DATE: TO:

December 31, 2013 Sen. Tony Lourey Sen. Kathy Sheran Rep. Tina Liebling Rep. Tom Huntley Commissioner Lucinda Jesson Amy Dellwo Legislative Director

FROM:

SUBJECT: 144.0724, Subd. 11, Nursing Facility Level of Care Implementation Delay

This letter is to inform you that the Department of Human Services has delayed implementation of the revised Nursing Facility Level of Care (NF LOC) criteria and the Essential Community Supports program until January 1, 2015. In 2009, the Minnesota Legislature passed legislation that changes nursing facility level of care criteria for public payment of long-term care. These revised criteria are found in Mn Statutes 144.0724, Subd. 11. Currently these changes are to be implemented January 1, 2014. This delay will provide additional time to make sure that the appropriate supports are available to serve the 3300 Minnesotans affected by this change. These alternative supports are evolving, but need additional time. The Community First Services and Supports program, for example, is not available currently and is anticipated to be implemented later in 2014. The Essential Community Services program is not fully automated and available statewide. Moreover, the definition of dependency is likely to be examined this legislative session, and if altered, may impact these upcoming changes. A one year delay will allow for these systematic changes to be implemented to ensure the right supports are in place for the people we serve. Governor Dayton requested this delay. DHS has been advised that he intends to include the cost of this delayed implementation in his 2014 Supplemental budget. The Nursing Facility Level of Care change affects the most independent people who would receive publicly-funded nursing facility services or publicly-funded long-term care services in the community through programs such as Elderly Waiver (EW), Alternative Care (AC), and Community Alternatives for Disabled Individuals (CADI). That legislation also provided for the implementation of the Essential Community Support (ECS) program to provide support for people age 65 and older with emerging needs

An equal opportunity and veteran-friendly employer

who are not eligible for EW or AC. The ECS program was later expanded by the Legislature to provide supportive services to individuals of all ages affected by the changes in the NF LOC criteria. Federal maintenance of effort requirements delayed implementation of the modified NF LOC criteria until January 1, 2014 for adults aged 21 and older.