Bill Text: MN SF1472 | 2011-2012 | 87th Legislature | Introduced
Bill Title: Home and community-based service waiver recipients housing provision modification
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Introduced - Dead) 2011-05-22 - Referred to Health and Human Services [SF1472 Detail]
Download: Minnesota-2011-SF1472-Introduced.html
1.2relating to human services; modifying housing provisions for certain home and
1.3community-based service waiver recipients;amending Minnesota Statutes 2010,
1.4sections 256B.0911, subdivision 3a, as amended if enacted; 256B.49, subdivision
1.515, by adding subdivisions; 256I.04, subdivision 2a.
1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.7 Section 1. Minnesota Statutes 2010, section 256B.0911, subdivision 3a, as amended by
1.8S.F. No. 760, article 6, section 12, if enacted, is amended to read:
1.9 Subd. 3a. Assessment and support planning. (a) Persons requesting assessment,
1.10services planning, or other assistance intended to support community-based living,
1.11including persons who need assessment in order to determine waiver or alternative care
1.12program eligibility, must be visited by a long-term care consultation team within 20
1.13calendar days after the date on which an assessment was requested or recommended. After
1.14January 1, 2011, these requirements also apply to personal care assistance services, private
1.15duty nursing, and home health agency services, on timelines established in subdivision 5.
1.16Face-to-face assessments must be conducted according to paragraphs (b) to (i).
1.17 (b) The county may utilize a team of either the social worker or public health nurse,
1.18or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the
1.19assessment in a face-to-face interview. The consultation team members must confer
1.20regarding the most appropriate care for each individual screened or assessed.
1.21 (c) The assessment must be comprehensive and include a person-centered
1.22assessment of the health, psychological, functional, environmental, and social needs of
1.23referred individuals and provide information necessary to develop a support plan that
1.24meets the consumers needs, using an assessment form provided by the commissioner.
2.1 (d) The assessment must be conducted in a face-to-face interview with the person
2.2being assessed and the person's legal representative, as required by legally executed
2.3documents, and other individuals as requested by the person, who can provide information
2.4on the needs, strengths, and preferences of the person necessary to develop a support
2.5plan that ensures the person's health and safety, but who is not a provider of service or
2.6has any financial interest in the provision of services. For persons who are to be assessed
2.7for elderly waiver customized living services under section256B.0915 , and with the
2.8permission of the person being assessed or the persons' designated or legal representative,
2.9the client's current or proposed provider of services may submit a copy of the provider's
2.10nursing assessment or written report outlining their recommendations regarding the
2.11client's care needs. The person conducting the assessment will notify the provider of the
2.12date by which this information is to be submitted. This information shall be provided to
2.13the person conducting the assessment prior to the assessment.
2.14 (e) The person, or the person's legal representative, must be provided with written
2.15recommendations for community-based services, including self-directed options, or
2.16institutional care that include documentation that the most cost-effective alternatives
2.17available were offered to the individual. For purposes of this requirement, "cost-effective
2.18alternatives" means community services and living arrangements that cost the same as
2.19or less than institutional care. For persons determined eligible for services defined under
2.20subdivision 1a, paragraph (a), clauses (7) to (9), the community support plan must also
2.21include the estimated annual and monthly average authorized budget amount for those
2.22services.
2.23 (f) (1) If the person chooses to use community-based services, the person or the
2.24person's legal representative must be provided with a written community support plan,
2.25regardless of whether the individual is eligible for Minnesota health care programs. The
2.26written community support plan must include:
2.27 (i) a summary of assessed needs as defined in paragraphs (c) and (d);
2.28 (ii) the individual's options and choices to meet identified needs, including all
2.29available options for case management services and providers, and alternatives to
2.30residential settings, including, but not limited to, foster care settings that are not the
2.31primary residence of the license holder;
2.32 (iii) identification of health and safety risks and how those risks will be addressed,
2.33including personal risk management strategies;
2.34 (iv) referral information; and
2.35 (v) informal caregiver supports, if applicable.
