete "
8" and insert "
9"
45.1Page 319, line 29, delete "
9" and insert "
10"
45.2Page 322, delete lines 24 and 25
45.3Page 322, line 26, delete "
(c)" and insert "
(b)"
45.4Page 349, line 21, before "
The" insert "
For providers regulated pursuant to sections
45.5144A.043 to 144A.482,"
45.6Page 350, lines 3, 16, and 23, before "
The" insert "
For providers regulated pursuant
45.7to sections 144A.043 to 144A.482,"
45.8Page 373, line 30, delete "
determination of" and insert "
failure to report"
45.9Page 373, line 31, delete everything after "
626.557" and insert a semicolon
45.10Page 373, delete lines 32 and 33
45.11Page 373, before line 34 insert:
45.12"
(2) failure to establish and implement procedures for reporting suspected
45.13maltreatment under section 144A.479, subdivision 6, paragraph (a);
45.14(3) failure to complete and implement an abuse prevention plan under section
45.15144.479, subdivision 6, paragraph (b);"
45.16Renumber the clauses in sequence
45.17Page 410, delete section 4 and insert:
45.18 "Sec. 4. Minnesota Statutes 2012, section 144.125, subdivision 1, is amended to read:
45.19 Subdivision 1.
Duty to perform testing. (a) It is the duty of (1) the administrative
45.20officer or other person in charge of each institution caring for infants 28 days or less
45.21of age, (2) the person required in pursuance of the provisions of section
144.215, to
45.22register the birth of a child, or (3) the nurse midwife or midwife in attendance at the
45.23birth, to arrange to have administered to every infant or child in its care tests for heritable
45.24and congenital disorders according to subdivision 2 and rules prescribed by the state
45.25commissioner of health.
45.26 (b) Testing
and the, recording
and of test results, reporting of test results
, and
45.27follow-up of infants with heritable congenital disorders, including hearing loss detected
45.28through the early hearing detection and intervention program in section 144.966, shall be
45.29performed at the times and in the manner prescribed by the commissioner of health.
The
45.30commissioner shall charge a fee so that the total of fees collected will approximate the
45.31costs of conducting the tests and implementing and maintaining a system to follow-up
45.32infants with heritable or congenital disorders, including hearing loss detected through the
45.33early hearing detection and intervention program under section
144.966.
45.34 (c) The fee
is $101 per specimen. Effective July 1, 2010, the fee shall be increased
45.35to $106 to support the newborn screening program, including tests administered under
45.36this section and section 144.966, shall be $135 per specimen.
The increased fee amount
46.1shall be deposited in the general fund. Costs associated with capital expenditures and
46.2the development of new procedures may be prorated over a three-year period when
46.3calculating the amount of the fees. This fee amount shall be deposited in the state treasury
46.4and credited to the state government special revenue fund.
46.5(d) The fee to offset the cost of the support services provided under section 144.966,
46.6subdivision 3a, shall be $5 per specimen. This fee shall be deposited in the state treasury
46.7and credited to the general fund."
46.8Page 412, after line 8, insert:
46.9 "Sec. 17. Minnesota Statutes 2012, section 144.966, subdivision 2, is amended to read:
46.10 Subd. 2.
Newborn Hearing Screening Advisory Committee. (a) The
46.11commissioner of health shall establish a Newborn Hearing Screening Advisory Committee
46.12to advise and assist the Department of Health and the Department of Education in:
46.13 (1) developing protocols and timelines for screening, rescreening, and diagnostic
46.14audiological assessment and early medical, audiological, and educational intervention
46.15services for children who are deaf or hard-of-hearing;
46.16 (2) designing protocols for tracking children from birth through age three that may
46.17have passed newborn screening but are at risk for delayed or late onset of permanent
46.18hearing loss;
46.19 (3) designing a technical assistance program to support facilities implementing the
46.20screening program and facilities conducting rescreening and diagnostic audiological
46.21assessment;
46.22 (4) designing implementation and evaluation of a system of follow-up and tracking;
46.23and
46.24 (5) evaluating program outcomes to increase effectiveness and efficiency and ensure
46.25culturally appropriate services for children with a confirmed hearing loss and their families.
