1.1                          A bill for an act 
  1.2             relating to human services; providing services for 
  1.3             developmentally disabled persons; providing payment 
  1.4             for crisis intervention services; amending Minnesota 
  1.5             Statutes 1994, sections 252.025, by adding 
  1.6             subdivisions; and 256B.501, by adding a subdivision; 
  1.7             proposing coding for new law in Minnesota Statutes, 
  1.8             chapter 252. 
  1.9   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.10     Section 1.  Minnesota Statutes 1994, section 252.025, is 
  1.11  amended by adding a subdivision to read: 
  1.12     Subd. 7.  [SERVICES FOR DEVELOPMENTALLY DISABLED PERSONS; 
  1.13  FARIBAULT REGIONAL CENTER CATCHMENT AREA.] (a) This section 
  1.14  governs the downsizing of the Faribault regional center (FRC).  
  1.15  As residents are discharged from the Faribault regional center, 
  1.16  the buildings will be transferred to the department of 
  1.17  corrections, and the department of human services will develop a 
  1.18  system of state-operated services that:  (1) meets the needs of 
  1.19  clients discharged from the Faribault regional center; (2) is 
  1.20  fiscally sound; and (3) accommodates the evolving nature of the 
  1.21  health care system. 
  1.22     (b) The Minnesota correctional facility at Faribault 
  1.23  (MCF-FRB) shall expand its existing capacity by 300 beds.  The 
  1.24  department of human services shall transfer buildings related to 
  1.25  this expansion according to agreements between the department of 
  1.26  corrections and the Faribault community task force, established 
  1.27  pursuant to section 252.51, no sooner than September 1, 1994. 
  2.1      After the city of Faribault has held a public hearing, the 
  2.2   Minnesota correctional facility at Faribault may subsequently 
  2.3   proceed with expansion of its capacity by an additional 300 
  2.4   beds, on or after a date when the commissioner of human services 
  2.5   certifies that the Faribault regional center campus will be 
  2.6   vacated because alternative community-based services, including 
  2.7   those developed by the department of human services in 
  2.8   accordance with subdivision 9, will be available for the 
  2.9   remaining residents of the Faribault regional center.  The 
  2.10  actual date on which the remainder of the Faribault regional 
  2.11  center campus will be transferred to the commissioner of 
  2.12  corrections shall be determined by mutual agreement between the 
  2.13  commissioners of human services and corrections, after 
  2.14  consultation with the exclusive representatives and the 
  2.15  Faribault community task force.  In no event shall the total 
  2.16  capacity of the Minnesota correctional facility at Faribault 
  2.17  exceed 1,200 beds, and the Minnesota correctional facility at 
  2.18  Faribault shall not include any maximum security beds.  The 
  2.19  transfer of the Faribault regional center campus to the 
  2.20  commissioner of corrections shall occur no sooner than July 1, 
  2.21  1998, unless negotiated with the exclusive representatives and 
  2.22  community task force. 
  2.23     (c) The department of corrections shall provide necessary 
  2.24  and appropriate modifications to road access on the Faribault 
  2.25  regional center campus within the available appropriation.  The 
  2.26  city of Faribault shall not bear any cost of such modifications. 
  2.27     The department of corrections shall request necessary 
  2.28  appropriations in future legislative sessions to provide 
  2.29  necessary and appropriate modifications to the water-sewage 
  2.30  system used by the Faribault regional center, the Minnesota 
  2.31  correctional facility at Faribault, and the city of Faribault.  
  2.32  The city of Faribault shall not bear any cost of such 
  2.33  modifications. 
  2.34     (d) No sooner than July 1, 1995, the Faribault regional 
  2.35  center shall transfer the operation of its power plant to the 
  2.36  Minnesota correctional facility at Faribault contingent upon the 
  3.1   Minnesota correctional facility at Faribault receiving a state 
  3.2   appropriation for the full cost of necessary positions.  The 
  3.3   Faribault regional center employees in positions assigned to the 
  3.4   power plant as of the transfer date shall be allowed to transfer 
  3.5   to the Minnesota correctional facility at Faribault or exercise 
  3.6   their memorandum of understanding options.  All employees who 
  3.7   transfer shall retain their current classification, employment 
  3.8   condition, and salary upon such transfer. 
  3.9      (e) Prior to the transfer of the Faribault regional center 
  3.10  laundry to the Minnesota correctional facility at Faribault, the 
  3.11  Faribault regional center shall decrease laundry positions as 
  3.12  the Faribault regional center resident population declines.  
