1.1    .................... moves to amend H. F. No. 1405, the first engrossment, as follows:
1.2Page 3, line 21, before "injections" insert "the drawing up of insulin,"
1.3Page 3, line 22, delete "nursing assessments"
1.4Page 3, line 23, after the period insert "Nothing in this subdivision shall interfere
1.5with the client's rights under sections 144A.44 or 144A.441."
1.6Page 3, delete section 3 and insert:

1.7    "Sec. 3. Minnesota Statutes 2006, section 256B.0915, is amended by adding a
1.8subdivision to read:
1.9    Subd. 3h. Rate exceptions demonstration project. (a) The commissioner of
1.10human services shall develop and implement a two-year demonstration project to examine
1.11the merits of allowing temporary rate exceptions for elderly waiver clients who are
1.12receiving customized living or 24-hour customized living services. The commissioner
1.13shall design the project to authorize, during each year of the demonstration, not more than
1.14500 clients who are receiving the customized living or 24-hour customized living service
1.15to obtain elderly waiver services costing up to 125 percent of the individual's monthly
1.16service cap, for a period of 30 days or less, if: (1) according to criteria established by the
1.17commissioner, the additional services would enable the client to avoid a hospitalization
1.18or an admission to a nursing facility; (2) the additional services could not be obtained
1.19through reassessment of case mix to accommodate a change in condition or authorization
1.20of increased assistance and oversight within the individual's monthly service cap; and (3)
1.21the additional services are not eligible for Medicare reimbursement.
1.22    (b) The demonstration project shall begin on the later of September 1, 2008, or upon
1.23federal approval if the commissioner determines that an amendment to the Elderly Home
1.24and Community Based Services Waiver is needed in order to implement this subdivision.
1.25    (c) The commissioner shall report the results of the demonstration project to
1.26the legislature by January 15 of the year following the end of the project, including an
2.1assessment of whether the project resulted in reduced state expenditures by diverting the
2.2participating clients away from an institutional level of care."
2.3Page 4, after line 11 insert:
2.4    "(2) the length of time it takes case managers to respond to requests to assess
2.5changes in need for Elderly Waiver participants, including recommendations on steps that
2.6clients, case managers, and service providers could take to improve the process;"
2.7Page 4, line 12, delete "(2)" and insert "(3)" and delete everything after "to" and insert
2.8"negotiate customized living and 24-hour customized living services and payment rates"
2.9Page 4, line 13, delete everything before "provided"
2.10Page 4, line 17, delete "(3)" and insert "(4)"