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Minn. Stat. § 256B.0911

LONG-TERM CARE CONSULTATION SERVICES.

Redline — January 1, 2012 → current.View current text →
Current — January 1, 2024
As of January 1, 2012
Subdivision 1. Purpose and goal.
Subdivision 1. Purpose and goal.
(a) The purpose of long-term care consultation services is to assist persons with long-term or chronic care needs in making care decisions and selecting support and service options that meet their needs and reflect their preferences. The availability of, and access to, information and other types of assistance, including assessment and support planning, is also intended to prevent or delay institutional placements and to provide access to transition assistance after admission. Further, the goal of these services is to contain costs associated with unnecessary institutional admissions. Long-term consultation services must be available to any person regardless of public program eligibility. The commissioner of human services shall seek to maximize use of available federal and state funds and establish the broadest program possible within the funding available.
(a) The purpose of long-term care consultation services is to assist persons with long-term or chronic care needs in making care decisions and selecting support and service options that meet their needs and reflect their preferences. The availability of, and access to, information and other types of assistance, including long-term care consultation assessment and support planning, is also intended to prevent or delay institutional placements and to provide access to transition assistance after placement. Further, the goal of long-term care consultation services is to contain costs associated with unnecessary institutional admissions. Long-term care consultation services must be available to any person regardless of public program eligibility.
(b) The commissioner of human services shall seek to maximize use of available federal and state funds and establish the broadest program possible within the funding available.
(c) Long-term care consultation services must be coordinated with long-term care options counseling, long-term care options counseling for assisted living, the Disability Hub, and preadmission screening.
(b) These services must be coordinated with long-term care options counseling provided under section 256.975, subdivision 7 , and section 256.01, subdivision 24 . The lead agency providing long-term care consultation services shall encourage the use of volunteers from families, religious organizations, social clubs, and similar civic and service organizations to provide community-based services.
(d) A lead agency providing long-term care consultation services shall encourage the use of volunteers from families, religious organizations, social clubs, and similar civic and service organizations to provide community-based services.
Subd. 1a. Definitions.
Subd. 1a.
For purposes of this section, the following definitions apply:
(a) Until additional requirements apply under paragraph (b), "long-term care consultation services" means:
(1) intake for and access to assistance in identifying services needed to maintain an individual in the most inclusive environment;
(2) providing recommendations for and referrals to cost-effective community services that are available to the individual;
(3) development of an individual's person-centered community support plan;
(4) providing information regarding eligibility for Minnesota health care programs;
(5) face-to-face long-term care consultation assessments, which may be completed in a hospital, nursing facility, intermediate care facility for persons with developmental disabilities (ICF/DDs), regional treatment centers, or the person's current or planned residence;
(6) federally mandated preadmission screening activities described under subdivisions 4a and 4b;
(7) determination of home and community-based waiver and other service eligibility as required under sections 256B.0913 , 256B.0915 , and 256B.49 , including level of care determination for individuals who need an institutional level of care as determined under section 256B.0911 , subdivision 4a, paragraph (d), based on assessment and community support plan development, appropriate referrals to obtain necessary diagnostic information, and including an eligibility determination for consumer-directed community supports;
(8) providing recommendations for institutional placement when there are no cost-effective community services available;
(9) providing access to assistance to transition people back to community settings after institutional admission; and
(10) providing information about competitive employment, with or without supports, for school-age youth and working-age adults and referrals to the Disability Linkage Line and Disability Benefits 101 to ensure that an informed choice about competitive employment can be made. For the purposes of this subdivision, "competitive employment" means work in the competitive labor market that is performed on a full-time or part-time basis in an integrated setting, and for which an individual is compensated at or above the minimum wage, but not less than the customary wage and level of benefits paid by the employer for the same or similar work performed by individuals without disabilities.
(b) Upon statewide implementation of lead agency requirements in subdivisions 2b, 2c, and 3a, "long-term care consultation services" also means:
(1) service eligibility determination for state plan home care services identified in:
(i) section 256B.0625, subdivisions 7 , 19a, and 19c;
(ii) section 256B.0657 ; or
(iii) consumer support grants under section 256.476 ;
(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024 , determination of eligibility for case management services available under sections 256B.0621, subdivision 2 , paragraph (4), and 256B.0924 and Minnesota Rules, part 9525.0016 ;
(3) determination of institutional level of care, home and community-based service waiver, and other service eligibility as required under section 256B.092 , determination of eligibility for family support grants under section 252.32 , semi-independent living services under section 252.275 , and day training and habilitation services under section 256B.092 ; and
(4) obtaining necessary diagnostic information to determine eligibility under clauses (2) and (3).
(c) "Long-term care options counseling" means the services provided by the linkage lines as mandated by sections 256.01 and 256.975, subdivision 7 , and also includes telephone assistance and follow up once a long-term care consultation assessment has been completed.
(d) "Minnesota health care programs" means the medical assistance program under chapter 256B and the alternative care program under section 256B.0913 .
(e) "Lead agencies" means counties administering or tribes and health plans under contract with the commissioner to administer long-term care consultation assessment and support planning services.
MS 2021 Supp [Repealed, 2022 c 98 art 16 s 31 ]
Subd. 2.
Subd. 2.
[Repealed, 1Sp2001 c 9 art 4 s 34 ]
[Repealed, 1Sp2001 c 9 art 4 s 34 ]
Subd. 2a.
Subd. 2a.
[Repealed, 1Sp2001 c 9 art 4 s 34 ]
[Repealed, 1Sp2001 c 9 art 4 s 34 ]
Subd. 2b. Certified assessors.
Subd. 2b.
(a) Each lead agency shall use certified assessors who have completed training and the certification processes determined by the commissioner in subdivision 2c. Certified assessors shall demonstrate best practices in assessment and support planning including person-centered planning principals and have a common set of skills that must ensure consistency and equitable access to services statewide. A lead agency may choose, according to departmental policies, to contract with a qualified, certified assessor to conduct assessments and reassessments on behalf of the lead agency.
(b) Certified assessors are persons with a minimum of a bachelor's degree in social work, nursing with a public health nursing certificate, or other closely related field with at least one year of home and community-based experience, or a registered nurse without public health certification with at least two years of home and community-based experience that has received training and certification specific to assessment and consultation for long-term care services in the state.
MS 2020 [Repealed, 2022 c 98 art 16 s 31 ]
Subd. 2c. Assessor training and certification.
Subd. 2c.
The commissioner shall develop and implement a curriculum and an assessor certification process. All existing lead agency staff designated to provide the services defined in subdivision 1a must be certified within timelines specified by the commissioner, but no sooner than six months after statewide availability of the training and certification process. The commissioner must establish the timelines for training and certification in a manner that allows lead agencies to most efficiently adopt the automated process established in subdivision 5. Each lead agency is required to ensure that they have sufficient numbers of certified assessors to provide long-term consultation assessment and support planning within the timelines and parameters of the service. Certified assessors are required to be recertified every three years.
