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E-Newsletter of June 26, 2012 | Vol. 4, No. 76


Item of Interest



On June 18, 2012, DHS released its long-awaited MA Reform waiver request for public comment.  Entitled, "Reform 2012: Pathways to Independence, Section 1115 Waiver Proposal" this waiver request seeks permission from CMS to dramatically reorganize delivery of institutional and home and community based services in Minnesota.  The 2011 Legislature directed DHS to request whatever waivers, state plan amendments and access to funding would be necessary to accomplish the waiver's stated goals for reform of MA:  community integration of services and independence for medically needy individuals; improved health care delivery; reduced reliance on institutional care; greater opportunities for employment and housing for needy individuals, and cost savings to allow long-term sustainability of needed services through better alignment of available services and people's needs.  The proposal would accomplish these goals by reducing eligibility for MA benefits by increasing the criteria for nursing home admissions, thereby reducing access to MA benefits for both nursing home care and home and community based services;  expanding access to home and community based services to more people through local community supports rather than MA programs; and further reducing MA expenditures by managing benefits to fit more closely with documented needs. 
A copy of the proposal is available here. The notice announcing a public comment period to end July 17, 2012, was published in the Minnesota State Register on June 18, 1012.  Two public hearings were held on June 22 and 25.  The first phase of the reform effort, the waiver request to allow nursing facility admission criteria to become more restrictive, entitled the Long Term Care Realignment Section 1115 Waiver Request, was submitted to CMS on February 13, 2012, and is awaiting a response from CMS.  

Submitted by Julian J. Zweber
Legislative Coordinator
Elder Law Section


Elder Law News


State takes steps against elder abuse | Echo Press
Elder Abuse Awareness |

Older and on their own: Single seniors make up growing portion of the population | LaCrosse Tribune

Nurse facing felony charges for stealing patient’s morphine | Mankato Free Press

Submitted by Joel Smith, Esq.

Elder Law Cases

There are no cases to report this week.

Elder Law Statutes, Regulations, and Bulletins

The following appeared in the State Register on June 18th, 2012:

Department of Human Services (DHS)
Health Care Administration
Public Notice Regarding Changes to Payment Rates and Methodologies, and Services under the Medical Assistance Program and the MinnesotaCare Program

NOTICE IS HEREBY GIVEN to recipients, providers of services, and to the public of certain statutory changes made to the Medical Assistance (MA) Program and the MinnesotaCare Program that the 2012 Minnesota Legislature enacted during the regular session.
This notice is published pursuant to 42 United States Code §1396a(a)(13)(A)  §1902(a)(13)(A) of the Social Security Act), which requires the Department to publish final institutional payment rates, the methodologies underlying the establishment of such rates, and the justification for such rates. It is also published pursuant to Code of Federal Regulations, title 42, part 447, section 205 (42 CFR §447.205), which requires publication of a notice when there is any significant proposed change in the methods and standards for setting payment rates for Medicaid services.
The legislative changes are estimated to result in a net increase of $1.2 million in the MA program for state fiscal year 2012 (July 1, 2011 through June 30, 2012), and a net increase of $29 million in the MA program for state fiscal year 2013 (July 1, 2012 through June 30, 2013).
Legislative changes are expected to have minimal effect on the Medicaid portion of the MinnesotaCare program in these two years: only an increase of $5,000 in state fiscal year 2013.
The actual text of most of the 2012 legislative changes is contained in Minnesota Laws 2012, Regular Session, Chapters 169, 216 and 247. These are available by calling the House of Representatives Public Information Office at (651) 296-2146 (voice) or (651) 296-9896 (TTY) or 1-800-657-3550 (Greater Minnesota) or 1-800-627-3529 (TTY); or the Senate Information Office at (651) 296-0504 (voice) or (651) 296-0250(TTY); for Greater Minnesota call 1-888-234-1112 (voice) or 1-888-234-1216 (TTY). These laws are also available on the internet at:

Department of Human Services (DHS)
Health Care Administration
Request for Comments on Reform 2020 Section 1115 Medicaid Waiver

