piers109uk/MN-Statutes huggingface dataset:
256R.05 REQUIRED PRACTICES.
(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, 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 section 256.975, subdivisions 7a to 7c. The nursing facility must include unreimbursed resident days in the nursing facility resident day totals reported to the commissioner.
(a) Notwithstanding sections 256R.04 and 256R.06, subdivisions 2 and 4, nursing facility providers that do not participate in or accept Medicare assignment must refer and document the referral of dual eligible recipients for whom placement is requested and for whom the resident would be qualified for a Medicare-covered stay to Medicare providers. The commissioner shall audit nursing facilities that do not accept Medicare and determine if dual eligible individuals with Medicare qualifying stays have been admitted. If such a determination is made, the commissioner shall deny Medicaid payment for the first 20 days of that resident's stay.
(b) A nursing facility that violates this subdivision is subject to section 256R.04, subdivisions 7 and 8.
256R.01 GENERAL.
Payment rates paid to any nursing facility receiving medical assistance payments must be those rates established pursuant to this chapter and rules adopted under it.
The commissioner shall establish, by rule, procedures for determining rates for care of residents of nursing facilities which qualify as vendors of medical assistance, and for implementing the provisions of this chapter and section 256B.50. The procedures shall specify the costs that are allowable for establishing payment rates through medical assistance.
If any provision of this chapter and section 256B.50 is determined by the United States government to be in conflict with existing or future requirements of the United States government with respect to federal participation in medical assistance, the federal requirements shall prevail.
256P.09 PROSPECTIVE BUDGETING OF BENEFITS.
Assistance units that qualify for child care assistance programs under chapter 142E, assistance units that receive housing support under chapter 256I and are not subject to reporting under section 256P.10, and assistance units that qualify for Minnesota supplemental aid under chapter 256D are exempt from this section.
An agency subject to this chapter must use prospective budgeting to calculate the assistance payment amount.
For the purpose of determining an assistance unit's level of benefits, an agency must take into account the income already received by the assistance unit during or anticipated to be received during the application period. Income anticipated to be received only in the initial month of eligibility must only be counted in the initial month.
An agency must use prospective budgeting to determine the amount of the assistance unit's benefit for the eligibility period based on the best information available at the time of approval. An agency shall only count anticipated income when the participant and the agency are reasonably certain of the amount of the payment and the month in which the payment will be received. If the exact amount of the income is not known, the agency shall consider only the amounts that can be anticipated as income.
An increase in income shall not affect an assistance unit's eligibility or benefit amount until the next review unless otherwise required to be reported in section 256P.07. A decrease in income shall be effective on the date that the change occurs if the change is reported by the tenth of the month following the month when the change occurred. If the assistance unit does not report the change in income by the tenth of the month following the month when the change occurred, the change in income shall be effective on the date that the change was reported.
256S.01 GENERALLY.
The commissioner is authorized to apply for a home and community-based services waiver for the elderly, authorized under section 1915(c) of the Social Security Act, to obtain federal financial participation to expand the availability of services for persons who are eligible for medical assistance. The commissioner may apply for additional waivers or pursue other federal financial participation that is advantageous to the state for funding home care services for the elderly who are eligible for medical assistance. The provision of waiver services to an elderly person receiving medical assistance must comply with the criteria for service definitions and provider standards approved in the elderly waiver.
The commissioner shall comply with the requirements in the federally approved transition plan for the elderly waiver authorized under this chapter.
(a) Services and supports provided under this chapter must meet the requirements in United States Code, title 42, section 1396n.
(b) Services and supports provided under this chapter must promote consumer choice and be arranged and provided consistent with individualized, written support plans.
Reimbursement for the services provided to a participant under this chapter and under the elderly waiver must be made from the medical assistance account through the invoice processing procedures of the department's Medicaid Management Information System (MMIS), only with the approval of the participant's case manager.
The budget for the state share of the Medicaid expenditures under this chapter must be forecasted with the medical assistance budget, and shall be consistent with the elderly waiver.
The state of Minnesota, or a county, managed care plan, county-based purchasing plan, or tribal government under contract to administer the elderly waiver, is not liable for damages, injuries, or liabilities sustained as a result of the participant, the participant's family, or the participant's authorized representatives purchasing direct supports or goods with funds received through consumer-directed community supports under the elderly waiver. Liabilities include, but are not limited to, workers' compensation liability, Federal Insurance Contributions Act under United States Code, title 26, subtitle c, chapter 21, or Federal Unemployment Tax Act under Internal Revenue Code, chapter 23.