3.1 (2) For persons determined eligible for services defined under subdivision 1a,
3.2paragraph (a), clauses (7) to (10), the community support plan must also include:
3.3 (i) identification of individual goals;
3.4 (ii) identification of short-term and long-term service outcomes. Short-term service
3.5outcomes are defined as achievable within six months;
3.6 (iii) a recommended schedule for case management visits. When achievement of
3.7short-term service outcomes may affect the amount of service required, the schedule must
3.8be at least every six months and must reflect evaluation and progress toward identified
3.9short-term service outcomes; and
3.10 (iv) the estimated annual and monthly budget amount for services.
3.11 (3) In addition, for persons determined eligible for state plan home care under
3.12subdivision 1a, paragraph (a), clause (8), the person or person's representative must also
3.13receive a copy of the home care service plan developed by a certified assessor.
3.14(4) A person may request assistance in identifying community supports without
3.15participating in a complete assessment. Upon a request for assistance identifying
3.16community support, the person must be transferred or referred to the services available
3.17under sections256.975, subdivision 7 , and
256.01 , subdivision 24, for telephone
3.18assistance and follow up.
3.19 (g) The person has the right to make the final decision between institutional
3.20placement and community placement after the recommendations have been provided,
3.21except as provided in subdivision 4a, paragraph (c).
3.22 (h) The team must give the person receiving assessment or support planning, or
3.23the person's legal representative, materials, and forms supplied by the commissioner
3.24containing the following information:
3.25 (1) the need for and purpose of preadmission screening if the person selects nursing
3.26facility placement;
3.27 (2) the role of the long-term care consultation assessment and support planning in
3.28waiver and alternative care program eligibility determination;
3.29 (3) information about Minnesota health care programs;
3.30 (4) the person's freedom to accept or reject the recommendations of the team;
3.31 (5) the person's right to confidentiality under the Minnesota Government Data
3.32Practices Act, chapter 13;
3.33 (6) the long-term care consultant's decision regarding the person's need for
3.34institutional level of care as determined under criteria established in section144.0724,
3.35subdivision 11 , or
256B.092 ; and
4.1(7) the person's right to appeal the decision regarding the need for nursing facility
4.2level of care or the county's final decisions regarding public programs eligibility according
4.3to section256.045, subdivision 3 .
4.4 (i) Face-to-face assessment completed as part of eligibility determination for
4.5the alternative care, elderly waiver, community alternatives for disabled individuals,
4.6community alternative care, and traumatic brain injury waiver programs under sections
4.7256B.0915
,
256B.0917 , and
256B.49 is valid to establish service eligibility for no more
4.8than 60 calendar days after the date of assessment. The effective eligibility start date
4.9for these programs can never be prior to the date of assessment. If an assessment was
4.10completed more than 60 days before the effective waiver or alternative care program
4.11eligibility start date, assessment and support plan information must be updated and
4.12documented in the department's Medicaid Management Information System (MMIS). The
4.13updated assessment may be completed by face-to-face visit, written communication, or
4.14telephone as determined by the commissioner to establish statewide consistency. The
4.15effective date of program eligibility in this case cannot be prior to the date the updated
4.16assessment is completed.
4.17 Sec. 2. Minnesota Statutes 2010, section 256B.49, subdivision 15, is amended to read:
4.18 Subd. 15. Individualized service plan. (a) Each recipient of home and
4.19community-based waivered services shall be provided a copy of the written service plan
4.20which:
4.21(1) is developed and signed by the recipient within ten working days of the
4.22completion of the assessment;
4.23(2) meets the assessed needs of the recipient;
4.24(3) reasonably ensures the health and safety of the recipient;
4.25(4) promotes independence;
4.26(5) allows for services to be provided in the most integrated settings; and
4.27(6) provides for an informed choice, as defined in section256B.77, subdivision 2 ,
4.28paragraph (p), of service and support providers.
4.29(b) When a county is evaluating denials, reductions, or terminations of home and
4.30community-based services under section256B.49 for an individual, the case manager
4.31shall offer to meet with the individual or the individual's guardian in order to discuss the
4.32prioritization of service needs within the individualized service plan. The reduction in
4.33the authorized services for an individual due to changes in funding for waivered services
4.34may not exceed the amount needed to ensure medically necessary services to meet the
4.35individual's health, safety, and welfare.
