1.1                          A bill for an act 
  1.2             relating to human services; authorizing a 
  1.3             demonstration project for long-term care in Dakota 
  1.4             county. 
  1.5   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.6      Section 1.  [PILOT PROJECT FOR LONG-TERM CARE IN DAKOTA 
  1.7   COUNTY.] 
  1.8      Subdivision 1.  [AUTHORIZATION.] (a) The commissioner of 
  1.9   human services shall establish a pilot project in Dakota county 
  1.10  to increase the capacity of local communities and local 
  1.11  governments to provide services to individuals with the 
  1.12  following characteristics: 
  1.13     (1) individuals 65 years or older who, within 180 days of 
  1.14  nursing home placement, would be eligible for medical 
  1.15  assistance, who are at risk for nursing home placement, and need 
  1.16  community-based services to remain in their own homes and are 
  1.17  currently eligible to receive services under the alternative 
  1.18  care (AC) programs; 
  1.19     (2) individuals 65 years and older who are on medical 
  1.20  assistance, are at risk for nursing home placement and need 
  1.21  community-based services in order to remain in their own homes 
  1.22  who are currently eligible for the elderly waiver (EW) services; 
  1.23     (3) individuals under the age of 65 years who are on 
  1.24  medical assistance, are at risk for nursing home placement and 
  1.25  need community-based services in order to remain in their own 
  2.1   homes and are otherwise eligible for community alternatives for 
  2.2   disabled adults (CADI); 
  2.3      (4) individuals who are at high risk for long-term hospital 
  2.4   placement, are eligible for medical assistance without regard to 
  2.5   parental income/assets and are currently eligible for the 
  2.6   community alternatives for care (CAC); 
  2.7      (5) individuals under 65 years of age with brain injury who 
  2.8   require the level of care available in nursing homes or in any 
  2.9   neurobehavioral hospitals, are certified disabled by the state 
  2.10  of Minnesota or the social security administration and are 
  2.11  eligible for medical assistance under the program providing 
  2.12  services for people with traumatic brain injury (TBI); and 
  2.13     (6) individuals 65 years and older who are duly eligible 
  2.14  for Medicare and medical assistance and are eligible for 
  2.15  enrollment in the state of Minnesota's long-term care options 
  2.16  project. 
  2.17     (b) This pilot project is authorized for a period of five 
  2.18  years beginning July 1, 1996.  
  2.19     Subd. 2.  [DUTIES OF DAKOTA COUNTY.] (a) Dakota county 
  2.20  department of public health shall: 
  2.21     (1) design and implement a system for assessing 
  2.22  eligibility, establishing service plans, and providing prior 
  2.23  authorization to vendors for services for any individual listed 
  2.24  in subdivision 1, paragraph (a); 
  2.25     (2) design and implement a community-based long-term care 
  2.26  system using new local services; and 
  2.27     (3) establish uniform and consolidated service rates based 
  2.28  on market forces. 
  2.29     (b) In implementing this pilot project, Dakota county may: 
  2.30     (1) use paraprofessionals to provide individual case 
  2.31  management under the supervision of a public health nurse or 
  2.32  social worker; and 
  2.33     (2) use the aggregated total costs for all individuals 
  2.34  listed in subdivision 1, paragraph (a), instead of using 
  2.35  individual limits for each individual in order to provide 
  2.36  services for those individuals. 
  3.1      Subd. 3.  [DUTIES OF COMMISSIONER.] The commissioner of 
  3.2   human services and the commissioner of health shall provide 
  3.3   oversight for the pilot project through consultation and setting 
  3.4   policies including the thresholds for stop loss. 
  3.5      Subd. 4.  [FUNDING.] (a) The commissioner of human services 
  3.6   shall establish an integrated fund for Dakota county to permit 
  3.7   flexibility in service design and service expenditures for 
  3.8   eligible populations based on local needs with local control. 
  3.9      (b) The revenues and expenditures included in the 
  3.10  integrated funds shall be as follows: 
  3.11     (1) alternative care funds; 
  3.12     (2) elderly waiver funds; 
  3.13     (3) community alternatives for disabled adults (CADI); 
  3.14     (4) community alternatives for care; 
  3.15     (5) traumatic brain injury funds; and 
  3.16     (6) long-term care options project funds. 
  3.17     (c) The commissioner of human services shall waive all 
  3.18  current rate caps including those for assisted living and 
  3.19  residential care services. 
  3.20     (d) The funds shall be funded using the 1994-1995 rates. 
  3.21     (e) The commissioner of human services shall allow 
  3.22  implementation of the long-term care options project by counties 
  3.23  or municipalities or groups of counties or municipalities 
  3.24  working jointly. 
  3.25     (f) The commissioner of human services shall allow Dakota 
  3.26  county to implement a used durable medical equipment purchase 
  3.27  plan. 
  3.28     Subd. 5.  [REPORTS.] Dakota county public health department 
  3.29  shall report to the legislature by January 15, 2001, on the 
  3.30  results of the pilot project.  The reports shall include: 
  3.31     (1) whether there were any administrative or service cost 
  3.32  savings, and what those savings were; 
  3.33     (2) whether the individuals listed in subdivision 1, 
  3.34  paragraph (a), are maintained in the local community; 
  3.35     (3) whether there was any cooperation and coordination 
  3.36  among medical, health, and social service entities and public 
  4.1   and private sectors; and 
  4.2      (d) whether any formal or informal service system was 
  4.3   developed as a result of this pilot project.