1.1    .................... moves to amend H.F. No. 2426 as follows:
1.2Delete everything after the enacting clause and insert:

1.3    "Section 1. Minnesota Statutes 2006, section 256B.055, subdivision 12, is amended to
1.4read:
1.5    Subd. 12. Disabled children. (a) A person is eligible for medical assistance if the
1.6person is under age 19 and qualifies as a disabled individual under United States Code,
1.7title 42, section 1382c(a), and would be eligible for medical assistance under the state
1.8plan if residing in a medical institution, and the child requires a level of care provided in
1.9a hospital, nursing facility, or intermediate care facility for persons with developmental
1.10disabilities, for whom home care is appropriate, provided that the cost to medical
1.11assistance under this section is not more than the amount that medical assistance would pay
1.12for if the child resides in an institution. After the child is determined to be eligible under
1.13this section, the commissioner shall review the child's disability under United States Code,
1.14title 42, section 1382c(a) and level of care defined under this section no more often than
1.15annually and may elect, based on the recommendation of health care professionals under
1.16contract with the state medical review team, to extend the review of disability and level of
1.17care up to a maximum of four years. The commissioner's decision on the frequency of
1.18continuing review of disability and level of care is not subject to administrative appeal
1.19under section 256.045. The county agency shall send a notice of disability review to the
1.20enrollee six months prior to the date the recertification of disability is due. Nothing in this
1.21subdivision shall be construed as affecting other redeterminations of medical assistance
1.22eligibility under this chapter and annual cost-effective reviews under this section.
1.23    (b) For purposes of this subdivision, "hospital" means an institution as defined
1.24in section 144.696, subdivision 3, 144.55, subdivision 3, or Minnesota Rules, part
1.254640.3600, and licensed pursuant to sections 144.50 to 144.58. For purposes of this
1.26subdivision, a child requires a level of care provided in a hospital if the child is determined
1.27by the commissioner to need an extensive array of health services, including mental health
2.1services, for an undetermined period of time, whose health condition requires frequent
2.2monitoring and treatment by a health care professional or by a person supervised by a
2.3health care professional, who would reside in a hospital or require frequent hospitalization
2.4if these services were not provided, and the daily care needs are more complex than
2.5a nursing facility level of care.
2.6    A child with serious emotional disturbance requires a level of care provided in a
2.7hospital if the commissioner determines that the individual requires 24-hour supervision
2.8because the person exhibits recurrent or frequent suicidal or homicidal ideation or
2.9behavior, recurrent or frequent psychosomatic disorders or somatopsychic disorders that
2.10may become life threatening, recurrent or frequent severe socially unacceptable behavior
2.11associated with psychiatric disorder, ongoing and chronic psychosis or severe, ongoing
2.12and chronic developmental problems requiring continuous skilled observation, or severe
2.13disabling symptoms for which office-centered outpatient treatment is not adequate, and
2.14which overall severely impact the individual's ability to function.
2.15    (c) For purposes of this subdivision, "nursing facility" means a facility which
2.16provides nursing care as defined in section 144A.01, subdivision 5, licensed pursuant to
2.17sections 144A.02 to 144A.10, which is appropriate if a person is in active restorative
2.18treatment; is in need of special treatments provided or supervised by a licensed nurse; or
2.19has unpredictable episodes of active disease processes requiring immediate judgment
2.20by a licensed nurse. For purposes of this subdivision, a child requires the level of care
2.21provided in a nursing facility if the child is determined by the commissioner to meet
2.22the requirements of the preadmission screening assessment document under section
2.23256B.0911 and the home care independent rating document under section 256B.0655,
2.24subdivision 4 , clause (3), adjusted to address age-appropriate standards for children age 18
2.25and under, pursuant to section 256B.0655, subdivision 3.
2.26    (d) For purposes of this subdivision, "intermediate care facility for persons with
2.27developmental disabilities" or "ICF/MR" means a program licensed to provide services to
2.28persons with developmental disabilities under section 252.28, and chapter 245A, and a
2.29physical plant licensed as a supervised living facility under chapter 144, which together
2.30are certified by the Minnesota Department of Health as meeting the standards in Code of
2.31Federal Regulations, title 42, part 483, for an intermediate care facility which provides
2.32services for persons with developmental disabilities who require 24-hour supervision
2.33and active treatment for medical, behavioral, or habilitation needs. For purposes of this
2.34subdivision, a child requires a level of care provided in an ICF/MR if the commissioner
2.35finds that the child has a developmental disability in accordance with section 256B.092,
2.36is in need of a 24-hour plan of care and active treatment similar to persons with
3.1developmental disabilities, and there is a reasonable indication that the child will need
3.2ICF/MR services.
3.3    (e) For purposes of this subdivision, a person requires the level of care provided
3.4in a nursing facility if the person requires 24-hour monitoring or supervision and a plan
3.5of mental health treatment because of specific symptoms or functional impairments
3.6associated with a serious mental illness or disorder diagnosis, which meet severity criteria
3.7for mental health established by the commissioner and published in March 1997 as
3.8the Minnesota Mental Health Level of Care for Children and Adolescents with Severe
3.9Emotional Disorders.
3.10    (f) The determination of the level of care needed by the child shall be made by
3.11the commissioner based on information supplied to the commissioner by the parent or
3.12guardian, the child's physician or physicians, and other professionals as requested by the
3.13commissioner. The commissioner shall establish a screening team to conduct the level of
3.14care determinations according to this subdivision.
3.15    (g) If a child meets the conditions in paragraph (b), (c), (d), or (e), the commissioner
3.16must assess the case to determine whether:
3.17    (1) the child qualifies as a disabled individual under United States Code, title 42,
3.18section 1382c(a), and would be eligible for medical assistance if residing in a medical
3.19institution; and
3.20    (2) the cost of medical assistance services for the child, if eligible under this
3.21subdivision, would not be more than the cost to medical assistance if the child resides in a
3.22medical institution to be determined as follows:
3.23    (i) for a child who requires a level of care provided in an ICF/MR, the cost of
3.24care for the child in an institution shall be determined using the average payment rate
3.25established for the regional treatment centers that are certified as ICF's/MR;
3.26    (ii) for a child who requires a level of care provided in an inpatient hospital setting
3.27according to paragraph (b), cost-effectiveness shall be determined according to Minnesota
3.28Rules, part 9505.3520, items F and G; and
3.29    (iii) for a child who requires a level of care provided in a nursing facility according
3.30to paragraph (c) or (e), cost-effectiveness shall be determined according to Minnesota
3.31Rules, part 9505.3040, except that the nursing facility average rate shall be adjusted to
3.32reflect rates which would be paid for children under age 16. The commissioner may
3.33authorize an amount up to the amount medical assistance would pay for a child referred to
3.34the commissioner by the preadmission screening team under section 256B.0911.
3.35    (h) Children eligible for medical assistance services under section 256B.055,
3.36subdivision 12 , as of June 30, 1995, must be screened according to the criteria in this
4.1subdivision prior to January 1, 1996. Children found to be ineligible may not be removed
4.2from the program until January 1, 1996."
4.3Correct the title numbers accordingly