46.26 (b) The commissioner of health shall appoint at least one member from each of the
46.27following groups with no less than two of the members being deaf or hard-of-hearing:
46.28 (1) a representative from a consumer organization representing culturally deaf
46.29persons;
46.30 (2) a parent with a child with hearing loss representing a parent organization;
46.31 (3) a consumer from an organization representing oral communication options;
46.32 (4) a consumer from an organization representing cued speech communication
46.33options;
46.34 (5) an audiologist who has experience in evaluation and intervention of infants
46.35and young children;
47.1 (6) a speech-language pathologist who has experience in evaluation and intervention
47.2of infants and young children;
47.3 (7) two primary care providers who have experience in the care of infants and young
47.4children, one of which shall be a pediatrician;
47.5 (8) a representative from the early hearing detection intervention teams;
47.6 (9) a representative from the Department of Education resource center for the deaf
47.7and hard-of-hearing or the representative's designee;
47.8 (10) a representative of the Commission of Deaf, DeafBlind and Hard-of-Hearing
47.9Minnesotans;
47.10 (11) a representative from the Department of Human Services Deaf and
47.11Hard-of-Hearing Services Division;
47.12 (12) one or more of the Part C coordinators from the Department of Education, the
47.13Department of Health, or the Department of Human Services or the department's designees;
47.14 (13) the Department of Health early hearing detection and intervention coordinators;
47.15 (14) two birth hospital representatives from one rural and one urban hospital;
47.16 (15) a pediatric geneticist;
47.17 (16) an otolaryngologist;
47.18 (17) a representative from the Newborn Screening Advisory Committee under
47.19this subdivision; and
47.20 (18) a representative of the Department of Education regional low-incidence
47.21facilitators.
47.22The commissioner must complete the appointments required under this subdivision by
47.23September 1, 2007.
47.24 (c) The Department of Health member shall chair the first meeting of the committee.
47.25At the first meeting, the committee shall elect a chair from its membership. The committee
47.26shall meet at the call of the chair, at least four times a year. The committee shall adopt
47.27written bylaws to govern its activities. The Department of Health shall provide technical
47.28and administrative support services as required by the committee. These services shall
47.29include technical support from individuals qualified to administer infant hearing screening,
47.30rescreening, and diagnostic audiological assessments.
47.31 Members of the committee shall receive no compensation for their service, but
47.32shall be reimbursed as provided in section
15.059 for expenses incurred as a result of
47.33their duties as members of the committee.
47.34 (d) This subdivision expires June 30,
2013 2019."
47.35Page 426, line 4, delete "
for licensing" and insert "
to license and operate"
47.36Page 428, line 9, delete "
data" and insert "
date"
48.1Page 441, line 22, delete "
training which" and insert "
procedures"
48.2Page 441, line 23, delete everything before "
for"
48.3Page 441, line 24, after "
personnel" insert a comma
48.4Page 442, line 4, delete "
place" and insert "
placed"
48.5Page 442, line 33, delete "
4" and insert "
12"
48.6Page 444, line 35, delete "
by certified alkaline hydrolysis facility staff"
48.7Page 444, line 36, after "
remains" insert "
, only by staff licensed or registered by the
48.8commissioner of health"
48.9Page 447, line 5, delete "
20" and insert "
29"
48.10Page 447, after line 33, insert:
48.12HUMAN SERVICES FORECAST ADJUSTMENTS
48.13
|
Section 1. DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.
|
48.14The dollar amounts shown are added to or, if shown in parentheses, are subtracted
48.15from the appropriations in Laws 2011, First Special Session chapter 9, article 10, as
48.16amended by Laws 2012, chapter 247, article 6, and Laws 2012, chapter 292, article 3,
48.17from the general fund, or any other fund named, to the Department of Human Services for
48.18the purposes specified in this article, to be available for the fiscal years indicated for each
48.19purpose. The figure "2013" used in this article means that the appropriations listed under
48.20them are available for the fiscal year ending June 30, 2013.
