Minnesota Department of Health - Home Care and Assisted Living Teleconference May 20, 2021

Minnesota Department of Health

Home Care and Assisted Living Teleconference │ May 20, 2021
          PROTECTI NG , M AINTAINING AND IM PROVING THE HEALTH OF ALL M IN N ESOT AN S

Assisted Living Licensure
   2020 Minnesota Statutes Chapter 144G

Agenda

 Relocation/Termination Notice - Lindsey Krueger (MDH)

 Provider Enrollment           - Chao Lee (DHS)

 Top 10 FAQs                   - Lindsey Krueger (MDH)

 Reminders & Updates           - Lindsey Krueger (MDH)

                                                            3

Housekeeping

▪ Presenters are unmuted
  – please announce
  yourself and your role
  prior to speaking
▪ Public attendees are
  muted – please submit
  any comments or
  questions in the chat
  feature (bottom right)
                                      4

Notice of and Planning for Discharge/Closures

Current comprehensive home care or HWS providers
with NO intent to convert (to ALL) or continue to
provide homecare services under chapter 144A:
   Must notify clients at least 60 days before
    expiration of their license, or by May 31, 2021,
    whichever is earliest

                                                          5

60 Day Notice Requirements

144G.191 Subd.3. (c) (1-5) and Subd. 4 (b) (1-5) 60 Day notice requirements:

(1) state that the provider will no longer be providing home care services under chapter 144A or that the housing with services establishment
does not intend to convert to an assisted living facility (whichever is applicable to your setting);

(2) include the date when the provider/HWS establishment will no longer be providing these services;

(3) include the name, e-mail address, and phone number of the individual associated with the comprehensive home care/HWS provider that
the recipient of home care services may contact to discuss the notice;

(4) include the contact information consisting of the phone number, e-mail address, mailing address, and website for the Office of
Ombudsman for Long-Term Care and the Office of Ombudsman for Mental Health and Developmental Disabilities; and

(5) for recipients of home care services who receive home and community-based waiver services under section 256B.49 and chapter 256S,
also be provided to the resident's case manager at the same time that it is provided to the resident.

                  This notice MUST be provided to the residents at least 60 days before the expiration of the
                                    license/registration, or no later than May 31, 2021.

                                                                                                                                          6

HWS Requirements

144D.04

144D.045

144D.09

                               7

Provider Relocation Requirements

 144A.44
 144A.441
 144A.442
 144A.4791

                                                 8

Home Care Bill of Rights

   144A.44 - HOME CARE BILL OF RIGHTS

   A client has the right to a coordinated
transfer when there will be a change in the
             provider of services.
                                                9

Coordinated Transfer of Care

        144A.442 - SERVICE TERMINATION

 A written notice of termination must include a statement
that the provider will participate in a coordinated transfer
of the care of the client to another provider or caregiver, as
  required by section 144A.44, subdivision 1, clause (18).

                                                             10

Termination of Service Plan

       144A.4791 - HOME CARE PROVIDER
   RESPONSIBILITIES WITH RESPECT TO CLIENTS
When the home care provider voluntarily discontinues services
     to all clients, the home care provider must notify the
 commissioner, lead agencies, and ombudsman for long-term
care about its clients and comply with the requirements in this
                           subdivision.
                                                             11

MDH Media Release

 MDH will be issuing a Media Release regarding
  Assisted Living Licensure in the upcoming days
 Can be used with provider termination notice to
  inform residents of licensure changes
 Will be posted to ALL webpage

                                                    12

Assisted Living Licensure and
            Customized Living Providers
Department of Human Services (DHS) I Provider Eligibility and Compliance
                                                                           13

Effective August 1, 2021

▪   Minn. Stat. Chapter 144G will change the license requirement for Customized Living Service
    providers effective Aug. 1, 2021

▪   Housing with Services registration no longer valid to provide customized living services

▪   Home and Community-Based Services (HCBS) waiver service for customized living providers need to
    do the following to continue to delivering customized living services
    on and after August 1, 2021:
    •   Obtain an assisted living facility license
    •   Delivering services in an exempt setting

▪   This requirement applies to these waiver programs: Elderly Waiver (EW), Brain Injury (BI),
    Community Access for Disability Inclusion (CADI)

                                                                                                 14

Action You Need To Take
To Continue Providing These Services – Step 1

  You must apply for an assisted living facility license
  no later than June 1, 2021, if you:
   Are registered as a housing with services establishment under
    chapter 144D; and
   Are providing home care services or have contracted with a
    comprehensive home care provider providing services to at least one
    resident; and
   Intend to provide customized living services on or after August 1,
    2021

                                                                          15

Action You Need to Take
To Continue Providing These Services – Step 2

You must update your Provider Enrollment Record with Minnesota Health Care Programs (MHCP) Provider
Eligibility and Compliance (PEC)

    Providers Requiring an Assisted Living Facility License - Upload a copy of the Assisted Living Facility
     License for each setting providing customized living services at Minnesota Provider Screening and
     Enrollment (MPSE) Portal (https://mn.gov/dhs/partners-and-providers/policies-
     procedures/minnesota-health-care-programs/provider/mpse/) as soon as you receive you license

