1st Unofficial Engrossment - 82nd Legislature (2001 - 2002) Posted on 12/15/2009 12:00am
1.1 A bill for an act 1.2 relating to human services; modifying provisions for 1.3 certain government data; modifying the Human Services 1.4 Licensing Act; modifying certain hearing provisions; 1.5 modifying provisions for reporting maltreatment of 1.6 vulnerable adults; modifying continuing care 1.7 provisions; modifying moratorium on certification of 1.8 nursing home beds; modifying certain case manager 1.9 training requirements; modifying certain medical 1.10 assistance provisions; modifying provisions for 1.11 interstate contracts for mental health services; 1.12 designating state agent to carry out responsibilities 1.13 under the Ryan White Comprehensive Aids Resources 1.14 Emergency Act; waiving prior authorization for certain 1.15 drugs used to treat mental illness; providing for 1.16 certain deaf-blind services; requiring a case 1.17 management study; providing for identification of 1.18 deceased individuals; establishing a donated dental 1.19 services program; modifying provisions for certain 1.20 health-related licenses; modifying commissioner's 1.21 duties; appropriating money; amending Minnesota 1.22 Statutes 2000, sections 13.41, subdivision 1; 13.46, 1.23 subdivision 3; 103H.251, subdivision 1; 144.05, by 1.24 adding a subdivision; 147B.02, subdivision 9; 150A.06, 1.25 by adding a subdivision; 245.462, subdivision 4; 1.26 245.4871, subdivision 4; 245.50, subdivisions 1, 2, 5; 1.27 245A.02, by adding subdivisions; 245A.035, subdivision 1.28 3; 245A.04, by adding subdivisions; 256.01, by adding 1.29 a subdivision; 256.9657, subdivision 1; 256B.0625, 1.30 subdivision 35, by adding a subdivision; 256B.0915, 1.31 subdivisions 4, 6, by adding a subdivision; 256B.431, 1.32 subdivisions 14, 30, by adding a subdivision; 1.33 256B.5012, subdivision 2; 626.557, subdivision 3a; 1.34 Minnesota Statutes 2001 Supplement, sections 13.46, 1.35 subdivisions 1, 4; 144A.071, subdivision 1a; 144A.36, 1.36 subdivision 1; 149A.90, subdivision 1; 245A.03, 1.37 subdivision 2; 245A.04, subdivisions 3, 3a, 3b; 1.38 245A.07, subdivisions 2a, 3; 245A.144; 245A.16, 1.39 subdivision 1; 256.045, subdivisions 3b, 4; 256B.0625, 1.40 subdivision 13; 256B.0627, subdivision 10; 256B.0911, 1.41 subdivisions 4b, 4d; 256B.0913, subdivisions 4, 5, 8, 1.42 10, 12, 14; 256B.0915, subdivisions 3, 5; 256B.0924, 1.43 subdivision 6; 256B.0951, subdivisions 7, 8; 256B.431, 1.44 subdivisions 2e, 33; 256B.437, subdivisions 3, 6, by 1.45 adding a subdivision; 256B.438, subdivision 1; 1.46 256B.69, subdivision 5b; 256B.76; 626.556, subdivision 2.1 10i; 626.557, subdivision 9d; proposing coding for new 2.2 law in Minnesota Statutes, chapters 144; 245A; 2.3 repealing Minnesota Statutes 2000, section 147B.01, 2.4 subdivisions 8, 15; Minnesota Statutes 2001 2.5 Supplement, section 256B.0621, subdivision 1. 2.6 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 2.7 ARTICLE 1 2.8 LICENSING 2.9 Section 1. Minnesota Statutes 2000, section 13.41, 2.10 subdivision 1, is amended to read: 2.11 Subdivision 1. [DEFINITION.] As used in this section 2.12 "licensing agency" means any board, department or agency of this 2.13 state which is given the statutory authority to issue 2.14 professional or other types of licenses, except the various 2.15 agencies primarily administered by the commissioner of human 2.16 services. Data pertaining to persons or agencies licensed or 2.17 registered under authority of the commissioner of human services 2.18 shall be administered pursuant to section 13.46, subdivision 4. 2.19 Sec. 2. Minnesota Statutes 2001 Supplement, section 13.46, 2.20 subdivision 1, is amended to read: 2.21 Subdivision 1. [DEFINITIONS.] As used in this section: 2.22 (a) "Individual" means an individual according to section 2.23 13.02, subdivision 8, but does not include a vendor of services. 2.24 (b) "Program" includes all programs for which authority is 2.25 vested in a component of the welfare system according to statute 2.26 or federal law, including, but not limited to, the aid to 2.27 families with dependent children program formerly codified in 2.28 sections 256.72 to 256.87, Minnesota Family Investment Program, 2.29 medical assistance, general assistance, general assistance 2.30 medical care, and child support collections. 2.31 (c) "Welfare system" includes the department of human 2.32 services, local social services agencies, county welfare 2.33 agencies, private licensing agencies, the public authority 2.34 responsible for child support enforcement, human services 2.35 boards, community mental health center boards, state hospitals, 2.36 state nursing homes, the ombudsman for mental health and mental 2.37 retardation, and persons, agencies, institutions, organizations, 2.38 and other entities under contract to any of the above agencies 3.1 to the extent specified in the contract. 3.2 (d) "Mental health data" means data on individual clients 3.3 and patients of community mental health centers, established 3.4 under section 245.62, mental health divisions of counties and 3.5 other providers under contract to deliver mental health 3.6 services, or the ombudsman for mental health and mental 3.7 retardation. 3.8 (e) "Fugitive felon" means a person who has been convicted 3.9 of a felony and who has escaped from confinement or violated the 3.10 terms of probation or parole for that offense. 3.11 (f) "Private licensing agency" means an agency licensed by 3.12 the commissioner of human services under chapter 245A to perform 3.13 the duties under section 245A.16. 3.14 Sec. 3. Minnesota Statutes 2000, section 13.46, 3.15 subdivision 3, is amended to read: 3.16 Subd. 3. [INVESTIGATIVE DATA.] (a) Data on persons, 3.17 including data on vendors of services and data on licensees, 3.18 that is collected, maintained, used, or disseminated by the 3.19 welfare system in an investigation, authorized by statute and 3.20 relating to the enforcement of rules or law, is confidential 3.21 data on individuals pursuant to section 13.02, subdivision 3, or 3.22 protected nonpublic data not on individuals pursuant to section 3.23 13.02, subdivision 13, and shall not be disclosed except: 3.24(a)(1) pursuant to section 13.05; 3.25(b)(2) pursuant to statute or valid court order; 3.26(c)(3) to a party named in a civil or criminal proceeding, 3.27 administrative or judicial, for preparation of defense; or 3.28(d)(4) to provide notices required or permitted by statute. 3.29 The data referred to in this subdivision shall be 3.30 classified as public data upon its submission to an 3.31 administrative law judge or court in an administrative or 3.32 judicial proceeding. Inactive welfare investigative data shall 3.33 be treated as provided in section 13.39, subdivision 3. 3.34 (b) Notwithstanding any other provision in law, the 3.35 commissioner of human services shall provide all active and 3.36 inactive investigative data, including the name of the reporter 4.1 of alleged maltreatment under section 626.556 or 626.557, to the 4.2 ombudsman for mental health and retardation upon the request of 4.3 the ombudsman. 4.4 Sec. 4. Minnesota Statutes 2001 Supplement, section 13.46, 4.5 subdivision 4, is amended to read: 4.6 Subd. 4. [LICENSING DATA.] (a) As used in this subdivision: 4.7 (1) "licensing data" means all data collected, maintained, 4.8 used, or disseminated by the welfare system pertaining to 4.9 persons licensed or registered or who apply for licensure or 4.10 registration or who formerly were licensed or registered under 4.11 the authority of the commissioner of human services; 4.12 (2) "client" means a person who is receiving services from 4.13 a licensee or from an applicant for licensure; and 4.14 (3) "personal and personal financial data" means social 4.15 security numbers, identity of and letters of reference, 4.16 insurance information, reports from the bureau of criminal 4.17 apprehension, health examination reports, and social/home 4.18 studies. 4.19 (b)(1) Except as provided in paragraph (c), the following 4.20 data on current and former licensees are public: name, address, 4.21 telephone number of licensees, date of receipt of a completed 4.22 application, dates of licensure, licensed capacity, type of 4.23 client preferred, variances granted, type of dwelling, name and 4.24 relationship of other family members, previous license history, 4.25 class of license, and the existence and status of complaints. 4.26 When a correction order or fine has been issued, a license is 4.27 suspended, immediately suspended, revoked, denied, or made 4.28 conditional, or a complaint is resolved, the following data on 4.29 current and former licensees are public: the substance and 4.30 investigative findings of the complaint, licensing violation, or 4.31 substantiated maltreatment; the record of informal resolution of 4.32 a licensing violation; orders of hearing; findings of fact; 4.33 conclusions of law; specifications of the final correction 4.34 order, fine, suspension, immediate suspension, revocation, 4.35 denial, or conditional license contained in the record of 4.36 licensing action; and the status of any appeal of these 5.1 actions. When an individual licensee is a substantiated 5.2 perpetrator of maltreatment, and the substantiated maltreatment 5.3 is a reason for the licensing action, the identity of the 5.4 licensee as a perpetrator is public data. For purposes of this 5.5 clause, a person is a substantiated perpetrator if the 5.6 maltreatment determination has been upheld under section 5.7 626.556, subdivision 10i, 626.557, subdivision 9d, or 256.045, 5.8 or an individual or facility has not timely exercised appeal 5.9 rights under these sections. 5.10 (2) For applicants who withdraw their application prior to 5.11 licensure or denial of a license, the following data are 5.12 public: the name of the applicant, the city and county in which 5.13 the applicant was seeking licensure, the dates of the 5.14 commissioner's receipt of the initial application and completed 5.15 application, the type of license sought, and the date of 5.16 withdrawal of the application. 5.17 (3) For applicants who are denied a license, the following 5.18 data are public: the name of the applicant, the city and county 5.19 in which the applicant was seeking licensure, the dates of the 5.20 commissioner's receipt of the initial application and completed 5.21 application, the type of license sought, the date of denial of 5.22 the application, the nature of the basis for the denial, and the 5.23 status of any appeal of the denial. 5.24 (4) The following data on persons subject to 5.25 disqualification under section 245A.04 in connection with a 5.26 license to provide family day care for children, child care 5.27 center services, foster care for children in the provider's 5.28 home, or foster care or day care services for adults in the 5.29 provider's home, are public: the nature of any disqualification 5.30 set aside under section 245A.04, subdivision 3b, and the reasons 5.31 for setting aside the disqualification; and the reasons for 5.32 granting any variance under section 245A.04, subdivision 9. 5.33 (5) When maltreatment is substantiated under section 5.34 626.556 or 626.557 and the victim and the substantiated 5.35 perpetrator are affiliated with a program licensed under chapter 5.36 245A, the commissioner of human services, local social services 6.1 agency, or county welfare agency may inform the license holder 6.2 where the maltreatment occurred of the identity of the 6.3 substantiated perpetrator and the victim. 6.4 (c) The following are private data on individuals under 6.5 section 13.02, subdivision 12, or nonpublic data under section 6.6 13.02, subdivision 9: personal and personal financial data on 6.7 family day care program and family foster care program 6.8 applicants and licensees and their family members who provide 6.9 services under the license. 6.10 (d) The following are private data on individuals: the 6.11 identity of persons who have made reports concerning licensees 6.12 or applicants that appear in inactive investigative data, and 6.13 the records of clients or employees of the licensee or applicant 6.14 for licensure whose records are received by the licensing agency 6.15 for purposes of review or in anticipation of a contested 6.16 matter. The names of reporters under sections 626.556 and 6.17 626.557 may be disclosed only as provided in section 626.556, 6.18 subdivision 11, or 626.557, subdivision 12b. 6.19 (e) Data classified as private, confidential, nonpublic, or 6.20 protected nonpublic under this subdivision become public data if 6.21 submitted to a court or administrative law judge as part of a 6.22 disciplinary proceeding in which there is a public hearing 6.23 concerning a license which has been suspended, immediately 6.24 suspended, revoked, or denied. 6.25 (f) Data generated in the course of licensing 6.26 investigations that relate to an alleged violation of law are 6.27 investigative data under subdivision 3. 6.28 (g) Data that are not public data collected, maintained, 6.29 used, or disseminated under this subdivision that relate to or 6.30 are derived from a report as defined in section 626.556, 6.31 subdivision 2, or 626.5572, subdivision 18, are subject to the 6.32 destruction provisions of sections 626.556, subdivision 11c, and 6.33 626.557, subdivision 12b. 6.34 (h) Upon request, not public data collected, maintained, 6.35 used, or disseminated under this subdivision that relate to or 6.36 are derived from a report of substantiated maltreatment as 7.1 defined in section 626.556 or 626.557 may be exchanged with the 7.2 department of health for purposes of completing background 7.3 studies pursuant to section 144.057 and with the department of 7.4 corrections for purposes of completing background studies 7.5 pursuant to section 241.021. 7.6 (i) Data on individuals collected according to licensing 7.7 activities under chapter 245A, and data on individuals collected 7.8 by the commissioner of human services according to maltreatment 7.9 investigations under sections 626.556 and 626.557, may be shared 7.10 with the department of human rights, the department of health, 7.11 the department of corrections, the ombudsman for mental health 7.12 and retardation, and the individual's professional regulatory 7.13 board when there is reason to believe that laws or standards 7.14 under the jurisdiction of those agencies may have been violated. 7.15 (j) In addition to the notice of determinations required 7.16 under section 626.556, subdivision 10f, if the commissioner or 7.17 the local social services agency has determined that an 7.18 individual is a substantiated perpetrator of maltreatment of a 7.19 child based on sexual abuse, as defined in section 626.556, 7.20 subdivision 2, and the commissioner or local social services 7.21 agency knows that the individual is a person responsible for a 7.22 child's care in another facility, the commissioner or local 7.23 social services agency shall notify the head of that facility of 7.24 this determination. The notification must include an 7.25 explanation of the individual's available appeal rights and the 7.26 status of any appeal. If a notice is given under this 7.27 paragraph, the government entity making the notification shall 7.28 provide a copy of the notice to the individual who is the 7.29 subject of the notice. 7.30 Sec. 5. Minnesota Statutes 2000, section 245A.02, is 7.31 amended by adding a subdivision to read: 7.32 Subd. 2a. [ADULT DAY CARE.] "Adult day care" means a 7.33 program operating less than 24 hours per day that provides 7.34 functionally impaired adults with an individualized and 7.35 coordinated set of services including health services, social 7.36 services, and nutritional services that are directed at 8.1 maintaining or improving the participants' capabilities for 8.2 self-care. Adult day care does not include programs where 8.3 adults gather or congregate primarily for purposes of 8.4 socialization, education, supervision, caregiver respite, 8.5 religious expression, exercise, or nutritious meals. 8.6 Sec. 6. Minnesota Statutes 2000, section 245A.02, is 8.7 amended by adding a subdivision to read: 8.8 Subd. 2b. [ANNUAL OR ANNUALLY.] "Annual" or "annually" 8.9 means prior to or within the same month of the subsequent 8.10 calendar year. 8.11 Sec. 7. Minnesota Statutes 2001 Supplement, section 8.12 245A.03, subdivision 2, is amended to read: 8.13 Subd. 2. [EXCLUSION FROM LICENSURE.] (a) This chapter does 8.14 not apply to: 8.15 (1) residential or nonresidential programs that are 8.16 provided to a person by an individual who is related unless the 8.17 residential program is a child foster care placement made by a 8.18 local social services agency or a licensed child-placing agency, 8.19 except as provided in subdivision 2a; 8.20 (2) nonresidential programs that are provided by an 8.21 unrelated individual to persons from a single related family; 8.22 (3) residential or nonresidential programs that are 8.23 provided to adults who do not abuse chemicals or who do not have 8.24 a chemical dependency, a mental illness, mental retardation or a 8.25 related condition, a functional impairment, or a physical 8.26 handicap; 8.27 (4) sheltered workshops or work activity programs that are 8.28 certified by the commissioner of economic security; 8.29 (5) programs for children enrolled in kindergarten to the 8.30 12th grade and prekindergarten special education in a school as 8.31 defined in section 120A.22, subdivision 4, and programs serving 8.32 children in combined special education and regular 8.33 prekindergarten programs that are operated or assisted by the 8.34 commissioner of children, families, and learning; 8.35 (6) nonresidential programs primarily for children that 8.36 provide care or supervision, without charge for ten or fewer 9.1 days a year, and for periods of less than three hours a day 9.2 while the child's parent or legal guardian is in the same 9.3 building as the nonresidential program or present within another 9.4 building that is directly contiguous to the building in which 9.5 the nonresidential program is located; 9.6 (7) nursing homes or hospitals licensed by the commissioner 9.7 of health except as specified under section 245A.02; 9.8 (8) board and lodge facilities licensed by the commissioner 9.9 of health that provide services for five or more persons whose 9.10 primary diagnosis is mental illness who have refused an 9.11 appropriate residential program offered by a county agency.9.12This exclusion expires on July 1, 1990; 9.13 (9) homes providing programs for persons placed there by a 9.14 licensed agency for legal adoption, unless the adoption is not 9.15 completed within two years; 9.16 (10) programs licensed by the commissioner of corrections; 9.17 (11) recreation programs for children or adults that 9.18 operate for fewer than 40 calendar days in a calendar year or 9.19 programs operated by a park and recreation board of a city of 9.20 the first class whose primary purpose is to provide social and 9.21 recreational activities to school age children, provided the 9.22 program is approved by the park and recreation board; 9.23 (12) programs operated by a school as defined in section 9.24 120A.22, subdivision 4, whose primary purpose is to provide 9.25 child care to school-age children, provided the program is 9.26 approved by the district's school board; 9.27 (13) Head Start nonresidential programs which operate for 9.28 less than 31 days in each calendar year; 9.29 (14) noncertified boarding care homes unless they provide 9.30 services for five or more persons whose primary diagnosis is 9.31 mental illness or mental retardation; 9.32 (15) nonresidential programs for nonhandicapped children 9.33 provided for a cumulative total of less than 30 days in any 9.34 12-month period; 9.35 (16) residential programs for persons with mental illness, 9.36 that are located in hospitals, until the commissioner adopts 10.1 appropriate rules; 10.2 (17) the religious instruction of school-age children; 10.3 Sabbath or Sunday schools; or the congregate care of children by 10.4 a church, congregation, or religious society during the period 10.5 used by the church, congregation, or religious society for its 10.6 regular worship; 10.7 (18) camps licensed by the commissioner of health under 10.8 Minnesota Rules, chapter 4630; 10.9 (19) mental health outpatient services for adults with 10.10 mental illness or children with emotional disturbance; 10.11 (20) residential programs serving school-age children whose 10.12 sole purpose is cultural or educational exchange, until the 10.13 commissioner adopts appropriate rules; 10.14 (21) unrelated individuals who provide out-of-home respite 10.15 care services to persons with mental retardation or related 10.16 conditions from a single related family for no more than 90 days 10.17 in a 12-month period and the respite care services are for the 10.18 temporary relief of the person's family or legal representative; 10.19 (22) respite care services provided as a home and 10.20 community-based service to a person with mental retardation or a 10.21 related condition, in the person's primary residence; 10.22 (23) community support services programs as defined in 10.23 section 245.462, subdivision 6, and family community support 10.24 services as defined in section 245.4871, subdivision 17; 10.25 (24) the placement of a child by a birth parent or legal 10.26 guardian in a preadoptive home for purposes of adoption as 10.27 authorized by section 259.47; 10.28 (25) settings registered under chapter 144D which provide 10.29 home care services licensed by the commissioner of health to 10.30 fewer than seven adults; or 10.31 (26) consumer-directed community support service funded 10.32 under the Medicaid waiver for persons with mental retardation 10.33 and related conditions when the individual who provided the 10.34 service is: 10.35 (i) the same individual who is the direct payee of these 10.36 specific waiver funds or paid by a fiscal agent, fiscal 11.1 intermediary, or employer of record; and 11.2 (ii) not otherwise under the control of a residential or 11.3 nonresidential program that is required to be licensed under 11.4 this chapter when providing the service. 11.5 For purposes of clause (6), a building is directly 11.6 contiguous to a building in which a nonresidential program is 11.7 located if it shares a common wall with the building in which 11.8 the nonresidential program is located or is attached to that 11.9 building by skyway, tunnel, atrium, or common roof. 11.10 (b) Nothing in this chapter shall be construed to require 11.11 licensure for any services provided and funded according to an 11.12 approved federal waiver plan where licensure is specifically 11.13 identified as not being a condition for the services and funding. 11.14 Sec. 8. Minnesota Statutes 2000, section 245A.035, 11.15 subdivision 3, is amended to read: 11.16 Subd. 3. [REQUIREMENTS FOR EMERGENCY LICENSE.] Before an 11.17 emergency license may be issued, the following requirements must 11.18 be met: 11.19 (1) the county agency must conduct an initial inspection of 11.20 the premises where the foster care is to be provided to ensure 11.21 the health and safety of any child placed in the home. The 11.22 county agency shall conduct the inspection using a form 11.23 developed by the commissioner; 11.24 (2) at the time of the inspection or placement, whichever 11.25 is earlier, the relative being considered for an emergency 11.26 license shall receive an application form for a child foster 11.27 care license;and11.28 (3) whenever possible, prior to placing the child in the 11.29 relative's home, the relative being considered for an emergency 11.30 license shall provide the information required by section 11.31 245A.04, subdivision 3, paragraph (b); and 11.32 (4) if the county determines, prior to the issuance of an 11.33 emergency license, that anyone requiring a background study may 11.34 be disqualified under section 245A.04, and the disqualification 11.35 is one which the commissioner cannot set aside, an emergency 11.36 license shall not be issued. 12.1 Sec. 9. Minnesota Statutes 2001 Supplement, section 12.2 245A.04, subdivision 3, is amended to read: 12.3 Subd. 3. [BACKGROUND STUDY OF THE APPLICANT; DEFINITIONS.] 12.4 (a) Individuals and organizations that are required in statute 12.5 to initiate background studies under this section shall comply 12.6 with the following requirements: 12.7 (1) Applicants for licensure, license holders, and other 12.8 entities as provided in this section must submit completed 12.9 background study forms to the commissioner before individuals 12.10 specified in paragraph (c), clauses (1) to (4), (6), and (7), 12.11 begin positions allowing direct contact in any licensed program. 12.12 (2) Applicants and license holders under the jurisdiction 12.13 of other state agencies who are required in other statutory 12.14 sections to initiate background studies under this section must 12.15 submit completed background study forms to the commissioner 12.16 prior to the background study subject beginning in a position 12.17 allowing direct contact in the licensed program, or where 12.18 applicable, prior to being employed. 12.19 (3) Organizations required to initiate background studies 12.20 under section 256B.0627 for individuals described in paragraph 12.21 (c), clause (5), must submit a completed background study form 12.22 to the commissioner before those individuals begin a position 12.23 allowing direct contact with persons served by the 12.24 organization. The commissioner shall recover the cost of these 12.25 background studies through a fee of no more than $12 per study 12.26 charged to the organization responsible for submitting the 12.27 background study form. The fees collected under this paragraph 12.28 are appropriated to the commissioner for the purpose of 12.29 conducting background studies. 12.30 Upon receipt of the background study forms from the 12.31 entities in clauses (1) to (3), the commissioner shall complete 12.32 the background study as specified under this section and provide 12.33 notices required in subdivision 3a. Unless otherwise specified, 12.34 the subject of a background study may have direct contact with 12.35 persons served by a program after the background study form is 12.36 mailed or submitted to the commissioner pending notification of 13.1 the study results under subdivision 3a. A county agency may 13.2 accept a background study completed by the commissioner under 13.3 this section in place of the background study required under 13.4 section 245A.16, subdivision 3, in programs with joint licensure 13.5 as home and community-based services and adult foster care for 13.6 people with developmental disabilities when the license holder 13.7 does not reside in the foster care residence and the subject of 13.8 the study has been continuously affiliated with the license 13.9 holder since the date of the commissioner's study. 13.10 (b) The definitions in this paragraph apply only to 13.11 subdivisions 3 to 3e. 13.12 (1) "Background study" means the review of records 13.13 conducted by the commissioner to determine whether a subject is 13.14 disqualified from direct contact with persons served by a 13.15 program, and where specifically provided in statutes, whether a 13.16 subject is disqualified from having access to persons served by 13.17 a program. 13.18 (2) "Continuous, direct supervision" means an individual is 13.19 within sight or hearing of the supervising person to the extent 13.20 that supervising person is capable at all times of intervening 13.21 to protect the health and safety of the persons served by the 13.22 program. 13.23 (3) "Contractor" means any person, regardless of employer, 13.24 who is providing program services for hire under the control of 13.25 the provider. 13.26 (4) "Direct contact" means providing face-to-face care, 13.27 training, supervision, counseling, consultation, or medication 13.28 assistance to persons served by the program. 13.29 (5) "Reasonable cause" means information or circumstances 13.30 exist which provide the commissioner with articulable suspicion 13.31 that further pertinent information may exist concerning a 13.32 subject. The commissioner has reasonable cause when, but not 13.33 limited to, the commissioner has received a report from the 13.34 subject, the license holder, or a third party indicating that 13.35 the subject has a history that would disqualify the person or 13.36 that may pose a risk to the health or safety of persons 14.1 receiving services. 14.2 (6) "Subject of a background study" means an individual on 14.3 whom a background study is required or completed. 14.4 (c) The applicant, license holder, registrant under section 14.5 144A.71, subdivision 1, bureau of criminal apprehension, 14.6 commissioner of health, and county agencies, after written 14.7 notice to the individual who is the subject of the study, shall 14.8 help with the study by giving the commissioner criminal 14.9 conviction data and reports about the maltreatment of adults 14.10 substantiated under section 626.557 and the maltreatment of 14.11 minors in licensed programs substantiated under section 14.12 626.556. If a background study is initiated by an applicant or 14.13 license holder and the applicant or license holder receives 14.14 information about a possible criminal or maltreatment history of 14.15 an individual who is the subject of a background study, the 14.16 applicant or license holder must immediately provide the 14.17 information to the commissioner. The individuals to be studied 14.18 shall include: 14.19 (1) the applicant; 14.20 (2) persons age 13 and over living in the household where 14.21 the licensed program will be provided; 14.22 (3) current employees or contractors of the applicant who 14.23 will have direct contact with persons served by the facility, 14.24 agency, or program; 14.25 (4) volunteers or student volunteers who have direct 14.26 contact with persons served by the program to provide program 14.27 services, if the contact is notdirectly supervised by the14.28individualsunder the continuous, direct supervision by an 14.29 individual listed in clause (1) or (3); 14.30 (5) any person required under section 256B.0627 to have a 14.31 background study completed under this section; 14.32 (6) persons ages 10 to 12 living in the household where the 14.33 licensed services will be provided when the commissioner has 14.34 reasonable cause; and 14.35 (7) persons who, without providing direct contact services 14.36 at a licensed program, may have unsupervised access to children 15.1 or vulnerable adults receiving services from the program 15.2 licensed to provide family child care for children, foster care 15.3 for children in the provider's own home, or foster care or day 15.4 care services for adults in the provider's own home when the 15.5 commissioner has reasonable cause. 15.6 (d) According to paragraph (c), clauses (2) and (6), the 15.7 commissioner shall review records from the juvenile courts. For 15.8 persons under paragraph (c), clauses (1), (3), (4), (5), and 15.9 (7), who are ages 13 to 17, the commissioner shall review 15.10 records from the juvenile courts when the commissioner has 15.11 reasonable cause. The juvenile courts shall help with the study 15.12 by giving the commissioner existing juvenile court records on 15.13 individuals described in paragraph (c), clauses (2), (6), and 15.14 (7), relating to delinquency proceedings held within either the 15.15 five years immediately preceding the background study or the 15.16 five years immediately preceding the individual's 18th birthday, 15.17 whichever time period is longer. The commissioner shall destroy 15.18 juvenile records obtained pursuant to this subdivision when the 15.19 subject of the records reaches age 23. 15.20 (e) Beginning August 1, 2001, the commissioner shall 15.21 conduct all background studies required under this chapter and 15.22 initiated by supplemental nursing services agencies registered 15.23 under section 144A.71, subdivision 1. Studies for the agencies 15.24 must be initiated annually by each agency. The commissioner 15.25 shall conduct the background studies according to this chapter. 15.26 The commissioner shall recover the cost of the background 15.27 studies through a fee of no more than $8 per study, charged to 15.28 the supplemental nursing services agency. The fees collected 15.29 under this paragraph are appropriated to the commissioner for 15.30 the purpose of conducting background studies. 15.31 (f) For purposes of this section, a finding that a 15.32 delinquency petition is proven in juvenile court shall be 15.33 considered a conviction in state district court. 15.34 (g) A study of an individual in paragraph (c), clauses (1) 15.35 to (7), shall be conducted at least upon application for initial 15.36 license for all license types or registration under section 16.1 144A.71, subdivision 1, and at reapplication for a licenseor16.2registrationfor family child care, child foster care, and adult 16.3 foster care. The commissioner is not required to conduct a 16.4 study of an individual at the time of reapplication for a 16.5 license or if the individual has been continuously affiliated 16.6 with a foster care provider licensed by the commissioner of 16.7 human services and registered under chapter 144D, other than a 16.8 family day care or foster care license, if: (i) a study of the 16.9 individual was conducted either at the time of initial licensure 16.10 or when the individual became affiliated with the license 16.11 holder; (ii) the individual has been continuously affiliated 16.12 with the license holder since the last study was conducted; and 16.13 (iii) the procedure described in paragraph (j) has been 16.14 implemented and was in effect continuously since the last study 16.15 was conducted. For the purposes of this section, a physician 16.16 licensed under chapter 147 is considered to be continuously 16.17 affiliated upon the license holder's receipt from the 16.18 commissioner of health or human services of the physician's 16.19 background study results. For individuals who are required to 16.20 have background studies under paragraph (c) and who have been 16.21 continuously affiliated with a foster care provider that is 16.22 licensed in more than one county, criminal conviction data may 16.23 be shared among those counties in which the foster care programs 16.24 are licensed. A county agency's receipt of criminal conviction 16.25 data from another county agency shall meet the criminal data 16.26 background study requirements of this section. 