5.1(c) At the time of reassessment, local agency case managers shall assess each
5.2recipient of community alternatives for disabled individuals or traumatic brain injury
5.3waivered services currently residing in a licensed adult foster home that is not the
5.4primary residence of the license holder, or in which the license holder is not the primary
5.5caregiver, to determine if that recipient could appropriately be served in an apartment
5.6setting. If appropriate for the recipient, the case manger shall offer the recipient, through
5.7a person-centered planning process, the option to enter a less restrictive setting and
5.8to receive customized living or 24-hour customized living services if necessary and
5.9appropriate. In the event that the recipient chooses to transfer from the adult foster home,
5.10the vacated bed shall not be filled with another recipient of waiver services or group
5.11residential housing. If the adult foster home becomes no longer viable due to these
5.12transfers, the county agency, with the assistance of the department, shall facilitate a
5.13consolidation of settings or closure. This process shall be completed by June 30, 2012.
5.14 Sec. 3. Minnesota Statutes 2010, section 256B.49, is amended by adding a subdivision
5.15to read:
5.16 Subd. 23. Living arrangements. The commissioner shall not place any limit on
5.17the number of recipients of home and community-based waivered services receiving
5.18customized living or 24-hour customized living services under Section 1915C of the
5.19Social Security Act who may reside in a single building, unless specifically prohibited by
5.20federal law. Customized living or 24-hour customized living service formerly known as
5.21assisted living and assisted living plus, respectively, can be provided to any number of
5.22apartments in a residential center for community alternatives for disabled individuals and
5.23traumatic brain injury waiver recipients who rent or own distinct units. Notwithstanding
5.24any other provision to the contrary, the commissioner shall not deny medical assistance
5.25provider enrollment to any otherwise qualified provider of these services.
5.26 Sec. 4. Minnesota Statutes 2010, section 256B.49, is amended by adding a subdivision
5.27to read:
5.28 Subd. 24. Community-living settings. "Community-living settings" means:
5.29(1) a single-family home or apartment where the service recipient or their family
5.30owns or rents, as demonstrated by a lease agreement, and maintains control over the
5.31individual unit;
5.32(2) the individual is not required to receive services;
5.33(3) the individual is not required to have a disability or specific diagnosis to live in
5.34the home;
6.1(4) the individual may hire a service provider of their choice;
6.2(5) the individual may determine whether to share their household and with whom;
6.3and
6.4(6) the unit includes sleeping, bathing, and cooking areas.
6.5 Sec. 5. Minnesota Statutes 2010, section 256I.04, subdivision 2a, is amended to read:
6.6 Subd. 2a. License required. A county agency may not enter into an agreement with
6.7an establishment to provide group residential housing unless:
6.8(1) the establishment is licensed by the Department of Health as a hotel and
6.9restaurant; a board and lodging establishment; a residential care home; a boarding care
6.10home before March 1, 1985; or a supervised living facility, and the service provider
6.11for residents of the facility is licensed under chapter 245A. However, an establishment
6.12licensed by the Department of Health to provide lodging need not also be licensed to
6.13provide board if meals are being supplied to residents under a contract with a food vendor
6.14who is licensed by the Department of Health;
6.15(2) the residence is: (i) licensed by the commissioner of human services under
6.16Minnesota Rules, parts 9555.5050 to 9555.6265; (ii) certified by a county human services
6.17agency prior to July 1, 1992, using the standards under Minnesota Rules, parts 9555.5050
6.18to 9555.6265; or (iii) a residence licensed by the commissioner under Minnesota Rules,
6.19parts 2960.0010 to 2960.0120, with a variance under section245A.04 , subdivision 9;
6.20(3) the establishment is registered under chapter 144D and provides three meals a
6.21day, or is an establishment voluntarily registered under section144D.025 as a supportive
6.22housing establishment; or
6.23(4) an establishment voluntarily registered under section144D.025 , other than
6.24a supportive housing establishment under clause (3), is not eligible to provide group
6.25residential housing, unless the establishment provides housing for persons entering the
6.26establishment directly from corporate adult foster homes.
