1.1    .................... moves to amend H. F. No. 408 as follows:
1.2Delete everything after the enacting clause and insert:

1.3    "Section 1. Minnesota Statutes 2006, section 256B.0621, subdivision 11, is amended to
1.4read:
1.5    Subd. 11. Data use agreement; notice of relocation assistance. The commissioner
1.6shall execute a data use agreement with the Centers for Medicare and Medicaid Services
1.7to obtain the long-term care minimum data set data to assist residents of nursing facilities
1.8who have establish a process with the Centers for Independent Living that allows a person
1.9residing in a Minnesota nursing facility to receive needed information, consultation, and
1.10assistance from one of the centers about the available community support options that may
1.11enable the person to relocate to the community, if the person: (1) is under the age of 65,
1.12(2) has indicated a desire to live in the community. The commissioner shall in turn enter
1.13into agreements with the Centers for Independent Living to provide information about
1.14assistance for persons who want to move to the community. The commissioner shall work
1.15with the Centers for Independent Living on both the content of the information to be
1.16provided and privacy protections for the individual residents, and (3) has signed a release
1.17of information authorized by the person or the person's appointed legal representative.
1.18The process established under this subdivision shall be coordinated with the long-term
1.19care consultation service activities established in section 256B.0911.

1.20    Sec. 2. Minnesota Statutes 2006, section 256B.0911, subdivision 3b, is amended to
1.21read:
1.22    Subd. 3b. Transition assistance. (a) A long-term care consultation team shall
1.23provide assistance to persons residing in a nursing facility, hospital, regional treatment
1.24center, or intermediate care facility for persons with developmental disabilities who
1.25request or are referred for assistance. Transition assistance must include assessment,
1.26community support plan development, referrals to Minnesota health care programs,
2.1and referrals to programs that provide assistance with housing. Transition assistance
2.2must also include information about the Centers for Independent Living and about other
2.3organizations that can provide assistance with relocation efforts, and information about
2.4contacting these organizations to obtain their assistance and support.
2.5    (b) The county shall develop transition processes with institutional social workers
2.6and discharge planners to ensure that:
2.7    (1) persons admitted to facilities receive information about transition assistance
2.8that is available;
2.9    (2) the assessment is completed for persons within ten working days of the date of
2.10request or recommendation for assessment; and
2.11    (3) there is a plan for transition and follow-up for the individual's return to the
2.12community. The plan must require notification of other local agencies when a person
2.13who may require assistance is screened by one county for admission to a facility located
2.14in another county.
2.15    (c) If a person who is eligible for a Minnesota health care program is admitted to a
2.16nursing facility, the nursing facility must include a consultation team member or the case
2.17manager in the discharge planning process.

2.18    Sec. 3. Minnesota Statutes 2006, section 256B.49, subdivision 11, is amended to read:
2.19    Subd. 11. Authority. (a) The commissioner is authorized to apply for home and
2.20community-based service waivers, as authorized under section 1915(c) of the Social
2.21Security Act to serve persons under the age of 65 who are determined to require the level
2.22of care provided in a nursing home and persons who require the level of care provided in a
2.23hospital. The commissioner shall apply for the home and community-based waivers in
2.24order to:
2.25    (i) promote the support of persons with disabilities in the most integrated settings;
2.26    (ii) expand the availability of services for persons who are eligible for medical
2.27assistance;
2.28    (iii) promote cost-effective options to institutional care; and
2.29    (iv) obtain federal financial participation.
2.30    (b) The provision of waivered services to medical assistance recipients with
2.31disabilities shall comply with the requirements outlined in the federally approved
2.32applications for home and community-based services and subsequent amendments,
2.33including provision of services according to a service plan designed to meet the needs of
2.34the individual. For purposes of this section, the approved home and community-based
2.35application is considered the necessary federal requirement.
3.1    (c) The commissioner shall provide interested persons serving on agency advisory
3.2committees and, task forces, the Centers for Independent Living, and others upon who
3.3request, with to be on a list to receive, notice of, and an opportunity to comment on,
3.4at least 30 days before any effective dates, (1) any substantive changes to the state's
3.5disability services provider manual, or (2) changes or amendments to the federally
3.6approved applications for home and community-based waivers, prior to their submission
3.7to the federal Centers for Medicare and Medicaid Services.
3.8    (d) The commissioner shall seek approval, as authorized under section 1915(c) of
3.9the Social Security Act, to allow medical assistance eligibility under this section for
3.10children under age 21 without deeming of parental income or assets.
3.11    (e) The commissioner shall seek approval, as authorized under section 1915(c) of
3.12the Social Act, to allow medical assistance eligibility under this section for individuals
3.13under age 65 without deeming the spouse's income or assets.