256P.05 SELF-EMPLOYMENT EARNINGS.
Participants who qualify for Minnesota supplemental aid under chapter 256D and housing support under chapter 256I on the basis of eligibility for Supplemental Security Income are exempt from this section. Participants who qualify for child care assistance programs under chapter 142E are exempt from subdivision 3.
Applicants and participants must choose one of the methods described in this subdivision for determining self-employment earned income. An agency must determine self-employment income, which is either:
(1) one-half of gross earnings from self-employment; or
(2) taxable income as determined from an Internal Revenue Service tax form that has been filed with the Internal Revenue Service for the most recent year and according to guidance provided for the Supplemental Nutrition Assistance Program. A 12-month average using taxable income shall be used to budget monthly income.
(a) The self-employment budget period begins in the month of application or in the first month of self-employment.
(b) Applicants and participants who elect to use taxable income as described in subdivision 2, clause (2), to determine self-employment income must continue to use this method until recertification, unless there is an unforeseen significant change in gross income equaling a decline in gross income of the amount equal to or greater than the earned income disregard as defined in section 256P.03 from the income used to determine the benefit for the current month.
(c) For applicants and participants who elect to use one-half of gross earnings as described in subdivision 2, clause (1), to determine self-employment income, earnings must be counted as income in the month received.
Rental income is subject to the requirements of this section.
256P.001 APPLICABILITY.
General assistance and Minnesota supplemental aid under chapter 256D, child care assistance programs under chapter 142E, and programs governed by chapter 256I or 256J are subject to the requirements of this chapter, unless otherwise specified or exempted.
256P.03 EARNED INCOME DISREGARD.
Participants who qualify for child care assistance programs under chapter 142E, Minnesota supplemental aid under chapter 256D, and housing support under chapter 256I on the basis of eligibility for Supplemental Security Income are exempt from this section.
The agency shall disregard the first $65 of earned income plus one-half of the remaining earned income per month.
256S.03 ADMINISTRATION BY TRIBES.
Notwithstanding any other state laws or rules, the commissioner may develop a model for tribal management of the elderly waiver and implement this model through a contract between the state and any of the state's federally recognized tribal governments. The model shall include the provision of tribal elderly waiver case management, assessment for personal care assistance, and administrative requirements otherwise carried out by lead agencies but shall not include tribal financial eligibility determination for medical assistance.
256P.10 SIX-MONTH REPORTING.
Assistance units that qualify for child care assistance programs under chapter 142E, assistance units that qualify for Minnesota supplemental aid under chapter 256D, and assistance units that qualify for housing support under chapter 256I and also receive Supplemental Security Income are exempt from this section.
(a) Every six months, an assistance unit that qualifies for the Minnesota family investment program under chapter 142G, an assistance unit that qualifies for general assistance under chapter 256D with an earned income of $100 per month or greater, or an assistance unit that qualifies for housing support under chapter 256I with an earned income of $100 per month or greater is subject to six-month reviews. The initial reporting period may be shorter than six months in order to align with other programs' reporting periods.
(b) An assistance unit that qualifies for the Minnesota family investment program or an assistance unit that qualifies for general assistance with an earned income of $100 per month or greater must complete household report forms as required by the commissioner for redetermination of benefits.
(c) An assistance unit that qualifies for housing support with an earned income of $100 per month or greater must complete household report forms as prescribed by the commissioner to provide information about earned income.
(d) An assistance unit that qualifies for housing support and also receives assistance through the Minnesota family investment program is subject to the requirements of this section for purposes of the Minnesota family investment program but not for housing support.
(e) An assistance unit covered by this section must submit a household report form in compliance with the provisions in section 256P.04, subdivision 11.
(f) An assistance unit covered by this section may choose to report changes under this section at any time.
(a) An agency must terminate benefits when the assistance unit fails to submit the household report form before the end of the six-month review period. If the assistance unit submits the household report form within 30 days of the termination of benefits and remains eligible, benefits must be reinstated and made available retroactively for the full benefit month.
(b) When an assistance unit is determined to be ineligible for assistance according to this section and chapter 256D, 256I, or 256J, the agency must terminate assistance.
256S.07 CASE MANAGEMENT ADMINISTRATION.
