HF 1276A

Conference Committee Report - 86th Legislature (2009 - 2010) Posted on 01/15/2013 08:25pm

1.1CONFERENCE COMMITTEE REPORT ON H. F. No. 1276

1.2A bill for an act

1.3relating to health and human services; relieving counties of certain mandates;
1.4making changes to residential treatment facilities; county payment of
1.5cremation, burial, and funeral expenses; child welfare provisions; health plan
1.6audits; nursing facilities; home health aides; inspections of day training and
1.7habilitation facilities; changing certain health care provisions relating to school
1.8districts, charter schools, and local governments;amending Minnesota Statutes
1.92008, sections 62Q.37, subdivision 3; 144A.04, subdivision 11, by adding a
1.10subdivision; 144A.43, by adding a subdivision; 144A.45, subdivision 1, by
1.11adding a subdivision; 245.4882, subdivision 1; 245.4885, subdivisions 1, 1a;
1.12256.935, subdivision 1; 256.962, subdivisions 6, 7; 256B.0945, subdivisions
1.131, 4; 256F.13, subdivision 1; 260C.212, subdivisions 4a, 11; 261.035; 471.61,
1.14subdivision 1; proposing coding for new law in Minnesota Statutes, chapter
1.15245B; repealing Minnesota Rules, part 4668.0110, subpart 5.
1.16May 18, 2009
1.17The Honorable Margaret Anderson Kelliher
1.18Speaker of the House of Representatives
1.19The Honorable James P. Metzen
1.20President of the Senate
1.21We, the undersigned conferees for H. F. No. 1276 report that we have agreed upon
1.22the items in dispute and recommend as follows:
1.23That the Senate recede from its amendment and that H. F. No. 1276 be further
1.24amended as follows:
1.25Delete everything after the enacting clause and insert:

1.26"ARTICLE 1

1.27HUMAN SERVICES

1.28    Section 1. Minnesota Statutes 2008, section 245.4882, subdivision 1, is amended to
1.29read:
1.30    Subdivision 1. Availability of residential treatment services. County boards
1.31must provide or contract for enough residential treatment services to meet the needs of
1.32each child with severe emotional disturbance residing in the county and needing this
2.1level of care. Length of stay is based on the child's residential treatment need and shall
2.2be subject to the six-month review process established in section 260C.212, subdivisions
2.37 and 9 subdivision 7, and for children in voluntary placement for treatment, the court
2.4review process in section 260D.06. Services must be appropriate to the child's age and
2.5treatment needs and must be made available as close to the county as possible. Residential
2.6treatment must be designed to:
2.7(1) prevent placement in settings that are more intensive, costly, or restrictive than
2.8necessary and appropriate to meet the child's needs;
2.9(2) help the child improve family living and social interaction skills;
2.10(3) help the child gain the necessary skills to return to the community;
2.11(4) stabilize crisis admissions; and
2.12(5) work with families throughout the placement to improve the ability of the
2.13families to care for children with severe emotional disturbance in the home.

2.14    Sec. 2. Minnesota Statutes 2008, section 245.4885, subdivision 1, is amended to read:
2.15    Subdivision 1. Admission criteria. The county board shall, (a) Prior to admission,
2.16except in the case of emergency admission, determine the needed level of care for all
2.17children referred for treatment of severe emotional disturbance in a treatment foster care
2.18setting, residential treatment facility, or informally admitted to a regional treatment center
2.19shall undergo an assessment to determine the appropriate level of care if public funds are
2.20used to pay for the services. The county board shall also determine the needed level of
2.21care for all children admitted to an acute care hospital for treatment of severe emotional
2.22disturbance if public funds other than reimbursement under chapters 256B and 256D
2.23are used to pay for the services.
2.24(b) The county board shall determine the appropriate level of care when
2.25county-controlled funds are used to pay for the services. When the child is enrolled in
2.26a prepaid health program under section 256B.69, the enrolled child's contracted health
2.27plan must determine the appropriate level of care. When more than one entity bears
2.28responsibility for coverage, the entities shall coordinate level of care determination
2.29activities to the extent possible.
2.30(c) The level of care determination shall determine whether the proposed treatment:
2.31(1) is necessary;
2.32(2) is appropriate to the child's individual treatment needs;
2.33(3) cannot be effectively provided in the child's home; and
2.34(4) provides a length of stay as short as possible consistent with the individual
2.35child's need.
3.1(d) When a level of care determination is conducted, the county board responsible
3.2entity may not determine that referral or admission to a treatment foster care setting,
3.3or residential treatment facility, or acute care hospital is not appropriate solely because
3.4services were not first provided to the child in a less restrictive setting and the child failed
3.5to make progress toward or meet treatment goals in the less restrictive setting. The level
3.6of care determination must be based on a diagnostic assessment that includes a functional
3.7assessment which evaluates family, school, and community living situations; and an
3.8assessment of the child's need for care out of the home using a validated tool which
3.9assesses a child's functional status and assigns an appropriate level of care. The validated
3.10tool must be approved by the commissioner of human services. If a diagnostic assessment
3.11including a functional assessment has been completed by a mental health professional
3.12within the past 180 days, a new diagnostic assessment need not be completed unless in the
3.13opinion of the current treating mental health professional the child's mental health status
3.14has changed markedly since the assessment was completed. The child's parent shall be
3.15notified if an assessment will not be completed and of the reasons. A copy of the notice
3.16shall be placed in the child's file. Recommendations developed as part of the level of care
3.17determination process shall include specific community services needed by the child and,
3.18if appropriate, the child's family, and shall indicate whether or not these services are
3.19available and accessible to the child and family.
3.20(e) During the level of care determination process, the child, child's family, or child's
3.21legal representative, as appropriate, must be informed of the child's eligibility for case
3.22management services and family community support services and that an individual
3.23family community support plan is being developed by the case manager, if assigned.
3.24(f) The level of care determination shall comply with section 260C.212. Wherever
3.25possible, The parent shall be consulted in the process, unless clinically inappropriate
3.26detrimental to the child.
3.27(g) The level of care determination, and placement decision, and recommendations
3.28for mental health services must be documented in the child's record.
3.29An alternate review process may be approved by the commissioner if the county
3.30board demonstrates that an alternate review process has been established by the county
3.31board and the times of review, persons responsible for the review, and review criteria are
3.32comparable to the standards in clauses (1) to (4).