3.14    Sec. 4. Minnesota Statutes 2006, section 256B.49, is amended by adding a subdivision
3.15to read:
3.16    Subd. 16a. Medical assistance reimbursement. (a) The commissioner shall
3.17seek federal approval for medical assistance reimbursement of independent living skills
3.18services, foster care waiver service, supported employment, prevocational service,
3.19structured day service, and adult day care under the home and community-based waiver
3.20for persons with a traumatic brain injury, the community alternatives for disabled
3.21individuals waivers, and the community alternative care waivers.
3.22    (b) Medical reimbursement shall be made only when the provider demonstrates
3.23evidence of its capacity to meet basic health, safety, and protection standards through
3.24one of the methods in paragraphs (c) to (e).
3.25    (c) The provider is licensed to provide services under chapter 245B and agrees to
3.26apply these standards to services funded through the traumatic brain injury, community
3.27alternatives for disabled, or community alternative care home and community-based
3.28waivers.
3.29    (d) The local agency contracting for the services certifies on a form provided by the
3.30commissioner that the provider has the capacity to meet the individual needs as identified
3.31in each person's individual service plan. When certifying that the service provider meets
3.32the necessary provider qualifications, the local agency shall verify that the provider has
3.33policies and procedures governing the following:
3.34    (1) protection of the consumer's rights and privacy;
3.35    (2) risk assessment and planning;
4.1    (3) record keeping and reporting of incidents and emergencies with documentation
4.2of corrective action if needed;
4.3    (4) service outcomes, regular reviews of progress, and periodic reports;
4.4    (5) complaint and grievance procedures;
4.5    (6) service termination or suspension;
4.6    (7) necessary training and supervision of direct care staff that includes:
4.7    (i) documentation in personnel files of 20 hours of orientation training in providing
4.8training related to service provision;
4.9    (ii) training in recognizing the symptoms and effects of certain disabilities, health
4.10conditions, and positive behavioral supports and interventions; and
4.11    (iii) a minimum of five hours of related training annually; and
4.12    (8) when applicable, the local agency shall verify that the provider has policies and
4.13procedures in place governing the following:
4.14    (i) safe medication administration;
4.15    (ii) proper handling of consumer funds; and
4.16    (iii) behavioral interventions that are in compliance with prohibitions and standards
4.17developed by the commissioner to meet federal requirements regarding the use of
4.18restraints and restrictive interventions.
4.19    (e) For foster care waiver services or independent living skills services, the local
4.20agency contracting for the services certifies on a form provided by the commissioner that
4.21the provider meets the following:
4.22    (1) the provider of foster care waiver services is licensed to provide adult foster
4.23care under Minnesota Rules, parts 9555.5105 to 9555.6265, or child foster care under
4.24Minnesota Rules, parts 2960.3000 to 2960.3230;
4.25    (2) the provider of independent living skills services also provides licensed foster
4.26care services and agrees to apply the following foster care standards: Minnesota Rules,
4.27parts 9555.5105; 9555.5705, subpart 2; 9555.6167; 9555.6185; 9555.6195; 9555.6225,
4.28subpart 8; 9555.6245; 9555.6255; and 9555.6265, or parts 2960.3010; 2960.3080, subparts
4.2910 and 11; 2960.3210; 2960.3220, subparts 5 to 7; and 2960.3230, for the provision of
4.30those services; and
4.31    (3) the provider has policies and procedures applying to the provision of foster
4.32care waiver services or independent living skills services that govern (i) behavioral
4.33interventions that are in compliance with prohibitions and standards developed by the
4.34commissioner to meet federal requirements regarding the use of restraints and restrictive
4.35interventions and (ii) documentation of service needs and outcomes, regular reviews
4.36of progress, and periodic reports.
5.1    (f) The local agency shall review each provider's continued compliance with
5.2the basic health, safety, and protection standards on a regular basis. For the review
5.3of paragraph (e), the local agency shall coordinate the review with the county review
5.4of foster care licensure.
5.5EFFECTIVE DATE.This section is effective the day following final enactment."
5.6Delete the title and insert:
5.7"A bill for an act
5.8relating to human services; regulating Centers for Independent Living; providing
5.9guidelines for medical assistance reimbursement;amending Minnesota Statutes
5.102006, sections 256B.0621, subdivision 11; 256B.0911, subdivision 3b; 256B.49,
5.11subdivision 11, by adding a subdivision."