6.27The requirements under clauses (1) to (4) do not apply to establishments exempt
6.28from state licensure because they are located on Indian reservations and subject to tribal
6.29health and safety requirements.
1.3community-based service waiver recipients;amending Minnesota Statutes 2010,
1.4sections 256B.0911, subdivision 3a, as amended if enacted; 256B.49, subdivision
1.515, by adding subdivisions; 256I.04, subdivision 2a.
1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.7 Section 1. Minnesota Statutes 2010, section 256B.0911, subdivision 3a, as amended by
1.8S.F. No. 760, article 6, section 12, if enacted, is amended to read:
1.9 Subd. 3a. Assessment and support planning. (a) Persons requesting assessment,
1.10services planning, or other assistance intended to support community-based living,
1.11including persons who need assessment in order to determine waiver or alternative care
1.12program eligibility, must be visited by a long-term care consultation team within 20
1.13calendar days after the date on which an assessment was requested or recommended. After
1.14January 1, 2011, these requirements also apply to personal care assistance services, private
1.15duty nursing, and home health agency services, on timelines established in subdivision 5.
1.16Face-to-face assessments must be conducted according to paragraphs (b) to (i).
1.17 (b) The county may utilize a team of either the social worker or public health nurse,
1.18or both. After January 1, 2011, lead agencies shall use certified assessors to conduct the
1.19assessment in a face-to-face interview. The consultation team members must confer
1.20regarding the most appropriate care for each individual screened or assessed.
1.21 (c) The assessment must be comprehensive and include a person-centered
1.22assessment of the health, psychological, functional, environmental, and social needs of
1.23referred individuals and provide information necessary to develop a support plan that
1.24meets the consumers needs, using an assessment form provided by the commissioner.
2.1 (d) The assessment must be conducted in a face-to-face interview with the person
2.2being assessed and the person's legal representative, as required by legally executed
2.3documents, and other individuals as requested by the person, who can provide information
2.4on the needs, strengths, and preferences of the person necessary to develop a support
2.5plan that ensures the person's health and safety, but who is not a provider of service or
2.6has any financial interest in the provision of services. For persons who are to be assessed
2.7for elderly waiver customized living services under section
2.8permission of the person being assessed or the persons' designated or legal representative,
2.9the client's current or proposed provider of services may submit a copy of the provider's
2.10nursing assessment or written report outlining their recommendations regarding the
2.11client's care needs. The person conducting the assessment will notify the provider of the
2.12date by which this information is to be submitted. This information shall be provided to
2.13the person conducting the assessment prior to the assessment.
2.14 (e) The person, or the person's legal representative, must be provided with written
2.15recommendations for community-based services, including self-directed options, or
2.16institutional care that include documentation that the most cost-effective alternatives
2.17available were offered to the individual. For purposes of this requirement, "cost-effective
2.18alternatives" means community services and living arrangements that cost the same as
2.19or less than institutional care. For persons determined eligible for services defined under
2.20subdivision 1a, paragraph (a), clauses (7) to (9), the community support plan must also
2.21include the estimated annual and monthly average authorized budget amount for those
2.22services.
2.23 (f) (1) If the person chooses to use community-based services, the person or the
2.24person's legal representative must be provided with a written community support plan,
2.25regardless of whether the individual is eligible for Minnesota health care programs. The
2.26written community support plan must include:
2.27 (i) a summary of assessed needs as defined in paragraphs (c) and (d);
2.28 (ii) the individual's options and choices to meet identified needs, including all
2.29available options for case management services and providers, and alternatives to
2.30residential settings, including, but not limited to, foster care settings that are not the
2.31primary residence of the license holder;
2.32 (iii) identification of health and safety risks and how those risks will be addressed,
2.33including personal risk management strategies;
2.34 (iv) referral information; and
2.35 (v) informal caregiver supports, if applicable.
