Legislative Session number- 82

Bill Name: SF1070

E Relating to long term care ARTICLE 1 CONSUMER INFORMATION AND ASSISTANCE AND
COMMUNITY BASED CARERequiring the commissioner of health in coordination with
the commissioner of human services to monitor and analyze the distribution of
older adult services in the different geographic areas of the state, specifying
certain study requirements and requiring annual reports to the legislature;
requiring the commissioners to identify and designate long term health care
providers as critical access service sites, defining critical access service
site and specifying certain duties of the commissioners; requiring the board on
aging to operate a statewide information and assistance service (senior linkAGE
line) to aid older residents and families in making informed choices relating to
long term care options and health care benefits, specifying certain availability
and service requirements; creating the community services development grants
program under the administration of the commissioner of human services for the
establishment of new older adult services as alternatives to nursing facility
care, specifying eligibility and a match requirement; changing the medical
assistance (MA) nursing facility preadmission screening program to long term
care consultation services, defining long term care consultation services and
modifying the purpose, requiring coordination with certain other services to
offer a variety of cost effective alternatives to persons with disabilities and
elderly persons and requiring county agencies providing consultation services to
encourage the use of volunteers; changing local screening teams to long term
care consultation teams, modifying certain duties and authorizing county boards
to designate public health or social services as the lead agency for the
consultation services; prescribing the assessment procedure, requiring a
community support plan for persons choosing to use community based services and
requiring the teams to provide persons receiving assessment or support planning
with certain information supplied by the commissioner of human services;
providing for transition assistance to certain persons residing in nursing
facilities, hospitals, regional treatment centers or intermediate care
facilities for persons with mental retardation (ICF MR), specifying certain
transition assistance requirements; requiring the commissioner to establish
demonstration projects to target critical areas for improvement in long term
care consultation services, requiring commissioner preliminary and final reports
on the demonstration models to the legislature by certain dates; requiring
preadmission screening of all applicants to medicaid certified nursing and
boarding care facilities, specifying screening criteria and requirements,
requiring case mix classification recommendations under certain conditions and
providing for certain exemptions and emergency admissions; modifying certain
billing and payment procedures; clarifying the purpose and goals of the
alternative care program and modifying certain eligibility and covered services
requirements; exempting residential care homes from housing with services
registration requirements; modifying certain provisions providing for assisted
living services under the alternative care program; regulating cash payments;
authorizing the commissioner to contract with federally recognized Indian tribes
to serve as the lead agency responsible for the local administration of the
alternative care program; modifying certain alternative care individual care and
county biennial plans, provider contracting and client premiums payment
requirements and the appropriation allocation formula; requiring the
commissioner to establish statewide maximum and eliminate county specific
service rate limits to improve access to community services and eliminate
payment disparities between the alternative care and elderly waiver programs,
authorizing county negotiation of individual service rates with vendors for
actual costs up to the statewide maximum service rate limit; modifying certain
provisions regulating the home and community based waiver; modifying the monthly
cost limits and the adult foster care and assisted living services payment
rates; requiring and providing for the commissioner to award contracts for
grants under the seniors agenda for independent living (SAIL) program to public
and private nonprofit agencies to establish services to strengthen the ability
of communities to provide home and community based services for elderly persons;
requiring the commissioner to submit to the legislature by a certain date
recommendations for creating coordinated service access at the county agency
level for both publicly subsidized and nonsubsidized long term care services and
housing options, specifying certain report content requirements; requiring the
board on aging to present recommendations to the legislature by a certain date
on providing in home and out of home respite care services on a sliding scale
basis under the federal older Americans act; repealing certain nursing facility
preadmission screening and alternative care program provisions, the special
medical assistance reimbursement rates for Anoka, Aitkin, Polk and Pennington
counties under the elderly waiver program, certain closure plan requirements and
certain rules relating to nursing facility cessations or service curtailments,
relocation planning and preadmission screening and alternative care ARTICLE 2
LONG TERM CARE SYSTEM REFORM AND REIMBURSEMENTIncreasing the dollar limit for
construction projects under the nursing home bed moratorium and expanding the
definition of project construction costs to new technology implemented as part
of the project, defining technology; eliminating the provision prohibiting the
carryforward of nursing home bed moratorium exception expenditures into the
following biennium; providing for the relocation of licensed nursing facility
residents upon facility closure or curtailment, reduction or change of