3.33    Sec. 3. Minnesota Statutes 2008, section 245.4885, subdivision 1a, is amended to read:
3.34    Subd. 1a. Emergency admission. Effective July 1, 2006, if a child is admitted to
3.35a treatment foster care setting, residential treatment facility, or acute care hospital for
4.1emergency treatment or held for emergency care by a regional treatment center under
4.2section 253B.05, subdivision 1, the level of care determination must occur within three
4.3five working days of admission.

4.4    Sec. 4. Minnesota Statutes 2008, section 256.935, subdivision 1, is amended to read:
4.5    Subdivision 1. Cremation, burial, and funeral expenses. On the death of any
4.6person receiving public assistance through MFIP, the county agency shall pay attempt to
4.7contact the decedent's spouse or next of kin. If the agency is not able to contact a spouse or
4.8next of kin and the personal preferences of the decedent or the practices of the decedent's
4.9faith tradition are not known, the agency shall pay for cremation of the person's remains
4.10and their burial or interment if the spouse or next of kin does not want to take possession
4.11of the ashes. If the county agency contacts the decedent's spouse or next of kin and it is
4.12determined that cremation is not in accordance with the decedent's personal preferences or
4.13the practices of the decedent's faith tradition or the personal preferences of the decedent's
4.14spouse or the decedent's next of kin, the county agency shall pay an amount for funeral
4.15expenses including the transportation of the body into or out of the community in which
4.16the deceased resided not exceeding the amount paid for comparable services under section
4.17261.035 plus actual cemetery charges. No cremation, burial, or funeral expenses shall
4.18be paid if the estate of the deceased is sufficient to pay such expenses or if the spouse,
4.19who was legally responsible for the support of the deceased while living, is able to pay
4.20such expenses; provided, that the additional payment or donation of the cost of cemetery
4.21lot, interment, religious service, or for the transportation of the body into or out of the
4.22community in which the deceased resided, shall not limit payment by the county agency
4.23as herein authorized. Freedom of choice in the selection of a funeral director shall be
4.24granted to persons lawfully authorized to make arrangements for the cremation or burial
4.25of any such deceased recipient. In determining the sufficiency of such estate, due regard
4.26shall be had for the nature and marketability of the assets of the estate. The county agency
4.27may grant cremation, burial, or funeral expenses where the sale would cause undue loss to
4.28the estate. Any amount paid for cremation, burial, or funeral expenses shall be a prior
4.29claim against the estate, as provided in section 524.3-805, and any amount recovered
4.30shall be reimbursed to the agency which paid the expenses. The commissioner shall
4.31specify requirements for reports, including fiscal reports, according to section 256.01,
4.32subdivision 2 , paragraph (17) (q). The state share shall pay the entire amount of county
4.33agency expenditures. Benefits shall be issued to recipients by the state or county subject
4.34to provisions of section 256.017.

5.1    Sec. 5. Minnesota Statutes 2008, section 256B.0945, subdivision 1, is amended to read:
5.2    Subdivision 1. Residential services; provider qualifications. Counties must
5.3arrange to provide residential services for children with severe emotional disturbance
5.4according to sections 245.4882, 245.4885, and this section. Services must be provided
5.5by a facility that is licensed according to section 245.4882 and administrative rules
5.6promulgated thereunder, and under contract with the county. Eligible service costs may be
5.7claimed for a facility that is located in a state that borders Minnesota if:
5.8(1) the facility is the closest facility to the child's home, providing the appropriate
5.9level of care; and
5.10(2) the commissioner of human services has completed an inspection of the
5.11out-of-state program according to the interagency agreement with the commissioner of
5.12corrections under section 260B.198, subdivision 11, paragraph (b), and the program has
5.13been certified by the commissioner of corrections under section 260B.198, subdivision
5.1411, paragraph (a), to substantially meet the standards applicable to children's residential
5.15mental health treatment programs under Minnesota Rules, chapter 2960. Nothing in
5.16this section requires the commissioner of human services to enforce the background
5.17study requirements under chapter 245C or the requirements related to prevention and
5.18investigation of alleged maltreatment under section 626.556 or 626.557. Complaints
5.19received by the commissioner of human services must be referred to the out-of-state
5.20licensing authority for possible follow-up.