3.1 (2) For persons determined eligible for services defined under subdivision 1a,
3.2paragraph (a), clauses (7) to (10), the community support plan must also include:
3.3 (i) identification of individual goals;
3.4 (ii) identification of short-term and long-term service outcomes. Short-term service
3.5outcomes are defined as achievable within six months;
3.6 (iii) a recommended schedule for case management visits. When achievement of
3.7short-term service outcomes may affect the amount of service required, the schedule must
3.8be at least every six months and must reflect evaluation and progress toward identified
3.9short-term service outcomes; and
3.10 (iv) the estimated annual and monthly budget amount for services.
3.11 (3) In addition, for persons determined eligible for state plan home care under
3.12subdivision 1a, paragraph (a), clause (8), the person or person's representative must also
3.13receive a copy of the home care service plan developed by a certified assessor.
3.14(4) A person may request assistance in identifying community supports without
3.15participating in a complete assessment. Upon a request for assistance identifying
3.16community support, the person must be transferred or referred to the services available
3.17under sections
3.18assistance and follow up.
3.19 (g) The person has the right to make the final decision between institutional
3.20placement and community placement after the recommendations have been provided,
3.21except as provided in subdivision 4a, paragraph (c).
3.22 (h) The team must give the person receiving assessment or support planning, or
3.23the person's legal representative, materials, and forms supplied by the commissioner
3.24containing the following information:
3.25 (1) the need for and purpose of preadmission screening if the person selects nursing
3.26facility placement;
3.27 (2) the role of the long-term care consultation assessment and support planning in
3.28waiver and alternative care program eligibility determination;
3.29 (3) information about Minnesota health care programs;
3.30 (4) the person's freedom to accept or reject the recommendations of the team;
3.31 (5) the person's right to confidentiality under the Minnesota Government Data
3.32Practices Act, chapter 13;
3.33 (6) the long-term care consultant's decision regarding the person's need for
3.34institutional level of care as determined under criteria established in section
3.35subdivision 11
4.1(7) the person's right to appeal the decision regarding the need for nursing facility
4.2level of care or the county's final decisions regarding public programs eligibility according
4.3to section
4.4 (i) Face-to-face assessment completed as part of eligibility determination for
4.5the alternative care, elderly waiver, community alternatives for disabled individuals,
4.6community alternative care, and traumatic brain injury waiver programs under sections
4.8than 60 calendar days after the date of assessment. The effective eligibility start date
4.9for these programs can never be prior to the date of assessment. If an assessment was
4.10completed more than 60 days before the effective waiver or alternative care program
4.11eligibility start date, assessment and support plan information must be updated and
4.12documented in the department's Medicaid Management Information System (MMIS). The
4.13updated assessment may be completed by face-to-face visit, written communication, or
4.14telephone as determined by the commissioner to establish statewide consistency. The
4.15effective date of program eligibility in this case cannot be prior to the date the updated
4.16assessment is completed.
4.17 Sec. 2. Minnesota Statutes 2010, section 256B.49, subdivision 15, is amended to read:
4.18 Subd. 15. Individualized service plan. (a) Each recipient of home and
4.19community-based waivered services shall be provided a copy of the written service plan
4.20which:
4.21(1) is developed and signed by the recipient within ten working days of the
4.22completion of the assessment;
4.23(2) meets the assessed needs of the recipient;
4.24(3) reasonably ensures the health and safety of the recipient;
4.25(4) promotes independence;
4.26(5) allows for services to be provided in the most integrated settings; and
4.27(6) provides for an informed choice, as defined in section
4.28paragraph (p), of service and support providers.
4.29(b) When a county is evaluating denials, reductions, or terminations of home and
4.30community-based services under section
4.31shall offer to meet with the individual or the individual's guardian in order to discuss the
4.32prioritization of service needs within the individualized service plan. The reduction in
4.33the authorized services for an individual due to changes in funding for waivered services
4.34may not exceed the amount needed to ensure medically necessary services to meet the
4.35individual's health, safety, and welfare.