MS 2020 [Repealed, 2022 c 98 art 16 s 31 ]
Subd. 3. Long-term care consultation team.
Subd. 3.
(a) A long-term care consultation team shall be established by the county board of commissioners. Two or more counties may collaborate to establish a joint local consultation team or teams.
(b) Certified assessors must be part of a multidisciplinary long-term care consultation team of professionals that includes public health nurses, social workers, and other professionals as defined in subdivision 2b, paragraph (b). The team is responsible for providing long-term care consultation services to all persons located in the county who request the services, regardless of eligibility for Minnesota health care programs.
(c) The commissioner shall allow arrangements and make recommendations that encourage counties and tribes to collaborate to establish joint local long-term care consultation teams to ensure that long-term care consultations are done within the timelines and parameters of the service. This includes integrated service models as required in subdivision 1, paragraph (b).
(d) Tribes and health plans under contract with the commissioner must provide long-term care consultation services as specified in the contract.
(e) The lead agency must provide the commissioner with an administrative contact for communication purposes.
MS 2020 [Repealed, 2022 c 98 art 16 s 31 ]
Subd. 3a. Assessment and support planning.
Subd. 3a.
(a) Persons requesting assessment, services planning, or other assistance intended to support community-based living, including persons who need assessment in order to determine waiver or alternative care program eligibility, must be visited by a long-term care consultation team within 20 calendar days after the date on which an assessment was requested or recommended. Upon statewide implementation of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment of a person requesting personal care assistance services and private duty nursing. The commissioner shall provide at least a 90-day notice to lead agencies prior to the effective date of this requirement. Face-to-face assessments must be conducted according to paragraphs (b) to (i).
(b) The lead agency may utilize a team of either the social worker or public health nurse, or both. Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified assessors to conduct the assessment. The consultation team members must confer regarding the most appropriate care for each individual screened or assessed. For a person with complex health care needs, a public health or registered nurse from the team must be consulted.
(c) The assessment must be comprehensive and include a person-centered assessment of the health, psychological, functional, environmental, and social needs of referred individuals and provide information necessary to develop a community support plan that meets the consumers needs, using an assessment form provided by the commissioner.
(d) The assessment must be conducted in a face-to-face interview with the person being assessed and the person's legal representative, and other individuals as requested by the person, who can provide information on the needs, strengths, and preferences of the person necessary to develop a community support plan that ensures the person's health and safety, but who is not a provider of service or has any financial interest in the provision of services. For persons who are to be assessed for elderly waiver customized living services under section 256B.0915 , with the permission of the person being assessed or the person's designated or legal representative, the client's current or proposed provider of services may submit a copy of the provider's nursing assessment or written report outlining its recommendations regarding the client's care needs. The person conducting the assessment will notify the provider of the date by which this information is to be submitted. This information shall be provided to the person conducting the assessment prior to the assessment.
(e) If the person chooses to use community-based services, the person or the person's legal representative must be provided with a written community support plan within 40 calendar days of the assessment visit, regardless of whether the individual is eligible for Minnesota health care programs. The written community support plan must include:
(1) a summary of assessed needs as defined in paragraphs (c) and (d);
(2) the individual's options and choices to meet identified needs, including all available options for case management services and providers;
(3) identification of health and safety risks and how those risks will be addressed, including personal risk management strategies;
(4) referral information; and
(5) informal caregiver supports, if applicable.
For a person determined eligible for state plan home care under subdivision 1a, paragraph (b), clause (1), the person or person's representative must also receive a copy of the home care service plan developed by the certified assessor.
(f) A person may request assistance in identifying community supports without participating in a complete assessment. Upon a request for assistance identifying community support, the person must be transferred or referred to long-term care options counseling services available under sections 256.975, subdivision 7 , and 256.01 , subdivision 24, for telephone assistance and follow up.
(g) The person has the right to make the final decision between institutional placement and community placement after the recommendations have been provided, except as provided in subdivision 4a, paragraph (c).
(h) The lead agency must give the person receiving assessment or support planning, or the person's legal representative, materials, and forms supplied by the commissioner containing the following information:
(1) written recommendations for community-based services and consumer-directed options;
(2) documentation that the most cost-effective alternatives available were offered to the individual. For purposes of this clause, "cost-effective" means community services and living arrangements that cost the same as or less than institutional care. For an individual found to meet eligibility criteria for home and community-based service programs under section 256B.0915 or 256B.49 , "cost-effectiveness" has the meaning found in the federally approved waiver plan for each program;
(3) the need for and purpose of preadmission screening if the person selects nursing facility placement;
(4) the role of long-term care consultation assessment and support planning in eligibility determination for waiver and alternative care programs, and state plan home care, case management, and other services as defined in subdivision 1a, paragraphs (a), clause (7), and (b);
(5) information about Minnesota health care programs;
(6) the person's freedom to accept or reject the recommendations of the team;
(7) the person's right to confidentiality under the Minnesota Government Data Practices Act, chapter 13;
(8) the certified assessor's decision regarding the person's need for institutional level of care as determined under criteria established in section 256B.0911, subdivision 4a , paragraph (d), and the certified assessor's decision regarding eligibility for all services and programs as defined in subdivision 1a, paragraphs (a), clause (7), and (b); and
(9) the person's right to appeal the certified assessor's decision regarding eligibility for all services and programs as defined in subdivision 1a, paragraphs (a), clause (7), and (b), and incorporating the decision regarding the need for institutional level of care or the lead agency's final decisions regarding public programs eligibility according to section 256.045, subdivision 3 .
(i) Face-to-face assessment completed as part of eligibility determination for the alternative care, elderly waiver, community alternatives for disabled individuals, community alternative care, and brain injury waiver programs under sections 256B.0913 , 256B.0915 , and 256B.49 is valid to establish service eligibility for no more than 60 calendar days after the date of assessment.
(j) The effective eligibility start date for programs in paragraph (i) can never be prior to the date of assessment. If an assessment was completed more than 60 days before the effective waiver or alternative care program eligibility start date, assessment and support plan information must be updated in a face-to-face visit and documented in the department's Medicaid Management Information System (MMIS). Notwithstanding retroactive medical assistance coverage of state plan services, the effective date of eligibility for programs included in paragraph (i) cannot be prior to the date the most recent updated assessment is completed.
MS 2021 Supp [Repealed, 2022 c 98 art 16 s 31 ]
Subd. 3b. Transition assistance.
Subd. 3b.
(a) Lead agency certified assessors shall provide assistance to persons residing in a nursing facility, hospital, regional treatment center, or intermediate care facility for persons with developmental disabilities who request or are referred for assistance. Transition assistance must include assessment, community support plan development, referrals to long-term care options counseling under section 256.975, subdivision 7 , for community support plan implementation and to Minnesota health care programs, including home and community-based waiver services and consumer-directed options through the waivers, and referrals to programs that provide assistance with housing. Transition assistance must also include information about the Centers for Independent Living, Disability Linkage Line, and about other organizations that can provide assistance with relocation efforts, and information about contacting these organizations to obtain their assistance and support.