5.21    Sec. 6. Minnesota Statutes 2008, section 256B.0945, subdivision 4, is amended to read:
5.22    Subd. 4. Payment rates. (a) Notwithstanding sections 256B.19 and 256B.041,
5.23payments to counties for residential services provided by a residential facility shall only
5.24be made of federal earnings for services provided under this section, and the nonfederal
5.25share of costs for services provided under this section shall be paid by the county from
5.26sources other than federal funds or funds used to match other federal funds. Payment to
5.27counties for services provided according to this section shall be a proportion of the per
5.28day contract rate that relates to rehabilitative mental health services and shall not include
5.29payment for costs or services that are billed to the IV-E program as room and board.
5.30    (b) Per diem rates paid to providers under this section by prepaid plans shall be
5.31the proportion of the per-day contract rate that relates to rehabilitative mental health
5.32services and shall not include payment for group foster care costs or services that are
5.33billed to the county of financial responsibility. Services provided in facilities located in
5.34bordering states are eligible for reimbursement on a fee-for-service basis only as described
5.35in paragraph (a) and are not covered under prepaid health plans.
6.1    (c) The commissioner shall set aside a portion not to exceed five percent of the
6.2federal funds earned for county expenditures under this section to cover the state costs of
6.3administering this section. Any unexpended funds from the set-aside shall be distributed
6.4to the counties in proportion to their earnings under this section.

6.5    Sec. 7. Minnesota Statutes 2008, section 256F.13, subdivision 1, is amended to read:
6.6    Subdivision 1. Federal revenue enhancement. (a) The commissioner of human
6.7services may enter into an agreement with one or more family services collaboratives
6.8to enhance federal reimbursement under title IV-E of the Social Security Act and
6.9federal administrative reimbursement under title XIX of the Social Security Act. The
6.10commissioner may contract with the Department of Education for purposes of transferring
6.11the federal reimbursement to the commissioner of education to be distributed to the
6.12collaboratives according to clause (2). The commissioner shall have the following
6.13authority and responsibilities regarding family services collaboratives:
6.14(1) the commissioner shall submit amendments to state plans and seek waivers as
6.15necessary to implement the provisions of this section;
6.16(2) the commissioner shall pay the federal reimbursement earned under this
6.17subdivision to each collaborative based on their earnings. Payments to collaboratives for
6.18expenditures under this subdivision will only be made of federal earnings from services
6.19provided by the collaborative;
6.20(3) the commissioner shall review expenditures of family services collaboratives
6.21using reports specified in the agreement with the collaborative to ensure that the base level
6.22of expenditures is continued and new federal reimbursement is used to expand education,
6.23social, health, or health-related services to young children and their families;
6.24(4) the commissioner may reduce, suspend, or eliminate a family services
6.25collaborative's obligations to continue the base level of expenditures or expansion of
6.26services if the commissioner determines that one or more of the following conditions
6.27apply:
6.28(i) imposition of levy limits that significantly reduce available funds for social,
6.29health, or health-related services to families and children;
6.30(ii) reduction in the net tax capacity of the taxable property eligible to be taxed by
6.31the lead county or subcontractor that significantly reduces available funds for education,
6.32social, health, or health-related services to families and children;
6.33(iii) reduction in the number of children under age 19 in the county, collaborative
6.34service delivery area, subcontractor's district, or catchment area when compared to the
7.1number in the base year using the most recent data provided by the State Demographer's
7.2Office; or
7.3(iv) termination of the federal revenue earned under the family services collaborative
7.4agreement;
7.5(5) the commissioner shall not use the federal reimbursement earned under this
7.6subdivision in determining the allocation or distribution of other funds to counties or
7.7collaboratives;
7.8(6) the commissioner may suspend, reduce, or terminate the federal reimbursement
7.9to a provider that does not meet the reporting or other requirements of this subdivision;
7.10(7) the commissioner shall recover from the family services collaborative any federal
7.11fiscal disallowances or sanctions for audit exceptions directly attributable to the family
7.12services collaborative's actions in the integrated fund, or the proportional share if federal
7.13fiscal disallowances or sanctions are based on a statewide random sample; and
7.14(8) the commissioner shall establish criteria for the family services collaborative
7.15for the accounting and financial management system that will support claims for federal
7.16reimbursement.
7.17(b) The family services collaborative shall have the following authority and
7.18responsibilities regarding federal revenue enhancement:
7.19(1) the family services collaborative shall be the party with which the commissioner
7.20contracts. A lead county shall be designated as the fiscal agency for reporting, claiming,
7.21and receiving payments;
7.22(2) the family services collaboratives may enter into subcontracts with other
7.23counties, school districts, special education cooperatives, municipalities, and other public
7.24and nonprofit entities for purposes of identifying and claiming eligible expenditures to
7.25enhance federal reimbursement, or to expand education, social, health, or health-related
7.26services to families and children;
7.27(3) the family services collaborative must continue the base level of expenditures for
7.28education, social, health, or health-related services to families and children from any state,
7.29county, federal, or other public or private funding source which, in the absence of the new
7.30federal reimbursement earned under this subdivision, would have been available for those
7.31services, except as provided in paragraph (a), clause (4). The base year for purposes of this
7.32subdivision shall be the four-quarter calendar year ending at least two calendar quarters
7.33before the first calendar quarter in which the new federal reimbursement is earned;
7.34(4) the family services collaborative must use all new federal reimbursement
7.35resulting from federal revenue enhancement to expand expenditures for education, social,
8.1health, or health-related services to families and children beyond the base level, except
8.2as provided in paragraph (a), clause (4);
8.3(5) (4) the family services collaborative must ensure that expenditures submitted
8.4for federal reimbursement are not made from federal funds or funds used to match other
8.5federal funds. Notwithstanding section 256B.19, subdivision 1, for the purposes of family
8.6services collaborative expenditures under agreement with the department, the nonfederal
8.7share of costs shall be provided by the family services collaborative from sources other
8.8than federal funds or funds used to match other federal funds;
8.9(6) (5) the family services collaborative must develop and maintain an accounting
8.10and financial management system adequate to support all claims for federal reimbursement,
8.11including a clear audit trail and any provisions specified in the agreement; and
8.12(7) (6) the family services collaborative shall submit an annual report to the
8.13commissioner as specified in the agreement.