16.27 (h) The commissioner may also conduct studies on 16.28 individuals specified in paragraph (c), clauses (3) and (4), 16.29 when the studies are initiated by: 16.30 (i) personnel pool agencies; 16.31 (ii) temporary personnel agencies; 16.32 (iii) educational programs that train persons by providing 16.33 direct contact services in licensed programs; and 16.34 (iv) professional services agencies that are not licensed 16.35 and which contract with licensed programs to provide direct 16.36 contact services or individuals who provide direct contact 17.1 services. 17.2 (i) Studies on individuals in paragraph (h), items (i) to 17.3 (iv), must be initiated annually by these agencies, programs, 17.4 and individuals. Except as provided in paragraph (a), clause 17.5 (3), no applicant, license holder, or individual who is the 17.6 subject of the study shall pay any fees required to conduct the 17.7 study. 17.8 (1) At the option of the licensed facility, rather than 17.9 initiating another background study on an individual required to 17.10 be studied who has indicated to the licensed facility that a 17.11 background study by the commissioner was previously completed, 17.12 the facility may make a request to the commissioner for 17.13 documentation of the individual's background study status, 17.14 provided that: 17.15 (i) the facility makes this request using a form provided 17.16 by the commissioner; 17.17 (ii) in making the request the facility informs the 17.18 commissioner that either: 17.19 (A) the individual has been continuously affiliated with a 17.20 licensed facility since the individual's previous background 17.21 study was completed, or since October 1, 1995, whichever is 17.22 shorter; or 17.23 (B) the individual is affiliated only with a personnel pool 17.24 agency, a temporary personnel agency, an educational program 17.25 that trains persons by providing direct contact services in 17.26 licensed programs, or a professional services agency that is not 17.27 licensed and which contracts with licensed programs to provide 17.28 direct contact services or individuals who provide direct 17.29 contact services; and 17.30 (iii) the facility provides notices to the individual as 17.31 required in paragraphs (a) to (j), and that the facility is 17.32 requesting written notification of the individual's background 17.33 study status from the commissioner. 17.34 (2) The commissioner shall respond to each request under 17.35 paragraph (1) with a written or electronic notice to the 17.36 facility and the study subject. If the commissioner determines 18.1 that a background study is necessary, the study shall be 18.2 completed without further request from a licensed agency or 18.3 notifications to the study subject. 18.4 (3) When a background study is being initiated by a 18.5 licensed facility or a foster care provider that is also 18.6 registered under chapter 144D, a study subject affiliated with 18.7 multiple licensed facilities may attach to the background study 18.8 form a cover letter indicating the additional facilities' names, 18.9 addresses, and background study identification numbers. When 18.10 the commissioner receives such notices, each facility identified 18.11 by the background study subject shall be notified of the study 18.12 results. The background study notice sent to the subsequent 18.13 agencies shall satisfy those facilities' responsibilities for 18.14 initiating a background study on that individual. 18.15 (j) If an individual who is affiliated with a program or 18.16 facility regulated by the department of human services or 18.17 department of health or who is affiliated with any type of home 18.18 care agency or provider of personal care assistance services, is 18.19 convicted of a crime constituting a disqualification under 18.20 subdivision 3d, the probation officer or corrections agent shall 18.21 notify the commissioner of the conviction. For the purpose of 18.22 this paragraph, "conviction" has the meaning given it in section 18.23 609.02, subdivision 5. The commissioner, in consultation with 18.24 the commissioner of corrections, shall develop forms and 18.25 information necessary to implement this paragraph and shall 18.26 provide the forms and information to the commissioner of 18.27 corrections for distribution to local probation officers and 18.28 corrections agents. The commissioner shall inform individuals 18.29 subject to a background study that criminal convictions for 18.30 disqualifying crimes will be reported to the commissioner by the 18.31 corrections system. A probation officer, corrections agent, or 18.32 corrections agency is not civilly or criminally liable for 18.33 disclosing or failing to disclose the information required by 18.34 this paragraph. Upon receipt of disqualifying information, the 18.35 commissioner shall provide the notifications required in 18.36 subdivision 3a, as appropriate to agencies on record as having 19.1 initiated a background study or making a request for 19.2 documentation of the background study status of the individual. 19.3 This paragraph does not apply to family day care and child 19.4 foster care programs. 19.5 (k) The individual who is the subject of the study must 19.6 provide the applicant or license holder with sufficient 19.7 information to ensure an accurate study including the 19.8 individual's first, middle, and last name and all other names by 19.9 which the individual has been known; home address, city, county, 19.10 and state of residence for the past five years; zip code; sex; 19.11 date of birth; and driver's license number or state 19.12 identification number. The applicant or license holder shall 19.13 provide this information about an individual in paragraph (c), 19.14 clauses (1) to (7), on forms prescribed by the commissioner. By 19.15 January 1, 2000, for background studies conducted by the 19.16 department of human services, the commissioner shall implement a 19.17 system for the electronic transmission of: (1) background study 19.18 information to the commissioner; and (2) background study 19.19 results to the license holder. The commissioner may request 19.20 additional information of the individual, which shall be 19.21 optional for the individual to provide, such as the individual's 19.22 social security number or race. 19.23 (l) For programs directly licensed by the commissioner, a 19.24 study must include information related to names of substantiated 19.25 perpetrators of maltreatment of vulnerable adults that has been 19.26 received by the commissioner as required under section 626.557, 19.27 subdivision 9c, paragraph (i), and the commissioner's records 19.28 relating to the maltreatment of minors in licensed programs, 19.29 information from juvenile courts as required in paragraph (c) 19.30 for persons listed in paragraph (c), clauses (2), (6), and (7), 19.31 and information from the bureau of criminal apprehension. For 19.32 child foster care, adult foster care, and family day care homes, 19.33 the study must include information from the county agency's 19.34 record of substantiated maltreatment of adults, and the 19.35 maltreatment of minors, information from juvenile courts as 19.36 required in paragraph (c) for persons listed in paragraph (c), 20.1 clauses (2), (6), and (7), and information from the bureau of 20.2 criminal apprehension. The commissioner may also review arrest 20.3 and investigative information from the bureau of criminal 20.4 apprehension, the commissioner of health, a county attorney, 20.5 county sheriff, county agency, local chief of police, other 20.6 states, the courts, or the Federal Bureau of Investigation if 20.7 the commissioner has reasonable cause to believe the information 20.8 is pertinent to the disqualification of an individual listed in 20.9 paragraph (c), clauses (1) to (7). The commissioner is not 20.10 required to conduct more than one review of a subject's records 20.11 from the Federal Bureau of Investigation if a review of the 20.12 subject's criminal history with the Federal Bureau of 20.13 Investigation has already been completed by the commissioner and 20.14 there has been no break in the subject's affiliation with the 20.15 license holder who initiated the background study. 20.16 (m) When the commissioner has reasonable cause to believe 20.17 that further pertinent information may exist on the subject, the 20.18 subject shall provide a set of classifiable fingerprints 20.19 obtained from an authorized law enforcement agency. For 20.20 purposes of requiring fingerprints, the commissioner shall be 20.21 considered to have reasonable cause under, but not limited to, 20.22 the following circumstances: 20.23 (1) information from the bureau of criminal apprehension 20.24 indicates that the subject is a multistate offender; 20.25 (2) information from the bureau of criminal apprehension 20.26 indicates that multistate offender status is undetermined; or 20.27 (3) the commissioner has received a report from the subject 20.28 or a third party indicating that the subject has a criminal 20.29 history in a jurisdiction other than Minnesota. 20.30 (n) The failure or refusal of an applicant, license holder, 20.31 or registrant under section 144A.71, subdivision 1, to cooperate 20.32 with the commissioner is reasonable cause to disqualify a 20.33 subject, deny a license application or immediately suspend, 20.34 suspend, or revoke a license or registration. Failure or 20.35 refusal of an individual to cooperate with the study is just 20.36 cause for denying or terminating employment of the individual if 21.1 the individual's failure or refusal to cooperate could cause the 21.2 applicant's application to be denied or the license holder's 21.3 license to be immediately suspended, suspended, or revoked. 21.4 (o) The commissioner shall not consider an application to 21.5 be complete until all of the information required to be provided 21.6 under this subdivision has been received. 21.7 (p) No person in paragraph (c), clauses (1) to (7), who is 21.8 disqualified as a result of this section may be retained by the 21.9 agency in a position involving direct contact with persons 21.10 served by the programor in a position allowingand no person in 21.11 paragraph (c), clauses (2), (6), and (7), or as provided 21.12 elsewhere in statute who is disqualified as a result of this 21.13 section may be allowed access to persons served by the 21.14 programas provided for in statutes, unless the commissioner has 21.15 provided written notice to the agency stating that: 21.16 (1) the individual may remain in direct contact during the 21.17 period in which the individual may request reconsideration as 21.18 provided in subdivision 3a, paragraph (b), clause (2) or (3); 21.19 (2) the individual's disqualification has been set aside 21.20 for that agency as provided in subdivision 3b, paragraph (b); or 21.21 (3) the license holder has been granted a variance for the 21.22 disqualified individual under subdivision 3e. 21.23 (q) Termination of affiliation with persons in paragraph 21.24 (c), clauses (1) to (7), made in good faith reliance on a notice 21.25 of disqualification provided by the commissioner shall not 21.26 subject the applicant or license holder to civil liability. 21.27 (r) The commissioner may establish records to fulfill the 21.28 requirements of this section. 21.29 (s) The commissioner may not disqualify an individual 21.30 subject to a study under this section because that person has, 21.31 or has had, a mental illness as defined in section 245.462, 21.32 subdivision 20. 21.33 (t) An individual subject to disqualification under this 21.34 subdivision has the applicable rights in subdivision 3a, 3b, or 21.35 3c. 21.36 (u) For the purposes of background studies completed by 22.1 tribal organizations performing licensing activities otherwise 22.2 required of the commissioner under this chapter, after obtaining 22.3 consent from the background study subject, tribal licensing 22.4 agencies shall have access to criminal history data in the same 22.5 manner as county licensing agencies and private licensing 22.6 agencies under this chapter. 22.7 Sec. 10. Minnesota Statutes 2001 Supplement, section 22.8 245A.04, subdivision 3a, is amended to read: 22.9 Subd. 3a. [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF 22.10 STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) Within 15 22.11 working days, the commissioner shall notify the applicant, 22.12 license holder, or registrant under section 144A.71, subdivision 22.13 1, and the individual who is the subject of the study, in 22.14 writing or by electronic transmission, of the results of the 22.15 study or that more time is needed to complete the study. When 22.16 the study is completed, a notice that the study was undertaken 22.17 and completed shall be maintained in the personnel files of the 22.18 program. For studies on individuals pertaining to a license to 22.19 provide family day care or group family day care, foster care 22.20 for children in the provider's own home, or foster care or day 22.21 care services for adults in the provider's own home, the 22.22 commissioner is not required to provide a separate notice of the 22.23 background study results to the individual who is the subject of 22.24 the study unless the study results in a disqualification of the 22.25 individual. 22.26 The commissioner shall notify the individual studied if the 22.27 information in the study indicates the individual is 22.28 disqualified from direct contact with persons served by the 22.29 program. The commissioner shall disclose the information 22.30 causing disqualification and instructions on how to request a 22.31 reconsideration of the disqualification to the individual 22.32 studied. An applicant or license holder who is not the subject 22.33 of the study shall be informed that the commissioner has found 22.34 information that disqualifies the subject from direct contact 22.35 with persons served by the program. However, only the 22.36 individual studied must be informed of the information contained 23.1 in the subject's background study unless the basis for the 23.2 disqualification is failure to cooperate, substantiated 23.3 maltreatment under section 626.556 or 626.557, the Data 23.4 Practices Act provides for release of the information, or the 23.5 individual studied authorizes the release of the information. 23.6 When a disqualification is based on the subject's failure to 23.7 cooperate with the background study or substantiated 23.8 maltreatment under section 626.556 or 626.557, the agency that 23.9 initiated the study shall be informed by the commissioner of the 23.10 reason for the disqualification. 23.11 (b) Except as provided in subdivision 3d, paragraph (b), if 23.12 the commissioner determines that the individual studied has a 23.13 disqualifying characteristic, the commissioner shall review the 23.14 information immediately available and make a determination as to 23.15 the subject's immediate risk of harm to persons served by the 23.16 program where the individual studied will have direct contact. 23.17 The commissioner shall consider all relevant information 23.18 available, including the following factors in determining the 23.19 immediate risk of harm: the recency of the disqualifying 23.20 characteristic; the recency of discharge from probation for the 23.21 crimes; the number of disqualifying characteristics; the 23.22 intrusiveness or violence of the disqualifying characteristic; 23.23 the vulnerability of the victim involved in the disqualifying 23.24 characteristic; and the similarity of the victim to the persons 23.25 served by the program where the individual studied will have 23.26 direct contact. The commissioner may determine that the 23.27 evaluation of the information immediately available gives the 23.28 commissioner reason to believe one of the following: 23.29 (1) The individual poses an imminent risk of harm to 23.30 persons served by the program where the individual studied will 23.31 have direct contact. If the commissioner determines that an 23.32 individual studied poses an imminent risk of harm to persons 23.33 served by the program where the individual studied will have 23.34 direct contact, the individual and the license holder must be 23.35 sent a notice of disqualification. The commissioner shall order 23.36 the license holder to immediately remove the individual studied 24.1 from direct contact. The notice to the individual studied must 24.2 include an explanation of the basis of this determination. 24.3 (2) The individual poses a risk of harm requiring 24.4 continuous, direct supervision while providing direct contact 24.5 services during the period in which the subject may request a 24.6 reconsideration. If the commissioner determines that an 24.7 individual studied poses a risk of harm that requires 24.8 continuous, direct supervision, the individual and the license 24.9 holder must be sent a notice of disqualification. The 24.10 commissioner shall order the license holder to immediately 24.11 remove the individual studied from direct contact services or 24.12 assure that the individual studied iswithin sight or hearing24.13 under the continuous, direct supervision of another staff person 24.14 when providing direct contact services during the period in 24.15 which the individual may request a reconsideration of the 24.16 disqualification. If the individual studied does not submit a 24.17 timely request for reconsideration, or the individual submits a 24.18 timely request for reconsideration, but the disqualification is 24.19 not set aside for that license holder, the license holder will 24.20 be notified of the disqualification and ordered to immediately 24.21 remove the individual from any position allowing direct contact 24.22 with persons receiving services from the license holder. 24.23 (3) The individual does not pose an imminent risk of harm 24.24 or a risk of harm requiring continuous, direct supervision while 24.25 providing direct contact services during the period in which the 24.26 subject may request a reconsideration. If the commissioner 24.27 determines that an individual studied does not pose a risk of 24.28 harm that requires continuous, direct supervision, only the 24.29 individual must be sent a notice of disqualification. The 24.30 license holder must be sent a notice that more time is needed to 24.31 complete the individual's background study. If the individual 24.32 studied submits a timely request for reconsideration, and if the 24.33 disqualification is set aside for that license holder, the 24.34 license holder will receive the same notification received by 24.35 license holders in cases where the individual studied has no 24.36 disqualifying characteristic. If the individual studied does 25.1 not submit a timely request for reconsideration, or the 25.2 individual submits a timely request for reconsideration, but the 25.3 disqualification is not set aside for that license holder, the 25.4 license holder will be notified of the disqualification and 25.5 ordered to immediately remove the individual from any position 25.6 allowing direct contact with persons receiving services from the 25.7 license holder. 25.8 (c) County licensing agencies performing duties under this 25.9 subdivision may develop an alternative system for determining 25.10 the subject's immediate risk of harm to persons served by the 25.11 program, providing the notices under paragraph (b), and 25.12 documenting the action taken by the county licensing agency. 25.13 Each county licensing agency's implementation of the alternative 25.14 system is subject to approval by the commissioner. 25.15 Notwithstanding this alternative system, county licensing 25.16 agencies shall complete the requirements of paragraph (a). 25.17 Sec. 11. Minnesota Statutes 2001 Supplement, section 25.18 245A.04, subdivision 3b, is amended to read: 25.19 Subd. 3b. [RECONSIDERATION OF DISQUALIFICATION.] (a) The 25.20 individual who is the subject of the disqualification may 25.21 request a reconsideration of the disqualification. 25.22 The individual must submit the request for reconsideration 25.23 to the commissioner in writing. A request for reconsideration 25.24 for an individual who has been sent a notice of disqualification 25.25 under subdivision 3a, paragraph (b), clause (1) or (2), must be 25.26 submitted within 30 calendar days of the disqualified 25.27 individual's receipt of the notice of disqualification. Upon 25.28 showing that the information in clause (1) or (2) cannot be 25.29 obtained within 30 days, the disqualified individual may request 25.30 additional time, not to exceed 30 days, to obtain that 25.31 information. A request for reconsideration for an individual 25.32 who has been sent a notice of disqualification under subdivision 25.33 3a, paragraph (b), clause (3), must be submitted within 15 25.34 calendar days of the disqualified individual's receipt of the 25.35 notice of disqualification. An individual who was determined to 25.36 have maltreated a child under section 626.556 or a vulnerable 26.1 adult under section 626.557, and who was disqualified under this 26.2 section on the basis of serious or recurring maltreatment, may 26.3 request reconsideration of both the maltreatment and the 26.4 disqualification determinations. The request for 26.5 reconsideration of the maltreatment determination and the 26.6 disqualification must be submitted within 30 calendar days of 26.7 the individual's receipt of the notice of disqualification. 26.8 Removal of a disqualified individual from direct contact shall 26.9 be ordered if the individual does not request reconsideration 26.10 within the prescribed time, and for an individual who submits a 26.11 timely request for reconsideration, if the disqualification is 26.12 not set aside. The individual must present information showing 26.13 that: 26.14 (1) the information the commissioner relied upon in 26.15 determining that the underlying conduct giving rise to the 26.16 disqualification occurred, and for maltreatment, that the 26.17 maltreatment was serious or recurring, is incorrector26.18inaccurate. If the basis of a reconsideration request is that a26.19maltreatment determination or disposition under section 626.55626.20or 626.557 is incorrect, and the commissioner has issued a final26.21order in an appeal of that determination or disposition under26.22section 256.045 or 245A.08, subdivision 5, the commissioner's26.23order is conclusive on the issue of maltreatment. If the26.24individual did not request reconsideration of the maltreatment26.25determination, the maltreatment determination is deemed26.26conclusive; or 26.27 (2) the subject of the study does not pose a risk of harm 26.28 to any person served by the applicant, license holder, or 26.29 registrant under section 144A.71, subdivision 1. 26.30 (b) The commissioner shall rescind the disqualification if 26.31 the commissioner finds that the information relied on to 26.32 disqualify the subject is incorrect. The commissioner may set 26.33 aside the disqualification under this section if the 26.34 commissioner finds that the individual does not pose a risk of 26.35 harm to any person served by the applicant, license holder, or 26.36 registrant under section 144A.71, subdivision 1. In determining 27.1 that an individual does not pose a risk of harm, the 27.2 commissioner shall consider the nature, severity, and 27.3 consequences of the event or events that lead to 27.4 disqualification, whether there is more than one disqualifying 27.5 event, the age and vulnerability of the victim at the time of 27.6 the event, the harm suffered by the victim, the similarity 27.7 between the victim and persons served by the program, the time 27.8 elapsed without a repeat of the same or similar event, 27.9 documentation of successful completion by the individual studied 27.10 of training or rehabilitation pertinent to the event, and any 27.11 other information relevant to reconsideration. In reviewing a 27.12 disqualification under this section, the commissioner shall give 27.13 preeminent weight to the safety of each person to be served by 27.14 the license holder, applicant, or registrant under section 27.15 144A.71, subdivision 1, over the interests of the license 27.16 holder, applicant, or registrant under section 144A.71, 27.17 subdivision 1. 27.18 (c) Unless the information the commissioner relied on in 27.19 disqualifying an individual is incorrect, the commissioner may 27.20 not set aside the disqualification of an individual in 27.21 connection with a license to provide family day care for 27.22 children, foster care for children in the provider's own home, 27.23 or foster care or day care services for adults in the provider's 27.24 own home if: 27.25 (1) less than ten years have passed since the discharge of 27.26 the sentence imposed for the offense; and the individual has 27.27 been convicted of a violation of any offense listed in sections 27.28 609.20 (manslaughter in the first degree), 609.205 (manslaughter 27.29 in the second degree), criminal vehicular homicide under 609.21 27.30 (criminal vehicular homicide and injury), 609.215 (aiding 27.31 suicide or aiding attempted suicide), felony violations under 27.32 609.221 to 609.2231 (assault in the first, second, third, or 27.33 fourth degree), 609.713 (terroristic threats), 609.235 (use of 27.34 drugs to injure or to facilitate crime), 609.24 (simple 27.35 robbery), 609.245 (aggravated robbery), 609.25 (kidnapping), 27.36 609.255 (false imprisonment), 609.561 or 609.562 (arson in the 28.1 first or second degree), 609.71 (riot), burglary in the first or 28.2 second degree under 609.582 (burglary), 609.66 (dangerous 28.3 weapon), 609.665 (spring guns), 609.67 (machine guns and 28.4 short-barreled shotguns), 609.749 (harassment; stalking), 28.5 152.021 or 152.022 (controlled substance crime in the first or 28.6 second degree), 152.023, subdivision 1, clause (3) or (4), or 28.7 subdivision 2, clause (4) (controlled substance crime in the 28.8 third degree), 152.024, subdivision 1, clause (2), (3), or (4) 28.9 (controlled substance crime in the fourth degree), 609.224, 28.10 subdivision 2, paragraph (c) (fifth-degree assault by a 28.11 caregiver against a vulnerable adult), 609.228 (great bodily 28.12 harm caused by distribution of drugs), 609.23 (mistreatment of 28.13 persons confined), 609.231 (mistreatment of residents or 28.14 patients), 609.2325 (criminal abuse of a vulnerable adult), 28.15 609.233 (criminal neglect of a vulnerable adult), 609.2335 28.16 (financial exploitation of a vulnerable adult), 609.234 (failure 28.17 to report), 609.265 (abduction), 609.2664 to 609.2665 28.18 (manslaughter of an unborn child in the first or second degree), 28.19 609.267 to 609.2672 (assault of an unborn child in the first, 28.20 second, or third degree), 609.268 (injury or death of an unborn 28.21 child in the commission of a crime), 617.293 (disseminating or 28.22 displaying harmful material to minors), a felony level 28.23 conviction involving alcohol or drug use, a gross misdemeanor 28.24 offense under 609.324, subdivision 1 (other prohibited acts), a 28.25 gross misdemeanor offense under 609.378 (neglect or endangerment 28.26 of a child), a gross misdemeanor offense under 609.377 28.27 (malicious punishment of a child), 609.72, subdivision 3 28.28 (disorderly conduct against a vulnerable adult); or an attempt 28.29 or conspiracy to commit any of these offenses, as each of these 28.30 offenses is defined in Minnesota Statutes; or an offense in any 28.31 other state, the elements of which are substantially similar to 28.32 the elements of any of the foregoing offenses; 28.33 (2) regardless of how much time has passed since the 28.34 involuntary termination of parental rights under section 28.35 260C.301 or the discharge of the sentence imposed for the 28.36 offense, the individual was convicted of a violation of any 29.1 offense listed in sections 609.185 to 609.195 (murder in the 29.2 first, second, or third degree), 609.2661 to 609.2663 (murder of 29.3 an unborn child in the first, second, or third degree), a felony 29.4 offense under 609.377 (malicious punishment of a child), a 29.5 felony offense under 609.324, subdivision 1 (other prohibited 29.6 acts), a felony offense under 609.378 (neglect or endangerment 29.7 of a child), 609.322 (solicitation, inducement, and promotion of 29.8 prostitution), 609.342 to 609.345 (criminal sexual conduct in 29.9 the first, second, third, or fourth degree), 609.352 29.10 (solicitation of children to engage in sexual conduct), 617.246 29.11 (use of minors in a sexual performance), 617.247 (possession of 29.12 pictorial representations of a minor), 609.365 (incest), a 29.13 felony offense under sections 609.2242 and 609.2243 (domestic 29.14 assault), a felony offense of spousal abuse, a felony offense of 29.15 child abuse or neglect, a felony offense of a crime against 29.16 children, or an attempt or conspiracy to commit any of these 29.17 offenses as defined in Minnesota Statutes, or an offense in any 29.18 other state, the elements of which are substantially similar to 29.19 any of the foregoing offenses; 29.20 (3) within the seven years preceding the study, the 29.21 individual committed an act that constitutes maltreatment of a 29.22 child under section 626.556, subdivision 10e, and that resulted 29.23 in substantial bodily harm as defined in section 609.02, 29.24 subdivision 7a, or substantial mental or emotional harm as 29.25 supported by competent psychological or psychiatric evidence; or 29.26 (4) within the seven years preceding the study, the 29.27 individual was determined under section 626.557 to be the 29.28 perpetrator of a substantiated incident of maltreatment of a 29.29 vulnerable adult that resulted in substantial bodily harm as 29.30 defined in section 609.02, subdivision 7a, or substantial mental 29.31 or emotional harm as supported by competent psychological or 29.32 psychiatric evidence. 29.33 In the case of any ground for disqualification under 29.34 clauses (1) to (4), if the act was committed by an individual 29.35 other than the applicant, license holder, or registrant under 29.36 section 144A.71, subdivision 1, residing in the applicant's or 30.1 license holder's home, or the home of a registrant under section 30.2 144A.71, subdivision 1, the applicant, license holder, or 30.3 registrant under section 144A.71, subdivision 1, may seek 30.4 reconsideration when the individual who committed the act no 30.5 longer resides in the home. 30.6 The disqualification periods provided under clauses (1), 30.7 (3), and (4) are the minimum applicable disqualification 30.8 periods. The commissioner may determine that an individual 30.9 should continue to be disqualified from licensure or 30.10 registration under section 144A.71, subdivision 1, because the 30.11 license holder, applicant, or registrant under section 144A.71, 30.12 subdivision 1, poses a risk of harm to a person served by that 30.13 individual after the minimum disqualification period has passed. 30.14 (d) The commissioner shall respond in writing or by 30.15 electronic transmission to all reconsideration requests for 30.16 which the basis for the request is that the information relied 30.17 upon by the commissioner to disqualify is incorrect or 30.18 inaccurate within 30 working days of receipt of a request and 30.19 all relevant information. If the basis for the request is that 30.20 the individual does not pose a risk of harm, the commissioner 30.21 shall respond to the request within 15 working days after 30.22 receiving the request for reconsideration and all relevant 30.23 information. If the request is based on both the correctness or 30.24 accuracy of the information relied on to disqualify the 30.25 individual and the risk of harm, the commissioner shall respond 30.26 to the request within 45 working days after receiving the 30.27 request for reconsideration and all relevant information. If 30.28 the disqualification is set aside, the commissioner shall notify 30.29 the applicant or license holder in writing or by electronic 30.30 transmission of the decision. 30.31 (e) Except as provided in subdivision 3c, if a 30.32 disqualification for which reconsideration was requested is not 30.33 set aside or is not rescinded, an individual who was 30.34 disqualified on the basis of a preponderance of evidence that 30.35 the individual committed an act or acts that meet the definition 30.36 of any of the crimeslistslisted in subdivision 3d, paragraph 31.1 (a), clauses (1) to (4); or for failure to make required reports 31.2 under section 626.556, subdivision 3, or 626.557, subdivision 3, 31.3 pursuant to subdivision 3d, paragraph (a), clause (4), may 31.4 request a fair hearing under section 256.045. Except as 31.5 provided under subdivision 3c, thecommissioner's final order31.6for an individual under this paragraph is conclusive on the31.7issue of maltreatment and disqualification, including for31.8purposes of subsequent studies conducted under subdivision 3,31.9andfair hearing is the only administrative appeal of the final 31.10 agency determination, specifically, including a challenge to the 31.11 accuracy and completeness of data under section 13.04. 31.12 (f) Except as provided under subdivision 3c, if an 31.13 individual was disqualified on the basis of a determination of 31.14 maltreatment under section 626.556 or 626.557, which was serious 31.15 or recurring, and the individual has requested reconsideration 31.16 of the maltreatment determination under section 626.556, 31.17 subdivision 10i, or 626.557, subdivision 9d, and also requested 31.18 reconsideration of the disqualification under this subdivision, 31.19 reconsideration of the maltreatment determination and 31.20 reconsideration of the disqualification shall be consolidated 31.21 into a single reconsideration. For maltreatment and 31.22 disqualification determinations made by county agencies, the 31.23 consolidated reconsideration shall be conducted by the county 31.24 agency. If the county agency has disqualified an individual on 31.25 multiple bases, one of which is a county maltreatment 31.26 determination for which the individual has a right to request 31.27 reconsideration, the county shall conduct the reconsideration of 31.28 all disqualifications. Except as provided under subdivision 3c, 31.29 if an individual who was disqualified on the basis of serious or 31.30 recurring maltreatment requests a fair hearing on the 31.31 maltreatment determination under section 626.556, subdivision 31.32 10i, or 626.557, subdivision 9d, and requests a fair hearing on 31.33 the disqualification, which has not been set aside or rescinded 31.34 under this subdivision, the scope of the fair hearing under 31.35 section 256.045 shall include the maltreatment determination and 31.36 the disqualification. Except as provided under subdivision 32.1 3c,the commissioner's final order for an individual under this32.2paragraph is conclusive on the issue of maltreatment and32.3disqualification, including for purposes of subsequent studies32.4conducted under subdivision 3, anda fair hearing is the only 32.5 administrative appeal of the final agency determination, 32.6 specifically, including a challenge to the accuracy and 32.7 completeness of data under section 13.04. 