5.1(c) At the time of reassessment, local agency case managers shall assess each
5.2recipient of community alternatives for disabled individuals or traumatic brain injury
5.3waivered services currently residing in a licensed adult foster home that is not the
5.4primary residence of the license holder, or in which the license holder is not the primary
5.5caregiver, to determine if that recipient could appropriately be served in an apartment
5.6setting. If appropriate for the recipient, the case manger shall offer the recipient, through
5.7a person-centered planning process, the option to enter a less restrictive setting and
5.8to receive customized living or 24-hour customized living services if necessary and
5.9appropriate. In the event that the recipient chooses to transfer from the adult foster home,
5.10the vacated bed shall not be filled with another recipient of waiver services or group
5.11residential housing. If the adult foster home becomes no longer viable due to these
5.12transfers, the county agency, with the assistance of the department, shall facilitate a
5.13consolidation of settings or closure. This process shall be completed by June 30, 2012.
5.14 Sec. 3. Minnesota Statutes 2010, section 256B.49, is amended by adding a subdivision
5.15to read:
5.16 Subd. 23. Living arrangements. The commissioner shall not place any limit on
5.17the number of recipients of home and community-based waivered services receiving
5.18customized living or 24-hour customized living services under Section 1915C of the
5.19Social Security Act who may reside in a single building, unless specifically prohibited by
5.20federal law. Customized living or 24-hour customized living service formerly known as
5.21assisted living and assisted living plus, respectively, can be provided to any number of
5.22apartments in a residential center for community alternatives for disabled individuals and
5.23traumatic brain injury waiver recipients who rent or own distinct units. Notwithstanding
5.24any other provision to the contrary, the commissioner shall not deny medical assistance
5.25provider enrollment to any otherwise qualified provider of these services.
5.26 Sec. 4. Minnesota Statutes 2010, section 256B.49, is amended by adding a subdivision
5.27to read:
5.28 Subd. 24. Community-living settings. "Community-living settings" means:
5.29(1) a single-family home or apartment where the service recipient or their family
5.30owns or rents, as demonstrated by a lease agreement, and maintains control over the
5.31individual unit;
5.32(2) the individual is not required to receive services;
5.33(3) the individual is not required to have a disability or specific diagnosis to live in
5.34the home;
6.1(4) the individual may hire a service provider of their choice;
6.2(5) the individual may determine whether to share their household and with whom;
6.3and
6.4(6) the unit includes sleeping, bathing, and cooking areas.
6.5 Sec. 5. Minnesota Statutes 2010, section 256I.04, subdivision 2a, is amended to read:
6.6 Subd. 2a. License required. A county agency may not enter into an agreement with
6.7an establishment to provide group residential housing unless:
6.8(1) the establishment is licensed by the Department of Health as a hotel and
6.9restaurant; a board and lodging establishment; a residential care home; a boarding care
6.10home before March 1, 1985; or a supervised living facility, and the service provider
6.11for residents of the facility is licensed under chapter 245A. However, an establishment
6.12licensed by the Department of Health to provide lodging need not also be licensed to
6.13provide board if meals are being supplied to residents under a contract with a food vendor
6.14who is licensed by the Department of Health;
6.15(2) the residence is: (i) licensed by the commissioner of human services under
6.16Minnesota Rules, parts 9555.5050 to 9555.6265; (ii) certified by a county human services
6.17agency prior to July 1, 1992, using the standards under Minnesota Rules, parts 9555.5050
6.18to 9555.6265; or (iii) a residence licensed by the commissioner under Minnesota Rules,
6.19parts 2960.0010 to 2960.0120, with a variance under section
6.20(3) the establishment is registered under chapter 144D and provides three meals a
6.21day, or is an establishment voluntarily registered under section
6.22housing establishment; or
6.23(4) an establishment voluntarily registered under section
6.24a supportive housing establishment under clause (3), is not eligible to provide group
6.25residential housing, unless the establishment provides housing for persons entering the
6.26establishment directly from corporate adult foster homes.
6.27The requirements under clauses (1) to (4) do not apply to establishments exempt
6.28from state licensure because they are located on Indian reservations and subject to tribal
6.29health and safety requirements.