8.14    Sec. 8. Minnesota Statutes 2008, section 260C.212, subdivision 4a, is amended to read:
8.15    Subd. 4a. Monthly caseworker visits. (a) Every child in foster care or on a
8.16trial home visit shall be visited by the child's caseworker or another person who has
8.17responsibility for visitation of the child on a monthly basis, with the majority of visits
8.18occurring in the child's residence. For the purposes of this section, the following
8.19definitions apply:
8.20    (1) "visit" is defined as a face-to-face contact between a child and the child's
8.21caseworker;
8.22    (2) "visited on a monthly basis" is defined as at least one visit per calendar month;
8.23    (3) "the child's caseworker" is defined as the person who has responsibility for
8.24managing the child's foster care placement case as assigned by the responsible social
8.25service agency; and
8.26    (4) "the child's residence" is defined as the home where the child is residing, and
8.27can include the foster home, child care institution, or the home from which the child was
8.28removed if the child is on a trial home visit.
8.29    (b) Caseworker visits shall be of sufficient substance and duration to address issues
8.30pertinent to case planning and service delivery to ensure the safety, permanency, and
8.31well-being of the child.

8.32    Sec. 9. Minnesota Statutes 2008, section 260C.212, subdivision 11, is amended to read:
9.1    Subd. 11. Rules; family and group foster care. The commissioner shall revise
9.2Minnesota Rules, parts 9545.0010 to 9545.0260, the rules setting standards for family and
9.3group family foster care. The commissioner shall:
9.4(1) require that, as a condition of licensure, foster care providers attend training on
9.5understanding and validating the cultural heritage of all children in their care, and on the
9.6importance of the Indian Child Welfare Act, United States Code, title 25, sections 1901 to
9.71923, and the Minnesota Indian Family Preservation Act, sections 260.751 to 260.835; and
9.8(2) review and, where necessary, revise foster care rules to reflect sensitivity to
9.9cultural diversity and differing lifestyles. Specifically, the commissioner shall examine
9.10whether space and other requirements discriminate against single-parent, minority, or
9.11low-income families who may be able to provide quality foster care reflecting the values
9.12of their own respective cultures; and
9.13(3) relieve relative foster care providers of the requirements promulgated as a result
9.14of clauses (1) and (2) when the safety of the child is not jeopardized and as allowed
9.15under federal law.

9.16    Sec. 10. Minnesota Statutes 2008, section 261.035, is amended to read:
9.17261.035 CREMATION, BURIAL, AND FUNERALS AT EXPENSE OF
9.18COUNTY.
9.19When a person dies in any county without apparent means to provide for that person's
9.20funeral or final disposition, the county board shall first investigate to determine whether
9.21that person had contracted for any prepaid funeral arrangements. If prepaid arrangements
9.22have been made, the county shall authorize arrangements to be implemented in accord
9.23with the instructions of the deceased. If it is determined that the person did not leave
9.24sufficient means to defray the necessary expenses of a funeral and final disposition, nor
9.25any spouse of sufficient ability to procure the burial, the county board shall provide pay for
9.26a funeral and final disposition cremation of the person's remains to be made at the expense
9.27of the county. and the person's burial or interment if the spouse or next of kin does not
9.28want to take possession of the ashes. If it is determined that cremation is not in accordance
9.29with the decedent's personal preferences or the known practices of the decedent's faith
9.30tradition or the personal preferences of the decedent's spouse or the decedent's next of
9.31kin, the county board shall provide for a burial and funeral. Any burial, funeral, and final
9.32disposition provided at the expense of the county shall be in accordance with religious and
9.33moral beliefs of the decedent or personal preferences or known practices of the decedent's
9.34faith tradition or the personal preferences of the decedent's spouse or the decedent's next of
9.35kin. If neither the wishes of the decedent are not known, nor the practices of the decedent's
10.1faith tradition are known, and the county has no information about the existence of or
10.2location of any next of kin, the county may determine the method of final disposition may
10.3provide for cremation of the person's remains and burial or interment.