32.8 Sec. 12. Minnesota Statutes 2000, section 245A.04, is 32.9 amended by adding a subdivision to read: 32.10 Subd. 3f. [CONCLUSIVE DETERMINATIONS OR DISPOSITIONS.] 32.11 Unless otherwise specified in statute, the following 32.12 determinations or dispositions are deemed conclusive: 32.13 (1) a maltreatment determination or disposition under 32.14 section 626.556 or 626.557, if: 32.15 (i) the commissioner has issued a final order in an appeal 32.16 of that determination or disposition under section 245A.08, 32.17 subdivision 5, or 256.045; 32.18 (ii) the individual did not request reconsideration of the 32.19 maltreatment determination or disposition under section 626.556 32.20 or 626.557; or 32.21 (iii) the individual did not request a hearing of the 32.22 maltreatment determination or disposition under section 256.045; 32.23 and 32.24 (2) a determination that the information relied upon to 32.25 disqualify an individual under subdivision 3d, was correct based 32.26 on serious or recurring maltreatment; or 32.27 (3) a preponderance of evidence shows that the individual 32.28 committed an act or acts that meet the definition of any of the 32.29 crimes listed in subdivision 3d, paragraph (a), clauses (1) to 32.30 (4); or the individual's failure to make required reports under 32.31 section 626.556, subdivision 3, or 626.557, subdivision 3, if: 32.32 (i) the commissioner has issued a final order in an appeal 32.33 of that determination under section 245A.08, subdivision 5, or 32.34 256.045, or a court has issued a final decision; 32.35 (ii) the individual did not request reconsideration of the 32.36 disqualification under this section; or 33.1 (iii) the individual did not request a hearing on the 33.2 disqualification under section 256.045. 33.3 Sec. 13. Minnesota Statutes 2000, section 245A.04, is 33.4 amended by adding a subdivision to read: 33.5 Subd. 3g. [PRESENTING FALSE INFORMATION FOR A BACKGROUND 33.6 STUDY; HIRING DISQUALIFIED PERSONS.] (a) A person who 33.7 intentionally presents, causes to be presented, or prepares with 33.8 knowledge or reason to believe that it will be presented, to the 33.9 commissioner of human services or the commissioner of health, 33.10 for purposes of a background study under this section, any 33.11 information that contains a false representation as to any 33.12 material fact regarding the applicant's name, address, sex, date 33.13 of birth, drivers license number, or criminal history is guilty 33.14 of a crime and may be sentenced as provided in paragraph (c). 33.15 (b) An entity that is required to conduct a background 33.16 check under this section that employs an individual after 33.17 receiving notice from the commissioner of human services, 33.18 health, or corrections that the individual is disqualified under 33.19 law from being employed and must be removed, is guilty of a 33.20 crime and may be sentenced as provided in paragraph (c). 33.21 (c) A person or entity that violates this section may be 33.22 sentenced to imprisonment for not more than one year or to 33.23 payment of a fine of not more than $3,000 or both. 33.24[EFFECTIVE DATE.] This section is effective August 1, 2002, 33.25 and applies to crimes committed on or after that date. 33.26 Sec. 14. Minnesota Statutes 2001 Supplement, section 33.27 245A.07, subdivision 2a, is amended to read: 33.28 Subd. 2a. [IMMEDIATE SUSPENSION EXPEDITED HEARING.] (a) 33.29 Within five working days of receipt of the license holder's 33.30 timely appeal, the commissioner shall request assignment of an 33.31 administrative law judge. The request must include a proposed 33.32 date, time, and place of a hearing. A hearing must be conducted 33.33 by an administrative law judge within 30 calendar days of the 33.34 request for assignment, unless an extension is requested by 33.35 either party and granted by the administrative law judge for 33.36 good cause. The commissioner shall issue a notice of hearing by 34.1 certified mail at least ten working days before the hearing. 34.2 The scope of the hearing shall be limited solely to the issue of 34.3 whether the temporary immediate suspension should remain in 34.4 effect pending the commissioner's final order under section 34.5 245A.08, regarding a licensing sanction issued under subdivision 34.6 3 following the immediate suspension. The burden of proof in 34.7 expedited hearings under this subdivision shall be limited to 34.8 the commissioner's demonstration that reasonable cause exists to 34.9 believe that the license holder's actions or failure to comply 34.10 with applicable law or rule poses an imminent risk of harm to 34.11 the health, safety, or rights of persons served by the program. 34.12 (b) The administrative law judge shall issue findings of 34.13 fact, conclusions, and a recommendation within ten working days 34.14 from the date of hearing. The commissioner's final order shall 34.15 be issued within ten working days from receipt of the 34.16 recommendation of the administrative law judge. Within 90 34.17 calendar days after a final order affirming an immediate 34.18 suspension, the commissioner shall make a determination 34.19 regarding whether a final licensing sanction shall be issued 34.20 under subdivision 3. The license holder shall continue to be 34.21 prohibited from operation of the program during this 90-day 34.22 period. 34.23 (c) When the final order under paragraph (b) affirms an 34.24 immediate suspension, and a final licensing sanction is issued 34.25 under subdivision 3, and the license holder appeals that 34.26 sanction, the license holder continues to be prohibited from 34.27 operation of the program pending a final commissioner's order 34.28 under section 245A.08, subdivision 5, regarding the final 34.29 licensing sanction. 34.30 Sec. 15. Minnesota Statutes 2001 Supplement, section 34.31 245A.07, subdivision 3, is amended to read: 34.32 Subd. 3. [LICENSE SUSPENSION, REVOCATION, OR FINE.] The 34.33 commissioner may suspend or revoke a license, or impose a fine 34.34 if a license holder fails to comply fully with applicable laws 34.35 or rules, or knowingly withholds relevant information from or 34.36 gives false or misleading information to the commissioner in 35.1 connection with an application for a license, in connection with 35.2 the background study status of an individual, or during an 35.3 investigation. A license holder who has had a license 35.4 suspended, revoked, or has been ordered to pay a fine must be 35.5 given notice of the action by certified mail. The notice must 35.6 be mailed to the address shown on the application or the last 35.7 known address of the license holder. The notice must state the 35.8 reasons the license was suspended, revoked, or a fine was 35.9 ordered. 35.10 (a) If the license was suspended or revoked, the notice 35.11 must inform the license holder of the right to a contested case 35.12 hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to 35.13 1400.8612 and successor rules. The license holder may appeal an 35.14 order suspending or revoking a license. The appeal of an order 35.15 suspending or revoking a license must be made in writing by 35.16 certified mail and must be received by the commissioner within 35.17 ten calendar days after the license holder receives notice that 35.18 the license has been suspended or revoked. Except as provided 35.19 in subdivision 2a, paragraph (c), a timely appeal of an order 35.20 suspending or revoking a license shall stay the suspension or 35.21 revocation until the commissioner issues a final order. 35.22 (b)(1) If the license holder was ordered to pay a fine, the 35.23 notice must inform the license holder of the responsibility for 35.24 payment of fines and the right to a contested case hearing under 35.25 chapter 14 and Minnesota Rules, parts 1400.8510 to 1400.8612 and 35.26 successor rules. The appeal of an order to pay a fine must be 35.27 made in writing by certified mail and must be received by the 35.28 commissioner within ten calendar days after the license holder 35.29 receives notice that the fine has been ordered. 35.30 (2) The license holder shall pay the fines assessed on or 35.31 before the payment date specified. If the license holder fails 35.32 to fully comply with the order, the commissioner may issue a 35.33 second fine or suspend the license until the license holder 35.34 complies. If the license holder receives state funds, the 35.35 state, county, or municipal agencies or departments responsible 35.36 for administering the funds shall withhold payments and recover 36.1 any payments made while the license is suspended for failure to 36.2 pay a fine. A timely appeal shall stay payment of the fine 36.3 until the commissioner issues a final order. 36.4 (3) A license holder shall promptly notify the commissioner 36.5 of human services, in writing, when a violation specified in the 36.6 order to forfeit a fine is corrected. If upon reinspection the 36.7 commissioner determines that a violation has not been corrected 36.8 as indicated by the order to forfeit a fine, the commissioner 36.9 may issue a second fine. The commissioner shall notify the 36.10 license holder by certified mail that a second fine has been 36.11 assessed. The license holder may appeal the second fine as 36.12 provided under this subdivision. 36.13 (4) Fines shall be assessed as follows: the license holder 36.14 shall forfeit $1,000 for each determination of maltreatment of a 36.15 child under section 626.556 or the maltreatment of a vulnerable 36.16 adult under section 626.557; the license holder shall forfeit 36.17 $200 for each occurrence of a violation of law or rule governing 36.18 matters of health, safety, or supervision, including but not 36.19 limited to the provision of adequate staff-to-child or adult 36.20 ratios, and failure to submit a background study; and the 36.21 license holder shall forfeit $100 for each occurrence of a 36.22 violation of law or rule other than those subject to a $1,000 or 36.23 $200 fine above. For purposes of this section, "occurrence" 36.24 means each violation identified in the commissioner's fine order. 36.25 (5) When a fine has been assessed, the license holder may 36.26 not avoid payment by closing, selling, or otherwise transferring 36.27 the licensed program to a third party. In such an event, the 36.28 license holder will be personally liable for payment. In the 36.29 case of a corporation, each controlling individual is personally 36.30 and jointly liable for payment. 36.31 Sec. 16. [245A.085] [CONSOLIDATION OF HEARINGS; 36.32 RECONSIDERATION.] 36.33 Hearings authorized under this chapter and sections 36.34 256.045, 626.556, and 626.557, shall be consolidated if feasible 36.35 and in accordance with other applicable statutes and rules. 36.36 Reconsideration under sections 245A.04, subdivision 3c; 626.556, 37.1 subdivision 10i; and 626.557, subdivision 9d, shall also be 37.2 consolidated if feasible. 37.3 Sec. 17. Minnesota Statutes 2001 Supplement, section 37.4 245A.144, is amended to read: 37.5 245A.144 [REDUCTION OF RISK OF SUDDEN INFANT DEATH SYNDROME 37.6 IN CHILD CARE PROGRAMS.] 37.7 License holders must ensure that before staff persons, 37.8 caregivers, and helpers assist in the care of infants, they 37.9 receive training on reducing the risk of sudden infant death 37.10 syndrome. The training on reducing the risk of sudden infant 37.11 death syndrome may be provided as orientation training under 37.12 Minnesota Rules, part 9503.0035, subpart 1, as initial training 37.13 under Minnesota Rules, part 9502.0385, subpart 2, as in-service 37.14 training under Minnesota Rules, part 9503.0035, subpart 4, or as 37.15 ongoing training under Minnesota Rules, part 9502.0385, subpart 37.16 3. Training required under this section must be at least one 37.17 hour in length and must be completed at least once every five 37.18 years. At a minimum, the training must address the risk factors 37.19 related to sudden infant death syndrome, means of reducing the 37.20 risk of sudden infant death syndrome in child care, and license 37.21 holder communication with parents regarding reducing the risk of 37.22 sudden infant death syndrome. Training for family and group 37.23 family child care providers must be approved by the county 37.24 licensing agency according to Minnesota Rules, part 9502.0385. 37.25 Sec. 18. [245A.151] [FIRE MARSHAL INSPECTION.] 37.26 When the requirements for licensure under this chapter 37.27 require a fire marshal to inspect a facility for compliance with 37.28 the Minnesota Uniform Fire Code under section 299F.011, a local 37.29 fire code inspector may conduct the inspection. If a community 37.30 does not have a local fire code inspector, a local fire code 37.31 inspector from another community may conduct the inspection and 37.32 may charge an applicant or license holder a fee for the actual 37.33 cost of the inspection not to exceed $50 per inspection. 37.34 Sec. 19. Minnesota Statutes 2001 Supplement, section 37.35 245A.16, subdivision 1, is amended to read: 37.36 Subdivision 1. [DELEGATION OF AUTHORITY TO AGENCIES.] (a) 38.1 County agencies and private agencies that have been designated 38.2 or licensed by the commissioner to perform licensing functions 38.3 and activities under section 245A.04, to recommend denial of 38.4 applicants under section 245A.05, to issue correction orders, to 38.5 issue variances, and recommend a conditional license under 38.6 section 245A.06, or to recommend suspending or revoking a 38.7 license or issuing a fine under section 245A.07, shall comply 38.8 with rules and directives of the commissioner governing those 38.9 functions and with this section. The following variances are 38.10 excluded from the delegation of variance authority and may be 38.11 issued only by the commissioner: 38.12 (1) dual licensure of family child care and child foster 38.13 care, dual licensure of child and adult foster care, and adult 38.14 foster care and family child care; 38.15 (2) adult foster care maximum capacity; 38.16 (3) adult foster care minimum age requirement; 38.17 (4) child foster care maximum age requirement; 38.18 (5) variances regarding disqualified individuals except 38.19 that county agencies may issue variances under section 245A.04, 38.20 subdivision 3e, regarding disqualified individuals when the 38.21 county is responsible for conducting a consolidated 38.22 reconsideration according to section 245A.04, subdivision 3b, 38.23 paragraph (f), of a county maltreatment determination and a 38.24 disqualification based on serious or recurring maltreatment; and 38.25 (6) the required presence of a caregiver in the adult 38.26 foster care residence during normal sleeping hours. 38.27 (b) County agencies must report information about 38.28 disqualification reconsiderations under section 245A.04, 38.29 subdivision 3b, paragraph (f), and variances granted under 38.30 paragraph (a), clause (5), to the commissioner at least monthly 38.31 in a format prescribed by the commissioner. 38.32 (c) For family day care programs, the commissioner may 38.33 authorize licensing reviews every two years after a licensee has 38.34 had at least one annual review. 38.35 Sec. 20. Minnesota Statutes 2001 Supplement, section 38.36 256.045, subdivision 3b, is amended to read: 39.1 Subd. 3b. [STANDARD OF EVIDENCE FOR MALTREATMENT AND 39.2 DISQUALIFICATION HEARINGS.] (a) The state human services referee 39.3 shall determine that maltreatment has occurred if a 39.4 preponderance of evidence exists to support the final 39.5 disposition under sections 626.556 and 626.557. For purposes of 39.6 hearings regarding disqualification, the state human services 39.7 referee shall affirm the proposed disqualification in an appeal 39.8 under subdivision 3, paragraph (a), clause (9), if a 39.9 preponderance of the evidence shows the individual has: 39.10 (1) committed maltreatment under section 626.556 or 39.11 626.557, which is serious or recurring; 39.12 (2) committed an act or acts meeting the definition of any 39.13 of the crimes listed in section 245A.04, subdivision 3d, 39.14 paragraph (a), clauses (1) to (4); or 39.15 (3) failed to make required reports under section 626.556 39.16 or 626.557, for incidents in which:39.17(i)the final disposition under section 626.556 or 626.557 39.18 was substantiated maltreatment; and39.19(ii) the maltreatment was recurring or serious; or39.20substantiated serious or recurring maltreatment of a minor under39.21section 626.556 or of a vulnerable adult under section 626.55739.22for which there is a preponderance of evidence that the39.23maltreatment occurred, and that the subject was responsible for39.24the maltreatmentthat was serious or recurring. 39.25 (b) If the disqualification is affirmed, the state human 39.26 services referee shall determine whether the individual poses a 39.27 risk of harm in accordance with the requirements of section 39.28 245A.04, subdivision 3b. 39.29 (c) The state human services referee shall recommend an 39.30 order to the commissioner of health, children, families, and 39.31 learning, or human services, as applicable, who shall issue a 39.32 final order. The commissioner shall affirm, reverse, or modify 39.33 the final disposition. Any order of the commissioner issued in 39.34 accordance with this subdivision is conclusive upon the parties 39.35 unless appeal is taken in the manner provided in subdivision 7. 39.36Except as provided under section 245A.04, subdivisions 3b,40.1paragraphs (e) and (f), and 3c,In any licensing appeal under 40.2 chapter 245A and sections 144.50 to 144.58 and 144A.02 to 40.3 144A.46, the commissioner's determination as to maltreatment is 40.4 conclusive as provided under section 245A.04, subdivision 3f. 40.5 Sec. 21. Minnesota Statutes 2001 Supplement, section 40.6 256.045, subdivision 4, is amended to read: 40.7 Subd. 4. [CONDUCT OF HEARINGS.] (a) All hearings held 40.8 pursuant to subdivision 3, 3a, 3b, or 4a shall be conducted 40.9 according to the provisions of the federal Social Security Act 40.10 and the regulations implemented in accordance with that act to 40.11 enable this state to qualify for federal grants-in-aid, and 40.12 according to the rules and written policies of the commissioner 40.13 of human services. County agencies shall install equipment 40.14 necessary to conduct telephone hearings. A state human services 40.15 referee may schedule a telephone conference hearing when the 40.16 distance or time required to travel to the county agency offices 40.17 will cause a delay in the issuance of an order, or to promote 40.18 efficiency, or at the mutual request of the parties. Hearings 40.19 may be conducted by telephone conferences unless the applicant, 40.20 recipient, former recipient, person, or facility contesting 40.21 maltreatment objects. The hearing shall not be held earlier 40.22 than five days after filing of the required notice with the 40.23 county or state agency. The state human services referee shall 40.24 notify all interested persons of the time, date, and location of 40.25 the hearing at least five days before the date of the hearing. 40.26 Interested persons may be represented by legal counsel or other 40.27 representative of their choice, including a provider of therapy 40.28 services, at the hearing and may appear personally, testify and 40.29 offer evidence, and examine and cross-examine witnesses. The 40.30 applicant, recipient, former recipient, person, or facility 40.31 contesting maltreatment shall have the opportunity to examine 40.32 the contents of the case file and all documents and records to 40.33 be used by the county or state agency at the hearing at a 40.34 reasonable time before the date of the hearing and during the 40.35 hearing. In hearings under subdivision 3, paragraph (a), 40.36 clauses (4), (8), and (9), either party may subpoena the private 41.1 data relating to the investigation prepared by the agency under 41.2 section 626.556 or 626.557 that is not otherwise accessible 41.3 under section 13.04, provided the identity of the reporter may 41.4 not be disclosed. 41.5 (b) The private data obtained by subpoena in a hearing 41.6 under subdivision 3, paragraph (a), clause (4), (8), or (9), 41.7 must be subject to a protective order which prohibits its 41.8 disclosure for any other purpose outside the hearing provided 41.9 for in this section without prior order of the district court. 41.10 Disclosure without court order is punishable by a sentence of 41.11 not more than 90 days imprisonment or a fine of not more than 41.12 $700, or both. These restrictions on the use of private data do 41.13 not prohibit access to the data under section 13.03, subdivision 41.14 6. Except for appeals under subdivision 3, paragraph (a), 41.15 clauses (4), (5), (8), and (9), upon request, the county agency 41.16 shall provide reimbursement for transportation, child care, 41.17 photocopying, medical assessment, witness fee, and other 41.18 necessary and reasonable costs incurred by the applicant, 41.19 recipient, or former recipient in connection with the appeal. 41.20 All evidence, except that privileged by law, commonly accepted 41.21 by reasonable people in the conduct of their affairs as having 41.22 probative value with respect to the issues shall be submitted at 41.23 the hearing and such hearing shall not be "a contested case" 41.24 within the meaning of section 14.02, subdivision 3. The agency 41.25 must present its evidence prior to or at the hearing, and may 41.26 not submit evidence after the hearing except by agreement of the 41.27 parties at the hearing, provided the petitioner has the 41.28 opportunity to respond. 41.29 (c) In hearings under subdivision 3, paragraph (a), clauses 41.30 (4), (8), and (9), involving determinations of maltreatment or 41.31 disqualification made by more than one county agency, by a 41.32 county agency and a state agency, or by more than one state 41.33 agency, the hearings may be consolidated into a single fair 41.34 hearing upon the consent of all parties and the state human 41.35 services referee. 41.36 Sec. 22. Minnesota Statutes 2001 Supplement, section 42.1 626.556, subdivision 10i, is amended to read: 42.2 Subd. 10i. [ADMINISTRATIVE RECONSIDERATION OF FINAL 42.3 DETERMINATION OF MALTREATMENT AND DISQUALIFICATION BASED ON 42.4 SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as 42.5 provided under paragraph (e), an individual or facility that the 42.6 commissioner of human services, a local social service agency, 42.7 or the commissioner of children, families, and learning 42.8 determines has maltreated a child, an interested person acting 42.9 on behalf of the child, regardless of the determination, who 42.10 contests the investigating agency's final determination 42.11 regarding maltreatment, may request the investigating agency to 42.12 reconsider its final determination regarding maltreatment. The 42.13 request for reconsideration must be submitted in writing to the 42.14 investigating agency within 15 calendar days after receipt of 42.15 notice of the final determination regarding maltreatment or, if 42.16 the request is made by an interested person who is not entitled 42.17 to notice, within 15 days after receipt of the notice by the 42.18 parent or guardian of the child. Effective January 1, 2002, an 42.19 individual who was determined to have maltreated a child under 42.20 this section and who was disqualified on the basis of serious or 42.21 recurring maltreatment under section 245A.04, subdivision 3d, 42.22 may request reconsideration of the maltreatment determination 42.23 and the disqualification. The request for reconsideration of 42.24 the maltreatment determination and the disqualification must be 42.25 submitted within 30 calendar days of the individual's receipt of 42.26 the notice of disqualification under section 245A.04, 42.27 subdivision 3a. 42.28 (b) Except as provided under paragraphs (e) and (f), if the 42.29 investigating agency denies the request or fails to act upon the 42.30 request within 15 calendar days after receiving the request for 42.31 reconsideration, the person or facility entitled to a fair 42.32 hearing under section 256.045 may submit to the commissioner of 42.33 human services or the commissioner of children, families, and 42.34 learning a written request for a hearing under that section. 42.35 Section 256.045 also governs hearings requested to contest a 42.36 final determination of the commissioner of children, families, 43.1 and learning. For reports involving maltreatment of a child in 43.2 a facility, an interested person acting on behalf of the child 43.3 may request a review by the child maltreatment review panel 43.4 under section 256.022 if the investigating agency denies the 43.5 request or fails to act upon the request or if the interested 43.6 person contests a reconsidered determination. The investigating 43.7 agency shall notify persons who request reconsideration of their 43.8 rights under this paragraph. The request must be submitted in 43.9 writing to the review panel and a copy sent to the investigating 43.10 agency within 30 calendar days of receipt of notice of a denial 43.11 of a request for reconsideration or of a reconsidered 43.12 determination. The request must specifically identify the 43.13 aspects of the agency determination with which the person is 43.14 dissatisfied. 43.15 (c) If, as a result of a reconsideration or review, the 43.16 investigating agency changes the final determination of 43.17 maltreatment, that agency shall notify the parties specified in 43.18 subdivisions 10b, 10d, and 10f. 43.19 (d) Except as provided under paragraph (f), if an 43.20 individual or facility contests the investigating agency's final 43.21 determination regarding maltreatment by requesting a fair 43.22 hearing under section 256.045, the commissioner of human 43.23 services shall assure that the hearing is conducted and a 43.24 decision is reached within 90 days of receipt of the request for 43.25 a hearing. The time for action on the decision may be extended 43.26 for as many days as the hearing is postponed or the record is 43.27 held open for the benefit of either party. 43.28 (e) Effective January 1, 2002, if an individual was 43.29 disqualified under section 245A.04, subdivision 3d, on the basis 43.30 of a determination of maltreatment, which was serious or 43.31 recurring, and the individual has requested reconsideration of 43.32 the maltreatment determination under paragraph (a) and requested 43.33 reconsideration of the disqualification under section 245A.04, 43.34 subdivision 3b, reconsideration of the maltreatment 43.35 determination and reconsideration of the disqualification shall 43.36 be consolidated into a single reconsideration. If 44.1 reconsideration of the maltreatment determination is denied or 44.2 the disqualification is not set aside or rescinded under section 44.3 245A.04, subdivision 3b, the individual may request a fair 44.4 hearing under section 256.045. If an individualdisqualified on44.5the basis of a determination of maltreatment, which was serious44.6or recurringrequests a fair hearingunder paragraph (b)on the 44.7 maltreatment determination and the disqualification, the scope 44.8 of the fair hearing shall include both the maltreatment 44.9 determination and the disqualification. 44.10 (f) Effective January 1, 2002, if a maltreatment 44.11 determination or a disqualification based on serious or 44.12 recurring maltreatment is the basis for a denial of a license 44.13 under section 245A.05 or a licensing sanction under section 44.14 245A.07, the license holder has the right to a contested case 44.15 hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to 44.16 1400.8612 and successor rules. As provided for under section 44.17 245A.08, subdivision 2a, the scope of the contested case hearing 44.18 shall include the maltreatment determination, disqualification, 44.19 and licensing sanction or denial of a license. In such cases, a 44.20 fair hearing regarding the maltreatment determination shall not 44.21 be conducted under paragraph (b). If the disqualified subject 44.22 is an individual other than the license holder and upon whom a 44.23 background study must be conducted under section 245A.04, 44.24 subdivision 3, the hearings of all parties may be consolidated 44.25 into a single contested case hearing upon consent of all parties 44.26 and the administrative law judge. 44.27 (g) For purposes of this subdivision, "interested person 44.28 acting on behalf of the child" means a parent or legal guardian; 44.29 stepparent; grandparent; guardian ad litem; adult stepbrother, 44.30 stepsister, or sibling; or adult aunt or uncle; unless the 44.31 person has been determined to be the perpetrator of the 44.32 maltreatment. 44.33 Sec. 23. Minnesota Statutes 2000, section 626.557, 44.34 subdivision 3a, is amended to read: 44.35 Subd. 3a. [REPORT NOT REQUIRED.] The following events are 44.36 not required to be reported under this section: 45.1 (a) A circumstance where federal law specifically prohibits 45.2 a person from disclosing patient identifying information in 45.3 connection with a report of suspected maltreatment, unless the 45.4 vulnerable adult, or the vulnerable adult's guardian, 45.5 conservator, or legal representative, has consented to 45.6 disclosure in a manner which conforms to federal requirements. 45.7 Facilities whose patients or residents are covered by such a 45.8 federal law shall seek consent to the disclosure of suspected 45.9 maltreatment from each patient or resident, or a guardian, 45.10 conservator, or legal representative, upon the patient's or 45.11 resident's admission to the facility. Persons who are 45.12 prohibited by federal law from reporting an incident of 45.13 suspected maltreatment shall immediately seek consent to make a 45.14 report. 45.15 (b) Verbal or physical aggression occurring between 45.16 patients, residents, or clients of a facility, or self-abusive 45.17 behavior by these persons does not constitute abuse unless the 45.18 behavior causes serious harm. The operator of the facility or a 45.19 designee shall record incidents of aggression and self-abusive 45.20 behavior to facilitate review by licensing agencies and county 45.21 and local welfare agencies. 45.22 (c) Accidents as defined in section 626.5572, subdivision 3. 45.23 (d) Events occurring in a facility that result from an 45.24 individual'ssingle mistakeerror in the provision of 45.25 therapeutic conduct to a vulnerable adult, asdefinedprovided 45.26 in section 626.5572, subdivision 17, paragraph (c), clause (4). 45.27 (e) Nothing in this section shall be construed to require a 45.28 report of financial exploitation, as defined in section 45.29 626.5572, subdivision 9, solely on the basis of the transfer of 45.30 money or property by gift or as compensation for services 45.31 rendered. 45.32 Sec. 24. Minnesota Statutes 2001 Supplement, section 45.33 626.557, subdivision 9d, is amended to read: 45.34 Subd. 9d. [ADMINISTRATIVE RECONSIDERATION OF FINAL 45.35 DISPOSITION OF MALTREATMENT AND DISQUALIFICATION BASED ON 45.36 SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as 46.1 provided under paragraph (e), any individual or facility which a 46.2 lead agency determines has maltreated a vulnerable adult, or the 46.3 vulnerable adult or an interested person acting on behalf of the 46.4 vulnerable adult, regardless of the lead agency's determination, 46.5 who contests the lead agency's final disposition of an 46.6 allegation of maltreatment, may request the lead agency to 46.7 reconsider its final disposition. The request for 46.8 reconsideration must be submitted in writing to the lead agency 46.9 within 15 calendar days after receipt of notice of final 46.10 disposition or, if the request is made by an interested person 46.11 who is not entitled to notice, within 15 days after receipt of 46.12 the notice by the vulnerable adult or the vulnerable adult's 46.13 legal guardian. An individual who was determined to have 46.14 maltreated a vulnerable adult under this section and who was 46.15 disqualified on the basis of serious or recurring maltreatment 46.16 under section 245A.04, subdivision 3d, may request 46.17 reconsideration of the maltreatment determination and the 46.18 disqualification. The request for reconsideration of the 46.19 maltreatment determination and the disqualification must be 46.20 submitted within 30 calendar days of the individual's receipt of 46.21 the notice of disqualification under section 245A.04, 46.22 subdivision 3a. 46.23 (b) Except as provided under paragraphs (e) and (f), if the 46.24 lead agency denies the request or fails to act upon the request 46.25 within 15 calendar days after receiving the request for 46.26 reconsideration, the person or facility entitled to a fair 46.27 hearing under section 256.045, may submit to the commissioner of 46.28 human services a written request for a hearing under that 46.29 statute. The vulnerable adult, or an interested person acting 46.30 on behalf of the vulnerable adult, may request a review by the 46.31 vulnerable adult maltreatment review panel under section 256.021 46.32 if the lead agency denies the request or fails to act upon the 46.33 request, or if the vulnerable adult or interested person 46.34 contests a reconsidered disposition. The lead agency shall 46.35 notify persons who request reconsideration of their rights under 46.36 this paragraph. The request must be submitted in writing to the 47.1 review panel and a copy sent to the lead agency within 30 47.2 calendar days of receipt of notice of a denial of a request for 47.3 reconsideration or of a reconsidered disposition. The request 47.4 must specifically identify the aspects of the agency 47.5 determination with which the person is dissatisfied. 47.6 (c) If, as a result of a reconsideration or review, the 47.7 lead agency changes the final disposition, it shall notify the 47.8 parties specified in subdivision 9c, paragraph (d). 47.9 (d) For purposes of this subdivision, "interested person 47.10 acting on behalf of the vulnerable adult" means a person 47.11 designated in writing by the vulnerable adult to act on behalf 47.12 of the vulnerable adult, or a legal guardian or conservator or 47.13 other legal representative, a proxy or health care agent 47.14 appointed under chapter 145B or 145C, or an individual who is 47.15 related to the vulnerable adult, as defined in section 245A.02, 47.16 subdivision 13. 