    Providers delivering services in an Exempt Setting - A Provider Assurance Statement will need to be
     completed and submitted with a Comprehensive Home Care License to PEC

          ▪   Exempt Setting pending approval from Minnesota Legislature

          ▪   See License requirement changes for customized living services providers
              (https://mn.gov/dhs/partners-and-providers/policies-procedures/minnesota-health-care-
              programs/provider/types/hcbs/customized-living.jsp) for more information

                                                                                                          16

Action You Need to Take
If You Will Not provide Customized Living Services after 8/1/2021

▪ Notify current residents no later than May 31, 2021
▪ Work with residents and their case managers or care coordinators to transition them to an
  eligible provider
▪ Notify Provider Eligibility and Compliance to end service or terminate your enrollment record
▪ Upload proper form to MPSE Portal (https://mn.gov/dhs/partners-and-providers/policies-
  procedures/minnesota-health-care-programs/provider/mpse/) or fax to 651-431-7493
   • To stop providing customized living services: HCBS Programs Service Request Form DHS-6638
     (PDF) (https://edocs.dhs.state.mn.us/lfserver/Public/DHS-6638-ENG)
   • To terminate provider enrollment for all services: Organization MHCP Provider Profile Change
     Form DHS 3535A (PDF) (https://edocs.dhs.state.mn.us/lfserver/Public/DHS-3535A-ENG)

                                                                                              17

Payment for Services

August 1, 2021 - Provider Eligibility and Compliance will suspend reimbursement for Customized Living Services
until providers have submitted proof of:
▪   Assisted Living Licensure (under 144G) OR
▪   Comprehensive Home Care License and the Assurance Statement form verifying Exempt Setting
    (144G.08 Subd. 7 (11-13) (www.revisor.mn.gov/statutes/cite/144G.08))

If there is a lapse in a provider's license (with an effective date after August 1, 2021), DHS will NOT pay for
services during the lapse.
 Services delivered after August 1, 2021 will ONLY be covered with proof of license with an effective date of
  August 1, 2021. If proof of license is provided after August 1, 2021, services will be covered retroactively to
  August 1, 2021, if proof of license has an effective date of August 1, 2021

                                                                                                                  18

Minnesota Provider Screening and Enrollment (MPSE)
    Portal Training
Webinars are available on the following dates from 9 a.m. to noon. You can
register for a training session by clicking the date of the training you would like
to attend:
     ▪ Tuesday, May 25, 2021
     ▪ Wednesday, May 26, 2021
     ▪ Thursday, May 27, 2021

See License requirement changes for customized living services providers
(https://mn.gov/dhs/partners-and-providers/policies-procedures/minnesota-
health-care-programs/provider/types/hcbs/customized-living.jsp) for more
information.

                                                                                 19

Questions?

Questions about new provider standards for customized living
providers?
 Contact DHS Aging and Adult Services Division at
  dhs.aasd.hcbs@state.mn.us
Questions about enrollment for customized living service
providers?
 Contact the MHCP Provider Call Center at
  651-431-2700 or 800-366-5411
                                                               20

10…9…8…7…6…
5…4…3…2…1!!!
    The Top 10!

10: Changes of Ownership (CHOWs)

▪ Transfer to a Different or New Corporation
▪ Termination of the Partnership
▪ Relinquishment of Control
▪ Transfer by a Sole Proprietor
                                     144A.472 Subd. 5
▪ Transfer of 50 Percent or More         144G.19

                                                        22

9: Innovation Variance/Waiver

 Must be a Licensed Assisted Living Facility
 Offer Innovative Services
 No Impairment of Services
 No Adverse Impact
 Likely Improve Services                144G.33

                                                      23

8: Capacity

Total Licensed Resident Capacity = what is or could be
the number of residents you will be or plan to be
serving in the license period without going over.

                                      AKA = Census

                                                         24

7: Licensed Assisted Living Director (LALD)

 Must apply for licensure by July 1, 2021, for legacy pathway
 Apply Online – then submit supporting materials to
  BELTSS.HLB@state.mn.us
 License Portal - Tasks marked Open (bubble with
  comments) or Completed
 Criminal Background Check = 1st Priority (ETA 30-40 days)
 You can be hired and become an Assisted Living Director in
  Residence (ALDIR)
                                          144G.10 Subd. 1a
                                                             25

6: Uniform Disclosure (UDALSA)

This is where the (prospective) resident
signs the form acknowledging that a
provider gave it to them, prior to signing a
contract for services.
                                                        ▪ 144G.40 Subd. 2
                                                                            26

5: Campus Language

How many applications do I need for a campus?

                                144G.08 Subd. 4a

                                                   27

4: Rules Chapter 4659

When will the RULES be finalized?
▪ Draft rules are approved by OAH, with minimal revisions
  ▪ Proposed Order
    (www.health.state.mn.us/facilities/regulation/assistedliving/docs/hearing
    /requestforapproval.pdf)

▪ OAH has closed file
▪ Revisor’s Office currently drafting
                                                                            28

3: HWS

Does the HWS registration need to be current?