10.4ARTICLE 2

10.5HEALTH CARE AND EDUCATION

10.6    Section 1. Minnesota Statutes 2008, section 62Q.37, subdivision 3, is amended to read:
10.7    Subd. 3. Audits. (a) The commissioner may conduct routine audits and
10.8investigations as prescribed under the commissioner's respective state authorizing statutes.
10.9If a nationally recognized independent organization has conducted an audit of the health
10.10plan company using audit procedures that are comparable to or more stringent than the
10.11commissioner's audit procedures:
10.12(1) the commissioner may shall accept the independent audit, including standards
10.13and audit practices, and require no further audit if the results of the independent audit
10.14show that the performance standard being audited meets or exceeds state standards;
10.15(2) the commissioner may accept the independent audit and limit further auditing
10.16if the results of the independent audit show that the performance standard being audited
10.17partially meets state standards;
10.18(3) the health plan company must demonstrate to the commissioner that the
10.19nationally recognized independent organization that conducted the audit is qualified and
10.20that the results of the audit demonstrate that the particular performance standard partially
10.21or fully meets state standards; and
10.22(4) if the commissioner has partially or fully accepted an independent audit of the
10.23performance standard, the commissioner may use the finding of a deficiency with regard
10.24to statutes or rules by an independent audit as the basis for a targeted audit or enforcement
10.25action.
10.26(b) If a health plan company has formally delegated activities that are required
10.27under either state law or contract to another organization that has undergone an audit by
10.28a nationally recognized independent organization, that health plan company may use
10.29the nationally recognized accrediting body's determination on its own behalf under this
10.30section.

10.31    Sec. 2. Minnesota Statutes 2008, section 144A.04, subdivision 11, is amended to read:
10.32    Subd. 11. Incontinent residents. Notwithstanding Minnesota Rules, part
10.334658.0520, an incontinent resident must be checked according to a specific time interval
10.34written in the resident's treated according to the comprehensive assessment and care plan.
11.1The resident's attending physician must authorize in writing any interval longer than
11.2two hours unless the resident, if competent, or a family member or legally appointed
11.3conservator, guardian, or health care agent of a resident who is not competent, agrees in
11.4writing to waive physician involvement in determining this interval, and this waiver
11.5is documented in the resident's care plan.

11.6    Sec. 3. Minnesota Statutes 2008, section 144A.04, is amended by adding a subdivision
11.7to read:
11.8    Subd. 12. Resident positioning. Notwithstanding Minnesota Rules, part 4658.0525,
11.9subpart 4, the position of residents unable to change their own position must be changed
11.10based on the comprehensive assessment and care plan.

11.11    Sec. 4. Minnesota Statutes 2008, section 144A.43, is amended by adding a subdivision
11.12to read:
11.13    Subd. 5. Medication reminder. "Medication reminder" means providing a verbal
11.14or visual reminder to a client to take medication. This includes bringing the medication
11.15to the client and providing liquids or nutrition to accompany medication that a client is
11.16self-administering.

11.17    Sec. 5. Minnesota Statutes 2008, section 144A.45, subdivision 1, is amended to read:
11.18    Subdivision 1. Rules. The commissioner shall adopt rules for the regulation of
11.19home care providers pursuant to sections 144A.43 to 144A.47. The rules shall include
11.20the following:
11.21    (1) provisions to assure, to the extent possible, the health, safety and well-being, and
11.22appropriate treatment of persons who receive home care services;
11.23    (2) requirements that home care providers furnish the commissioner with specified
11.24information necessary to implement sections 144A.43 to 144A.47;
11.25    (3) standards of training of home care provider personnel, which may vary according
11.26to the nature of the services provided or the health status of the consumer;
11.27    (4) standards for medication management which may vary according to the nature of
11.28the services provided, the setting in which the services are provided, or the status of the
11.29consumer. Medication management includes the central storage, handling, distribution,
11.30and administration of medications;
11.31    (5) standards for supervision of home care services requiring supervision by a
11.32registered nurse or other appropriate health care professional which must occur on site
11.33at least every 62 days, or more frequently if indicated by a clinical assessment, and in
12.1accordance with sections 148.171 to 148.285 and rules adopted thereunder, except that,
12.2notwithstanding the provisions of Minnesota Rules, part 4668.0110, subpart 5, item B,
12.3supervision of a person performing home care aide tasks for a class B licensee providing
12.4paraprofessional services must occur only every 180 days, or more frequently if indicated
12.5by a clinical assessment does not require nursing supervision;
12.6    (6) standards for client evaluation or assessment which may vary according to the
12.7nature of the services provided or the status of the consumer;
12.8    (7) requirements for the involvement of a consumer's physician, the documentation
12.9of physicians' orders, if required, and the consumer's treatment plan, and the maintenance
12.10of accurate, current clinical records;
12.11    (8) the establishment of different classes of licenses for different types of providers
12.12and different standards and requirements for different kinds of home care services; and
12.13    (9) operating procedures required to implement the home care bill of rights.

12.14    Sec. 6. Minnesota Statutes 2008, section 144A.45, is amended by adding a subdivision
12.15to read:
12.16    Subd. 1b. Home health aide qualifications. Notwithstanding the provisions of
12.17Minnesota Rules, part 4668.0100, subpart 5, a person may perform home health aide tasks
12.18if the person maintains current registration as a nursing assistant on the Minnesota nursing
12.19assistant registry. Maintaining current registration on the Minnesota nursing assistant
12.20registry satisfies the documentation requirements of Minnesota Rules, part 4668.0110,
12.21subpart 3.