(a) For participants not enrolled in a managed care organization, the county of residence or tribe must provide or arrange to provide elderly waiver case management activities under section 256S.09, subdivisions 2 and 3.
(b) If a county agency provides case management under contracts with other individuals or agencies and the county agency utilizes a competitive proposal process for the procurement of contracted case management services, the competitive proposal process must include evaluation criteria to ensure that the county maintains a culturally responsive program for case management services adequate to meet the needs of the population of the county. For the purposes of this section, "culturally responsive program" means a case management services program that:
(1) ensures effective, equitable, comprehensive, and respectful quality care services that are responsive to individuals within a specific population's values, beliefs, practices, health literacy, preferred language, and other communication needs; and
(2) is designed to address the unique needs of individuals who share a common language or racial, ethnic, or social background.
Notwithstanding any requirements in this chapter and in accordance with contract requirements established by the commissioner, for participants enrolled in a managed care organization, the managed care organization must provide or arrange to provide elderly waiver case management activities under section 256S.09, subdivisions 2 and 3.
256S.08 CASE MANAGEMENT PROVIDER QUALIFICATIONS AND STANDARDS.
(a) Except as provided in section 256S.07, subdivision 2, elderly waiver case management must be provided by a lead agency or by a private agency that is enrolled as a medical assistance provider.
(b) Any private agency that provides case management to a participant must not have a financial interest in the provision of any other services included in the participant's support plan.
The commissioner must enroll providers qualified to provide elderly waiver case management under the elderly waiver. The enrollment process must ensure the provider's ability to meet the qualification requirements and standards in this section and other federal and state requirements of this service.
Except as provided in section 256S.07, subdivision 2, a case management provider must be an enrolled medical assistance provider who is determined by the commissioner to have the following characteristics:
(1) the demonstrated capacity and experience to provide the components of case management to coordinate and link community resources needed by the eligible population;
(2) administrative capacity and experience in serving the target population for whom the provider will provide services and in ensuring quality of services under state and federal requirements;
(3) a financial management system that provides accurate documentation of services and costs under state and federal requirements; and
(4) the capacity to document and maintain individual case records under state and federal requirements.
The lead agency may allow a case manager to delegate certain aspects of the case management activity to a case aide if there is oversight of the case aide by the case manager. The case manager must not delegate those aspects that require professional judgment including assessments, reassessments, and support plan development.
A case aide shall provide assistance to the case manager in carrying out administrative activities of the elderly waiver case management function. The case aide must not assume responsibilities that require professional judgment including assessments, reassessments, and support plan development. The case manager is responsible for providing oversight of the case aide.
256R.03 CONDITIONS FOR FUNDING.
(a) No medical assistance payments shall be made to any nursing facility unless the nursing facility is certified to participate in the medical assistance program under title XIX of the federal Social Security Act and has in effect a provider agreement with the commissioner meeting the requirements of state and federal statutes and rules.
(b) No medical assistance payments shall be made to any nursing facility unless the nursing facility complies with all requirements of Minnesota Statutes including, but not limited to, this chapter and chapter 256B and rules adopted under them that govern participation in the program.
(c) Subject to exceptions in section 256B.25, subdivision 3, no nursing facility may receive any state or local payment for providing care to a person eligible for medical assistance, except under the medical assistance program.
A nursing home or boarding care home that has received a notice to suspend admissions under section 144A.105 shall be ineligible to receive payment for admissions that occur during the effective dates of the suspension. Upon termination of the suspension by the commissioner of health, payments may be made for eligible persons, beginning with the day after the suspension ends.
This section applies whether the nursing facility participates fully in the medical assistance program or is withdrawing from the medical assistance program. No medical assistance payments may be made to any nursing facility which has withdrawn or is withdrawing from the medical assistance program except as provided in subdivision 4, or federal law.
If a nursing facility terminates its participation in the medical assistance program, whether voluntarily or involuntarily, the commissioner may authorize the nursing facility to receive continued medical assistance reimbursement until medical assistance residents can be relocated to nursing facilities participating in the medical assistance program.
A nursing facility located in Minnesota electing to enroll as a medical assistance provider must enter into a contract with the commissioner. Payment rates and procedures are determined and governed by this section and by the terms of the contract. The commissioner may negotiate different contract terms for different nursing facilities.
(a) All contracts entered into under this section are for a term not to exceed four years. Either party may terminate a contract at any time without cause by providing 90 calendar days advance written notice to the other party. The decision to terminate a contract is not appealable. The provisions of the contract shall be renegotiated at a minimum of every four years by the parties prior to the expiration date of the contract. The parties may voluntarily amend the terms of the contract at any time by mutual agreement.