  3.13  However, the department of human services and the Faribault 
  3.14  regional center laundry management shall actively pursue 
  3.15  additional shared service contracts to offset any involuntary 
  3.16  position reductions in the laundry.  The additional laundry work 
  3.17  done as a result of the initial 300-bed corrections expansion 
  3.18  will also be used to offset any involuntary position reductions. 
  3.19  Further expansion of corrections beds and the resultant 
  3.20  increased laundry will also be used to offset any involuntary 
  3.21  reductions.  If, after the above, position reductions are 
  3.22  necessary, they shall occur pursuant to the memorandum of 
  3.23  understanding between the state, the department of human 
  3.24  services, and the exclusive representatives. 
  3.25     Upon the transfer of the Faribault regional center campus 
  3.26  to the commissioner of corrections, the Faribault regional 
  3.27  center may transfer the laundry to the Minnesota correctional 
  3.28  facility at Faribault.  If the transfer occurs, the Minnesota 
  3.29  correctional facility at Faribault shall operate the laundry as 
  3.30  a prison industry.  The Minnesota correctional facility at 
  3.31  Faribault shall maintain existing shared service contracts.  The 
  3.32  shared service positions shall be maintained by the Minnesota 
  3.33  correctional facility at Faribault unless shared service income 
  3.34  does not support these positions.  If such positions are to be 
  3.35  eliminated, such elimination shall be pursuant to the memorandum 
  3.36  of understanding.  However, other than specified above, the 
  4.1   Minnesota correctional facility at Faribault shall only 
  4.2   eliminate positions through attrition. 
  4.3      All Faribault regional center employees assigned to the 
  4.4   laundry as of the transfer date shall be allowed to transfer to 
  4.5   the Minnesota correctional facility at Faribault or exercise 
  4.6   their memorandum of understanding options.  All employees who 
  4.7   transfer shall retain their current classification, employment 
  4.8   condition, and salary upon such transfer. 
  4.9      (f) In consultation with the applicable exclusive 
  4.10  representatives, the departments of corrections, human services, 
  4.11  and employee relations shall establish training programs to 
  4.12  enhance the opportunity of the Faribault regional center 
  4.13  employees to obtain positions beyond entry level at the 
  4.14  Minnesota correctional facility at Faribault.  While 
  4.15  participating in this training, individuals shall remain on the 
  4.16  Faribault regional center payroll and the department of human 
  4.17  services shall seek a legislative appropriation for this 
  4.18  purpose.  The department of corrections shall seek a legislative 
  4.19  appropriation for retraining the Faribault regional center 
  4.20  employees. 
  4.21     Sec. 2.  Minnesota Statutes 1994, section 252.025, is 
  4.22  amended by adding a subdivision to read: 
  4.23     Subd. 8.  [SOUTHERN CITIES COMMUNITY HEALTH CLINIC.] The 
  4.24  department of human services shall consult with the Faribault 
  4.25  community task force and the exclusive representatives before 
  4.26  making any decisions about:  
  4.27     (1) the future of the Southern Cities Community Health 
  4.28  Clinic; 
  4.29     (2) the services currently provided by that clinic to 
  4.30  developmentally disabled clients in the Faribault regional 
  4.31  center catchment area; and 
  4.32     (3) changes in the model for providing those services.  
  4.33  The department of human services shall guarantee the provision 
  4.34  of medically necessary psychiatric and dental services to 
  4.35  developmentally disabled clients in the Faribault service area 
  4.36  until or unless other appropriate arrangements have been made to 
  5.1   provide those clients with those services. 
  5.2      Sec. 3.  Minnesota Statutes 1994, section 252.025, is 
  5.3   amended by adding a subdivision to read: 
  5.4      Subd. 9.  [STATE-OPERATED SERVICES IN THE FARIBAULT 
  5.5   CATCHMENT AREA.] (a) Notwithstanding subdivision 4, and in 
  5.6   addition to the programs already developed, the department of 
  5.7   human services shall establish the following state-operated, 
  5.8   community-based programs in the Faribault regional center 
  5.9   catchment area: 
  5.10     (1) state-operated community residential services to serve 
  5.11  as a primary provider for 40 current residents of the Faribault 
  5.12  regional center whose clinical symptoms or behaviors make them 
  5.13  difficult to serve.  Those state-operated, community-based 
  5.14  residential services shall be configured as ten four-bed 
  5.15  waivered services homes.  The program configuration may be 
  5.16  modified in accordance with paragraph (c).  