48.21
48.22
|
Sec. 2. COMMISSIONER OF HUMAN
SERVICES
|
|
|
|
|
48.23
|
Subdivision 1.Total Appropriation
|
$
|
(161,031,000)
|
|
|
48.24
|
Appropriations by Fund
|
48.25
|
|
2013
|
|
48.26
|
General Fund
|
(158,668,000)
|
|
48.27
|
Health Care Access
|
(7,179,000)
|
|
48.28
|
TANF
|
4,816,000
|
|
48.29
|
Subd. 2.Forecasted Programs
|
|
|
|
|
48.30
|
(a) MFIP/DWP Grants
|
|
|
|
|
|
48.31
|
Appropriations by Fund
|
48.32
|
General Fund
|
(8,211,000)
|
|
48.33
|
TANF
|
4,399,000
|
|
48.34
|
(b) MFIP Child Care Assistance Grants
|
|
10,113,000
|
|
|
49.1
|
(c) General Assistance Grants
|
|
3,230,000
|
|
|
49.2
|
(d) Minnesota Supplemental Aid Grants
|
|
(1,008,000)
|
|
|
49.3
|
(e) Group Residential Housing Grants
|
|
(5,423,000)
|
|
|
49.4
|
(f) MinnesotaCare Grants
|
|
(7,179,000)
|
|
|
49.5This appropriation is from the health care
49.6access fund.
49.7
|
(g) Medical Assistance Grants
|
|
(159,733,000)
|
|
|
49.8
|
(h) Alternative Care Grants
|
|
-0-
|
|
|
49.9
|
(i) CD Entitlement Grants
|
|
2,364,000
|
|
|
49.10
|
Subd. 3.Technical Activities
|
|
417,000
|
|
|
49.11This appropriation is from the TANF fund.
49.12 Sec. 3.
EFFECTIVE DATE.
49.13Sections 1 and 2 are effective the day following final enactment."
49.14Page 448, delete section 1 and insert:
49.15
|
"Section 1. SUMMARY OF APPROPRIATIONS.
|
49.16The amounts shown in this section summarize direct appropriations, by fund, made
49.17in this article.
49.18
|
|
|
2014
|
|
2015
|
|
Total
|
49.19
|
General
|
$
|
5,648,596,000
|
$
|
5,914,450,000
|
$
|
11,563,046,000
|
49.20
49.21
|
State Government Special
Revenue
|
|
70,996,000
|
|
73,066,000
|
|
144,062,000
|
49.22
|
Health Care Access
|
|
597,449,000
|
|
424,738,000
|
|
1,022,187,000
|
49.23
|
Federal TANF
|
|
269,628,000
|
|
266,526,000
|
|
536,154,000
|
49.24
|
Lottery Prize Fund
|
|
1,665,000
|
|
1,665,000
|
|
3,330,000
|
49.25
|
Total
|
$
|
6,588,334,000
|
$
|
6,680,445,000
|
$
|
13,268,779,000"
|
49.26Page 448, line 28, delete "
6,418,000,000" and insert "
6,460,239,000" and delete
49.27"
6,382,943,000" and insert "
6,493,273,000"
49.28Page 448, line 31, delete "
5,564,459,000" and insert "
5,565,387,000" and delete
49.29"
5,899,531,000" and insert "
5,836,434,000"
49.30Page 448, line 34, delete "
589,992,000" and insert "
631,207,000" and delete
49.31"
218,768,000" and insert "
394,096,000"
49.32Page 448, line 35, delete "
257,819,000" and insert "
257,915,000" and delete
49.33"
256,714,000" and insert "
254,813,000"
50.1Page 454, line 8, delete "
96,928,000" and insert "
98,727,000" and delete
50.2"
91,123,000" and insert "
94,277,000"
50.3Page 454, line 11, delete "
12,453,000" and insert "
13,177,000" and delete
50.4"
12,453,000" and insert "
13,004,000"
50.5Page 455, line 11, delete "
$1,883,000" and insert "
$1,825,000"
50.6Page 455, line 12, delete "
$2,347,000" and insert "
$2,502,000"
50.7Page 455, line 16, delete "
$3,219,000" and insert "
$3,222,000"
50.8Page 455, line 17, delete "
$3,062,000" and insert "
$3,037,000"
50.9Page 455, line 19, delete "
$6,085,000" and insert "
$6,662,000" and delete "
is" and
50.10insert "
and $1,148,000 in fiscal year 2015 are"
50.11Page 455, line 25, delete "
$6,085,000" and insert "
$6,662,000"
50.12Page 455, line 26, after "
appropriation" insert "
in fiscal year 2014 and the $1,148,000
50.13appropriation in fiscal year 2015"
50.14Page 456, line 10, delete "
$18,814,000" and insert "
$16,992,000"
50.15Page 456, line 12, delete "
$6,813,000" and insert "
$6,099,000"
50.16Page 456, line 13, delete "
$2,672,000" and insert "
$1,185,000" and after the period,
50.17insert "
The health access fund base is decreased by $551,000 in fiscal years 2016 and 2017."
