1.1                          A bill for an act
  1.2             relating to human services; establishing an advisory 
  1.3             council on services to persons with mental retardation 
  1.4             and related developmental disabilities; providing 
  1.5             principles for new purchasing and delivery models; 
  1.6             establishing an advisory committee on direct care 
  1.7             staff; requiring maintenance of current policies; 
  1.8             proposing coding for new law in Minnesota Statutes, 
  1.9             chapter 252. 
  1.10  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.11     Section 1.  [PURPOSE.] 
  1.12     The legislature finds that potential reductions in federal 
  1.13  funding, and the state's structural deficit, make it necessary 
  1.14  for Minnesota to contain the rate of increase in the cost of 
  1.15  providing services to Minnesotans with mental retardation and 
  1.16  related developmental disabilities.  The legislature further 
  1.17  finds that this focus on cost containment must be accompanied by 
  1.18  initiatives to:  enhance the quality of these services, maintain 
  1.19  eligibility and proportionate funding, provide opportunities for 
  1.20  consumer control, and develop new purchasing and service 
  1.21  delivery models for these services.  The legislature further 
  1.22  finds that the December 1995 report by the developmental 
  1.23  disabilities working group on a cost-effective future for 
  1.24  Minnesotans with developmental disabilities is a valuable first 
  1.25  step towards achieving these objectives.  It is therefore the 
  1.26  intent of this legislation to provide a framework for the 
  1.27  delivery of services to Minnesotans with mental retardation and 
  2.1   related developmental disabilities, by refining and expanding 
  2.2   upon the goals, plan, and recommendations of the working group. 
  2.3      Sec. 2.  [252.53] [GENERAL PRINCIPLES.] 
  2.4      In developing and implementing new purchasing and service 
  2.5   delivery models for Minnesotans with mental retardation and 
  2.6   related developmental disabilities, the commissioner and any 
  2.7   advisory bodies established by the commissioner shall evaluate 
  2.8   alternative models to the extent that they conform to the 
  2.9   following principles:  maximum informed consumer control of 
  2.10  purchasing decisions, the utilization of outcome-based data, 
  2.11  regulatory reform, competition among management entities and 
  2.12  providers, cost containment, and quality assurance. 
  2.13     Sec. 3.  [252.54] [ADVISORY COUNCIL ON SERVICES TO PERSONS 
  2.14  WITH MENTAL RETARDATION AND RELATED DEVELOPMENTAL DISABILITIES.] 
  2.15     Subdivision 1.  [ESTABLISHMENT.] The commissioner of human 
  2.16  services shall, by June 1, 1996, convene an advisory council 
  2.17  representative of key stakeholders in services to Minnesotans 
  2.18  with mental retardation and related developmental disabilities.  
  2.19  The advisory council shall, by January 1, 1997, present a report 
  2.20  to the commissioner and legislature containing recommendations 
  2.21  for the purchasing and delivery of services to Minnesotans with 
  2.22  mental retardation and related developmental disabilities.  
  2.23  These recommendations must conform to the principles established 
  2.24  in section 252.53. 
  2.25     Subd. 2.  [REQUIREMENTS FOR REPORT.] The advisory council's 
  2.26  report shall: 
  2.27     (1) develop a statement of common purpose for services to 
  2.28  Minnesotans with mental retardation and related developmental 
  2.29  disabilities, with goals and outcomes; 
  2.30     (2) develop procedures and programs to enhance consumer 
  2.31  choice and control of services for Minnesotans with mental 
  2.32  retardation and related developmental disabilities; 
  2.33     (3) develop and recommend at least three models for the 
  2.34  management of service delivery and purchasing of services, 
  2.35  including:  (i) models based upon the plan developed by the 
  2.36  developmental disabilities working group on a cost-effective 
  3.1   future for Minnesotans with developmental disabilities; (ii) 
  3.2   performance based contracting programs; and (iii) other pilot 
  3.3   programs; 
  3.4      (4) recommend procedures to ensure equitable access to 
  3.5   resources and services by members of underserved populations of 
  3.6   eligible Minnesotans with mental retardation and related 
  3.7   developmental disabilities; 
  3.8      (5) develop recommendations to streamline program 
  3.9   regulation and develop statewide standards and procedures to 
  3.10  ensure the health and safety, including protection from abuse 
  3.11  and neglect, of all Minnesotans with mental retardation and 
  3.12  related developmental disabilities; 
  3.13     (6) develop recommendations to create an outcome-based 
  3.14  system with a plan for developing a definition of outcomes, 
  3.15  collecting and utilizing outcome data, and allocating resources 
  3.16  needed for technical assistance and training; 
  3.17     (7) recommend ways to reform guardianship and 
  3.18  representative payee procedures to maximize consumer 
  3.19  participation, choice, and control; 
  3.20     (8) develop and recommend an accurate system of accounting, 
  3.21  by county, of baseline expenditures for Minnesotans with mental 
  3.22  retardation and related developmental disabilities; 
  3.23     (9) recommend copayment standards to maximize resources to 
  3.24  needy individuals; 
  3.25     (10) develop recommendations that address the need for 
  3.26  proper wages and benefits for direct care staff, and that enable 
  3.27  providers to meet increasing costs of operation; 
  3.28     (11) develop recommendations to assist managing entities in 
  3.29  integrating responsibility for acute care; 
  3.30     (12) develop recommendations to provide technical 
  3.31  assistance to counties and other management entities; 
  3.32     (13) develop and recommend procedures that would allow 
  3.33  counties to seek the commissioner's approval to authorize 
  3.34  services and spend state funds for services to Minnesotans with 
  3.35  mental retardation and related developmental disabilities, or to 
  3.36  contract with other entities to do so; 
  4.1      (14) develop recommendations to ensure that every eligible 
  4.2   consumer has access to at least two management entities for 
  4.3   mental retardation or related developmental disabilities; 
  4.4      (15) define the state's role in providing highly 
  4.5   specialized services to Minnesotans with mental retardation and 
  4.6   related developmental disabilities. 