MS 2020 [Repealed, 2022 c 98 art 16 s 31 ]
Subd. 3c.
MS 2020 [Renumbered 256.975, subd 7e]
Subd. 3d.
MS 2020 [Renumbered 256.975, subd 7f]
Subd. 3e.
MS 2020 [Renumbered 256.975, subd 7g]
Subd. 3f.
MS 2021 Supp [Repealed, 2022 c 98 art 16 s 31 ]
Subd. 3g.
MS 2020 [Repealed, 2022 c 98 art 16 s 31 ]
Subd. 4.
[Repealed, 1Sp2001 c 9 art 4 s 34 ]
Subd. 4a.
[Repealed, 2013 c 108 art 2 s 45 ]
Subd. 4b.
[Repealed, 2013 c 108 art 2 s 45 ]
Subd. 4c.
[Repealed, 2013 c 108 art 2 s 45 ]
Subd. 4d.
MS 2020 [Repealed, 2022 c 98 art 16 s 31 ]
Subd. 4e.
MS 2020 [Repealed, 2022 c 98 art 16 s 31 ]
Subd. 5.
MS 2020 [Repealed, 2022 c 98 art 16 s 31 ]
Subd. 6.
MS 2020 [Repealed, 2022 c 98 art 16 s 31 ]
Subd. 6a.
[Repealed, 2015 c 78 art 6 s 32 ]
Subd. 7.
[Repealed, 2016 c 99 art 1 s 43 ]
Subd. 8.
[Repealed, 2001 c 161 s 58 ]
Subd. 9.
[Repealed, 1Sp2001 c 9 art 4 s 34 ]
Subd. 10. Definitions.
(a) For purposes of this section, the following definitions apply.
(b) "Available service and setting options" or "available options," with respect to the home and community-based waivers under chapter 256S and sections 256B.092 and 256B.49 , means all services and settings defined under the waiver plan for which a waiver applicant or waiver participant is eligible.
(c) "Competitive employment" means work in the competitive labor market that is performed on a full-time or part-time basis in an integrated setting, and for which an individual is compensated at or above the minimum wage, but not less than the customary wage and level of benefits paid by the employer for the same or similar work performed by individuals without disabilities.
(d) "Cost-effective" means community services and living arrangements that cost the same as or less than institutional care. For an individual found to meet eligibility criteria for home and community-based service programs under chapter 256S or section 256B.49 , "cost-effectiveness" has the meaning found in the federally approved waiver plan for each program.
(e) "Independent living" means living in a setting that is not controlled by a provider.
(f) "Informed choice" has the meaning given in section 256B.4905, subdivision 1a .
(g) "Lead agency" means a county administering or a Tribe or health plan under contract with the commissioner to administer long-term care consultation services.
(h) "Long-term care consultation services" means the activities described in subdivision 11.
(i) "Long-term care options counseling" means the services provided by sections 256.01 , subdivision 24, and 256.975, subdivision 7 , and also includes telephone assistance and follow-up after a long-term care consultation assessment has been completed.
(j) "Long-term care options counseling for assisted living" means the services provided under section 256.975, subdivisions 7e to 7g.
(k) "Minnesota health care programs" means the medical assistance program under this chapter and the alternative care program under section 256B.0913 .
(l) "Person-centered planning" is a process that includes the active participation of a person in the planning of the person's services, including in making meaningful and informed choices about the person's own goals, talents, and objectives, as well as making meaningful and informed choices about the services the person receives, the settings in which the person receives the services, and the setting in which the person lives.
(m) "Preadmission screening" means the services provided under section 256.975 , subdivisions 7a to 7c.
Subd. 11. Long-term care consultation services.
(b) The lead agency shall ensure that: (1) referrals for in-person assessments are taken from long-term care options counselors as provided for in section 256.975, subdivision 7 , paragraph (b), clause (11); (2) persons assessed in institutions receive information about transition assistance that is available; (3) the assessment is completed for persons within 20 calendar days of the date of request or recommendation for assessment; (4) there is a plan for transition and follow-up for the individual's return to the community, including notification of other local agencies when a person may require assistance from agencies located in another county; and (5) relocation targeted case management as defined in section 256B.0621 , subdivision 2, clause (4), is authorized for an eligible medical assistance recipient. Subd. 3c. Consultation for housing with services. (a) The purpose of long-term care consultation for registered housing with services is to support persons with current or anticipated long-term care needs in making informed choices among options that include the most cost-effective and least restrictive settings. Prospective residents maintain the right to choose housing with services or assisted living if that option is their preference. (b) Registered housing with services establishments shall inform each prospective resident or the prospective resident's designated or legal representative of the availability of long-term care consultation and the need to receive and verify the consultation prior to signing a lease or contract. Long-term care consultation for registered housing with services is provided as determined by the commissioner of human services. The service is delivered under a partnership between lead agencies as defined in subdivision 1a, paragraph (d), and the Area Agencies on Aging, and is a point of entry to a combination of telephone-based long-term care options counseling provided by Senior LinkAge Line and in-person long-term care consultation provided by lead agencies. The point of entry service must be provided within five working days of the request of the prospective resident as follows: (1) the consultation shall be conducted with the prospective resident, or in the alternative, the resident's designated or legal representative, if: (i) the resident verbally requests; or (ii) the registered housing with services provider has documentation of the designated or legal representative's authority to enter into a lease or contract on behalf of the prospective resident and accepts the documentation in good faith; (2) the consultation shall be performed in a manner that provides objective and complete information; (3) the consultation must include a review of the prospective resident's reasons for considering housing with services, the prospective resident's personal goals, a discussion of the prospective resident's immediate and projected long-term care needs, and alternative community services or housing with services settings that may meet the prospective resident's needs; (4) the prospective resident shall be informed of the availability of a face-to-face visit at no charge to the prospective resident to assist the prospective resident in assessment and planning to meet the prospective resident's long-term care needs; and (5) verification of counseling shall be generated and provided to the prospective resident by Senior LinkAge Line upon completion of the telephone-based counseling. (c) Housing with services establishments registered under chapter 144D shall: (1) inform each prospective resident or the prospective resident's designated or legal representative of the availability of and contact information for consultation services under this subdivision; (2) receive a copy of the verification of counseling prior to executing a lease or service contract with the prospective resident, and prior to executing a service contract with individuals who have previously entered into lease-only arrangements; and (3) retain a copy of the verification of counseling as part of the resident's file. (d) Emergency admissions to registered housing with services establishments prior to consultation under paragraph (b) are permitted according to policies established by the commissioner. Subd. 3d. Exemptions. Individuals shall be exempt from the requirements outlined in subdivision 3c in the following circumstances: (1) the individual is seeking a lease-only arrangement in a subsidized housing setting; (2) the individual has previously received a long-term care consultation assessment under this section. In this instance, the assessor who completes the long-term care consultation will issue a verification code and provide it to the individual; (3) the individual is receiving or is being evaluated for hospice services from a hospice provider licensed under sections 144A.75 to 144A.755 ; or (4) the individual has used financial planning services and created a long-term care plan as defined by the commissioner in the 12 months prior to signing a lease or contract with a registered housing with services establishment. Subd. 3e. Consultation at hospital discharge. (a) Hospitals shall refer all individuals described in paragraph (b) prior to discharge from an inpatient hospital stay to the Senior LinkAge Line for long-term care options counseling. Hospitals shall make these referrals using referral protocols and processes developed under section 256.975 , subdivision 7. The purpose of the counseling is to support persons with current or anticipated long-term care needs in making informed choices among options that include the most cost-effective and least restrictive setting. (b) The individuals who shall be referred under paragraph (a) include older adults who are at risk of nursing home placement. Protocols