12.22    Sec. 7. Minnesota Statutes 2008, section 147C.10, subdivision 2, as amended by Laws
12.232009, chapter 142, article 2, section 3, is amended to read:
12.24    Subd. 2. Other health care practitioners. (a) Nothing in this chapter shall prohibit
12.25the practice of any profession or occupation licensed or registered by the state by any
12.26person duly licensed or registered to practice the profession or occupation or to perform
12.27any act that falls within the scope of practice of the profession or occupation.
12.28(b) Nothing in this chapter shall be construed to require a respiratory care license for:
12.29(1) a student enrolled in a respiratory therapy or polysomnography technology
12.30education program accredited by the Commission on Accreditation of Allied Health
12.31Education Programs, its successor organization, or another nationally recognized
12.32accrediting organization;
12.33(2) a respiratory therapist as a member of the United States armed forces while
12.34performing duties incident to that duty;
13.1(3) an individual employed by a durable medical equipment provider or a home
13.2medical equipment provider who delivers, sets up, instructs the patient on the use of, or
13.3maintains respiratory care equipment, but does not perform assessment, education, or
13.4evaluation of the patient;
13.5(4) self-care by a patient or gratuitous care by a friend or relative who does not
13.6purport to be a licensed respiratory therapist; or
13.7(5) an individual employed in a sleep lab or center as a polysomnographic
13.8technologist under the supervision of a licensed physician.

13.9    Sec. 8. [245B.031] ACCREDITATION, ALTERNATIVE INSPECTION, AND
13.10DEEMED COMPLIANCE.
13.11    Subdivision 1. Day training and habilitation or supported employment services
13.12programs; alternative inspection status. (a) A license holder providing day training and
13.13habilitation services or supported employment services according to this chapter, with a
13.14three-year accreditation from the Commission on Rehabilitation Facilities, that has had at
13.15least one on-site inspection by the commissioner following issuance of the initial license,
13.16may request alternative inspection status under this section.
13.17    (b) The request for alternative inspection status must be made in the manner
13.18prescribed by the commissioner, and must include:
13.19    (1) a copy of the license holder's application to the Commission on Rehabilitation
13.20Facilities for accreditation;
13.21    (2) the most recent Commission on Rehabilitation Facilities accreditation survey
13.22report; and
13.23    (3) the most recent letter confirming the three-year accreditation and approval of the
13.24license holder's quality improvement plan.
13.25    Based on the request and the accompanying materials, the commissioner may
13.26approve alternative inspection status.
13.27    (c) Following approval of alternative inspection status, the commissioner may
13.28terminate the alternative inspection status or deny a subsequent alternative inspection
13.29status if the commissioner determines that any of the following conditions have occurred
13.30after approval of the alternative inspection process:
13.31    (1) the license holder has not maintained full three-year accreditation;
13.32    (2) the commissioner has substantiated maltreatment for which the license holder or
13.33facility is determined to be responsible during the three-year accreditation period; and
14.1    (3) during the three-year accreditation period, the license holder has been issued
14.2an order for conditional license, a fine, suspension, or license revocation that has not
14.3been reversed upon appeal.
14.4    (d) The commissioner's decision that the conditions for approval for the alternative
14.5licensing inspection status have not been met is final and not subject to appeal under the
14.6provisions of chapter 14.
14.7    Subd. 2. Programs exempt from certain statutes. (a) A license holder approved
14.8for alternative inspection status under this section is exempt from the requirements under:
14.9    (1) section 245B.04;
14.10    (2) section 245B.05, subdivisions 5 and 6;
14.11    (3) section 245B.06, subdivisions 1, 3, 4, 5, and 6; and
14.12    (4) section 245B.07, subdivisions 1, 4, and 6.
14.13    (b) Upon receipt of a complaint regarding a requirement under paragraph (a), the
14.14commissioner shall refer the complaint to the Commission on Rehabilitation Facilities for
14.15possible follow-up.
14.16    Subd. 3. Programs deemed to be in compliance with nonexempt licensing
14.17requirements. (a) License holders approved for alternative inspection status under this
14.18section are required to maintain compliance with all licensing standards from which they
14.19are not exempt under subdivision 2, paragraph (a).
14.20    (b) License holders approved for alternative inspection status under this section shall
14.21be deemed to be in compliance with all nonexempt statutes, and the commissioner shall
14.22not perform routine licensing inspections.
14.23    (c) Upon receipt of a complaint regarding the services of a license holder approved
14.24for alternative inspection under this section that is not related to a licensing requirement
14.25from which the license holder is exempt under subdivision 2, the commissioner shall
14.26investigate the complaint and may take any action as provided under section 245A.06 or
14.27245A.07.
14.28    Subd. 4. Investigations of alleged maltreatment of minors or vulnerable adults.
14.29    Nothing in this section changes the commissioner's responsibilities to investigate alleged
14.30or suspected maltreatment of a minor under section 626.556 or vulnerable adult under
14.31section 626.557.
14.32    Subd. 5. Request to Commission on Rehabilitation Facilities to expand
14.33accreditation survey. The commissioner shall submit a request to the Commission on
14.34Rehabilitation Facilities to routinely inspect for compliance with standards that are similar
14.35to the following nonexempt licensing requirements:
15.1    (1) section 245A.54;
15.2    (2) section 245A.66;
15.3    (3) section 245B.05, subdivisions 1, 2, and 7;
15.4    (4) section 245B.055;
15.5    (5) section 245B.06, subdivisions 2, 7, 9, and 10;
15.6    (6) section 245B.07, subdivisions 2, 5, and 8, paragraph (a), clause (7);
15.7    (7) section 245C.04, subdivision 1, paragraph (f);
15.8    (8) section 245C.07;
15.9    (9) section 245C.13, subdivision 2;
15.10    (10) section 245C.20; and
15.11    (11) Minnesota Rules, parts 9525.2700 to 9525.2810.