  4.7      (16) define a recommended minimum benefit package, and 
  4.8   maximum waiting period for those benefits, for all eligible 
  4.9   Minnesotans with mental retardation and related developmental 
  4.10  disabilities; 
  4.11     (17) develop and recommend a single, statewide standard for 
  4.12  eligibility for all services to eligible Minnesotans with mental 
  4.13  retardation and related developmental disabilities; 
  4.14     (18) develop and recommend a streamlined process to 
  4.15  determine eligibility for services to Minnesotans with mental 
  4.16  retardation and related developmental disabilities including, as 
  4.17  appropriate, presumptive eligibility, due process protection, 
  4.18  and independent assessment procedures; and 
  4.19     (19) develop recommendations to provide earmarked set-aside 
  4.20  resources for needed statewide initiatives, such as:  quality 
  4.21  enhancement; support to local entities for program design, 
  4.22  developing payment systems, and quality assurance programs; and 
  4.23  regional conferences or fairs for informational sharing. 
  4.24     Subd. 3.  [MEMBERSHIP.] The advisory council shall consist 
  4.25  of the following 18 members: 
  4.26     (1) two members appointed by the Minnesota association for 
  4.27  retarded citizens; 
  4.28     (2) one member appointed by the Disability Law Center; 
  4.29     (3) two residential providers appointed by the association 
  4.30  of residential resources in Minnesota; 
  4.31     (4) one day training and habilitation provider appointed by 
  4.32  the Minnesota developmental achievement center association; 
  4.33     (5) one day training and habilitation provider appointed by 
  4.34  the Minnesota habilitation coalition; 
  4.35     (6) one family member of a Minnesotan with mental 
  4.36  retardation or related developmental disabilities appointed by 
  5.1   the commissioner; 
  5.2      (7) one self-advocate appointed by advocating change 
  5.3   together; 
  5.4      (8) two members appointed by the association of Minnesota 
  5.5   counties; 
  5.6      (9) two department of human services staff specializing in 
  5.7   developmental disabilities appointed by the commissioner; 
  5.8      (10) one specialist in mental retardation and related 
  5.9   developmental disabilities appointed by the Minnesota school 
  5.10  superintendents association; 
  5.11     (11) two members appointed by the American federation of 
  5.12  state, county, and municipal employees; 
  5.13     (12) one member appointed by the center of community living 
  5.14  and institute on community integration; and 
  5.15     (13) one direct services employee employed by private 
  5.16  facilities providing services to Minnesotans with mental 
  5.17  retardation and related developmental disabilities appointed by 
  5.18  the commissioner. 
  5.19     Subd. 4.  [GOVERNANCE.] The advisory council is governed by 
  5.20  section 15.059, except that it expires July 1, 2001. 
  5.21     Subd. 5.  [ADDITIONAL DUTIES.] Upon enactment of a system 
  5.22  for the purchase and delivery of services for Minnesotans with 
  5.23  mental retardation and related developmental disabilities, the 
  5.24  advisory council shall oversee, evaluate, and periodically 
  5.25  report to the commissioner and legislature challenges and 
  5.26  accomplishments in the effort to reform services to Minnesotans 
  5.27  with mental retardation and related developmental disabilities. 
  5.28     Sec. 4.  [252.55] [ADVISORY COMMITTEE ON DIRECT CARE 
  5.29  STAFF.] 
  5.30     The commissioner shall establish an advisory committee on 
  5.31  the recruitment, training, and retention of direct care staff 
  5.32  providing services to Minnesotans with mental retardation and 
  5.33  related developmental disabilities, in order to address current 
  5.34  and projected needs in the provider community.  This advisory 
  5.35  committee is governed by section 15.059. 
  5.36     Sec. 5.  [252.56] [MAINTENANCE OF CURRENT POLICIES.] 
  6.1      Subdivision 1.  [APPLICABILITY.] The commissioner shall 
  6.2   comply with the requirements of this section until changes 
  6.3   enacted by the legislature in response to recommendations made 
  6.4   by the advisory council established under section 252.54 are 
  6.5   implemented by the commissioner. 
  6.6      Subd. 2.  [ELIGIBILITY.] The commissioner shall maintain 
  6.7   the definition and criteria for eligibility for services for 
  6.8   Minnesotans with mental retardation and related developmental 
  6.9   disabilities in effect on July 1, 1995. 
  6.10     Subd. 3.  [MAINTENANCE OF PROPORTIONATE EFFORT.] For each 
  6.11  fiscal year, the commissioner shall maintain the total of 
  6.12  federal and state expenditures for services to eligible 
  6.13  Minnesotans with mental retardation and related developmental 
  6.14  disabilities, relative to overall federal and state health care 
  6.15  expenditures in Minnesota for that fiscal year, at the same 
  6.16  proportionate level as these expenditures constituted in fiscal 
  6.17  year 1995 relative to overall federal and state health care 
  6.18  expenditures in Minnesota for fiscal year 1995. 
  6.19     Subd. 4.  [CONTINUITY OF FUNDING.] The commissioner shall 
  6.20  fund services to eligible Minnesotans with mental retardation 
  6.21  and related developmental disabilities using the general service 
  6.22  categories based upon provider and service type in effect on 
  6.23  July 1, 1995.