for identifying at-risk individuals shall be developed under section 256.975, subdivision 7 , paragraph (b), clause (12). (c) Counseling provided under this subdivision shall meet the requirements for the consultation required under section 256B.0911, subdivision 3c . Subd. 4. [Repealed, 1Sp2001 c 9 art 4 s 34 ] Subd. 4a. Preadmission screening activities related to nursing facility admissions. (a) All applicants to Medicaid certified nursing facilities, including certified boarding care facilities, must be screened prior to admission regardless of income, assets, or funding sources for nursing facility care, except as described in subdivision 4b. The purpose of the screening is to determine the need for nursing facility level of care as described in paragraph (d) and to complete activities required under federal law related to mental illness and developmental disability as outlined in paragraph (b). (b) A person who has a diagnosis or possible diagnosis of mental illness or developmental disability must receive a preadmission screening before admission regardless of the exemptions outlined in subdivision 4b, paragraph (b), to identify the need for further evaluation and specialized services, unless the admission prior to screening is authorized by the local mental health authority or the local developmental disabilities case manager, or unless authorized by the county agency according to Public Law 101-508. The following criteria apply to the preadmission screening: (1) the lead agency must use forms and criteria developed by the commissioner to identify persons who require referral for further evaluation and determination of the need for specialized services; and (2) the evaluation and determination of the need for specialized services must be done by: (i) a qualified independent mental health professional, for persons with a primary or secondary diagnosis of a serious mental illness; or (ii) a qualified developmental disability professional, for persons with a primary or secondary diagnosis of developmental disability. For purposes of this requirement, a qualified developmental disability professional must meet the standards for a qualified developmental disability professional under Code of Federal Regulations, title 42, section 483.430. (c) The local county mental health authority or the state developmental disability authority under Public Laws 100-203 and 101-508 may prohibit admission to a nursing facility if the individual does not meet the nursing facility level of care criteria or needs specialized services as defined in Public Laws 100-203 and 101-508. For purposes of this section, "specialized services" for a person with developmental disability means active treatment as that term is defined under Code of Federal Regulations, title 42, section 483.440 (a)(1). (d) The determination of the need for nursing facility level of care must be made according to criteria developed by the commissioner, and in section 256B.092 , using forms developed by the commissioner. Effective no sooner than on or after July 1, 2012, for individuals age 21 and older, and on or after October 1, 2019, for individuals under age 21, the determination of need for nursing facility level of care shall be based on criteria in section 144.0724, subdivision 11 . In assessing a person's needs, consultation team members shall have a physician available for consultation and shall consider the assessment of the individual's attending physician, if any. The individual's physician must be included if the physician chooses to participate. Other personnel may be included on the team as deemed appropriate by the lead agency. Subd. 4b. Exemptions and emergency admissions. (a) Exemptions from the federal screening requirements outlined in subdivision 4a, paragraphs (b) and (c), are limited to: (1) a person who, having entered an acute care facility from a certified nursing facility, is returning to a certified nursing facility; (2) a person transferring from one certified nursing facility in Minnesota to another certified nursing facility in Minnesota; and (3) a person, 21 years of age or older, who satisfies the following criteria, as specified in Code of Federal Regulations, title 42, section 483.106(b)(2): (i) the person is admitted to a nursing facility directly from a hospital after receiving acute inpatient care at the hospital; (ii) the person requires nursing facility services for the same condition for which care was provided in the hospital; and (iii) the attending physician has certified before the nursing facility admission that the person is likely to receive less than 30 days of nursing facility services. (b) Persons who are exempt from preadmission screening for purposes of level of care determination include: (1) persons described in paragraph (a); (2) an individual who has a contractual right to have nursing facility care paid for indefinitely by the veterans' administration; (3) an individual enrolled in a demonstration project under section 256B.69, subdivision 8 , at the time of application to a nursing facility; and (4) an individual currently being served under the alternative care program or under a home and community-based services waiver authorized under section 1915(c) of the federal Social Security Act. (c) Persons admitted to a Medicaid-certified nursing facility from the community on an emergency basis as described in paragraph (d) or from an acute care facility on a nonworking day must be screened the first working day after admission. (d) Emergency admission to a nursing facility prior to screening is permitted when all of the following conditions are met: (1) a person is admitted from the community to a certified nursing or certified boarding care facility during county nonworking hours; (2) a physician has determined that delaying admission until preadmission screening is completed would adversely affect the person's health and safety; (3) there is a recent precipitating event that precludes the client from living safely in the community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's inability to continue to provide care; (4) the attending physician has authorized the emergency placement and has documented the reason that the emergency placement is recommended; and (5) the county is contacted on the first working day following the emergency admission. Transfer of a patient from an acute care hospital to a nursing facility is not considered an emergency except for a person who has received hospital services in the following situations: hospital admission for observation, care in an emergency room without hospital admission, or following hospital 24-hour bed care. (e) A nursing facility must provide written information to all persons admitted regarding the person's right to request and receive long-term care consultation services as defined in subdivision 1a. The information must be provided prior to the person's discharge from the facility and in a format specified by the commissioner. Subd. 4c. Screening requirements. (a) A person may be screened for nursing facility admission by telephone or in a face-to-face screening interview. Certified assessors shall identify each individual's needs using the following categories: (1) the person needs no face-to-face screening interview to determine the need for nursing facility level of care based on information obtained from other health care professionals; (2) the person needs an immediate face-to-face screening interview to determine the need for nursing facility level of care and complete activities required under subdivision 4a; or (3) the person may be exempt from screening requirements as outlined in subdivision 4b, but will need transitional assistance after admission or in-person follow-along after a return home. (b) Persons admitted on a nonemergency basis to a Medicaid-certified nursing facility must be screened prior to admission. (c) The lead agency screening or intake activity must include processes to identify persons who may require transition assistance as described in subdivision 3b. Subd. 4d. Preadmission screening of individuals under 65 years of age. (a) It is the policy of the state of Minnesota to ensure that individuals with disabilities or chronic illness are served in the most integrated setting appropriate to their needs and have the necessary information to make informed choices about home and community-based service options. (b) Individuals under 65 years of age who are admitted to a nursing facility from a hospital must be screened prior to admission as outlined in subdivisions 4a through 4c. (c) Individuals under 65 years of age who are admitted to nursing facilities with only a telephone screening must receive a face-to-face assessment from the long-term care consultation team member of the county in which the facility is located or from the recipient's county case manager within 40 calendar days of admission. (d) Individuals under 65 years of age who are admitted to a nursing facility without preadmission screening according to the exemption described in subdivision 4b, paragraph (a), clause (3), and who remain in the facility longer than 30 days must receive a face-to-face assessment within 40 days of admission. (e) At the face-to-face assessment, the long-term care consultation team member