(b) If a nursing facility fails to comply with the terms of a contract, the commissioner shall provide reasonable notice regarding the breach of contract and a reasonable opportunity for the facility to come into compliance. If the facility fails to come into compliance or to remain in compliance, the commissioner may terminate the contract.
256S.09 CASE MANAGEMENT ACTIVITIES.
An eligible participant may choose any qualified provider of elderly waiver case management.
Elderly waiver case management activities provided to or arranged for a participant include:
(1) development of the support plan under section 256S.10;
(2) informing the participant or the participant's legal guardian or conservator of service options and options for elderly waiver case management and providers;
(3) consulting with relevant medical experts or service providers;
(4) assisting the participant in identifying potential providers;
(5) assisting the participant with gaining access to needed elderly waiver and other state plan services;
(6) assisting the participant with gaining access to needed medical, social, educational, and other services regardless of the funding source for the services to which access is gained;
(7) coordination of services;
(8) ongoing evaluation and monitoring of the provision of services included in the participant's support plan under subdivision 3; and
(9) assisting the participant in appeals under section 256.045.
(a) Elderly waiver case managers shall collaborate with the participant, the participant's family, the participant's legal representatives, and relevant medical experts and service providers to develop and periodically review the participant's support plan.
(b) Case managers shall initiate the process of reassessment and review of the participant's support plan and review the plan at intervals specified in the elderly waiver plan.
(c) The case manager's evaluation and monitoring of a participant's services must incorporate at least one annual face-to-face visit by the case manager with each participant.
256S.10 SUPPORT PLANS.
Each participant's case manager shall provide the participant with a copy of the participant's written support plan.
Within the timelines established by the commissioner and section 256B.0911, subdivision 29, the case manager must develop with the participant and the participant must sign the participant's individualized written support plan.
Each participant's support plan must:
(1) include the participant's need for service and identify service needs that will be or that are met by the participant's relatives, friends, and others, as well as community services used by the general public;
(2) include the use of volunteers, religious organizations, social clubs, and civic and service organizations to support the participant in the community;
(3) reasonably ensure the health and welfare of the participant;
(4) identify the participant's preferences for services as stated by the participant or the participant's legal guardian or conservator;
(5) reflect the participant's informed choice between institutional and community-based services, as well as choice of services, supports, and providers, including available elderly waiver case management providers;
(6) identify the participant's long-range and short-range goals;
(7) identify specific services and the amount, frequency, duration, and cost of the services to be provided to the participant based on assessed needs, preferences, and available resources;
(8) include information about the right to appeal decisions under section 256.045; and
(9) include the authorized annual and estimated monthly amounts for the services.
The lead agency must be held harmless for damages or injuries sustained through the use of volunteers and organizations under subdivision 3, clause (2), including workers' compensation liability.
256R.11 NONALLOWED COSTS.
(a) The following costs shall not be recognized as allowable:
(1) political contributions;
(2) salaries or expenses of a lobbyist, as defined in section 10A.01, subdivision 21, for lobbying activities;
(3) advertising designed to encourage potential residents to select a particular nursing facility;
(4) assessments levied by the commissioner of health for uncorrected violations;
(5) legal and related expenses for unsuccessful challenges to decisions by governmental agencies;
(6) memberships in sports, health or similar social clubs or organizations;
(7) costs incurred for activities directly related to influencing employees with respect to unionization; and
(8) costs of providing services which are billed separately from the nursing facility's payment rate or pursuant to Minnesota Rules, parts 9505.0170 to 9505.0475.
(b) The commissioner shall by rule exclude the costs of any other items not directly related to the provision of resident care.
Costs incurred for any activities which are directed at or are intended to influence or dissuade employees in the exercise of their legal rights to freely engage in the process of selecting an exclusive representative for the purpose of collective bargaining with their employer shall not be allowable for purposes of setting payment rates.
256S.11 APPROVAL REQUIRED FOR CERTAIN STATE PLAN HOME CARE SERVICES.
Medical assistance funding for the following services for a participant must be approved by the case manager and included in the participant's support plan:
(1) skilled nursing services;
(2) home care nursing;
(3) home health aide services; and
(4) personal care assistance services.
256S.12 ADULT DAY SERVICES.