50.18Page 456, line 16, delete "
7,967,000" and insert "
8,082,000" and delete "
7,910,000"
50.19and insert "
8,018,000"
50.20Page 456, line 34, delete "
$94,000" and insert "
$300,000"
50.21Page 457, line 5, delete "
13,817,000" and insert "
13,843,000" and delete
50.22"
13,530,000" and insert "
13,639,000"
50.23Page 457, line 6, delete "
24,602,000" and insert "
26,404,000" and delete
50.24"
22,634,000" and insert "
29,914,000"
50.25Page 457, line 8, delete "
$1,842,000" and insert "
$8,177,000"
50.26Page 457, line 9, before the period, insert "
and by $6,712,000 in fiscal year 2017"
50.27Page 457, line 12, delete "
19,414,000" and insert "
19,503,000" and delete
50.28"
20,769,000" and insert "
21,044,000"
50.29Page 457, line 20, delete "
$9,207,000" and insert "
$3,324,000"
50.30Page 457, line 21, delete "
$9,182,000" and insert "
$3,324,000"
50.31Page 457, line 24, delete "
4,482,000" and insert "
4,494,000" and delete "
4,282,000"
50.32and insert "
4,294,000"
50.33Page 457, line 31, delete "
77,783,000" and insert "
73,742,000" and delete
50.34"
75,831,000" and insert "
75,261,000"
50.35Page 457, line 32, delete "
77,846,000" and insert "
80,342,000" and delete
50.36"
78,452,000" and insert "
76,851,000"
51.1Page 457, line 33, delete "
58,771,000" and insert "
64,316,000" and delete
51.2"
63,383,000" and insert "
68,536,000"
51.3Page 458, line 1, delete "
54,259,000" and insert "
54,787,000" and delete
51.4"
55,566,000" and insert "
56,068,000"
51.5Page 458, line 19, delete "
38,642,000" and insert "
38,646,000" and delete
51.6"
39,814,000" and insert "
39,821,000"
51.7Page 458, line 20, delete "
138,614,000" and insert "
141,138,000" and delete
51.8"
148,515,000" and insert "
150,988,000"
51.9Page 458, line 26, delete "
233,186,000" and insert "
296,581,000" and delete
51.10"
38,928,000" and insert "
227,598,000"
51.11Page 458, delete lines 27 to 31
51.12Page 459, line 2, delete "
4,362,916,000" and insert "
4,348,570,000" and delete
51.13"
4,676,238,000" and insert "
4,602,815,000"
51.14Page 459, line 3, delete "
318,811,000" and insert "
292,067,000" and delete
51.15"
143,813,000" and insert "
121,417,000"
51.16Page 459, line 8, delete "
46,452,000" and insert "
46,653,000" and delete
51.17"
44,650,000" and insert "
44,500,000"
51.18Page 459, line 18, delete "
79,807,000" and insert "
81,440,000" and delete
51.19"
81,169,000" and insert "
74,875,000"
51.20Page 459, line 28, delete "
9,833,000" and insert "
13,333,000" and delete
51.21"
11,633,000" and insert "
13,333,000"
51.22Page 459, line 29, delete "
98,111,000" and insert "
94,611,000" and delete
51.23"
96,311,000" and insert "
94,611,000"
51.24Page 459, line 30, delete "
$668,000" and insert "
$2,168,000"
51.25Page 459, line 31, delete "
, and $1,500,000"
51.26Page 459, delete line 32
51.27Page 460, line 19, delete "
in fiscal year 2014 is from the" and insert "
each year"
51.28Page 460, delete line 20
51.29Page 460, line 21, delete "
fiscal year 2015"
51.30Page 460, line 30, delete "
in fiscal year 2014" and insert "
each year"
51.31Page 460, line 31, delete "
, and $200,000 in"
51.32Page 460, delete line 32
51.33Page 460, line 33, delete "
fund,"
51.34Page 461, delete lines 1 to 3 and insert "
The TANF fund base is increased by
51.35$200,000 in fiscal years 2016 and 2017."