47.17 (e) If an individual was disqualified under section 47.18 245A.04, subdivision 3d, on the basis of a determination of 47.19 maltreatment, which was serious or recurring, and the individual 47.20 has requested reconsideration of the maltreatment determination 47.21 under paragraph (a) and reconsideration of the disqualification 47.22 under section 245A.04, subdivision 3b, reconsideration of the 47.23 maltreatment determination and requested reconsideration of the 47.24 disqualification shall be consolidated into a single 47.25 reconsideration. If reconsideration of the maltreatment 47.26 determination is denied or if the disqualification is not set 47.27 aside or rescinded under section 245A.04, subdivision 3b, the 47.28 individual may request a fair hearing under section 256.045. If 47.29 an individualwho was disqualified on the basis of serious or47.30recurring maltreatmentrequests a fair hearingunder paragraph47.31(b)on the maltreatment determination and the disqualification, 47.32 the scope of the fair hearing shall include both the 47.33 maltreatment determination and the disqualification. 47.34 (f) If a maltreatment determination or a disqualification 47.35 based on serious or recurring maltreatment is the basis for a 47.36 denial of a license under section 245A.05 or a licensing 48.1 sanction under section 245A.07, the license holder has the right 48.2 to a contested case hearing under chapter 14 and Minnesota 48.3 Rules, parts 1400.8510 to 1400.8612 and successor rules. As 48.4 provided for under section 245A.08, the scope of the contested 48.5 case hearing shall include the maltreatment determination, 48.6 disqualification, and licensing sanction or denial of a 48.7 license. In such cases, a fair hearing shall not be conducted 48.8 under paragraph (b). If the disqualified subject is an 48.9 individual other than the license holder and upon whom a 48.10 background study must be conducted under section 245A.04, 48.11 subdivision 3, the hearings of all parties may be consolidated 48.12 into a single contested case hearing upon consent of all parties 48.13 and the administrative law judge. 48.14 (g) Until August 1, 2002, an individual or facility that 48.15 was determined by the commissioner of human services or the 48.16 commissioner of health to be responsible for neglect under 48.17 section 626.5572, subdivision 17, after October 1, 1995, and 48.18 before August 1, 2001, that believes that the finding of neglect 48.19 does not meet an amended definition of neglect may request a 48.20 reconsideration of the determination of neglect. The 48.21 commissioner of human services or the commissioner of health 48.22 shall mail a notice to the last known address of individuals who 48.23 are eligible to seek this reconsideration. The request for 48.24 reconsideration must state how the established findings no 48.25 longer meet the elements of the definition of neglect. The 48.26 commissioner shall review the request for reconsideration and 48.27 make a determination within 15 calendar days. The 48.28 commissioner's decision on this reconsideration is the final 48.29 agency action. 48.30 (1) For purposes of compliance with the data destruction 48.31 schedule under subdivision 12b, paragraph (d), when a finding of 48.32 substantiated maltreatment has been changed as a result of a 48.33 reconsideration under this paragraph, the date of the original 48.34 finding of a substantiated maltreatment must be used to 48.35 calculate the destruction date. 48.36 (2) For purposes of any background studies under section 49.1 245A.04, when a determination of substantiated maltreatment has 49.2 been changed as a result of a reconsideration under this 49.3 paragraph, any prior disqualification of the individual under 49.4 section 245A.04 that was based on this determination of 49.5 maltreatment shall be rescinded, and for future background 49.6 studies under section 245A.04 the commissioner must not use the 49.7 previous determination of substantiated maltreatment as a basis 49.8 for disqualification or as a basis for referring the 49.9 individual's maltreatment history to a health-related licensing 49.10 board under section 245A.04, subdivision 3d, paragraph (b). 49.11 ARTICLE 2 49.12 CONTINUING CARE PROGRAMS 49.13 Section 1. Minnesota Statutes 2001 Supplement, section 49.14 144A.071, subdivision 1a, is amended to read: 49.15 Subd. 1a. [DEFINITIONS.] For purposes of sections 144A.071 49.16 to 144A.073, the following terms have the meanings given them: 49.17 (a) "Attached fixtures" has the meaning given in Minnesota 49.18 Rules, part 9549.0020, subpart 6. 49.19 (b) "Buildings" has the meaning given in Minnesota Rules, 49.20 part 9549.0020, subpart 7. 49.21 (c) "Capital assets" has the meaning given in section 49.22 256B.421, subdivision 16. 49.23 (d) "Commenced construction" means that all of the 49.24 following conditions were met: the final working drawings and 49.25 specifications were approved by the commissioner of health; the 49.26 construction contracts were let; a timely construction schedule 49.27 was developed, stipulating dates for beginning, achieving 49.28 various stages, and completing construction; and all zoning and 49.29 building permits were applied for. 49.30 (e) "Completion date" means the date on which a certificate 49.31 of occupancy is issued for a construction project, or if a 49.32 certificate of occupancy is not required, the date on which the 49.33 construction project is available for facility use. 49.34 (f) "Construction" means any erection, building, 49.35 alteration, reconstruction, modernization, or improvement 49.36 necessary to comply with the nursing home licensure rules. 50.1 (g) "Construction project" means: 50.2 (1) a capital asset addition to, or replacement of a 50.3 nursing home or certified boarding care home that results in new 50.4 space or the remodeling of or renovations to existing facility 50.5 space; 50.6 (2) the remodeling or renovation of existing facility space 50.7 the use of which is modified as a result of the project 50.8 described in clause (1). This existing space and the project 50.9 described in clause (1) must be used for the functions as 50.10 designated on the construction plans on completion of the 50.11 project described in clause (1) for a period of not less than 24 50.12 months; or 50.13 (3) capital asset additions or replacements that are 50.14 completed within 12 months before or after the completion date 50.15 of the project described in clause (1). 50.16 (h) "New licensed" or "new certified beds" means: 50.17 (1) newly constructed beds in a facility or the 50.18 construction of a new facility that would increase the total 50.19 number of licensed nursing home beds or certified boarding care 50.20 or nursing home beds in the state; or 50.21 (2) newly licensed nursing home beds or newly certified 50.22 boarding care or nursing home beds that result from remodeling 50.23 of the facility that involves relocation of beds but does not 50.24 result in an increase in the total number of beds, except when 50.25 the project involves the upgrade of boarding care beds to 50.26 nursing home beds, as defined in section 144A.073, subdivision 50.27 1. "Remodeling" includes any of the type of conversion, 50.28 renovation, replacement, or upgrading projects as defined in 50.29 section 144A.073, subdivision 1. 50.30 (i) "Project construction costs" means the cost of the 50.31 facility capital asset additions, replacements, renovations, or 50.32 remodeling projects, construction site preparation costs, and 50.33 related soft costs. Project construction costs include the cost 50.34 of any remodeling or renovation of existing facility space which 50.35 is modified as a result of the construction project. Project 50.36 construction costs also includes the cost of new technology 51.1 implemented as part of the construction project. Project 51.2 construction costs also include the cost of new technology 51.3 implemented as part of the construction project and depreciable 51.4 equipment directly identified to the project. Any new 51.5 technology and depreciable equipment included in the project 51.6 construction costs shall, at the written election of the 51.7 facility, be included in the facility's appraised value for 51.8 purposes of Minnesota Rules, part 9549.0020, subpart 5, and debt 51.9 incurred for its purchase shall be included as allowable debt 51.10 for purposes of Minnesota Rules, part 9549.0060, subpart 5, 51.11 items A and C. Any new technology and depreciable equipment 51.12 included in the project construction costs that the facility 51.13 elects not to include in its appraised value and allowable debts 51.14 shall be treated as provided in section 256B.431, subdivision 51.15 17, paragraph (b). Written election under this paragraph must 51.16 be included in the facility's request for the rate change 51.17 related to the project, and this election may not be changed. 51.18 (j) "Technology" means information systems or devices that 51.19 make documentation, charting, and staff time more efficient or 51.20 encourage and allow for care through alternative settings 51.21 including, but not limited to, touch screens, monitors, 51.22 hand-helds, swipe cards, motion detectors, pagers, telemedicine, 51.23 medication dispensers, and equipment to monitor vital signs and 51.24 self-injections, and to observe skin and other conditions. 51.25 Sec. 2. Minnesota Statutes 2001 Supplement, section 51.26 144A.36, subdivision 1, is amended to read: 51.27 Subdivision 1. [DEFINITIONS.] "Eligible nursing home" 51.28 means any nursing home licensed under sections 144A.01 to 51.29 144A.155andor a boarding care facility, certified by the 51.30 appropriate authority under United States Code, title 42, 51.31 sections 1396-1396p, to participate as a vendor in the medical 51.32 assistance program established under chapter 256B. 51.33 Sec. 3. Minnesota Statutes 2000, section 245.462, 51.34 subdivision 4, is amended to read: 51.35 Subd. 4. [CASE MANAGEMENT SERVICE PROVIDER.] (a) "Case 51.36 management service provider" means a case manager or case 52.1 manager associate employed by the county or other entity 52.2 authorized by the county board to provide case management 52.3 services specified in section 245.4711. 52.4 (b) A case manager must: 52.5 (1) be skilled in the process of identifying and assessing 52.6 a wide range of client needs; 52.7 (2) be knowledgeable about local community resources and 52.8 how to use those resources for the benefit of the client; 52.9 (3) have a bachelor's degree in one of the behavioral 52.10 sciences or related fields including, but not limited to, social 52.11 work, psychology, or nursing from an accredited college or 52.12 university or meet the requirements of paragraph (c); and 52.13 (4) meet the supervision and continuing education 52.14 requirements described in paragraphs (d), (e), and (f), as 52.15 applicable. 52.16 (c) Case managers without a bachelor's degree must meet one 52.17 of the requirements in clauses (1) to (3): 52.18 (1) have three or four years of experience as a case 52.19 manager associate as defined in this section; 52.20 (2) be a registered nurse without a bachelor's degree and 52.21 have a combination of specialized training in psychiatry and 52.22 work experience consisting of community interaction and 52.23 involvement or community discharge planning in a mental health 52.24 setting totaling three years; or 52.25 (3) be a person who qualified as a case manager under the 52.26 1998 department of human service waiver provision and meet the 52.27 continuing education and mentoring requirements in this section. 52.28 (d) A case manager with at least 2,000 hours of supervised 52.29 experience in the delivery of services to adults with mental 52.30 illness must receive regular ongoing supervision and clinical 52.31 supervision totaling 38 hours per year of which at least one 52.32 hour per month must be clinical supervision regarding individual 52.33 service delivery with a case management supervisor. The 52.34 remaining 26 hours of supervision may be provided by a case 52.35 manager with two years of experience. Group supervision may not 52.36 constitute more than one-half of the required supervision 53.1 hours. Clinical supervision must be documented in the client 53.2 record. 53.3 (e) A case manager without 2,000 hours of supervised 53.4 experience in the delivery of services to adults with mental 53.5 illness must: 53.6 (1) receive clinical supervision regarding individual 53.7 service delivery from a mental health professional at least one 53.8 hour per week until the requirement of 2,000 hours of experience 53.9 is met; and 53.10 (2) complete 40 hours of training approved by the 53.11 commissioner in case management skills and the characteristics 53.12 and needs of adults with serious and persistent mental illness. 53.13 (f) A case manager who is not licensed, registered, or 53.14 certified by a health-related licensing board must receive 30 53.15 hours of continuing education and training in mental illness and 53.16 mental health servicesannuallyevery two years. 53.17 (g) A case manager associate (CMA) must: 53.18 (1) work under the direction of a case manager or case 53.19 management supervisor; 53.20 (2) be at least 21 years of age; 53.21 (3) have at least a high school diploma or its equivalent; 53.22 and 53.23 (4) meet one of the following criteria: 53.24 (i) have an associate of arts degree in one of the 53.25 behavioral sciences or human services; 53.26 (ii) be a registered nurse without a bachelor's degree; 53.27 (iii) within the previous ten years, have three years of 53.28 life experience with serious and persistent mental illness as 53.29 defined in section 245.462, subdivision 20; or as a child had 53.30 severe emotional disturbance as defined in section 245.4871, 53.31 subdivision 6; or have three years life experience as a primary 53.32 caregiver to an adult with serious and persistent mental illness 53.33 within the previous ten years; 53.34 (iv) have 6,000 hours work experience as a nondegreed state 53.35 hospital technician; or 53.36 (v) be a mental health practitioner as defined in section 54.1 245.462, subdivision 17, clause (2). 54.2 Individuals meeting one of the criteria in items (i) to 54.3 (iv), may qualify as a case manager after four years of 54.4 supervised work experience as a case manager associate. 54.5 Individuals meeting the criteria in item (v), may qualify as a 54.6 case manager after three years of supervised experience as a 54.7 case manager associate. 54.8 (h) A case management associate must meet the following 54.9 supervision, mentoring, and continuing education requirements: 54.10 (1) have 40 hours of preservice training described under 54.11 paragraph (e), clause (2); 54.12 (2) receive at least 40 hours of continuing education in 54.13 mental illness and mental health services annually; and 54.14 (3) receive at least five hours of mentoring per week from 54.15 a case management mentor. 54.16 A "case management mentor" means a qualified, practicing case 54.17 manager or case management supervisor who teaches or advises and 54.18 provides intensive training and clinical supervision to one or 54.19 more case manager associates. Mentoring may occur while 54.20 providing direct services to consumers in the office or in the 54.21 field and may be provided to individuals or groups of case 54.22 manager associates. At least two mentoring hours per week must 54.23 be individual and face-to-face. 54.24 (i) A case management supervisor must meet the criteria for 54.25 mental health professionals, as specified in section 245.462, 54.26 subdivision 18. 54.27 (j) An immigrant who does not have the qualifications 54.28 specified in this subdivision may provide case management 54.29 services to adult immigrants with serious and persistent mental 54.30 illness who are members of the same ethnic group as the case 54.31 manager if the person: 54.32 (1) is currently enrolled in and is actively pursuing 54.33 credits toward the completion of a bachelor's degree in one of 54.34 the behavioral sciences or a related field including, but not 54.35 limited to, social work, psychology, or nursing from an 54.36 accredited college or university; 55.1 (2) completes 40 hours of training as specified in this 55.2 subdivision; and 55.3 (3) receives clinical supervision at least once a week 55.4 until the requirements of this subdivision are met. 55.5 Sec. 4. Minnesota Statutes 2000, section 245.4871, 55.6 subdivision 4, is amended to read: 55.7 Subd. 4. [CASE MANAGEMENT SERVICE PROVIDER.] (a) "Case 55.8 management service provider" means a case manager or case 55.9 manager associate employed by the county or other entity 55.10 authorized by the county board to provide case management 55.11 services specified in subdivision 3 for the child with severe 55.12 emotional disturbance and the child's family. 55.13 (b) A case manager must: 55.14 (1) have experience and training in working with children; 55.15 (2) have at least a bachelor's degree in one of the 55.16 behavioral sciences or a related field including, but not 55.17 limited to, social work, psychology, or nursing from an 55.18 accredited college or university or meet the requirements of 55.19 paragraph (d); 55.20 (3) have experience and training in identifying and 55.21 assessing a wide range of children's needs; 55.22 (4) be knowledgeable about local community resources and 55.23 how to use those resources for the benefit of children and their 55.24 families; and 55.25 (5) meet the supervision and continuing education 55.26 requirements of paragraphs (e), (f), and (g), as applicable. 55.27 (c) A case manager may be a member of any professional 55.28 discipline that is part of the local system of care for children 55.29 established by the county board. 55.30 (d) A case manager without a bachelor's degree must meet 55.31 one of the requirements in clauses (1) to (3): 55.32 (1) have three or four years of experience as a case 55.33 manager associate; 55.34 (2) be a registered nurse without a bachelor's degree who 55.35 has a combination of specialized training in psychiatry and work 55.36 experience consisting of community interaction and involvement 56.1 or community discharge planning in a mental health setting 56.2 totaling three years; or 56.3 (3) be a person who qualified as a case manager under the 56.4 1998 department of human services waiver provision and meets the 56.5 continuing education, supervision, and mentoring requirements in 56.6 this section. 56.7 (e) A case manager with at least 2,000 hours of supervised 56.8 experience in the delivery of mental health services to children 56.9 must receive regular ongoing supervision and clinical 56.10 supervision totaling 38 hours per year, of which at least one 56.11 hour per month must be clinical supervision regarding individual 56.12 service delivery with a case management supervisor. The other 56.13 26 hours of supervision may be provided by a case manager with 56.14 two years of experience. Group supervision may not constitute 56.15 more than one-half of the required supervision hours. 56.16 (f) A case manager without 2,000 hours of supervised 56.17 experience in the delivery of mental health services to children 56.18 with emotional disturbance must: 56.19 (1) begin 40 hours of training approved by the commissioner 56.20 of human services in case management skills and in the 56.21 characteristics and needs of children with severe emotional 56.22 disturbance before beginning to provide case management 56.23 services; and 56.24 (2) receive clinical supervision regarding individual 56.25 service delivery from a mental health professional at least one 56.26 hour each week until the requirement of 2,000 hours of 56.27 experience is met. 56.28 (g) A case manager who is not licensed, registered, or 56.29 certified by a health-related licensing board must receive 30 56.30 hours of continuing education and training in severe emotional 56.31 disturbance and mental health servicesannuallyevery two years. 56.32 (h) Clinical supervision must be documented in the child's 56.33 record. When the case manager is not a mental health 56.34 professional, the county board must provide or contract for 56.35 needed clinical supervision. 56.36 (i) The county board must ensure that the case manager has 57.1 the freedom to access and coordinate the services within the 57.2 local system of care that are needed by the child. 57.3 (j) A case manager associate (CMA) must: 57.4 (1) work under the direction of a case manager or case 57.5 management supervisor; 57.6 (2) be at least 21 years of age; 57.7 (3) have at least a high school diploma or its equivalent; 57.8 and 57.9 (4) meet one of the following criteria: 57.10 (i) have an associate of arts degree in one of the 57.11 behavioral sciences or human services; 57.12 (ii) be a registered nurse without a bachelor's degree; 57.13 (iii) have three years of life experience as a primary 57.14 caregiver to a child with serious emotional disturbance as 57.15 defined in section 245.4871, subdivision 6, within the previous 57.16 ten years; 57.17 (iv) have 6,000 hours work experience as a nondegreed state 57.18 hospital technician; or 57.19 (v) be a mental health practitioner as defined in 57.20 subdivision 26, clause (2). 57.21 Individuals meeting one of the criteria in items (i) to 57.22 (iv) may qualify as a case manager after four years of 57.23 supervised work experience as a case manager associate. 57.24 Individuals meeting the criteria in item (v) may qualify as a 57.25 case manager after three years of supervised experience as a 57.26 case manager associate. 57.27 (k) Case manager associates must meet the following 57.28 supervision, mentoring, and continuing education requirements; 57.29 (1) have 40 hours of preservice training described under 57.30 paragraph (f), clause (1); 57.31 (2) receive at least 40 hours of continuing education in 57.32 severe emotional disturbance and mental health service annually; 57.33 and 57.34 (3) receive at least five hours of mentoring per week from 57.35 a case management mentor. A "case management mentor" means a 57.36 qualified, practicing case manager or case management supervisor 58.1 who teaches or advises and provides intensive training and 58.2 clinical supervision to one or more case manager associates. 58.3 Mentoring may occur while providing direct services to consumers 58.4 in the office or in the field and may be provided to individuals 58.5 or groups of case manager associates. At least two mentoring 58.6 hours per week must be individual and face-to-face. 58.7 (l) A case management supervisor must meet the criteria for 58.8 a mental health professional as specified in section 245.4871, 58.9 subdivision 27. 58.10 (m) An immigrant who does not have the qualifications 58.11 specified in this subdivision may provide case management 58.12 services to child immigrants with severe emotional disturbance 58.13 of the same ethnic group as the immigrant if the person: 58.14 (1) is currently enrolled in and is actively pursuing 58.15 credits toward the completion of a bachelor's degree in one of 58.16 the behavioral sciences or related fields at an accredited 58.17 college or university; 58.18 (2) completes 40 hours of training as specified in this 58.19 subdivision; and 58.20 (3) receives clinical supervision at least once a week 58.21 until the requirements of obtaining a bachelor's degree and 58.22 2,000 hours of supervised experience are met. 58.23 Sec. 5. Minnesota Statutes 2000, section 245.50, 58.24 subdivision 1, is amended to read: 58.25 Subdivision 1. [DEFINITIONS.] For purposes of this 58.26 section, the following terms have the meanings given them. 58.27 (a) "Bordering state" means Iowa, North Dakota, South 58.28 Dakota, or Wisconsin. 58.29 (b) "Receiving agencyor facility" means a public or 58.30 private hospital, mental health center, or other person or 58.31 organizationauthorized by a state to providewhich provides 58.32 mental health services under this section to individuals from a 58.33 state other than the state in which the agency is located. 58.34 (c) "Receiving state" means the state in which a receiving 58.35 agency is located. 58.36 (d) "Sending agency" means a state or county agency which 59.1 sends an individual to a bordering state for treatment under 59.2 this section. 59.3 (e) "Sending state" means the state in which the sending 59.4 agency is located. 59.5 Sec. 6. Minnesota Statutes 2000, section 245.50, 59.6 subdivision 2, is amended to read: 59.7 Subd. 2. [PURPOSE AND AUTHORITY.] (a) The purpose of this 59.8 section is to enable appropriate treatment to be provided to 59.9 individuals, across state lines from the individual's state of 59.10 residence, in qualified facilities that are closer to the homes 59.11 of individuals than are facilities available in the individual's 59.12 home state. 59.13 (b) Unless prohibited by another law and subject to the 59.14 exceptions listed in subdivision 3, a county board or the 59.15 commissioner of human services may contract with an agency or 59.16 facility in a bordering state for mental health services for 59.17 residents of Minnesota, and a Minnesota mental health agency or 59.18 facility may contract to provide services to residents of 59.19 bordering states. Except as provided in subdivision 5, a person 59.20 who receives services in another state under this section is 59.21 subject to the laws of the state in which services are 59.22 provided. A person who will receive services in another state 59.23 under this section must be informed of the consequences of 59.24 receiving services in another state, including the implications 59.25 of the differences in state laws, to the extent the individual 59.26 will be subject to the laws of the receiving state. 59.27 Sec. 7. Minnesota Statutes 2000, section 245.50, 59.28 subdivision 5, is amended to read: 59.29 Subd. 5. [SPECIAL CONTRACTS;WISCONSINBORDERING 59.30 STATES.]The commissioner of the Minnesota department of human59.31services must enter into negotiations with appropriate personnel59.32at the Wisconsin department of health and social services and59.33must develop an agreement that conforms to the requirements of59.34subdivision 4, to enable the placement in Minnesota of patients59.35who are on emergency holds or who have been involuntarily59.36committed as mentally ill or chemically dependent in Wisconsin60.1and to enable the temporary placement in Wisconsin of patients60.2who are on emergency holds in Minnesota under section 253B.05,60.3provided that the Minnesota courts retain jurisdiction over60.4Minnesota patients, and the state of Wisconsin affords to60.5Minnesota patients the rights under Minnesota law. Persons60.6committed by the Wisconsin courts and placed in Minnesota60.7facilities shall continue to be in the legal custody of60.8Wisconsin and Wisconsin's laws governing length of commitment,60.9reexaminations, and extension of commitment shall continue to60.10apply to these residents. In all other respects, Wisconsin60.11residents placed in Minnesota facilities are subject to60.12Minnesota laws. The agreement must specify that responsibility60.13for payment for the cost of care of Wisconsin residents shall60.14remain with the state of Wisconsin and the cost of care of60.15Minnesota residents shall remain with the state of Minnesota.60.16The commissioner shall be assisted by attorneys from the60.17Minnesota attorney general's office in negotiating and60.18finalizing this agreement. The agreement shall be completed so60.19as to permit placement of Wisconsin residents in Minnesota60.20facilities and Minnesota residents in Wisconsin facilities60.21beginning July 1, 1994.(a) An individual who is detained, 60.22 committed, or placed on an involuntary basis under chapter 253B 60.23 may be confined or treated in a bordering state pursuant to a 60.24 contract under this section. An individual who is detained, 60.25 committed, or placed on an involuntary basis under the civil law 60.26 of a bordering state may be confined or treated in Minnesota 60.27 pursuant to a contract under this section. A peace or health 60.28 officer who is acting under the authority of the sending state 60.29 may transport an individual to a receiving agency that provides 60.30 services pursuant to a contract under this section, and may 60.31 transport the individual back to the sending state under the 60.32 laws of the sending state. Court orders valid under the law of 60.33 the sending state are granted recognition and reciprocity in the 60.34 receiving state for individuals covered by a contract under this 60.35 section to the extent that the court orders relate to 60.36 confinement for treatment or care of mental illness. Such 61.1 treatment or care may address other conditions that may be 61.2 co-occurring with the mental illness. These court orders are 61.3 not subject to legal challenge in the courts of the receiving 61.4 state. Individuals who are detained, committed, or placed under 61.5 the law of a sending state and who are transferred to a 61.6 receiving state under this section continue to be in the legal 61.7 custody of the authority responsible for them under the law of 61.8 the sending state. Except in emergencies, those individuals may 61.9 not be transferred, removed, or furloughed from a receiving 61.10 agency without the specific approval of the authority 61.11 responsible for them under the law of the sending state. 61.12 (b) While in the receiving state pursuant to a contract 61.13 under this section, an individual shall be subject to the 61.14 sending state's laws and rules relating to length of 61.15 confinement, reexaminations, and extensions of confinement. No 61.16 individual may be sent to another state pursuant to a contract 61.17 under this section until the receiving state has enacted a law 61.18 recognizing the validity and applicability of this section. 61.19 (c) If an individual receiving services pursuant to a 61.20 contract under this section leaves the receiving agency without 61.21 permission and the individual is subject to involuntary 61.22 confinement under the law of the sending state, the receiving 61.23 agency shall use all reasonable means to return the individual 61.24 to the receiving agency. The receiving agency shall immediately 61.25 report the absence to the sending agency. The receiving state 61.26 has the primary responsibility for, and the authority to direct, 61.27 the return of these individuals within its borders and is liable 61.28 for the cost of the action to the extent that it would be liable 61.29 for costs of its own resident. 61.30 (d) Responsibility for payment for the cost of care remains 61.31 with the sending agency. 61.32 (e) This subdivision also applies to county contracts under 61.33 subdivision 2 which include emergency care and treatment 61.34 provided to a county resident in a bordering state. 61.35 Sec. 8. Minnesota Statutes 2000, section 256.01, is 61.36 amended by adding a subdivision to read: 62.1 Subd. 20. [RYAN WHITE COMPREHENSIVE AIDS RESOURCES 62.2 EMERGENCY ACT.] The commissioner shall act as the designated 62.3 state agent for carrying out responsibilities required under 62.4 Title II of the federal Ryan White Comprehensive AIDS Resources 62.5 Emergency (CARE) Act. These responsibilities include: 62.6 (1) coordinating statewide HIV/AIDS needs assessment 62.7 activities; 62.8 (2) developing the state's plan to meet identified health 62.9 and support service needs of people living with HIV/AIDS; 62.10 (3) administering federal funds designed to provide 62.11 comprehensive health and support services to persons living with 62.12 HIV/AIDS; 62.13 (4) administering federal funds designated for the AIDS 62.14 drug assistance program (ADAP); 62.15 (5) collecting rebates from pharmaceutical manufacturers on 62.16 drugs purchased with federal ADAP funds; and 62.17 (6) utilizing ADAP rebate funds in accordance with 62.18 guidelines of the federal Health Resources and Services 62.19 Administration. 62.20 Rebates collected under this subdivision shall be deposited into 62.21 the ADAP account in the special revenue fund and are 62.22 appropriated to the commissioner for purposes of this 62.23 subdivision. 62.24 Sec. 9. Minnesota Statutes 2000, section 256.9657, 62.25 subdivision 1, is amended to read: 62.26 Subdivision 1. [NURSING HOME LICENSE SURCHARGE.] (a) 62.27 Effective July 1, 1993, each non-state-operated nursing home 62.28 licensed under chapter 144A shall pay to the commissioner an 62.29 annual surcharge according to the schedule in subdivision 4. 62.30 The surcharge shall be calculated as $620 per licensed bed. If 62.31 the number of licensed beds is reduced, the surcharge shall be 62.32 based on the number of remaining licensed beds the second month 62.33 following the receipt of timely notice by the commissioner of 62.34 human services that beds have been delicensed. The nursing home 62.35 must notify the commissioner of health in writing when beds are 62.36 delicensed. The commissioner of health must notify the 63.1 commissioner of human services within ten working days after 63.2 receiving written notification. If the notification is received 63.3 by the commissioner of human services by the 15th of the month, 63.4 the invoice for the second following month must be reduced to 63.5 recognize the delicensing of beds. Beds on layaway status 63.6 continue to be subject to the surcharge. The commissioner of 63.7 human services must acknowledge a medical care surcharge appeal 63.8 within 30 days of receipt of the written appeal from the 63.9 provider. 63.10 (b) Effective July 1, 1994, the surcharge in paragraph (a) 63.11 shall be increased to $625. 63.12 (c) Between April 1, 2002, and August 15, 2003, a facility 63.13 governed by this subdivision may elect to assume full 63.14 participation in the medical assistance program by agreeing to 63.15 comply with all of the requirements of the medical assistance 63.16 program, including the rate equalization law in section 256B.48, 63.17 subdivision 1, paragraph (a), and all other requirements 63.18 established in law or rule, and to begin intake of new medical 63.19 assistance recipients. Rates will be determined under Minnesota 63.20 Rules, parts 9549.0010 to 9549.0080. Notwithstanding section 63.21 256B.431, subdivision 27, paragraph (i), rate calculations will 63.22 be subject to limits as prescribed in rule and law. Other than 63.23 the adjustments in sections 256B.431, subdivisions 30 and 32; 63.24 256B.437, subdivision 3, paragraph (b); Minnesota Rules, part 63.25 9549.0057, and any other applicable legislation enacted prior to 63.26 the finalization of rates, facilities assuming full 63.27 participation in medical assistance under this paragraph are not 63.28 eligible for any rate adjustments until the July 1 following 63.29 their settle-up period. 