DHS is announcing a 30-day comment period on the Reform 2020 Section 1115 Medicaid waiver Request. The 2011 Minnesota Legislature directed the Department of Human Services (DHS) to develop a proposal to reform the Medical Assistance Program. Goals of the reform include: community integration and independence; improved health; reduced reliance on institutional care; maintained or obtained employment and housing; and long-term sustainability of needed services through better alignment of available services that most effectively meet people’s needs.
In order to accomplish this goal, the legislature designated twelve separate initiatives to be examined. Several of these initiatives will result in the need for a waiver request under section 1115 of the Social Security Act. DHS has developed the section 1115 Medicaid waiver request entitled Reform 2020 in order to implement several key components of the overall Medicaid reform initiative.
A copy of the waiver request can be found here.
To request a paper copy of the waiver request, please contact Quitina Cook at (651) 431-2191.
Written comments may be submitted to the following email mailbox: DHS would like to be able to provide copies of comments received in a format that is accessible for persons with disabilities. Therefore, we request that comments be submitted in Microsoft Word format or incorporated within the email text. If you would also like to provide a signed copy of the comment letter, you may submit a second copy in pdf format or mail it to the address below. Comments must be received by July 17, 2012.

David Godfrey, Medicaid Director
Minnesota Department of Human Services
P.O. Box 64998
St. Paul, Minnesota 55164

In addition to the opportunity to submit written comments during the 30 day public comment period, public hearings will be held to provide stakeholders and other interested persons the opportunity to comment on the waiver request. If you would like to attend a hearing via telephone, please send an email request to to obtain the call-in information. If you would like to attend a hearing in person, the time and location for the two public hearings are provided below. If you plan to testify by telephone or in person, please send an email to

Public Hearing #1
Date: Friday, June 22, 2012
Time: 2:00 - 5:00 pm
Location: MDH, Snelling Office Park, Mississippi Room, 1645 Energy Park Drive, St. Paul, MN 55108.

Public Hearing #2
Date: Monday, June 25, 2012
Time: 9:00am - Noon
Location: DHS, Elmer L. Andersen Human Services Building, Room 2370/80, 540 Cedar St., St. Paul, MN 55164.

Additionally, DHS announced the following on June 22, 2012:

DHS Bulletin # 12-69-02
2012 Legislative Changes Affecting GA, MSA, DWP, MFIP, WB, CCAP, and SNAP
TOPIC.  This bulletin summarizes changes made during the 2012 legislative session to General Assistance, Minnesota Supplemental Aid, Diversionary Work Program, Minnesota Family Investment Program, Work Benefit Program, Child Care
Assistance Program, and Supplemental Nutrition Assistance Program. The purpose of this bulletin is to provide information and instructions on policy changes to counties, tribal human services and employment services staff. The complete Bulletin, dated June 22, 2012 can be found here.

Submitted by Marit Anne Peterson, Esq.

Upcoming Events and CLE Programs

SAVE THE DATE!  The 22nd Annual Elder Law Institute will be held on October 11-12, 2012 at the Minnesota CLE Center in Minneapolis. 


Elder Law Section Activities


MA COMMITTEE MEETING: The next MA Committee meeting will be at 3:30 p.m. on Tuesday, June 26, 2012. The Medical Assistance Committee is a study group to analyze Elder Law Section member questions and case studies and to discuss administrative policies and procedures in relation to Medical Assistance in Minnesota.  Cathryn D. Reher of Long, Reher & Hanson, P.A., is Committee Chair.  For directions, or to attend by phone, please contact Tracie Fenske with Long, Reher & Hanson, P.A., at 952-929-0622 at least 24 hours in advance of the meeting. Topics for the meeting may be submitted to under the subject heading “MA Committee Topic”, or faxed to 952-542-9201. Please be reminded that the meeting location is: Estate & Elder Law Services (formerly MAO Legal Services), Monroe Village, 1900 Central Avenue NE, Minneapolis, Minnesota 55418. The meeting takes place in the building’s conference room. There are a few parking spaces behind the building and lots of street parking. People should walk to the back of the building and come to the back door which faces directly into the meeting room.

GOVERNING COUNCIL:  The next meeting will be held in August. The meetings will be held at the offices of the Volunteers of America (VOA) at 1900 Central Avenue NE, Suite 106, Minneapolis, MN 55418. For further information, please contact Suzy Scheller, Chair, at:


Elder Law Website


DON'T FORGET THAT THE ELDER LAW WEBSITE IS A GREAT RESOURCE. Here’s what you can find on the Website:  Links to the DHS Health Care Programs Manual, the DHS Bulletin on treatment of uncompensated transfers, the Minnesota Bankers Association Compliance Bulletin on Powers of Attorney, legislative summary; Practice Links to organizations such as NAELA, ABA Commission on Law and Aging, Links to Federal and State Government Agencies, Statutes, and Regulations; Meeting Notices, Listings of Officers and Council Members, Section Bylaws, and more.


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