operations or services; specifying certain licensee notice requirements;
prescribing the planning process, specifying certain duties of the local social
service agency and the licensee, requiring involvement of the departments of
health and human services in closure, curtailment or change plan development and
specifying certain plan requirements; requiring the licensee to provide for the
safe, orderly and appropriate relocation of residents, requiring cooperation
with the departments, the office of ombudsman for older Minnesotans and the
ombudsman for mental health and mental retardation; specifying certain
responsibilities of the licensee before relocation, notice requirements,
requiring establishment of an interdisciplinary team to be responsible for plan
coordination and implementation, specifying certain team membership
representation requirements; requiring and providing for licensee preparation of
a resource list of relocation options; requiring assistance to residents in
making site visits to available facilities; specifying certain resident personal
possessions inventory and possessions and records transfer requirements;
specifying certain responsibilities of the licensee after relocation, requiring
certain status reports; specifying certain responsibilities of the local social
service agency, specifying certain notice and plan compliance monitoring and
resident visit requirements, requiring reports to the commissioners of health
and human services of relocations endangering the health, safety or well being
of residents; requiring the commissioner of human services to negotiate with the
local agency for funding of relocation costs; subjecting licensees to correction
orders and civil monetary penalties for violation of the requirements; providing
for the conforming reuse of closed or curtailed nursing facilities; requiring
the commissioner of health to establish a transition planning grant program to
assist eligible nursing homes in developing strategic plans to meet the older
adult service needs of the community, specifying certain strategic plan content
requirements, providing for allocation of the grants and requiring the
commissioner to evaluate the effectiveness of the program; requiring and
providing for the commissioner to implement alternative procedures for the
nursing home survey process, specifying certain survey interval requirements and
requiring the commissioner to develop a process for identifying the survey
cycles for skilled nursing facilities based on the compliance history of the
facility, requiring public notice of the classification process and
identification of the selected survey cycles for each facility, specifying
certain monitoring requirements, requiring the commissioner to establish a
process for surveying and monitoring certain facilities, prohibiting survey
agency funding reductions upon implementation of the alternative survey process
and requiring the commissioner to expand survey agency ability to conduct
training and educational efforts for skilled nursing facilities and the public
and to develop an alternative survey process evaluation procedure; requiring and
providing for nursing and intermediate care facility (ICF MR) and waivered
services provider medical assistance (MA) payment rate increases for operating
costs and to increase the per hour pay rate of certain employees, specifying
certain commissioner of human services calculation and nursing facility
distribution and provider compliance plan requirements, providing additional
increases for low rate facilities; providing for nursing facility voluntary
closures and planning and development of community based alternatives; requiring
the commissioner to establish a process to adjust the capacity and distribution
of long term care services to equalize the supply and demand for different types
of services, requiring the commissioner to issue requests for proposals to
contract with regional long term care planning groups, specifying certain group
membership representation requirements and duties; requiring the commissioner to
establish a process to support and facilitate expansion of community based
services under the alternative care and elderly waiver programs before the
transitioning or closure of nursing facilities, specifying certain plan and
county board and commissioner of health cooperation requirements; requiring and
providing for the commissioner of human services to by a certain date implement
and announce a program for closure or partial closure of nursing facilities,
specifying certain application requirements, criteria for review, commissioner
of health certification requirements and certain medical assistance payment rate
adjustments; requiring and providing for the commissioner of human services to
develop and implement a quality profile system for nursing facilities and other
providers of long term care services, providing for certain quality measurement
tools and consumer surveys and for the dissemination of quality profiles,
requiring a public awareness campaign; expanding the reporting requirements of
the commissioners of health and human services relating to maltreatment of
vulnerable adults in facilities; extending the expiration date of a certain
provision requiring frequent checking of incontinent nursing facility residents;
requiring the commissioner of human services to develop and report to the
legislature by a certain date on a system to replace the current nursing
facility reimbursement system under medical assistance, specifying certain
consultation and system requirements; requiring the commissioner to conduct a
time motion study to determine the amount of time devoted to the care of high
need nursing facility residents and report the results to the legislature by a
certain date; requiring the commissioners of health and human services to
develop a summary of federal nursing facility and community long term care
regulations hampering state flexibility and placing burdens on the goal of