Adult day services may be authorized for up to 48 units, or 12 hours, per day based on the needs of the participant and the participant's family caregivers.
If a bath is authorized for a participant receiving adult day services, at least two 15-minute units must be authorized to allow for adequate time to meet the participant's needs.
256S.14 TERMINATION OF ELDERLY WAIVER SERVICES.
The case manager must give the participant a ten-day written notice of any denial, reduction, or termination of elderly waiver services.
257.02 SURRENDER OF PARENTAL RIGHTS.
No person other than the parents or relatives may assume the permanent care and custody of a child under 14 years of age unless authorized so to do by an order or decree of court. However, if a parent of a child who is being cared for by a relative dies, or if the parent is not or cannot fulfill parental duties with respect to the child, the relative may bring a petition under section 260C.141. Except in proceedings for adoption or by a consent decree entered under section 257C.07, no parent may assign or otherwise transfer to another parental rights or duties with respect to the permanent care and custody of a child under 14 years of age. Any such transfer shall be void.
256S.13 INDIVIDUAL COMMUNITY LIVING SUPPORTS.
A provider of individual community living supports must not be the landlord of the participant receiving individual community living supports, nor have any interest in the participant's housing.
Licensing standards for individual community living supports shall be reviewed jointly by the Departments of Health and Human Services to avoid conflict with provider regulatory standards pursuant to sections 144A.43 to 144A.483 and chapter 245D.
Individual community living supports must be delivered in a single-family home or apartment that the participant or the participant's family owns or rents, as demonstrated by a lease agreement, and maintains control over the individual unit.
A case manager must develop an individual community living support plan in consultation with the participant using a tool developed by the commissioner.
The commissioner shall establish rates and establish mechanisms to align payments with the type and amount of service provided, ensure statewide uniformity for rates, and ensure cost-effectiveness.
257.01 RECORDS REQUIRED.
Each person or authorized child-placing agency permitted by law to receive children, secure homes for children, or care for children, shall keep a record containing the name, age, former residence, legal status, health records, sex, race, and accumulated length of time in foster care, if applicable, of each child received; the name, former residence, occupation, health history, and character, of each birth parent; the date of reception, placing out, and adoption of each child, and the name, race, occupation, and residence of the person with whom a child is placed; the date of the removal of any child to another home and the reason for removal; the date of termination of the guardianship; the history of each child until the child reaches the age of 21 years, is legally adopted, or is discharged according to law; and further demographic and other information as is required by the commissioner of children, youth, and families.
256R.16 QUALITY OF CARE.
(a) The commissioner shall determine a quality score for each nursing facility using quality measures established in section 256B.439, according to methods determined by the commissioner in consultation with stakeholders and experts, and using the most recently available data as provided in the Minnesota Nursing Home Report Card. These methods must be exempt from the rulemaking requirements under chapter 14.
(b) For each quality measure, a score must be determined with the number of points assigned as determined by the commissioner using the methodology established according to this subdivision. The determination of the quality measures to be used and the methods of calculating scores may be revised annually by the commissioner.
(c) The quality score must include up to 50 points related to the Minnesota quality indicators score derived from the minimum data set, up to 40 points related to the resident quality of life score derived from the consumer survey conducted under section 256B.439, subdivision 3, and up to ten points related to the state inspection results score.
(d) The commissioner, in cooperation with the commissioner of health, may adjust the formula in paragraph (c), or the methodology for computing the total quality score, with five months advance public notice. In changing the formula, the commissioner shall consider quality measure priorities registered by report card users, advice of stakeholders, and available research.
If an annual cost report or field audit indicates that expenditures for direct resident care have been reduced in amounts large enough to indicate a possible detrimental effect on the quality of care, the commissioner shall notify the commissioner of health.
256S.15 ESTABLISHMENT OF ELDERLY WAIVER SERVICE RATES AND SERVICE RATE LIMITS.
The commissioner shall establish statewide service rates and service rate limits. The commissioner shall publish updated service rates and service rate limits at least annually.
The elderly waiver payment for the foster care service in combination with the payment for all other elderly waiver services, including case management, must not exceed the monthly case mix budget cap for the participant as specified in sections 256S.18, subdivision 3, and 256S.19, subdivision 3.
[See Note.]
257C.07 CUSTODY CONSENT DECREE.
