1.1.................... moves to amend H.F. No. 2408 as follows:
1.2Page 1, after line 14, insert:

1.3    "Sec. .... Minnesota Statutes 2010, section 144A.351, is amended to read:
1.6    The commissioners of health and human services, in consultation with the
1.7cooperation of counties and stakeholders, including persons who need or are using
1.8long-term care services and supports, lead agencies, regional entities, senior and disability
1.9organization representatives, service providers, community members, including local
1.10businesses, and church representatives shall prepare a report to the legislature by August
1.1115, 2004 2014, and biennially thereafter, regarding the status of the full range of long-term
1.12care services and supports for the elderly and children and adults with disabilities in
1.13Minnesota. The report shall address:
1.14    (1) demographics and need for long-term care services and supports in Minnesota;
1.15    (2) summary of county and regional reports on long-term care gaps, surpluses,
1.16imbalances, and corrective action plans;
1.17    (3) status of long-term care services by county and region including:
1.18    (i) changes in availability of the range of long-term care services and housing
1.20    (ii) access problems regarding long-term care services; and
1.21    (iii) comparative measures of long-term care services availability and progress
1.22changes over time; and
1.23    (4) recommendations regarding goals for the future of long-term care services and
1.24supports, policy and fiscal changes, and resource needs."
1.25Page 2, line 12, strike everything after the comma
1.26Page 2, strike line 13
2.1Page 2, line 14, strike everything before the period and insert "as a component of the
2.2report on the status of long-term care services, required under section 144A.351"
2.3Page 3, line 12, strike ", and" and insert a period and strike "immediately" and after
2.4the second "the" insert "statewide" and strike "for the"
2.5Page 3, line 13, strike "home" and delete the new language
2.6Page 3, line 14, delete the new language and insert "if necessary to maintain
2.7statewide long-term care residential service capacity within budgetary limits, including
2.8all legislatively mandated reductions. If a licensed adult foster home becomes no
2.9longer viable, the lead agency, with the assistance of the department, shall facilitate a
2.10consolidation of settings or closure"
2.11Page 3, after line 16, insert:
2.12    "(f) A resource need determination process, managed at the state level, using
2.13the available reports required by section 144A.351, will determine where the reduced
2.14capacity required under paragraph (e), will occur. The commissioner shall consult with
2.15the stakeholders described in section 144A.351, and employ a variety of methods to
2.16improve the state's capacity to meet long-term care service needs within budgetary limits,
2.17including seeking proposals from service providers or lead agencies to change service
2.18type, capacity, or location to improve services, increase the independence of residents,
2.19and better meet needs identified by the long-term care services reports and statewide data
2.20and information. By February 1 of each year, the commissioner shall provide information
2.21and data on the overall capacity of licensed long-term care services, actions taken under
2.22this subdivision to manage statewide long-term care services and supports resources, and
2.23any recommendations for change to the legislative committees with jurisdiction over the
2.24health and human services budget."
2.25Page 13, after line 16, insert:

2.26    "Sec. .... Minnesota Statutes 2011 Supplement, section 256B.49, subdivision 15, is
2.27amended to read:
2.28    Subd. 15. Individualized service plan; comprehensive transitional service plan;
2.29maintenance service plan. (a) Each recipient of home and community-based waivered
2.30services shall be provided a copy of the written service plan which:
2.31    (1) is developed and signed by the recipient within ten working days of the
2.32completion of the assessment;
2.33    (2) meets the assessed needs of the recipient;
2.34    (3) reasonably ensures the health and safety of the recipient;
2.35    (4) promotes independence;
2.36    (5) allows for services to be provided in the most integrated settings; and
3.1    (6) provides for an informed choice, as defined in section 256B.77, subdivision 2,
3.2paragraph (p), of service and support providers.
3.3    (b) In developing the comprehensive transitional service plan, the individual
3.4receiving services, the case manager, and the guardian, if applicable, will identify
3.5the transitional service plan fundamental service outcome and anticipated timeline to
3.6achieve this outcome. Within the first 20 days following a recipient's request for an
3.7assessment or reassessment, the transitional service planning team must be identified. A
3.8team leader must be identified who will be responsible for assigning responsibility and
3.9communicating with team members to ensure implementation of the transition plan and
3.10ongoing assessment and communication process. The team leader should be an individual,
3.11such as the case manager or guardian, who has the opportunity to follow the recipient to
3.12the next level of service.
3.13    Within ten days following an assessment, a comprehensive transitional service plan
3.14must be developed incorporating elements of a comprehensive functional assessment and
3.15including short-term measurable outcomes and timelines for achievement of and reporting
3.16on these outcomes. Functional milestones must also be identified and reported according
3.17to the timelines agreed upon by the transitional service planning team. In addition, the
3.18comprehensive transitional service plan must identify additional supports that may assist
3.19in the achievement of the fundamental service outcome such as the development of greater
3.20natural community support, increased collaboration among agencies, and technological
3.22    The timelines for reporting on functional milestones will prompt a reassessment of
3.23services provided, the units of services, rates, and appropriate service providers. It is
3.24the responsibility of the transitional service planning team leader to review functional
3.25milestone reporting to determine if the milestones are consistent with observable skills
3.26and that milestone achievement prompts any needed changes to the comprehensive
3.27transitional service plan.
3.28    For those whose fundamental transitional service outcome involves the need to
3.29procure housing, a plan for the recipient to seek the resources necessary to secure the least
3.30restrictive housing possible should be incorporated into the plan, including employment
3.31and public supports such as housing access and shelter needy funding.
3.32    (c) Counties and other agencies responsible for funding community placement and
3.33ongoing community supportive services are responsible for the implementation of the
3.34comprehensive transitional service plans. Oversight responsibilities include both ensuring
3.35effective transitional service delivery and efficient utilization of funding resources.
4.1    (d) Following one year of transitional services, the transitional services planning
4.2team will make a determination as to whether or not the individual receiving services
4.3requires the current level of continuous and consistent support in order to maintain the
4.4recipient's current level of functioning. Recipients who are determined to have not had
4.5a significant change in functioning for 12 months must move from a transitional to a
4.6maintenance service plan. Recipients on a maintenance service plan must be reassessed
4.7to determine if the recipient would benefit from a transitional service plan at least every
4.812 months and at other times when there has been a significant change in the recipient's
4.9functioning. This assessment should consider any changes to technological or natural
4.10community supports.
4.11    (e) When a county is evaluating denials, reductions, or terminations of home and
4.12community-based services under section 256B.49 for an individual, the case manager
4.13shall offer to meet with the individual or the individual's guardian in order to discuss the
4.14prioritization of service needs within the individualized service plan, comprehensive
4.15transitional service plan, or maintenance service plan. The reduction in the authorized
4.16services for an individual due to changes in funding for waivered services may not exceed
4.17the amount needed to ensure medically necessary services to meet the individual's health,
4.18safety, and welfare.
4.19    (f) At the time of reassessment, local agency case managers shall assess each
4.20recipient of community alternatives for disabled individuals or traumatic brain injury
4.21waivered services currently residing in a licensed adult foster home that is not the primary
4.22residence of the license holder, or in which the license holder is not the primary caregiver,
4.23to determine if that recipient could appropriately be served in a community-living setting.
4.24If appropriate for the recipient, the case manager shall offer the recipient, through a
4.25person-centered planning process, the option to receive alternative housing and service
4.26options. In the event that the recipient chooses to transfer from the adult foster home,
4.27the vacated bed shall not be filled with another recipient of waiver services and group
4.28residential housing, unless provided under section 245A.03, subdivision 7, paragraph (a),
4.29clauses (3) and (4), and the licensed capacity shall be reduced accordingly. If the adult
4.30foster home becomes no longer viable due to these transfers, the county agency, with the
4.31assistance of the department, shall facilitate a consolidation of settings or closure. This
4.32reassessment process shall be completed by June 30, 2012 July 1, 2013."
4.33Page 14, line 5, delete everything after "institution"
4.34Page 14, delete line 6
4.35Page 14, line 7, delete "institution" and insert "which" and after the colon insert "
4.36regimented meal and sleep times, limitations on visitors, and lack of privacy. Restrictions
5.1agreed to and documented in the person's individual service plan shall not result in a
5.2residence having the qualities of an institution as long as the restrictions for the person are
5.3not imposed upon others in the same residence and are the least restrictive alternative,
5.4imposed for the shortest possible time to meet the person's needs."
5.5Page 14, delete lines 8 to 10
5.6Page 15, line 27, delete the new language
5.7Page 15, delete lines 28 to 32
5.8Page 15, line 33, delete the new language
5.9Page 16, line 1, delete the new language
5.10Page 16, delete lines 2 to 4
5.11Page 19, after line 31, insert:

5.14    By September 1, 2012, the commissioner of human services shall submit
5.15amendments to the home and community-based services waiver plans consistent with
5.16the definition of home and community-based settings under Minnesota Statutes, section
5.17256B.492, and a request to allow an exception for a five year transition period for those
5.18settings that serve more than 20 percent of persons with disabilities as of January 1, 2012,
5.19but otherwise meet the definition in this section. Within the parameters of the approved
5.20home and community-based services waiver plans, providers may request an exception for
5.21a transition period from the commissioner of human services. The commissioner must
5.22maintain a list of those settings that have been approved for this exception, and allow
5.23home and community-based payments to be made for services provided."
5.24Renumber the sections in sequence and correct the internal references
5.25Amend the title accordingly