MA-EPD testimony

2016 MN-CCD Legislative Session Policy Agenda Wrap-Up

Medical Assistance Reform
Effective July 1, 2016 the MA Spend-down standard will see a small increase allowing people to keep approximately $50 per month more of their income. This was passed in 2015 and will go into effect soon. Unfortunately, Medical Assistance Disability Reform was not funded any further in 2016. Minnesota’s current policy is unfair, short-sighted and incredibly burdensome to thousands of Minnesota families who are expected to live below poverty in order to qualify for home and community based services.
Update from Jeff Nachbar , MN Brain Injury Alliance,

Spousal Anti-Impoverishment/Treatment of Spousal Assets for Medical Assistance Eligibility
Minnesota is being required to apply new federal rules regarding how a married couple’s assets are treated when a person is seeking Medical Assistance (MA) for long-term care (LTC) services through a HCBS waiver program and/or for Community First Services and Supports (CFSS).

Prior to this requirement, Minnesota only counted the income and assets of the spouse who is applying for MA payment of LTC services. Under the new rules, the state will count the couples’ combined assets and divide those assets in half. Due to the change passed in the HHS proposal in 2016, the spouse who is not seeking LTC services will retain half of their combined assets (up to a maximum of $119,220) , and the spouse receiving LTC will be subject to the spenddown to 80% of the Federal Poverty Level and the remainder of the assets until $3,000 is left. Effective June 1, 2016 for new applicants and March 1, 2017 for current enrollees.

Changes in 2016 also include a provision to allow a family to seek a “hardship waiver” to protect assets in specific retirement savings accounts or college savings plans. Implemented effective June 1, 2016, but subject to approval by the Centers for Medicaid and Medicare Services (CMS).
Update from Jeff Nachbar , MN Brain Injury Alliance,

Mental Health
(all Mental Health Updates from Anni Simons , Frederickson and Byron)

Certification Process for Community Behavioral Health Clinics
Both policy language and related necessary funding was passed this session to support next steps related to the Excellence in Mental Health Demonstration project that passed last session. This is a federal demonstration project to test a new model of providing and paying for integrated and coordinated mental health and substance use disorder treatment and services. Minnesota’s Department of Human Services applied for and was one of 24 states that received a federal planning grant for the development of Certified Community Behavioral Health Clinics (CCBHCs). In order to move into the next step in the process, this legislation was necessary.

Funding for State Operated Services
Financing for the following chain of events related to state operated mental health services was passed: Fund the staffing needs of 6 of the 7 Community Behavioral Health Hospitals (CBHH), close the St. Peter area CBHH, CARE (a state operated chemical dependency program) would move to the empty CBHH, a new standalone Competency Restoration program would then go into the CARE building, and some of the individuals waiting at Anoka and the Minnesota Security Hospital for competency restoration services could then move to this standalone competency restoration program to access these services.

Broadening Eligibility for the Crisis Housing Assistance Program
Language was passed broadening eligibility for this program to include those with serious mental illness who require inpatient or residential care (it is currently limited to those with serious and persistent mental illness who require inpatient or residential care).

Autism Bills
This year autism advocates promoted bills that would enable providers to access funding for early intervention, and would expand the insurance mandate to cover treatment. Both bills passed the Senate, but were not heard in the House. We hold out hope that the Governor will include what we are now calling the autism package in his special session, if he decides to call one.
Update from Randy Bachman, Autism Recovery Foundation

Consumer Directed Community Supports (CDCS)
Legislation passed this session to continue the 20% CDCS budget increase for graduating students. This option to increase the budgets of high school students on consumer directed community supports (CDCS) by 20% upon graduation has existed for several years. Passing this legislation will enable individuals to receive employment or day services support while staying on CDCS. Legislation extending this option and making other improvements in CDCS passed in 2015, but its implementation depended upon approval by the federal Centers for Medicare and Medicaid Services (CMS). Since approval was delayed, this legislation was necessary. This proposal had no fiscal note, because the funding is already in the state budget. This option costs less than if individuals had to switch to more formal day programs.
Update from Steve Larson, The ARC Minnesota,

Miscellaneous items
Information provided by Anni Simons , Frederickson and Byron

Commissioner Required to Reform Minnesota’s Substance Use Disorder Treatment System
Language was passed this session that calls on the Commissioner to design a reform of Minnesota’s substance use disorder treatment system to ensure a full continuum of care for individuals with substance use disorders. A report on this reform proposal is required by February 1st, 2017. As part of this reform planning work, the bill calls on DHS to submit a waiver to CMS allowing MN to receive Medical Assistance funds for substance abuse treatment services provided in IMDs (Institution for Mental Disease).

Temporary Family Healthcare Dwelling
Legislation was passed this session creating a process for a conditional use permit for a “temporary family health care dwelling”. This is essentially a mobile home for an individual who needs caregiving services that is placed on the property of a relative or caregiver, making it easier for the caregiver to provide care.

Residential Care and Services Electronic Monitoring Work group
This piece of legislation that was passed into law establishes a residential care and services electronic monitoring work group tasked with developing recommendations for legislation to authorize the use of voluntary electronic monitoring to protect vulnerable adults and children.

Action Plan to Increase Community Integration of People with Disabilities
The language that was passed into law requires the Commissioners of human services, education, employment and economic development, and information technology to develop a collaborative action plan in alignment with the state’s Olmstead Plan to increase the community integration of people with disabilities, including housing, community living, and competitive employment. Recommendations must include a proposed method to allow people with disabilities who access services from state agencies to access a unified record of the services they receive. This method must also allow people with disabilities to efficiently provide information to multiple agencies regarding service choices and preferences. Recommendations for this action plan must be provided to the legislature by January 1, 2017, and must include proposed statutory changes, including any changes necessary to the data practices act to allow for data sharing, and information technology solutions required to implement the actions.

Housing Support Services for Minnesotans with Disabilities
This provision that was passed into law requires the Commissioner to design comprehensive housing services to support an individual’s ability to obtain or maintain stable housing. By February 1, 2017, the Commissioner must present an update to the legislature on the progress of the proposal with recommendations on legislative changes and funding necessary to implement the proposal. In developing this proposal, the Commissioner must consult with stakeholders, including people who may utilize the service, advocates, providers, counties, tribes, health plans, and landlords.

Funding for Staff to Assist State Agencies and the Governor’s Council on Developmental Disabilities in Carrying out Olmstead Plan Work.
This session there was $148,000 per year in ongoing funding allocated to state agencies including the Governor’s Council on Developmental Disabilities for work related to requirements in the state’s Olmstead Plan.

Funding for Jensen Settlement and Olmstead Plan Related work at the Minnesota Department of Human Services
$100,000 in the next fiscal year, and $250,000 in the following years was allocated this session to DHS to assist them in carrying out Jensen Settlement and Olmstead Plan requirements.