In a proceeding under this chapter, a parent may transfer legal and physical custody of a child by a consent decree entered under this section. The court may approve a proposed consent decree if the custody arrangement is in the best interests of the child and all parties to the decree agree to it after being fully informed of its contents. A consent decree under this section must:
(1) transfer legal and physical custody of the child to a third party and state that this includes the ability to determine the child's residence; make decisions regarding the child's education, religious training, and health care; and obtain information and public services on behalf of the child in the same manner as a parent;
(2) indicate whether the transfer of custody is temporary or permanent; and
(3) include an order for child support in the guidelines amount and an allocation of child care costs as provided by section 518A.40, subject to income withholding under section 518A.53 and including an order for medical support under section 518A.41.
A party to a consent decree under this section may file a motion to modify or terminate the consent decree at any time. Section 518.18, paragraphs (d) and (e), apply to all modifications. A party who has custody of a child under this section must seek modification of the consent decree before transferring physical or legal custody of the child to anyone.
256S.17 COSTS EXCLUDED FROM ELDERLY WAIVER SERVICE RATES.
Elderly waiver service rates for foster care and customized living must not include room and board, rent, or raw food costs.
256R.17 CASE MIX.
The case mix classifications shall be those established under section 144.0724.
(a) The commissioner shall assign a case mix index to each case mix classification as determined by the commissioner of health under section 144.0724.
(b) An index maximization approach shall be used to classify residents. "Index maximization" has the meaning given in section 144.0724, subdivision 2, paragraph (c).
(a) Nursing facilities must conduct and submit case mix classification assessments according to the schedule established by the commissioner of health under section 144.0724, subdivisions 4 and 5.
(b) The case mix classifications established under section 144.0724, subdivision 3a, are effective the day of admission for new admission assessments. The effective date for significant change assessments is the assessment reference date. The effective date for annual and quarterly assessments and significant corrections assessments is the first day of the month following assessment reference date.
Nursing facilities shall provide notice to a resident of the resident's case mix classification according to procedures established by the commissioner of health under section 144.0724, subdivision 7.
Any request for reconsideration of a resident case mix classification must be made under section 144.0724, subdivision 8.
256S.16 AUTHORIZATION OF ELDERLY WAIVER SERVICES AND SERVICE RATES.
A lead agency must use the service rates and service rate limits published by the commissioner to authorize services.
257.025 CUSTODY AND PARENTING TIME DISPUTES.
(a) In any custody or parenting time proceeding involving unmarried parents, the court shall consider section 518.175 and evaluate all relevant factors in section 518.17, subdivision 1, to determine the best interests of the child.
(b) The fact that the parents of the child are not or were never married to each other shall not be determinative of the custody and parenting time of the child.
(c) A person may seek custody of a child by filing a petition or motion pursuant to section 518.156.
(d) Section 518.619 applies to this section.
257.026 NOTIFICATION OF RESIDENCE WITH CERTAIN CONVICTED PERSONS.
A person who is granted or exercises custody of a child or parenting time with a child under this chapter or chapter 518 must notify the child's other parent, if any, the county social services agency, and the court that granted the custody or parenting time, if the person knowingly marries or lives in the same residence with a person who has been convicted of a crime listed in section 518.179, subdivision 2.
256R.21 TOTAL PAYMENT RATE.
For each facility, the commissioner shall calculate a total payment rate using the statistical and cost report filed by each nursing facility for the reporting period ending 15 months prior to the rate year.
The total payment rates are the total payment rates in effect on the first day of the rate year, unless another date is specified.
A facility's total care-related payment rate is the sum of:
(1) its direct care payment rate as determined in section 256R.23, subdivision 7; and
(2) its other care-related payment rate as determined in section 256R.23, subdivision 8.
A facility's total care-related payment rate is its total care-related payment rate associated with a case mix index of 1.00.
A facility's operating payment rate is the sum of:
(1) its total care-related payment rate as determined in subdivision 2; and
(2) its other operating payment rate as determined in section 256R.24.
A facility's operating payment rate is its operating payment rate associated with a case mix index of 1.00.
A facility's total payment rate is the sum of:
(1) its operating payment rate as determined in subdivision 3;
(2) its external fixed costs payment rate as determined in section 256R.25; and
(3) its property payment rate as determined in section 256R.26.
A facility's total payment rate is its total payment rate associated with a case mix index of 1.00.
For a new nursing facility created under section 144A.071, subdivisions 2 and 3, the total payment rate must be determined according to section 256R.27.