or county case manager must perform the activities required under subdivision 3b. (f) For individuals under 21 years of age, a screening interview which recommends nursing facility admission must be face-to-face and approved by the commissioner before the individual is admitted to the nursing facility. (g) In the event that an individual under 65 years of age is admitted to a nursing facility on an emergency basis, the county must be notified of the admission on the next working day, and a face-to-face assessment as described in paragraph (c) must be conducted within 40 calendar days of admission. (h) At the face-to-face assessment, the long-term care consultation team member or the case manager must present information about home and community-based options, including consumer-directed options, so the individual can make informed choices. If the individual chooses home and community-based services, the long-term care consultation team member or case manager must complete a written relocation plan within 20 working days of the visit. The plan shall describe the services needed to move out of the facility and a time line for the move which is designed to ensure a smooth transition to the individual's home and community. (i) An individual under 65 years of age residing in a nursing facility shall receive a face-to-face assessment at least every 12 months to review the person's service choices and available alternatives unless the individual indicates, in writing, that annual visits are not desired. In this case, the individual must receive a face-to-face assessment at least once every 36 months for the same purposes. (j) Notwithstanding the provisions of subdivision 6, the commissioner may pay county agencies directly for face-to-face assessments for individuals under 65 years of age who are being considered for placement or residing in a nursing facility. Subd. 5. Administrative activity. The commissioner shall streamline the processes, including timelines for when assessments need to be completed, required to provide the services in this section and shall implement integrated solutions to automate the business processes to the extent necessary for community support plan approval, reimbursement, program planning, evaluation, and policy development. Subd. 6. Payment for long-term care consultation services. (a) The total payment for each county must be paid monthly by certified nursing facilities in the county. The monthly amount to be paid by each nursing facility for each fiscal year must be determined by dividing the county's annual allocation for long-term care consultation services by 12 to determine the monthly payment and allocating the monthly payment to each nursing facility based on the number of licensed beds in the nursing facility. Payments to counties in which there is no certified nursing facility must be made by increasing the payment rate of the two facilities located nearest to the county seat. (b) The commissioner shall include the total annual payment determined under paragraph (a) for each nursing facility reimbursed under section 256B.431 , 256B.434 , or 256B.441 . (c) In the event of the layaway, delicensure and decertification, or removal from layaway of 25 percent or more of the beds in a facility, the commissioner may adjust the per diem payment amount in paragraph (b) and may adjust the monthly payment amount in paragraph (a). The effective date of an adjustment made under this paragraph shall be on or after the first day of the month following the effective date of the layaway, delicensure and decertification, or removal from layaway. (d) Payments for long-term care consultation services are available to the county or counties to cover staff salaries and expenses to provide the services described in subdivision 1a. The county shall employ, or contract with other agencies to employ, within the limits of available funding, sufficient personnel to provide long-term care consultation services while meeting the state's long-term care outcomes and objectives as defined in subdivision 1. The county shall be accountable for meeting local objectives as approved by the commissioner in the biennial home and community-based services quality assurance plan on a form provided by the commissioner. (e) Notwithstanding section 256B.0641 , overpayments attributable to payment of the screening costs under the medical assistance program may not be recovered from a facility. (f) The commissioner of human services shall amend the Minnesota medical assistance plan to include reimbursement for the local consultation teams. (g) Until the alternative payment methodology in paragraph (h) is implemented, the county may bill, as case management services, assessments, support planning, and follow-along provided to persons determined to be eligible for case management under Minnesota health care programs. No individual or family member shall be charged for an initial assessment or initial support plan development provided under subdivision 3a or 3b. (h) The commissioner shall develop an alternative payment methodology for long-term care consultation services that includes the funding available under this subdivision, and sections 256B.092 and 256B.0659 . In developing the new payment methodology, the commissioner shall consider the maximization of other funding sources, including federal funding, for all long-term care consultation and preadmission screening activity. Subd. 6a. Withholding. If any provider obligated to pay the long-term care consultation amount as described in subdivision 6 is more than two months delinquent in the timely payment of the monthly installment, the commissioner may withhold payments, penalties, and interest in accordance with the methods outlined in section 256.9657 , subdivision 7a. Any amount withheld under this provision must be returned to the county to whom the delinquent payments were due. Subd. 7. Reimbursement for certified nursing facilities. (a) Medical assistance reimbursement for nursing facilities shall be authorized for a medical assistance recipient only if a preadmission screening has been conducted prior to admission or the county has authorized an exemption. Medical assistance reimbursement for nursing facilities shall not be provided for any recipient who the local screener has determined does not meet the level of care criteria for nursing facility placement in section 144.0724, subdivision 11 , or, if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus Budget Reconciliation Act of 1987 completed unless an admission for a recipient with mental illness is approved by the local mental health authority or an admission for a recipient with developmental disability is approved by the state developmental disability authority. (b) The nursing facility must not bill a person who is not a medical assistance recipient for resident days that preceded the date of completion of screening activities as required under subdivisions 4a, 4b, and 4c. The nursing facility must include unreimbursed resident days in the nursing facility resident day totals reported to the commissioner. Subd. 8. [Repealed, 2001 c 161 s 58 ] Subd. 9. [Repealed, 1Sp2001 c 9 art 4 s 34 ]
The following activities are included in long-term care consultation services: (1) intake for and access to assistance in identifying services needed to maintain an individual in the most inclusive environment; (2) transfer or referral to long-term care options counseling services for telephone assistance and follow-up after a person requests assistance in identifying community supports without participating in a complete long-term care consultation assessment; (3) long-term care consultation assessments conducted according to subdivisions 17 to 21, 23, or 24, which may be completed in a hospital, nursing facility, intermediate care facility for persons with developmental disabilities (ICF/DDs), regional treatment center, or the person's current or planned residence; (4) providing recommendations for and referrals to cost-effective community services that are available to the individual; (5) providing recommendations for institutional placement when there are no cost-effective community services available; (6) providing information regarding eligibility for Minnesota health care programs; (7) determining service eligibility for the following state plan services: (i) personal care assistance services under section 256B.0625, subdivisions 19a and 19c; (ii) consumer support grants under section 256.476 ; or (iii) community first services and supports under section 256B.85 ; (8) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024 , gaining access to the following services, including obtaining necessary diagnostic information to determine eligibility: (i) relocation targeted case management services available under section 256B.0621 , subdivision 2, clause (4); (ii) case management services targeted to vulnerable adults or people with developmental disabilities under section 256B.0924 ; and (iii) case management services targeted to people with developmental disabilities under Minnesota Rules, part 9525.0016 ; (9) determining eligibility for semi-independent living services under section 252.275 , including obtaining necessary diagnostic information; (10) determining home and community-based