  5.17     Beginning July 1, 1995, in addition to the residential 
  5.18  services for those 40 clients, the department of human services 
  5.19  agrees to seek legislation to develop and establish 
  5.20  state-operated, community-based residential services for any 
  5.21  other current residents of the Faribault regional center for 
  5.22  whom the commissioner of human services finds that respective 
  5.23  counties of financial responsibility are unable to find 
  5.24  appropriate residential services operated by private providers.  
  5.25  Counties shall give the strongest possible consideration to the 
  5.26  placement preference of clients and families; 
  5.27     (2) a minimum of four state-operated day training and 
  5.28  habilitation facilities for persons leaving the Faribault 
  5.29  regional center as the result of downsizing and for other 
  5.30  individuals referred by county agencies; 
  5.31     (3) crisis services for developmentally disabled persons in 
  5.32  the Faribault regional center catchment area, including crisis 
  5.33  beds and mobile intervention teams.  These state-operated crisis 
  5.34  services shall be configured as three four-bed programs.  The 
  5.35  program configuration may be modified in accordance with 
  5.36  paragraph (c); 
  6.1      (4) area management services sufficient to manage 
  6.2   state-operated, community-based programs within the existing 
  6.3   Faribault regional center catchment area; 
  6.4      (5) area maintenance services sufficient to maintain the 
  6.5   physical facilities housing state-operated services in the 
  6.6   Faribault regional center catchment area; and 
  6.7      (6) technical assistance and training services for both 
  6.8   public and private providers. 
  6.9      (b) All employees of the state-operated services 
  6.10  established under this subdivision shall be state employees 
  6.11  under chapters 43A and 179A and shall consist of no fewer than 
  6.12  182 full-time employee equivalents, excluding additional 
  6.13  personnel that may be necessary to staff additional 
  6.14  state-operated, community-based residential services. 
  6.15     (c) Any changes in the configuration and design of programs 
  6.16  described in this subdivision must be negotiated and agreed to 
  6.17  by the affected exclusive representatives.  The parties also 
  6.18  must meet and discuss ways to provide the highest quality 
  6.19  services, while maintaining or increasing cost effectiveness. 
  6.20     (d) The department of human services shall assist the 
  6.21  counties with financial responsibility for those Faribault 
  6.22  regional center residents who will be discharged into 
  6.23  state-operated, community-based residential programs in 
  6.24  developing service options located in and around the city of 
  6.25  Faribault. 
  6.26     The department of human services shall seek funding, 
  6.27  including the capital bonding necessary to establish the 
  6.28  state-operated services authorized in this subdivision, 
  6.29  including area management services to be located in or around 
  6.30  the city of Faribault. 
  6.31     Sec. 4.  [252.031] [CAMBRIDGE COMMUNITY INTEGRATION 
  6.32  PROGRAM.] 
  6.33     (a) The commissioner of human services, in collaboration 
  6.34  with the commissioner of administration and the community group 
  6.35  established under section 252.51, shall identify and make 
  6.36  recommendations by February 1, 1996, with respect to the 
  7.1   following programs to be operated by the Cambridge regional 
  7.2   human services center: 
  7.3      (1) community integration programs to serve persons with 
  7.4   developmental disabilities; 
  7.5      (2) programs on the campus of the Cambridge regional human 
  7.6   services center to serve the difficult-to-serve clients who 
  7.7   remain at or are committed to the care of the Cambridge 
  7.8   facility; 
  7.9      (3) needed capital improvements; 
  7.10     (4) alternative uses for the buildings and land on the 
  7.11  Cambridge campus which are not used to serve clients under 
  7.12  clause (2); and 
  7.13     (5) other state agency services that could be operated on 
  7.14  the Cambridge campus, including but not limited to the operation 
  7.15  of a satellite office for local administration of MinnesotaCare. 
  7.16     Sec. 5.  Minnesota Statutes 1994, section 256B.501, is 
  7.17  amended by adding a subdivision to read: 
  7.18     Subd. 8a.  [PAYMENT FOR PERSONS WITH SPECIAL NEEDS FOR 
  7.19  CRISIS INTERVENTION SERVICES.] State-operated, community-based 
  7.20  crisis services provided in accordance with section 252.50, 
  7.21  subdivision 7, to a resident of an intermediate care facility 
  7.22  for persons with mental retardation (ICF/MR) reimbursed under 
  7.23  this section shall be paid by medical assistance in accordance 
  7.24  with the paragraphs in this subdivision.  
