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Probate & Trust Law Section Conference Manual ... - Minnesota CLE

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the monthly contribution, monitoring its payment and enforcing the<br />

requirement against delinquent spouses would cost more than the support<br />

that could be expected to be collected from spouses. Nevertheless, the<br />

proposal was included in the 2012 Omnibus Health and Humans Services<br />

Finance Act.<br />

C. REPEAL OF THE COMMUNITY SPOUSE SUPPORT OBLIGTION<br />

<strong>Law</strong>s of <strong>Minnesota</strong> 2013, Ch. ___, Art. 7, Sec. 64, repealing Minn. Stat. §<br />

256B.14, subd. 3a, effective July 1, 2013.<br />

DHS opposition has prevailed. Never mind.<br />

XIV. REDESIGN OF HOME AND COMMUNITY BASED SERVICES<br />

A. HIGH HOPES FOR REDESIGN<br />

The Dayton Administration, like its predecessor, has pinned its hopes for medical<br />

assistance cost containment from day one on a major redesign of government<br />

programs to provide home and community based services to keep older<br />

<strong>Minnesota</strong>ns out of nursing homes. <strong>Minnesota</strong> was an early leader in regulating<br />

nursing homes to improve their quality and prevent deficient care. As a result,<br />

<strong>Minnesota</strong> has a higher percentage of the elderly in nursing homes than many<br />

other states. Also, because of the high degree of regulation and the costs of<br />

compliance with regulatory standards, <strong>Minnesota</strong> nursing homes are very<br />

expensive.<br />

The accepted theory is that substantial savings will result if fewer persons enter<br />

nursing homes for care. The theory includes the belief that substantial savings will<br />

result from delaying, even for a short time, entry into a nursing home. A<br />

necessary part of this theory is the belief that there are a number of nursing home<br />

residents who do not need to be there. The term “right-sizing care” is often heard<br />

in support of efforts to redesign <strong>Minnesota</strong>’s health care delivery system.<br />

As noted earlier, since 2009 <strong>Minnesota</strong> has been planning for decentralization of<br />

the health care delivery system. We are now approaching the day when these<br />

plans might be put into effect. Whether these plans will be implemented on<br />

January 1, 2014, or at some later date, depends on approval of the pending Long<br />

Term Care Realignment Waiver and the Reform 2020 Waiver Requests currently<br />

at the Centers for Medicare and Medicaid Services (CMS).<br />

B. INCREASED NURSING FACILITY LEVEL OF CARE CRITERIA<br />

CRITICAL TO REDESIGN<br />

38

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