This is the first in a series of detailed analyses regarding legislation passed during the recent legislative session.    

During sessions the Minnesota Senior Federation joins forces with allies to support and monitor legislation to final passage.

Health and human services legislation is of particular interest and concern. The legislature passed Chapter 147 (HF1078) as the Health and Human Services Omnibus bill and the governor signed the bill into law on May 25. The full bill and a House research document, “Act Summary for Chapter 147” (76 pages) can be found at  www.house.leg.state.mn.us.

Through our work with the Minnesota Board on Aging public policy committee and the Minnesota Department of Human Services we offer the following summary of the legislation.

Provider Rate Increases
Nursing facility rate increases beginning Oct. 1. Provides a nursing facility rate increase of 1.87 percent for the rate year beginning Oct. 1. Seventy-five percent of the money must be used for compensation-related increases for eligible employees. Of that amount, two-thirds must be used for an equal hourly percentage wage increase for all eligible employees. The portion of the rate increase not set aside for employee compensation must be paid to facilities effective Oct. 1. Article 7, sec. 21- 22.

Calculation of [NF] quality add-on for the rate year beginning Oct. 1. Provides nursing facilities in fiscal year 2008 with the opportunity to earn up to an additional .3 percent by demonstrating quality in six measured categories. Article 7, sec. 44.

Provider rate increases. Provides rate increases of 2 percent beginning Oct. 1, 2007 and 2 percent beginning Oct. 1, 2008, for specified community-based providers and programs. Seventy-five percent of the money must be used for compensation-related increases for eligible employees. Of that amount, two-thirds must be used for an equal hourly percentage wage increase for all eligible employees. Providers must certify to DHS that they have increased employee compensation and wages as required. Article 7, sec. 71.

[In the past these rate increases only applied to Elderly Waiver and Alternative Care. This is the first time that all home- and community-based senior services (providers, programs and grants) administered by DHS and Minnesota Board on Aging have received this type of funding increase. More information will be forthcoming regarding the mechanism for distributing increases in accordance with legislative language.]

Housing with services and assisted living
Housing with services and home care providers study report. Requires that the commissioner of human services study how the state can assist the elderly in selecting long-term care services that meet their needs, reflect their preferences and enable them to maintain financial self-sufficiency. The final report is due by Dec. 15, 2008. Article 7, sec. 73.

Transition to housing with services. Requires housing with services establishments that provide assisted living services to inform prospective residents about the availability of transitional consultation services prior to executing a lease or contract. Article 7, sec. 14.

Senior Nutrition and Volunteer Programs
The Senior Nutrition Program. A rider allocates an additional $125,000 in each year of the biennium for this program. Article 19, sec. 3, subd. 8 (a).

Senior Companion Program, Retired and Senior Volunteer Program, and Foster Grandparent Program. A rider to the legislation provides an additional $125,000 each year of the biennium to be shared by these three programs ($42,000, $42,000, $41,000). Article 19, sec. 3, subd. 8 (a).

Ombudsman Office
Office of ombudsman for long-term care name change. Changes the name of the Office of Ombudsman for Older Minnesotans to the Office of Ombudsman for Long-Term Care. Article 6, sec. 9.

Client. Clarifies that an individual receiving home care services is a client of the Office of Ombudsman for Long-Term Care. Article 6, sec. 11.

Long-term care facility. Modifies the definition of long-term care facility to allow the Office of Ombudsman for LTC access to “a licensed or registered residential setting which provides or arranges for the provision of home care services” at any time without notice. Article 6, sec. 10.

Posting. Requires that counties provide clients receiving long-term care consultation services or home- and community-based services with information on the office of ombudsman. (Current law only requires this for clients receiving a consumer support grant or service allowance.)  Article 6, sec.12.

Ombudsman for Veterans Home. A full-time Ombudsman at the Minneapolis Veterans Home for this biennium was provided for in the Agriculture and Veterans Affairs Omnibus bill.

Self-directed supports option.
Specifies that Medical Assistance covers the self-directed supports option upon federal approval. Makes this section effective upon federal approval of the state Medicaid plan amendment. Article 7, sec. 7, 12.

Home care under MSHO study
A rider provides $100,000 funding for the Commissioner of DHS to contract for a study of how the home care benefit is being provided under Minnesota Senior Health Options and Minnesota Disability Health Options. Article 19, sec. 3, subd. 6 (c) 6.

Long-term Care Consultation
Ensures all individuals in nursing facilities are provided with information about their right to receive an LTCC and information about The Office of Ombudsman for LTC. Requires LTCC consultants to provide people with disabilities in institutional settings with transition assistance information and support. Starting Oct. 1, 2008, requires all assisted living providers to inform prospective residents of the LTCC transitional assistance support option prior to signing a contract. Prescribes the components of transitional assistance to be offered by the LTCC team within five days of the request for consultation. Establishes that face-to-face assessments for the purposes of Minnesota Health Care Program eligibility are valid for 60 days and services are not authorized prior to the assessment date. Article 6, sec. 12, 23 to 26, 28. Article 7, sec. 13, 14.

Personal Care Assistant (PCA)
Personal Care Assistant (PCA) Service. Incorporates into statute several rules that allow for more transparency and better understanding of the PCA program; among the specific areas addressed are: PCA training requirements, personal care provider responsibilities, PCA employment prohibitions and supervision requirements. Article 6, sec. 19-22.

Timeliness of PCA assessments clarifies service updates for PCA services may be completed by telephone if there is no need for an increase in PCA services. Requires PCA providers to notify the county and service recipient 60 days prior to the end of the current prior authorization. Starting July 1, 2008, assesses a 25 percent penalty on the PCA assessment payment rate if assessments are not conducted and supporting documentation completed to ensure continuation of services for recipients. Article 7, sec. 8-11.

Elderly Waiver and customized living services
Defines case management, case aide services and county of service.  Establishes the “lead” agency definition. Sets forth a budget methodology for MA nursing facility clients who want to use EW to move into the community using the consumer-directed option. Establishes requirements for setting customized living service rates and specifies appropriate documentation. Effective the day following enactment, requires lead agencies to negotiate rates using the parameters established by the commissioner and to itemize services customized for each recipient and employs lead agencies not authorize 24-hour customized living services unless there is a documented need. Article 7, sec. 15.

Dual sensory loss program
Expands the existing deaf/blind support program to provide services to additional children and adults with a dual-sensory loss; invests in training to support counties to maximize the use of existing programs for deaf/blind people and additional training for the senior community-based service infrastructure.  Article 7, sec. 61.