  7.25     (a) "Crisis services" means the specialized services listed 
  7.26  in clauses (1) to (3) provided to prevent the recipient from 
  7.27  requiring placement in a more restrictive institutional setting 
  7.28  such as an inpatient hospital or regional treatment center and 
  7.29  to maintain the recipient in his or her present community 
  7.30  setting.  
  7.31     (1) The crisis services provider shall assess the 
  7.32  recipient's behavior and environment to identify factors 
  7.33  contributing to the crisis.  
  7.34     (2) The crisis services provider shall develop a 
  7.35  recipient-specific intervention plan in coordination with the 
  7.36  service planning team and provide recommendations for revisions 
  8.1   to the individual service plan if necessary to prevent or 
  8.2   minimize the likelihood of future crisis situations.  The 
  8.3   intervention plan shall include a transition plan to aid the 
  8.4   recipient in returning to the community-based ICF/MR if the 
  8.5   recipient is receiving residential crisis services.  
  8.6      (3) The crisis services provider shall consult with and 
  8.7   provide training and ongoing technical assistance to the 
  8.8   recipient's service providers to aid in the implementation of 
  8.9   the intervention plan and revisions to the individual service 
  8.10  plan.  
  8.11     (b) "Residential crisis services" means crisis services 
  8.12  that are provided to a recipient admitted to the crisis services 
  8.13  foster care setting because the ICF/MR receiving reimbursement 
  8.14  under this section is not able, as determined by the 
  8.15  commissioner, to provide the intervention and protection of the 
  8.16  recipient and others living with the recipient that is necessary 
  8.17  to prevent the recipient from requiring placement in a more 
  8.18  restrictive institutional setting.  
  8.19     (c) Crisis services providers must be licensed by the 
  8.20  commissioner under section 245A.03 to provide foster care, must 
  8.21  exclusively provide short-term crisis intervention, and must not 
  8.22  be located in a private residence.  
  8.23     (d) Payment rates are determined annually for each crisis 
  8.24  services provider based on cost of care for each provider as 
  8.25  defined in section 246.50.  Interim payment rates are calculated 
  8.26  on a per diem basis by dividing the projected cost of providing 
  8.27  care by the projected number of contact days for the fiscal 
  8.28  year, as estimated by the commissioner.  Final payment rates are 
  8.29  calculated by dividing the actual cost of providing care by the 
  8.30  actual number of contact days in the applicable fiscal year.  
  8.31     (e) Payment shall be made for each contact day.  "Contact 
  8.32  day" means any day in which the crisis services provider has 
  8.33  face-to-face contact with the recipient or any of the 
  8.34  recipient's medical assistance service providers for the purpose 
  8.35  of providing crisis services as defined in paragraph (c).  
  8.36     (f) Payment for residential crisis services unless an 
  9.1   additional period is authorized by the commissioner.  The 
  9.2   additional period may not exceed 21 days.  
  9.3      (g) Payment for crisis services shall be made only for 
  9.4   services provided while the ICF/MR receiving reimbursement under 
  9.5   this section: 
  9.6      (1) has a shared services agreement with the crisis 
  9.7   services provider in effect in accordance with section 246.57; 
  9.8      (2) has reassigned payment for the provision of the crisis 
  9.9   services under this subdivision to the commissioner in 
  9.10  accordance with Code of Federal Regulations, title 42, section 
  9.11  447.10(e); and 
  9.12     (3) has executed a cooperative agreement with the crisis 
  9.13  services provider to implement the intervention plan and 
  9.14  revisions to the individual service plan as necessary to prevent 
  9.15  or minimize the likelihood of future crisis situations, to 
  9.16  maintain the recipient in his or her present community setting, 
  9.17  and to prevent the recipient from requiring a more restrictive 
  9.18  institutional setting.  
  9.19     (h) Payment to the ICF/MR receiving reimbursement under 
  9.20  this section shall be made for each therapeutic leave day during 
  9.21  which the recipient is receiving residential crisis services, if 
  9.22  the ICF/MR is otherwise eligible to receive payment for a 
  9.23  therapeutic leave day under Minnesota Rules, part 9505.0415.  
  9.24  Payment under this paragraph shall be terminated if the 
  9.25  commissioner determines that the ICF/MR is not meeting the terms 
  9.26  of the cooperative agreement under paragraph (g) or that the 
  9.27  recipient will not return to the ICF/MR.