63.30[EFFECTIVE DATE.] This section is effective April 1, 2002. 63.31 Sec. 10. Minnesota Statutes 2001 Supplement, section 63.32 256B.0625, subdivision 13, is amended to read: 63.33 Subd. 13. [DRUGS.] (a) Medical assistance covers drugs, 63.34 except for fertility drugs when specifically used to enhance 63.35 fertility, if prescribed by a licensed practitioner and 63.36 dispensed by a licensed pharmacist, by a physician enrolled in 64.1 the medical assistance program as a dispensing physician, or by 64.2 a physician or a nurse practitioner employed by or under 64.3 contract with a community health board as defined in section 64.4 145A.02, subdivision 5, for the purposes of communicable disease 64.5 control. The commissioner, after receiving recommendations from 64.6 professional medical associations and professional pharmacist 64.7 associations, shall designate a formulary committee to advise 64.8 the commissioner on the names of drugs for which payment is 64.9 made, recommend a system for reimbursing providers on a set fee 64.10 or charge basis rather than the present system, and develop 64.11 methods encouraging use of generic drugs when they are less 64.12 expensive and equally effective as trademark drugs. The 64.13 formulary committee shall consist of nine members, four of whom 64.14 shall be physicians who are not employed by the department of 64.15 human services, and a majority of whose practice is for persons 64.16 paying privately or through health insurance, three of whom 64.17 shall be pharmacists who are not employed by the department of 64.18 human services, and a majority of whose practice is for persons 64.19 paying privately or through health insurance, a consumer 64.20 representative, and a nursing home representative. Committee 64.21 members shall serve three-year terms and shall serve without 64.22 compensation. Members may be reappointed once. 64.23 (b) The commissioner shall establish a drug formulary. Its 64.24 establishment and publication shall not be subject to the 64.25 requirements of the Administrative Procedure Act, but the 64.26 formulary committee shall review and comment on the formulary 64.27 contents. The formulary committee shall review and recommend 64.28 drugs which require prior authorization. The formulary 64.29 committee may recommend drugs for prior authorization directly 64.30 to the commissioner, as long as opportunity for public input is 64.31 provided. Prior authorization may be requested by the 64.32 commissioner based on medical and clinical criteria before 64.33 certain drugs are eligible for payment. Before a drug may be 64.34 considered for prior authorization at the request of the 64.35 commissioner: 64.36 (1) the drug formulary committee must develop criteria to 65.1 be used for identifying drugs; the development of these criteria 65.2 is not subject to the requirements of chapter 14, but the 65.3 formulary committee shall provide opportunity for public input 65.4 in developing criteria; 65.5 (2) the drug formulary committee must hold a public forum 65.6 and receive public comment for an additional 15 days; and 65.7 (3) the commissioner must provide information to the 65.8 formulary committee on the impact that placing the drug on prior 65.9 authorization will have on the quality of patient care and 65.10 information regarding whether the drug is subject to clinical 65.11 abuse or misuse. Prior authorization may be required by the 65.12 commissioner before certain formulary drugs are eligible for 65.13 payment. The formulary shall not include: 65.14 (i) drugs or products for which there is no federal 65.15 funding; 65.16 (ii) over-the-counter drugs, except for antacids, 65.17 acetaminophen, family planning products, aspirin, insulin, 65.18 products for the treatment of lice, vitamins for adults with 65.19 documented vitamin deficiencies, vitamins for children under the 65.20 age of seven and pregnant or nursing women, and any other 65.21 over-the-counter drug identified by the commissioner, in 65.22 consultation with the drug formulary committee, as necessary, 65.23 appropriate, and cost-effective for the treatment of certain 65.24 specified chronic diseases, conditions or disorders, and this 65.25 determination shall not be subject to the requirements of 65.26 chapter 14; 65.27 (iii) anorectics, except that medically necessary 65.28 anorectics shall be covered for a recipient previously diagnosed 65.29 as having pickwickian syndrome and currently diagnosed as having 65.30 diabetes and being morbidly obese; 65.31 (iv) drugs for which medical value has not been 65.32 established; and 65.33 (v) drugs from manufacturers who have not signed a rebate 65.34 agreement with the Department of Health and Human Services 65.35 pursuant to section 1927 of title XIX of the Social Security Act. 65.36 The commissioner shall publish conditions for prohibiting 66.1 payment for specific drugs after considering the formulary 66.2 committee's recommendations. An honorarium of $100 per meeting 66.3 and reimbursement for mileage shall be paid to each committee 66.4 member in attendance. 66.5 (c) The basis for determining the amount of payment shall 66.6 be the lower of the actual acquisition costs of the drugs plus a 66.7 fixed dispensing fee; the maximum allowable cost set by the 66.8 federal government or by the commissioner plus the fixed 66.9 dispensing fee; or the usual and customary price charged to the 66.10 public. The pharmacy dispensing fee shall be $3.65, except that 66.11 the dispensing fee for intravenous solutions which must be 66.12 compounded by the pharmacist shall be $8 per bag, $14 per bag 66.13 for cancer chemotherapy products, and $30 per bag for total 66.14 parenteral nutritional products dispensed in one liter 66.15 quantities, or $44 per bag for total parenteral nutritional 66.16 products dispensed in quantities greater than one liter. Actual 66.17 acquisition cost includes quantity and other special discounts 66.18 except time and cash discounts. The actual acquisition cost of 66.19 a drug shall be estimated by the commissioner, at average 66.20 wholesale price minus nine percent, except that where a drug has 66.21 had its wholesale price reduced as a result of the actions of 66.22 the National Association of Medicaid Fraud Control Units, the 66.23 estimated actual acquisition cost shall be the reduced average 66.24 wholesale price, without the nine percent deduction. The 66.25 maximum allowable cost of a multisource drug may be set by the 66.26 commissioner and it shall be comparable to, but no higher than, 66.27 the maximum amount paid by other third-party payors in this 66.28 state who have maximum allowable cost programs. The 66.29 commissioner shall set maximum allowable costs for multisource 66.30 drugs that are not on the federal upper limit list as described 66.31 in United States Code, title 42, chapter 7, section 1396r-8(e), 66.32 the Social Security Act, and Code of Federal Regulations, title 66.33 42, part 447, section 447.332. Establishment of the amount of 66.34 payment for drugs shall not be subject to the requirements of 66.35 the Administrative Procedure Act. An additional dispensing fee 66.36 of $.30 may be added to the dispensing fee paid to pharmacists 67.1 for legend drug prescriptions dispensed to residents of 67.2 long-term care facilities when a unit dose blister card system, 67.3 approved by the department, is used. Under this type of 67.4 dispensing system, the pharmacist must dispense a 30-day supply 67.5 of drug. The National Drug Code (NDC) from the drug container 67.6 used to fill the blister card must be identified on the claim to 67.7 the department. The unit dose blister card containing the drug 67.8 must meet the packaging standards set forth in Minnesota Rules, 67.9 part 6800.2700, that govern the return of unused drugs to the 67.10 pharmacy for reuse. The pharmacy provider will be required to 67.11 credit the department for the actual acquisition cost of all 67.12 unused drugs that are eligible for reuse. Over-the-counter 67.13 medications must be dispensed in the manufacturer's unopened 67.14 package. The commissioner may permit the drug clozapine to be 67.15 dispensed in a quantity that is less than a 30-day supply. 67.16 Whenever a generically equivalent product is available, payment 67.17 shall be on the basis of the actual acquisition cost of the 67.18 generic drug, unless the prescriber specifically indicates 67.19 "dispense as written - brand necessary" on the prescription as 67.20 required by section 151.21, subdivision 2. 67.21 (d) For purposes of this subdivision, "multisource drugs" 67.22 means covered outpatient drugs, excluding innovator multisource 67.23 drugs for which there are two or more drug products, which: 67.24 (1) are related as therapeutically equivalent under the 67.25 Food and Drug Administration's most recent publication of 67.26 "Approved Drug Products with Therapeutic Equivalence 67.27 Evaluations"; 67.28 (2) are pharmaceutically equivalent and bioequivalent as 67.29 determined by the Food and Drug Administration; and 67.30 (3) are sold or marketed in Minnesota. 67.31 "Innovator multisource drug" means a multisource drug that was 67.32 originally marketed under an original new drug application 67.33 approved by the Food and Drug Administration. 67.34 (e) The basis for determining the amount of payment for 67.35 drugs administered in an outpatient setting shall be the lower 67.36 of the usual and customary cost submitted by the provider; the 68.1 average wholesale price minus five percent; or the maximum 68.2 allowable cost set by the federal government under United States 68.3 Code, title 42, chapter 7, section 1396r-8(e), and Code of 68.4 Federal Regulations, title 42, section 447.332, or by the 68.5 commissioner under paragraph (c). 68.6 (f) Prior authorization shall not be required or utilized 68.7 for any antipsychotic drug prescribed for the treatment of 68.8 mental illness where there is no generically equivalent drug 68.9 available unless the commissioner determines that prior 68.10 authorization is necessary for patient safety. This paragraph 68.11 applies to any supplemental drug rebate program established or 68.12 administered by the commissioner. 68.13 (g) Prior authorization shall not be required or utilized 68.14 for any antihemophilic factor drug prescribed for the treatment 68.15 of hemophilia and blood disorders where there is no generically 68.16 equivalent drug available unless the commissioner determines 68.17 that prior authorization is necessary for patient safety. This 68.18 paragraph applies to any supplemental drug rebate program 68.19 established or administered by the commissioner. 68.20 Sec. 11. Minnesota Statutes 2000, section 256B.0625, 68.21 subdivision 35, is amended to read: 68.22 Subd. 35. [FAMILY COMMUNITY SUPPORT SERVICES.] (a) Medical 68.23 assistance covers family community support services as defined 68.24 in section 245.4871, subdivision 17. In addition to the 68.25 provisions of section 245.4871, and to the extent authorized by 68.26 rules promulgated by the state agency, medical assistance covers 68.27 the following services as family community support services: 68.28 (1) services identified in an individual treatment plan 68.29 when provided by a trained mental health behavioral aide under 68.30 the direction of a mental health practitioner or mental health 68.31 professional; 68.32 (2) mental health crisis intervention and crisis 68.33 stabilization services provided outside of hospital inpatient 68.34 settings; and 68.35 (3) the therapeutic components of preschool and therapeutic 68.36 camp programs. 69.1 (b) Notwithstanding the provisions of Minnesota Rules, 69.2 parts 9505.0324, subpart 2, 9505.0326, subpart 2, and 9505.0327, 69.3 subpart 2, a provider of family community support services, 69.4 home-based mental health services, or therapeutic support of 69.5 foster care services under contract with a county may continue 69.6 to provide existing services, and may provide new services, to a 69.7 child if that child is placed in foster care, or the child and 69.8 family relocate, outside the original county of residence. 69.9 Sec. 12. Minnesota Statutes 2000, section 256B.0625, is 69.10 amended by adding a subdivision to read: 69.11 Subd. 44. [TARGETED CASE MANAGEMENT SERVICES.] Medical 69.12 assistance covers case management services for vulnerable adults 69.13 and adults with developmental disabilities, as provided under 69.14 section 256B.0924. 69.15 Sec. 13. Minnesota Statutes 2001 Supplement, section 69.16 256B.0627, subdivision 10, is amended to read: 69.17 Subd. 10. [FISCAL INTERMEDIARY OPTION AVAILABLE FOR 69.18 PERSONAL CARE ASSISTANT SERVICES.] (a) The commissioner may 69.19 allow a recipient of personal care assistant services to use a 69.20 fiscal intermediary to assist the recipient in paying and 69.21 accounting for medically necessary covered personal care 69.22 assistant services authorized in subdivision 4 and within the 69.23 payment parameters of subdivision 5. Unless otherwise provided 69.24 in this subdivision, all other statutory and regulatory 69.25 provisions relating to personal care assistant services apply to 69.26 a recipient using the fiscal intermediary option. 69.27 (b) The recipient or responsible party shall: 69.28 (1) recruit, hire, and terminate a qualified professional, 69.29 if a qualified professional is requested by the recipient or 69.30 responsible party; 69.31 (2) verify and document the credentials of the qualified 69.32 professional, if a qualified professional is requested by the 69.33 recipient or responsible party; 69.34 (3) develop a service plan based on physician orders and 69.35 public health nurse assessment with the assistance of a 69.36 qualified professional, if a qualified professional is requested 70.1 by the recipient or responsible party, that addresses the health 70.2 and safety of the recipient; 70.3 (4) recruit, hire, and terminate the personal care 70.4 assistant; 70.5 (5) orient and train the personal care assistant with 70.6 assistance as needed from the qualified professional; 70.7 (6) supervise and evaluate the personal care assistant with 70.8 assistance as needed from the recipient's physician or the 70.9 qualified professional; 70.10 (7) monitor and verify in writing and report to the fiscal 70.11 intermediary the number of hours worked by the personal care 70.12 assistant and the qualified professional; and 70.13 (8) enter into a written agreement, as specified in 70.14 paragraph (f). 70.15 (c) The duties of the fiscal intermediary shall be to: 70.16 (1) bill the medical assistance program for personal care 70.17 assistant and qualified professional services; 70.18 (2) request and secure background checks on personal care 70.19 assistants and qualified professionals according to section 70.20 245A.04; 70.21 (3) pay the personal care assistant and qualified 70.22 professional based on actual hours of services provided; 70.23 (4) withhold and pay all applicable federal and state 70.24 taxes; 70.25 (5) verify and keep records of hours worked by the personal 70.26 care assistant and qualified professional; 70.27 (6) make the arrangements and pay unemployment insurance, 70.28 taxes, workers' compensation, liability insurance, and other 70.29 benefits, if any; 70.30 (7) enroll in the medical assistance program as a fiscal 70.31 intermediary; and 70.32 (8) enter into a written agreement as specified in 70.33 paragraph (f) before services are provided. 70.34 (d) The fiscal intermediary: 70.35 (1) may not be related to the recipient, qualified 70.36 professional, or the personal care assistant; 71.1 (2) must ensure arm's length transactions with the 71.2 recipient and personal care assistant; and 71.3 (3) shall be considered a joint employer of the personal 71.4 care assistant and qualified professional to the extent 71.5 specified in this section. 71.6 The fiscal intermediary or owners of the entity that 71.7 provides fiscal intermediary services under this subdivision 71.8 must pass a criminal background check as required in section 71.9 256B.0627, subdivision 1, paragraph (e). 71.10 (e) If the recipient or responsible party requests a 71.11 qualified professional, the qualified professional providing 71.12 assistance to the recipient shall meet the qualifications 71.13 specified in section 256B.0625, subdivision 19c. The qualified 71.14 professional shall assist the recipient in developing and 71.15 revising a plan to meet the recipient's needs, as assessed by 71.16 the public health nurse. In performing this function, the 71.17 qualified professional must visit the recipient in the 71.18 recipient's home at least once annually. The qualified 71.19 professional must report any suspected abuse, neglect, or 71.20 financial exploitation of the recipient to the appropriate 71.21 authorities. 71.22 (f) The fiscal intermediary, recipient or responsible 71.23 party, personal care assistant, and qualified professional shall 71.24 enter into a written agreement before services are started. The 71.25 agreement shall include: 71.26 (1) the duties of the recipient, qualified professional, 71.27 personal care assistant, and fiscal agent based on paragraphs 71.28 (a) to (e); 71.29 (2) the salary and benefits for the personal care assistant 71.30 and the qualified professional; 71.31 (3) the administrative fee of the fiscal intermediary and 71.32 services paid for with that fee, including background check 71.33 fees; 71.34 (4) procedures to respond to billing or payment complaints; 71.35 and 71.36 (5) procedures for hiring and terminating the personal care 72.1 assistant and the qualified professional. 72.2 (g) The rates paid for personal care assistant 72.3 services, shared care services, qualified professional services, 72.4 and fiscal intermediary services under this subdivision shall be 72.5 the same rates paid for personal care assistant services and 72.6 qualified professional services under subdivision 2 72.7 respectively. Except for the administrative fee of the fiscal 72.8 intermediary specified in paragraph (f), the remainder of the 72.9 rates paid to the fiscal intermediary must be used to pay for 72.10 the salary and benefits for the personal care assistant or the 72.11 qualified professional. 72.12 (h) As part of the assessment defined in subdivision 1, the 72.13 following conditions must be met to use or continue use of a 72.14 fiscal intermediary: 72.15 (1) the recipient must be able to direct the recipient's 72.16 own care, or the responsible party for the recipient must be 72.17 readily available to direct the care of the personal care 72.18 assistant; 72.19 (2) the recipient or responsible party must be 72.20 knowledgeable of the health care needs of the recipient and be 72.21 able to effectively communicate those needs; 72.22 (3) a face-to-face assessment must be conducted by the 72.23 local county public health nurse at least annually, or when 72.24 there is a significant change in the recipient's condition or 72.25 change in the need for personal care assistant services; 72.26 (4)the recipient cannot select the shared services option72.27as specified in subdivision 8recipients who choose to use the 72.28 shared care option as specified in subdivision 8 must utilize 72.29 the same fiscal intermediary; and 72.30 (5) parties must be in compliance with the written 72.31 agreement specified in paragraph (f). 72.32 (i) The commissioner shall deny, revoke, or suspend the 72.33 authorization to use the fiscal intermediary option if: 72.34 (1) it has been determined by the qualified professional or 72.35 local county public health nurse that the use of this option 72.36 jeopardizes the recipient's health and safety; 73.1 (2) the parties have failed to comply with the written 73.2 agreement specified in paragraph (f); or 73.3 (3) the use of the option has led to abusive or fraudulent 73.4 billing for personal care assistant services. 73.5 The recipient or responsible party may appeal the 73.6 commissioner's action according to section 256.045. The denial, 73.7 revocation, or suspension to use the fiscal intermediary option 73.8 shall not affect the recipient's authorized level of personal 73.9 care assistant services as determined in subdivision 5. 73.10 Sec. 14. Minnesota Statutes 2001 Supplement, section 73.11 256B.0911, subdivision 4b, is amended to read: 73.12 Subd. 4b. [EXEMPTIONS AND EMERGENCY ADMISSIONS.] (a) 73.13 Exemptions from the federal screening requirements outlined in 73.14 subdivision 4a, paragraphs (b) and (c), are limited to: 73.15 (1) a person who, having entered an acute care facility 73.16 from a certified nursing facility, is returning to a certified 73.17 nursing facility;and73.18 (2) a person transferring from one certified nursing 73.19 facility in Minnesota to another certified nursing facility in 73.20 Minnesota; and 73.21 (3) a person, 21 years of age or older, who satisfies the 73.22 following criteria, as specified in Code of Federal Regulations, 73.23 title 42, section 483.106(b)(2): 73.24 (i) the person is admitted to a nursing facility directly 73.25 from a hospital after receiving acute inpatient care at the 73.26 hospital; 73.27 (ii) the person requires nursing facility services for the 73.28 same condition for which care was provided in the hospital; and 73.29 (iii) the attending physician has certified before the 73.30 nursing facility admission that the person is likely to receive 73.31 less than 30 days of nursing facility services. 73.32 (b) Persons who are exempt from preadmission screening for 73.33 purposes of level of care determination include: 73.34 (1) persons described in paragraph (a); 73.35 (2) an individual who has a contractual right to have 73.36 nursing facility care paid for indefinitely by the veterans' 74.1 administration; 74.2 (3) an individual enrolled in a demonstration project under 74.3 section 256B.69, subdivision 8, at the time of application to a 74.4 nursing facility; 74.5 (4) an individual currently being served under the 74.6 alternative care program or under a home and community-based 74.7 services waiver authorized under section 1915(c) of the federal 74.8 Social Security Act; and 74.9 (5) individuals admitted to a certified nursing facility 74.10 for a short-term stay, which is expected to be 14 days or less 74.11 in duration based upon a physician's certification, and who have 74.12 been assessed and approved for nursing facility admission within 74.13 the previous six months. This exemption applies only if the 74.14 consultation team member determines at the time of the initial 74.15 assessment of the six-month period that it is appropriate to use 74.16 the nursing facility for short-term stays and that there is an 74.17 adequate plan of care for return to the home or community-based 74.18 setting. If a stay exceeds 14 days, the individual must be 74.19 referred no later than the first county working day following 74.20 the 14th resident day for a screening, which must be completed 74.21 within five working days of the referral. The payment 74.22 limitations in subdivision 7 apply to an individual found at 74.23 screening to not meet the level of care criteria for admission 74.24 to a certified nursing facility. 74.25 (c) Persons admitted to a Medicaid-certified nursing 74.26 facility from the community on an emergency basis as described 74.27 in paragraph (d) or from an acute care facility on a nonworking 74.28 day must be screened the first working day after admission. 74.29 (d) Emergency admission to a nursing facility prior to 74.30 screening is permitted when all of the following conditions are 74.31 met: 74.32 (1) a person is admitted from the community to a certified 74.33 nursing or certified boarding care facility during county 74.34 nonworking hours; 74.35 (2) a physician has determined that delaying admission 74.36 until preadmission screening is completed would adversely affect 75.1 the person's health and safety; 75.2 (3) there is a recent precipitating event that precludes 75.3 the client from living safely in the community, such as 75.4 sustaining an injury, sudden onset of acute illness, or a 75.5 caregiver's inability to continue to provide care; 75.6 (4) the attending physician has authorized the emergency 75.7 placement and has documented the reason that the emergency 75.8 placement is recommended; and 75.9 (5) the county is contacted on the first working day 75.10 following the emergency admission. 75.11 Transfer of a patient from an acute care hospital to a nursing 75.12 facility is not considered an emergency except for a person who 75.13 has received hospital services in the following situations: 75.14 hospital admission for observation, care in an emergency room 75.15 without hospital admission, or following hospital 24-hour bed 75.16 care. 75.17 (e) A nursing facility must provide a written notice to 75.18 persons who satisfy the criteria in paragraph (a), clause (3), 75.19 regarding the person's right to request and receive long-term 75.20 care consultation services as defined in subdivision 1a. The 75.21 notice must be provided prior to the person's discharge from the 75.22 facility and in a format specified by the commissioner. 75.23[EFFECTIVE DATE.] This section is effective the day 75.24 following final enactment. 75.25 Sec. 15. Minnesota Statutes 2001 Supplement, section 75.26 256B.0911, subdivision 4d, is amended to read: 75.27 Subd. 4d. [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65 75.28 YEARS OF AGE.] (a) It is the policy of the state of Minnesota to 75.29 ensure that individuals with disabilities or chronic illness are 75.30 served in the most integrated setting appropriate to their needs 75.31 and have the necessary information to make informed choices 75.32 about home and community-based service options. 75.33 (b) Individuals under 65 years of age who are admitted to a 75.34 nursing facility from a hospital must be screened prior to 75.35 admission as outlined in subdivisions 4a through 4c. 75.36 (c) Individuals under 65 years of age who are admitted to 76.1 nursing facilities with only a telephone screening must receive 76.2 a face-to-face assessment from the long-term care consultation 76.3 team member of the county in which the facility is located or 76.4 from the recipient's county case manager within 20 working days 76.5 of admission. 76.6 (d) Individuals under 65 years of age who are admitted to a 76.7 nursing facility without preadmission screening according to the 76.8 exemption described in subdivision 4b, paragraph (a), clause 76.9 (3), and who remain in the facility longer than 30 days must 76.10 receive a face-to-face assessment within 40 days of admission. 76.11 (e) At the face-to-face assessment, the long-term care 76.12 consultation team member or county case manager must perform the 76.13 activities required under subdivision 3b. 76.14(e)(f) For individuals under 21 years of age, a screening 76.15 interview which recommends nursing facility admission must be 76.16 face-to-face and approved by the commissioner before the 76.17 individual is admitted to the nursing facility. 76.18(f)(g) In the event that an individual under 65 years of 76.19 age is admitted to a nursing facility on an emergency basis, the 76.20 county must be notified of the admission on the next working 76.21 day, and a face-to-face assessment as described in paragraph (c) 76.22 must be conducted within 20 working days of admission. 76.23(g)(h) At the face-to-face assessment, the long-term care 76.24 consultation team member or the case manager must present 76.25 information about home and community-based options so the 76.26 individual can make informed choices. If the individual chooses 76.27 home and community-based services, the long-term care 76.28 consultation team member or case manager must complete a written 76.29 relocation plan within 20 working days of the visit. The plan 76.30 shall describe the services needed to move out of the facility 76.31 and a time line for the move which is designed to ensure a 76.32 smooth transition to the individual's home and community. 76.33(h)(i) An individual under 65 years of age residing in a 76.34 nursing facility shall receive a face-to-face assessment at 76.35 least every 12 months to review the person's service choices and 76.36 available alternatives unless the individual indicates, in 77.1 writing, that annual visits are not desired. In this case, the 77.2 individual must receive a face-to-face assessment at least once 77.3 every 36 months for the same purposes. 77.4(i)(j) Notwithstanding the provisions of subdivision 6, 77.5 the commissioner may pay county agencies directly for 77.6 face-to-face assessments for individuals under 65 years of age 77.7 who are being considered for placement or residing in a nursing 77.8 facility. 77.9[EFFECTIVE DATE.] This section is effective the day 77.10 following final enactment. 77.11 Sec. 16. Minnesota Statutes 2001 Supplement, section 77.12 256B.0913, subdivision 4, is amended to read: 77.13 Subd. 4. [ELIGIBILITY FOR FUNDING FOR SERVICES FOR 77.14 NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services 77.15 under the alternative care program is available to persons who 77.16 meet the following criteria: 77.17 (1) the person has been determined by a community 77.18 assessment under section 256B.0911 to be a person who would 77.19 require the level of care provided in a nursing facility, but 77.20 for the provision of services under the alternative care 77.21 program; 77.22 (2) the person is age 65 or older; 77.23 (3) the person would be eligible for medical assistance 77.24 within 180 days of admission to a nursing facility; 77.25 (4) the person is not ineligible for the medical assistance 77.26 program due to an asset transfer penalty; 77.27 (5) the person needs services that are not funded through 77.28 other state or federal funding; and 77.29 (6) the monthly cost of the alternative care services 77.30 funded by the program for this person does not exceed 75 percent 77.31 of the statewide weighted average monthly nursing facility rate 77.32 of the case mix resident class to which the individual 77.33 alternative care client would be assigned under Minnesota Rules, 77.34 parts 9549.0050 to 9549.0059, less the recipient's maintenance 77.35 needs allowance as described in section 256B.0915, subdivision 77.36 1d, paragraph (a), until the first day of the state fiscal year 78.1 in which the resident assessment system, under section 256B.437, 78.2 for nursing home rate determination is implemented. Effective 78.3 on the first day of the state fiscal year in which a resident 78.4 assessment system, under section 256B.437, for nursing home rate 78.5 determination is implemented and the first day of each 78.6 subsequent state fiscal year, the monthly cost of alternative 78.7 care services for this person shall not exceed the alternative 78.8 care monthly cap for the case mix resident class to which the 78.9 alternative care client would be assigned under Minnesota Rules, 78.10 parts 9549.0050 to 9549.0059, which was in effect on the last 78.11 day of the previous state fiscal year, and adjusted by the 78.12 greater of any legislatively adopted home and community-based 78.13 services cost-of-living percentage increase or any legislatively 78.14 adopted statewide percent rate increase for nursing facilities. 78.15 This monthly limit does not prohibit the alternative care client 78.16 from payment for additional services, but in no case may the 78.17 cost of additional services purchased under this section exceed 78.18 the difference between the client's monthly service limit 78.19 defined under section 256B.0915, subdivision 3, and the 78.20 alternative care program monthly service limit defined in this 78.21 paragraph. If medical supplies and equipment or environmental 78.22 modifications are or will be purchased for an alternative care 78.23 services recipient, the costs may be prorated on a monthly basis 78.24 for up to 12 consecutive months beginning with the month of 78.25 purchase. If the monthly cost of a recipient's other 78.26 alternative care services exceeds the monthly limit established 78.27 in this paragraph, the annual cost of the alternative care 78.28 services shall be determined. In this event, the annual cost of 78.29 alternative care services shall not exceed 12 times the monthly 78.30 limit described in this paragraph. 78.31 (b) Alternative care funding under this subdivision is not 78.32 available for a person who is a medical assistance recipient or 78.33 who would be eligible for medical assistance without a spenddown 78.34 or waiver obligation. A person whose initial application for 78.35 medical assistance is being processed may be served under the 78.36 alternative care program for a period up to 60 days. If the 79.1 individual is found to be eligible for medical assistance, 79.2 medical assistance must be billed for services payable under the 79.3 federally approved elderly waiver plan and delivered from the 79.4 date the individual was found eligible for the federally 79.5 approved elderly waiver plan. Notwithstanding this provision, 79.6 upon federal approval, alternative care funds may not be used to 79.7 pay for any service the cost of which is payable by medical 79.8 assistance or which is used by a recipient to meet a medical 79.9 assistance income spenddown or waiver obligation. 79.10 (c) Alternative care funding is not available for a person 79.11 who resides in a licensed nursing home, certified boarding care 79.12 home, hospital, or intermediate care facility, except for case 79.13 management services which are provided in support of the 79.14 discharge planning process to a nursing home resident or 79.15 certified boarding care home residentwho is ineligible for case79.16management funded by medical assistance. 