15.12    Sec. 9. Minnesota Statutes 2008, section 256.962, subdivision 6, is amended to read:
15.13    Subd. 6. School districts and charter schools. (a) At the beginning of each school
15.14year, a school district or charter school shall provide information to each student on the
15.15availability of health care coverage through the Minnesota health care programs.
15.16    (b) For each child who is determined to be eligible for the free and reduced-price
15.17school lunch program, the district shall provide the child's family with information on how
15.18to obtain an application for the Minnesota health care programs and application assistance.
15.19    (c) A school district or charter school shall also ensure that applications and
15.20information on application assistance are available at early childhood education sites and
15.21public schools located within the district's jurisdiction.
15.22    (d) Each district shall designate an enrollment specialist to provide application
15.23assistance and follow-up services with families who have indicated an interest in receiving
15.24information or an application for the Minnesota health care program. A district is eligible
15.25for the application assistance bonus described in subdivision 5.
15.26    (e) Each (c) If a school district or charter school maintains a district Web site, the
15.27school district or charter school shall provide on their its Web site a link to information on
15.28how to obtain an application and application assistance.

15.29    Sec. 10. Minnesota Statutes 2008, section 260B.171, subdivision 3, is amended to read:
15.30    Subd. 3. Disposition order; copy to school. (a) If a juvenile is enrolled in school,
15.31the juvenile's probation officer shall transmit a ensure that either a mailed notice or an
15.32electronic copy of the court's disposition order be transmitted to the superintendent of the
15.33juvenile's school district or the chief administrative officer of the juvenile's school if the
16.1juvenile has been adjudicated delinquent for committing an act on the school's property
16.2or an act:
16.3(1) that would be a violation of section 609.185 (first-degree murder); 609.19
16.4(second-degree murder); 609.195 (third-degree murder); 609.20 (first-degree
16.5manslaughter); 609.205 (second-degree manslaughter); 609.21 (criminal vehicular
16.6homicide and injury); 609.221 (first-degree assault); 609.222 (second-degree assault);
16.7609.223 (third-degree assault); 609.2231 (fourth-degree assault); 609.224 (fifth-degree
16.8assault); 609.2242 (domestic assault); 609.24 (simple robbery); 609.245 (aggravated
16.9robbery); 609.25 (kidnapping); 609.255 (false imprisonment); 609.342 (first-degree
16.10criminal sexual conduct); 609.343 (second-degree criminal sexual conduct); 609.344
16.11(third-degree criminal sexual conduct); 609.345 (fourth-degree criminal sexual conduct);
16.12609.3451 (fifth-degree criminal sexual conduct); 609.498 (tampering with a witness);
16.13609.561 (first-degree arson); 609.582, subdivision 1 or 2 (burglary); 609.713 (terroristic
16.14threats); or 609.749 (harassment and stalking), if committed by an adult;
16.15(2) that would be a violation of section 152.021 (first-degree controlled substance
16.16crime); 152.022 (second-degree controlled substance crime); 152.023 (third-degree
16.17controlled substance crime); 152.024 (fourth-degree controlled substance crime); 152.025
16.18(fifth-degree controlled substance crime); 152.0261 (importing a controlled substance);
16.19152.0262 (possession of substances with intent to manufacture methamphetamine); or
16.20152.027 (other controlled substance offenses), if committed by an adult; or
16.21(3) that involved the possession or use of a dangerous weapon as defined in section
16.22609.02, subdivision 6 .
16.23When a disposition order is transmitted under this subdivision, the probation officer
16.24shall notify the juvenile's parent or legal guardian that the disposition order has been
16.25shared with the juvenile's school.
16.26(b) In addition, the juvenile's probation officer may transmit a copy of the court's
16.27disposition order to the superintendent of the juvenile's school district or the chief
16.28administrative officer of the juvenile's school if the juvenile has been adjudicated
16.29delinquent for offenses not listed in paragraph (a) and placed on probation. The probation
16.30officer shall notify the superintendent or chief administrative officer when the juvenile is
16.31discharged from probation.
16.32(c) The disposition order must be accompanied by a notice to the school that the
16.33school may obtain additional information from the juvenile's probation officer with the
16.34consent of the juvenile or the juvenile's parents, as applicable. The disposition order must
16.35be maintained, shared, or released only as provided in section 121A.75.
17.1(d) The juvenile's probation officer shall maintain a record of disposition orders
17.2released under this subdivision and the basis for the release.
17.3(e) No later than September 1, 2002, the criminal and juvenile justice information
17.4policy group, in consultation with representatives of probation officers and educators, shall
17.5prepare standard forms for use by juvenile probation officers in forwarding information
17.6to schools under this subdivision and in maintaining a record of the information that is
17.7released. The group shall provide a copy of any forms or procedures developed under this
17.8paragraph to the legislature by January 15, 2003.
17.9(f) As used in this subdivision, "school" means a charter school or a school as
17.10defined in section 120A.22, subdivision 4, except a home school.