                                                29

2: Background Studies

▪ Completed application to MDH - info passed to DHS

▪ DHS emails Authorized Agent with info on next steps

▪ Need to identify Sensitive Information Person (SIP)

▪ Set-up occurs in NetStudy 2.0 for ALL license

                                                        30

1: SS-4 Alternatives

All documentation must be issued by the IRS and include information sufficient
to confirm the identity of the business and corresponding FEIN.
Confidential information should be redacted prior to submission.

▪ Computer generated notice issued by the IRS when the applicant first applied for the
  FEIN. This notice is issued as a confirmation of the application for, and receipt of a FEIN.

▪ If the applicant used the FEIN to open a bank account or apply for any type of state or
  local license, they may contact the bank or agency to secure the FEIN and send
  confirmation to MDH.

▪ Appropriately redacted first page of an as-filed tax return
  (1120, 990, 1065, 941, 1099-NEC, w-4, 5500)

                                                                                                 31

1: SS-4 Alternatives (continued)

▪ IRS determination letter for tax-exempt organizations

▪ Printout or screenshot of search results from Search for Tax Exempt Organizations
  (www.irs.gov/charities-non-profits/search-for-tax-exempt-organizations) showing
  the organization listed in IRS Pub. 78 for tax exempt organizations

▪ Listing in an as-filed 990 group return

▪ S-Corp election confirmation

▪ Any other correspondence from the IRS that includes the organization name and EIN
  (i.e., audit notice letter, request for documents, notice of late filing of a tax return)

                                                                                              32

Reminders and Updates

Outdoor Space

            Considerations when applying for an
            assisted living with dementia care license:
            ▪ Current Statutory Language 144G.84 (g);
              legislative update
            ▪ No need to delay –
              submit your application now!

!   !   !           !            !             !
                                                          34

Customized Living Services and Assisted Living Licensure

Hot off the HCBS Provider Relations Press…

License Requirement Changes for Customized Living Services Providers
(https://mn.gov/dhs/partners-and-providers/policies-procedures/minnesota-
health-care-programs/provider/types/hcbs/customized-living.jsp)

 MPSE portal training for existing customized living service providers
  May 25, 26 and 27 (9 a.m. to noon)

 Additional sessions will be added for June and July
                                                                            35

DHS Portal

             36

Updates from BELTSS

They are around May 9th for processing applications
Please avoid calling - “clogs” up the system
Make sure your college transcripts go directly to
 BELTSS – DO NOT OPEN!
Please label uploaded documents appropriately
Plan to open ALD and ALDIR applications mid-June
                                                       37

Document Uploading Tips

 SAVE your application, LOG OUT & RESTART your computer
 Docs are in correct FORMAT (pdf, doc, docx, txt)
 DOC NAME (80-character max, no special characters, no dashes)
 ONE document at a time
 May take 10 MINUTES
 Do not NAVIGATE AWAY from the page
 CHROME

                                                                  38

Application - Technical Difficulties

Email health.assistedliving@state.mn.us
Include your application number – ALF#####
Be SPECIFIC and DETAILED about your issue
Include SCREEN SHOTS that describe or explain your
 issue/error

                                                         39

Payment Notification Email

From: donotreply@state.mn.us
Date: May 15, 2021, at 8:26:07 AM CDT
To: ABCDEFG@gmail.com
Subject: Proceed to Payment for submitted Assisted Living License application - HFID: 99999, ABCDEF RESIDENTIAL CARE

Hello,
The Minnesota Department of Health has received all the documents needed to begin the verification process for your assisted living facility license
application.
A license fee of $2225.00 is now due. The license fee is based on the type of Assisted Living License and the building capacity information provided in
the application.
License Type: Assisted Living Facility
Total Licensed Resident Capacity: 3
Please use this link to login and to complete the payment process. https://icsd.web.health.state.mn.us/security/login.do
Once your application is complete, including receipt of the license fee payment and notice that required background studies are passed, the Minnesota
Department of Health has 60 days to fully verify the application. You will receive an email notification of the outcome of this process.
Please use the contact information given below for questions you may have about this application.
Home Care and Assisted Living Program
Minnesota Department of Health
Office: 651-201-4200
health.assistedliving@state.mn.us

                                                                                                                                                          40

Complete the Payment Process

  ▪ Payment Process is
    completed within your
    application
  ▪ Once payment is
    enabled a new box will
    appear

                            41

Payment Confirmation & Next Steps

   Once payment is received:
    application goes to final
     review
    background checks are
     verified
    LALD is verified
                                 42

Application Stats

 1007 conversion applications have
  not been opened yet
 730 are in progress by providers
 628 have been submitted to MDH
 107 are ready for provider payment
 130 MDH has confirmed payment

                                                      43

Upcoming Presentations

 Thursday, June 3, 2021    Thursday, June 10, 2021
10:00 a.m. to 11:30 a.m.   10:00 a.m. to 11:30 a.m.
  CLIA Waiver Review        Person-Centered Care
  Preparing for Rules       Nursing Assessments
   Required Policies                 TBD

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Questions?
             45

Thank you.
Lindsey Krueger - health.assistedliving@state.mn.us

                   WWW.H EA L TH. M N. GO V