79.17 Sec. 17. Minnesota Statutes 2001 Supplement, section 79.18 256B.0913, subdivision 5, is amended to read: 79.19 Subd. 5. [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 79.20 Alternative care funding may be used for payment of costs of: 79.21 (1) adult foster care; 79.22 (2) adult day care; 79.23 (3) home health aide; 79.24 (4) homemaker services; 79.25 (5) personal care; 79.26 (6) case management; 79.27 (7) respite care; 79.28 (8) assisted living; 79.29 (9) residential care services; 79.30 (10) care-related supplies and equipment; 79.31 (11) meals delivered to the home; 79.32 (12) transportation; 79.33 (13)skillednursing services; 79.34 (14) chore services; 79.35 (15) companion services; 79.36 (16) nutrition services; 80.1 (17) training for direct informal caregivers; 80.2 (18)telemedicinetelehome care devices to monitor 80.3 recipients in their own homes as an alternative to hospital 80.4 care, nursing home care, or home visits; 80.5 (19) other services which includes discretionary funds and 80.6 direct cash payments to clients, following approval by the 80.7 commissioner, subject to the provisions of paragraph (j). Total 80.8 annual payments for "other services" for all clients within a 80.9 county may not exceedeither ten25 percent of that county's 80.10 annual alternative care program base allocationor $5,000,80.11whichever is greater. In no case shall this amount exceed the80.12county's total annual alternative care program base allocation; 80.13 and 80.14 (20) environmental modifications. 80.15 (b) The county agency must ensure that the funds are not 80.16 used to supplant services available through other public 80.17 assistance or services programs. 80.18 (c) Unless specified in statute, theserviceservices, 80.19 service definitions, and standards for alternative care services 80.20 shall be the same as theserviceservices, service definitions, 80.21 and standards specified in the federally approved elderly waiver 80.22 plan. Except for the county agencies' approval of direct cash 80.23 payments to clients as described in paragraph (j) or for a 80.24 provider of supplies and equipment when the monthly cost of the 80.25 supplies and equipment is less than $250, persons or agencies 80.26 must be employed by or under a contract with the county agency 80.27 or the public health nursing agency of the local board of health 80.28 in order to receive funding under the alternative care program. 80.29 Supplies and equipment may be purchased from a vendor not 80.30 certified to participate in the Medicaid program if the cost for 80.31 the item is less than that of a Medicaid vendor. 80.32 (d) The adult foster care rate shall be considered a 80.33 difficulty of care payment and shall not include room and 80.34 board. The adult foster care rate shall be negotiated between 80.35 the county agency and the foster care provider. The alternative 80.36 care payment for the foster care service in combination with the 81.1 payment for other alternative care services, including case 81.2 management, must not exceed the limit specified in subdivision 81.3 4, paragraph (a), clause (6). 81.4 (e) Personal care services must meet the service standards 81.5 defined in the federally approved elderly waiver plan, except 81.6 that a county agency may contract with a client's relative who 81.7 meets the relative hardship waiver requirement as defined in 81.8 section 256B.0627, subdivision 4, paragraph (b), clause (10), to 81.9 provide personal care services if the county agency ensures 81.10 supervision of this service by aregistered nurse or mental81.11health practitionerqualified professional as defined in section 81.12 256B.0625, subdivision 19c. 81.13 (f) For purposes of this section, residential care services 81.14 are services which are provided to individuals living in 81.15 residential care homes. Residential care homes are currently 81.16 licensed as board and lodging establishments and are registered 81.17 with the department of health as providing special services 81.18 under section 157.17 and are not subject to registration under 81.19 chapter 144D. Residential care services are defined as 81.20 "supportive services" and "health-related services." 81.21 "Supportive services" means the provision of up to 24-hour 81.22 supervision and oversight. Supportive services includes: (1) 81.23 transportation, when provided by the residential care home only; 81.24 (2) socialization, when socialization is part of the plan of 81.25 care, has specific goals and outcomes established, and is not 81.26 diversional or recreational in nature; (3) assisting clients in 81.27 setting up meetings and appointments; (4) assisting clients in 81.28 setting up medical and social services; (5) providing assistance 81.29 with personal laundry, such as carrying the client's laundry to 81.30 the laundry room. Assistance with personal laundry does not 81.31 include any laundry, such as bed linen, that is included in the 81.32 room and board rate. "Health-related services" are limited to 81.33 minimal assistance with dressing, grooming, and bathing and 81.34 providing reminders to residents to take medications that are 81.35 self-administered or providing storage for medications, if 81.36 requested. Individuals receiving residential care services 82.1 cannot receive homemaking services funded under this section. 82.2 (g) For the purposes of this section, "assisted living" 82.3 refers to supportive services provided by a single vendor to 82.4 clients who reside in the same apartment building of three or 82.5 more units which are not subject to registration under chapter 82.6 144D and are licensed by the department of health as a class A 82.7 home care provider or a class E home care provider. Assisted 82.8 living services are defined as up to 24-hour supervision, and 82.9 oversight, supportive services as defined in clause (1), 82.10 individualized home care aide tasks as defined in clause (2), 82.11 and individualized home management tasks as defined in clause 82.12 (3) provided to residents of a residential center living in 82.13 their units or apartments with a full kitchen and bathroom. A 82.14 full kitchen includes a stove, oven, refrigerator, food 82.15 preparation counter space, and a kitchen utensil storage 82.16 compartment. Assisted living services must be provided by the 82.17 management of the residential center or by providers under 82.18 contract with the management or with the county. 82.19 (1) Supportive services include: 82.20 (i) socialization, when socialization is part of the plan 82.21 of care, has specific goals and outcomes established, and is not 82.22 diversional or recreational in nature; 82.23 (ii) assisting clients in setting up meetings and 82.24 appointments; and 82.25 (iii) providing transportation, when provided by the 82.26 residential center only. 82.27 (2) Home care aide tasks means: 82.28 (i) preparing modified diets, such as diabetic or low 82.29 sodium diets; 82.30 (ii) reminding residents to take regularly scheduled 82.31 medications or to perform exercises; 82.32 (iii) household chores in the presence of technically 82.33 sophisticated medical equipment or episodes of acute illness or 82.34 infectious disease; 82.35 (iv) household chores when the resident's care requires the 82.36 prevention of exposure to infectious disease or containment of 83.1 infectious disease; and 83.2 (v) assisting with dressing, oral hygiene, hair care, 83.3 grooming, and bathing, if the resident is ambulatory, and if the 83.4 resident has no serious acute illness or infectious disease. 83.5 Oral hygiene means care of teeth, gums, and oral prosthetic 83.6 devices. 83.7 (3) Home management tasks means: 83.8 (i) housekeeping; 83.9 (ii) laundry; 83.10 (iii) preparation of regular snacks and meals; and 83.11 (iv) shopping. 83.12 Individuals receiving assisted living services shall not 83.13 receive both assisted living services and homemaking services. 83.14 Individualized means services are chosen and designed 83.15 specifically for each resident's needs, rather than provided or 83.16 offered to all residents regardless of their illnesses, 83.17 disabilities, or physical conditions. Assisted living services 83.18 as defined in this section shall not be authorized in boarding 83.19 and lodging establishments licensed according to sections 83.20 157.011 and 157.15 to 157.22. 83.21 (h) For establishments registered under chapter 144D, 83.22 assisted living services under this section means either the 83.23 services described in paragraph (g) and delivered by a class E 83.24 home care provider licensed by the department of health or the 83.25 services described under section 144A.4605 and delivered by an 83.26 assisted living home care provider or a class A home care 83.27 provider licensed by the commissioner of health. 83.28 (i) Payment for assisted living services and residential 83.29 care services shall be a monthly rate negotiated and authorized 83.30 by the county agency based on an individualized service plan for 83.31 each resident and may not cover direct rent or food costs. 83.32 (1) The individualized monthly negotiated payment for 83.33 assisted living services as described in paragraph (g) or (h), 83.34 and residential care services as described in paragraph (f), 83.35 shall not exceed the nonfederal share in effect on July 1 of the 83.36 state fiscal year for which the rate limit is being calculated 84.1 of the greater of either the statewide or any of the geographic 84.2 groups' weighted average monthly nursing facility payment rate 84.3 of the case mix resident class to which the alternative care 84.4 eligible client would be assigned under Minnesota Rules, parts 84.5 9549.0050 to 9549.0059, less the maintenance needs allowance as 84.6 described in section 256B.0915, subdivision 1d, paragraph (a), 84.7 until the first day of the state fiscal year in which a resident 84.8 assessment system, under section 256B.437, of nursing home rate 84.9 determination is implemented. Effective on the first day of the 84.10 state fiscal year in which a resident assessment system, under 84.11 section 256B.437, of nursing home rate determination is 84.12 implemented and the first day of each subsequent state fiscal 84.13 year, the individualized monthly negotiated payment for the 84.14 services described in this clause shall not exceed the limit 84.15 described in this clause which was in effect on the last day of 84.16 the previous state fiscal year and which has been adjusted by 84.17 the greater of any legislatively adopted home and 84.18 community-based services cost-of-living percentage increase or 84.19 any legislatively adopted statewide percent rate increase for 84.20 nursing facilities. 84.21 (2) The individualized monthly negotiated payment for 84.22 assisted living services described under section 144A.4605 and 84.23 delivered by a provider licensed by the department of health as 84.24 a class A home care provider or an assisted living home care 84.25 provider and provided in a building that is registered as a 84.26 housing with services establishment under chapter 144D and that 84.27 provides 24-hour supervision in combination with the payment for 84.28 other alternative care services, including case management, must 84.29 not exceed the limit specified in subdivision 4, paragraph (a), 84.30 clause (6). 84.31 (j) A county agency may make payment from their alternative 84.32 care program allocation for "other services" which include use 84.33 of "discretionary funds" for services that are not otherwise 84.34 defined in this section and direct cash payments to the client 84.35 for the purpose of purchasing the services. The following 84.36 provisions apply to payments under this paragraph: 85.1 (1) a cash payment to a client under this provision cannot 85.2 exceed80 percent ofthe monthly payment limit for that client 85.3 as specified in subdivision 4, paragraph (a), clause (6); 85.4 (2) a county may not approve any cash payment for a client 85.5 who meets either of the following: 85.6 (i) has been assessed as having a dependency in 85.7 orientation, unless the client has an authorized 85.8 representative. An "authorized representative" means an 85.9 individual who is at least 18 years of age and is designated by 85.10 the person or the person's legal representative to act on the 85.11 person's behalf. This individual may be a family member, 85.12 guardian, representative payee, or other individual designated 85.13 by the person or the person's legal representative, if any, to 85.14 assist in purchasing and arranging for supports; or 85.15 (ii) is concurrently receiving adult foster care, 85.16 residential care, or assisted living services; 85.17 (3) cash payments to a person or a person's family will be 85.18 provided through a monthly payment and be in the form of cash, 85.19 voucher, or direct county payment to a vendor. Fees or premiums 85.20 assessed to the person for eligibility for health and human 85.21 services are not reimbursable through this service option. 85.22 Services and goods purchased through cash payments must be 85.23 identified in the person's individualized care plan and must 85.24 meet all of the following criteria: 85.25 (i) they must be over and above the normal cost of caring 85.26 for the person if the person did not have functional 85.27 limitations; 85.28 (ii) they must be directly attributable to the person's 85.29 functional limitations; 85.30 (iii) they must have the potential to be effective at 85.31 meeting the goals of the program; 85.32 (iv) they must be consistent with the needs identified in 85.33 the individualized service plan. The service plan shall specify 85.34 the needs of the person and family, the form and amount of 85.35 payment, the items and services to be reimbursed, and the 85.36 arrangements for management of the individual grant; and 86.1 (v) the person, the person's family, or the legal 86.2 representative shall be provided sufficient information to 86.3 ensure an informed choice of alternatives. The local agency 86.4 shall document this information in the person's care plan, 86.5 including the type and level of expenditures to be reimbursed; 86.6 (4) the state of Minnesota, county, lead agency under 86.7 contract, or tribal government under contract to administer the 86.8 alternative care program shall not be liable for damages, 86.9 injuries, or liabilities sustained through the purchase of 86.10 direct supports or goods by the person, the person's family, or 86.11 the authorized representative with funds received through the 86.12 cash payments under this section. Liabilities include, but are 86.13 not limited to, workers' compensation, the Federal Insurance 86.14 Contributions Act (FICA), or the Federal Unemployment Tax Act 86.15 (FUTA); 86.16 (5) persons receiving grants under this section shall have 86.17 the following responsibilities: 86.18 (i) spend the grant money in a manner consistent with their 86.19 individualized service plan with the local agency; 86.20 (ii) notify the local agency of any necessary changes in 86.21 the grant expenditures; 86.22 (iii) arrange and pay for supports; and 86.23 (iv) inform the local agency of areas where they have 86.24 experienced difficulty securing or maintaining supports; and 86.25 (6) the county shall report client outcomes, services, and 86.26 costs under this paragraph in a manner prescribed by the 86.27 commissioner. 86.28(k) Upon implementation of direct cash payments to clients86.29under this section, any person determined eligible for the86.30alternative care program who chooses a cash payment approved by86.31the county agency shall receive the cash payment under this86.32section and not under section 256.476 unless the person was86.33receiving a consumer support grant under section 256.476 before86.34implementation of direct cash payments under this section.86.35 Sec. 18. Minnesota Statutes 2001 Supplement, section 86.36 256B.0913, subdivision 8, is amended to read: 87.1 Subd. 8. [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The 87.2 case manager shall implement the plan of care for each 87.3 alternative care client and ensure that a client's service needs 87.4 and eligibility are reassessed at least every 12 months. The 87.5 plan shall include any services prescribed by the individual's 87.6 attending physician as necessary to allow the individual to 87.7 remain in a community setting. In developing the individual's 87.8 care plan, the case manager should include the use of volunteers 87.9 from families and neighbors, religious organizations, social 87.10 clubs, and civic and service organizations to support the formal 87.11 home care services. The county shall be held harmless for 87.12 damages or injuries sustained through the use of volunteers 87.13 under this subdivision including workers' compensation 87.14 liability. The lead agency shall provide documentation in each 87.15 individual's plan of care and, if requested, to the commissioner 87.16 that the most cost-effective alternatives available have been 87.17 offered to the individual and that the individual was free to 87.18 choose among available qualified providers, both public and 87.19 private. The case manager must give the individual a ten-day 87.20 written notice of anydecrease in ordenial, termination, or 87.21 reduction of alternative care services. 87.22 (b) If the county administering alternative care services 87.23 is different than the county of financial responsibility, the 87.24 care plan may be implemented without the approval of the county 87.25 of financial responsibility. 87.26 Sec. 19. Minnesota Statutes 2001 Supplement, section 87.27 256B.0913, subdivision 10, is amended to read: 87.28 Subd. 10. [ALLOCATION FORMULA.] (a) The alternative care 87.29 appropriation for fiscal years 1992 and beyond shall cover only 87.30 alternative care eligible clients.Prior toBy July 1 of each 87.31 year, the commissioner shall allocate to county agencies the 87.32 state funds available for alternative care for persons eligible 87.33 under subdivision 2. 87.34 (b) The adjusted base for each county is the county's 87.35 current fiscal year base allocation plus any targeted funds 87.36 approved during the current fiscal year. Calculations for 88.1 paragraphs (c) and (d) are to be made as follows: for each 88.2 county, the determination of alternative care program 88.3 expenditures shall be based on payments for services rendered 88.4 from April 1 through March 31 in the base year, to the extent 88.5 that claims have been submitted and paid by June 1 of that year. 88.6 (c) If the alternative care program expenditures as defined 88.7 in paragraph (b) are 95 percent or more of the county's adjusted 88.8 base allocation, the allocation for the next fiscal year is 100 88.9 percent of the adjusted base, plus inflation to the extent that 88.10 inflation is included in the state budget. 88.11 (d) If the alternative care program expenditures as defined 88.12 in paragraph (b) are less than 95 percent of the county's 88.13 adjusted base allocation, the allocation for the next fiscal 88.14 year is the adjusted base allocation less the amount of unspent 88.15 funds below the 95 percent level. 88.16 (e) If the annual legislative appropriation for the 88.17 alternative care program is inadequate to fund the combined 88.18 county allocations for a biennium, the commissioner shall 88.19 distribute to each county the entire annual appropriation as 88.20 that county's percentage of the computed base as calculated in 88.21 paragraphs (c) and (d). 88.22 Sec. 20. Minnesota Statutes 2001 Supplement, section 88.23 256B.0913, subdivision 12, is amended to read: 88.24 Subd. 12. [CLIENT PREMIUMS.] (a) A premium is required for 88.25 all alternative care eligible clients to help pay for the cost 88.26 of participating in the program. The amount of the premium for 88.27 the alternative care client shall be determined as follows: 88.28 (1) when the alternative care client's income less 88.29 recurring and predictable medical expenses is greater than the 88.30 recipient's maintenance needs allowance as defined in section 88.31 256B.0915, subdivision 1d, paragraph (a), but less than 150 88.32 percent of the federal poverty guideline effective on July 1 of 88.33 the state fiscal year in which the premium is being computed, 88.34 and total assets are less than $10,000, the fee is zero; 88.35 (2) when the alternative care client's income less 88.36 recurring and predictable medical expenses is greater than 150 89.1 percent of the federal poverty guideline effective on July 1 of 89.2 the state fiscal year in which the premium is being computed, 89.3 and total assets are less than $10,000, the fee is 25 percent of 89.4 the cost of alternative care services or the difference between 89.5 150 percent of the federal poverty guideline effective on July 1 89.6 of the state fiscal year in which the premium is being computed 89.7 and the client's income less recurring and predictable medical 89.8 expenses, whichever is less; and 89.9 (3) when the alternative care client's total assets are 89.10 greater than $10,000, the fee is 25 percent of the cost of 89.11 alternative care services. 89.12 For married persons, total assets are defined as the total 89.13 marital assets less the estimated community spouse asset 89.14 allowance, under section 256B.059, if applicable. For married 89.15 persons, total income is defined as the client's income less the 89.16 monthly spousal allotment, under section 256B.058. 89.17 All alternative care services except case management shall 89.18 be included in the estimated costs for the purpose of 89.19 determining 25 percent of the costs. 89.20The monthly premium shall be calculated based on the cost89.21of the first full month of alternative care services and shall89.22continue unaltered until the next reassessment is completed or89.23at the end of 12 months, whichever comes first.Premiums are 89.24 due and payable each month alternative care services are 89.25 received unless the actual cost of the services is less than the 89.26 premium. 89.27 (b) The fee shall be waived by the commissioner when: 89.28 (1) a person who is residing in a nursing facility is 89.29 receiving case management only; 89.30 (2) a person is applying for medical assistance; 89.31 (3) a married couple is requesting an asset assessment 89.32 under the spousal impoverishment provisions; 89.33 (4) a person is found eligible for alternative care, but is 89.34 not yet receiving alternative care services; or 89.35 (5) a person's fee under paragraph (a) is less than $25. 89.36 (c) The county agency must record in the state's receivable 90.1 system the client's assessed premium amount or the reason the 90.2 premium has been waived. The commissioner will bill and collect 90.3 the premium from the client. Money collected must be deposited 90.4 in the general fund and is appropriated to the commissioner for 90.5 the alternative care program. The client must supply the county 90.6 with the client's social security number at the time of 90.7 application. The county shall supply the commissioner with the 90.8 client's social security number and other information the 90.9 commissioner requires to collect the premium from the client. 90.10 The commissioner shall collect unpaid premiums using the Revenue 90.11 Recapture Act in chapter 270A and other methods available to the 90.12 commissioner. The commissioner may require counties to inform 90.13 clients of the collection procedures that may be used by the 90.14 state if a premium is not paid. This paragraph does not apply 90.15 to alternative care pilot projects authorized in Laws 1993, 90.16 First Special Session chapter 1, article 5, section 133, if a 90.17 county operating under the pilot project reports the following 90.18 dollar amounts to the commissioner quarterly: 90.19 (1) total premiums billed to clients; 90.20 (2) total collections of premiums billed; and 90.21 (3) balance of premiums owed by clients. 90.22 If a county does not adhere to these reporting requirements, the 90.23 commissioner may terminate the billing, collecting, and 90.24 remitting portions of the pilot project and require the county 90.25 involved to operate under the procedures set forth in this 90.26 paragraph. 90.27(d) The commissioner shall begin to adopt emergency or90.28permanent rules governing client premiums within 30 days after90.29July 1, 1991, including criteria for determining when services90.30to a client must be terminated due to failure to pay a premium.90.31 Sec. 21. Minnesota Statutes 2001 Supplement, section 90.32 256B.0913, subdivision 14, is amended to read: 90.33 Subd. 14. [PROVIDER REQUIREMENTS, PAYMENT, AND RATE 90.34 ADJUSTMENTS.] (a) Unless otherwise specified in statute, 90.35 providers must be enrolled in the state's Minnesota health care 90.36 program and abide by the requirements for provider participation 91.1 according to Minnesota Rules, part 9505.0195. 91.2 (b) Payment for provided alternative care services as 91.3 approved by the client's case manager shallbeoccur through the 91.4 invoice processing procedures of the department's Medicaid 91.5 Management Information System (MMIS). To receive payment, the 91.6 county or vendor must submit invoices within 12 months following 91.7 the date of service. The county agency and its vendors under 91.8 contract shall not be reimbursed for services which exceed the 91.9 county allocation. 91.10(b)(c) The county shall negotiate individual rates with 91.11 vendors and may authorize service payment for actual costs up to 91.12 the county's current approved rate. Notwithstanding any other 91.13 rule or statutory provision to the contrary, the commissioner 91.14 shall not be authorized to increase rates by an annual inflation 91.15 factor, unless so authorized by the legislature. To improve 91.16 access to community services and eliminate payment disparities 91.17 between the alternative care program and the elderly waiver 91.18 program, the commissioner shall establish statewide maximum 91.19 service rate limits and eliminate county-specific service rate 91.20 limits. 91.21 (1) Effective July 1, 2001, for service rate limits, except 91.22 those in subdivision 5, paragraphs (d) and (i), the rate limit 91.23 for each service shall be the greater of the alternative care 91.24 statewide maximum rate or the elderly waiver statewide maximum 91.25 rate. 91.26 (2) Counties may negotiate individual service rates with 91.27 vendors for actual costs up to the statewide maximum service 91.28 rate limit. 91.29 Sec. 22. Minnesota Statutes 2001 Supplement, section 91.30 256B.0915, subdivision 3, is amended to read: 91.31 Subd. 3. [LIMITS OF CASES, RATES, PAYMENTS, AND 91.32 FORECASTING.] (a) The number of medical assistance waiver 91.33 recipients that a county may serve must be allocated according 91.34 to the number of medical assistance waiver cases open on July 1 91.35 of each fiscal year. Additional recipients may be served with 91.36 the approval of the commissioner. 92.1 (b) The monthly limit for the cost of waivered services to 92.2 an individual elderly waiver client shall be the weighted 92.3 average monthly nursing facility rate of the case mix resident 92.4 class to which the elderly waiver client would be assigned under 92.5 Minnesota Rules, parts 9549.0050 to 9549.0059, less the 92.6 recipient's maintenance needs allowance as described in 92.7 subdivision 1d, paragraph (a), until the first day of the state 92.8 fiscal year in which the resident assessment system as described 92.9 in section 256B.437 for nursing home rate determination is 92.10 implemented. Effective on the first day of the state fiscal 92.11 year in which the resident assessment system as described in 92.12 section 256B.437 for nursing home rate determination is 92.13 implemented and the first day of each subsequent state fiscal 92.14 year, the monthly limit for the cost of waivered services to an 92.15 individual elderly waiver client shall be the rate of the case 92.16 mix resident class to which the waiver client would be assigned 92.17 under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect 92.18 on the last day of the previous state fiscal year, adjusted by 92.19 the greater of any legislatively adopted home and 92.20 community-based services cost-of-living percentage increase or 92.21 any legislatively adopted statewide percent rate increase for 92.22 nursing facilities. 92.23 (c) If extended medical supplies and equipment or 92.24 environmental modifications are or will be purchased for an 92.25 elderly waiver client, the costs may be prorated for up to 12 92.26 consecutive months beginning with the month of purchase. If the 92.27 monthly cost of a recipient's waivered services exceeds the 92.28 monthly limit established in paragraph (b), the annual cost of 92.29 all waivered services shall be determined. In this event, the 92.30 annual cost of all waivered services shall not exceed 12 times 92.31 the monthly limit of waivered services as described in paragraph 92.32 (b). 92.33 (d) For a person who is a nursing facility resident at the 92.34 time of requesting a determination of eligibility for elderly 92.35 waivered services, a monthly conversion limit for the cost of 92.36 elderly waivered services may be requested. The monthly 93.1 conversion limit for the cost of elderly waiver services shall 93.2 be the resident class assigned under Minnesota Rules, parts 93.3 9549.0050 to 9549.0059, for that resident in the nursing 93.4 facility where the resident currently resides until July 1 of 93.5 the state fiscal year in which the resident assessment system as 93.6 described in section 256B.437 for nursing home rate 93.7 determination is implemented. Effective on July 1 of the state 93.8 fiscal year in which the resident assessment system as described 93.9 in section 256B.437 for nursing home rate determination is 93.10 implemented, the monthly conversion limit for the cost of 93.11 elderly waiver services shall be the per diem nursing facility 93.12 rate as determined by the resident assessment system as 93.13 described in section 256B.437 for that resident in the nursing 93.14 facility where the resident currently resides multiplied by 365 93.15 and divided by 12, less the recipient's maintenance needs 93.16 allowance as described in subdivision 1d. The initially 93.17 approved conversion rate may be adjusted by the greater of any 93.18 subsequent legislatively adopted home and community-based 93.19 services cost-of-living percentage increase or any subsequent 93.20 legislatively adopted statewide percentage rate increase for 93.21 nursing facilities. The limit under this clause only applies to 93.22 persons discharged from a nursing facility after a minimum 93.23 30-day stay and found eligible for waivered services on or after 93.24 July 1, 1997. The following costs must be included in 93.25 determining the total monthly costs for the waiver client: 93.26 (1) cost of all waivered services, including extended 93.27 medical supplies and equipment and environmental modifications; 93.28 and 93.29 (2) cost of skilled nursing, home health aide, and personal 93.30 care services reimbursable by medical assistance. 93.31 (e) Medical assistance funding for skilled nursing 93.32 services, private duty nursing, home health aide, and personal 93.33 care services for waiver recipients must be approved by the case 93.34 manager and included in the individual care plan. 93.35 (f) A county is not required to contract with a provider of 93.36 supplies and equipment if the monthly cost of the supplies and 94.1 equipment is less than $250. 94.2 (g) The adult foster care rate shall be considered a 94.3 difficulty of care payment and shall not include room and 94.4 board. The adult foster care service rate shall be negotiated 94.5 between the county agency and the foster care provider. The 94.6 elderly waiver payment for the foster care service in 94.7 combination with the payment for all other elderly waiver 94.8 services, including case management, must not exceed the limit 94.9 specified in paragraph (b). 94.10 (h) Payment for assisted living service shall be a monthly 94.11 rate negotiated and authorized by the county agency based on an 94.12 individualized service plan for each resident and may not cover 94.13 direct rent or food costs. 94.14 (1) The individualized monthly negotiated payment for 94.15 assisted living services as described in section 256B.0913, 94.16 subdivision 5, paragraph (g) or (h), and residential care 94.17 services as described in section 256B.0913, subdivision 5, 94.18 paragraph (f), shall not exceed the nonfederal share, in effect 94.19 on July 1 of the state fiscal year for which the rate limit is 94.20 being calculated, of the greater of either the statewide or any 94.21 of the geographic groups' weighted average monthly nursing 94.22 facility rate of the case mix resident class to which the 94.23 elderly waiver eligible client would be assigned under Minnesota 94.24 Rules, parts 9549.0050 to 9549.0059, less the maintenance needs 94.25 allowance as described in subdivision 1d, paragraph (a), until 94.26 the July 1 of the state fiscal year in which the resident 94.27 assessment system as described in section 256B.437 for nursing 94.28 home rate determination is implemented. Effective on July 1 of 94.29 the state fiscal year in which the resident assessment system as 94.30 described in section 256B.437 for nursing home rate 94.31 determination is implemented and July 1 of each subsequent state 94.32 fiscal year, the individualized monthly negotiated payment for 94.33 the services described in this clause shall not exceed the limit 94.34 described in this clause which was in effect on June 30 of the 94.35 previous state fiscal year and which has been adjusted by the 94.36 greater of any legislatively adopted home and community-based 95.1 services cost-of-living percentage increase or any legislatively 95.2 adopted statewide percent rate increase for nursing facilities. 95.3 (2) The individualized monthly negotiated payment for 95.4 assisted living services described in section 144A.4605 and 95.5 delivered by a provider licensed by the department of health as 95.6 a class A home care provider or an assisted living home care 95.7 provider and provided in a building that is registered as a 95.8 housing with services establishment under chapter 144D and that 95.9 provides 24-hour supervision in combination with the payment for 95.10 other elderly waiver services, including case management, must 95.11 not exceed the limit specified in paragraph (b). 95.12 (i) The county shall negotiate individual service rates 95.13 with vendors and may authorize payment for actual costs up to 95.14 the county's current approved rate. Persons or agencies must be 95.15 employed by or under a contract with the county agency or the 95.16 public health nursing agency of the local board of health in 95.17 order to receive funding under the elderly waiver program, 95.18 except as a provider of supplies and equipment when the monthly 95.19 cost of the supplies and equipment is less than $250. 95.20 (j) Reimbursement for the medical assistance recipients 95.21 under the approved waiver shall be made from the medical 95.22 assistance account through the invoice processing procedures of 95.23 the department's Medicaid Management Information System (MMIS), 95.24 only with the approval of the client's case manager. The budget 95.25 for the state share of the Medicaid expenditures shall be 95.26 forecasted with the medical assistance budget, and shall be 95.27 consistent with the approved waiver. 