waiver and other service eligibility as required under chapter 256S and sections 256B.0913 , 256B.092 , and 256B.49 , including: (i) level of care determination for individuals who need an institutional level of care as determined under subdivision 26; (ii) appropriate referrals to obtain necessary diagnostic information; and (iii) an eligibility determination for consumer-directed community supports; (11) providing information about competitive employment, with or without supports, for school-age youth and working-age adults and referrals to the Disability Hub and Disability Benefits 101 to ensure that an informed choice about competitive employment can be made; (12) providing information about independent living to ensure that an informed choice about independent living can be made; (13) providing information about self-directed services and supports, including self-directed funding options, to ensure that an informed choice about self-directed options can be made; (14) developing an individual's person-centered assessment summary; and (15) providing access to assistance to transition people back to community settings after institutional admission. Subd. 12. Exception to use of MnCHOICES assessment; contracted assessors. A lead agency that has not implemented MnCHOICES assessments and uses contracted assessors as of January 1, 2022, is not subject to the requirements of subdivisions 11, clauses (7) to (9); 13; 14, paragraphs (a) to (c); 16 to 21; 23; 24; and 29 to 31. Subd. 13. MnCHOICES assessor qualifications, training, and certification. (a) The commissioner shall develop and implement a curriculum and an assessor certification process. (b) MnCHOICES certified assessors must: (1) either have a bachelor's degree in social work, nursing with a public health nursing certificate, or other closely related field or be a registered nurse; and (2) have received training and certification specific to assessment and consultation for long-term care services in the state. (c) Certified assessors shall demonstrate best practices in assessment and support planning, including person-centered planning principles, and have a common set of skills that ensures consistency and equitable access to services statewide. (d) Certified assessors must be recertified every three years. Subd. 14. Use of MnCHOICES certified assessors required. (a) Each lead agency shall use MnCHOICES certified assessors who have completed MnCHOICES training and the certification process determined by the commissioner in subdivision 13. (b) Each lead agency must ensure that the lead agency has sufficient numbers of certified assessors to provide long-term consultation assessment and support planning within the timelines and parameters of the service. (c) A lead agency may choose, according to departmental policies, to contract with a qualified, certified assessor to conduct assessments and reassessments on behalf of the lead agency. (d) Tribes and health plans under contract with the commissioner must provide long-term care consultation services as specified in the contract. (e) A lead agency must provide the commissioner with an administrative contact for communication purposes. Subd. 15. Long-term care consultation team. (a) Each county board of commissioners shall establish a long-term care consultation team. Two or more counties may collaborate to establish a joint local long-term care consultation team or teams. (b) Each lead agency shall establish and maintain a team of certified assessors qualified under subdivision 13. Each team member is responsible for providing consultation with other team members upon request. The team is responsible for providing long-term care consultation services to all persons located in the county who request the services, regardless of eligibility for Minnesota health care programs. The team of certified assessors must include, at a minimum: (1) a social worker; and (2) a public health nurse or registered nurse. (c) The commissioner shall allow arrangements and make recommendations that encourage counties and Tribes to collaborate to establish joint local long-term care consultation teams to ensure that long-term care consultations are done within the timelines and parameters of the service. This includes coordinated service models as required in subdivision 1, paragraph (c). Subd. 16. MnCHOICES certified assessors; responsibilities. (a) Certified assessors must use person-centered planning principles to conduct an interview that identifies what is important to the person; the person's needs for supports and health and safety concerns; and the person's abilities, interests, and goals. (b) Certified assessors are responsible for: (1) ensuring persons are offered objective, unbiased access to resources; (2) ensuring persons have the needed information to support informed choice, including where and how they choose to live and the opportunity to pursue desired employment; (3) determining level of care and eligibility for long-term services and supports; (4) using the information gathered from the interview to develop a person-centered assessment summary that reflects identified needs and support options within the context of values, interests, and goals important to the person; and (5) providing the person with an assessment summary of findings, support options, and agreed-upon next steps. Subd. 17. MnCHOICES assessments. (a) A person requesting long-term care consultation services must be visited by a long-term care consultation team within 20 working days after the date on which an assessment was requested or recommended. Assessments must be conducted according to this subdivision and subdivisions 19 to 21, 23, 24, and 29 to 31. (b) Lead agencies shall use certified assessors to conduct the assessment. (c) For a person with complex health care needs, a public health or registered nurse from the team must be consulted. (d) The lead agency must use the MnCHOICES assessment provided by the commissioner to complete a comprehensive, conversation-based, person-centered assessment. The assessment must include the health, psychological, functional, environmental, and social needs of the individual necessary to develop a person-centered assessment summary that meets the individual's needs and preferences. (e) Except as provided in subdivision 24, an assessment must be conducted by a certified assessor in an in-person conversational interview with the person being assessed. Subd. 18. Exception to use of MnCHOICES assessments; long-term care consultation team visit; notice. (a) Until statewide implementation of MnCHOICES assessments, the requirement under subdivision 17, paragraph (a), does not apply to an assessment of a person requesting personal care assistance services. The commissioner shall provide at least a 90-day notice to lead agencies prior to the effective date of statewide implementation. (b) This subdivision expires upon statewide implementation of MnCHOICES assessments. The commissioner shall notify the revisor of statutes when statewide implementation has occurred. Subd. 19. MnCHOICES assessments; third-party participation. (a) The person's legal representative, if any, must provide input during the assessment process and may do so remotely if requested. (b) At the request of the person, other individuals may participate in the assessment to provide information on the needs, strengths, and preferences of the person necessary to complete the assessment and assessment summary. Except for legal representatives or family members invited by the person, a person participating in the assessment may not be a provider of service or have any financial interest in the provision of services. (c) For a person assessed for elderly waiver customized living or adult day services under chapter 256S, with the permission of the person being assessed or the person's designated or legal representative, the client's current or proposed provider of services may submit a copy of the provider's nursing assessment or written report outlining its recommendations regarding the client's care needs. The person conducting the assessment must notify the provider of the date by which to submit this information. This information must be provided to the person conducting the assessment prior to the assessment. (d) For a person assessed for waiver services under section 256B.092 or 256B.49 , with the permission of the person being assessed or the person's designated legal representative, the person's current provider of services may submit a written report outlining recommendations regarding the person's care needs that the person completed in consultation with someone who is known to the person and who has interaction with the person on a regular basis. The provider must submit the report at least 60 days before the end of the person's current service agreement. The certified assessor must consider the content of the submitted report prior to finalizing the person's assessment or reassessment. Subd. 20. MnCHOICES assessments; duration of validity. (a) An assessment that is completed as part of an eligibility determination for multiple programs for the alternative care, elderly waiver, developmental disabilities, community access for disability inclusion, community alternative care, and brain injury waiver programs