51.36Page 461, line 17, delete "
$2,918,000" and insert "
$4,618,000"
52.1Page 461, line 18, after the period, insert "
The TANF fund base is increased by
52.2$1,700,000 in fiscal years 2016 and 2017."
52.3Page 461, line 20, delete "
39,900,000" and insert "
40,351,000" and delete
52.4"
42,894,000" and insert "
43,658,000"
52.5Page 461, line 22, delete "
$1,442,000" and insert "
$1,278,000"
52.6Page 461, line 23, delete "
$1,552,000" and insert "
$1,349,000"
52.7Page 462, delete lines 29 to 31
52.8Page 462, line 32, delete "
16,222,000" and insert "
18,897,000" and delete
52.9"
16,223,000" and insert "
18,903,000"
52.10Page 463, after line 3, insert:
52.11"
Family Assets for Independence.
52.12 $250,000 each year is for the Family Assets
52.13for Independence Minnesota program. This
52.14appropriation is available in either year of the
52.15biennium and may be transferred between
52.16fiscal years. This appropriation is added to
52.17the base."
52.18Page 463, line 7, delete "
190,000" and insert "
2,228,000" and delete "
190,000" and
52.19insert "
1,413,000"
52.20Page 463, after line 7, insert:
52.21"
Base Adjustment. The health care access
52.22fund is decreased by $1,223,000 in fiscal
52.23years 2016 and 2017."
52.24Page 463, delete lines 22 to 24
52.25Page 463, line 26, delete "
17,895,000" and insert "
18,048,000"
52.26Page 463, line 32, delete "
$1,016,000" and insert "
$502,000"
52.27Page 463, line 33, delete "
$1,190,000" and insert "
$676,000"
52.28Page 464, line 3, delete "
68,310,000" and insert "
68,803,000"
52.29Page 464, line 12, delete "
$5,802,000" and insert "
$4,461,000"
52.30Page 465, line 9, delete "
$2,000,000" and insert "
$1,000,000"
52.31Page 465, line 11, delete "
and"
52.32Page 465, line 14, before the period, insert "
, and up to $2,713,000 each year is
52.33available for the purposes of paragraph (b), clause (3), of that subdivision"
52.34Page 465, after line 28 insert:
52.35
|
"Subd. 10.Transfer.
|
|
|
|
|
53.1The commissioner of management and
53.2budget must transfer $65,000,000 in fiscal
53.3year 2014 from the general fund to the health
53.4care access fund. This is a onetime transfer."
53.5Page 466, line 2, delete "
49,515,000" and insert "
50,203,000" and delete
53.6"
50,076,000" and insert "
50,123,000"
53.7Page 468, line 11, delete "
15,849,000" and insert "
16,537,000" and delete
53.8"
16,407,000" and insert "
16,454,000"
53.9Page 468, line 15, delete "
$20,000" and insert "
$2,000" and delete "
years 2016"
53.10and insert "
year 2017."
53.11Page 468, line 16, delete "
and 2017."
53.12Renumber the articles and sections in sequence and correct the internal references
53.13Amend the title as follows:
53.14Page 1, line 11, delete "repealing"
53.15Page 1, line 12, delete "MinnesotaCare;"
53.16Correct the title numbers accordingly