95.28 (k) To improve access to community services and eliminate 95.29 payment disparities between the alternative care program and the 95.30 elderly waiver, the commissioner shall establish statewide 95.31 maximum service rate limits and eliminate county-specific 95.32 service rate limits. 95.33 (1) Effective July 1, 2001, for service rate limits, except 95.34 those described or defined in paragraphs (g) and (h), the rate 95.35 limit for each service shall be the greater of the alternative 95.36 care statewide maximum rate or the elderly waiver statewide 96.1 maximum rate. 96.2 (2) Counties may negotiate individual service rates with 96.3 vendors for actual costs up to the statewide maximum service 96.4 rate limit. 96.5 (l) Beginning July 1, 1991, the state shall reimburse 96.6 counties according to the payment schedule in section 256.025 96.7 for the county share of costs incurred under this subdivision on 96.8 or after January 1, 1991, for individuals who are receiving 96.9 medical assistance. 96.10 Sec. 23. Minnesota Statutes 2000, section 256B.0915, 96.11 subdivision 4, is amended to read: 96.12 Subd. 4. [TERMINATION NOTICE.] The case manager must give 96.13 the individual a ten-day written notice of anydecrease in96.14 denial, reduction, or termination of waivered services. 96.15 Sec. 24. Minnesota Statutes 2001 Supplement, section 96.16 256B.0915, subdivision 5, is amended to read: 96.17 Subd. 5. [ASSESSMENTS AND REASSESSMENTS FOR WAIVER 96.18 CLIENTS.] Each client shall receive an initial assessment of 96.19 strengths, informal supports, and need for services in 96.20 accordance with section 256B.0911, subdivisions 3, 3a, and 3b. 96.21 A reassessment of a client served under the elderly waiver must 96.22 be conducted at least every 12 months and at other times when 96.23 the case manager determines that there has been significant 96.24 change in the client's functioning. This may include instances 96.25 where the client is discharged from the hospital. 96.26 Sec. 25. Minnesota Statutes 2000, section 256B.0915, 96.27 subdivision 6, is amended to read: 96.28 Subd. 6. [IMPLEMENTATION OF CARE PLAN.] Each elderly 96.29 waiver client shall be provided a copy of a written care plan 96.30 that meets the requirements outlined in section 256B.0913, 96.31 subdivision 8. If the county administering waivered services is 96.32 different than the county of financial responsibility, the care 96.33 plan may be implemented without the approval of the county of 96.34 financial responsibility. 96.35 Sec. 26. Minnesota Statutes 2000, section 256B.0915, is 96.36 amended by adding a subdivision to read: 97.1 Subd. 8. [SERVICES AND SUPPORTS.] (a) Services and 97.2 supports shall meet the requirements set out in United States 97.3 Code, title 42, section 1396n. 97.4 (b) Services and supports shall promote consumer choice and 97.5 be arranged and provided consistent with individualized, written 97.6 care plans. 97.7 (c) The state of Minnesota, county, or tribal government 97.8 under contract to administer the elderly waiver shall not be 97.9 liable for damages, injuries, or liabilities sustained through 97.10 the purchase of direct supports or goods by the person, the 97.11 person's family, or the authorized representatives with funds 97.12 received through consumer directed community support services 97.13 under the federally approved waiver plan. Liabilities include, 97.14 but are not limited to, workers' compensation liability, the 97.15 Federal Insurance Contributions Act (FICA), or the Federal 97.16 Unemployment Tax Act (FUTA). 97.17 Sec. 27. Minnesota Statutes 2001 Supplement, section 97.18 256B.0924, subdivision 6, is amended to read: 97.19 Subd. 6. [PAYMENT FOR TARGETED CASE MANAGEMENT.] (a) 97.20 Medical assistance and MinnesotaCare payment for targeted case 97.21 management shall be made on a monthly basis. In order to 97.22 receive payment for an eligible adult, the provider must 97.23 document at least one contact per month and not more than two 97.24 consecutive months without a face-to-face contact with the adult 97.25 or the adult's legal representative, family, primary caregiver, 97.26 or other relevant persons identified as necessary to the 97.27 development or implementation of the goals of the personal 97.28 service plan. 97.29 (b) Payment for targeted case management provided by county 97.30 staff under this subdivision shall be based on the monthly rate 97.31 methodology under section 256B.094, subdivision 6, paragraph 97.32 (b), calculated as one combined average rate together with adult 97.33 mental health case management under section 256B.0625, 97.34 subdivision 20, except for calendar year 2002. In calendar year 97.35 2002, the rate for case management under this section shall be 97.36 the same as the rate for adult mental health case management in 98.1 effect as of December 31, 2001. Billing and payment must 98.2 identify the recipient's primary population group to allow 98.3 tracking of revenues. 98.4 (c) Payment for targeted case management provided by 98.5 county-contracted vendors shall be based on a monthly rate 98.6 negotiated by the host county. The negotiated rate must not 98.7 exceed the rate charged by the vendor for the same service to 98.8 other payers. If the service is provided by a team of 98.9 contracted vendors, the county may negotiate a team rate with a 98.10 vendor who is a member of the team. The team shall determine 98.11 how to distribute the rate among its members. No reimbursement 98.12 received by contracted vendors shall be returned to the county, 98.13 except to reimburse the county for advance funding provided by 98.14 the county to the vendor. 98.15 (d) If the service is provided by a team that includes 98.16 contracted vendors and county staff, the costs for county staff 98.17 participation on the team shall be included in the rate for 98.18 county-provided services. In this case, the contracted vendor 98.19 and the county may each receive separate payment for services 98.20 provided by each entity in the same month. In order to prevent 98.21 duplication of services, the county must document, in the 98.22 recipient's file, the need for team targeted case management and 98.23 a description of the different roles of the team members. 98.24 (e) Notwithstanding section 256B.19, subdivision 1, the 98.25 nonfederal share of costs for targeted case management shall be 98.26 provided by the recipient's county of responsibility, as defined 98.27 in sections 256G.01 to 256G.12, from sources other than federal 98.28 funds or funds used to match other federal funds. 98.29 (f) The commissioner may suspend, reduce, or terminate 98.30 reimbursement to a provider that does not meet the reporting or 98.31 other requirements of this section. The county of 98.32 responsibility, as defined in sections 256G.01 to 256G.12, is 98.33 responsible for any federal disallowances. The county may share 98.34 this responsibility with its contracted vendors. 98.35 (g) The commissioner shall set aside five percent of the 98.36 federal funds received under this section for use in reimbursing 99.1 the state for costs of developing and implementing this section. 99.2 (h) Notwithstanding section 256.025, subdivision 2, 99.3 payments to counties for targeted case management expenditures 99.4 under this section shall only be made from federal earnings from 99.5 services provided under this section. Payments to contracted 99.6 vendors shall include both the federal earnings and the county 99.7 share. 99.8 (i) Notwithstanding section 256B.041, county payments for 99.9 the cost of case management services provided by county staff 99.10 shall not be made to the state treasurer. For the purposes of 99.11 targeted case management services provided by county staff under 99.12 this section, the centralized disbursement of payments to 99.13 counties under section 256B.041 consists only of federal 99.14 earnings from services provided under this section. 99.15 (j) If the recipient is a resident of a nursing facility, 99.16 intermediate care facility, or hospital, and the recipient's 99.17 institutional care is paid by medical assistance, payment for 99.18 targeted case management services under this subdivision is 99.19 limited to the last 180 days of the recipient's residency in 99.20 that facility and may not exceed more than six months in a 99.21 calendar year. 99.22 (k) Payment for targeted case management services under 99.23 this subdivision shall not duplicate payments made under other 99.24 program authorities for the same purpose. 99.25 (l) Any growth in targeted case management services and 99.26 cost increases under this section shall be the responsibility of 99.27 the counties. 99.28 Sec. 28. Minnesota Statutes 2001 Supplement, section 99.29 256B.0951, subdivision 7, is amended to read: 99.30 Subd. 7. [WAIVER OF RULES.] If a federal waiver is 99.31 approved under subdivision 8, the commissioner of health may 99.32 exempt residents of intermediate care facilities for persons 99.33 with mental retardation (ICFs/MR) who participate in the 99.34three-yearalternative quality assurancepilotproject 99.35 established in section 256B.095 from the requirements of 99.36 Minnesota Rules, chapter 4665, upon approval by the federal100.1government of a waiver of federal certification requirements for100.2ICFs/MR. 100.3 Sec. 29. Minnesota Statutes 2001 Supplement, section 100.4 256B.0951, subdivision 8, is amended to read: 100.5 Subd. 8. [FEDERAL WAIVER.] The commissioner of human 100.6 services shall seekfederal authority to waive provisions of100.7intermediate care facilities for persons with mental retardation100.8(ICFs/MR) regulations to enable the demonstration and evaluation100.9of the alternative quality assurance system for ICFs/MR under100.10the project. The commissioner of human services shall apply for100.11any necessary waivers as soon as practicable.a federal waiver 100.12 to allow intermediate care facilities for persons with mental 100.13 retardation (ICFs/MR) in Region 10 of Minnesota to participate 100.14 in the alternative licensing system. If it is necessary for 100.15 purposes of participation in this alternative licensing system 100.16 for a facility to be decertified as an ICF/MR facility according 100.17 to the terms of the federal waiver, when the facility seeks 100.18 recertification under the provisions of ICF/MR regulations at 100.19 the end of the demonstration project, it will not be considered 100.20 a new ICF/MR as defined under section 252.291 provided the 100.21 licensed capacity of the facility did not increase during its 100.22 participation in the alternative licensing system. The 100.23 provisions of sections 252.82, 252.292, and 256B.5011 to 100.24 256B.5015 will remain applicable for counties in Region 10 of 100.25 Minnesota and the ICFs/MR located within those counties 100.26 notwithstanding a county's participation in the alternative 100.27 licensing system. 100.28 Sec. 30. Minnesota Statutes 2001 Supplement, section 100.29 256B.431, subdivision 2e, is amended to read: 100.30 Subd. 2e. [CONTRACTS FOR SERVICES FOR VENTILATOR-DEPENDENT 100.31 PERSONS.] The commissioner maycontractnegotiate with a nursing 100.32 facility eligible to receive medical assistance payments to 100.33 provide services to a ventilator-dependent person identified by 100.34 the commissioner according to criteria developed by the 100.35 commissioner, including: 100.36 (1) nursing facility care has been recommended for the 101.1 person by a preadmission screening team; 101.2 (2) the person has been hospitalized and no longer requires 101.3 inpatient acute care hospital services; and 101.4 (3) the commissioner has determined that necessary services 101.5 for the person cannot be provided under existing nursing 101.6 facility rates. 101.7The commissioner may issue a request for proposals to101.8provide services to a ventilator-dependent person to nursing101.9facilities eligible to receive medical assistance payments and101.10shall select nursing facilities from among respondents according101.11to criteria developed by the commissioner, including:101.12(1) the cost-effectiveness and appropriateness of services;101.13(2) the nursing facility's compliance with federal and101.14state licensing and certification standards; and101.15(3) the proximity of the nursing facility to a101.16ventilator-dependent person identified by the commissioner who101.17requires nursing facility placement.101.18 The commissioner may negotiate an adjustment to the 101.19 operating cost payment rate for a nursing facilityselected by101.20the commissioner from among respondents to the request for101.21proposalswith a resident who is ventilator-dependent, for that 101.22 resident. The negotiated adjustment must reflect only the 101.23 actual additional cost of meeting the specialized care needs of 101.24 a ventilator-dependent person identified by the commissioner for 101.25 whom necessary services cannot be provided under existing 101.26 nursing facility rates and which are not otherwise covered under 101.27 Minnesota Rules, parts 9549.0010 to 9549.0080 or 9505.0170 to 101.28 9505.0475. For persons who are initially admitted to a nursing 101.29 facility before July 1, 2001, and have their payment rate under 101.30 this subdivision negotiated after July 1, 2001, the negotiated 101.31 payment rate must not exceed 200 percent of the highest multiple 101.32 bedroom payment rate for the facility, as initially established 101.33 by the commissioner for the rate year for case mix 101.34 classification K; or, upon implementation of the RUGs-based case 101.35 mix system, 200 percent of the highest RUGs rate. For persons 101.36 initially admitted to a nursing facility on or after July 1, 102.1 2001, the negotiated payment rate must not exceed 300 percent of 102.2 the facility's multiple bedroom payment rate for case mix 102.3 classification K; or, upon implementation of the RUGs-based case 102.4 mix system, 300 percent of the highest RUGs rate. The 102.5 negotiated adjustment shall not affect the payment rate charged 102.6 to private paying residents under the provisions of section 102.7 256B.48, subdivision 1. 102.8 Sec. 31. Minnesota Statutes 2000, section 256B.431, 102.9 subdivision 14, is amended to read: 102.10 Subd. 14. [LIMITATIONS ON SALES OF NURSING FACILITIES.] 102.11 (a) For rate periods beginning on October 1, 1992, and for rate 102.12 years beginning after June 30, 1993, a nursing facility's 102.13 property-related payment rate as established under subdivision 102.14 13 shall be adjusted by either paragraph (b) or (c) for the sale 102.15 of the nursing facility, including sales occurring after June 102.16 30, 1992, as provided in this subdivision. 102.17 (b) If the nursing facility's property-related payment rate 102.18 under subdivision 13 prior to sale is greater than the nursing 102.19 facility's rental rate under Minnesota Rules, parts 9549.0010 to 102.20 9549.0080, and this section prior to sale, the nursing 102.21 facility's property-related payment rate after sale shall be the 102.22 greater of its property-related payment rate under subdivision 102.23 13 prior to sale or its rental rate under Minnesota Rules, parts 102.24 9549.0010 to 9549.0080, and this section calculated after sale. 102.25 (c) If the nursing facility's property-related payment rate 102.26 under subdivision 13 prior to sale is equal to or less than the 102.27 nursing facility's rental rate under Minnesota Rules, parts 102.28 9549.0010 to 9549.0080, and this section prior to sale, the 102.29 nursing facility's property-related payment rate after sale 102.30 shall be the nursing facility's property-related payment rate 102.31 under subdivision 13 plus the difference between its rental rate 102.32 calculated under Minnesota Rules, parts 9549.0010 to 9549.0080, 102.33 and this section prior to sale and its rental rate calculated 102.34 under Minnesota Rules, parts 9549.0010 to 9549.0080, and this 102.35 section calculated after sale. 102.36 (d) For purposes of this subdivision, "sale" means the 103.1 purchase of a nursing facility's capital assets with cash or 103.2 debt. The term sale does not include a stock purchase of a 103.3 nursing facility or any of the following transactions: 103.4 (1) a sale and leaseback to the same licensee that does not 103.5 constitute a change in facility license; 103.6 (2) a transfer of an interest to a trust; 103.7 (3) gifts or other transfers for no consideration; 103.8 (4) a merger of two or more related organizations; 103.9 (5) a change in the legal form of doing business, other 103.10 than a publicly held organization that becomes privately held or 103.11 vice versa; 103.12 (6) the addition of a new partner, owner, or shareholder 103.13 who owns less than 20 percent of the nursing facility or the 103.14 issuance of stock; and 103.15 (7) a sale, merger, reorganization, or any other transfer 103.16 of interest between related organizations other than those 103.17 permitted in this section. 103.18 (e) For purposes of this subdivision, "sale" includes the 103.19 sale or transfer of a nursing facility to a close relative as 103.20 defined in Minnesota Rules, part 9549.0020, subpart 38, item C, 103.21 upon the death of an owner, due to serious illness or 103.22 disability, as defined under the Social Security Act, under 103.23 United States Code, title 42, section 423(d)(1)(A), or upon 103.24 retirement of an owner from the business of owning or operating 103.25 a nursing home at 62 years of age or older. For sales to a 103.26 close relative allowed under this paragraph, otherwise 103.27 nonallowable debt resulting from seller financing of all or a 103.28 portion of the debt resulting from the sale shall be allowed and 103.29 shall not be subject to Minnesota Rules, part 9549.0060, subpart 103.30 5, item E, provided that in addition to existing requirements 103.31 for allowance of debt and interest, the debt is subject to 103.32 repayment through annual principal payments and the interest 103.33 rate on the related organization debt does not exceed three 103.34 percentage points above the posted yield for standard 103.35 conventional fixed rate mortgages of the Federal Home Loan 103.36 Mortgage Corporation for delivery in 60 days in effect on the 104.1 day of sale. If at any time, the seller forgives the related 104.2 organization debt allowed under this paragraph for other than 104.3 equal amount of payment on that debt, then the buyer shall pay 104.4 to the state the total revenue received by the nursing facility 104.5 after the sale attributable to the amount of allowable debt 104.6 which has been forgiven. Any assignment, sale, or transfer of 104.7 the debt instrument entered into by the close relatives, either 104.8 directly or indirectly, which grants to the close relative buyer 104.9 the right to receive all or a portion of the payments under the 104.10 debt instrument shall, effective on the date of the transfer, 104.11 result in the prospective reduction in the corresponding portion 104.12 of the allowable debt and interest expense. Upon the death of 104.13 the close relative seller, any remaining balance of the close 104.14 relative debt must be refinanced and such refinancing shall be 104.15 subject to the provisions of Minnesota Rules, part 9549.0060, 104.16 subpart 7, item G. This paragraph shall not apply to sales 104.17 occurring on or after June 30, 1997. 104.18 (f) For purposes of this subdivision, "effective date of 104.19 sale" means the later of either the date on which legal title to 104.20 the capital assets is transferred or the date on which closing 104.21 for the sale occurred. 104.22 (g) The effective day for the property-related payment rate 104.23 determined under this subdivision shall be the first day of the 104.24 month following the month in which the effective date of sale 104.25 occurs or October 1, 1992, whichever is later, provided that the 104.26 notice requirements under section 256B.47, subdivision 2, have 104.27 been met. 104.28 (h) Notwithstanding Minnesota Rules, part 9549.0060, 104.29 subparts 5, item A, subitems (3) and (4), and 7, items E and F, 104.30 the commissioner shall limit the total allowable debt and 104.31 related interest for sales occurring after June 30, 1992, to the 104.32 sum of clauses (1) to (3): 104.33 (1) the historical cost of capital assets, as of the 104.34 nursing facility's most recent previous effective date of sale 104.35 or, if there has been no previous sale, the nursing facility's 104.36 initial historical cost of constructing capital assets; 105.1 (2) the average annual capital asset additions after 105.2 deduction for capital asset deletions, not including 105.3 depreciations; and 105.4 (3) one-half of the allowed inflation on the nursing 105.5 facility's capital assets. The commissioner shall compute the 105.6 allowed inflation as described in paragraph(h)(i). 105.7 (i) For purposes of computing the amount of allowed 105.8 inflation, the commissioner must apply the following principles: 105.9 (1) the lesser of the Consumer Price Index for all urban 105.10 consumers or the Dodge Construction Systems Costs for Nursing 105.11 Homes for any time periods during which both are available must 105.12 be used. If the Dodge Construction Systems Costs for Nursing 105.13 Homes becomes unavailable, the commissioner shall substitute the 105.14 index in subdivision 3f, or such other index as the secretary of 105.15 the health care financing administration may designate; 105.16 (2) the amount of allowed inflation to be applied to the 105.17 capital assets in paragraph (g), clauses (1) and (2), must be 105.18 computed separately; 105.19 (3) the amount of allowed inflation must be determined on 105.20 an annual basis, prorated on a monthly basis for partial years 105.21 and if the initial month of use is not determinable for a 105.22 capital asset, then one-half of that calendar year shall be used 105.23 for purposes of prorating; 105.24 (4) the amount of allowed inflation to be applied to the 105.25 capital assets in paragraph (g), clauses (1) and (2), must not 105.26 exceed 300 percent of the total capital assets in any one of 105.27 those clauses; and 105.28 (5) the allowed inflation must be computed starting with 105.29 the month following the nursing facility's most recent previous 105.30 effective date of sale or, if there has been no previous sale, 105.31 the month following the date of the nursing facility's initial 105.32 occupancy, and ending with the month preceding the effective 105.33 date of sale. 105.34 (j) If the historical cost of a capital asset is not 105.35 readily available for the date of the nursing facility's most 105.36 recent previous sale or if there has been no previous sale for 106.1 the date of the nursing facility's initial occupancy, then the 106.2 commissioner shall limit the total allowable debt and related 106.3 interest after sale to the extent recognized by the Medicare 106.4 intermediary after the sale. For a nursing facility that has no 106.5 historical capital asset cost data available and does not have 106.6 allowable debt and interest calculated by the Medicare 106.7 intermediary, the commissioner shall use the historical cost of 106.8 capital asset data from the point in time for which capital 106.9 asset data is recorded in the nursing facility's audited 106.10 financial statements. 106.11 (k) The limitations in this subdivision apply only to debt 106.12 resulting from a sale of a nursing facility occurring after June 106.13 30, 1992, including debt assumed by the purchaser of the nursing 106.14 facility. 106.15 Sec. 32. Minnesota Statutes 2000, section 256B.431, 106.16 subdivision 30, is amended to read: 106.17 Subd. 30. [BED LAYAWAY AND DELICENSURE.] (a) For rate 106.18 years beginning on or after July 1, 2000, a nursing facility 106.19 reimbursed under this section which has placed beds on layaway 106.20 shall, for purposes of application of the downsizing incentive 106.21 in subdivision 3a, paragraph(d)(c), and calculation of the 106.22 rental per diem, have those beds given the same effect as if the 106.23 beds had been delicensed so long as the beds remain on layaway. 106.24 At the time of a layaway, a facility may change its single bed 106.25 election for use in calculating capacity days under Minnesota 106.26 Rules, part 9549.0060, subpart 11. The property payment rate 106.27 increase shall be effective the first day of the month following 106.28 the month in which the layaway of the beds becomes effective 106.29 under section 144A.071, subdivision 4b. 106.30 (b) For rate years beginning on or after July 1, 2000, 106.31 notwithstanding any provision to the contrary under section 106.32 256B.434, a nursing facility reimbursed under that section which 106.33 has placed beds on layaway shall, for so long as the beds remain 106.34 on layaway, be allowed to: 106.35 (1) aggregate the applicable investment per bed limits 106.36 based on the number of beds licensed immediately prior to 107.1 entering the alternative payment system; 107.2 (2) retain or change the facility's single bed election for 107.3 use in calculating capacity days under Minnesota Rules, part 107.4 9549.0060, subpart 11; and 107.5 (3) establish capacity days based on the number of beds 107.6 immediately prior to the layaway and the number of beds after 107.7 the layaway. 107.8 The commissioner shall increase the facility's property payment 107.9 rate by the incremental increase in the rental per diem 107.10 resulting from the recalculation of the facility's rental per 107.11 diem applying only the changes resulting from the layaway of 107.12 beds and clauses (1), (2), and (3). If a facility reimbursed 107.13 under section 256B.434 completes a moratorium exception project 107.14 after its base year, the base year property rate shall be the 107.15 moratorium project property rate. The base year rate shall be 107.16 inflated by the factors in section 256B.434, subdivision 4, 107.17 paragraph (c). The property payment rate increase shall be 107.18 effective the first day of the month following the month in 107.19 which the layaway of the beds becomes effective. 107.20 (c) If a nursing facility removes a bed from layaway status 107.21 in accordance with section 144A.071, subdivision 4b, the 107.22 commissioner shall establish capacity days based on the number 107.23 of licensed and certified beds in the facility not on layaway 107.24 and shall reduce the nursing facility's property payment rate in 107.25 accordance with paragraph (b). 107.26 (d) For the rate years beginning on or after July 1, 2000, 107.27 notwithstanding any provision to the contrary under section 107.28 256B.434, a nursing facility reimbursed under that section, 107.29 which has delicensed beds after July 1, 2000, by giving notice 107.30 of the delicensure to the commissioner of health according to 107.31 the notice requirements in section 144A.071, subdivision 4b, 107.32 shall be allowed to: 107.33 (1) aggregate the applicable investment per bed limits 107.34 based on the number of beds licensed immediately prior to 107.35 entering the alternative payment system; 107.36 (2) retain or change the facility's single bed election for 108.1 use in calculating capacity days under Minnesota Rules, part 108.2 9549.0060, subpart 11; and 108.3 (3) establish capacity days based on the number of beds 108.4 immediately prior to the delicensure and the number of beds 108.5 after the delicensure. 108.6 The commissioner shall increase the facility's property payment 108.7 rate by the incremental increase in the rental per diem 108.8 resulting from the recalculation of the facility's rental per 108.9 diem applying only the changes resulting from the delicensure of 108.10 beds and clauses (1), (2), and (3). If a facility reimbursed 108.11 under section 256B.434 completes a moratorium exception project 108.12 after its base year, the base year property rate shall be the 108.13 moratorium project property rate. The base year rate shall be 108.14 inflated by the factors in section 256B.434, subdivision 4, 108.15 paragraph (c). The property payment rate increase shall be 108.16 effective the first day of the month following the month in 108.17 which the delicensure of the beds becomes effective. 108.18 (e) For nursing facilities reimbursed under this section or 108.19 section 256B.434, any beds placed on layaway shall not be 108.20 included in calculating facility occupancy as it pertains to 108.21 leave days defined in Minnesota Rules, part 9505.0415. 108.22 (f) For nursing facilities reimbursed under this section or 108.23 section 256B.434, the rental rate calculated after placing beds 108.24 on layaway may not be less than the rental rate prior to placing 108.25 beds on layaway. 108.26 (g) A nursing facility receiving a rate adjustment as a 108.27 result of this section shall comply with section 256B.47, 108.28 subdivision 2. 108.29 (h) A facility that does not utilize the space made 108.30 available as a result of bed layaway or delicensure under this 108.31 subdivision to reduce the number of beds per room or provide 108.32 more common space for nursing facility uses or perform other 108.33 activities related to the operation of the nursing facility 108.34 shall have its property rate increase calculated under this 108.35 subdivision reduced by the ratio of the square footage made 108.36 available that is not used for these purposes to the total 109.1 square footage made available as a result of bed layaway or 109.2 delicensure. 109.3 Sec. 33. Minnesota Statutes 2001 Supplement, section 109.4 256B.431, subdivision 33, is amended to read: 109.5 Subd. 33. [STAGED REDUCTION IN RATE DISPARITIES.] (a) For 109.6 the rate years beginning July 1, 2001, and July 1, 2002, the 109.7 commissioner shall adjust the operating payment rates for 109.8 low-rate nursing facilities reimbursed under this section or 109.9 section 256B.434. 109.10 (b) For the rate year beginning July 1, 2001, for each case 109.11 mix level, if the amount computed under subdivision3231 is 109.12 less than the amount in clause (1), the commissioner shall make 109.13 available the lesser of the amount in clause (1) or an increase 109.14 of ten percent over the rate in effect on June 30, 2001, as an 109.15 adjustment to the operating payment rate. For the rate year 109.16 beginning July 1, 2002, for each case mix level, if the amount 109.17 computed under subdivision3231 is less than the amount in 109.18 clause (2), the commissioner shall make available the lesser of 109.19 the amount in clause (2) or an increase of ten percent over the 109.20 rate in effect on June 30, 2002, as an adjustment to the 109.21 operating payment rate. For purposes of this subdivision, 109.22 nursing facilities shall be considered to be metro if they are 109.23 located in Anoka, Carver, Dakota, Hennepin, Olmsted, Ramsey, 109.24 Scott, or Washington counties; or in the cities of Moorhead or 109.25 Breckenridge; or in St. Louis county, north of Toivola and south 109.26 of Cook; or in Itasca county, east of a north south line two 109.27 miles west of Grand Rapids: 109.28 (1) Operating Payment Rate Target Level for July 1, 2001: 109.29 Case Mix Classification Metro Nonmetro 109.30 A $ 76.00 $ 68.13 109.31 B $ 83.40 $ 74.46 109.32 C $ 91.67 $ 81.63 109.33 D $ 99.51 $ 88.04 109.34 E $107.46 $ 94.87 109.35 F $107.96 $ 95.29 109.36 G $114.67 $100.98 110.1 H $126.99 $111.31 110.2 I $131.42 $115.06 110.3 J $138.34 $120.85 110.4 K $152.26 $133.10 110.5 (2) Operating Payment Rate Target Level for July 1, 2002: 110.6 Case Mix Classification Metro Nonmetro 110.7 A $ 78.28 $ 70.51 110.8 B $ 85.91 $ 77.16 110.9 C $ 94.42 $ 84.62 110.10 D $102.50 $ 91.42 110.11 E $110.68 $ 98.40 110.12 F $111.20 $ 98.84 110.13 G $118.11 $104.77 110.14 H $130.80 $115.64 110.15 I $135.38 $119.50 110.16 J $142.49 $125.38 110.17 K $156.85 $137.77 110.18 Sec. 34. Minnesota Statutes 2000, section 256B.431, is 110.19 amended by adding a subdivision to read: 110.20 Subd. 37. [DESIGNATION OF AREAS TO RECEIVE METROPOLITAN 110.21 RATES.] For rate years beginning on or after July 1, 2003, 110.22 nursing facilities located in areas designated as metropolitan 110.23 areas by the federal Office of Management and Budget using 110.24 census bureau data shall be part of the metropolitan array for 110.25 purposes of calculating a median, determining a historical base 110.26 reimbursement rate, or otherwise establishing a statistical 110.27 measure of nursing facility payment rates, in order to: 110.28 (1) determine future rate increases under this section, 110.29 section 256B.434, or any other section; and 110.30 (2) establish nursing facility reimbursement rates for the 110.31 new nursing facility reimbursement system developed under Laws 110.32 2001, First Special Session chapter 9, article 5, section 35. 110.33 Sec. 35. Minnesota Statutes 2001 Supplement, section 110.34 256B.437, subdivision 3, is amended to read: 110.35 Subd. 3. [APPLICATIONS FOR PLANNED CLOSURE OF NURSING 110.36 FACILITIES.] (a) By August 15, 2001, the commissioner of human 111.1 services shall implement and announce a program for closure or 111.2 partial closure of nursing facilities. Names and identifying 111.3 information provided in response to the announcement shall 111.4 remain private unless approved, according to the timelines 111.5 established in the plan. The announcement must specify: 111.6 (1) the criteria in subdivision 4 that will be used by the 111.7 commissioner to approve or reject applications; 111.8 (2)a requirement for the submission of a letter of intent111.9before the submission of an application;111.10(3)the information that must accompany an application; and 111.11(4)(3) that applications may combine planned closure rate 111.12 adjustments with moratorium exception funding, in which case a 111.13 single application may serve both purposes. 