under chapter 256S and sections 256B.0913 , 256B.092 , and 256B.49 is valid to establish service eligibility for no more than 365 days after the date of the assessment. (b) The effective eligibility start date for programs in paragraph (a) can never be prior to the date of assessment. Notwithstanding retroactive medical assistance coverage of state plan services, the effective date of eligibility for programs included in paragraph (a) cannot be prior to the completion date of the most recent updated assessment. [See Note.] Subd. 21. MnCHOICES assessments; exceptions following institutional stay. (a) A person receiving home and community-based waiver services under section 256B.0913 , 256B.092 , or 256B.49 or chapter 256S may return to a community with home and community-based waiver services under the same waiver without being assessed or reassessed under this section if the person temporarily entered one of the following for 121 or fewer days: (1) a hospital; (2) an institution of mental disease; (3) a nursing facility; (4) an intensive residential treatment services program; (5) a transitional care unit; or (6) an inpatient substance use disorder treatment setting. (b) Nothing in paragraph (a) changes annual long-term care consultation reassessment requirements, payment for institutional or treatment services, medical assistance financial eligibility, or any other law. Subd. 22. MnCHOICES reassessments. (a) Prior to a reassessment, the certified assessor must review the person's most recent assessment. (b) Reassessments must: (1) be tailored using the professional judgment of the assessor to the person's known needs, strengths, preferences, and circumstances; (2) provide information to support the person's informed choice and opportunities to express choice regarding activities that contribute to quality of life, as well as information and opportunity to identify goals related to desired employment, community activities, and preferred living environment; (3) provide a review of the most recent assessment, the current support plan's effectiveness and monitoring of services, and the development of an updated person-centered assessment summary; (4) verify continued eligibility, offer alternatives as warranted, and provide an opportunity for quality assurance of service delivery; and (5) be conducted annually or as required by federal and state laws. (c) The certified assessor and the individual responsible for developing the support plan must ensure the continuity of care for the person receiving services and complete the updated assessment summary and the updated support plan no more than 60 days after the reassessment visit. (d) The commissioner shall develop mechanisms for providers and case managers to share information with the assessor to facilitate a reassessment and support planning process tailored to the person's current needs and preferences. Subd. 23. MnCHOICES reassessments; option for alternative and self-directed waiver services. (a) At the time of reassessment, the certified assessor shall assess a person receiving waiver residential supports and services and currently residing in a setting listed in clauses (1) to (5) to determine if the person would prefer to be served in a community-living setting as defined in section 256B.492 , subdivision 1, paragraph (b), or in a setting not controlled by a provider, or to receive integrated community supports as described in section 245D.03, subdivision 1 , paragraph (c), clause (8). The certified assessor shall offer the person through a person-centered planning process the option to receive alternative housing and service options. This paragraph applies to those currently residing in a: (1) community residential setting; (2) licensed adult foster care home that is either not the primary residence of the license holder or in which the license holder is not the primary caregiver; (3) family adult foster care residence; (4) customized living setting; or (5) supervised living facility. (b) At the time of reassessment, the certified assessor shall assess each person receiving waiver day services to determine if that person would prefer to receive employment services as described in section 245D.03, subdivision 1 , paragraph (c), clauses (5) to (7). The certified assessor shall describe to the person through a person-centered planning process the option to receive employment services. (c) At the time of reassessment, the certified assessor shall assess each person receiving non-self-directed waiver services to determine if that person would prefer an available service and setting option that would permit self-directed services and supports. The certified assessor shall describe to the person through a person-centered planning process the option to receive self-directed services and supports. [See Note.] Subd. 24. Remote reassessments. (a) Assessments performed according to subdivisions 17 to 20 and 23 must be in person unless the assessment is a reassessment meeting the requirements of this subdivision. Remote reassessments conducted by interactive video or telephone may substitute for in-person reassessments. (b) For services provided by the developmental disabilities waiver under section 256B.092 , and the community access for disability inclusion, community alternative care, and brain injury waiver programs under section 256B.49 , remote reassessments may be substituted for two consecutive reassessments if followed by an in-person reassessment. (c) For services provided by alternative care under section 256B.0913 , essential community supports under section 256B.0922 , and the elderly waiver under chapter 256S, remote reassessments may be substituted for one reassessment if followed by an in-person reassessment. (d) For personal care assistance provided under section 256B.0659 and community first services and supports provided under section 256B.85 , remote reassessments may be substituted for two consecutive reassessments if followed by an in-person reassessment. (e) A remote reassessment is permitted only if the lead agency provides informed choice and the person being reassessed or the person's legal representative provides informed consent for a remote assessment. Lead agencies must document that informed choice was offered. (f) The person being reassessed, or the person's legal representative, may refuse a remote reassessment at any time. (g) During a remote reassessment, if the certified assessor determines an in-person reassessment is necessary in order to complete the assessment, the lead agency shall schedule an in-person reassessment. (h) All other requirements of an in-person reassessment apply to a remote reassessment, including updates to a person's support plan. [See Note.] Subd. 25. Reassessments for Rule 185 case management. Unless otherwise required by federal law, the county agency is not required to conduct or arrange for an annual needs reassessment by a certified assessor for people receiving Rule 185 case management under Minnesota Rules, part 9525.0016 . The case manager who works on behalf of the person to identify the person's needs and to minimize the impact of the disability on the person's life must instead develop a person-centered service plan based on the person's assessed needs and preferences. The person-centered service plan must be reviewed annually for persons with developmental disabilities who are receiving only case management services under Minnesota Rules, part 9525.0016 , and who make an informed choice to decline an assessment under this section. Subd. 26. Determination of institutional level of care. (a) The determination of need for hospital and intermediate care facility levels of care must be made according to criteria developed by the commissioner, and in section 256B.092 , using forms developed by the commissioner. (b) The determination of need for nursing facility level of care must be made based on criteria in section 144.0724, subdivision 11 . Subd. 27. Transition assistance. (a) Lead agency certified assessors shall provide transition assistance to persons residing in a nursing facility, hospital, regional treatment center, or intermediate care facility for persons with developmental disabilities who request or are referred for assistance. (b) Transition assistance must include: (1) assessment; (2) referrals to long-term care options counseling under section 256.975, subdivision 7 , for support plan implementation and to Minnesota health care programs, including home and community-based waiver services and consumer-directed options through the waivers; and (3) referrals to programs that provide assistance with housing. (c) Transition assistance must also include information about the Centers for Independent Living, Disability Hub, and other organizations that can provide assistance with relocation efforts and information about contacting these organizations to obtain their assistance and support. (d) The lead agency shall ensure that: (1) referrals for in-person assessments are taken from long-term care options counselors as provided for in section 256.975, subdivision 7 , paragraph (b), clause (11); (2) persons assessed in institutions receive information about available transition assistance; (3) the assessment is completed for persons within 20 calendar days of the date of