1.1 	A bill for an act
1.2 	relating to human services; directing the commissioner of human services to 
1.3 	expand clinical pain and palliative care services for pediatric patients receiving 
1.4 	medical assistance; appropriating money;proposing coding for new law in 
1.5 	Minnesota Statutes, chapter 256B.
1.6 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.7 	Section 1. [256B.0638] PAIN AND PALLIATIVE CARE SERVICES FOR 
1.8 	CHILDREN.
1.9 		Subdivision 1.Definitions. For the purposes of this section, the following terms 
1.10 	have the meanings given:
1.11 	(a) "Child" means a person 21 years of age or younger.
1.12 	(b) "Terminal condition" means an illness or medical condition likely to result in 
1.13 	death before the age of 21 as determined by a physician.
1.14 	(c) "Clinical pain and palliative care services" means pain and symptom management 
1.15 	services provided to a child with a terminal illness by a physician, registered nurse, or 
1.16 	licensed social worker.
1.17 	(d) "Other core pain and palliative care services" means services designed to address 
1.18 	the psychosocial needs of children with a terminal condition including, but not limited to, 
1.19 	child life services, social work, chaplaincy, and bereavement services.
1.20 	(e) "Eligible child" means a child receiving medical assistance under this chapter, 
1.21 	including waiver programs and prepaid medical assistance products (PMAPs).
1.22 	(f) "Pediatric palliative care consultation" means consultation over the telephone 
1.23 	or in a hospital by a hospice physician, certified hospice nurse, or clinical social worker 
1.24 	trained in palliative or hospice care to provide clinical support and expertise related to 
1.25 	pain and symptom management.
2.1 	(g) "Agency with expertise in pediatric pain and palliative care" means an agency 
2.2 	licensed as a hospice in the state providing two or more core services and having two or 
2.3 	more staff who have received formal, ongoing pediatric palliative care.
2.4 		Subd. 2.Palliative care services coverage. (a) The commissioner shall expand 
2.5 	coverage under the medical assistance program for eligible children receiving palliative 
2.6 	care consultation services and other core pain and palliative care services.
2.7 	(b) The commissioner shall provide coverage to reimburse pain and palliative care 
2.8 	services provided by a primary home care agency with expertise in pediatric palliative 
2.9 	care or as provided in conjunction with a secondary agency with expertise in pediatric 
2.10 	palliative care. When determined necessary by a physician, skilled nursing visits are 
2.11 	eligible for reimbursement regardless of home services already being received by an 
2.12 	eligible child including extended hours nursing, care provided by personal care attendants, 
2.13 	and other medical care provided in a home or group home setting. More than one agency 
2.14 	may be reimbursed under this section for services described in this paragraph.
2.15 	(c) The commissioner shall provide coverage to reimburse other core pain and 
2.16 	palliative care services provided by an agency with expertise in pediatric pain and 
2.17 	palliative care including palliative care coordination provided in collaboration with a 
2.18 	medical home, psychosocial support services, child life services, bereavement services, 
2.19 	and support services provided by a chaplain.
2.20 	(d) The commissioner shall extend coverage for pediatric palliative care services to 
2.21 	all children, including children living in areas or institutions without pediatric palliative 
2.22 	care expertise. Medical assistance shall provide coverage to reimburse pain and palliative 
2.23 	care consultation services provided by an agency with expertise in pediatric pain and 
2.24 	palliative care in underserved areas, including: (1) direct consultation or education to 
2.25 	a home care agency, group home, hospital, or medical home for pain and symptom 
2.26 	management of an eligible child; and (2) consultations provided in person, electronically, 
2.27 	or by telephone to an eligible child and the child's family.

2.28 	Sec. 2. APPROPRIATION.
 2.29 	(a) $420,000 is appropriated for fiscal year 2009 from the general fund to the 
2.30 	commissioner of human services for the purposes of providing medical assistance 
2.31 	coverage for pain and palliative care services for children under Minnesota Statutes, 
2.32 	section 256B.0638, subdivision 2, paragraph (b).
2.33 	(b) $35,000 is appropriated for fiscal year 2009 from the general fund to the 
2.34 	commissioner of human services for the purposes of providing medical assistance 
3.1 	coverage for other core pain and palliative care services for children under Minnesota 
3.2 	Statutes, section 256B.0638, subdivision 2, paragraph (c).
3.3 	(c) $35,000 is appropriated for fiscal year 2009 from the general fund to the 
3.4 	commissioner of human services for the purposes of providing medical assistance 
3.5 	coverage for palliative care services for children in underserved areas under Minnesota 
3.6 	Statutes, section 256B.0638, subdivision 2, paragraph (d).