111.14 Between August 1, 2001, and June 30, 2003, the commissioner may 111.15 approve planned closures of up to 5,140 nursing facility beds, 111.16 less the number oflicensedbeds delicensed in facilitiesthat111.17closeduring the same time period without approved closure plans 111.18 or that have notified the commissioner of health of their intent 111.19 to close without an approved closure plan. 111.20 (b) A facility or facilities reimbursed under section 111.21 256B.431 or 256B.434 with a closure plan approved by the 111.22 commissioner under subdivision 5 may assign a planned closure 111.23 rate adjustment to another facility or facilities that are not 111.24 closing or in the case of a partial closure, to the facility 111.25 undertaking the partial closure. A facility may also elect to 111.26 have a planned closure rate adjustment shared equally by the 111.27 five nursing facilities with the lowest total operating payment 111.28 rates in the state development region designated under section 111.29 462.385, in which the facility that is closing is located. The 111.30 planned closure rate adjustment must be calculated under 111.31 subdivision 6. Facilities thatclosedelicense beds without a 111.32 closure plan, or whose closure plan is not approved by the 111.33 commissioner, are not eligible to assign a planned closure rate 111.34 adjustment under subdivision 6., unless they are delicensing 111.35 five or fewer beds, or less than six percent of their total 111.36 licensed bed capacity, whichever is greater. Facilities 112.1 delicensing, in any three-month period, five or fewer beds or 112.2 less than six percent of their total licensed bed capacity, 112.3 whichever is greater, without an approved closure plan are 112.4 eligible to assign the amount calculated under subdivision 6 to 112.5 themselves, if the facilities are located in a county that is in 112.6 the top three quartiles when ranked on nursing facility beds per 112.7 thousand individuals age 65 and older. When facilities are 112.8 delicensing more than five beds, or six percent or more of their 112.9 total licensed bed capacity, whichever is greater, and if they 112.10 do not have an approved closure plan or are not eligible for the 112.11 adjustment under subdivision 6, the commissioner shall calculate 112.12 the amount the facility or facilities would have been eligible 112.13 to assign under subdivision 6, and shall use this amount to 112.14 provide equal rate adjustments to the five nursing facilities 112.15 with the lowest total operating payment rates in the state 112.16 development region designated under section 462.385, in which 112.17 the facility or facilities thatclosed isdelicense beds are 112.18 located. 112.19 (c) To be considered for approval, an application must 112.20 include: 112.21 (1) a description of the proposed closure plan, which must 112.22 include identification of the facility or facilities to receive 112.23 a planned closure rate adjustmentand the amount and timing of a112.24planned closure rate adjustment proposed for each facility; 112.25 (2) the proposed timetable for any proposed closure, 112.26 including the proposed dates for announcement to residents, 112.27 commencement of closure, and completion of closure; 112.28 (3) if available, the proposed relocation plan for current 112.29 residents of any facility designated for closure.The proposed112.30 If a relocation plan is not available, the application must 112.31 include a statement agreeing to develop a relocation planmust112.32bedesigned to comply withall applicable state and federal112.33statutes and regulations, including, but not limited to,section 112.34 144A.161; 112.35 (4) a description of the relationship between the nursing 112.36 facility that is proposed for closure and the nursing facility 113.1 or facilities proposed to receive the planned closure rate 113.2 adjustment. If these facilities are not under common ownership, 113.3 copies of any contracts, purchase agreements, or other documents 113.4 establishing a relationship or proposed relationship must be 113.5 provided; 113.6 (5) documentation, in a format approved by the 113.7 commissioner, that all the nursing facilities receiving a 113.8 planned closure rate adjustment under the plan have accepted 113.9 joint and several liability for recovery of overpayments under 113.10 section 256B.0641, subdivision 2, for the facilities designated 113.11 for closure under the plan; and 113.12 (6) an explanation of how the application coordinates with 113.13 planning efforts under subdivision 2. If the planning group 113.14 does not support a level of nursing facility closures that the 113.15 commissioner considers to be reasonable, the commissioner may 113.16 approve a planned closure proposal without its support. 113.17 (d) The application must address the criteria listed in 113.18 subdivision 4. 113.19 Sec. 36. Minnesota Statutes 2001 Supplement, section 113.20 256B.437, subdivision 6, is amended to read: 113.21 Subd. 6. [PLANNED CLOSURE RATE ADJUSTMENT.] (a) The 113.22 commissioner of human services shall calculate the amount of the 113.23 planned closure rate adjustment available under subdivision 3, 113.24 paragraph (b), for up to 5,140 beds according to clauses (1) to 113.25 (4): 113.26 (1) the amount available is the net reduction of nursing 113.27 facility beds multiplied by $2,080; 113.28 (2) the total number of beds in the nursing facility or 113.29 facilities receiving the planned closure rate adjustment must be 113.30 identified; 113.31 (3) capacity days are determined by multiplying the number 113.32 determined under clause (2) by 365; and 113.33 (4) the planned closure rate adjustment is the amount 113.34 available in clause (1), divided by capacity days determined 113.35 under clause (3). 113.36 (b) A planned closure rate adjustment under this section is 114.1 effective on the first day of the month following completion of 114.2 closure of the facility designated for closure in the 114.3 application and becomes part of the nursing facility's total 114.4 operating payment rate. 114.5 (c) Applicants may use the planned closure rate adjustment 114.6 to allow for a property payment for a new nursing facility or an 114.7 addition to an existing nursing facility or as an operating 114.8 payment rate adjustment. Applications approved under this 114.9 subdivision are exempt from other requirements for moratorium 114.10 exceptions under section 144A.073, subdivisions 2 and 3. 114.11 (d) Upon the request of a closing facility, the 114.12 commissioner must allow the facility a closure rate adjustment 114.13 as provided under section 144A.161, subdivision 10. 114.14 (e) If the per bed dollar amount specified in paragraph 114.15 (a), clause (1) is increased, the commissioner shall recalculate 114.16 planned closure rate adjustments for facilities that delicense 114.17 beds under this section on or after July 1, 2001, to reflect the 114.18 increase in the per bed dollar amount. The recalculated planned 114.19 closure rate adjustment shall be effective from the date the per 114.20 bed dollar amount is increased. 114.21 (f) A facility that has received a planned closure rate 114.22 adjustment may reassign it to another facility that is under the 114.23 same ownership at any time within three years of its effective 114.24 date. The amount of the adjustment shall be computed according 114.25 to paragraph (a). 114.26 Sec. 37. Minnesota Statutes 2001 Supplement, section 114.27 256B.437, is amended by adding a subdivision to read: 114.28 Subd. 9. [TRANSFER OF BEDS.] The board of commissioners of 114.29 Saint Louis county may amend their planned closure rate 114.30 adjustment application to allow up to 50 beds of a 159-licensed 114.31 bed county-owned nursing facility that is in the process of 114.32 closing to be transferred to a hospital-attached nursing 114.33 facility in Aurora and up to 50 beds to a 235-bed nursing 114.34 facility in Duluth, and may also assign all or a portion of the 114.35 planned closure rate adjustment that would be received as a 114.36 result of closure to the Aurora facility or the Duluth facility. 115.1 Sec. 38. Minnesota Statutes 2001 Supplement, section 115.2 256B.438, subdivision 1, is amended to read: 115.3 Subdivision 1. [SCOPE.] This section establishes the 115.4 method and criteria used to determine resident reimbursement 115.5 classifications based upon the assessments of residents of 115.6 nursing homes and boarding care homes whose payment rates are 115.7 established under section 256B.431, 256B.434, or 256B.435. 115.8 Resident reimbursement classifications shall be established 115.9 according to the 34 group, resource utilization groups, version 115.10 III or RUG-III model as described in section 144.0724. 115.11 Reimbursement classifications established under this section 115.12 shall be implemented after June 30, 2002, but no later than 115.13 January 1, 2003. Reimbursement classifications established 115.14 under this section shall be implemented no earlier than six 115.15 weeks after the commissioner mails notices of payment rates to 115.16 the facilities. 115.17 Sec. 39. Minnesota Statutes 2000, section 256B.5012, 115.18 subdivision 2, is amended to read: 115.19 Subd. 2. [OPERATING PAYMENT RATE.] (a) The operating 115.20 payment rate equals the facility's total payment rate in effect 115.21 on September 30, 2000, minus the property rate. The operating 115.22 payment rate includes the special operating rate and the 115.23 efficiency incentive in effect as of September 30, 2000. Within 115.24 the limits of appropriations specifically for this purpose, the 115.25 operating payment shall be increased for each rate year by the 115.26 annual percentage change in the Employment Cost Index for 115.27 Private Industry Workers - Total Compensation, as forecasted by 115.28 the commissioner of finance's economic consultant, in the second 115.29 quarter of the calendar year preceding the start of each rate 115.30 year. In the case of the initial rate year beginning October 1, 115.31 2000, and continuing through December 31, 2001, the percentage 115.32 change shall be based on the percentage change in the Employment 115.33 Cost Index for Private Industry Workers - Total Compensation for 115.34 the 15-month period beginning October 1, 2000, as forecast by 115.35 Data Resources, Inc., in the first quarter of 2000. 115.36 (b) Effective October 1, 2000, the operating payment rate 116.1 shall be adjusted to reflect an occupancy rate equal to 100 116.2 percent of the facility's capacity days as of September 30, 2000. 116.3 (c) Effective July 1, 2001, the operating payment rate 116.4 shall be adjusted for the increases in the department of health 116.5 licensing fees that were authorized in Laws 2001, First Special 116.6 Session chapter 9, article 1, section 30. 116.7 Sec. 40. Minnesota Statutes 2001 Supplement, section 116.8 256B.76, is amended to read: 116.9 256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 116.10 (a) Effective for services rendered on or after October 1, 116.11 1992, the commissioner shall make payments for physician 116.12 services as follows: 116.13 (1) payment for level one Health Care Finance 116.14 Administration's common procedural coding system (HCPCS) codes 116.15 titled "office and other outpatient services," "preventive 116.16 medicine new and established patient," "delivery, antepartum, 116.17 and postpartum care," "critical care," cesarean delivery and 116.18 pharmacologic management provided to psychiatric patients, and 116.19 HCPCS level three codes for enhanced services for prenatal high 116.20 risk, shall be paid at the lower of (i) submitted charges, or 116.21 (ii) 25 percent above the rate in effect on June 30, 1992. If 116.22 the rate on any procedure code within these categories is 116.23 different than the rate that would have been paid under the 116.24 methodology in section 256B.74, subdivision 2, then the larger 116.25 rate shall be paid; 116.26 (2) payments for all other services shall be paid at the 116.27 lower of (i) submitted charges, or (ii) 15.4 percent above the 116.28 rate in effect on June 30, 1992; 116.29 (3) all physician rates shall be converted from the 50th 116.30 percentile of 1982 to the 50th percentile of 1989, less the 116.31 percent in aggregate necessary to equal the above increases 116.32 except that payment rates for home health agency services shall 116.33 be the rates in effect on September 30, 1992; 116.34 (4) effective for services rendered on or after January 1, 116.35 2000, payment rates for physician and professional services 116.36 shall be increased by three percent over the rates in effect on 117.1 December 31, 1999, except for home health agency and family 117.2 planning agency services; and 117.3 (5) the increases in clause (4) shall be implemented 117.4 January 1, 2000, for managed care. 117.5 (b) Effective for services rendered on or after October 1, 117.6 1992, the commissioner shall make payments for dental services 117.7 as follows: 117.8 (1) dental services shall be paid at the lower of (i) 117.9 submitted charges, or (ii) 25 percent above the rate in effect 117.10 on June 30, 1992; 117.11 (2) dental rates shall be converted from the 50th 117.12 percentile of 1982 to the 50th percentile of 1989, less the 117.13 percent in aggregate necessary to equal the above increases; 117.14 (3) effective for services rendered on or after January 1, 117.15 2000, payment rates for dental services shall be increased by 117.16 three percent over the rates in effect on December 31, 1999; 117.17 (4) the commissioner shall award grants to community 117.18 clinics or other nonprofit community organizations, political 117.19 subdivisions, professional associations, or other organizations 117.20 that demonstrate the ability to provide dental services 117.21 effectively to public program recipients. Grants may be used to 117.22 fund the costs related to coordinating access for recipients, 117.23 developing and implementing patient care criteria, upgrading or 117.24 establishing new facilities, acquiring furnishings or equipment, 117.25 recruiting new providers, or other development costs that will 117.26 improve access to dental care in a region. In awarding grants, 117.27 the commissioner shall give priority to applicants that plan to 117.28 serve areas of the state in which the number of dental providers 117.29 is not currently sufficient to meet the needs of recipients of 117.30 public programs or uninsured individuals. The commissioner 117.31 shall consider the following in awarding the grants: 117.32 (i) potential to successfully increase access to an 117.33 underserved population; 117.34 (ii) the ability to raise matching funds; 117.35 (iii) the long-term viability of the project to improve 117.36 access beyond the period of initial funding; 118.1 (iv) the efficiency in the use of the funding; and 118.2 (v) the experience of the proposers in providing services 118.3 to the target population. 118.4 The commissioner shall monitor the grants and may terminate 118.5 a grant if the grantee does not increase dental access for 118.6 public program recipients. The commissioner shall consider 118.7 grants for the following: 118.8 (i) implementation of new programs or continued expansion 118.9 of current access programs that have demonstrated success in 118.10 providing dental services in underserved areas; 118.11 (ii) a pilot program for utilizing hygienists outside of a 118.12 traditional dental office to provide dental hygiene services; 118.13 and 118.14 (iii) a program that organizes a network of volunteer 118.15 dentists, establishes a system to refer eligible individuals to 118.16 volunteer dentists, and through that network provides donated 118.17 dental care services to public program recipients or uninsured 118.18 individuals; 118.19 (5) beginning October 1, 1999, the payment for tooth 118.20 sealants and fluoride treatments shall be the lower of (i) 118.21 submitted charge, or (ii) 80 percent of median 1997 charges; 118.22 (6) the increases listed in clauses (3) and (5) shall be 118.23 implemented January 1, 2000, for managed care; and 118.24 (7) effective for services provided on or after January 1, 118.25 2002, payment for diagnostic examinations and dental x-rays 118.26 provided to children under age 21 shall be the lower of (i) the 118.27 submitted charge, or (ii) 85 percent of median 1999 charges. 118.28 (c) Effective for dental services rendered on or after 118.29 January 1, 2002, the commissioner may, within the limits of 118.30 available appropriation, increase reimbursements to dentists and 118.31 dental clinics deemed by the commissioner to be critical access 118.32 dental providers. Reimbursement to a critical access dental 118.33 provider may be increased by not more than 50 percent above the 118.34 reimbursement rate that would otherwise be paid to the 118.35 provider. Payments to health plan companies shall be adjusted 118.36 to reflect increased reimbursements to critical access dental 119.1 providers as approved by the commissioner. In determining which 119.2 dentists and dental clinics shall be deemed critical access 119.3 dental providers, the commissioner shall review: 119.4 (1) the utilization rate in the service area in which the 119.5 dentist or dental clinic operates for dental services to 119.6 patients covered by medical assistance, general assistance 119.7 medical care, or MinnesotaCare as their primary source of 119.8 coverage; 119.9 (2) the level of services provided by the dentist or dental 119.10 clinic to patients covered by medical assistance, general 119.11 assistance medical care, or MinnesotaCare as their primary 119.12 source of coverage; and 119.13 (3) whether the level of services provided by the dentist 119.14 or dental clinic is critical to maintaining adequate levels of 119.15 patient access within the service area. 119.16 In the absence of a critical access dental provider in a service 119.17 area, the commissioner may designate a dentist or dental clinic 119.18 as a critical access dental provider if the dentist or dental 119.19 clinic is willing to provide care to patients covered by medical 119.20 assistance, general assistance medical care, or MinnesotaCare at 119.21 a level which significantly increases access to dental care in 119.22 the service area. 119.23 (d) Effective July 1, 2001, the medical assistance rates 119.24 for outpatient mental health services provided by an entity that 119.25 operates: 119.26 (1) a Medicare-certified comprehensive outpatient 119.27 rehabilitation facility; and 119.28 (2) a facility that was certified prior to January 1, 1993, 119.29 with at least 33 percent of the clients receiving rehabilitation 119.30 services in the most recent calendar year are medical assistance 119.31 recipients, will be increased by 38 percent, when those services 119.32 are provided within the comprehensive outpatient rehabilitation 119.33 facility and provided to residents of nursing facilities owned 119.34 by the entity. 119.35 (e) An entity that operates both a Medicare certified 119.36 comprehensive outpatient rehabilitation facility and a facility 120.1 which was certified prior to January 1, 1993, that is licensed 120.2 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 120.3 whom at least 33 percent of the clients receiving rehabilitation 120.4 services in the most recent calendar year are medical assistance 120.5 recipients, shall be reimbursed by the commissioner for 120.6 rehabilitation services at rates that are 38 percent greater 120.7 than the maximum reimbursement rate allowed under paragraph (a), 120.8 clause (2), when those services are (1) provided within the 120.9 comprehensive outpatient rehabilitation facility and (2) 120.10 provided to residents of nursing facilities owned by the entity. 120.11 Sec. 41. [PILOT PROGRAM FOR DEAF-BLIND SERVICES.] 120.12 (a) The commissioners of human services; children, 120.13 families, and learning; and state services for the blind shall 120.14 meet with deaf-blind citizens, parents of deaf-blind children, 120.15 and the Minnesota commission serving deaf and hard-of-hearing 120.16 individuals to determine which agency can most efficiently and 120.17 effectively develop and administer a pilot program for 120.18 consumer-directed services to provide needed services to 120.19 deaf-blind adults, children, and their families. 120.20 (b) The planning for this pilot program must proceed using 120.21 current appropriations. The agency that develops the pilot 120.22 program described in paragraph (a) shall provide a report to the 120.23 senate and house of representatives policy and fiscal committees 120.24 having jurisdiction over human services issues by January 1, 120.25 2003, that addresses future funding for the program. The report 120.26 shall include the program proposal, recommendations, and a 120.27 fiscal note. 120.28 Sec. 42. [SERVICES FOR DEAF-BLIND PERSONS.] 120.29 (a) Effective for fiscal years beginning on or after July 120.30 1, 2003, the commissioner of human services shall combine the 120.31 existing $1,000,000 biennial base level funding for deaf-blind 120.32 services into a single grant program. Within the limits of the 120.33 appropriation for this purpose, each biennium at least $350,000 120.34 shall be awarded for services to deaf-blind children and their 120.35 families and at least $250,000 shall be awarded for services to 120.36 deaf-blind adults. 121.1 (b) The commissioner may make grants to organizations for: 121.2 (1) services provided by the organizations; or 121.3 (2) consumer-directed services. 121.4 (c) Any entity that is able to satisfy the grant criteria 121.5 is eligible to receive a grant under paragraph (a). 121.6 (d) Deaf-blind service providers are not required to, but 121.7 may, provide intervenor services as part of the service package 121.8 provided with grant funds under this section. 121.9 Sec. 43. [FEASIBILITY ASSESSMENT OF MEDICAL ASSISTANCE 121.10 EXPANSION TO COVER DEAF-BLIND SERVICES.] 121.11 (a) The commissioner of human services shall study and 121.12 report to the legislature by January 15, 2003, with a 121.13 feasibility assessment of the costs and policy implications, 121.14 including the necessity of federal waivers, to expand benefits 121.15 covered under medical assistance and under medical assistance 121.16 waiver programs to include the following services for deaf-blind 121.17 persons: 121.18 (1) sign language interpreters; 121.19 (2) intervenors; 121.20 (3) support service persons; 121.21 (4) orientation and mobility services; and 121.22 (5) rehabilitation teaching services. 121.23 Any costs related to this study shall be paid out of base-level 121.24 funding to the commissioner for deaf and hard of hearing grants. 121.25 (b) Notwithstanding Laws 2001, First Special Session, 121.26 chapter 9, article 17, section 10, subdivision 3, the 121.27 commissioner of human services may transfer deaf and hard of 121.28 hearing grants to operations for purposes of paragraph (a). 121.29 Sec. 44. [CASE MANAGEMENT STUDY.] 121.30 The commissioner of human services shall study case 121.31 management services for persons with disabilities, in 121.32 consultation with consumers, consumer advocates, and local 121.33 social service agencies. The commissioner shall report to the 121.34 chairs and ranking minority members of the house and senate 121.35 committees having jurisdiction over health and human services 121.36 policy and funding, by January 15, 2003, on strategies that: 122.1 (1) streamline administration; 122.2 (2) improve case management service availability across the 122.3 state; 122.4 (3) enhance consumer access to needed services and 122.5 supports; 122.6 (4) improve accountability and the use of performance 122.7 measures; 122.8 (5) provide for consumer choice of vendor; and 122.9 (6) improve the financing of case management services. 122.10[EFFECTIVE DATE.] This section is effective the day 122.11 following final enactment. 122.12 Sec. 45. [REPEALER; TARGETED CASE MANAGEMENT.] 122.13 Minnesota Statutes 2001 Supplement, section 256B.0621, 122.14 subdivision 1, is repealed. 122.15 ARTICLE 3 122.16 MISCELLANEOUS 122.17 Section 1. Minnesota Statutes 2000, section 103H.251, 122.18 subdivision 1, is amended to read: 122.19 Subdivision 1. [METHODS.] (a) Thecommissioner of122.20agriculture for pollution resulting from agricultural chemicals122.21and practices and thepollution control agencyfor other122.22pollutantsshall evaluate the detection of pollutants, other 122.23 than pollutants resulting from agricultural chemicals and 122.24 practices, in groundwater of the state. The detection of 122.25 pollutants resulting from agricultural chemicals and practices 122.26 in groundwater shall be evaluated according to section 122.27 144.3705. Evaluation of the detection may include collection 122.28 technique, sampling handling technique, laboratory practices, 122.29 other quality control practices, climatological conditions, and 122.30 potential pollutant sources. 122.31 (b) If conditions indicate a likelihood of the detection of 122.32 the pollutant or pollutant breakdown product to be a common 122.33 detection, the commissioner of agriculture for pollutants 122.34 resulting from agricultural chemicals and practices or the 122.35 pollution control agency for other pollutants must begin 122.36 development of best management practices and continue to monitor 123.1 for the pollutant or pollutant breakdown products. 123.2 Sec. 2. Minnesota Statutes 2000, section 144.05, is 123.3 amended by adding a subdivision to read: 123.4 Subd. 4. [IDENTIFICATION OF DECEASED INDIVIDUALS.] Upon 123.5 receiving notice under section 149A.90, subdivision 1, of the 123.6 death of an individual who cannot be identified, the 123.7 commissioner must post on the department's Web site information 123.8 regarding the individual for purposes of obtaining information 123.9 that may aid in identifying the individual and for purposes of 123.10 notifying relatives who may be seeking the individual. The 123.11 information must remain on the Web site continuously until the 123.12 person's identity is determined. 123.13 Sec. 3. [144.129] [DONATED DENTAL SERVICES.] 123.14 Subdivision 1. [ESTABLISHMENT.] A donated dental services 123.15 program is established in which dentists who volunteer their 123.16 services without compensation provide dental care to public 123.17 program recipients and the uninsured. The program shall be 123.18 developed and operated by the Minnesota dental association, or 123.19 another appropriate and qualified organization, as determined by 123.20 the commissioner. The program shall: 123.21 (1) establish a network of volunteer dentists, including 123.22 dental specialties, to donate dental services to eligible 123.23 individuals; 123.24 (2) provide, in consultation with the commissioner of 123.25 health, information to participating dentists on serving diverse 123.26 populations and rights and responsibilities under the Americans 123.27 With Disabilities Act and the Minnesota Human Rights Act; 123.28 (3) establish a system to refer eligible individuals to the 123.29 appropriate volunteer dentists; 123.30 (4) develop and implement a public awareness campaign to 123.31 educate eligible individuals about the availability of the 123.32 program; and 123.33 (5) establish, in consultation with the commissioner of 123.34 health, specific performance and outcome measures that the 123.35 program must meet. 123.36 Subd. 2. [REPORT.] The organization shall provide an 124.1 annual report to the house and senate committees having 124.2 jurisdiction over health and human services that: 124.3 (1) accounts for state funding received by the program; 124.4 (2) documents the number of individuals served by the 124.5 program and the number of dentists participating as program 124.6 providers; and 124.7 (3) provides data on meeting the specific performance and 124.8 outcome measures. 124.9 Sec. 4. [144.3705] [EVALUATION OF DETECTION OF POLLUTANTS 124.10 RESULTING FROM AGRICULTURAL CHEMICALS AND PRACTICES.] 124.11 The commissioner of health shall evaluate the detection of 124.12 pollutants resulting from agricultural chemicals and practices 124.13 in the groundwater of the state. Evaluation of the detection 124.14 may include collection technique, sampling handling technique, 124.15 laboratory practices, other quality control practices, 124.16 climatological conditions, and potential pollutant sources. 124.17 Sec. 5. Minnesota Statutes 2000, section 147B.02, 124.18 subdivision 9, is amended to read: 124.19 Subd. 9. [RENEWAL.] (a) To renew a license an applicant 124.20 must: 124.21 (1) annually, or as determined by the board, complete a 124.22 renewal application on a form provided by the board; 124.23 (2) submit the renewal fee; 124.24 (3)provide evidence annually of one hour of continuing124.25education in the subject of infection control, including blood124.26borne pathogen diseases;124.27(4)provide documentation of current and active NCCAOM 124.28 certification; or 124.29(5)(4) if licensed under subdivision 5 or 6, meet the same 124.30 NCCAOM professional development activity requirements as those 124.31 licensed under subdivision 7. 124.32 (b) An applicant shall submit any additional information 124.33 requested by the board to clarify information presented in the 124.34 renewal application. The information must be submitted within 124.35 30 days after the board's request, or the renewal request is 124.36 nullified. 125.1 Sec. 6. Minnesota Statutes 2001 Supplement, section 125.2 149A.90, subdivision 1, is amended to read: 125.3 Subdivision 1. [DEATH RECORD.] (a) Except as provided in 125.4 this section, a death record must be completed and filed for 125.5 every known death by the mortician, funeral director, or other 125.6 person lawfully in charge of the disposition of the body. 125.7 (b) If the body is that of an individual whose identity is 125.8 unknown, the person in charge of the disposition of the body 125.9 must notify the commissioner for purposes of compliance with 125.10 section 144.05, subdivision 4. 125.11 Sec. 7. Minnesota Statutes 2000, section 150A.06, is 125.12 amended by adding a subdivision to read: 125.13 Subd. 2c. [GUEST LICENSE OR REGISTRATION.] (a) The board 125.14 shall grant a guest license to practice as a dentist or dental 125.15 hygienist or a guest registration to practice as a dental 125.16 assistant if the following conditions are met: 125.17 (1) the dentist, dental hygienist, or dental assistant is 125.18 currently licensed or registered in good standing in North 125.19 Dakota, South Dakota, Iowa, or Wisconsin; 125.20 (2) the dentist, dental hygienist, or dental assistant is 125.21 currently engaged in the practice of that person's respective 125.22 profession in North Dakota, South Dakota, Iowa, or Wisconsin; 125.23 (3) the dentist, dental hygienist, or dental assistant is 125.24 seeking to practice in a public health setting in Minnesota that 125.25 (i) is approved by the board; (ii) was established by a 125.26 nonprofit organization that is tax exempt under section 125.27 501(c)(3) of the Internal Revenue Code of 1986; and (iii) 125.28 provides dental care to patients who have difficulty accessing 125.29 dental care; 125.30 (4) the dentist, dental hygienist, or dental assistant 125.31 agrees to treat indigent patients who meet the eligibility 125.32 criteria established by the clinic; and 125.33 (5) the dentist, dental hygienist, or dental assistant has 125.34 applied to the board for a guest license or registration, 125.35 providing evidence of being currently licensed or registered in 125.36 good standing in North Dakota, South Dakota, Iowa, or Wisconsin, 126.1 and has paid a nonrefundable license fee to the board of $50. 126.2 (b) A dentist, dental hygienist, or dental assistant 126.3 practicing under a guest license or registration may only 126.4 practice at a single, specific location in Minnesota. A guest 126.5 license or registration must be renewed annually with the board 126.6 and an annual renewal fee of $50 must be paid to the board. If 126.7 the clinic in Minnesota at which a dentist, dental hygienist, or 126.8 dental assistant seeks to practice permanently ceases operation, 126.9 the guest license or registration issued under this subdivision 126.10 is automatically revoked. 126.11 (c) A dentist, dental hygienist, or dental assistant 126.12 practicing under a guest license or registration under this 126.13 subdivision shall have the same obligations as a dentist, dental 126.14 hygienist, or dental assistant who is licensed in Minnesota and 126.15 shall be subject to the laws and rules of Minnesota and the 126.16 regulatory authority of the board. If the board suspends or 126.17 revokes the guest license or registration of, or otherwise 126.18 disciplines, a dentist, dental hygienist, or dental assistant 126.19 practicing under this subdivision, the board shall promptly 126.20 report such disciplinary action to the dentist's, dental 126.21 hygienist's, or dental assistant's regulatory board in the 126.22 border state. 126.23[EFFECTIVE DATE.] This section is effective the day 126.24 following final enactment. 126.25 Sec. 8. Minnesota Statutes 2001 Supplement, section 126.26 256B.69, subdivision 5b, is amended to read: 126.27 Subd. 5b. [PROSPECTIVE REIMBURSEMENT RATES.] (a) For 126.28 prepaid medical assistance and general assistance medical care 126.29 program contract rates set by the commissioner under subdivision 126.30 5 and effective on or after January 1, 1998, capitation rates 126.31 for nonmetropolitan counties shall on a weighted average be no 126.32 less than 88 percent of the capitation rates for metropolitan 126.33 counties, excluding Hennepin county. The commissioner shall 126.34 make a pro rata adjustment in capitation rates paid to counties 126.35 other than nonmetropolitan counties in order to make this 126.36 provision budget neutral. The commissioner, in consultation 127.1 with a health care actuary, shall evaluate the regional rate 127.2 relationships based on actual health plan costs for Minnesota 127.3 health care programs. The commissioner may establish, based on 127.4 the actuary's recommendation, new rate regions that recognize 127.5 metropolitan areas outside of the seven-county metropolitan area. 127.6 (b) For prepaid medical assistance program contract rates 127.7 set by the commissioner under subdivision 5 and effective on or 127.8 after January 1, 2001, capitation rates for nonmetropolitan 127.9 counties shall, on a weighted average, be no less than 89 127.10 percent of the capitation rates for metropolitan counties, 127.11 excluding Hennepin county. 127.12 (c) This subdivision shall not affect the nongeographically 127.13 based risk adjusted rates established under section 62Q.03, 127.14 subdivision 5a. 127.15 Sec. 9. [APPROPRIATION.] 127.16 In fiscal year 2003 only, $75,000 of the general fund 127.17 appropriations for HIV/AIDS grants that are no longer needed as 127.18 a result of greater than anticipated collections under the AIDS 127.19 drug assistance program rebate must be transferred to the 127.20 commissioner of health and is appropriated for a grant to the 127.21 Minnesota dental association, or another appropriate and 127.22 qualified organization, as determined by the commissioner, to 127.23 develop and operate the donated dental services program under 127.24 section 3. The grant may be used for administrative or 127.25 technical support. 127.26 Sec. 10. [REPEALER.] 127.27 Minnesota Statutes 2000, section 147B.01, subdivisions 8 127.28 and 15, are repealed.