request or recommendation for assessment; (4) there is a plan for transition and follow-up for the individual's return to the community, including notification of other local agencies when a person may require assistance from agencies located in another county; and (5) relocation targeted case management as defined in section 256B.0621, subdivision 2, clause (4), is authorized for an eligible medical assistance recipient. Subd. 28. Transition assistance; nursing home residents under 65 years of age. (a) Upon referral from the Senior LinkAge Line, individuals under 65 years of age who are admitted to nursing facilities on an emergency basis with only a telephone screening must receive an in-person assessment from the long-term care consultation team member of the county in which the facility is located within the timeline established by the commissioner based on review of data. (b) At the in-person assessment, the long-term care consultation team member or county case manager must: (1) perform the activities required under subdivision 27; and (2) present information about home and community-based options, including consumer-directed options, so the individual can make informed choices. (c) If the individual chooses home and community-based services, the long-term care consultation team member or case manager must complete a written relocation plan within 20 working days of the visit. The plan must describe the services needed to move the individual out of the facility and a timeline for the move that is designed to ensure a smooth transition to the individual's home and community. (d) For individuals under 21 years of age, a screening interview that recommends nursing facility admission must be in person and approved by the commissioner before the individual is admitted to the nursing facility. (e) An individual under 65 years of age residing in a nursing facility must receive an in-person assessment at least every 12 months to review the person's service choices and available alternatives unless the individual indicates in writing that annual visits are not desired. In this case, the individual must receive an in-person assessment at least once every 36 months for the same purposes. (f) Notwithstanding subdivision 33, the commissioner may pay county agencies directly for in-person assessments for individuals under 65 years of age who are being considered for placement or residing in a nursing facility. Subd. 29. Support planning. (a) The certified assessor and the individual responsible for developing the support plan must complete the assessment summary and the support plan no more than 60 calendar days after the assessment visit. (b) The person or the person's legal representative must be provided with a written assessment summary within the timelines established by the commissioner, regardless of whether the person is eligible for Minnesota health care programs. (c) For a person being assessed for elderly waiver services under chapter 256S, a provider who submitted information under subdivision 19, paragraph (c), must receive the final written support plan when available. (d) The written support plan must include: (1) a summary of assessed needs as defined in subdivision 17, paragraphs (d) and (e); (2) the individual's options and choices to meet identified needs, including all available options for: (i) case management services and providers; (ii) employment services, settings, and providers; (iii) living arrangements; (iv) self-directed services and supports, including self-directed budget options; and (v) service provided in a non-disability-specific setting; (3) identification of health and safety risks and how those risks will be addressed, including personal risk management strategies; (4) referral information; and (5) informal caregiver supports, if applicable. (e) For a person determined eligible for state plan home care under subdivision 11, clause (7), the person or person's legal representative must also receive a copy of the home care service plan developed by the certified assessor. Subd. 30. Assessment and support planning; supplemental information. The lead agency must give the person receiving long-term care consultation services or the person's legal representative materials and forms supplied by the commissioner containing the following information: (1) written recommendations for community-based services and consumer-directed options; (2) documentation that the most cost-effective alternatives available were offered to the person; (3) the need for and purpose of preadmission screening conducted by long-term care options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects nursing facility placement. If the person selects nursing facility placement, the lead agency shall forward information needed to complete the level of care determinations and screening for developmental disability and mental illness collected during the assessment to the long-term care options counselor using forms provided by the commissioner; (4) the role of long-term care consultation assessment and support planning in eligibility determination for waiver and alternative care programs and state plan home care, case management, and other services as defined in subdivision 11, clauses (7) to (10); (5) information about Minnesota health care programs; (6) the person's freedom to accept or reject the recommendations of the team; (7) the person's right to confidentiality under the Minnesota Government Data Practices Act, chapter 13; (8) the certified assessor's decision regarding the person's need for institutional level of care as determined under criteria established in subdivision 26 and regarding eligibility for all services and programs as defined in subdivision 11, clauses (7) to (10); (9) the person's right to appeal the certified assessor's decision regarding eligibility for all services and programs as defined in subdivision 11, clauses (5), (7) to (10), and (15), and the decision regarding the need for institutional level of care or the lead agency's final decisions regarding public programs eligibility according to section 256.045, subdivision 3. The certified assessor must verbally communicate this appeal right to the person and must visually point out where in the document the right to appeal is stated; and (10) documentation that available options for employment services, independent living, and self-directed services and supports were described to the person. Subd. 31. Assessment and support planning; right to final decision. The person has the right to make the final decision: (1) between institutional placement and community placement after the recommendations have been provided under subdivision 30, clause (1), except as provided in section 256.975 , subdivision 7a, paragraph (d); (2) between community placement in a setting controlled by a provider and living independently in a setting not controlled by a provider; (3) between day services and employment services; and (4) regarding available options for self-directed services and supports, including self-directed funding options. Subd. 32. Administrative activity. (a) The commissioner shall: (1) streamline the processes, including timelines for when assessments need to be completed; (2) provide the services in this section; and (3) implement integrated solutions to automate the business processes to the extent necessary for support plan approval, reimbursement, program planning, evaluation, and policy development. (b) The commissioner shall work with lead agencies responsible for conducting long-term care consultation services to: (1) modify the MnCHOICES application and assessment policies to create efficiencies while ensuring federal compliance with medical assistance and long-term services and supports eligibility criteria; and (2) develop a set of measurable benchmarks sufficient to demonstrate quarterly improvement in the average time per assessment and other mutually agreed upon measures of increasing efficiency. (c) The commissioner shall collect data on the benchmarks developed under paragraph (b) and provide to the lead agencies an annual trend analysis of the data in order to demonstrate the commissioner's compliance with the requirements of this subdivision. Subd. 33. Payment for long-term care consultation services. (a) Payments for long-term care consultation services are available to the county or counties to cover staff salaries and expenses to provide the services described in subdivision 11. The county shall employ, or contract with other agencies to employ, within the limits of available funding, sufficient personnel to provide long-term care consultation services while meeting the state's long-term care outcomes and objectives as defined in subdivision 1. (b) The county is accountable for meeting local objectives as approved by the commissioner in the biennial home and community-based services quality assurance plan. The county must document its compliance with the local objectives on a form provided by the commissioner. (c) The state shall pay 81.9 percent of the nonfederal share as reimbursement to the counties.

Official source: Minnesota Office of the Revisor of Statutes. Reproduced from public-domain Minnesota statutes; confirm against the official source for the current text. Not legal advice.