256S.19 MONTHLY CASE MIX BUDGET CAPS; NURSING FACILITY RESIDENTS.
A participant who is a nursing facility resident when requesting an eligibility determination for elderly waiver services may request an elderly waiver monthly conversion budget cap for the cost of elderly waiver services.
Only a participant discharged from a nursing facility after a minimum 30-day stay is eligible under this section for an elderly waiver monthly conversion budget cap.
(a) The elderly waiver monthly conversion budget cap for the cost of elderly waiver services must be based on the nursing facility case mix adjusted total payment rate of the nursing facility where the elderly waiver applicant currently resides for the applicant's case mix classification as determined according to section 256R.17.
(b) The elderly waiver monthly conversion budget cap for the cost of elderly waiver services must be calculated by multiplying the applicable nursing facility case mix adjusted total payment rate by 365, dividing by 12, and subtracting the participant's maintenance needs allowance.
(c) A participant's initially approved monthly conversion budget cap for elderly waiver services must be adjusted at least annually as described in section 256S.18, subdivision 5.
(d) Conversion budget caps for individuals participating in consumer-directed community supports must be set as described in paragraphs (a) to (c).
[See Note.]
For the elderly waiver monthly conversion budget cap for the cost of elderly waiver services with consumer-directed community supports, the nursing facility case mix adjusted total payment rate used under subdivision 3 to calculate the monthly conversion budget cap for elderly waiver services without consumer-directed community supports must be reduced by a percentage equal to the percentage difference between the consumer-directed community supports budget limit that would be assigned according to the elderly waiver plan and the corresponding monthly case mix budget cap under this chapter, but not to exceed 50 percent.
257.03 NOTICE TO COMMISSIONER OF CHILDREN, YOUTH, AND FAMILIES.
Any person not exempted from the requirement for licensure under chapter 142B receiving a child in the person's home:
(1) because of the death, injury, or illness of the child's parent if the person intends to keep the child for more than 30 days; or
(2) with intent to adopt the child or keep the child permanently, except a person receiving a child from an authorized agency, must notify the commissioner of children, youth, and families in writing within 30 days after the child is received. Notice shall state the true name of the child; the child's last previous address; the name and address of the child's parents or legal guardian and of persons with whom the child last resided; and the names and addresses of persons who placed the child in the home, arranged for, or assisted with arrangements for the child's placement there; and such other facts about the child or the home as the commissioner may require. It is the duty of the commissioner or a designated agent to investigate the circumstances surrounding the child's entry into the home and to take appropriate action to assure for the child, the biological parents, and the foster parents the full protection of all laws of Minnesota relating to custody and foster care of children. Except as provided by section 317A.907, no person shall solicit, receive, or accept any payment, promise of payment, or compensation, for placing a child in foster care or for assisting to place a child in foster care. Nor shall any person pay or promise to pay or in any way compensate any person, for placing or for assisting to place a child in foster care.
256R.22 CASE MIX ADJUSTED TOTAL PAYMENT RATE.
For each facility, the commissioner shall calculate case mix adjusted payment rates for each case mix classification.
A facility's case mix adjusted total care-related payment rate for each case mix classification is the sum of:
(1) its direct care payment rate as determined in section 256R.23, subdivision 7, multiplied by the case mix index; and
(2) its other care-related payment rate as determined in section 256R.23, subdivision 8.
A facility's case mix adjusted operating payment rate for each case mix classification is the sum of:
(1) its case mix adjusted total care-related payment rate as determined in subdivision 2; and
(2) its other operating payment rate as determined in section 256R.24.
A facility's case mix adjusted total payment rate for each case mix classification is the sum of:
(1) its case mix adjusted operating payment rate as determined in subdivision 3;
(2) its external fixed costs payment rate as determined in section 256R.25; and
(3) its property payment rate as determined in section 256R.26.
256R.23 TOTAL CARE-RELATED PAYMENT RATES.
Each facility's total care-related cost per day is the sum of its direct care cost per standardized day and its other care-related cost per resident day.
Each facility's direct care cost per standardized day is the facility's direct care costs divided by the sum of the facility's standardized days. A facility's direct care cost per standardized day is the facility's cost per day for direct care services associated with a case mix index of 1.00.
Each facility's other care-related cost per resident day is its other care-related costs, divided by the sum of the facility's resident days.
The commissioner must determine the median total care-related cost per day using the cost reports from nursing facilities in Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, and Washington Counties.