achieving high quality care and optimum outcomes for consumers of services, to
report to the legislature by a certain date on the number of nursing facility
closures and alternatives to nursing facility care and to deliver to the
governor and the legislature by a certain date a plan for updating staffing
standards in nursing facilities and home and community based services; requiring
the commissioner of health to update the nursing assistant and home health aide
curriculum and to establish a long term care grant program demonstrating best
practices and innovation for long term care service delivery and housing;
specifying certain reference deletion instructions to the revisor of statutes;
repealing a certain provision and certain rules relating to nursing facility
cessation or curtailment of operations and certain rules relating to relocation
planning ARTICLE 3 WORKFORCE RECRUITMENT AND RETENTIONModifying the definition
of qualifying consortium under the job skills partnership health care and human
services worker training program, specifying a grant limit and modifying local
match requirements, expanding marketing and recruitment strategy requirements
relating to meeting the needs of non-English speaking persons and providing for
an expedited grant process; expanding the post-secondary summer health care
interns program to nursing facilities and home care providers, modifying the
costs payment requirement, eliminating a certain letter of recommendation
requirement and expanding student eligibility; expanding the loan forgiveness
program for nurses agreeing to practice in nursing homes or intermediate care
facilities for persons with mental retardation or related conditions (ICF MR),
payments to be split between the health care access and general fund education
accounts; authorizing commissioner of health grants to qualifying consortia for
intergenerational programs to encourage middle and high school students to work
and volunteer in health care and long term care settings, specifying grant
qualification requirements; requiring the commissioner of human services to
establish and administer the long term care employee health insurance assistance
program to provide the advantages of pooling for the purchase of health coverage
for long term care employers, requiring the commissioner to solicit bids from
health maintenance organizations (HMO) to provide health coverage to dependents
of eligible employees, requiring the offering of coverage on a guaranteed issue
and renewal basis, requiring the commissioner to determine coverage options,
premium and contractual arrangements and other administrative matters and to
consult with representatives of the long term care industry on issues relating
to administration of the program, requiring the commissioner to establish
procedures for employer application for coverage, providing for individual
eligibility, specifying certain health plan coverage requirements and providing
for the payment of premiums; requiring the commissioner to increase medical
assistance (MA) reimbursement rates to nursing facilities, intermediate care
facilities for persons with mental retardation or related conditions (ICF MR)
and certain waivered services providers for employee scholarship costs and to
provide job related training on the job site in English as a second language,
specifying certain facility or provider reporting requirements; requiring the
commissioner to seek waivers to obtain enhanced matching funds under the state
children's health insurance program and to claim eligible expenditures against
available funding under CHIP upon federal approval of the waiver; appropriating
money to the commissioner of health to expand the summer health care interns and
nurses loan forgiveness programs, to the commissioner of human services to
implement and administer the scholarships and ESL job training programs and for
the long term care employee health insurance assistance program and to the job
skills partnership board to fund the health care and human services worker
training program, repealing certain provisions relating to the programARTICLE 4
REGULATION OF SUPPLEMENTAL NURSING SERVICES AGENCIESRequiring and providing for
the registration of supplemental nursing services agencies with the commissioner
of health, requiring background checks at a fee and specifying certain
application requirements and registration criteria, requiring commissioner
establishment by rule of penalties for violation of the requirements; requiring
the commissioner to establish a system for reporting complaints against
supplemental nursing services agencies or employees; limiting charges to health
care facilities by the agencies; requiring the commissioner to require health
care facilities to periodically report certain information on the use of
supplemental nursing services; appropriating money to the commissioner for
services agencies regulation purposes ARTICLE 5 LONG TERM CARE INSURANCE
Defining certain additional terms for qualified long term care insurance
policies regulation purposes; requiring insurers to provide certain information
to the commissioner of commerce before insurance sale availability; specifying
certain rating practices disclosure and nonforfeiture benefit requirements of
long term care and qualified long term care policies and regulating premium rate
schedule increases; exempting certain policies from certain minimum loss ratio
requirements; requiring the board on aging to promote the provision of employer
sponsored long term care insurance; requiring the commissioners of human
services and commerce subject to federal waiver approval to establish the
Minnesota partnership for long term care program to provide for the financing of
long term care through a combination of private insurance and medical assistance
(MA), specifying eligibility and partnership policy requirements; appropriating
money to the commissioner of human services for board long term care insurance
coverage promotion purposes and for partnership federal waiver development and
application (ja)