17.11    Sec. 11. Minnesota Statutes 2008, section 471.61, subdivision 1, is amended to read:
17.12    Subdivision 1. Officers, employees. A county, municipal corporation, town, school
17.13district, county extension committee, other political subdivision or other body corporate
17.14and politic of this state, other than the state or any department of the state, through its
17.15governing body, and any two or more subdivisions acting jointly through their governing
17.16bodies, may insure or protect its or their officers and employees, and their dependents, or
17.17any class or classes of officers, employees, or dependents, under a policy or policies or
17.18contract or contracts of group insurance or benefits covering life, health, and accident, in
17.19the case of employees, and medical and surgical benefits and hospitalization insurance
17.20or benefits for both employees and dependents or dependents of an employee whose
17.21death was due to causes arising out of and in the course of employment, or any one or
17.22more of those forms of insurance or protection. A governmental unit, including county
17.23extension committees and those paying their employees, may pay all or any part of
17.24the premiums or charges on the insurance or protection. A payment is deemed to be
17.25additional compensation paid to the officers or employees, but for purposes of determining
17.26contributions or benefits under a public pension or retirement system it is not deemed
17.27to be additional compensation. One or more governmental units may determine that
17.28a person is an officer or employee if the person receives income from the governmental
17.29subdivisions without regard to the manner of election or appointment, including but not
17.30limited to employees of county historical societies that receive funding from the county
17.31and employees of the Minnesota Inter-county Association. The appropriate officer of
17.32the governmental unit, or those disbursing county extension funds, shall deduct from
17.33the salary or wages of each officer and employee who elects to become insured or so
17.34protected, on the officer's or employee's written order, all or part of the officer's or
18.1employee's share of premiums or charges and remit the share or portion to the insurer or
18.2company issuing the policy or contract.
18.3A governmental unit, other than a school district, that pays all or part of the premiums
18.4or charges is authorized to levy and collect a tax, if necessary, in the next annual tax levy
18.5for the purpose of providing the necessary money for the payment of the premiums or
18.6charges, and the sums levied and appropriated are not, in the event the sum exceeds the
18.7maximum sum allowed by the charter of a municipal corporation, considered part of
18.8the cost of government of the governmental unit as defined in any levy or expenditure
18.9limitation; provided at least 50 percent of the cost of benefits on dependents must be
18.10contributed by the employee or be paid by levies within existing charter tax limitations.
18.11The word "dependents" as used in this subdivision means spouse and minor
18.12unmarried children under the age of 18 years actually dependent upon the employee.
18.13Notwithstanding any law to the contrary, a political subdivision described in this
18.14subdivision may provide health benefits to its employees, dependents, and any class
18.15or classes of officers, employers, or dependents through negotiated contributions to
18.16self-funded multiemployer health and welfare funds.
18.17EFFECTIVE DATE.This section is effective the day following final enactment;
18.18applies to contributions made before, on, or after that date; and is intended as a clarification
18.19of existing law.

18.20    Sec. 12. REPEALER.
18.21Minnesota Rules, part 4668.0110, subpart 5, is repealed."
18.22Delete the title and insert:

18.23"A bill for an act

18.24relating to local government; relieving counties of certain health and human
18.25services mandates; making changes to residential treatment facilities; county
18.26payment of cremation, burial, and funeral expenses; child welfare provisions;
18.27health plan audits; nursing facilities; home health aides; inspections of day
18.28training and habilitation facilities; changing certain health care provisions
18.29relating to school districts, charter schools, and local governments;amending
18.30Minnesota Statutes 2008, sections 62Q.37, subdivision 3; 144A.04, subdivision
18.3111, by adding a subdivision; 144A.43, by adding a subdivision; 144A.45,
18.32subdivision 1, by adding a subdivision; 147C.10, subdivision 2, as amended;
18.33245.4882, subdivision 1; 245.4885, subdivisions 1, 1a; 256.935, subdivision 1;
18.34256.962, subdivision 6; 256B.0945, subdivisions 1, 4; 256F.13, subdivision
18.351; 260B.171, subdivision 3; 260C.212, subdivisions 4a, 11; 261.035; 471.61,
18.36subdivision 1; proposing coding for new law in Minnesota Statutes, chapter
18.37245B; repealing Minnesota Rules, part 4668.0110, subpart 5."
We request the adoption of this report and repassage of the bill.House Conferees: (Signed) Kim Norton, Patti Fritz, Matt DeanSenate Conferees: (Signed) Ann Lynch, Ann H. Rest, David Hann

19.1	We request the adoption of this report and repassage of the bill.
19.2	House Conferees:(Signed)
19.3	.....		.....
19.4	Kim Norton		Patti Fritz
19.5	.....
19.6	Matt Dean
19.7	Senate Conferees:(Signed)
19.8	.....		.....
19.9	Ann Lynch		Ann H. Rest
19.10	.....
19.11	David Hann