The commissioner must determine each facility's total care-related payment rate limit by:
(1) multiplying the facility's quality score, as determined under section 256R.16, subdivision 1, by 0.5625;
(2) adding 89.375 to the amount determined in clause (1), and dividing the total by 100; and
(3) multiplying the amount determined in clause (2) by the median total care-related cost per day.
No facility shall be subject in any rate year to a care-related payment rate limit reduction greater than five percent of the median determined in subdivision 4.
A facility's direct care payment rate equals the lesser of (1) the facility's direct care costs per standardized day, or (2) the facility's direct care costs per standardized day divided by its cost to limit ratio.
A facility's other care-related payment rate equals the lesser of (1) the facility's other care-related cost per resident day, or (2) the facility's other care-related cost per resident day divided by its cost to limit ratio.
A facility's total care-related payment rate is the sum of its direct care payment rate as determined in subdivision 7 and its other care-related payment rate as determined in subdivision 8.
256S.20 CUSTOMIZED LIVING SERVICES; POLICY.
(a) To deliver customized living services or 24-hour customized living services, a provider must:
(1) be licensed as an assisted living facility under chapter 144G; or
(2) be licensed as a comprehensive home care provider under chapter 144A, be delivering services in a setting exempted from assisted living facility licensure under section 144G.08, subdivision 7, clauses (10) to (13), and meet standards in the federally approved home and community-based waiver plans under this chapter or section 256B.49. A licensed home care provider is subject to section 256B.0651, subdivision 14.
(b) Settings exempted from assisted living facility licensure under section 144G.08, subdivision 7, clauses (10) to (13), must comply with section 325F.722.
MS 2020 [Repealed, 1Sp2021 c 7 art 13 s 79]
The lead agency, with input from the provider of customized living services and within the parameters established by the commissioner, shall ensure that there is a documented need for all authorized customized living or 24-hour customized living component services.
(a) The lead agency shall not authorize 24-hour customized living services unless the participant receiving customized living services requires assistance, including 24-hour supervision, due to needs related to one or more of the following:
(1) intermittent assistance with toileting, positioning, or transferring;
(2) cognitive or behavioral issues;
(3) a medical condition that requires clinical monitoring; or
(4) the need for medication management, at least 50 hours of services per month, and a dependency in at least three of the following activities of daily living as determined by assessment under section 256B.0911: bathing, dressing, grooming, walking, or eating when the dependency score in eating is three or greater.
(b) The lead agency must document the need for 24-hour supervision.
(c) The lead agency shall ensure that the frequency and mode of supervision of the participant and the qualifications of staff providing supervision are described and meet the needs of the participant.
A provider of customized living services or 24-hour customized living services must not bill or otherwise charge a participant or the participant's family for: (1) additional units of any allowable component service beyond those available under the service rate limits described in section 256S.202, or (2) additional units of any allowable component service beyond those component services in the customized living service plan approved by the lead agency.
257.035 EMERGENCY.
A relative who acts to protect a child in an emergency or when a parent dies is not a custodian as defined under section 260C.007. If the relative is unable or unwilling to provide for the ongoing care, custody, and control of the child, the child may be considered a child in need of protection or services under section 260C.007. The relative may report the death or emergency to the local social service agency. Upon receiving the report, the local social service agency shall assess the circumstances and the needs of the child. The agency may place the child in foster care with a relative who meets the licensing standards under chapters 245A and 245C, and may pursue court action on behalf of the child.
256S.201 CUSTOMIZED LIVING SERVICES; RATES.
The rates for customized living services and 24-hour customized living services shall be the monthly rates authorized by the lead agency based on the customized living service plan developed within the parameters established by the commissioner and specified in the customized living service plan.
The customized living service plan developed by a lead agency must delineate the amount of each component service included in each participant's customized living service plan.
The authorized rates for customized living services and 24-hour customized living services must be based on the amount of component services to be provided utilizing component rates established by the commissioner. Counties and tribes shall use tools issued by the commissioner to develop and document customized living service plans and rates.
Component service rates for customized living services and 24-hour customized living services must not exceed rates for comparable elderly waiver or medical assistance services and must reflect economies of scale.
257.04 INVESTIGATION.
Upon receipt of the notice provided for in section 257.03 the commissioner of children, youth, and families or a designated agent of the commissioner shall visit the child and the home and shall continue to visit and supervise the home and the child or take other appropriate action to assure that the welfare of the child, biological parents and foster parents are fully protected.